Researcher:
Mecit, Nesimi

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Nesimi

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Mecit

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Mecit, Nesimi

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2019 - 201912020 - 20228

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Now showing 1 - 9 of 9
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    First laparoscopic donor hepatectomy cases of Turkey
    (Wiley, 2019) N/A; N/A; Karataş, Cihan; Alper, Aydın; Mecit, Nesimi; Kalayoğlu, Münci; Kanmaz, Turan; Doctor; Faculty Member; Doctor; Doctor; Faculty Member; N/A; School of Medicine; N/A; N/A; School of Medicine; Koç University Hospital; N/A; Koç University Hospital; Koç University Hospital; N/A; N/A; 119809; N/A; N/A; 275799
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    Association of graft to recipient weight ratio and outcomes of living and split donor liver transplantation in pediatric less than 20 kg
    (Wiley, 2021) N/A; N/A; N/A; N/A; N/A; N/A; Andaçoğlu, Oya Münevver; Karataş, Cihan; Baygül, Arzu Eden; Mecit, Nesimi; Kanmaz, Turan; Kalayoğlu, Münci; Doctor; Doctor; Faculty Member; Doctor; Faculty Member; Doctor; Koç University Hospital; N/A; N/A; 272290; N/A; 275799; N/A
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    Cardiac intervention before liver transplantation
    (Elsevier Science Inc, 2021) N/A; N/A; Imam, Ashraf; Karataş, Cihan; Mecit, Nesimi; Kalayoğlu, Münci; Kanmaz, Turan; Doctor; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; N/A; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 275799
    Background. Cardiovascular complication is one of the leading causes of mortality after liver transplantation (LT). Thus, a thorough cardiac evaluation is a must before proceeding to a liver transplant surgery. Percutaneous coronary intervention (PCI) with stent and to a lesser extent coronary artery bypass grafting (CABG) are both valuable treatment options for patients with coronary artery disease. Methods. A retrospective, single-center study that included patients who underwent cardiac intervention and subsequent LT for end-stage liver disease. All patients who had PCI or CABG were included in the study. Results. Twenty-nine adult patients out of 51 had a cardiac intervention before liver transplantation. Twenty-four patients had a diagnostic PCI, 3 patients had therapeutic PCI with stent, and 2 had failed PCI and proceeded to CABG before liver transplant. The mean age of the patients was 60.5 years. There were 24 men. All patients had cirrhosis. The 2 CABG cases were done during the same admission with a 13- and 18-day interval between the CABG and the transplantation. Both cases were live-related liver transplantation. No mortality was reported. Conclusion. In case of PCI failure, CABG may be a valuable and safe treatment option for cirrhotic patients as a preparation for liver transplantation. Live donor liver transplantation may be a good back-up for those patients in case they develop hepatic decompensation.
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    Three consequent pediatric liver transplant deaths in the COVID-19 era
    (Avicenna Organ Transplant Center, 2020) N/A; N/A; Imam, Ashraf; Karataş, Cihan; Imam, Riham; Armutlu, Ayşe; Mecit, Nesimi; Karakaya, Afak Durur; Kalayoğlu, Münci; Kanmaz, Turan; Doctor; Doctor; Other; Teaching Faculty; Doctor; Faculty Member; Doctor; Faculty Member; N/A; N/A; N/A; School of Medicine; N/A; School of Medicine; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; N/A; N/A; Koç University Hospital; N/A; Koç University Hospital; N/A; N/A; N/A; N/A; 133567; N/A; 269567; N/A; 275799
    The effect of COVID-19 on the transplant recipients is not well-established. Many reports underestimate the effect of COVID-19 on the immunosuppressed population. Herein, we report on 3 pediatric liver transplant recipients who were transplanted at our center between February 11 and March 10, 2020-during the COVID-19 pandemic era. The 3 patients aged between 5 and 10 months, had a rapid and aggressive respiratory deterioration that necessitated mechanical ventilation and extracorporeal life support; and eventually died. The clinical and pathological pictures likely represent COVID-19 pneumonia. Chest x-rays showed progressive infiltrates. Lung autopsies showed diffuse alveolar damage in two cases. We concluded that COVID-19 is very likely to have catastrophic effects on transplant recipients.
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    Using pericholedochal varix inflow for complete portal vein thrombosis in living donor liver transplantation: a case report
    (Elsevier Science Inc, 2022) N/A; N/A; N/A; N/A; N/A; Tırnova, İsmail; Karataş, Cihan; Mecit, Nesimi; Kanmaz, Turan; Kalayoğlu, Münci; Doctor; Doctor; Doctor; Faculty Member; Doctor; N/A; N/A; N/A; School of Medicine; N/A; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; 275799; N/A
