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Intraoperative intracardiac thrombosis in a liver transplant patient

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World Journal of Hepatology 2010年第5期2卷 198-200页

作者： Lena Sibulesky Prith Peiris c burcin taner David J Kramer Juan M canabal Justin H Nguyen Department of Transplantation Division of Transplant SurgeryMayo ClinicJacksonvilleFL 32224United States Department of Anesthesiology Mayo ClinicJacksonvilleFL 32224United States Departments of Trans-plantation and critical care Mayo ClinicJacksonvilleFL32224United States

A 66-year-old female with cryptogenic cirrhosis complicated by ascites,hepatic encephalopathy,variceal bleeding and malnutrition with MELD of 34 underwent orthotopic deceased donor liver transplantation performed with piggyback *** eversion thromboendovenectomy was performed for a portal vein thrombus which resulted in an excellent portal vein *** liver graft was recirculated without any hemodynamic ***,the patient became hypotensive progressing to *** was resuscitated and a transesophageal probe was inserted which revealed a mobile right atrial thrombus and an underfilled poorly contractile right *** patient was noted to be coagulopathic at the *** became progressively more stable with a TEE showing complete resolution of the intracardiac thrombus.

关键词： Liver transplantation cardiac thrombus Reperfusion injury coagulopathy Transesophageal echocardiogram

Outcomes following liver transplantation in intensive care unit patients

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World Journal of Hepatology 2013年第1期5卷 26-32页

作者： Lena Sibulesky Michael G Heckman c burcin taner Juan M canabal Nancy N Diehl Dana K Perry Darren L Willingham Surakit Pungpapong Barry G Rosser David J Kramer Justin H Nguyen Department of Transplantation Mayo ClinicJacksonvilleFL 32225United States Biostatistics Unit Mayo ClinicJacksonvilleFL 32225United States Departments of Transplantation and critical care Medicine Mayo ClinicJacksonvilleFL 32225United States Department of critical care Medicine and Internal Medicine Aurora Health CareMilwaukeeWI 53204United States

AIM:To determine feasibility of liver transplantation in patients from the intensive care unit (IcU) by estimating graft and patient ***:This single center retrospective study included 39 patients who had their first liver transplant directly from the intensive care unit and 927 non-IcU patients who were transplanted from hospital ward or home between January 2005 and December ***:In comparison to non-IcU patients,IcU patients had a higher model for end-stage liver disease (MELD) at transplant (median:37 vs 20,P cU patients (41%) were ventilator dependent immediately prior to LT with 9 patients undergoing percutaneous tracheostomy prior to ***-five IcU patients (64%) required dialysis *** 1,3 and 5 years after LT,graft survival was 76%,68% and 62% in IcU patients vs 90%,81% and 75% in non-IcU *** survival at 1,3 and 5 years after LT was 78%,70% and 65% in IcU patients vs 94%,85% and 79% in non-IcU *** formally comparing graft survival and patient survival between IcU and nonIcU patients using cox proportional hazards regression models,both graft survival [relative risk (RR):1.94,95%cI:1.09-3.48,P=0.026] and patient survival (RR:2.32,95%cI:1.26-4.27,P=0.007) were lower in IcU patients vs non-IcU patients in single variable *** findings were consistent in multivariable *** not statistically significant,graft survival was worse in both patients with cryptogenic cirrhosis (RR:3.29,P=0.056) and patients who received donor after cardiac death (DcD) grafts (RR:3.38,P=0.060).These findings reached statistical significance when considering patient survival,which was worse for patients with cryptogenic cirrhosis (RR:3.97,P=0.031) and patients who were transplanted with DcD livers (

关键词： Donor pool Donor outcomes Onor after cardiac death grafts Liver graft survival Patient survival

Liver transplantation: current status and challenges

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World Journal of Gastroenterology 2016年第18期22卷 4438-4445页

作者： caroline c Jadlowiec Timucin taner William J. von Liebig Transplantation center Division of Transplant Surgery Department of SurgeryMayo Clinic

Great progress has been made in the field of liver transplantation over the past two decades. This progress, however, also brings up the next set of challenges: First, organ shortage remains a major limitation, and accounts for a large proportion of wait list mortality. While living donation has successfully increased the total number of liver transplants done in Asian countries, the total number of such transplants has been stagnant in the western hemisphere. As such, there has been a significant effort over the past decade to increase the existing deceased donor pool. This effort has resulted in a greater use of liver allografts following donation after cardiac death(DcD) along with marginal and extended criteria donors. Improved understanding of the pathophysiology of liver allografts procured after circulatory arrest has not only resulted in better selection and management of DcD donors, but has also helped in the development of mechanical perfusion strategies. Early outcomes demonstrating the clinical applicability of both hypothermic and normothermic perfusion and its potential to impact patient survival and allograft function have generated much interest. Second, long-term outcomes of liver transplant recipients have not improved significantly, as recipients continue to succumb to complications of long-term immunosuppression, such as infection, malignancy and renal failure. Furthermore, recent evidence suggests that chronic immune-mediated injury to the liver may also impact graft function.

