Browsing by Author "Huseynov, Amil"

Now showing 1 - 8 of 8

Comparison of Domino Transplantation with Two-Way Paired Exchange and Normal Transplantation: Acute Rejection, Surgical Complications, and 5-Year Survival Outcomes
(Springer, 2025) Huseynov, Amil; Cicek, Sevim Nuran Kuslu
Background Domino kidney paired donation and Two-Way Paired Exchange have emerged as vital strategies to expand the donor pool in renal transplantation, especially for patients facing ABO or HLA incompatibilities. Despite their potential benefits, concerns remain regarding immunological risks, infectious complications, and long-term graft survival. Methods In this retrospective cohort study conducted at Medicana Transplant Center, 980 adult kidney transplant recipients were categorized into three groups: Domino (n = 144), Two-Way Paired Exchange (n = 350), and Normal Transplant (n = 486). Baseline characteristics, acute rejection rates, and surgical or infectious complications were collected, alongside data on 1-year and 5-year patient and graft survival. Statistical analysis included Kaplan-Meier survival curves and Cox proportional hazards modeling for independent predictors of graft outcomes. Results The Domino group had the highest 1-year acute rejection rate (17.4%) compared to Two-Way Paired Exchange (4.3%) and Normal Transplant (3.7%), yet 1-year graft survival rates remained comparable (92%, 95%, and 96%, respectively; p = 0.271). Infectious complications were more frequent in the Domino group (25%) than in others (p < 0.01). Extended follow-up to 5 years indicated no statistically significant difference in overall graft or patient survival among the three groups (log-rank p = 0.197), despite a trend toward lower 5-year graft survival in the Domino group. Donor-specific antibodies and higher HLA mismatches independently predicted acute rejection. Conclusions Domino transplantation, while associated with higher immunologic challenges, achieves acceptable short-term and 5-year outcomes akin to Two-Way Paired Exchange and Normal Transplant. Careful immunosuppressive strategies, vigilant monitoring, and collaborative protocols are integral for optimizing long-term success in high-risk transplant scenarios.
Effect of Multi-Artery Renal Grafts on Patient Outcomes in Living Donor Kidney Transplantation
(Springer, 2025) Huseynov, Amil; Sengul, Halil
BackgroundMultiple renal arteries (MRA) in a donor kidney can increase surgical complexity in living donor kidney transplantation. However, the impact of MRA on early transplant outcomes, including delayed graft function (DGF) and early graft failure, remains unclear.MethodsWe performed a single-center retrospective cohort study of 1,200 living donor kidney transplants conducted between 2019 and 2024. Donor kidneys were classified as having a single renal artery or multiple renal arteries (two or more). Recipient and donor characteristics, intraoperative details (ischemia times, vascular anastomosis technique), and postoperative outcomes (delayed graft function [DGF], primary nonfunction, and graft survival) were compared between the two groups. Logistic regression analyses were used to examine associations between MRA and the risk of DGF or graft failure within the first 90 days, both before and after adjusting for prespecified covariates.ResultsOf the 1,200 transplanted kidneys, 882 (73.5%) had a single artery and 318 (26.5%) had multiple arteries. Although the median cold-ischemia time was longer for multi-artery grafts (35.2 min vs. 29.4 min, p = 0.004), there were no significant differences in donor or recipient baseline characteristics. Multivariable logistic regression revealed no significant association between MRA and either DGF or early graft loss. Kaplan-Meier curves, censored for death, demonstrated similar graft survival in both groups (log-rank p = 0.25).ConclusionsIn this single-center cohort of living donor kidney transplants, grafts with multiple renal arteries did not exhibit an elevated risk of DGF or early graft loss. While additional surgical complexity is often required for MRA grafts, our findings suggest that these kidneys remain a safe and effective option for transplantation, supporting their broader use to expand the donor pool.
