Is ultra-short cold ischemia the key to ischemic cholangiopathy avoidance in DCD-LT?
DETRY, Olivier ; DE ROOVER, Arnaud ; et al
in Acta Chirurgica Belgica (2013, May), Supplement 113(3), 6729Detailed reference viewed: 19 (5 ULg)
Is ultra-short cold ischemia the key to IBDL avoidance in DCD-LT?
DETRY, Olivier ; DE ROOVER, Arnaud ; et al
Poster (2013, February 08)Detailed reference viewed: 18 (3 ULg)
Replication Capacity and Susceptibility to Telaprevir of the T54S Resistant Variant is Modulated by Others Hepatitis C Virus NS3 Mutations
; BONTEMS, Sébastien ; et al
Poster (2013)Detailed reference viewed: 4 (0 ULg)
Prevalence of HIV and HCV infections in two populations of Malian women and serological assays performances
; VAIRA, Dolorès ; Gothot, André et al
in World Journal of Hepatology (2012)Detailed reference viewed: 12 (5 ULg)
Donation after cardio-circulatory death liver transplantation.
; DE ROOVER, Arnaud ; KABA, Abdourahmane et al
in World Journal of Gastroenterology (2012), 18(33), 4491-506
The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ ... [more ▼]
The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ supply and following the request of potential DCD families. Since then, DCD organ procurement and transplantation activities have rapidly expanded, particularly for non-vital organs, like kidneys. In liver transplantation (LT), DCD donors are a valuable organ source that helps to decrease the mortality rate on the waiting lists and to increase the availability of organs for transplantation despite a higher risk of early graft dysfunction, more frequent vascular and ischemia-type biliary lesions, higher rates of re-listing and re-transplantation and lower graft survival, which are obviously due to the inevitable warm ischemia occurring during the declaration of death and organ retrieval process. Experimental strategies intervening in both donors and recipients at different phases of the transplantation process have focused on the attenuation of ischemia-reperfusion injury and already gained encouraging results, and some of them have found their way from pre-clinical success into clinical reality. The future of DCD-LT is promising. Concerted efforts should concentrate on the identification of suitable donors (probably Maastricht category III DCD donors), better donor and recipient matching (high risk donors to low risk recipients), use of advanced organ preservation techniques (oxygenated hypothermic machine perfusion, normothermic machine perfusion, venous systemic oxygen persufflation), and pharmacological modulation (probably a multi-factorial biologic modulation strategy) so that DCD liver allografts could be safely utilized and attain equivalent results as DBD-LT. [less ▲]Detailed reference viewed: 17 (5 ULg)
Liège experience in donation after cardiac death liver transplantation: 2003-2011
Le Dinh, Hieu ; DELWAIDE, Jean ; MONARD, Josée et al
in Acta Chirurgica Belgica (2012, May), 112(3), 6811
Objectives: Results of DCD-LT at the University Hospital of Liège were evaluated from 2003 to 2011. Methods: Medical records of 56 DCD liver recipients were retrospectively reviewed with regard to patient ... [more ▼]
Objectives: Results of DCD-LT at the University Hospital of Liège were evaluated from 2003 to 2011. Methods: Medical records of 56 DCD liver recipients were retrospectively reviewed with regard to patient and graft survivals and biliary complications. Mean follow-up was 26.4 months. Mean donor age was 56.3±14.5 years (25 - 83). Donor causes of death were due to anoxia (51.8%), stroke (32.1%) and head trauma (14.3%). Mean WIT, CIT and suture time were 20.5±7.1min (10 – 39), 265.6±85.1min (105 – 576), and 40.8±7.8 min (25 – 61), respectively. 95% of liver grafts were locally shared. HTK was the most commonly used perfusion solution (86%). Mean recipient age was 56.6±10.5 years (29 – 73). Indications for LT included ESLD (53.6%) and HCC (46.6%). Mean MELD score at transplant was 15.6±6.1points (6 – 40). Results: No primary non-function grafts. Mean peak serum AST and bilirubin levels were 2520±3621UI/L and 50.2±49.2mg/L, respectively. Eight patients (14.3%) developed biliary complications. No intra-hepatic bile duct strictures or re-transplantation. Global patient and graft survival was 92.6% at 3 months, 92.6% at 1 year, 73.8% at 3 years and 60% at 5 years. Death-censored patient and graft survival at the corresponding time points was 92.6%, 92.6%, 87.7% and 87.7%. Thirteen liver grafts were lost during follow-up exclusively due to recipient deaths. The rate of HCC recurrence was 33.3%. Conclusions: Controlled DCD donors are a valuable source of transplantable liver grafts. Primary results are encouraging and apparently as good as those from brain-dead donation LT essentially due to short WIT and CIT. [less ▲]Detailed reference viewed: 28 (1 ULg)
Laparoscopic liver resection: a single center experience
SZECEL, Delphine ; DE ROOVER, Arnaud ; DELWAIDE, Jean et al
in Acta Chirurgica Belgica (2012, May), 112(3), 631Detailed reference viewed: 27 (1 ULg)
Update of the Belgian Association for the Study of the Liver Guidelines for the treatment of chronic hepatitis C genotype 1 with protease inhibitors.
