Researcher:
Akyollu, Başak

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Doctor

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Başak

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Akyollu

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Akyollu, Başak

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2020 - 202212

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    Improving the urine spot protein/creatinine ratio by the estimated creatinine excretion to predict proteinuria in pediatric kidney transplant recipients
    (Wiley, 2021) Palaoğlu, Kerim Erhan; N/A; İncir, Said; Taşdemir, Mehmet; Koçak, Burak; Yelken, Berna; Arpalı, Emre; Akyollu, Başak; Baygül, Arzu Eden; Bilge, İlmay; Türkmen, Aydın; Doctor; Faculty Member; Faculty Member; Doctor; Doctor; Doctor; Faculty Member; Faculty Member; Doctor; N/A; School of Medicine; School of Medicine; N/A; N/A; N/A; School of Medicine; School of Medicine; N/A; Koç University Hospital; N/A; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; Koç University Hospital; 175430; 175867; 220671; N/A; N/A; N/A; 272290; 198907; N/A
    Background Since the daily creatinine excretion rate (CER) is directly affected by muscle mass, which varies with age, gender, and body weight, using the spot protein/creatinine ratio (Spot P/Cr) follow-up of proteinuria may not always be accurate. Estimated creatinine excretion rate (eCER) can be calculated from spot urine samples with formulas derived from anthropometric factors. Multiplying Spot P/Cr by eCER gives the estimated protein excretion rate (ePER). We aimed to determine the most applicable equation for predicting daily CER and examine whether ePER values acquired from different equations can anticipate measured 24 h urine protein (m24 h UP) better than Spot P/Cr in pediatric kidney transplant recipients. Methods This study enrolled 23 children with kidney transplantation. To estimate m24 h UP, we calculated eCER and ePER values with three formulas adapted to children (Cockcroft-Gault, Ghazali-Barratt, and Hellerstein). To evaluate the accuracy of the methods, Passing-Bablok and Bland-Altman analysis were used. Results A statistically significant correlation was found between m24 h UP and Spot P/Cr (p < .001, r = 0.850), and the correlation was enhanced by multiplying the Spot P/Cr by the eCER equations. The average bias of the ePER formulas adjusted by the Cockcroft-Gault, Ghazali-Barratt, and Hellerstein equations were -0.067, 0.031, and 0.064 g/day, respectively, whereas the average bias of Spot P/Cr was -0.270 g/day obtained by the Bland-Altman graphics. Conclusion Using equations to estimate eCER may improve the accuracy and reduce the spot urine samples' bias in pediatric kidney transplantation recipients. Further studies in larger populations are needed for ePER reporting to be ready for clinical practice.
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    Post-transplant recurrence of masked monoclonal gammopathy of renal significance in a patient with C3 glomerulonephritis: a case report
    (Lippincott Williams & Wilkins, 2022) N/A; N/A; N/A; N/A; N/A; N/A; N/A; Yelken, Berna; Arpalı, Emre; Akyollu, Başak; Koçak, Burak; Baydar, Dilek Ertoy; Akay, Olga Meltem; Türkmen, Aydın; Doctor; Doctor; Doctor; Faculty Member; Faculty Member; Faculty Member; Doctor; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine; School of Medicine, School of Medicine; N/A; N/A; N/A; N/A; 8025; 170966; N/A
    Introduction: Monoclonal gammopathy of renal significance (MGRS) is a recently defined group of renal diseases caused by monoclonal immunoglobulin secreted by nonmalignant proliferative B cell or plasma cell causes renal damage. Here we report a case known as primary kidney disease C3 glomerulonephritis but after kidney transplant diagnosed MGRS. Case presentation: A 32-year old man underwent live related renal transplant in December 2020 for ESRF secondary C3 glomerulonephritis. At 2 months post-transplant, his serum kreatinin levels increased from a basaline creatinine of 1.2 mg/dl to 1.7mg/dl, and he developed proteinuria (1.2 gr/day). Renal biopsy showed monoclonal membranoproliferative glomerulonephritis. His serum and urine kappa/lambda light chain ratio was normal and he had no monoclonal protein in serum and urine immunfixation electrophoresis. After the patient was treated with Rituximab (4 cycles), his serum creatinin levels and proteinuria increased and repeat biopsy showed increase of monoclonal immun complexes in glomeruler capillers. The patient was treated bortezomib-based chemotherapy (4 cycles). Repeat biopsy showed no regression renal pathology. His renal functions and proteinuria continued to deteriorate. There were a rise in urine kappa/lambda light chain ratio. He received no further chemotherapy, a decision was taken to manage her kidney condition conservatively. Conclusions: Monoclonol immunoglobulin deposits may not be detectable in standart immunofluorescence techniques and can result missing the diagnosis of MGRS. Patiens with C3glomerulonephritis should be examined in detail for monoclonal gammapathy before kidney transplantation. 
