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Öğe Doppler ultrasound findings in kidney transplant recipients with and without of new onset diabetes mellitus beyond 5 years after transplantation(E-Century Publishing Corp, 2015) Boran, Mediha; Tola, Muharrem; Boran, Ertay; Boran, MertayObjective: Renal Doppler Ultrasound (RDU) indices: resistive index (RI) and pulsatility index (PI) are frequently applied as a noninvasive method that measured possible causes of allograft dysfunction in kidney transplant patients. We aimed to compare long-term prognosis and associated risk factors including the RDU markers in recipients with and without new-onset diabetes after transplantation (NODAT) beyond 5 years after kidney transplantation. Methods: A prospectively maintained database of 137 kidney allograft recipients, transplanted in a single center, maintained on reduced tacrolimus-based immunosuppressive regimen and angiotensin receptor blocker (ARB) was retrospectively analyzed. The assessment including incidence of NODAT and associated risk factors including RI and PI was compared between 12 recipients with and 125 recipients without NODAT median 77.5 months and 74 months, respectively, after kidney transplantation. Results: NODAT was detected in 12 (9.6%) of the 137 kidney transplant recipients, without gender predilection. In univariate regression analysis recipient age (P < 0.001), recipients weight at the time of NODAT >= 65 kg (P < 0.001), as well as proteinuria (P = 0.026), tacrolimus trough levels (P = 0.005), PI (P = 0.023) were associated with the long-term risk of NODAT and multivariate regression analysis also revealed that recipients weight at the time of NODAT = 65 kg (P = 0.004) was independent long-term risk factor for NODAT. Conclusions: Our study demonstrated that beyond 5 years after kidney transplantation the RDU indices: RI and PI are not long-term risk factors for NODAT and the correction of recipient's body weight, the treatment with ARB and maintained reduced TAC doses lowered the incidence of NODAT.Öğe HLA-Identical Sibling Renal Transplantation: Influence of Donor and Recipient Gender Mismatch on Long-term Outcomes(Elsevier Science Inc, 2014) Boran, Mediha; Boran, Mertay; Boran, ErtayBackground. Long-term function of living-related kidney allograft depends on multiple variables. The aim of the present study was to assess the influence of donor and recipient gender mismatch on the short and long-term outcomes in human leukocyte antigen (HLA)-identical sibling renal transplants (SRTs) receiving induction therapy and different immunosuppressive regimens. Material and Methods. Twenty-nine recipients who were grafted from their HLA-identical siblings between 1994 and 2008 were divided into 2 groups (same and mismatched) according to gender of donor and recipient. The analyzed variables were age, gender, cholesterol, triglyceride, proteinuria, estimated glomerular filtration rate, weight, body mass index, and serum creatinine at 6, 12, 24, 36, 48, and 60 months, and median follow-up. Univariate and multivariate logistic regression models (when appropriate) were used to evaluate the effects of variables on allograft survival. Results. The number of male donors (P = .001) and recipient age (P = .019) was significantly higher in the same gender group than in mismatched gender group; there were no relationships between remainder analyzed parameters. Multivariate regression analysis revealed that after median follow-up period of 84 months (range, 60-232) the most important potential factors to significantly influence long-term outcomes were male donor (P = .002), recipient age (P < .001), and donor age (P = .021). Conclusion. Our study demonstrated that male donor, and donor and recipient age affected long-term survival of HLA-identical SRTs, supported with antibody induction therapy and lifetime immunosuppression.Öğe Is the ABO Blood Group a Predictor of Renal Allograft Survival in ABO Identical Donor Recipients?(2021) Boran, Ertay; Boran, MedihaObjective: The effect of the ABO blood group on renal allograft survival (AS) is unclear. We assessed the influence of theABO blood group on AS and performed a comparative analysis of AS in kidney transplant recipients with different ABOblood groups.Methods: The 239 renal transplant recipients who underwent transplantation in a single center were stratified into the3 groups: blood group O (84, 35.14%), blood group A (104, 43.51%), and due to the low number of blood group AB patients,blood groups B and AB were classified as blood group B (51, 21.3%). Clinical outcomes and patient demographics wereinvestigated and compared between groups.Results: The AS of blood group O recipients was significantly longer than that of blood group B recipients (P = .001).Correlation analyses revealed that recipient age (P = .002), donor age (P = .013), creatinine level (P = .022), estimated glomerular filtration rate (eGFR) (P = .005), human leukocyte antigen (HLA) mismatches (P = .001), blood group O (P < .0001),blood group B (P < .0001), cyclosporine A (P < .0001), and sirolimus treatment (P = .032) were predictors of AS. Multivariateregression analyses indicated that blood group B (? = ?0.618, P < .0001) and cyclosporine A-based immunosuppression (?