    One of the crucial steps of liver transplantation is to provide the portal inflow. Portal vein throm-bosis is the most challenging factor to achieve. Using a pericholedochal varix for portal inflow in a patient with complete portal vein thrombosis in living donor liver transplantation (LDLT) is a rare technique. We present our experience of a LDLT with PVT.
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    PublicationOpen Access
    Are the criteria always right? Assessment of hepatocellular carcinoma cases in living donor liver transplantation at a high-volume center
    (TÜBİTAK, 2021) Yankol, Y.; Hoş, G.; Çakaloğlu, Y.; Acarlı, K. S.; Kanmaz, Turan; Mecit, Nesimi; Faculty Member; School of Medicine; Koç University Hospital
    Background/aim: with the increased experience in living donor liver transplantation (LDLT), it has been adopted for the treatment of hepatocellular carcinoma (HCC), with emerging discussions of criteria beyond tumor size and number. In contrast to deceased donor liver transplantation (DDLT), recipient selection for LDLT is not limited by organ allocation systems. We discuss herein the assessment, criteria, and experience with liver transplantation (LT) in HCC cases at a high-volume LDLT center. Material and methods: between August 2006 and December 2017, 191 adult LT HCC recipients with at least one-year follow-up were retrospectively analyzed. Results: in 191 patients, one-, three-and five-year survival rates were 87.2%, 81.6%, and 76.2%, respectively, including early postoperative mortality. In 174 patients with long-term follow-up, one-, three-and five-year disease-free survival rates were 91.6%, 87.7%, and 84.4%, respectively. When multivariate analysis was utilized, tumor differentiation was the only factor which statistically affected survival (p = 0.025). Conclusion: LDLT allows us to push the limits forward and the question ""Are the criteria always right?"" is always on the table. We can conclude that, with the advantage of LDLT, every HCC patient deserves a case-by-case basis discussion for LT under scientific literature support. In borderline cases, tumor biopsy might help determine the decision for LT.
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    PublicationOpen Access
    Anatomical variations of the hepatic artery: a closer view of rare unclassified variants
    (Via Medica Journals, 2021) Karataş, Cihan; Mecit, Nesimi; Karakaya, Afak Durur; Yıldırımoğlu, Turan; Kalayoğlu, Münci; Kanmaz, Turan; Faculty Member; Faculty Member; Koç University Hospital
    Background: defining the hepatic artery anatomy is of great importance for both surgeons and radiologists. Michel classification was designed to classify hepatic artery variations. Nevertheless, there are variations that do not fit into this classification. In this study, we aim to define the incidence of all variations in a healthy liver donor by reviewing their CT scan with special emphasis on variations that do not fit in any of the Michel classes. Materials and methods: a retrospective analysis of CT scan of donors and potential liver donors who were evaluated by triphasic CT scan. The CT scans were reviewed independently by a radiologist and two transplant surgeons. Cases that did not fit in any of the Michel classes were classified as class 0. Results: out of 241 donors, 210 were classified within the Michel classification, of which 60.9 % were class I and 9.1% class II. Thirty-one donors (12.9%) classified as class 0. Of which, nine, three, two and three had replaced right hepatic artery from pancreaticoduodenal artery, gastroduodenal artery, aorta and celiac artery, respectively. Two and 6 donors had accessory right hepatic artery from pancreaticoduodenal artery and gastroduodenal artery respectively. Segment 4 artery originated from left and right hepatic artery in 56.8% and 31.9%, respectively. Conclusions: a great caution should be taken when evaluating the hepatic artery anatomy, clinicians should anticipate and be familiar with the rare unclassified variations of the hepatic artery.
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    PublicationOpen Access
    Complications and outcomes of 890 living liver donor hepatectomies at a single center: risks of saving loved one's life
    (Bilimsel Tıp Yayınevi, 2020) Yankol, Yücel; Acarlı, Koray; Mecit, Nesimi; Kanmaz, Turan; Kalayoğlu, Münci; Faculty Member; Koç University Hospital
    Objective: living liver donor surgery is a major surgical procedure applied to healthy people with mortality and morbidity risks and does not provide any direct therapeutic advantage to the donor. We retrospectively analyzed the postoperative complication of our living liver donors to figure out the risks of donation. Material and methods: between November, 2006 and December, 2018, a total of 939 living liver donor hepatectomies were performed with no mortality to the living-related donors. Eight hundred and ninety donors with a minimum 1-year follow-up were analyzed retrospectively. Results: Of the 890 donors, 519 (58.3%) were males and 371 (41.7%) were females. Mean age was 35 years (18-64) and mean body mass index was 25.7 kg/m2(17.7-40). Right donor hepatectomy was performed to 601 (67.5%), left donor hepatectomy