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Article ; Online: Outcome of Renal Transplantation in Patients With Diabetes Mellitus: A Single-Center Experience.

Akagun, Tulin / Yelken, Berna / Usta, Murat / Turkmen, Aydin

2022 Volume 54, Issue 8, Page(s) 2174–2178

Abstract: Background: An increasing proportion of kidney recipients have diabetes mellitus (DM). Some concerns have been raised about the kidney transplantation results in diabetic patients. Therefore, we assessed the effect of DM on morbidity and mortality of ... ...

Abstract	Background: An increasing proportion of kidney recipients have diabetes mellitus (DM). Some concerns have been raised about the kidney transplantation results in diabetic patients. Therefore, we assessed the effect of DM on morbidity and mortality of diabetic patients with renal transplantation. Methods: We retrospectively studied adult patients with and without DM who underwent living donor transplantation between 2007 and 2016. Information concerning demographic and clinical data were retrospectively analyzed by reviewing the patient files. Results: Of the 1536 transplant recipients, 126 (8%) had diabetes mellitus (mean age 49.4 ± 11.8) and 525 patients were evaluated in the non-diabetic control group (mean age 36.2 ± 15.9). The diabetic and non-diabetic patient groups had a mean follow-up after kidney transplantation 42.5 months (0.27-101.7 months) and 58.8 ± 10.6 months, respectively. In the diabetic patient group, only 3 patients had lost graft and 13 patients were exitus. Three patients had lost graft and 5 patients were exitus in non-diabetic patient group. Cardiac death (54.5%) was the most common cause of mortality in diabetic group. The 6-year patient and graft survival rates are 84.9% and 95.3%; 97.5% and 97.2% in the diabetic and non-diabetic patient groups, respectively. Conclusions: Both infection and cardiovascular diseases increase morbidity and mortality in renal transplant patients with diabetes mellitus. The mortality risk of diabetic patients after renal transplantation is higher than the non-diabetic kidney recipients. Therefore, diabetic patients need meticulous cardiac evaluation before renal transplantation and a close follow-up, in terms of infection, after transplantation.
MeSH term(s)	Adult ; Humans ; Middle Aged ; Young Adult ; Kidney Transplantation/methods ; Graft Survival ; Retrospective Studies ; Diabetes Mellitus/etiology ; Living Donors ; Kidney Failure, Chronic/etiology ; Diabetic Nephropathies/complications
Language	English
Publishing date	2022-10-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2022.08.024
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Article: Experience of kidney transplantation to a patient with Bernard Soulier syndrome: A case report.

Karataş, Cihan / Akyollu, Başak / Arpalı, Emre / Yelken, Berna / Türkmen, Aydın / Koçak, Burak

Turkish journal of surgery

2023 Volume 39, Issue 1, Page(s) 86–88

Abstract: Renal transplantation could be a challenging operation in patients with haemorrhagic diathesis, with predictable difficulties or even with unpredictable hurdles. Bernard Soulier Syndrome (BSS) is one of the ethiologies of the thrombocytopenia and it is a ...

Abstract	Renal transplantation could be a challenging operation in patients with haemorrhagic diathesis, with predictable difficulties or even with unpredictable hurdles. Bernard Soulier Syndrome (BSS) is one of the ethiologies of the thrombocytopenia and it is a rare hereditary disease associated with defects of the platelet glycoprotein complex glycoprotein Ib/V/IX and characterized by large platelets, thrombocytopenia, and severe bleeding symptoms. Here, we present a challenging renal transplantation in BSS.
Language	English
Publishing date	2023-03-03
Publishing country	Turkey
Document type	Case Reports
ISSN	2564-6850
ISSN	2564-6850
DOI	10.47717/turkjsurg.2022.4567
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Article ; Online: Successful Kidney Transplantation in

Bülbül, Mustafa Cem / Avcı, Şahin / Yelken, Berna / Koçak, Burak / Akay, Olga Meltem

Turkish journal of haematology : official journal of Turkish Society of Haematology

2023 Volume 40, Issue 3, Page(s) 232–233

MeSH term(s)	Humans ; Kidney Transplantation ; Thrombocytopenia/etiology ; Thrombocytopenia/genetics
Language	English
Publishing date	2023-06-06
Publishing country	Turkey
Document type	Journal Article
ZDB-ID	2185903-6
ISSN	1308-5263 ; 1300-7777
ISSN (online)	1308-5263
ISSN	1300-7777
DOI	10.4274/tjh.galenos.2023.2023-0138
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Article ; Online: Case report: A kidney transplant patient with mild COVID-19.

