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Current practice of live donor nephrectomy in Turkey

World Journal of Transplantation 2022年第12期12卷 405-414页

作者： Bakytbek Mankiev sanem guler cimen Ismail Oskay Kaya Sertac cimen Asir Eraslan Department of General Surgery Sağlık BilimleriÜniversitesiAnkara 65100Turkey Departments of Surgery University of Health SciencesDiskapi Yildirim Beyazit Training and Research HospitalAnkara 65100Turkey Department of Urology Saglık Bilimleri UniversitesiAnkara 65100Turkey Department of Urology Somalia Turkish Training and Research HospitalMogadishu 23451Somalia

BACKGROUND Over the last few years,the deceased donor organ donation rate was declined or remained stable,whereas the live donor organ donation rate has increased to compensate for the *** invasive techniques for live donor nephrectomy(LDN)have also improved the live donor kidney donation *** increase has led to an interest in the surgical procedures used for *** To evaluate the LDN techniques performed in Turkey,the structure of surgical teams,and the training ***,the number of kidney transplantations at different centers,the surgeon experience level,differences in surgical approach during donor surgeries,and outcomes were *** A questionnaire was sent to the Turkish Ministry of Health-accredited transplant *** inquired of the number of LDN surgeries,surgical techniques,complications,optimization protocols,the experience of surgeons,and the *** statistics were outlined as follows:Discrete numeric variables were expressed as medians(minimum-maximum),while categorical variables were shown as numbers and *** a result of the goodness-of-fit tests,if the significance of the differences between the groups in discrete numerical variables for which the parametric test statistical assumptions were not met,data were analyzed with the Mann Whitney U test and theχ^(2)*** The questionnaire was sent to 72 transplant centers,all of which *** centers that reported not performing LDN procedures were *** from the remaining 67 centers were *** 2019,the median number of kidney transplants performed was 45,and the median number of kidney transplants from living donors was 28(1-238).Eleven(16.5%)centers performed 5-10,while 34(50.7%)centers performed more than 100 live donor kidney transplants in *** 19(28.4%)centers performed the LDN procedures using the open technique,48(71.6%)centers implemented minimally invasive *** the centers prefer

关键词： Kidney donation Live donor nephrectomy Laparoscopic donor nephrectomy Donor complications Minimally invasive techniques Donation rate

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Vitamin D deficiency may predispose patients to increased risk of kidney transplant rejection

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World Journal of Transplantation 2022年第9期12卷 299-309页

作者： Semih Buyukdemirci Ebru Gok Oguz sanem guler cimen Hatice Sahin Sertac cimen Mehmet Deniz Ayli Department of Internal Medicine Sağlık Bilimleri UniversitesiAnkara 65000AltındağTurkey Department of Nephrology Sağlık Bilimleri UniversitesiAnkara 65000AltındağTurkey Department of General Surgery Sağlık Bilimleri UniversitesiAnkara 65000AltındağTurkey Department of Urology Sağlık Bilimleri UniversitesiAnkara 65000AltındağTurkey

BACKGROUND Vitamin D deficiency occurs in more than 80%of kidney transplant *** immunomodulatory effects can predispose transplant recipients to rejection and chronic allograft nephropathy(CAN).This study determined the association between serum 25(OH)vitamin D,biopsy-proven allograft rejection,and CAN *** To determine the relationship between serum 25(OH)vitamin D level and biopsy-proven allograft rejection and CAN rate in renal transplant *** Adult renal transplant recipients followed at the clinic between January 2013 and 2018 were *** requiring graft biopsy due to declined function,hematuria,and proteinuria were *** two groups were compared regarding collected data,including the biopsy results,immunologic parameters,vitamin D,parathyroid hormone(PTH),phosphorus,albumin levels,and graft function *** Fifty-two recipients who underwent graft biopsy met the inclusion *** all,14 recipients had a vitamin D level>15 ng/mL(group 1)vs≤15 ng/mL(group 2)in *** total,27 patients had biopsy-proven rejection,and 19 had *** was only 1 recipient with biopsyproven rejection in group 1,whereas there were 24 patients with rejection in group *** rejection rate was significantly higher in group 2 than in group 1(P<0.001).Four patients were diagnosed with CAN in group 1 vs fifteen in group *** was no significant difference in the CAN rate between the two *** was higher at the time of graft biopsy(P=0.009,P=0.022)in group 1 with a mean of 268 pg/***-specific antibodies were detected in 14(56.0%)of the recipients with *** D level was 9.7±3.4 ng/mL in the rejection group vs 14.7±7.2 in the non-rejection group;this difference was statistically significant(P=0.003).The albumin levels were significantly lower in patients with rejection than in those without rejection(P=0.001).In univariate regression analysis of risk factors affecting rejection,sex,serum vitamin D,phosphorus a