; ; et al
in Acta Gastro-Enterologica Belgica (2012), 75(2), 245-259Detailed reference viewed: 6 (1 ULg)
The influence of laboratory-induced Meld score differences on liver allocation: more reality than myth.
; ; et al
in Clinical Transplantation (2012), 26(1), 62-70
Background: Liver allocation in Eurotransplant (ET) is based on the MELD score. Interlaboratory MELD score differences in INR and creatinine determination have been reported. The clinical implication of ... [more ▼]
Background: Liver allocation in Eurotransplant (ET) is based on the MELD score. Interlaboratory MELD score differences in INR and creatinine determination have been reported. The clinical implication of this observation has not been demonstrated. Methods: MELD scores were calculated in 66 patients with liver cirrhosis using bilirubin, creatinine, and INR analyzed in six liver transplant centers. Based on allocation results of ET, patients transplanted from December 2006 to June 2007 were divided according to MELD score in four groups. For each group, the influence of the match MELD on the probability of receiving a transplant was studied (Cox proportional hazards model). Results: Laboratory-dependent significant differences in MELD score were demonstrated. Cox proportional hazards model showed a significant association between MELD score and the probability of organ allocation. The unadjusted hazard ratio for receiving a liver transplant was significantly different between group 2 and group 4 (group 2: MELD 19–24; group 4: MELD > 30). Conclusion: Laboratory-dependent significant differences in MELD score were observed between the six transplant centers. We demonstrated a significant association between the MELD score and the probability of organ allocation. The observed interlaboratory variation might yield a significant difference in organ allocation in patients with high MELD scores. [less ▲]Detailed reference viewed: 15 (2 ULg)
HBV infection in Belgium: results of the BASL observatory of 1456 HBsAg carriers.
; ; et al
in Acta Gastro-Enterologica Belgica (2012), 75(1), 35-41
Introduction : Nationwide studies are mandatory to assess changes in the epidemiology of HBV infection in Europe. Aim : To describe epidemiological characteristics of HBsAgpositive patients, especially ... [more ▼]
Introduction : Nationwide studies are mandatory to assess changes in the epidemiology of HBV infection in Europe. Aim : To describe epidemiological characteristics of HBsAgpositive patients, especially inactive carriers, and to evaluate how practitioners manage HBV patients in real life. Methods : Belgian physicians were asked to report all chronically infected HBV patients during a one-year period. Results : Among 1,456 patients included, 1,035 (71%) were classified into one of four phases of chronic infection : immune tolerance (n = 10), HBeAg-positive hepatitis (n = 248), HBeAgnegative hepatitis (n = 420) and inactive carrier state (n = 357 HBeAg-negative patients with ALT < upper limit of normal (ULN) and HBV DNA < 2,000 IU/mL). Using less restrictive criteria for ALT (1-2 ULN) or HBV DNA (2,000-20,000 IU/mL), 93 unclassified patients were added to the group of inactive carriers. These 93 additional inactive carriers were younger, more frequently males, with similar risk factors for HBV infection and histological features compared to inactive carriers according to recent guidelines. Recent guidelines on management of HBV patients were generally followed, but systematic HBV DNA measurements and HDV coinfection screening should be reinforced. Conclusion : In Belgium, an inactive carrier state was a common form of chronic HBV infection. Using less restrictive criteria for classification of inactive carriers did not modify their main characteristics and seemed better adapted to clinical practice. Recent guidelines on management of HBV patients should be reinforced. [less ▲]Detailed reference viewed: 19 (3 ULg)
HCV screening in African (Malian) women : relevancy of the HCV NS3 epitope
; VAIRA, Dolorès ; GOTHOT, André et al
Poster (2012)Detailed reference viewed: 5 (3 ULg)
Study of HCV and HIV infections in Mali: Comparative Epidemiology and Risk Factors
; VAIRA, Dolorès ; GOTHOT, André et al
Poster (2012)Detailed reference viewed: 9 (4 ULg)
Liver transplantation for acute hepatic failure due to chemotherapy-induced HBV reactivation in lymphoma patients.
