References of "DE ROOVER, Arnaud"
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See detailSurgical management of hepatic metastases of colorectal origin.
Gilson, Nathalie; Honore, Charles ULg; Detry, Olivier ULg et al

in Acta Gastro-Enterologica Belgica (2009), 72(3), 321-6

Colorectal cancer is the most frequent digestive cancer. Prognosis is greatly depending on the TNM stage at the time of diagnosis. Fifty percent of all patients shall develop, synchronously or ... [more ▼]

Colorectal cancer is the most frequent digestive cancer. Prognosis is greatly depending on the TNM stage at the time of diagnosis. Fifty percent of all patients shall develop, synchronously or metachronously, liver metastases. Different means such as chemotherapy, targeted therapies, radiofrequency ablation, portal vein embolization and two-stage hepatectomy may be used to make these metastases eventually resectable and to increase overall survival. This is a short review of these different methods used to increase resectability but also on the integration of these parameters in a larger approach of colorectal liver metastasis surgery especially insisting on multidisciplinary discussion. [less ▲]

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See detailA Retrospective Monocenter Review of Simultaneous Pancreas-Kidney Transplantation.
Decker, Emmanuel ULg; Coimbra, C.; Weekers, Laurent ULg et al

in Transplantation Proceedings (2009), 41(8), 3389-3392

OBJECTIVE: Herein we have reviewed a consecutive series of simultaneous pancreas-kidney (SPK) transplantations performed at our institution over a 6-year period. PATIENTS AND METHODS: The study population ... [more ▼]

OBJECTIVE: Herein we have reviewed a consecutive series of simultaneous pancreas-kidney (SPK) transplantations performed at our institution over a 6-year period. PATIENTS AND METHODS: The study population included 22 patients (15 males and 7 females) who underwent SPK transplantation between 2001 and 2007. The mean recipient age was 47 years (range, 26-63 years). Eighteen patients suffered type 1 and 4 type 2 diabetes mellitus. The mean donor age was 33 years (range, 14-56 years). The mean HLA match was 2.1 (range, 1-5). Immunosuppressive treatment consisted of basiliximab induction followed by tacrolimus, mycophenolate mofetil, and prednisone. RESULTS: The mean hospital stay was 20 days (range, 11-52 days). After a mean follow-up of 44 months (range, 17-88 months), patient, kidney, and pancreas graft survivals were 86%, 82%, and 73%, respectively. Two patients died in the immediate postoperative period due to, respectively, disseminated intravascular coagulation and pulmonary embolism. A kidney graft was lost due to early hyperacute rejection. Other early complications associated with the pancreas graft included 2 cases of immediate reperfusion defects that led to early vascular thrombosis in 1 patient and a duodenal graft fistula in the other patient; a third patient developed type 2 diabetes mellitus. Beyond the postoperative period, graft loss was limited to 1 case of noncompliance to the immunosuppressive medications and 1 death secondary to pulmonary infection with a functional allograft after 4 years. CONCLUSIONS: SPK transplantation is a valid therapeutic option for patients with insulin-dependent diabetes mellitus and renal failure due to diabetic nephropathy. The main complications of SPK transplantation occur in the immediate postoperative period consequent to vascular or rejection processes. [less ▲]

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See detailLiver Transplantation Is Feasible in Super-Obese Patients: A Case Report.
Detry, Olivier ULg; Seydel, Benoît ULg; Kohnen, Laurent ULg et al

in Transplantation Proceedings (2009), 41(8), 3430-3431

Short- and long-term results of liver transplantation in morbidly obese patients may be impaired compared with the general transplant population. As a consequence, severe obesity has been considered to be ... [more ▼]

Short- and long-term results of liver transplantation in morbidly obese patients may be impaired compared with the general transplant population. As a consequence, severe obesity has been considered to be a relative contraindication to liver transplantation in many centers. Surgically, liver transplantation in severe obesity may be challenging. Moreover, obesity may lead to an increased rate of early and late medical complications. Herein we have reported successful liver transplantation in a super-obese patient (body mass index, 55.1 kg/m(2)) who had developed terminal acute-on-chronic liver disease. In the first 6 months of follow-up, the patient underwent a severe diet that led to a significant weight loss reduction to a body mass index of 39 kg/m(2). This report of successful liver transplantation in a super-obese patient suggests that severe obesity should not be considered to be an absolute contraindication to liver transplantation. [less ▲]

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See detailBudd-Chiari Syndrome Complicating Hepatic Sarcoidosis: Definitive Treatment by Liver Transplantation: A Case Report.
Delfosse, Vincent ULg; De Leval, Laurence ULg; De Roover, Arnaud ULg et al

in Transplantation Proceedings (2009), 41(8), 3432-3434

Sarcoidotic involvement of the liver is frequent, albeit uncommonly symptomatic. Severe complications are rare, but may seldom require liver transplantation. Budd-Chiari syndrome has been described in a ... [more ▼]

