Researcher: Demir, Barış
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Demir, Barış
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Publication Metadata only Patient with hemophilia a undergoing consecutive coronary bypass and live donor liver transplantation: a case report(Elsevier Science Inc, 2021) N/A; N/A; Karataş, Cihan; Alim, Altan; Tırnova, İsmail; Demir, Barış; 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; 275800Liver transplantation surgery due to cirrhosis in patients with hemophilia is rare and there are limited cases in the literature. We present a case of a patient with hemophilia A who underwent 2 consecutive surgeries owing to coronary artery disease and cryptogenic cirrhosis with hepatocel-lular carcinoma. After these surgeries, no bleeding or other complications were seen, and the fac-tor VIII levels have not changed since liver transplantation in the follow-up.Publication Metadata only Posterior reversible encephalopathy syndrome in a five-year-old child: a case report(Elsevier, 2019) Acar, Şencan; Kavlak, Mustafa Emre; Özkan, Perihan; Polat, Kamil Yalçın; Akyıldız, Murat; N/A; N/A; Demir, Barış; Arıkan, Çiğdem; Doctor; Faculty Member; School of Medicine; School of Medicine; Koç University Hospital; N/A; 240198Posterior reversible encephalopathy syndrome (PRES) is a neuroradiologic syndrome. The etiology of PRES is still unclear. Some factors were described. We present a case of a pediatric patient with liver transplant who developed PRES following blood transfusion while receiving tacrolimus therapy. A 51/2-year-old boy who underwent living donor liver transplantation, and PRES developed on the sixth day post transplant under tacrolimus treatment after 6 hours of red blood transfusion. PRES is a rare condition; it should be kept in mind about patients who have received organ transplants and develop sudden neurologic symptoms.Publication Metadata only Hepatic artery intimal dissection during living donor liver transplantation: a new modified approach(Elsevier Inc., 2023) Karataş, Cihan; Alim, Altan; Tırnova, İsmail; Demir, Barış; Akbulut, Akın; Kanmaz, Turan; Doctor; Doctor; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; N/A; N/A; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 275799Ensuring optimal arterial flow in solid organ transplantation is very important. Insufficient flow causes important problems such as bile duct problems, intrahepatic abscess formation, and organ loss. Arterial intimal dissection is an important factor that negatively affects organ blood flow. In this study, hepatic artery dissections that we detected in patients who underwent living donor liver transplantation in our clinic were defined, and the microvascular intima-adventitial fixation technique, which can be considered a new approach, was described.Publication Metadata only Split liver transplant from deceased marginal donor: a case report(Elsevier Science Inc, 2022) N/A; N/A; Karataş, Cihan; Alim, Altan; Yıldırımoğlu, Turan; Tırnova, İsmail; Demir, Barış; Akbulut, Akın; Kanmaz, Turan; Doctor: Doctor; Other; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; N/A; N/A; N/A; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; N/A; 275800The relative paucity of deceased donor organs and the progressive increase in patients with cirrhosis have led transplant centers to consider organs from marginal donors (elderly donors, prolonged stay in the intensive care unit (ICU), liver steatosis-steatotic grafts, severe hypernatremia, and use of inotropes). Recently, the use of those marginal grafts has increased, but splitting liver is still debatable.Herein, we present a 28-year-old deceased donor who had a history of traumatic brain injury. The patient stayed in ICU for 3 days with high sodium level (188 mEq/L) and was hemodynamically supported with single inotrope. At the time of procurement, core biopsies were taken from the right lobe and left lateral segment of the liver, with results demonstrating 5% necrosis. A decision was made for split liver transplant as left lateral sector and extended right lobe.Liver graft was divided into a left lateral segment to be transplanted to a 4-year-old child with secondary biliary cirrhosis due to previous liver transplant and a right extended liver lobe for an adult patient with hepatocellular carcinoma waiting 10 months on the waiting list. Both liver transplants were performed uneventfully. Patients were discharged on the 11th and 56th days after transplant. The liver function tests remained normal during