A renal transplant patient with a solitary plasmacytoma in the oral cavity.
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Adult↗
Biomedical subjects
Aydin Turkmen
Publications and source records attributed to Aydin Turkmen.
Changes in endothelial function before and after renal transplantation.
Endothelial dysfunction is an early key event in the development of atherosclerotic cardiovascular disease observed in chronic renal failure patients. The role of renal transplantation (RTx) on endothelial dysfunction is still unclear. The aim of this study was to evaluate the endothelial function of chronic renal failure patients before RTx (while they were on hemodialysis, HD), and after RTx (at the 6th and 12th months) by a noninvasive method, brachial arterial ultrasound. A total of 22 (17 male, mean age: 33.9 +/- 11.6 years) RTx recipients were enrolled in the study. Endothelium-dependent vasodilation (EDD) was assessed by establishing reactive hyperemia. EDD prior to transplantation was significantly lower when compared with EDD measured at the 6th and 12th months after RTx (EDD pretransplantation: 6 +/- 3.7%, EDD at the 6th month of RTx: 8.3 +/- 2.3% and EDD at the 12th month of RTx: 12.1 +/- 3.6%, P < 0.001). When the EDD values measured at the 6th and 12th months of RTx were compared, measurements of the 12th month were found significantly higher than those of the 6th month (P < 0.001). Our results also showed that RTx has provided improvement in endothelial function by eliminating the uremic environment although not in the early post-RTx period.
Adolescent↗
Fuzzy organ allocation system for cadaveric kidney transplantation.
BACKGROUND: The recipient selection decision for a cadaveric donor kidney is complex and based on multiple criteria, not only medical but also ethical and political criteria. METHODS: In this study, we develop the Fuzzy Organ Allocation System (FORAS) to determine who among potential recipients receives a cadaveric kidney when it becomes available. FORAS balances various kidney allocation objectives and deals with the ambiguity and fuzziness in the allocation process. RESULTS: We used simulation to investigate how well FORAS represents the thinking of a transplant physician with regard to kidney allocation. We also compared FORAS with the United Network for Organ Sharing (UNOS) scoring system and the Turkish National Coordination for Organ Transplant (TONKS) algorithm used in Turkey. We found that FORAS well represents expert thinking in kidney allocation. CONCLUSIONS: A simulated kidney allocation experiment based on real patient and donor data showed that FORAS is more useful than other kidney allocation systems because its results more closely reflect the thinking of experienced transplant physicians.
Algorithms↗
The effect of calcineurin inhibitors on endothelial function in renal transplant recipients.
Endothelial dysfunction is of vital importance, as it may cause ischemia and dysfunction in various organs. Despite, this problem has been well documented in patients with end-stage renal disease (ESRD), there is not enough data considering this issue following renal transplantation. One of the potential causes of endothelial dysfunction in renal transplant recipients may be administration of calcineurin inhibitors. The aim of this study is to evaluate the effects of two different calcineurin inhibitors [cyclosporin A (CsA) and tacrolimus (FK506)] on endothelial function in renal transplant patients. Forty-four renal transplant recipients [22 on FK506 (group I) and 22 on CsA (group II)] were studied. Endothelial functions of the brachial artery were evaluated by using high resolution vascular ultrasound. Endothelium-dependent and -independent vasodilations were assessed by establishing reactive hyperemia and using sublingual nitroglycerine (NTG), respectively. Results are presented as percentage change from baseline values. Significant endothelial dysfunction was noted in renal transplant patients treated with CsA. While endothelium-dependent vasodilation was 12.1 +/- 5.1% in group I and it was 6.5 +/- 3.7% in group II (p < 0.001). The increase in brachial artery diameter after sublingual NTG was 20.1 +/- 6.3 and 12.7 +/- 5.6% in groups I and II, respectively. This indicates that the endothelium-dependent and -independent vasodilation of the patients on FK506 is better preserved than the patients on CsA therapy. Besides, blood flow volume (BFV) increase was 51.2 +/- 39.4 and 43.9 +/- 24.3%, in groups I and II, respectively, in reactive hyperemia period (p > 0.05). Post-transplant course of renal transplant recipients is complicated by endothelial dysfunction. This problem is more prominent in patients on CsA therapy, which can predispose these patients to more frequent cardiac complications.
Adult↗
Severe alloimmune hemolytic anemia after renal transplantation.
Alloimmune hemolytic anemia is a rare complication following allogeneic organ transplantation. Despite that some other drugs have also been reported, in the majority of cases this complication has been associated with cyclosporine therapy. We here present a case of severe alloimmune hemolytic anemia due to ABO minor incompatibility after renal transplantation in a patient treated with tacrolimus.
ABO Blood-Group System↗