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    Case report: a kidney transplant patient with mild COVID-19
    (Wiley, 2020) N/A; N/A; N/A; N/A; N/A; N/A; Arpalı, Emre; Akyollu, Başak; Yelken, Berna; Tekin, Süda; Türkmen, Aydın; Koçak, Burak; Doctor; Doctor; Doctor; Faculty Member; Doctor; Faculty Member; N/A; N/A; N/A; School of Medicine; N/A; School of Medicine; Koç University Hospital; N/A; N/A; N/A; 42146; N/A; 220671
    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.
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    Risk factors for febrile urinary tract infections in the first year after pediatric renal transplantation
    (Wiley, 2020) Akinci, Serkan; Gunaydin, Bilal; Nayir, Ahmet; N/A; N/A; N/A; N/A; N/A; Arpalı, Emre; Karataş, Cihan; Akyollu, Başak; Şal, Oğuzhan; Koçak, Burak; Doctor; Doctor; Doctor; Undergraduate Student; Faculty Member; N/A; N/A; N/A; School of Medicine; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 341966; 220671
    Urinary tract infection is the most common infectious complication following kidney transplant. Anatomic abnormalities, bladder dysfunction, a positive history of febrile urinary tract infection, and recipient age are reported risk factors. The aim of this study was to determine the risk factors for fUTI, which necessitated hospitalization in the first year after renal transplantation in our pediatric transplant population. A retrospective review of 195 pediatric patients who underwent kidney transplant between 2008 and 2017 from a single institution was performed. All patients admitted to the hospital with fUTI were marked for further analyses. The risk factors including age, gender, dialysis type, history of urologic disorders, and preoperative proteinuria for fUTI in the first year after kidney transplantation and graft survivals were investigated. Independent-sample t test and chi-square tests were used for univariate analysis. Exhaustive CHAID algorithm was used for multivariate analysis. The data of 115 male and 80 female patients were retracted. The mean ages of our cohort for males and females were 9.5 +/- 5.1 and 10 +/- 4.8 years, respectively. The age of the patients at transplant and their gender were found to be a statistically significant risk factors for developing fUTIs. Multivariate analysis showed that fUTI was common in female patients and a subgroup of male patients who had preoperative proteinuria, but no neurogenic bladder had higher risk compared with male patients without proteinuria. Patient surveillance and antibiotic prophylaxis algorithms can be developed to prevent febrile urinary tract infections seen after pediatric kidney transplantation in risky population.
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    Implanting a robot-assisted kidney transplant program for transplant surgeons with no robotic surgery background
    (Lippincott Williams and Wilkins, 2022) N/A; N/A; Koçak, Burak; Çelik, Neslihan; Arpalı, Emre; Akyollu, Başak; Kılıçer, Beşir; Canda, Abdullah Erdem; Kordan, Yakup; Faculty Member; PhD Student; Doctor; Doctor; Other; Faculty Member; Faculty Member; School of Medicine; Graduate School of Health Sciences; N/A; N/A; N/A; School of Medicine; School of Medicine; N/A; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; 220671; N/A; N/A; N/A; N/A; 116202; 157552
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    Effects of 5-fluorouracil released from different prosthetic meshes on post-operative adhesion formation in rats
    (Kare Yayıncılık, 2022) Balas, Sener; Dori, Devrim Demir; Erol, Timucin; Korkusuz, Petek; Hamaloglu, Erhan; N/A; Akyollu, Başak; Doctor; N/A; Koç University Hospital; N/A
    Objective: Post-operative adhesion is a common problem in abdominal surgery. Especially, foreign materials are strong stimulus for the development of adhesions. The aim of this study was to investigate whether drug release material coated prosthetic mesh decreases intra-abdominal adhesion formation or not. Methods: 5-Fluorouracil (5-FU) releasing "chitosan gels" were loaded to polypropylene and polyglactin-910 grafts. Polypropylene, polyglactin-910 grafts, chitosan gel, and 5-FU-loaded polyglactin 910, polypropylene grafts were used to cover abdominal defects of rats which were created under sterile conditions (n=84). Each group was divided into two subgroups (n=6). Subgroups were sacrificed on the 7(th) and 30(th) days. Results: The 7(th) day macroscopic examinations were similar. Polypropylene group was most adhesive group on the 30(th) day. There were less adhesions in chitosan gel and 5-FU-loaded groups. Capsule and capsule margins showed no difference on both the 7(th) and 30(th) days. Polypropylene-5-FU group and polypropylene-chitosan gel group showed significantly less macroscopic adhesions than polypropylene control group. Furthermore, polyglactin-910-chitosan gel group was less adhesive than polypropylene control group. Conclusion: This study showed that 5-FU decreases the adhesions but the dosage and release kinetics need further investigations. / Giriş-Amaç: Postoperatif adezyon gelişimi abdominal cerrahide sık karşılaşılan bir problemdir. Özellikle yabancı cisimler intraabdominal yapışıklık oluşumunda önemli etkenlerdendir. Bu çalışmada intraabdominal yerleştirilen greftlerden salınan 5- Fu’nun adezyon engelleyici etkisi denetlendi. Yöntem: Polipropilen ve polyglactin 910 greft materyaleri üzerine 5-Fu salabilen ‘chitosan jel’ yüklendi. Steril koşullar altında ratlar da oluşturulan karın duvarı defektlerine kontrol gruplarında polipropilen greft, poly glactin 910 greft, taşıyıcı jel, deney gruplarına, taşıyıcı jel yüklenmiş Polipropilen ve poliglactin 910 ve 5-Fu yüklenmiş. Polipropilen ve poliglactin 910 yerleştirildi.