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  1. Article: Comparison of tacrolimus with a cyclosporine microemulsion for immunosuppressive therapy in kidney transplantation.

    Ekmekçioğlu, Ozan / Turkan, Sadi / Yıldız, Şener / Güneş, Zeki Ender

    Turkish journal of urology

    2015  Volume 39, Issue 1, Page(s) 16–21

    Abstract: Objective: To compare the efficacy and side effects of a cyclosporine microemulsion and tacrolimus in immunosuppressive therapy of renal transplantation.: Material and methods: Between March 2003 and June 2005, the patients who had undergone kidney ... ...

    Abstract Objective: To compare the efficacy and side effects of a cyclosporine microemulsion and tacrolimus in immunosuppressive therapy of renal transplantation.
    Material and methods: Between March 2003 and June 2005, the patients who had undergone kidney transplantation surgery and who were administered either basiliximab, a cyclosporine microemulsion, mycophenolate mofetil and prednisolone or basiliximab, tacrolimus, mycophenolate mofetil and prednisolone for baseline immunosuppressive therapy were recruited to our study. We evaluated the results of an 18-month follow-up period. The donors were called back weekly for a follow-up in the first month, fortnightly in the second month and then monthly for 18 months after discharge. A total of 41 patients were included in the study. The patients were evaluated as for demographic characteristics, acute rejection, cardiovascular and metabolic side effects, graft function, infections, hirsutism, gingival hyperplasia, cosmetic side effects, nephrotoxicity, drug changes and the survival rates.
    Results: There were no significant differences among the patients with regard to age, sex, donor type, dialysis periods, preoperative and postoperative systolic blood pressures, creatinine levels, hepatotoxicity, nephrotoxicity, occurrence of diabetes mellitus and the incidence of infection. The duration of hospitalization was prolonged in the cyclosporine A group. Acute rejection emerged in 5 patients (23.8%) in the tacrolimus group and in 4 patients (20%) in the cyclosporine A group. In the cyclosporin A group, the cholesterol and triglyceride levels were significantly higher than the tacrolimus group. The cosmetic side effects (gingival hyperplasia and hirsutism) as a reason for a change in medication were only observed in the cyclosporin A group, not in the tacrolimus group. A medication change was made in 8 patients in the cyclosporine A group and in 1 patient in the tacrolimus group. No death was observed in either group. Graft loss was observed in only 1 patient in the cyclosporine A group.
    Conclusion: Regarding the cosmetic side effects and hyperlipidemia, tacrolimus was found to be superior to cyclosporine A. Where hyperlipidemia is considered to be a risk factor for cardiovascular disease, tacrolimus use should be considered as a more acceptable treatment modality. However, the immunosuppressive regimen should be evaluated individually.
    Language English
    Publishing date 2015-06-01
    Publishing country Turkey
    Document type Journal Article
    ISSN 2149-3235
    ISSN 2149-3235
    DOI 10.5152/tud.2013.004
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article: Multidetector computed tomography for preoperative evaluation of vascular anatomy in living renal donors.

    Türkvatan, Aysel / Akinci, Serkan / Yildiz, Sener / Olçer, Tülay / Cumhur, Turhan

    Surgical and radiologic anatomy : SRA

    2009  Volume 31, Issue 4, Page(s) 227–235

    Abstract: Background: Currently, multidetector computed tomographic (MDCT) angiography has become a noninvasive alternative imaging modality to catheter renal angiography for the evaluation of renal vascular anatomy in living renal donors. In this study, we ... ...

    Abstract Background: Currently, multidetector computed tomographic (MDCT) angiography has become a noninvasive alternative imaging modality to catheter renal angiography for the evaluation of renal vascular anatomy in living renal donors. In this study, we investigated the diagnostic accuracy of 16-slice MDCT in the preoperative assessment of living renal donors.
    Methods: Fifty-nine consecutive living renal donors (32 men, 27 women) underwent MDCT angiography followed by open donor nephrectomy. All MDCT studies were performed by using a 16-slice MDCT scanner with the same protocol consisting of arterial and nephrographic phases followed by conventional abdominal radiography. The MDCT images were assessed retrospectively for the number and branching pattern of the renal arteries and for the number and presence of major or minor variants of the renal veins. The results were compared with open surgical results.
    Results: The sensitivity and specificity of MDCT for the detection of anatomic variants of renal arteries including the accessory arteries (n = 9), early arterial branching (n = 7) and major renal venous anomalies including the accessory renal veins (n = 3), late venous confluence (n = 4), circumaortic (n = 2) or retroaortic (n = 3) left renal veins were 100%. However, the sensitivity for identification of minor venous variants was 79%. All of three ureteral duplications were correctly identified at excretory phase conventional abdominal radiography.
    Conclusion: Sixteen-slice MDCT is highly accurate for the identification of anatomic variants of renal arteries and veins. Dual-phase MDCT angiography including arterial and nephrographic phases followed by conventional abdominal radiography enables complete assessment of renal donors without significant increase of radiation dose. However, the evaluation of minor venous variants may be problematic because of their small diameters and poor opacification.
    MeSH term(s) Adult ; Angiography ; Female ; Humans ; Kidney Transplantation/methods ; Male ; Middle Aged ; Nephrectomy ; Preoperative Care ; Renal Artery/anatomy & histology ; Renal Artery/diagnostic imaging ; Renal Veins/anatomy & histology ; Renal Veins/diagnostic imaging ; Retrospective Studies ; Sensitivity and Specificity ; Tissue Donors ; Tomography, X-Ray Computed
    Language English
    Publishing date 2009-04
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 632839-8
    ISSN 1279-8517 ; 0930-1038 ; 0930-312X
    ISSN (online) 1279-8517
    ISSN 0930-1038 ; 0930-312X
    DOI 10.1007/s00276-008-0428-0
    Database MEDical Literature Analysis and Retrieval System OnLINE

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