关键词： Kidney transplantation Rejection 25(OH)vitamin D Vitamin D Chronic allograft nephropathy

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Psychological review of hemodialysis patients and kidney transplant recipients during the COVID-19 pandemic

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World Journal of Clinical Cases 2023年第16期11卷 3780-3790页

作者： Ayse Gokcen Gundogmus Ebru Gok Oguz sanem guler-cimen Yasemin Kocyigit Ahmet Emin Dogan Mehmet Deniz Ayli Department of Psychiatry Etlik City HospitalAnkara 65100CankayaTurkey Department of Nephrology Etlik City HospitalAnkara 65100CankayaTurkey Department of General Surgery Etlik City HospitalAnkara 65100CankayaTurkey Department of Urology Etlik City HospitalAnkara 65100CankayaTurkey

BACKGROUND Kidney transplantation(KT)and end-stage renal disease(ESRD)requiring hemodialysis(HD)increase the incidence of morbidity and mortality associated with coronavirus disease 2019(COVID-19)*** COVID-19 pandemic has had a negative effect on the psychological well-being of COVID-19 patients,especially those with a high-risk of infectious *** prevalence of anxiety and depression is known to be higher in ESRD patients undergoing HD than in the general *** the other hand,KT recipients have different treatment requirements compared to HD patients,including adherence to complex immunosuppressive regimens and compliance with follow-up *** hypothesized that psychosocial difficulties and stressors would differ between ESRD patients undergoing HD and KT recipients during the COVID-19 *** so,each group may require different interventions to maintain their psychosocial *** To measure and compare the levels of stress,anxiety,depression,concerns related to the pandemic,and coping skills in ESRD patients undergoing HD and KT recipients during the COVID-19 *** This cross-sectional study was performed at a training and research *** study included ESRD patients undergoing HD(HD group)and KT recipients(with stable graft function for≥6 mo prior to the study)(KT group).Patients completed a demographics form,the impact of events scale,the hospital anxiety and depression scale,and the Connor-Davidson resilience *** findings at the last clinical follow-up were ***χ^(2)test was used to assess the relationship between the HD and KT groups and the categorical *** relationships between the scale scores were analyzed using Pearson’s correlation test,and differences between the groups were analyzed using the independent groups *** The study included 125 patients,of which 89(71.2%)were in the HD group and 36(28.8%)were in the KT *** levels of anxiety and de

关键词： Kidney transplantation Dialysis Anxiety Depression Psychological resilience

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Challenges of pancreas transplantation in developing countries,exploring the Turkey example

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World Journal of Transplantation 2019年第8期9卷 158-164页

作者： sanem guler cimen Sertac cimen Nicos Kessaris Eyup Kahveci Acar Tuzuner Department of General Surgery Diskapi Research and Training HospitalHealth Sciences UniversityAnkara 65000Turkey Department of Urology and Transplantation Diskapi Research and Training HospitalHealth Sciences UniversityAnkara 65000Turkey Department of Nephrology and Transplantation Guy's HospitalLondon SE19RTUnited Kingdom Turkish Transplant Foundation Ankara 65000Turkey Department of General Surgery Ankara University Medical SchoolAnkara 65000Turkey

