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Öğe Pancreas survival in simultaneous pancreas-kidney and pancreas-after-kidney transplantations: A five-year follow-up report(Int Scientific Literature, Inc, 2012) Dinckan, Ayhan; Aliosmanoglu, Ibrahim; Kocak, Huseyin; Sari, Ramazan; Erdogan, Okan; Ertug, Zeki; Suleymanlar, GultekinBackground: Pancreas transplantation methods, such as simultaneous pancreas-kidney (SPK) transplantation and pancreas-after-kidney (PAK) transplantation, have become the most important treatments for patients with type-1 diabetes mellitus (DM)-related end-stage renal diseases (ESRD). The purpose of the study was to compare the clinical results of the pancreas graft in patients after SPK and PAK transplantations and to present the findings of our 5-year follow-up. Material/Method: A total of 55 patients who had kidney and pancreas transplantation between February 2003 and December 2010 were included in the study. The patients were divided into 2 groups based on the timing of the pancreas transplantation: SPK (n=21) and PAK (n=34). Result: The patients in the SPK group consisted of 13 males and 8 females, with a mean age of 33.6 +/- 6.8 years; whereas 25 males and 9 females formed the PAK group, with a mean age of 32.0 +/- 6.0 years. In the early postoperative period, the SPK group had 3 patients with vascular thrombosis (2 venous, 1 arterial) and the PAK group had 7 patients with thrombosis (4 venous, 3 arterial) (p=0.319). At the end of the 5-year follow-up, the patient, kidney and pancreas survival rates in the SPK group were 95.2%, 95.2%, and 61.9% respectively, and the corresponding values in the PAK group were 97%, 91.2%, 61.8% (p=0.382, p=0.504, p=0.927). Conclusions: We concluded that PAK is just as effective as SPK to prevent the destructive effects of DM when the waiting time for SPK is long and a potential live donor is present.Öğe A population-based survey of Chronic REnal Disease In Turkey-the CREDIT study(Oxford Univ Press, 2011) Suleymanlar, Gultekin; Utas, Cengiz; Arinsoy, Turgay; Ates, Kenan; Altun, Bulent; Altiparmak, Mehmet Riza; Ecder, TevfikBackground. Chronic kidney disease (CKD) is a growing health problem worldwide that leads to end-stage kidney failure and cardiovascular complications. We aimed to determine the prevalence of CKD in Turkey, and to evaluate relationships between CKD and cardiovascular risk factors in a population-based survey. Methods. Medical data were collected through home visits and interviews. Serum creatinine, blood glucose, total cholesterol, triglycerides, HDL, LDL and uric acid were determined from 12-h fasting blood samples, and spot urine tests were performed for subjects who gave consent to laboratory evaluation. Results. A total of 10 872 participants were included in the study. The final analysis was performed on 10 748 subjects (mean age 40.5 +/- 16.3 years; 55.7% women) and excluded 124 pregnant women. A low glomerular filtration rate (GFR) (<60 mL/min/1.73 m(2)) was present in 5.2% of the subjects who were evaluated for GFR, while micro-albuminuria and macroalbuminuria were observed in 10.2% and 2% of the subjects, respectively. The presence of CKD was assessed in subjects who gave consent for urinary albumin excretion measurement (n = 8765). The overall prevalence of CKD was 15.7%; it was higher in women than men (18.4% vs. 12.8%, P < 0.001) and increased with increasing age of the subjects. The prevalence of hypertension (32.7% in the general population), diabetes (12.7%), dyslipidaemia (76.3%), obesity (20.1%) and metabolic syndrome (31.3%) was significantly higher in subjects with CKD than subjects without CKD (P < 0.001 for all). Conclusions. The prevalence of CKD in Turkey is 15.7%. Cardiovascular risk factors were significantly more prevalent in CKD patients.Öğe Therapy Modalities for Antibody Mediated Rejection in Renal Transplant Patients(Taylor & Francis Inc, 2016) Yilmaz, Vural Taner; Suleymanlar, Gultekin; Koksoy, Sadi; Ulger, Burak Veli; Ozdem, Sebahat; Akbas, Halide; Akkaya, BaharIntroduction: The aim of our study was to determine the effectiveness of immunoglobulin, rituximab and plasmapheresis in renal transplant patients with antibody mediated rejection (AMR). Patients and Methods: Fourteen renal transplant patients with AMR were included in this study. The mean age of the patients was 33.9 +/- 10.3years and 10 (71.4%) of them were male. Lymphocyte cross match was negative for all patients and 10 (71.4%) of them were living donor transplants. Six patients were administered tacrolimus, three patients cyclosporine, two patients everolimus, and three patients sirolimus for immunosuppression. The patients with AMR were administered IVIG, rituximab and plasmapheresis. Results: Patient survival rate was 100%, graft survival rate after AMR was 50% in the first year and 33% in the 2nd and third years. AMR developed 31.9 +/- 25.9 months after transplantation. Seven (50%) patients lost their grafts. Delayed graft function was observed in 28.6%, chronic allograft dysfunction in 78.5%, diabetes after transplantation in 14.3%, and cytomegalovirus infection in 7.1% of the patients. At the last follow-up, the mean blood creatinine was 3.1 +/- 1.4, the mean proteinuria was 2300 (1300-3300) mg/day and the mean GFR was 34.5 +/- 17.6ml/min. C4d was positive in peritubullar capillaries in all patients, while neutrophil accumulation in peritubular and glomerular capillaries was observed in 8 patients. Chronic allograft vasculopathy was observed in 12 patients. Conclusion: AMR leads to progressive loss of renal function and has low graft survival. More effective treatment alternatives are needed for this clinical issue.Öğe Vascular access practice in a large cohort of chronic hemodialysis patients(Oxford Univ Press, 2007) Sever, Mehmet Sukru; Dogan, Cengiz; Yildiz, Alaattin; Yilmaz, Mehmet Emin; Suleymanlar, Gultekin; Arinsoy, Turgay; Ok, Ercan[Abstract Not Available]