; ; Bataille, Christian et al
in World journal of gastroenterology : WJG (2011), 17(25), 3069-72
Hepatitis B (HBV) reactivation induced by chemotherapy is problem encountered recently in the management of malignant diseases. Chemotherapy-induced HBV reactivation may ultimately lead to terminal acute ... [more ▼]
Hepatitis B (HBV) reactivation induced by chemotherapy is problem encountered recently in the management of malignant diseases. Chemotherapy-induced HBV reactivation may ultimately lead to terminal acute liver failure. Liver transplantation (LT) currently remains the only definitive treatment option for such cases, but is generally denied to patients suffering from malignancy. Here, the authors describe 2 cases of cancer-free and HBV graft re-infection-free survival after LT performed for terminal liver failure arising from HBV reactivation induced by chemotherapy for advanced stage lymphoma. These 2 cases, and some other reports in the literature, may suggest that patients suffering from hematologic malignancies and terminal liver disease can be considered for LT if the prognosis of their hematologic malignancy is good. [less ▲]Detailed reference viewed: 17 (2 ULg)
Efficacy of interferon-based antiviral therapy in patients with chonic hepatitis C infected HCV genotype 5: a meta-analysis of two large prospective clinical trials
; ; et al
in Journal of Medical Virology (2011), 83(5), 815-819
The characteristics and response rate to pegylated interferon and ribavirin (PEG-INF + RBV) of patients with chronic hepatitis C infected with genotype 5 are poorly documented. A meta-analysis of two ... [more ▼]
The characteristics and response rate to pegylated interferon and ribavirin (PEG-INF + RBV) of patients with chronic hepatitis C infected with genotype 5 are poorly documented. A meta-analysis of two large phase III/IV prospective randomized clinical trials conducted in Belgium in patients with chronic hepatitis C (n = 1,073 patients) was performed in order to compare the response to antiviral therapy of hepatitis C virus (HCV) genotype 5 with that of other HCV genotypes. A subset of HCV-1 infected patients selected from within the study database were selected to match the HCV-5 sample for known prognostic factors. In Belgium HCV-5 is responsible for a significant minority of cases of chronic hepatitis C CHC (4.5%) and is characterized by a more advanced age (58.4 years), a high frequency of cirrhosis (27.7%), a specific mode of HCV acquisition, and a particular geographic origin (66.7% of patients from West Flanders). The primary comparative analysis showed that response to treatment with PEG-INF + RBV of HCV-5 is similar to HCV-1 and lower compared to HCV-2/3. The analysis of the matched patient subgroup demonstrates that the HCV-5 "intrinsic sensitivity" to PEG-IFN + RBV therapy is identical to HCV-1, with a sustained virological response of 55% in both groups. In contrast to previous publications, this meta-analysis suggests that HCV-5 response to treatment is closer to HCV-1 than to HCV-2/3 and suggests that in Belgium HCV-5 infection should be treated with the same antiviral regimen as HCV-1. [less ▲]Detailed reference viewed: 13 (1 ULg)
Liver transplantation for donation after cardiocirculatory death donors: Belgian experience 2003-2009
DE ROOVER, Arnaud ; ; et al
Conference (2011, March 24)Detailed reference viewed: 9 (2 ULg)
Laparoscopic liver resection: monocentric university experience
; ARENAS SANCHEZ, Maria Mara ; DE ROOVER, Arnaud et al
in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 30Detailed reference viewed: 31 (7 ULg)
Donation after Cardiac Death increases the number of liver grafts for liver transplantation
; HANS, Marie-France ; MONARD, Josée et al
in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 10Detailed reference viewed: 16 (1 ULg)
Outcome of patients with hepatocellular carcinoma listed for liver transplantation before and after the MELD-based allocation system within Eurotransplant. A BElgian multicentre retrospective study.
; ; et al
in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 13Detailed reference viewed: 23 (3 ULg)
Ruptured hepatocellular carcinoma following transcatheter arterial chemoembolization.
BRULS, Samuel ; JOSKIN, Julien ; Chauveau, Raphaël et al
in JBR-BTR : Journal Belge de Radiologie - Belgisch Tijdschrift voor Radiologie (2011), 94(2), 68-70
Transcatheter arterial chemoembolization (TACE) is known to be an effective palliative treatment in unresectable hepatocellular carcinoma (HCC). Although TACE can control tumour growth and palliate the ... [more ▼]
Transcatheter arterial chemoembolization (TACE) is known to be an effective palliative treatment in unresectable hepatocellular carcinoma (HCC). Although TACE can control tumour growth and palliate the patients, complications of TACE with significant morbidity are well known and adversely affect the outcome of patients. Necrotic tumor rupture is a serious complication of TACE and has a high mortality rate. We report a case of ruptured HCC following TACE in a 78-year-old male patient who subsequently developed peritonitis and pneumoperitoneum. This case gives us the opportunity to underline the importance of such complications and demonstrates the utility of CT imaging for diagnosis and management of patients with ruptured HCC. [less ▲]Detailed reference viewed: 9 (1 ULg)
Evolution over a 15 year period of the epidemiological profile of 2884 newly diagnosed HCV patients in Belgium.
LOLY, Jean ; GERARD, Christiane ; VAIRA, Dolorès et al
in Acta Gastro-Enterologica Belgica (2011, March), 74Detailed reference viewed: 25 (8 ULg)