Pancreas transplantation significantly improves the quality of life for people with type 1 diabetes,primarily by eliminating the need for insulin and frequent blood glucose *** the growing numbers of solid organ transplantations worldwide,number of pancreas transplantations in the developing countries`remain significantly *** difference of pancreas transplantation practices was striking among the participating countries at the 1st International Transplant Network Meeting which was held in Turkey on *** this meeting more than 40 countries were *** of these counties were developing countries located in Africa,Middle East or *** aim of this article is to identify the challenges and limiting factors for pancreas transplantations in these developing countries,by exploring the Turkish *** challenges faced by the developing countries are broadly classified in four categories;wait-listing,donor pool,team work and follow *** these categorical titles,issues are further discussed in detail,giving examples from Turkish practice of pancreas ***,several solutions to these challenges have been proposed-some of which have already been undertaken by the Turkish Ministry of *** the insight and methods presented in this article,pancreas transplantation should be made possible for the potential recipients in the developing countries.

关键词： Pancreas transplantation Challenges Transplantation Quality of life Developing country

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Listening to music during arteriovenous fistula surgery alleviates anxiety: A randomized single-blind clinical trial

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World Journal of Transplantation 2020年第4期10卷 79-89页

作者： sanem guler cimen Ebru Oguz Ayse Gokcen Gundogmus Sertac cimen Fatih Sandikci Mehmet Deniz Ayli Department of General Surgery Diskapi Research and Training HospitalHealth Sciences UniversityAnkara 06110Turkey Division of Nephrology Department of Internal MedicineDiskapi Research and Training HospitalHealth Sciences UniversityAnkara 06110Turkey Department of Psychiatry Diskapi Research and Traning HospitalHealth Sciences UniversityAnkara 06110Turkey Department of Urology Diskapi Research and Traning HospitalHealth Sciences UniversityAnkara 06110Turkey

BACKGROUND Both end-stage renal disease and being wait-listed for a kidney transplant are anxiety-causing ***-listed patients usually require arteriovenous fistula surgery for dialysis *** procedure is performed under local *** investigated the effects of music on the anxiety,perceived pain and satisfaction levels of patients who underwent fistula *** To investigate the effect of music therapy on anxiety levels and perceived pain of patients undergoing fistula *** Patients who were on a waiting list for kidney transplants and scheduled for fistula surgery were randomized to control and music *** music group patients listened to music throughout the fistula *** State-Trait Anxiety Inventory was performed to assess anxiety,additionally visual analog scale was used to evaluate perceived pain,willingness to repeat the procedure and patient *** features,comorbidities,surgical history,basic surgical data(location of fistula creation,duration of surgery,incision length)and intraoperative hemodynamic parameters were recorded by an investigator blinded to the study *** additional trait anxiety assessment was performed following the *** There was a total of 55 patients included in the ***,14 patients did not fulfill the criteria due to requirement of sedation during surgery or uncompleted *** remaining 41 patients were included in the *** were 26 males and 15 *** control and music groups consisted of 20 and 21 patients,*** regard to basic surgical and demographic data,there was no difference between the *** patient satisfaction was significantly higher and intra-operative heart rate and blood pressure were significantly lower in the music group(P<0.05).Postoperative state anxiety levels were significantly lower in the music *** Music therapy can be a complimentary treatment for patients undergo

关键词： Music Music therapy Anxiety Arteriovenous fistula Kidney transplant Waitlist State-Trait Anxiety Inventory Dialysis access End-stage kidney disease

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COVID-19 infection in a kidney transplant recipient—special emphasis on pharmacokinetic interactions:A case report

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World Journal of Transplantation 2020年第11期10卷 365-371页

作者： Ebru Gok Oguz Kadir Gokhan Atilgan sanem guler cimen Hatice Sahin Tamer Selen Fatma AyerdenEbinc Sertac cimen Mehmet Deniz Ayli Department of Nephrology Diskapi Yildirim Beyazit Training and Res HospAnkara 6500Turkey Department of Nephrology Health Sciences UniversityAnkara 6500Turkey Department of General Surgery Diskapi Research and Training HospitalHealth Sciences UniversityAnkara 65000Select OneTurkey Department of Urology and Transplantation Health Sciences UniversityAnkara 65000Select OneTurkey Department of Nephrology and Transplantation Diskapi Yildirim Beyazit Teaching and Research HospitalAnkara 6500Turkey

