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    Delayed graft function in living-donor renal transplantation: a single-center experience with 1537 patients
    (E-Century Publishing Corp, 2016) Ozkul, Faruk; Erbis, Halil; Yilmaz, Vural Taner; Ozturk, Bunyamin; Kocak, Huseyin; Osmanoglu, Ibrahim Ali; Dinckan, Ayhan
    Objectives: To analyze the incidence, clinical characteristics and possible causes of delayed graft function (DGF) among a large number of living kidney transplant recipients at a single center. Patients and Methods: We analyzed the medical records of 1537 patients over 18 years of age who received a kidney transplant from a living donor between January 2003 and June 2014. The demographic characteristics of the patients, graft survivals, acute rejection rates and renal functions were compared between patients with and without DGF. Results: Longer dialysis time before transplantation (50.6 +/- 53.1 vs. 31.4 +/- 42.9 months; P<0.001) and lower donor GFR (48.2 +/- 10.2 vs. 45.4 +/- 13 months; P=0.014) were associated with a greater incidence of DGF in this series. The DGF cases showed a higher incidence of acute rejection episodes (19.9% vs. 4.8%), chronic graft dysfunction (10% vs. 1%), prolonged hospitalization (16.8 +/- 6.7 days vs. 8.3 +/- 5.6 days), and worse renal function after 1-year follow-up period compared with non-DGF patients. Conclusions: Longer dialysis time before transplantation and lower donor GFR were associated with a higher risk for DGF, with prolonged hospitalization time, worse graft prognosis and higher rates of acute rejection episodes and chronic graft dysfunction.
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    Effect of age on the outcome of renal transplantation: A single-center experience
    (Professional Medical Publications, 2016) Ozkul, Faruk; Erbis, Halil; Yilmaz, Vural Taner; Kocak, Huseyin; Osmanoglu, Ibrahim Ali; Dinckan, Ayhan
    Objectives: To analyze the effects of old age on renal transplantation (Tx) results and graft survival, and compared elderly patient population with the young patients. Methods: A total of 1946 renal transplant were performed from 1537 living and 409 cadaveric donors between 2003 and 2014. The recipients were divided into two groups according to their age at the time of transplantation. The young age group consisted of 18 -59-year-old, and the elderly group consisted of the ones >= 60 years. Results: Acute rejection was seen in 19.5% of the young age group while this rate was 16.7% in the old age group (p=0.535). DGF was seen in 6.3% of the young age group, and in 13.5% of the old age group (p<0.001). Analysis of the overall survival rates demonstrated that 1.6% of the patients in the young age group and 6.8% of the patients in the old age groups died (p=0.003). Conclusions: Renal transplant had high graft survival rates in the elderly as in the young patients. However, the risks for complications were higher in the older age group compared to the younger age group. Thus, it is important to make a careful selection among elderly candidates for renal transplantation.
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    Left ventricle ejection fraction may predict mortality in renal transplant patients
    (Taylor & Francis Ltd, 2016) Ozkul, Faruk; Arik, Muhammmet Kasim; Erbis, Halil; Akbas, Alpaslan; Yilmaz, Vural Taner; Barutcu, Ahmet; Osmanoglu, Ibrahim Ali
    Purpose: Mortality is a major problem in renal transplant patients, and appropriate preoperative evaluation is very important. We retrospectively reviewed the left ventricle ejection fraction (LVEF) of renal transplant patients.Material and methods: The clinical records of 1763 patients who had preoperative LVEF results and who underwent renal transplantation at Akdeniz University Faculty of Medicine during the years 2004-2014 were studied. The LVEF limit was set at 55%. LVEF, age, gender, diabetes mellitus, hypertension, type of dialysis were assessed by linear multiple regression analysis on survival.Results: There were a total of 1763 renal transplant patients. Those with LVEF of <55% were identified as having left ventricular dysfunction. The mean LVEF was 59.49.1 in the 43 patients who died after renal transplantation, while it was 62.6 +/- 7.4 in the survivors (p=0.02). The mortality rate in the LVEF <55% group was 6.8% (11/162 patients), while mortality in the LVEF55% group was 2% (32/1601 patients, p<0.001). LVEF was found to be the most powerful variable on survival by the linear multiple regression analysis, R-2 = 0.05, p<0.001.Conclusion: LVEF may predict mortality in renal transplant patients. LVEF is known to be lower in patients with high cardiac mortality, who may require greater modifications of the postoperative risks.