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M Kalayoglu

Publications and source records attributed to M Kalayoglu.

At least 91 records · Page 5Linked to original sources
PubMed1991

Current status of organ preservation with University of Wisconsin solution.

A retrospective analysis of all organs that were preserved with University of Wisconsin solution was undertaken to assess the impact of this solution on early allograft function. From May 1987 until June 1990, 181 livers, 92 pancreata, and 92 kidneys were preserved with University of Wisconsin solution for extended periods of time. The mean (+/- SD) preservation times were as follows: liver, 12.6 +/- 4.5 hours; pancreas, 16.7 +/- 4.4 hours; and kidney, 18.3 +/- 4.3 hours. The overall rate of primary nonfunction and hepatic artery thrombosis were 6.1% and 3.9%, respectively. No differences in the rates of primary nonfunction and hepatic artery thrombosis were noted for combined liver-pancreas procurement vs isolated liver retrievals or when reduced-size liver transplants were compared with nonreduced liver transplants. Likewise, no difference in primary nonfunction or hepatic artery thrombosis was seen in livers that were preserved for less than 6, 6 to 12, and greater than 12 hours. However, serum aminotransferase levels and prothrombin times were lower on the first postoperative day in livers that were preserved for less than 6 hours when compared with 6 to 12 or greater than 12 hours. Early pancreatic allograft function was also excellent for up to 24 hours of cold-storage preservation. All patients were immediately insulin independent, and there were no cases of initial nonfunction or graft pancreatitis. There were only two cases (2.2%) of pancreatic vascular thrombosis in this series. No difference in pancreatic function was noted for organs that were preserved for less than 6, 6 to 12, or greater than 12 hours. Likewise, renal allograft function was excellent, with only two patients (2.2%) requiring postoperative hemodialysis. The actuarial 1-month patient survival for liver and pancreas-kidney transplant recipients was 91.5% and 98.9%, respectively. Actuarial 1-month allograft survival for liver, pancreas, and kidney transplants was 83.0%, 96.7%, and 97.8%, respectively. In conclusion, University of Wisconsin solution represents a significant advancement in cold-storage organ preservation and is ideally suited as a universal intra-abdominal aortic-flush and cold-storage solution.

Adenosine↗
PubMed1990

Organ preservation: experience with University of Wisconsin solution and plans for the future.

Transplantation of organs continues to be a primary therapeutic modality for treatment of end-stage organ disease, and 1-year graft survival rates show increasing improvements for most organs. A number of transplant centers show 1-yr graft survival rates approaching 90% or more for the kidney, liver and pancreas. Rejection continues to be the major cause for loss of organs and there is still a major shortage of organs for transplantation. Additionally, many organs showed delayed graft function (or primary nonfunction) which may be related to either donor factors or preservation factors. The University of Wisconsin solution for organ preservation has increased the safe time of preservation for the liver, kidney, and pancreas and helped to increase the quality and number of organs available for transplantation. However, the long-range goal of organ preservation (unlimited preservation) is still far from being reached. In the past, preservation could accurately be categorized as an art and preservation solutions were developed based upon theoretical rationales about the mechanisms of organ injury at hypothermia and what agents would suppress injury. The utility and success of this approach is exemplified by the developments of Collins solution and the UW solution. However, further developments in methods to increase the quality and duration of preservation of all transplantable organs would appear to be dependent upon defining, systematically, how organs are injured and what can be done to suppress the injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Forecasting↗
PubMed1990

Living-unrelated renal transplantation at the University of Wisconsin.

1. Use of LUrDs under a DST protocol results in a 70% actuarial graft survival at 6 years which is not statistically different from haploidentical or primary cadaver recipients transplanted over the same time period. 2. Sensitization is common, despite the use of Aza, especially in husband-to-wife donor-to-recipient relationship. 3. Rejection occurs frequently, despite the use of DST, however, it is usually reversible. The high rejection rate did not influence the quality of long-term graft survival with very few patients losing grafts to chronic rejection. 4. Expansion of the use of LUrDs could help provide additional organs for transplantation.

Adult↗
PubMed1990

Experience with reduced-size liver transplantation.

Orthotopic liver transplantation with reduced-size liver transplants (RLT) has been proposed as a way of alleviating the limited availability of size-matched donor organs for pediatric recipients. The use of RLT should increase the pool of available donors and decrease the number of pediatric patients who die while awaiting a full-size hepatic graft. Between May 1988 and April 1989, 15 RLT were placed in 12 patients. Twelve were left lobe and three were extended right lobe grafts. The mean donor to recipient ratio was 9.0:1.0 (range of 3.3:1.0 to 19.9:1.0). Graft complications occurred in four RLT, and extrahepatic complications occurred in five patients. Preservation of grafts with University of Wisconsin solution was used in all instances, with a mean preservation time of 14.1 hours (range of 8.5 to 19.5 hours). Retransplantation with RLT was successful in three of four patients. The actual patient survival rate was 83 per cent after a mean follow-up interval of 6.7 months (range of one to 11 months). Our experience indicates that patient survival with RLT is comparable with full-size grafting and should be offered as an acceptable method of therapy for end-stage liver disease in pediatric patients. The application of RLT techniques in a more elective setting may yield further improvements in patient survival.

Child↗