The life of the 46-year-old man Nevzat Orman changed completely 2,5 years ago when he was diagnosed with renal failure. Due to coronary failure developed during the dialysis treatment, they said he could receive transplantation and he was on the danger list. Nevzat Orman’s difficult operation was performed by the General Surgeon Prof. Dr. Gürkan Tellioğlu at the Organ Transplantation Center of the Yeditepe University Hospitals. A kidney donated by his son was transplanted into him.
Having worked as a seller for a living, Nevzat Orman did not have any problems with his kidneys. When he went to a doctor because of his chest pains 2,5 years ago, he was informed about the unexpected news after tests. His kidneys were not working properly and he needed transplantation immediately. Nevzat Orman’s difficult life story started after this diagnosis. First he started to go to dialysis treatments. After a while, he was hospitalized because of coronary failure. Nevzat Orman, who was told that he would need an immediate cardiac pacemaker operation but then he would not be able to have transplantation, told us his experience saying:
“While I was waiting for a kidney-transplant, all my family and I got so disappointed by these news. Because I was first informed that it would be possible to do heart and kidney transplantation together at the same time. I did not accept it and I left the hospital. I started to live with both coronary failure and renal failure problems. During that period, I was going to dialysis treatments and was looking for different centers for kidney transplant. However, nobody accepted my demand because of the high risks. While I was continuing living hopelessly, I was called by the Yeditepe University for appropriate donor and detailed tests.”
The reason for coronary failure is renal failure
Stating the fact that patients with coronary failure caused by chronic renal failure like Nevzat Orman could only recover with kidney transplantation, Prof. Dr. Gürkan Tellioğlu shared the following information:
“When the patient came to our hospital, the cardiology evaluation result said that his “cardiac movements are seriously damaged and the heart is almost not straining”. Because the ejection fraction level was 15 per cent. The coronary failure was based on renal failure. However, there might be difficulties when evaluating these kinds of patients and the need of heart transplantation might be considered. In fact, the source of problems with the heart might be based on the kidneys; when we solve the problems with the kidneys, the heart problems can automatically be solved. Making a distinction requires experience”.
“After the kidney transplant was done, the coronary failure problem disappeared”
Prof. Dr. Gürkan Tellioğlu, who stated that there were tragic figures about the patient considering the cardio evaluations, said: “Since this case developed slowly over 1,5-2 years, the body adopted itself but started to reach its limits. If we had not treated the patient, the heart would not have tolerated the case anymore soon and he would have experienced fatal problems. The chances for a patient like Nevzat to survive are 50 per cent in one year, therefore it was a very risky and difficult surgery”.
Kalbi bu kadar yorulan bir hastayı ameliyat ederken vücudu zorladığınız için ne yanıt alacaklarını bilemediklerini hatırlatan Prof. Dr. Gürkan Tellioğlu, sözlerine şöyle devam etti; “Nakledilen böbreğin iyi fonksiyon göstermesi kalbin performansıyla ilişkilidir. Nevzat Bey örneğinde olduğu gibi, böbrek kalbe yardımcı oldu, kalp de böbreğe. Biz de ameliyat öncesinde hastaya ardışık diyaliz uygulayarak vücudundaki fazla sıvıyı çektik. Ardından yaptığımız ekokardiyografide kalbinde düzelme olduğunu gördük. Bir anlamda böbrek naklinin simüle etmiş olduk. Sonuçta kalpteki düzelme bize doğru yolda olduğumuz gösterdi. Oğlundan aldığımız böbrekle nakli gerçekleştirdik.”
Reminding the fact that they did not know what would be the results of an operation on a patient who has such a tired heart since the operation forced the body, Prof. Dr. Gürkan Tellioğlu continued his words saying: “The transplanted kidney’s functioning well is related to the performance of the heart. As we saw in Nevzat’s case, the kidneys helped the heart and the heart helped the kidneys. We applied sequential dialysis for the patient to absorb extra water from the body. Then we found an improvement in the heart during the eco-cardiograph. In some ways, we had simulated a kidney transplant. As a result, the improvement in the heart showed that we were on the right way. We accomplished the kidney transplant with a kidney from his son.”
Mismatching dialysis might result in coronary failure
Prof. Dr. Gürkan Tellioğlu, who explained that some patients with renal failure, like Nevzat Orman, might have serious functional losses in the heart after they start dialysis treatment, said: “Although this group is small among the dialysis patients, especially young male patients might get affected by this. Following a rise in the creatine value, the patients’ failure in adjusting to the dialysis and drinking too much water despite a lack of urination might cause the patients to encounter serious coronary failure problems. However, what is important is that when the patients are treated, they might have new kidneys besides a recovered heart so they can go back to their business life.”
I Have a Life and Dreams!
Nevzat Orman, who said that he was out of the hospital one week after the surgery and now feels healthy, stated that he was living without any dreams about his life because of the fear of death but now he has a life and dreams.
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