Sarcoidotic involvement of the liver is frequent, albeit uncommonly symptomatic. Severe complications are rare, but may seldom require liver transplantation. Budd-Chiari syndrome has been described in a few patients with hepatic sarcoidosis. Herein we have reported the case of a young woman suffering from hepatic sarcoidosis who developed severe cholestasis and chronic Budd-Chiari syndrome. She successfully underwent orthotopic liver transplantation (OLT) and is asymptomatic with normal liver function at 3 years follow-up. Histopathological assessment of the liver explant demonstrated a florid granulomatous process, with involvement of the large intrahepatic veins, providing an anatomical basis for the vascular flow disturbances. This case adds further evidence that liver transplantation may be the curative treatment for complicated sarcoidotic liver disease. [less ▲]

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See detailFulminant Hepatic Failure Induced by Venlafaxine and Trazodone Therapy: A Case Report.
Detry, Olivier ULg; Delwaide, Jean ULg; De Roover, Arnaud ULg et al

in Transplantation Proceedings (2009), 41(8), 3435-3436

Although acute hepatitis may be a side effect of many medications, most cases are reversible after treatment interruption, and fulminant hepatic failure (FHF) is rare. Venlafaxine and trazodone are 2 ... [more ▼]

Although acute hepatitis may be a side effect of many medications, most cases are reversible after treatment interruption, and fulminant hepatic failure (FHF) is rare. Venlafaxine and trazodone are 2 popular antidepressant agents. Alteration of liver enzyme levels has been reported as a side effect of these drugs at normal doses. Herein we have reported the case of a 48-year-old woman without any previous history of liver disease, who developed fulminant liver failure after 4 months of venlafaxine and trazodone therapy. She required liver transplantation, a procedure that was successful with full patient recovery. The first 5 years of follow-up were uneventful. This case documented that venlafaxine and trazodone at normal doses can produce severe liver toxicity. Liver tests should be monitored regularly in patients who receive this therapy. [less ▲]

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See detailEffect of Clonidine on Propofol and Remifentanil requirements using BIS score and the A-line ARX (AAI) index during laparoscopic gastric bypass in obese patients
Rosant, Séverine; Nkiko, Gédéon; Lauwick, Séverine ULg et al

in Acta Anaesthesiologica Belgica (2008, June 14), 59(3), 228

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See detailMilestones in Pancreas Transplantation in Belgium
De Roover, Arnaud ULg; Squifflet, Jean-Paul ULg

in Acta Chirurgica Belgica (2008), 108

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See detailImmunosuppression in Pancreas Transplantation The Euro SPK Trials and Beyond
Malaise, J.; De Roover, Arnaud ULg; Squifflet, Jean-Paul ULg et al

in Acta Chirurgica Belgica (2008), 108

The Immunosuppression in Pancreas Transplantation was historically based on the fact that the pancreas is an extremely immunogenic organ. Quadruple drug therapy with polyclonal or monoclonal antibodies ... [more ▼]

The Immunosuppression in Pancreas Transplantation was historically based on the fact that the pancreas is an extremely immunogenic organ. Quadruple drug therapy with polyclonal or monoclonal antibodies induction was the mainstay therapy since the introduction of Cyclosporine A. In the modern era of Immunosuppression, Mycophenolate Mofetil replaced Azathioprine while Tacrolimus-another potent calcineurin inhibitor-had-and still has-a difficult challenge to replaced Cyclosporine A, due to its potential diabetogenic effect. Thanks to the first two EuroSPK studies which prospectively tried to answer several questions in that field. But, the future challenge will be in understanding the impact of innate immunity and ischemic reperfusion injuries on the long term graft function. Hopefully, new drugs will be available and tested to block unspecific deleterious reactions to attenuate the proinflammatory response. It will be the aim of the third Euro SPK Stud [less ▲]

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See detailPancreas graft drainage in recipient duodenum: Preliminary experience
De Roover, Arnaud ULg; Coimbra Marques, Carla ULg; Detry, Olivier ULg et al

in Transplantation (2007), 84(6), 795-797

Pancreas graft survival has continuously improved over the years to become a main treatment option of uncontrolled complicated diabetes. Rejection remains the major challenge as it often goes unnoticed ... [more ▼]

Pancreas graft survival has continuously improved over the years to become a main treatment option of uncontrolled complicated diabetes. Rejection remains the major challenge as it often goes unnoticed until severe damage of the graft manifests itself by elevated blood sugar. Pancreas enzymes monitoring in the blood and in the urine is a sensitive marker of rejection but lack of specificity. Biopsy remains the gold standard. Cystoscopy-guided biopsy of bladder-drained pancreas has a good success rate for obtaining tissue but the vesical drainage exposes to metabolic and urologic morbidity. Percutaneous pancreas biopsy can be performed with a low morbidity rate but severe complications can occur. We discuss a technique of pancreas transplantation with the drainage of exocrine secretions of the pancreatic graft in the recipient duodenum, which permits easy monitoring of the graft by upper endoscopy of the duodenum. [less ▲]

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See detailBloodless liver transplantation: Experience with Jehovah's witnesses
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in Transplant International (2007, September), 20(Supplement 2), 291812

