Predictors of Immediate Tracheal Extubation in the Operating Room After Pediatric Liver Transplantation.

Objectives: Pediatric orthotopic liver transplant recipients frequently need mechanical ventilation during the immediate posttransplant period. However, intensive care unit beds are costly and scarce; therefore, anticipating which patients will require postoperative mechanical ventilation support is important. In addition, immediate postoperative extubation may reduce the incidence of postoperative respiratory complications and improve patient outcomes after orthotopic liver transplant.

Distal Limb Reperfusion During Percutaneous Femoral Arterial Cannulation for Veno-Arterial Extracorporeal Membrane Oxygenation in an Adult Patient.

Ischemia and compartment syndrome may be seen, especially in the distal limb, after femora-femoral cannulation for extracorporeal membrane oxygenation (ECMO). Several techniques have been used to decrease the rate of complications. Arterial hypoxemia may be prevented by reperfusion with distal limb.

Risk Factors for Postoperative Prolonged Mechanical Ventilation After Pediatric Liver Transplantation.

Objectives: Duration of postoperative mechanical ventilation after pediatric liver transplant may influence pulmonary functions, and postoperative prolonged mechanical ventilation is associated with higher morbidity and mortality. Here, we determined its incidence and risk factors after pediatric liver transplant at our center.

Materials And Methods: We retrospectively analyzed the records of 121 children who underwent liver transplant between April 2007 and April 2017 (305 total liver transplant procedures were performed during this period).

Early Postoperative Acute Kidney Injury Among Pediatric Liver Transplant Recipients.

Objectives: Acute kidney injury after pediatric liver transplant is associated with increased morbidity and mortality. Here, we evaluated children with acute kidney injury early posttransplant using KDIGO criteria to determine incidence, risk factors, and clinical outcomes.

Materials And Methods: In this retrospective cohort study, medical records of all patients < 16 years old who underwent liver transplant from April 2007 to April 2017 were reviewed.

Immediate Tracheal Extubation After Pediatric Liver Transplantation.

Objectives: We examined whether immediate tracheal extubation among pediatric liver transplant recipients was safe and feasible.

Materials And Methods: We retrospectively analyzed medical records of pediatric liver transplant recipients at Baskent University Hospital from January 2012 to December 2017. We grouped children who were extubated in the operating room versus those extubated in the intensive care unit.

Incidence and Patient Outcomes in Renal Replacement Therapy After Orthotopic Liver Transplant.

Objectives: Our objective was to evaluate the incidence of renal replacement therapy after orthotopic liver transplant and to evaluate and analyze patient outcomes.

Materials And Methods: We performed a retrospective analysis of 177 consecutive patients at a tertiary care unit who underwent orthotopic liver transplant between January 2010 and June 2016. Patients who were admitted to the intensive care unit after orthotopic liver transplant and who required renal replacement therapy were included.

Perioperative Venoarterial Extracorporeal Membrane Oxygenation Support During Heart Transplant.

Objectives: Heart transplant is the only definitive treatment of end-stage heart failure. Venoarterial extracorporeal membrane oxygenation may be used as a bridge to heart transplant. This technique may be used after heart transplant for conditions refractory to medical treatment like primary graft failure.

Effect of Graft Weight to Recipient Body Weight Ratio on Hemodynamic and Metabolic Parameters in Pediatric Liver Transplant: A Retrospective Analysis.

Objectives: To analyze how graft-weight-to-bodyweight ratio in pediatric liver transplant affects intraoperative and early postoperative hemodynamic and metabolic parameters.

Materials And Methods: We reviewed data from 130 children who underwent liver transplant between 2005 and 2015. Recipients were divided into 2 groups: those with a graft weight to body weight ratio > 4% (large for size) and those with a ratio ≤ 4% (normal for size).

Venoarterial Extracorporeal Membrane Oxygenation Support as a Bridge to Heart Transplant: Report of 3 Cases.

Heart transplant is the only definitive treatment of end-stage heart failure. Venoarterial extracorporeal membrane oxygenation may be used as a bridge to heart transplant. Among 31 patients who underwent heart transplant between January 2014 and June 2016, we present our experiences with 3 patients who received venoarterial extracorporeal support as a bridge to heart transplant.

Decompression of Left Ventricle During Venoarterial Extracorporeal Membrane Oxygenation Support as a Step to Transplant.

Objectives: Left ventricular distention can be recognized during the use of venoarterial extracorporeal membrane oxygenation as a key complication. Left ventricular decompression may decrease pulmonary pressure, minimize ventricular distention, and allow myocardial recovery.

Materials And Methods: We applied venoarterial extracorporeal membrane oxygenation to 4 patients while on a wait list for cardiac transplant.

A Randomized Controlled Comparison of the Internal Jugular Vein and the Subclavian Vein as Access Sites for Central Venous Catheterization in Pediatric Cardiac Surgery.

Objectives: To compare internal jugular vein and subclavian vein access for central venous catheterization in terms of success rate and complications.

Design: A 1:1 randomized controlled trial.

Setting: Baskent University Medical Center.

Neurologic Complications After Cardiac Transplant.

Objectives: Cardiac transplant is the best available therapy for patients with end-stage heart failure. Neurologic complications occur at a rate of 30% to 70% in patients undergoing cardiac transplant, and they affect mortality and morbidity of these patients. Risk factors for neurologic complications include immunosuppressive medication toxicity, infections, brain lesions, and metabolic disorders.

Rituximab Therapy for Rejection in Pediatric Heart Transplant.