to 28 (3.2%) and left lateral sector hepatectomy to 261 (29.3%) of the donors. Of the 890 donors, 174 (19.5%) donors experienced a total of 204 early and late complications including life- threatening and nearly life- threatening complications in 26 (2.9%) of them. Intraoperative complication occurred in 4 (0.5%) donors. Right donors hepatectomy complication rate (23.3%) was higher than left donor (14.3%) and left lateral sector donor hepatectomy (11.5%). Conclusion: all donor candidates should be well-informed not only on the details of early and late complications of living liver donation, also possible outcomes of the recipient. In addition to detailed physical evaluation, preoperative psychosocial evaluation is also mandatory. Comprehensive donor evaluation, surgical experience, surgical technique, close postoperative follow-up and establishing a good dialog with the donor allows better outcomes. / Giriş ve amaç: canlı karaciğer verici ameliyatı tamamen sağlıklı bireylere uygulanan, vericinin doğrudan terapötik bir kazanç elde etmediği, ölüm ve ciddi komplikasyon riskleri taşıyan büyük bir cerrahi işlemdir. Bu çalışmamızda; canlı karaciğer vericisi olmanın riskini ortaya koymak amacıyla retrospektif olarak canlı karaciğer verici ameliyatı geçirmiş vericilerimizin ameliyat sonrası komplikasyonlarını ve sonuçlarını inceledik. Gereç ve yöntem: Kasım 2006-Aralık 2018 tarihleri arasında merkezimizde alıcısı ile yakınlık ilişkisi bulunan toplam 939 karaciğer vericisine, canlı karaciğer verici hepatektomisi mortalitesiz olarak gerçekleştirildi. Bu olgulardan minimum bir yıl takipli 890’ı retrospektif olarak incelendi. Bulgular: incelen 890 vericiden, 519 (%58,3)’u erkek, 371 (%41,7)’i kadındı. Ortalama yaş 35 (18-64) ve ortalama beden kütle indeksi 25,7 kg/m2 (17.7-40) idi. Canlı sağ verici hepatektomisi 601 (%67,5), sol verici hepatektomisi 28 (%3,2) ve verici sol lateral sektör hepatektomisi 261 (%29,3) vericide gerçekleştirilmiştir. Vericilerden 174 (%19,5)’ünde toplam 204 komplikasyon görülmüştür. Bunların 26 (%2,9)’sında hayatı tehdit edici komplikasyonlar gelişmiştir. Cerrahi işlem sırasında 4 (%0,5) vericide komplikasyon gelişmiştir. Canlı sağ verici hepatektomisinde (%23,3) komplikasyon oranları, sol (14,3%) ve sol lateral sektör hepatektomisine (%11,5) göre daha fazla gözlenmiştir. Sonuç: tüm verici adayları sadece verici ameliyatının detayları, erken ve geç komplikasyonları ile ilgili olarak değil ayrıca alıcının olası sonuçları hakkında da ayrıntılı olarak bilgilendirilmelidir. Ayrıntılı klinik muayene, tetkik ve değerlendirmelere ek olarak psiko-sosyal değerlendirme de kaçınılmazdır. Kapsamlı verici değerlendirilmesi, cerrahi deneyim ve teknik, yakın cerrahi sonrası takip, verici ve yakınları ile kurulacak iyi diyalog daha iyi sonuçları elde etmemizi sağlayacaktır.
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    PublicationOpen Access
    A comparison of rates and severity of chronic kidney disease in deceased-donor and living-donor liver transplant recipients: times matter
    (TÜBİTAK, 2021) Yankol, Yücel; Bugeaud, Emily; Zens, Tiffany; Rizzari, Michael; Leverson, Glen E.; Foley, David; Mezrich, Joshua D.; D'Alessandro, Anthony M.; Acarlı, Koray S.; Fernandez, Luis A.; Mecit, Nesimi; Kanmaz, Turan; Andaçoğlu, Oya Münevver; Kalayoğlu, Münci; Faculty Member; School of Medicine; Koç University Hospital
    Background/aim: the progression of chronic kidney disease (CKD) in recipients of living-donor liver transplant (LDLT) compared to deceased-donor liver transplant (DDLT) has not been studied in the literature. We hypothesize that CKD stage progression in LDLT recipients is reduced compared to that of their DDLT counterparts. Materials and methods: a retrospective study was undertaken including 999 adult, single-organ, primary liver transplant recipients (218 LDLT and 781 DDLT) at 2 centers between January 2003 and December 2012, in which CKD progression and regression were evaluated within the first 3 years after transplantation. Results: waiting time from evaluation to transplantation was significantly lower in LDLT patients compared to recipients of DDLT. CKD stage progression from preoperative transplant evaluation to transplantation was significantly greater in DDLT. Deceased-donor liver transplant recipients continued to have higher rates of clinically significant renal disease progression (from stage I-II to stage III-V) across multiple time points over the first 3 years posttransplant. Furthermore, a greater degree of CKD regression was observed in recipients of LDLT. Conclusion: it can be concluded that LDLT provides excellent graft and patient survival, significantly reducing the overall incidence of clinically significant CKD stage progression when compared to DDLT. Moreover, there is a significantly higher incidence of CKD stage regression in LDLT compared to DDLT. These observations were maintained in both high and low model for end-stage liver disease(MELD)populations. This observation likely reflects earlier access to transplantation in LDLT as one of the contributing factors to preventing CKD progression.