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    Comparison of Liver Transplant Outcomes in Biliary Atresia Patients, Considering Whether They Underwent the Kasai Procedure Beforehand: A Single Center Analysis of 72 Patients
    (Elsevier Inc., 2023) Demir, H.B.; Umman, V.; Gümüs, T.; Tunalı, S.; Barut, D.; Karakoyun, M.; Akarca, U.S.
    Background: This study examines the results of liver transplantation (LT) in patients with biliary atresia, considering whether they underwent the Kasai procedure beforehand. LT and determine postoperative and long-term graft outcomes. Methods: This single-center, retrospective study included 72 pediatric patients diagnosed with postpartum biliary atresia who underwent LT between 2010 and 2022. We included patients who underwent LT either after or without the Kasai procedure and compared the demographic data of the patients with various factors, such as the Pediatric End-Stage Liver Disease scores and laboratory values. Results: The study included 72 patients, with 39 of them being female (54.2%) and 33 of them being male (45.8%). Of the 72 patients in the study, 47 (65.3%) had undergone the Kasai procedure, and 25 (34.7%) had not. The preoperative and postoperative month 1 bilirubin values were lower in patients who underwent the Kasai procedure and were higher in postoperative months 3 and 6. Preoperative bilirubin values, postoperative month 3 bilirubin values, and preoperative albumin values were higher in patients who developed mortality (P <.05). Cold ischemia time was longer in patients who developed mortality (P <.05). Conclusions: Our study showed a higher mortality rate in patients who underwent the Kasai procedure. The results also showed that LT was more effective in children, as patients with Kasai had higher mean bilirubin values and higher preoperative albumin values than patients without Kasai. © 2023 Elsevier Inc.
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    Quality of Life and Psychological Well-Being in Children and Adolescents After Renal Transplantation
    (Elsevier Inc., 2023) Demir, M.H.B.; Taner, S.; Demir, H.B.; Taşdemir, A.I.; Keskinoğlu, A.; Bulut, I.K.; Sezer, T.O.
    Background: Kidney transplantation is the predominant treatment option in patients with end-stage renal disease. The aim of this study was to evaluate the effect of the presence of a psychiatric disorder on the quality of life in children and adolescents after kidney transplantation. Methods: A total of 43 patients aged 6 to 18 years were included in the study. All participants and their parents were asked to complete the Pediatric Quality of Life Inventory (PedsQL), and families only, the Strengths and Challenges Questionnaire. Psychiatric symptoms and disorders of the patients were evaluated according to the Schedule for Mood Disorders and Schizophrenia for School-Age Children/Now and Lifetime Turkish Version. Patients were divided into 2 groups according to psychiatric symptoms and disorders. Results: The most common psychiatric disorder was attention deficit and hyperactivity disorder (26%). The questionnaires filled out by the patients revealed a lower Total PedsQL Score (P =.003), PedsQL Physical Functionality Score (P =.019), and PedsQL Social Functioning Score (P =.016) in patients with psychiatric disorders. When the parents filled out the questionnaires, the Total PedsQL Score was similar in both groups. The PedsQL Emotional Functionality Score (P =.001) and PedsQL School Functionality Score (P =.004) were significantly lower in patients with psychiatric disorders. The Strengths and Difficulties Questionnaire revealed significantly higher total (P =.014) and hyperactivity/inattention subscale scores (P =.001) in those with a psychiatric disorder. Conclusions: Psychiatric disorders in kidney transplant patients adversely affect the quality of life. © 2023 Elsevier Inc.