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2003-2011 Yılları Arasında Meram Tıp Fakültesi Organ Nakli Merkezinde Yapılan Böbrek Nakli Olgularının Sonuçları

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Renal Transplant Results of the Organ Transplant Center of Meram Medical School Between 2003-2011

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Sayfa Aralığı:: 
34-44

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Abstract (Original Language): 
AMA Ç: Son dönem böbrek yetmezliği (SDBY) hastalarında en iyi tedavi şekli böbrek naklidir. Çalışmamızda, son 8 yılda merkezimizde kadavra ve canlıdan yapılan böbrek nakillerinin(BN) demografik verileri ile birlikte böbrek fonksiyonları ve posttransplant medikal komplikasyonları, hastagraft sağkalımını araştırmayı hedefledik. GEREÇ ve YÖN TEML ER: Çalışmaya 40’ı kadavradan, 26’sı canlıdan BN yapılan 66 hasta (kadın/ erkek: 36/30) dahil edildi. Nakil sonrası nefroloji polikliniğine başvurularda yaş, cinsiyet, böbrek yetmezliği nedeni, diyaliz türü-süresi, nakil türü, aldıkları indüksiyon tedavileri, kullandığı idame immünsupresif tedaviler, akut rejeksiyon sayısı ve verilen tedaviler, nakil sonrası 1., 6., 12., 24. ve 60. aylardaki biyokimya-hemogram parametreleri ve medikal komplikasyonlar hasta dosyalarından retrospektif olarak elde edildi. BUL GULA R: Alıcıların ortalama yaşı 41±11,6 yıldı. Ortalama nakil sonrası süre 32,2±31,4 ay, kreatinin değerleri 1,4±0,9 mg/dl tespit edildi. En sık uygulanan immünsüpresif tedavi protokolü ko rtikosteroid+takrolimus+mikofenolat mofetil/sodyumdu. Gecikmiş graft fonksiyonu, kronik allograft disfonksiyonu ve akut rejeksiyon oranları sırasıyla %27,3, %25,7 ve %13,6 idi. 1 ve 5 yıllık hasta sağkalımı canlıdan yapılan BN’lerinde sırasıyla %100 ve %100, kadavradan yapılan BN’lerinde ise %85 ve %85 olarak bulundu. 1 ve 5 yıllık graft sağkalımı canlıdan BN yapılanlarda sırasıyla %100 ve %100, kadavradan BN yapılanlarda ise %80 ve %80 olarak saptandı. En sık görülen medikal komplikasyonlar yeni gelişen diyabet ve dislipidemiydi. Erken ve geç dönemde en sık karşılaşılan enfeksiyon idrar yolu enfeksiyonuydu. SONU Ç: BN, hasta-graft sağkalımının yüksek olduğu bir renal replasman tedavi seçeneğidir. Bununla birlikte metabolik komplikasyonlar açısından yakın takip gereklidir.
Abstract (2. Language): 
OBJECTIVE: Renal transplantation (RTx) is the best therapeutic modality for end-stage renal disease patients. We report 8 years single-centre experience on cadaveric and living donor RTx in terms of demographic features along with graft functions, posttransplant medical complications, patients-graft survivals. MA TERIAL and M ETHODS: We enrolled 66 RTx (female/male: 36/30) patients including 40 cadaveric and 26 living donors. At admission age, gender, causes of renal failure, dialysis typeduration, type of RTx, induction and maintenance immunosuppressive modalities, rejection episodes, biochemistry-hemogram parameters at 1, 6, 12, 24 and 60 months after transplantation and medical complications were obtained from the medical records. RESUL TS: Mean recipient age was 41±11.6 years. Mean transplant duration was 32.2±31.4 months, and the mean creatinine values was 1.4±0.9 mg/dl. The most commonly used immunosuppressive protocol was corticosteroid+tacrolimus+mycophenolate mofetil. Delayed graft function, chronic allograft nephropathy and acute rejection were observed in 27.3%, 25.7% and 13.6% of patients, respectively. 1- and 5-year patient survival rates were 100% and 100% for living donor patients and 85% and 85% for cadaveric patients, respectively. 1- and 5-year graft survival rates were 100% and 100% for living donor RTx patients, and 80% and 80% for cadaveric RTx patients, respectively. The most common medical complications were new onset diabetes mellitus and dyslipidemia. The most common early and late infection was urinary tract infection. CONCLU SION: RTx is the best renal replacement therapy in terms of patient-graft survival. However, patients should be closely moniterized for metabolic complications.

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DOI: 
DOI 10.5262/tndt.2013.1001.05

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