关键词： Donation after cardiac death Mechanical perfusion Renal-sparing immunosuppression Antibody-mediated rejection

Revisiting the liver’s role in transplant alloimmunity

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World Journal of Gastroenterology 2019年第25期25卷 3123-3135页

作者： Nitin Abrol caroline c Jadlowiec Timucin taner William J.von Liebig center for Transplantation and clinical Regeneration Massyo ClinicRochesterMN 55905United States Transplant center Mayo ClinicPhoenixAZ 85259United States

The transplanted liver can modulate the recipient immune system to induce tolerance after *** phenomenon was observed nearly five decades ***,the liver’s role in multivisceral transplantation was recognized,as it has a protective role in preventing rejection of simultaneously transplanted solid organs such as kidney and *** liver has a unique architecture and is home to many cells involved in immunity and *** transplantation,these cells migrate from the liver into the *** studies identified chimerism as an important mechanism by which the liver modulates the human immune *** studies on human T-cell subtypes,cytokine expression,and gene expression in the allograft have expanded our knowledge on the potential mechanisms underlying *** this article,we discuss the privileged state of liver transplantation compared to other solid organ transplantation,the liver allograft’s role in multivisceral transplantation,various cells in the liver involved in immune responses,and the potential mechanisms underlying immunomodulation of host alloresponses.

关键词： Liver transplantation Alloimmunity Liver-kidney transplant Tolerance Rejection

Approximation Properties of Julia Polynomials

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Acta Mathematica Sinica,English Series 2007年第7期23卷 1303-1310页

作者： Daniyal M.ISRAFILOV burcin OKTAY Department of Mathematics Faculty of Art and SciencesBalikesir University

Let G be a finite simply connected domain in the complex plane c, bounded by a rectifiable Jordan curve L, and let w = φ0 （z） be the Riemann conformal mapping of G onto D （0, r0）：= {E-mail：：｜｜〈 r0}, normalized by the conditions φ0 （z0） = 0, φ＇0 （z0） = 1.In this work, the rate of approximation of φ0 by the polynomials, defined with the help of the solutions of some extremal problem, in a closed domain G is studied. This rate depends on the geometric properties of the boundary L.

关键词： conformal mapping extremal polynomials bounded boundary rotation Dini-smooth boundary

Kidney transplantation from donors with hepatitis c infection

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World Journal of Gastroenterology 2014年第11期20卷 2801-2809页

作者： Massimiliano Veroux Daniela corona Nunziata Sinagra Alessia Giaquinta Domenico Zerbo burcin Ekser Giuseppe Giuffrida Pietro caglià Riccardo Gula Vincenzo Ardita Pierfrancesco Veroux Vascular Surgery and Organ Transplant Unit Department of SurgeryTransplantation and Advanced TechnologiesUniversity Hospital of Catania95123 CataniaItaly

The increasing demand for organ donors to supply the increasing number of patients on kidney waiting lists has led to most transplant centers developing protocols that allow safe utilization from donors with special clinical situations which previously were regarded as contraindications. Deceased donors with previous hepatitis c infection may represent a safe resource to expand the donor pool. When allocated to serology-matched recipients, kidney transplantation from donors with hepatitis c may result in an excellent short-term outcome and a significant reduction of time on the waiting list. Special care must be dedicated to the pre-transplant evaluation of potential candidates, particularly with regard to liver functionality and evidence of liver histological damage, such as cirrhosis, that could be a contraindication to transplantation. Pre-transplant antiviral therapy could be useful to reduce the viral load and to improve the long-term results, which may be affected by the progression of liver disease in the recipients. An accurate selection of both donor and recipient is mandatory to achieve a satisfactory long-term outcome.