= ?0.924, P < .0001) were negative predictors of AS.Conclusion: The data presented here showed that eGFR, low recipient age, low donor age, patient gender (male), and3 HLA mismatches were correlated with long-term AS. In contrast, shorter AS was associated with the blood group B andcyclosporine A treatment.Öğe Late-Onset BK Viruria in Renal Transplant Recipients(Elsevier Science Inc, 2015) Boran, Mediha; Yıldırım, Tuğçe; Boran, Ertay; Boran, Mertay; Kılıç, H.Background. Most cases of BK virus (BKV) infections emerge within the 1st years of kidney transplantation. We aimed to determine the prevalence of late-onset BKV infection and whether there are any differences between risk factors in early and late BKV infections. Methods. In this single-center retrospective study, we reviewed 300 kidney transplant recipients that were under regular follow-up and selected recipients with BKV infection and recorded associated risk factors, connection with immunosuppression, and responses to modification of treatment. Results. BKV was detected within the 1st 5 years after transplantation in 20 patients (6.6%, group 1) and after 5 years in 15 patients (5.0%, group 2). There were no significant differences between the 2 groups regarding age, sex, sex mismatches, donor type, BKV elimination time, serum creatinine, and estimated glomerular filtration rate at the times of BKV detection and last follow-up visit. In group 1, 2 recipients had biopsy-proven BKV-associated nephropathy (BKVAN), 3 recipients had BK viruria and viremia without BKVAN (biopsy proven), and 15 recipients (75%) had only BK viruria. In group 2, all of the patients had only BK viruria. In this group, on detection of BK viruria and immediate modification of immunosuppressive regimens prevented BK viremia. Conclusions. Routine screening of renal transplant recipients for BKV was indicated not only during the 1st 5 years, but also for the full follow-up period after transplantation.Öğe Late-onset BK viruria in renal transplant recipients [conferenceObject](Lippincott Williams & Wilkins, 2016) Boran, Mediha; Yıldırım, Tolga; Boran, Ertay; Boran, Mertay…Öğe Renal Doppler Resistance Indices in Kidney Transplant Recipients With Proteinuria(Elsevier Science Inc, 2018) Boran, Mediha; Boran, Ertay; Tola, MuharremBackground. The onset of proteinuria in renal transplant recipients may be associated with an increased risk of allograft failure. Little is known about the relationships between factors influencing proteinuria and the Doppler ultrasound (DU) intrarenal resistive index (RI) and pulsatility index (PI) among donor recipients with proteinuria <1000 mg/24 h. Methods. We assessed correlations between the DU RI and PI and protein content in 93 selected renal transplant recipients: 62 patients with proteinuria 100 to 299 mg/24 h, 16 patients with proteinuria 300 to 499 mg/24 h, and 15 patients with proteinuria 500 to 999 mg/24 h. All patients underwent transplantation in a single center and were monitored by DU for at least 28 months post-transplantation. Results. The DU RI values of the proteinuria 100 to 299 mg/24 h, 300 to 499 mg/24 h, and 500 to 999 mg/24 h groups were 0.67 +/- 0.05; 0.65 +/- 0.04, and 0.64 +/- 0.07, respectively, and the P1 values were 1.21 +/- 0.20, 1.10 + 0.14, and 1.15 +/- 0.22, respectively. Multivariate logistic regression analysis revealed a correlation between group 100 to 299 mg/24 h and RI values, serum creatinine, living donor (R-2 = 19.6%, P = .05); group 300 to 499 mg/24 h and the RI, PI values, cadaver donor (R-2 = 17.5%, P = .001); and group 500 to 999 mg/24 h and the RI, PI values, serum creatinine, graft survival (R-2 = 15.4%, P = .005). Conclusions. Among donor recipients with proteinuria <1000 mg/24 h, DU RI values were <0.72 and PI values were <1.41 and correlations were revealed between the incidence of proteinuria and factors such as the RI, PI, and serum creatinine level.Öğe Renal Resistance Indices After Kidney Transplantation(Wiley-Blackwell, 2014) Boran, Mediha; Tola, Muharrem; Boran, Mertay; Boran, Ertay…Öğe Renal Resistance Indices After Kidney Transplantation.(Lippincott Williams & Wilkins, 2014) Boran, Mediha; Tola, Muharrem; Boran, Mertay; Boran, Ertay…
