Browsing by Author "Karaca, Can A."

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Citation - WoS: 3
Citation - Scopus: 6
Duct-To Biliary Reconstruction in Pediatric Split-Liver Transplantation [letter]
(Wiley, 2018-02-12) Yılmaz, Cahit; Karaca, Can A.; Ferecov, Rasim; Iakobadze, Zaza; Kilic, Kamil; Tosun, Adnan; Kılıç, Murat
[Abstract Not Available]
Citation - WoS: 1
Hepatic Venous Outflow Reconstruction Directly Into the Right Atrium
(Baskent Univ, 2025-05) Karaca, Can A.; Yilmaz, Cahit; Farajov, Rasim; Iakobadze, Zaza; Kilic, Kamil; Buket, Suat; Kilic, Murat
Objectives: Living-donor liver transplant for Budd-Chiari syndrome is particularly challenging because of the need for venous outflow reconstruction as grafts from living donors lack vena cava. In addition, recipient vena cava may be thrombotic and fibrotic to such an extent that it would not allow graft venous outflow reconstruction. Under these circumstances, the right atrium provides an easily accessible alternative for venous outflow reconstruction, omitting the need for vena cava replacement. Materials and Methods: Data from 3 patients who were treated using this technique were collected and evaluated with regard to surgical technique and outcomes. Results: All patients were alive without vascular complications after a mean follow-up of 67 months. The applied surgical technique was similar except with regard to vena cava preservation. Conclusions: During the natural course of the disease, venous collaterals form as chronic thrombosis extends into the vena cava. The vena cava can be safely resected in these patients to facilitate hepatectomy through dense adhesions, which is another common clinical problem in this disease. Consequently, venous outflow reconstruction to the right atrium creates the feasible opportunity of draining the graft liver without having to replace the vena cava.
Citation - WoS: 2
Citation - Scopus: 1
Portal Vein Pull-Through Technique and Thrombectomy for Extensive Portal Vein Thrombosis
(Elsevier Science Inc, 2023-03) Kılıç, Murat; Farajov, Rasim; Iakobadze, Zaza; Akcalar, Seray; Camli, Dilsat; Kilic, Kamil; Yılmaz, Cahit; Karaca, Can A.
Background. Herein, a different technique is presented describing complete dissection of the entire portal vein (PV), superior mesenteric vein (SMV), and splenic vein, thus enabling a complete thrombectomy without the risk of uncontrolled hemorrhage due to blind thrombectomy. Methods. In cases where a thrombectomy would not be an option because of extensive thrombosis involving the confluence of the PV and SMV, small branches of the SMV, including the inferior mesenteric vein, were divided. Both the SMV and splenic vein were encircled separately. Then, the side branches of the PV above the pancreas, left gastric vein on the left side, and superior pancreatoduodenal vein on the right side were divided. The lateral and posterior part of the PV were dissected within the pancreas both from above and below, allowing the main PV completely free from attachments. At this point, the splenic vein and SMV were clamped, and the main PV was divided above the pancreas and then pulled back through the pancreatic tunnel. The thrombus was easily dissected of the vein under direct visualization, and afterward the PV was redirected to its original position. Then, the liver transplant was carried out in a regular fashion. Results. This technique was applied to 2 patients. The first was a 43-year-old man who underwent a right lobe living donor liver transplant because of hepatitis B virus-related cirrhosis. The patient is still alive and well with stable liver function after 15 years of follow-up. The second was a 69-year-old woman who underwent a right lobe living donor liver transplant because of hepatitis C virus and hepatocellular carcinoma. She survived the procedure and her liver function was entirely normal afterward. She died of pneumonia and sepsis 5 months after transplant. Conclusions. This technique enables complete dissection of the entire PV, SMV, and splenic vein. Thus, complete thrombectomy under direct visualization without the risk of uncontrolled hemorrhage can be performed.