关键词： Kidney transplantation Deceased donor Hepatitis c virus De novo glomerulonephritis Liver failure Graft survival End-stage renal disease Hemodialysis

Boric acid reduces axonal and myelin damage in experimental sciatic nerve injury

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Neural Regeneration Research 2016年第10期11卷 1660-1665页

作者： Zahir Kizilay Haydar Ali Erken Nesibe Kahraman cetin Serdar Aktas burcin lrem Abas Ali Yilmaz Department of Neurosurgery Faculty of Medicine Adnan Menderes University Aydin Turkey Department of Physiology Faculty of Medicine Balikesir University BalikesirTurkey Department of Pathology Faculty of Medicine Adnan Menderes University Aydin Turkey Department of Pharmacology and Toxicology Faculty of Medicine Adnan Menderes University Aydin Turkey Department of clinical Biochemistry Faculty of Medicine Adnan Menderes University AydinTurkey

The aim of this study was to investigate the effects of boric acid in experimental acute sciatic nerve injury. Twenty-eight adult male rats were randomly divided into four equal groups （n = 7）： control （c）, boric acid （BA）, sciatic nerve injury （I） , and sciatic nerve injury ＋ boric acid treatment （BAI）. Sciatic nerve injury was generated using a Yasargil aneurysm clip in the groups I and BAI. Boric acid was given four times at 100 mg/kg to rats in the groups BA and BAI after injury （by gavage at 0, 24, 48 and 72 hours） but no injury was made in the group BA. In vivo electrophysiological tests were performed at the end of the day 4 and sciatic nerve tissue samples were taken for histopathological examination. The amplitude of compound action potential, the nerve conduction velocity and the number of axons were significantly lower and the myelin structure was found to be broken in group I compared with those in groups c and BA. However, the amplitude of the compound action potential, the nerve conduction velocity and the number of axons were significantly greater in group BAI than in group I. Moreover, myelin injury was significantly milder and the intensity of nuclear factor kappa B immunostaining was significantly weaker in group BAI than in group I. The results of this study show that administration of boric acid at 100 mg/kg after sciatic nerve injury in rats markedly reduces myelin and axonal injury and improves the electrophysiological function of injured sciatic nerve possibly through alleviating oxidative stress reactions.

关键词： nerve regeneration peripheral nerve injury sciatic nerve boric acid nerve conduction velocity axon myelin electrophysiology neural regeneration

PLATELET AGGREGATION IN HUMANS AND NONHUMAN PRIMATES:RELEVANcE TO XENOTRANSPLANTATION

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PLATELET AGGREGATION IN HUMANS AND NONHUMAN PRIMATES:RELEVAN...

比马前列素对开角型青光眼或高眼压症患者眼部循环的影响

2012中国器官移植大会

作者： Hayato Iwase burcin Ekser Eefje Dons David K.c.cooper Mohamed Ezzelarab Thomas E Starzl Transplantation Institute University of PittsburghPittsburghPAUSA Department of Surgery Transplantation and Advanced TechologiesVascular Surgery and Organ Transplant UnitUniversity Hospital of CataniaCataniaItaly

【Introduction】Platelet activation/aggregation plays a key role in the dysregulation of coagulation and the development of thrombotic microangiopathy in nonhuman primate recipients of pig *** a preliminary to the study of anti-platelet therapy in vitro and in vivo,the present study aimed to compare platelet aggregation in whole blood from humans,baboons,and cynomolgus monkeys.【Methods】Using ’chrono-log’ technology(two-sample four-channel chrono-log Whole Blood Aggregometer),we studied

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世界核心医学期刊文摘（眼科学分册） 2005年第4期1卷 30-31页

作者： Akarsu c. Yilmaz S. taner P. Ergin A. 齐翔云 cagdas. Sokak 37/13 06130 Aydinlikevler Ankara Turkey

Purpose: To study the effect of bimatoprost 0.03% (Lumigan) on ocular hemodynamics in patients with open- angle glaucoma or ocular hypertension. Methods: One randomly selected eye of each of 26 patients with open- angle glaucoma or ocular hypertension was enrolled. Each patient received a drop of bimatoprost 0.03% once daily for 1 month. The effect of bimatoprost on ocular circulation was assessed by color Doppler imaging (cDI), which measured peak systolic, end- diastolic blood flow velocities and resistance indices in the ophthalmic, posterior ciliary and central retinal arteries. Retrobulbar hemodynamics by cDI, intraocular pressure by Goldmann applanation tonometer, blood pressure by cuff, and heart rate by palpation were measured at baseline and at 1 month after bimatoprost treatment. Results: Blood flow velocities and r esistance indices in all retrobulbar vessels showed no statistically significant differences between baseline and bimatoprost condition (P > 0.05). Bimatoprost lowered intraocular pressure significantly (P change of 6.5 mmHg (27% ) after 1 month of treatment. The systolic (P=0.38) and diastolic (P=0.74) blood pressures and pulse rate (P=0.94) did not show statistically significant differences during the study period. conclusions: The results of this study suggest that topical bimatoprost 0.03% significantly reduces intraocular pressure in patients with open- angle glaucoma or ocular hypertension. However, it does not have any effect on retrobulbar hemodynamics in open- angle glaucoma and ocular hypertension.

关键词：比马前列素开角型青光眼高眼压症压平眼压计视网膜中央动脉血流动力学睫状后动脉彩色多普勒成像眼内压眼动脉