the follow up period of 2 years. A marginal graft with more than one risk factor should not be discarded liberally. Splitting such grafts could be considered in a highly selective recipients.Publication Metadata only Using O-Arm (TM) cholangiography in living donor liver transplantation(Lippincott Williams & Wilkins, 2022) Hoş, Gültekin; N/A; Karataş, Cihan; Alim, Altan; Yalçın, Ali Bektaş; Demir, Barış; Tırnova, İsmail; Akbulut, Akın; Alper, Aydın; Kanmaz, Turan; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Faculty Member; Faculty Member; N/A; N/A; N/A; N/A; N/A; N/A; School of Medicine; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; 119809; 275799N/APublication Metadata only Course of vitamin D levels before and after liver transplantation in pediatric patients(Wiley, 2021) N/A; N/A; N/A; N/A; N/A; N/A; Yüksel, Muhammed; Demir, Barış; Mızıkoğlu, Özlem; Akyıldız, Murat; Baygül, Arzu Eden; Arıkan, Çiğdem; Researcher; Doctor; Researcher; Faculty Member; Faculty Member; Faculty Member; Koç University Research Center for Translational Medicine (KUTTAM) / Koç Üniversitesi Translasyonel Tıp Araştırma Merkezi (KUTTAM); N/A; N/A; N/A; School of Medicine; School of Medicine; School of Medicine; Koç University Hospital; N/A; N/A; N/A; 123080; 272290; 240198Background: 25-hydroxy VD insufficiency is known in children undergoing LT but the serial post-transplant VD course and supplementation modalities in the peri-transplant period are lacking. We aimed to determine the pre-VD status and the post-transplant VD status course following VD supplementation and to elucidate its relationship with post-transplant outcome parameters such as infection and survival. Methods: Pre- and post-VD levels were monitored in parallel with interventions to adjust VD levels in LT patients. VD status was categorized as circulating levels <30–21 ng/ml (insufficiency), 20–10 ng/ml (deficiency), and <10 ng/ml (severe deficiency). Patients received stoss (300000IU) VD3 within the pretransplant period if serum levels were <20 ng/ml. Results: 135 transplanted children were included. The age at LT was 22 months (IQR: 8–60). The pretransplant median VD level was 14 ng/ml. Despite stoss dose, post-transplant median VD level was 1.8 ng/ml (day one), 4 ng/ml (week one), 19 ng/ml (month one), 33 ng/ml (month three), 38 ng/ml (months 6–12), and 40 ng/ml (month 24). After 6 months, VD status reached >30 ng/ml in 98% of patients. Only at pre-LT, higher infection rate (18.7%) in the severe VD deficiency group was observed compared to the VD deficiency group (2.9%, p = .04). Survival was not affected by serum VD levels. Conclusion: VD levels fell substantially after LT but are rectifiable by stoss dose, which was well tolerated. Only the infection rate was associated with the VD status.Publication Metadata only Urgent liver transplantation from deceased donor with a calcified hydatid cyst: a case report(Elsevier Science Inc, 2022) N/A; N/A; Karataş, Cihan; Alim, Altan; Tırnova, İsmail; Akbulut, Akın; Demir, Barış; Kanmaz, Turan; Doctor; Doctor; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; N/A; N/A; N/A; School of Medicine; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; 275799Liver transplantation is the final treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The large gap between the growing list of patients awaiting liver transplantation and the scarcity of donor organs has fueled efforts to maximize the existing donor pool and identify new avenues. We treated a 13-year-old boy who had acute liver failure, due to Wilson's disease, with transplantation of a liver from a deceased liver donor with a calcified hydatid cyst. After 3 years of follow-up, liver function tests remained normal, hydatid cyst serology was negative, and no hydatid cyst or other problems were observed.Publication Metadata only Evaluation of pulmonary arterial stiffness and comparison with right ventricular functions in patients with cirrhosis preparing for liver transplantation(Wiley, 2022) Elçioğlu, Betül Cengiz; Baydar, Onur; Helvacı, Füsun; Karataş, Cihan; Aslan, Gamze; Kılıç, Alparslan; Tefik, Nihal; Demir, Barış; Gürsoy, Erol; Demirci, Yasemin; Ural, Dilek; Kanmaz, Turan; Aytekin, Vedat; Aytekin, Saide; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Doctor; Faculty Member; Faculty Member; Faculty Member; Doctor; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; N/A; N/A; N/A; NA; N/A; N/A; 1057; 275799; 140946; N/AObjective Pulmonary complications are common in patients with liver cirrhosis. Devolopment