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    Comparison of Bipolar vascular sealing and conventional back-table dissection in terms of post-renal transplant drainage and back-table preparation times
    (Verduci Publisher, 2023) Eren, E.; Tokac, M.; Ozcelik, U.; Sahin, T.; Tellioglu, G.; Peksen, C.; Dinckan, A.
    - OBJECTIVE: The usage of ves-sel sealing devices has been gaining popularity in all surgical specialties. Post-renal transplant drain placement is a common practice among transplant surgeons. However, prolonged drain-age accompanied by surgical wound complica-tions and perirenal fluid collections is a frequent complication experienced by the recipients. This study aimed to compare Bipolar vascular seal-ing with conventional back-table dissection in terms of post-renal transplant drainage dura-tion, amount, surgical wound complication, and back-table preparation time. PATIENTS AND METHODS: A double-blind clinical study randomizes recipients into 2 groups, using Bipolar vascular sealing (Group 1) and conventional ligation (Group 2) back -ta-ble dissection. Variables such as recipient age, gender, body mass index (BMI), cause of end -stage renal disease, amount and duration of sur-gical drainage, back-table time, and cold isch-emia time (CIT) were collected prospectively. RESULTS: Ninety-eight consecutive living do-nor (M/F: 69/29) renal transplant recipients were enrolled in this prospective randomized clini-cal trial. There were 49 patients in each group. The mean BMI was 26.76 & PLUSMN;4.57. There was no difference among the groups regarding recipi-ent age, BMI, total drainage, and surgical drain-age duration. The surgical site infection rate was not different between the two groups. Group 1 had significantly shorter back-table time, with mean back-table time being 15.26 & PLUSMN;2.51 minutes in Group 1 and 28.83 & PLUSMN;6.27 minutes in Group 2 (p<0.001). The CIT was also significantly differ-ent between the 2 groups (p<0.001). In Group 1, the recorded CIT was 43.3 & PLUSMN;11.4, and in Group 2, 57.1 & PLUSMN;13.3 minutes. CONCLUSIONS: The use of Bipolar vascular sealing to seal lymphatic vessels at the back -ta-ble is feasible, safe, and easy to perform. It also expedites the dissection and shortens the time required for back-table graft preparation.
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    Using small size grafts in live donor liver transplantation: is size important?
    (Pamukkale University, 2023) Eren, E.; Dinçkan, A.
    Purpose: In living donor liver transplantation, it is preferred that the ratio of the weight of the graft to the weight of the recipient (GRWR) be higher than 0.8%. We aimed to compare recipients with a GRWR greater than 0.8% and those with a small GRWR regarding post-transplant complications and outcomes. Materials and methods: Data of the patients who had undergone living donor liver transplant surgery in İstinye University Hospital Liver Transplant Unit between January 2017 and July 2022 were reviewed. The study group patients were classified as GRWR<0.8% (Group 1), GRWR 0.8-1% (Group 2), and GRWR>1% (Group 3) and compared regarding clinical data, complications, and mortality rates. Results: Liver transplant recipients from 220 living donors were included. The mean recipient age was 53.6 (18-79). The comparative analysis between Group 1 (n=29), Group 2 (n=70), and Group 3 (n=121) revealed significant differences concerning the rates of bile leak and the length of hospital stay (p=0.033, p<0.05). Bile leak rates were 7.4% in Group 1, 6% in Group 2, and 0.8% in Group 3. The bile leakage rate was significantly lower in Group 3 than in Groups 1 and 2 (p=0.041, p<0.05). The medians of hospitalization periods were 18 (7-40) days, 15 (5-46) days, and 16 (1-130) days in groups 1, 2, and 3. In addition, the median length of stay was higher in Group 1 than in groups 2 and 3 (p=0.033). In terms of other parameters, the three groups gave similar results. Conclusion: Although a GRWR value of lower than 0.8 seems as a factor causing prolonged hospital stay, and a GRWR value of higher than 1 seems to lower the risk of biliary complications after a live donor liver transplantation, these changes are not associated with the changes in total complication and acute rejection rates and patient survival. © 2023, Pamukkale University. All rights reserved.