Arpali, Emre / Akyollu, Basak / Yelken, Berna / Tekin, Suda / Turkmen, Aydin / Kocak, Burak

Transplant infectious disease : an official journal of the Transplantation Society

2020 Volume 22, Issue 4, Page(s) e13296

Abstract: Coronavirus Disease 2019 (COVID-19) is currently a pandemic with a mortality rate of 1%-6% in the general population. However, the mortality rate seems to be significantly higher in elderly patients, especially those hospitalized with comorbidities, such ...

Abstract	Coronavirus Disease 2019 (COVID-19) is currently a pandemic with a mortality rate of 1%-6% in the general population. However, the mortality rate seems to be significantly higher in elderly patients, especially those hospitalized with comorbidities, such as hypertension, diabetes, or coronary artery diseases. Because viral diseases may have atypical presentations in immunosuppressed patients, the course of the disease in the transplant patient population is unknown. Hence, the management of these patients with COVID-19 is an area of interest, and a unique approach is warranted. Here, we report the clinical features and our treatment approach for a kidney transplant patient with a diagnosis of COVID-19. We believe that screening protocols for SARS-Cov-2 should be re-evaluated in patients with solid-organ transplants.
MeSH term(s)	Adult ; Antiviral Agents/therapeutic use ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/complications ; Coronavirus Infections/drug therapy ; Cough/etiology ; Disease Management ; Female ; Fever/etiology ; Glucocorticoids ; Graft Rejection/prevention & control ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/therapeutic use ; Kidney Failure, Chronic/surgery ; Kidney Transplantation ; Lupus Nephritis/surgery ; Oseltamivir/therapeutic use ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/drug therapy ; Prednisone/therapeutic use ; SARS-CoV-2 ; Severity of Illness Index ; Tacrolimus/therapeutic use
Chemical Substances	Antiviral Agents ; Glucocorticoids ; Immunosuppressive Agents ; Oseltamivir (20O93L6F9H) ; Prednisone (VB0R961HZT) ; Tacrolimus (WM0HAQ4WNM)
Keywords	covid19
Language	English
Publishing date	2020-05-04
Publishing country	Denmark
Document type	Case Reports ; Journal Article
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.13296
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Article ; Online: Propensity score-matched analysis of long-term outcomes for living kidney donation in alternative complement pathway diseases: a pilot study.

Caliskan, Yasar / Safak, Seda / Oto, Ozgur Akin / Velioglu, Arzu / Yelken, Berna / Mirioglu, Safak / Dirim, Ahmet Burak / Yildiz, Abdulmecit / Guller, Nurana / Yazici, Halil / Ersoy, Alparslan / Turkmen, Aydin / Lentine, Krista L

Journal of nephrology

2023 Volume 36, Issue 4, Page(s) 979–986

Abstract: Background: Atypical hemolytic syndrome (aHUS) and C3 glomerulopathy (C3G) are complement-mediated rare diseases with excessive activation of the alternative pathway. Data to guide the evaluation of living-donor candidates for aHUS and C3G are very ... ...