Factors Affecting the Presence of Renal Cortical Cysts in Kidney Donors
(Aves, 2024) Cicek, Sevim Nuran Kuslu; Huseynov, Amil
Objective: Simple renal cysts (SRCs) represent the most frequently occurring type of renal cysts, frequently observed in the elderly population. While generally considered benign, SRCs may sometimes be connected to comorbid conditions such as hypertension, aortic diseases, and renal dysfunction. This research aims to investigate the factors influencing the development of SRCs in kidney donors and the associated risks. Methods: This retrospective cohort study included 1012 living kidney donors, aged 18-87 years, who underwent renal transplant donor nephrectomy between 2008 and 2023. Data on demographic information, cyst characteristics, comorbidities, and associated risk factors were collected and analyzed using statistical methods, including Binary Logistic Regression Analysis. Renal cysts were identified and classified using computed tomography (CT) and magnetic resonance imaging (MRI) methods. Results: Renal cortical cysts were more frequently observed in males (52.76%) compared to females (47.24%), with a significant difference (P = .031). Donors with renal cortical cysts were significantly older (mean age 54.43 +/- 12.17 years) compared to those without cysts (46.26 +/- 12.35 years, P < .001). Substantial differences were likewise noted in fasting blood glucose, uric acid, creatinine, HbA1c, and glomerular filtration rate (GFR).The prevalence of aortic atherosclerosis was notably elevated in donors with cysts (47.74%) compared to those without (23.57%, P < .001). Binary logistic regression analysis indicated that older age and being male were significant factors influencing the presence of cortical cysts. Conclusion: The study confirms that SRCs are the most common renal cyst type and are more frequently observed in the elderly population. While generally benign, SRCs may be associated with increased uric acid levels and other comorbidities, suggesting potential impacts on kidney health. Additional studies are required to investigate these associations. The presence of SRCs in kidney donors is significantly associated with male gender, age, uric acid levels, and creatinine levels. These findings should be considered during the evaluation of potential kidney donors, particularly regarding the associated risks and management of SRCs.
Factors Influencing Fistula Formation Following Perianal Abscess Treatment
(2025) Huseynov, Amil; Çiçek, Sevim Nuran Kuşlu
Objectives: Perianal abscesses are frequently encountered in clinical practice and are primarily attributed to a cryptoglandular origin. Despite prompt incision and drainage, a subset of patients still develop anal fistulas. This study aims to identify risk factors associated with fistula formation after perianal abscess management. Methods: A total of 145 patients (64 females, 81 males) with perianal abscess were retrospectively reviewed between 2020 and 2024. All underwent urgent incision and drainage under anesthesia. Demographic characteristics, comorbidities, type of surgical intervention, and postoperative outcomes were analyzed. Postoperative complications were assessed at both early (≤30 days) and late (>30 days) time points. Univariate and logistic regression analyses were conducted to determine independent predictors of fistula formation. Results: The median patient age was 42 years (IQR: 35-50), and 37.9% had at least one comorbidity (17.2% diabetes mellitus, 13.8% hypertension). Intraoperative fistulas were identified in 37.9% of cases and managed via fistulotomy or seton placement when feasible. Early postoperative complications occurred in 24.1% of patients, most of which were minor. Over a median follow-up of 7 months (IQR: 4-12), abscess recurrence was observed in 6.9% and new-onset fistula in 14.5%. Comorbidities such as diabetes mellitus were associated with a higher likelihood of fistula formation. Anal incontinence was documented in 2.8% of patients, most cases resolving spontaneously or with conservative measures. Conclusions: Although urgent incision and drainage generally yields favorable early outcomes, a notable proportion of patients develop late complications, particularly fistula formation. Close follow-up and tailored surgical strategies, including fistulotomy or seton placement when indicated, may help reduce morbidity. Prospective and multicenter studies with extended follow-up are warranted to further refine treatment protocols and identify high-risk individuals.
Laparoscopic Hand-Assisted Donor Nephrectomy: A Decade of Single-Center Experience and Outcomes
(AVES, 2024) Cicek, Sevim Nuran Kuslu; Huseynov, Amil
Objective: Kidney transplantation is the most effective treatment for end-stage renal disease, but the shortage of cadaveric donors has increased reliance on living donors. Traditional open donor nephrectomy, while effective, is associated with significant morbidity. Hand-assisted laparoscopic donor nephrectomy (HALDN) combines the advantages of minimally invasive surgery with the tactile feedback of open surgery. This study presents the outcomes of HALDN procedures performed at the center. Methods: A total of 1221 living donor nephrectomies performed between September 2009 and August 2021 at Medicana & Idot;stanbul Hospital were analyzed. Donor characteristics, surgical details, and postoperative outcomes were recorded. Data analysis was conducted using SPSS version 22.0, with continuous variables assessed for normality and expressed accordingly. Results: Donor ages ranged from 19 to 87 years (mean 48.50 +/- 12.75 years), with 54.8% female donors. The average body mass index (BMI) was 27.99 +/- 3.7 kg/m2. Left-sided nephrectomies constituted 78.5% of cases, with HALDN performed in 94.7% of these surgeries. Warm ischemia time averaged 99.21 +/- 56.67 seconds. The average blood loss was 70 mL, and the mean hospital stay was 4.12 +/- 1.2 days. Complications included conversion to open surgery due to bleeding in 3.3% of cases, postoperative atelectasis (0.6%), incisional hernia (0.33%), wound infection (0.16%), and scrotal swelling (0.25%). The findings indicate that HALDN is a safe and effective method for donor nephrectomy, aligning with similar studies regarding operation and warm ischemia times. The minimally invasive nature of HALDN contributes to shorter hospital stays and quicker postoperative recovery. The rate of conversion to open surgery was within acceptable limits, and complications were manageable. Obesity (BMI > 30 kg/m2) was identified as a risk factor for incisional hernia, suggesting the need for careful surgical technique in this group. Conclusion: Hand-assisted laparoscopic donor nephrectomy offers a minimally invasive, safe, and effective alternative for living donor nephrectomy, enhancing donor recovery and potentially encouraging organ donation. Its adoption may play a significant role in reducing the number of patients awaiting organ transplants.
