Biomedical subjects

Cezmi Karaca

Publications and source records attributed to Cezmi Karaca.

4 recordsLinked to original sources

PubMed2005

Non-heart-beating donors: is it worthwhile?

OBJECTIVE: Due to organ shortage in renal transplantation, many transplant centers attempt to increase the donor pool. Non-heart-beating donors seem to be a promising alternative. PATIENTS AND METHODS: We performed 14 renal transplantations from 8 non-heart-beating donors. 2, 1, 3 and 2 donors were from groups 1, 2, 3 and 4, respectively, according to Maastricht classification. RESULTS: In 6 of the patients' warm ischemia time was over 30 minutes. Three of them had primary non-function. In 6 patients delayed graft function was seen. The remaining 5 kidneys functioned immediately. Two patients whose kidney functioned returned to hemodialysis in the I I and 13th months after their transplantations. One of the patients with primary non-function died. 9 kidneys function well in their follow-up period between 5-111 months. 1 and 5-year graft survival rates were 69.8 and 61.1 percent, respectively. The mean graft survival time is 69.9 +/- 14.5 months. CONCLUSION: Despite the high primary non-function rate, we think that non-heart-beating donors especially in Maastricht classification 3 and 4 should be used due to dramatic shortage of organs.

Adult↗

PubMed2005

Multiple renal arteries in laparoscopic donor nephrectomy.

BACKGROUND: Laparoscopic donor nephrectomy has gained popularity throughout the world recently. The more centers became experienced the more this technique began to be used, even in extreme cases. Kidneys with multiple renal arteries are one of the difficult cases for laparoscopic donor nephrectomy. PATIENTS AND METHOD: Thirty living laparoscopic donor nephrectomies have been performed between January 2001 and December 2002. Twenty-three of them had single and seven kidneys had multiple renal arteries. Single (SA) and multiple (MA) artery groups were statistically similar in terms of donor age, rate of received right kidneys and serum creatinine clearance of the donors. RESULTS: The mean duration of the donor surgery was 225 min and 240 min in SA and MA groups. In the SA and MA groups, the mean warm and cold ischemia times were statistically similar. Laparoscopic nephrectomy was converted to open procedure in five and one donors, in the SA and MA artery groups, respectively. Intraoperative bleeding (single artery: 4, multiple arteries: 1) was the most common cause for conversion. Postoperative urinary complications were seen in four and one patients, in the SA and MA groups, respectively. Lengths of hospital stay of the donors were similar in both groups. Serum creatinine levels of the patients on seventh, 30th, 90th days, and 1 year were found to be statistically similar in both groups. CONCLUSION: Laparoscopic donor nephrectomy was found to be a safe procedure in the donors with multiple renal arteries by the experienced surgical teams, as much as in donors with single arteries.

Adult↗

PubMed2004

Marginal donors in kidney transplantation.

BACKGROUND: Due to organ shortage, it is not easy to find an ideal donor in renal transplantation. To enhance donor pool, marginal donors can be acceptable even in living renal transplantations. We compared optimal and marginal donor transplantations in terms of graft and patient survival. METHODS: We performed 32 living related renal transplantations, 11 of which were from marginal donors, from January 1999 to December 2000. Recipients from optimal and marginal donors were compared in terms of renal function, acute tubular necrosis (ATN) and acute rejection (AR) rates. RESULTS: Although mean serum creatinine level in the seventh day was found to be higher in the recipients from marginal donors (1,88 mg/dl vs. 2,51 mg/dl); it did not reach to a statistical difference (p = 0.1). Serum creatinine levels after thirtieth day, ATN and AR rates were statistically similar in both groups, as well. In optimal and marginal groups, 3-year graft survival rates were found to be 85 and 72 percent respectively (p = 0.72). 3-year patient survival rates were also found to be similar in both groups (90% vs. 91%) (p = 0.91). CONCLUSION: Functional and survival results in the transplantations from marginal donors were as good as from optimal donors. So, we thought that marginal donors could be used safely with a good preoperative evaluation to increase donor pool.

Adult↗

PubMed2003

The toxicity rates of two different regimens of irinotecan.

The role of chemotherapy in the management of advanced colorectal cancer has been well established. Although fluorouracil has been the main cytotoxic agent used for colorectal cancer, newer drugs have been developed with promising results. In this study, we compared two different doses of irinotecan combined with 5-fluorouracil/leucoverin (5-FU/LV) in terms of progression-free and overall survival time and toxicity in the patients with recurrent or metastatic colorectal cancer. Patients were divided into groups. The first group received 350 mg/m2 irinotecan every three weeks. The second group was treated by 150 mg/m2 once a week for consecutive four weeks followed by a two-week drug-free interval. All the patients received 500 mg/m2 5-fluorouracil and 20 mg/m2 leucoverin every time they were treated with irinotecan. Median progression-free survival time was found to be 7 +/- 1 and 6 +/- 1 months in the first and seconds groups, respectively. Median overall survival time was found to be 19 +/- 4 and 12 +/- 4 months in the first and second groups, respectively. Alopecia grade 3-4 reaction rates were found to be significantly higher in the first group, while hematological grade 3-4 toxicity rates were higher in the second group. Although overall and progression-free survival curves were found to be similar in each group, hematological complications were less and response rates were higher in the 3-week course group. The 3-week course seemed to have a more comfortable administration schedule as well. So, we suggest the 350 mg/m2 once every 3 weeks regimen.

Adult↗