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    How to select which anterior sector drainage veins to reconstruct in right lobe living donor liver transplantation?
    (Wiley, 2019) Ertuğrul, Gökhan; Şeker, Mehmet Metin; Yaprak, Onur; Dayangaç, Murat
    [Abstract Not Available]
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    Is routine reconstruction for all sizeable anterior sector drainage veins necessary in right lobe living donor liver transplantation?
    (Lippincott Williams & Wilkins, 2019) Ertuğrul, Gökhan; Yaprak, Onur; Dayangaç, Murat
    [Abstract Not Available]
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    Novel intraoperative strategies significantly reduce transfusion requirements in liver transplantation
    (Wiley, 2019) Yanaral, Tümay; Ertuğrul, Gökhan; Karaaslan, Pelin; Yaprak, Onur; Dayangaç, Murat
    [Abstract Not Available]
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    Role of pre-transplant 18F-FDG PET/CT in predicting hepatocellular carcinoma recurrence after liver transplantation
    (Baishideng Publishing Group Inc, 2018) Yaprak, Onur; Acar, Sencan; Ertuğrul, Gökhan; Dayangaç, Murat
    The last two decades have seen a paradigm shift in the selection of patients with hepatocellular carcinoma (HCC) for liver transplantation. Microvascular invasion and differentiation have been the most significant factors affecting post-transplant recurrence; however, because of inherent disadvantages of pre-transplant biopsy, histological criteria never gained popularity. Recently, the selection criteria evolved from morphological to biological criteria, such as biomarkers and response to loco-regional therapy. With the introduction of multimodality imaging, combination of computed tomography with nuclear medicine imaging, particularly, 18F-fluorodeoxyglucose positron emission tomography fulfilled an unmet need and rapidly became a critical component of HCC management. This review article will focus on the use of 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography in the pre-transplant evaluation of HCC patients with special discussion on its ability to predict HCC recurrence after liver transplantation.
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    The comparison of local tumor control after microwave ablation, surgical resection and combined treatment for colorectal liver metastases
    (ValpoScholar-Valparaiso University, 2022) Güngören, Fatma Zeynep; Erol, Cengiz; Bilici, Ahmet; Dayangaç, Murat; Şeker, Mehmet; Ölmez, Ömer Fatih; Yaprak, Onur; Yıldız, Özcan; Öncel, Mustafa
    Aim. We aimed to compare the local therapeutic efficiency of microwave ablation (MWA), surgical resection, and combined treatment, assess the outcomes, and identify predictive factors for local treatment response in colorectal liver metastases (CLMs). Methods. From March 2013 to September 2019, a total of 54 patients with 302 CLMs were enrolled in this retrospective study. Eleven patients (20.4%) were treated with MWA, 9 patients (16.7%) with surgery, and 34 patients (63%) with the combined method. Univariate and multivariate analyses were performed to investigate overall survival (OS) and hepatic progression-free survival (HPFS) using the Cox proportional hazard regression model. The logistic regression analysis was used to identify the predictive factors for the local treatment response. Results. Total treatment response was achieved in 46.3% (n=25) of the patients. Local tumor progression was seen in 7.4% (n=4) of the patients, and the rate of intrahepatic distal recurrence was 46.3% (n=25). There were no significant differences in HPFS and OS between the three groups (p=0.56 and 0.90, respectively). Younger age (<60), smaller (<= 2 cm) or fewer (<= 3) liver metastases, and wild-type RAS were predictive for higher rates of local treatment response (OR 0.22, 95% CI 0.15-0.93, p=0.04; OR 1.12, 95% CI 0.54-2.12, p=0.029; OR 1.37, 95% CI 0.97-2.37, p=0.035; OR 0.23, 95% CI 0.10-0.85, p=0.028, respectively). Conclusions. The results of this study reveal that the use of MWA, alone or combined with resection, may achieve high local treatment response and similar survival rates compared to patients undergoing resection, suggesting that MWA could potentially be preferred over surgical procedures.
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    Ultrasound-guided bilateral erector spinae plane block in the management of postoperative analgesia in living liver donors: a randomized, prospective study
    (2024) Uludağ Yanaral, Tümay; Güngör, Hande; İnce, Ayşe; Çelik, Erkan Cem; Yaprak, Onur; Atalay, Yunus Oktay; Çiftçi, Bahadır; Karaaslan, Pelin
    BACKGROUND: Living donor hepatectomy is a procedure associated with notable postoperative pain, impacting patient recovery and satisfaction. Addressing this challenge, we aimed to examine the effect of ultrasound-guided bilateral erector spinae plane block (ESPB) in postoperative analgesia management of patients undergoing living donor hepatectomy for liver transplantation. METHODS: Asingle-center prospective, randomized, controlled study was conducted on ASAI-IIpatients aged 18-65 who underwent elective living donor hepatectomy. Participants were randomized into ESPB (N.=20) and control (N.=21) groups. ESPB was performed under ultrasound guidance with 0.25% bupivacaine (20 mLbilaterally) at T7-T9 levels. The control group received no block. Postoperative analgesia included IVacetaminophen, opioids, alongside fentanyl patient-controlled analgesia. Pain intensity was assessed using Numeric Rating Scale (NRS) at various time intervals. Primary outcome was to compare postoperative opioid consumption levels and secondary outcomes were to evaluate postoperative pain scores, requirement of rescue analgesia, and opioid-related side effects. RESULTS: Patients in ESBP group exhibited lower total fentanyl consumption (P=0.023) and lower meperidine use for rescue analgesia (P=0.001) compared to controls. While static pain scores showed no significant difference, Group ESPB reported lower dynamic pain scores in the immediate postoperative period (P=0.047). The incidence of nausea was lower in Group ESPB (6 vs. 17, P=0.002) with no observed complications. CONCLUSIONS: ESPB displayed promise in effectively managing post-living donor hepatectomy pain, resulting in decreased opioid consumption, improved pain relief, and reduced rescue analgesia requirements. This technique holds potential to enhance recovery and patient satisfaction following donor hepatectomy.