Objectives: Humoral rejection is the B-cell-mediated production of immunoglobulin G antibody against the transplanted heart. Antibody-mediated rejection may be resistant to standard immunosuppressive therapy and is associated with high mortality and graft loss. Rituximab can be used to treat antibody-mediated rejection in heart transplant recipients.

Perioperative Characteristics of Siblings Undergoing Liver or Kidney Transplant.

Objectives: Reasons for chronic liver and kidney failure may vary; sometimes more than 1 family member may be affected, and may require a transplant. The aim of this study was to examine the similarities or differences between the perioperative characteristics of siblings undergoing liver or kidney transplant.

Materials And Methods: The medical records of 6 pairs of siblings who underwent liver transplant and 4 pairs of siblings who underwent kidney transplant at Baskent University Hospital between 1989 and 2014 were retrospectively analyzed.

Percutaneous Dilational Tracheotomy in Solid-Organ Transplant Recipients.

Objectives: Solid-organ transplant recipients may require percutaneous dilational tracheotomy because of prolonged mechanical ventilation or airway issues, but data regarding its safety and effectiveness in solid-organ transplant recipients are scarce. Here, we evaluated the safety, effectiveness, and benefits in terms of lung mechanics, complications, and patient comfort of percutaneous dilational tracheotomy in solid-organ transplant recipients.

Materials And Methods: Medical records from 31 solid-organ transplant recipients (median age of 41.

Acute Respiratory Failure in Renal Transplant Recipients: A Single Intensive Care Unit Experience.

Objectives: Frequency of pulmonary complications after renal transplant has been reported to range from 3% to 17%. The objective of this study was to evaluate renal transplant recipients admitted to an intensive care unit to identify incidence and cause of acute respiratory failure in the postoperative period and compare clinical features and outcomes between those with and without acute respiratory failure.

Materials And Methods: We retrospectively screened the data of 540 consecutive adult renal transplant recipients who received their grafts at a single transplant center and included those patients admitted to an intensive care unit during this period for this study.

Acute Respiratory Failure in Cardiac Transplant Recipients.

Objectives: This study sought to evaluate the incidence, risk factors, and outcomes of acute respiratory failure in cardiac transplant recipients.

Materials And Methods: Cardiac transplant recipients >15 years of age and readmitted to the intensive care unit after cardiac transplant between 2005 and 2015 were included.

Results: Thirty-nine patients were included in the final analyses.

Late Intensive Care Unit Admission in Liver Transplant Recipients: 10-Year Experience.

Objectives: We evaluated late intensive care unit admission in liver transplant recipients to identify incidences and causes of acute respiratory failure in the postoperative period and to compare these results with results in patients who did not have acute respiratory failure.

Materials And Methods: We retrospectively screened the data of 173 consecutive adult liver transplant recipients from January 2005 through March 2015 to identify patients with late admission (> 30 d posttransplant) to an intensive care unit. Patients were divided into 2 groups: patients with and without acute respiratory failure.

Early postoperative pulmonary complications after heart transplantation.

Objective: The aim of this study was to determine the types, incidence, and risk factors for early postoperative pulmonary complications in heart transplant recipients.

Methods: We retrospectively collected data from the records of consecutive heart transplantations from January 2003 to December 2013. A total of 83 patients underwent heart transplantation.

Postoperative effects of intraoperative hyperglycemia in liver transplant patients.

Objectives: The aim of this study was to determine the effects of intraoperative hyperglycemia on postoperative outcomes in orthotopic liver transplant recipients.

Materials And Methods: After ethics committee approval was obtained, we retrospectively analyzed the records of patients who underwent orthotopic liver transplant from January 2000 to December 2013. A total 389 orthotopic liver transplants were performed in our center, but patients aged < 15 years (179 patients) were not included in the analyses.

Accuracy of continuous noninvasive arterial pressure monitoring in living-liver donors during transplantation.

Objectives: Hemodynamic monitoring is vital during liver transplant surgeries because distinct hemodynamic changes are expected. The continuous noninvasive arterial pressure (CNAP) monitor is a noninvasive device for continuous arterial pressure measurement by a tonometric method. This study compared continuous noninvasive arterial pressure monitoring with invasive direct arterial pressure monitoring in living-liver donors during transplant.

Anesthetic management in pediatric orthotopic liver transplant for fulminant hepatic failure and end-stage liver disease.

Objectives: We assessed the anesthetic management and short-term morbidity and mortality in pediatrics patients who underwent an orthotopic liver transplant for fulminant hepatic failure or end-stage liver disease in a university hospital.

Material And Methods: We retrospectively analyzed the records of children who underwent orthotopic liver transplant from May 2002 to May 2012. Patients were categorized into 2 groups: group fulminant hepatic failure (n=22) and group end-stage liver disease (n=19).

Early-onset posterior reversible encephalopathy syndrome after solid organ transplantation in pediatric patients: a report of 2 cases.

Posterior reversible encephalopathy syndrome (PRES) is a neurological disturbance that occurs due to different reasons and presents with different clinical symptoms. It can be a devastating situation, but, timely treatment may lead to complete recovery. We report 2 cases of PRES, which developed and fully recovered in the early period after solid organ transplantation in pediatric patients.

RIFLE criteria for acute kidney dysfunction following heart transplantation: incidence and risk factors.

Background And Purpose: There are few data regarding the occurrence of (RIFLE)-based acute kidney dysfunction (AKD) after heart transplantation (HT) and its risk factors. The aim of this study was to apply RIFLE criteria in patients who developed AKD following HT to compare patients with and without AKD and to determine incidence and risk factors of AKD.

Patients And Methods: We retrospectively analyzed the records of 65 patients who underwent HT between 2003 and 2012.