(n=84) Gruplar ikiye ayrılıp 7. ve 30.günlerde sakrifiye edilerek örnekler incelendi(n=6). Bulgular: Makroskopik değerlendirmede 7.gün yapışıklıkları benzer olarak bulundu.Otuzuncu günde en çok yapışıklık polipropilen grubunda izlendi. Taşıyıcı jel ve ilaç yüklü gruplarda daha az yapışıklık izlendi. Mikroskopik olarak yapılan kapsül ve kapsül çevresi değerlendirmelerinin istatiksel analizinde anlamlı fark gözlenmedi. Otuzuncu günde polipropilen -5 fu grubu ile polipropilen kontrol grubu arasında, polipropilen jel ve polipropilen kontrol grupları arasında makroskopik adezyon skoru açısından anlamlı fark izlendi. (p< 0.05).Yine 30.günde polyglactin 910 - jel grubu ile polipropilen kontrol grubu arasında adezyon açısından anlamlı fark izlendi. (p< 0.05) Sonuç: Bu çalışmada intra abdominal yerleştirilen greftlerin adezyon oluşturucu etkilerini antimetabolitlerle engellenebileceği ancak uygun doz ve salınım zamanları için ek araştırmalara ihtiyaç olduğu sonucuna varıldı. (NCI-2021-10-18).
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    Why and how we do native nephrectomy in low weight pediatric kidney transplantation patients
    (Wiley, 2022) N/A; Çelik, Neslihan; Akyollu, Başak; Arpalı, Emre; Akıncı, Nurver; Koçak, Burak; PhD Student; Doctor; Doctor; Doctor; N/A; Faculty Member; Graduate School of Health Sciences; N/A; N/A; N/A; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 220671
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    Catastrophic ebv infection after cadaveric kidney transplantation
    (Lippincott Williams & Wilkins, 2022) Türkmen, Aydın; Yelken, Berna; Arpalı, Emre; Akyollu, Başak; Koçak, Burak; Doctor; Doctor; Doctor; Doctor; Faculty Member; School of Medicine; N/A; N/A; N/A; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; 220671
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    Implanting a robot-assisted kidney transplant program for asts trained transplant surgeons with no robotic surgery background.
    (Wiley, 2022) N/A; N/A; Koçak, Burak; Çelik, Neslihan; Arpalı, Emre; Akyollu, Başak; Kılıçer, Beşir; Canda, Abdullah Erdem; Kordan, Yakup; Faculty Member; PhD Student; Doctor; Doctor; Other; Faculty Member; Faculty Member; School of Medicine; Graduate School of Health Sciences; N/A; N/A; N/A; School of Medicine; School of Medicine; N/A; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; 220671; N/A; N/A; N/A; N/A; 116202; 157552
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    PublicationOpen Access
    Hand-assisted laparoscopic donor nephrectomy in kidneys with multiple renal arteries versus a single renal artery: an analysis of vascular complications from 1,350 cases
    (Aves, 2020) Günaydın, Bilal; Arpalı, Emre; Karataş, Cihan; Akyollu, Başak; Yaprak, Doğukan; Koçak, Burak; Faculty Member; Koç University Hospital
    Objective: laparoscopic donor nephrectomy (LDN) has been shown to be a safe approach with better morbidity results. Impact of multiple renal arteries (MRAs) and anatomical variations has been reviewed by many authors. In our study, the relationship between the donors with MRAs and risk of perioperative vascular complications related to donor nephrectomy was investigated. Material and methods: patients who underwent hand-assisted LDNs between January 2007 and February 2018 were reviewed retrospectively. Patient age, sex, body mass index (BMI), waist circumference, side of donor nephrectomies, donors with MRAs, intraoperative vascular complications, conversion rates, hospitalization durations, and operative times were extracted. Risk factors for perioperative vascular complications were defined. Results: there were MRAs in 288 kidney donors (21.3%). The number of patients who underwent a right donor nephrectomy was 113 (8.4%). BMI, waist circumference, and postoperative hospital stay were not significantly different between donors with one artery and those with MRAs (p>0.05). The renovascular complication rate and overall conversion rate to open surgery were significantly higher in donors with MRAs (p<0.05). Conclusion: perioperative safety of the kidney donors is of crucial importance. Surgeons performing LDNs must be aware of the potential risks. Our analysis suggests that procurement of kidneys from donors with MRAs is a risk factor for renovascular complications.