BACKGROUND Solid organ transplant recipients are considered to be at high-risk of developing coronavirus disease 2019(COVID-19)-related *** optimal treatment for this patient group is ***,the treatment of COVID-19 in kidney transplant recipients should be determined individually,considering patient age and comorbidities,as well as graft function,time of transplant,and immunosuppressive *** treatments may give rise to severe *** the contrary,they may also lead to a milder and atypical presentation by diminishing the immune system *** SUMMARY A 50-year old female kidney transplant recipient presented to the transplant clinic with a progressive dry cough and fever that started three days *** the COVID-19 test was found to be negative,chest computed tomography images showed consolidation typical of the disease;thus,following hospital admission,anti-bacterial and COVID-19 treatments were ***,despite clinical improvement of the lung consolidation,her creatinine levels continued to *** of the graft showed no *** tacrolimus blood level was determined and the elevation in creatinine was found to be related to an interaction between tacrolimus and *** During the COVID-19 pandemic,various single or combination drugs have been utilized to find an effective treatment *** has increased the possibility of drug interactions.A limited number of studies published in the literature have highlighted some of these pharmacokinetic *** used for COVID-19 therapy;azithromycin,atazanavir,lopinavir/ritonavir,remdesivir,favipiravir,chloroquine,hydroxychloroquine,nitazoxanide,ribavirin,and tocilizumab,interact with immunosuppressive treatments,most importantly with calcineurin ***,their levels should be frequently monitored to prevent toxicity.

关键词： COVID-19 Kidney transplantation Drug interaction Pharmacokinetics Azithromycin Case report Calcineurin inhibitor

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Correlation of Surgical Times with Laparoscopic Live Donor Kidney Transplant Outcomes

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Open Journal of Organ Transplant Surgery 2013年第4期3卷 68-72页

作者： Sertac cimen sanem guler Ian Alwayn Joseph Lawen Bryce Kiberd Atlantic Centre for Transplantation Research Dalhousie University Halifax Canada Department of Urology Dalhousie University Queen Elizabeth II Health Sciences Centre Halifax Canada Faculty of Medicine Dalhousie University Queen Elizabeth II Health Sciences Centre Halifax Canada The Division of General Surgery Dalhousie University Queen Elizabeth II Health Sciences Centre Halifax Canada

Most studies revealed that ischemic time has substantial role in occurrence of delayed graft function (DGF) after deceased donor kidney transplantation. However, less is known about the potential impact of surgical times on early outcomes following live donor kidney transplantation. A retrospective cohort of 189 consecutive laparoscopic live donor kidney transplant (LDKT) recipients from January 2006 to August 2012 was analyzed to reveal the impact of pneumoperitoneum time (PT) and anastomosis time (AT) on donor and recipient length of hospital stay and early graft function (EGF). DGF was observed in 13 (6.8%) patients while slow graft function (SGF) was seen in 27 (14%) of the recipients. The median AT was 28 minutes (interquartile range 23, 35 minutes). AT was associated with DGF (Odds Ratio [OR] 1.044, per minute, 95% CI 1.007, 1.082, p = 0.018). Median recipient length of hospital stay was 8 (interquartile range 7, 11) days. Every 13.5 minutes of longer AT was associated with 1 extra day in hospital. The median PT was 180 minutes (interquartile range 144, 234 minutes). PT was associated with both DGF (OR 1.013 per minute, 95% CI 1.005, 1.021, p = 0.001) and SGF (OR 1.009 per minute, 95% CI 1.002, 1.016, p = 0.016). Every extra hour of PT was associated with 0.42 more days in hospital for the donor. Surgical times may be underestimated variables in dictating use of hospital resources. The effect of surgical times on long term hard outcomes entails further study.

关键词： Delayed Graft Function Slow Graft Function Anastomosis Time Pneumoperitoneum Time Kidney Transplantation

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