Abstract	Background: Atypical hemolytic syndrome (aHUS) and C3 glomerulopathy (C3G) are complement-mediated rare diseases with excessive activation of the alternative pathway. Data to guide the evaluation of living-donor candidates for aHUS and C3G are very limited. The outcomes of living donors to recipients with aHUS and C3G (Complement disease-living donor group) were compared with a control group to improve our understanding of the clinical course and outcomes of living donation in this context. Methods: Complement disease-living donor group [n = 28; aHUS(53.6%), C3G(46.4%)] and propensity score-matched control-living donor group (n = 28) were retrospectively identified from 4 centers (2003-2021) and followed for major cardiac events (MACE), de novo hypertension, thrombotic microangiopathy (TMA), cancer, death, estimated glomerular filtration rate (eGFR) and proteinuria after donation. Results: None of the donors for recipients with complement-related kidney diseases experienced MACE or TMA whereas two donors in the control group developed MACE (7.1%) after 8 (IQR, 2.6-12.8) years (p = 0.15). New-onset hypertension was similar between complement disease and control donor groups (21.4% vs 25%, respectively, p = 0.75). There were no differences between study groups regarding last eGFR and proteinuria levels (p = 0.11 and p = 0.70, respectively). One related donor for a recipient with complement-related kidney disease developed gastric cancer and another related donor developed a brain tumor and died in the 4th year after donation (2, 7.1% vs none, p = 0.15). No recipient had donor-specific human leukocyte antigen antibodies at the time of transplantation. Median follow-up period of transplant recipients was 5 years (IQR, 3-7). Eleven (39.3%) recipients [aHUS (n = 3) and C3G (n = 8)] lost their allografts during the follow-up period. Causes of allograft loss were chronic antibody-mediated rejection in 6 recipients and recurrence of C3G in 5. Last serum creatinine and last eGFR of the remaining patients on follow up were 1.03 ± 038 mg/dL and 73.2 ± 19.9 m/min/1.73 m2 for aHUS patients and 1.30 ± 0.23 mg/dL and 56.4 ± 5.5 m/min/1.73 m2 for C3G patients. Conclusion: The present study highlights the importance and complexity of living related-donor kidney transplant for patients with complement-related kidney disorders and motivates the need for further research to determine the optimal risk-assessment for living donor candidates to recipients with aHUS and C3G.
MeSH term(s)	Humans ; Pilot Projects ; Complement Pathway, Alternative ; Atypical Hemolytic Uremic Syndrome ; Retrospective Studies ; Propensity Score ; Kidney ; Kidney Diseases/complications ; Thrombotic Microangiopathies ; Complement System Proteins ; Hypertension/complications ; Proteinuria/complications
Chemical Substances	Complement System Proteins (9007-36-7)
Language	English
Publishing date	2023-02-20
Publishing country	Italy
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.1007/s40620-023-01588-x
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Article ; Online: Long-Term Outcomes of Living-Related Kidney Donation for Alport Syndrome Spectrum: A Propensity Score-Matched Analysis.

Oto, Ozgur Akin / Safak, Seda / Mirioglu, Safak / Yelken, Berna / Velioglu, Arzu / Dirim, Ahmet Burak / Guller, Nurana / Yildiz, Abdulmecit / Ersoy, Alparslan / Turkmen, Aydin / Yazici, Halil / Lentine, Krista L / Caliskan, Yasar

American journal of nephrology

2022 Volume 53, Issue 8-9, Page(s) 628–635

Abstract: Introduction: Data to guide the evaluation of living-related donor candidates for kidney transplant recipients with Alport syndrome (AS) spectrum are limited. We aimed to examine a cohort of living-related donors to recipients with AS and compare their ... ...

Abstract	Introduction: Data to guide the evaluation of living-related donor candidates for kidney transplant recipients with Alport syndrome (AS) spectrum are limited. We aimed to examine a cohort of living-related donors to recipients with AS and compare their outcomes with a control group to improve understanding of the clinical course and outcomes of living donation in this context. Methods: Living donors (LDs) of AS recipients and propensity score-matched control LDs without any family history of AS (control group) were followed for major cardiac events, death, post-donation estimated glomerular filtration rate (eGFR), and proteinuria. Results: There were 31 LDs (48.4% male), in whom relationship to AS recipient included mother (45.2%), father (32.3%), sibling (16.1%), grandparent (3.2%), and uncle (3.2%). Long-term outcomes over 10.0 (IQR, 3.0-15.0) years were evaluated in 25 and 25 LDs from study and control groups, respectively. During follow-up, 5 LDs (20.0%) in study group developed major cardiac event (acute coronary ischemia [n = 4] and severe congestive heart failure [n = 1]) after 5.5 (IQR, 4.5-10.3) years, whereas only 2 (8.0%) LDs in control group developed major cardiac events (p = 0.221). New-onset hypertension was higher in study group (56.0%) compared to the control group (16.0%) (p = 0.003). Three donors in study and 2 donors in control group who developed new-onset hypertension died during follow-up (p = 0.297). Major cardiac event rate was significantly higher in donors who developed hypertension after donation (0 vs. 28.0%, p < 0.001). There were no differences between study groups regarding last eGFR and proteinuria levels (p = 0.558 and p = 0.120, respectively). Discussion/conclusion: Although the risk of kidney disease can be minimized by careful donor evaluation, our findings suggest that hypertension risk after the donation is higher than expected in related donors of recipients with AS.
MeSH term(s)	Male ; Humans ; Female ; Nephritis, Hereditary/epidemiology ; Kidney Transplantation/adverse effects ; Propensity Score ; Living Donors ; Kidney ; Glomerular Filtration Rate ; Proteinuria/epidemiology ; Proteinuria/etiology ; Hypertension/epidemiology ; Hypertension/etiology ; Nephrectomy
Language	English
Publishing date	2022-11-08
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	604540-6
ISSN	1421-9670 ; 0250-8095
ISSN (online)	1421-9670
ISSN	0250-8095
DOI	10.1159/000527180
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Article ; Online: Oligosymptomatic Kidney Transplant Patients With COVID-19: Do They Pose a Risk to Other Recipients?