De Novo Malignancy Development Following Kidney Transplantation: Managing Risks and Outcomes in Clinical Practice
(Galenos Publ House, 2025) Huseynov, Amil; Cicek, Sevim Nuran Kuslu
Objective: Denovo malignancy is a significant complication following kidney transplantation, attributed to prolonged immunosuppression.This study evaluates the incidence, risk factors, and clinical outcomes of denovo malignancies in kidney transplant recipients. Material and Methods: A retrospective cohort analysis was conducted on 1200 kidney transplant recipients between 2016 and 2023. Patients were categorized based on the presence or absence of de novo malignancies. Statistical analyses were performed to identify risk factors, including age, sex, comorbidities, and immunosuppressive regimens. Patient and graft survival were assessed using Kaplan-Meier analysis and the log-rank test. Results: Among the study population, 43 patients (3.6%) developed de novo malignancies. The most frequent malignancy types were non-melanoma skin cancers (27.9%) and post-transplant lymphoproliferative disorders (18.6%). Patients with malignancies exhibited a lower three-year survival rate (83.7%) compared to those without malignancies (91.4%), though the difference was not statistically significant (p=0.067). Graft survival at three years was slightly lower in the malignancy group (84.0% vs. 88.7%, p=0.146). Older recipient age was identified as a significant risk factor (hazard ratio=1.03 per year, p=0.025). Conclusion: De novo malignancy remains a concern in kidney transplant recipients, particularly among older patients. Regular screening protocols, lifestyle interventions, and individualized immunosuppressive regimens are essential to mitigate risk and improve outcomes.
Optimized Surgical Outcomes in Living Donor Nephrectomy: A Single-Center Experience with 250 Cases Using a Novel Technique
(Aves, 2025) Huseynov, Amil
Objective: Laparoscopic donor nephrectomy has become a standard of care for living kidney donors, providing reduced morbidity, quicker recovery, and enhanced patient satisfaction compared with open techniques. This study evaluates a modified laparoscopic donor nephrectomy technique designed to minimize colon mobilization while optimizing visualization, thereby improving donor outcomes. Methods: A cross-sectional study of 250 consecutive living donor nephrectomies performed by a single surgeon between March 2022 and March 2024 was conducted. All donors underwent preoperative imaging (3D computed tomography and computed tomographic angiography). The modified approach avoided splenic flexure dissection and introduced early ligation of the adrenal vein. We analyzed intraoperative parameters (operative time, estimated blood loss, complications) and postoperative measures (hospital stay, pain scores, complication rates, satisfaction) were analyzed. Results: The mean operative time was 72.8 +/- 16.2 minutes, with an estimated blood loss of 100 +/- 40 mL. No conversions to open surgery or intraoperative transfusions were required. The mean length of hospital stay was 2.0 +/- 1.0 days. Postoperative pain (mean Visual Analog Scale [VAS] 2.5 +/- 1.8) was low, and major vascular injury occurred in 0.8% of cases. Wound infection and incisional hernia rates were each 0.8%. Patient satisfaction was high (Patient Satisfaction Questionnaire [PSQ] 3.3 +/- 1.4), indicating favorable perceptions of comfort and outcomes. Conclusion: This modified laparoscopic donor nephrectomy technique is safe, effective, and associated with enhanced patient comfort and reduced complications. The findings underscore its potential to improve donor experiences, potentially expanding the living donor pool. Further investigations should confirm these outcomes over a longer follow-up period.
Results in Kidney Transplant Recipients from Living Donors 75 Years of Age or Older
(Elsevier Science Inc, 2024) Cicek, Sevim Nuran Kuslu; Huseynov, Amil; Tuncer, Murat
The increasing age of patients receiving renal replacement therapy (RRT) in Turkey, coupled with a shortage of kidney donors, has led to longer waiting times for transplants and an escalation in mortality rates. This retrospective study aimed to assess the effect on transplant outcomes of accepting kidneys from donors >= 70 years of age, given the rising number of older patients in the population. In all, 1400 patients were transplanted with kidneys from donors >50 years, with patient and graft survival as primary endpoints. Our results demonstrated that the most significant risk factors for graft function were recipient age >65 years, male sex, and presence of type 2 diabetes. Moreover, kidneys from donors >= 75 years of age achieved a half-life of 5 years. These findings suggest that donor age does not necessarily correlate with graft failure and that transplantation from older donors could help alleviate the organ shortage. Further research is needed to substantiate these conclusions.