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See detailProlonged anhepatic state after early liver graft removal
Detry, Olivier ULg; De Roover, Arnaud ULg; Delwaide, Jean ULg et al

in Hepato-Gastroenterology (2007), 54(79, Oct-Nov), 2109-2112

Two-stage liver transplantation, i.e. salvage emergent total hepatectomy with prolonged anhepatic state, and subsequent liver transplantation, has been described as a life-saving procedure in selected ... [more ▼]

Two-stage liver transplantation, i.e. salvage emergent total hepatectomy with prolonged anhepatic state, and subsequent liver transplantation, has been described as a life-saving procedure in selected cases. The principal drawback of two-stage liver transplantation is the fact that anhepatic patient survival only depends on the future availability of a liver graft. The pathophysiologic alterations induced by total hepatectomy are not fully known, as it is not known how long a patient may be anhepatic before it is too late for hope of survival. In this report the authors describe the cases of three liver recipients who had to undergo salvage liver graft removal early during or after liver transplantation as a life-saving maneuver. All were afterwards registered for emergent liver retransplantation. Mean anhepatic period was 20 hours (Range: 17-24 hours). Two patients survived and fully recovered. From this experience and from other cases reported in the literature, the authors concluded that total hepatectomy may be life-saving in some cases if a liver graft is available in a timely manner. [less ▲]

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See detailPrevention and treatment of major blood loss
Detry, Olivier ULg; De Roover, Arnaud ULg; Honore, Pierre ULg

in New England Journal of Medicine [=NEJM] (2007), 357(12), 1261-1261

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See detailActualites therapeutiques dans le domaine de l'obesite.
Rorive, Marcelle ULg; De Flines, Jenny ULg; Paquot, Nicolas ULg et al

in Revue Médicale de Liège (2007), 62(5-6), 329-34

The management of an obese patient aims not only at obtaining a durable weight loss, but also at attenuating various associated risk factors. This latter objective may already be obtained with a rather ... [more ▼]

The management of an obese patient aims not only at obtaining a durable weight loss, but also at attenuating various associated risk factors. This latter objective may already be obtained with a rather moderate weight reduction (5-10% of initial body weight). The first step should favour life-style changes (diet and physical exercise), eventually together with a psychological support. In case of insufficient success, a pharmacological approach may be considered, in addition to life-style advices. Pharmacotherapy currently includes drugs that act on the central nervous system to decrease appetite (sibutramine), in the gastrointestinal tract to diminish fat absorption (orlistat) or at both central and peripheral sites (rimonabant). In case of extreme obesity or severe obesity associated with comorbidities, refractory to medical approaches, bariatric surgery may represent the only solution to obtain a major and sustained weight loss, together with a significant improvement of associated risk factors. Gastroplasty, especially laparoscopic gastric banding, has become very popular in our country. However, because of several limitations, it is increasingly replaced by derivative procedures, especially gastric bypass. In all cases, a multidisciplinary, integrated and individualized approach should be recommended, using realistic goals and targeting long-term weight reduction and improved health. [less ▲]

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See detailComplications in living liver donor according to Clavien's classification: An European experience
De Roover, Arnaud ULg; Detry, Olivier ULg; Meurisse, Nicolas ULg et al

in Journal of Hepatology (2007), 46(Suppl. 1), 66

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See detailCadaveric liver transplantation for non-acetaminophen fulminant hepatic failure: A 20-year experience
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in World Journal of Gastroenterology (2007), 13(9), 1427-1430

AIM: To investigate the long-term results of liver transplantation (LT) for non-acetaminophen fulminant hepatic failure (FHF). METHODS: Over a 20-year period, 29 FHF patients underwent cadaveric whole LT ... [more ▼]

AIM: To investigate the long-term results of liver transplantation (LT) for non-acetaminophen fulminant hepatic failure (FHF). METHODS: Over a 20-year period, 29 FHF patients underwent cadaveric whole LT. Most frequent causes of FHF were hepatitis B virus and drug-related (not acetaminophen) liver failure. All surviving patients were regularly controlled at the out-patient clinic and none was lost to follow-up. Mean follow-up was 101 mo. RESULTS: One month, one-, five- and ten-year patient survival was 79%, 72%, 68% and 68%, respectively. One month, one-, five- and ten-year graft survival was 69%, 65%, 51% and 38%, respectively. Six patients needed early (< 2 mo) retransplantation, four for primary non-function, one for early acute refractory rejection because of ABO blood group incompatibility, and one for a malignant tumor found in the donor. Two patients with hepatitis B FHF developed cerebral lesions peri-transplantion: One developed irreversible and extensive brain damage leading to death, and one suffered from deep deficits leading to continuous medical care in a specialized institution. CONCLUSION: Long-term outcome of patients transplanted for non-acetaminophen FHF may be excellent. As the quality of life of these patients is also particularly good, LT for FHF is clearly justified, despite lower graft survival compared with LT for other liver diseases. (C) 2007 The WJG Press. All rights reserved. [less ▲]

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