of pulmonary hypertension (PH) is associated with a poor prognosis in these patients. Pulmonary arterial stiffness (PAS) is considered an early sign of pulmonary vascular remodeling. The aim of this study is to investigate PAS and compare it with right ventricular (RV) functions in patients with cirrhosis who are scheduled for liver transplantation. Methods The study included 52 cirrhosis patients (mean age 51.01 +/- 12.18 years, male gender 76.9%) who were prepared for liver transplantation and 59 age and sex matched (mean age 51.28 +/- 13.63 years, male gender 62.7%) healthy individuals. Patients with left ventricular ejection fraction (LVEF) less than 55%, ischemic heart disease, more than mild valvular heart disease, chronic pulmonary disease, congenital heart disease, rheumatic disease, moderate to high echocardiographic PH probability, rhythm or conduction disorders on electrocardiography were excluded from the study. In addition to conventional echocardiographic parameters, PAS value, pulmonary vascular resistance (PVR) and RV ejection efficiency was calculated by the related formulas with transthoracic echocardiography (TTE). Results Demographic characteristics and cardiovascular risk factors of the groups were similar. PAS, PVR, and sPAP values were found to be significantly higher in the patient group (20.52 +/- 6.52 and 13.73 +/- 2.05; 1.43 +/- 0.15 and 1.27 +/- 0.14; 27.69 +/- 3.91 and 23.37 +/- 3.81 p < 0.001, respectively). RV FAC and RV Ee were significantly lower and RV MPI was significantly higher in the patient group (45.31 +/- 3.85 and 49.66 +/- 3.62, p < 0.001; 1.69 +/- 0.35 and 1.85 +/- 0.23, p = 0.005; 0.39 +/- 0.07 and 0.33 +/- 0.09, p = 0.001, respectively). PAS was significantly correlated with RV FAC and MPI (r = -0.423, p < 0.001; r = 0.301, p = 0.001, respectively). Conclusions Increased PAS in cirrhosis patients may be associated with early pulmonary vascular involvement. Evaluation of RV functions is important to determine the prognosis in these patients. FAC, MPI, and RV Ee measurements instead of TAPSE or RV S ' may be more useful in demonstrating subclinical dysfunction. The correlation of PAS with RV FAC and MPI may indicate that RV subclinical dysfunction is associated with early pulmonary vascular remodeling in patients with liver cirrhosis.Publication Metadata only Liver transplantation for congenital metabolic disorders(İstanbul Üniversitesi, 2022) N/A; N/A; N/A; N/A; N/A; N/A; Alim, Altan; Tırnova, İsmail; Karataş, Cihan; Akbulut, Akın; Demir, Barış; Kanmaz, Turan; Doctor; Doctor; Doctor; Doctor; Doctor; Faculty Member; N/A; N/A; N/A; N/A; N/A; School of Medicine; Koç University Hospital; N/A; N/A; N/A; N/A; N/A; 275799Objective: The aim of the study is to identify the indications for and the outcomes of liver transplantation in congenital metabolic diseases. Methods: Indications, survival, and complications of liver transplantation performed between July 2018 and September 2021 for congenital metabolic diseases were examined. Demographic information of patients, liver graft types, and donor information were included in the analysis. Results: A total of 23 liver transplants were performed in 22 patients with a mean age of 7.3 ± 9.3 and a mean weight of 23.6 ± 21.7. The types and frequencies of liver grafts used for transplantation in this analysis include 18 left lateral sectors, 1 left lobe, 3 right lobes, and 1 deceased full-size liver. Two of the left lateral sectors were retrieved from deceased split liver grafts. Mortality was observed in 2 patients (9%), 1 in the early and the second in the late postoperative period. Excluding the 2 fatalities, 3 patients required reoperation due to issues with blood flow through the portal vein. Due to hepatic artery thrombosis, 1 patient required stent placement. Biliary tract complications developed in 5 (22%) patients with dilatation and stenting being performed by interventional radiology. The surviving patients (91%) had an uneventful postoperative course after discharge from the hospital. Conclusion: Liver transplantation is increasingly used either as a definitive treatment method or to improve the course of the disease for metabolic diseases. With the high survival rates, reduction in the frequency of attacks, improved effects on growth, development, and nutrition, it is clear that liver transplantation is a valuable tool for use in congenital metabolic disorders. Examining appropriate patient selection and ideal timing for transplantation remain important issues for further examination.