Kocak, Burak / Arpali, Emre / Akyollu, Basak / Yelken, Berna / Tekin, Suda / Kanbay, Mehmet / Turkmen, Aydin / Kalayoglu, Munci

Transplantation proceedings

2020 Volume 52, Issue 9, Page(s) 2663–2666

Abstract: The clinical course of viral infections in patients under immunosuppression can be atypical and/or fatal if not diagnosed and treated appropriately. The coronavirus disease 2019 (COVID-19) may also have an atypical presentation. Contrary to the general ... ...

Abstract	The clinical course of viral infections in patients under immunosuppression can be atypical and/or fatal if not diagnosed and treated appropriately. The coronavirus disease 2019 (COVID-19) may also have an atypical presentation. Contrary to the general opinion, transplant patients may be asymptomatic or oligosymptomatic, which could be a risk factor for underdiagnosis and the dissemination of this viral disease. This study presents the clinical features of 2 oligosymptomatic kidney transplant patients diagnosed with COVID-19. We suggest that new screening algorithms for COVID-19 should be reconsidered for the transplant patient population.
MeSH term(s)	Adult ; Betacoronavirus ; COVID-19 ; Coronavirus Infections/immunology ; Female ; Humans ; Immunocompromised Host ; Immunosuppressive Agents/therapeutic use ; Kidney Transplantation ; Middle Aged ; Pandemics ; Pneumonia, Viral/immunology ; Risk Factors ; SARS-CoV-2 ; Transplant Recipients
Chemical Substances	Immunosuppressive Agents
Keywords	covid19
Language	English
Publishing date	2020-05-15
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2020.05.028
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Article: Case report: A kidney transplant patient with mild COVID-19

Arpali, Emre / Akyollu, Basak / Yelken, Berna / Tekin, Suda / Turkmen, Aydin / Kocak, Burak

Transpl Infect Dis

Abstract	Coronavirus Disease 2019 (COVID-19) is currently a pandemic with a mortality rate of 1%-6% in the general population. However, the mortality rate seems to be significantly higher in elderly patients, especially those hospitalized with comorbidities, such as hypertension, diabetes, or coronary artery diseases. Because viral diseases may have atypical presentations in immunosuppressed patients, the course of the disease in the transplant patient population is unknown. Hence, the management of these patients with COVID-19 is an area of interest, and a unique approach is warranted. Here, we report the clinical features and our treatment approach for a kidney transplant patient with a diagnosis of COVID-19. We believe that screening protocols for SARS-Cov-2 should be re-evaluated in patients with solid-organ transplants.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #73020
Database	COVID19

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Book ; Online: Oligosymptomatic kidney transplant patients with COVID-19

Arpalı, Emre / Akyollu, Başak / Koçak, Burak / Yelken, Berna / Kalayoğlu, Münci / Türkmen, Aydın / Koruk, Süda Tekin / Kanbay, Mehmet (ORCID 0000-0002-1297-0675 & YÖK ID 110580)

Transplantation Proceedings

do they pose a risk to other recipients?

2020

Abstract	The clinical course of viral infections in patients under immunosuppression can be atypical and/or fatal if not diagnosed and treated appropriately. The coronavirus disease 2019 (COVID-19) may also have an atypical presentation. Contrary to the general opinion, transplant patients may be asymptomatic or oligosymptomatic, which could be a risk factor for underdiagnosis and the dissemination of this viral disease. This study presents the clinical features of 2 oligosymptomatic kidney transplant patients diagnosed with COVID-19. We suggest that new screening algorithms for COVID-19 should be reconsidered for the transplant patient population.
Keywords	Medicine ; Middle East respiratory syndrome coronavirus ; Coronavirus infections ; covid19
Language	English
Publisher	Elsevier
Publishing country	tr
Document type	Book ; Online
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Article ; Online: Case report

Arpali, Emre / Akyollu, Basak / Yelken, Berna / Tekin, Suda / Turkmen, Aydin / Kocak, Burak

Transplant Infectious Disease

A kidney transplant patient with mild COVID‐19

2020 Volume 22, Issue 4

Keywords	Transplantation ; Infectious Diseases ; covid19
Language	English
Publisher	Wiley
Publishing country	us
Document type	Article ; Online
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.13296
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