References of "DELWAIDE, Jean"
     in
Bookmark and Share    
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 92 (16 ULg)
Full Text
Peer Reviewed
See detailOutcome of Patients with Hepatocellular Carcinoma Listed for Liver Transplantation Within the Eurotransplant Allocation System
Adler, Michael; De Pauw, Filip; Vereerstraeten, Pierre et al

in Liver Transplantation (2008), 14

Although hepatocellular carcinoma (HCC) has become a recognized indication for liver transplantation, the rules governing priority and access to the waiting list are not well defined. Patient- and tumor ... [more ▼]

Although hepatocellular carcinoma (HCC) has become a recognized indication for liver transplantation, the rules governing priority and access to the waiting list are not well defined. Patient- and tumor-related variables were evaluated in 226 patients listed primarily for HCC in Belgium, a region where the allocation system is patient-driven, priority being given to sicker patients, based on the Child-Turcotte-Pugh (CTP) score. Intention-to-treat and posttransplantation survival rates at 4 years were 56.5 and 66%, respectively, and overall HCC recurrence rate was 10%. The most significant predictors of failure to receive a transplant in due time were baseline CTP score equal to or above 9 (relative risk [RR] 4.1; confidence interval [CI]: 1.7-9.9) and alpha fetoprotein above 100 ng/mL (RR 3.0; CI: 1.2-7.1). Independent predictors of posttransplantation mortality were age equal to or above 50 years (RR 2.5; CI: 1.0-3.7) and United Network for Organ Sharing pathological tumor nodule metastasis above the Milan criteria (RR 2.1; CI: 1.0-5.9). Predictors of recurrence (10%) were _ fetoprotein above 100 ng/mL (RR 3.2; CI:1.1-10) and vascular involvement of the tumor on the explant (RR 3.6; CI: 1.1-11.3). Assessing the value of the pretransplantation staging by imaging compared to explant pathology revealed 34% accuracy, absence of carcinoma in 8.3%, overstaging in 36.2%, and understaging in 10.4%. Allocation rules for HCC should consider not only tumor characteristics but also the degree of liver impairment. Patients older than 50 years with a stage above the Milan criteria at transplantation have a poorer prognosis after transplantation. [less ▲]

Detailed reference viewed: 46 (12 ULg)
Full Text
Peer Reviewed
See detailChronic hepatitis C infection in a patient with bone marrow hypoplasia.
Bethlen, S.; Chandrikakumari, Kavitha; de Leval, Laurence ULg et al

in World Journal of Gastroenterology (2008), 14(26), 4238-40

Chronic hepatitis C virus (HCV) infection is associated with multifarious extra-hepatic manifestations; the most described and discussed being mixed cryoglobulinemia which is strongly related to B-cell ... [more ▼]

Chronic hepatitis C virus (HCV) infection is associated with multifarious extra-hepatic manifestations; the most described and discussed being mixed cryoglobulinemia which is strongly related to B-cell lymphoproliferative disorders (LPDs). We present a case of chronic HCV infection and mixed cryoglobulinemia, with minimal liver involvement. The case is a 53-year-old patient who was diagnosed as having bone marrow hypoplasia at the age of three. She received several blood transfusions to normalize her haemoglobin. At the age of 31, she was diagnosed with rheumatoid arthritis on account of her diffuse joint pain and inflammation, elevated rheumatoid factor (RF) and Raynaud's phenomenon. Twenty years later, monoclonal gammopathy of IgG Lambda (one year later, changed to IgM Kappa) was detected during a routine examination. A bone marrow biopsy showed hypoplasia, Kappa positive B-lymphocytes and low-grade malignant lymphoma cells. PCR of the bone marrow aspirate was not contributory. No treatment was initiated owing to her poor bone marrow function and she is under regular follow-up. [less ▲]

Detailed reference viewed: 52 (6 ULg)
Full Text
Peer Reviewed
See detailDiscussion on the risk of surgery in patients with cirrhosis
Colle, I.; Orlent, H.; Delwaide, Jean ULg

in Acta Gastro-Enterologica Belgica (2008), 71(1), 47

Several reasons result in the finding that patients with cirrhosis need surgery more often than other patients groups. Patients with cirrhosis frequently have comorbidities resulting in gastrointestinal ... [more ▼]

Several reasons result in the finding that patients with cirrhosis need surgery more often than other patients groups. Patients with cirrhosis frequently have comorbidities resulting in gastrointestinal, lung or cervical cancer, among others. Independent of cirrhosis, surgical resection may be the best alternative for a number of those malignancies. Comorbidities may also result in an increased incidence of vascular complications (such as lower extremity atherosclerosis and coronary stenosis) sorne of them being potential indications for surgery, Patients with alcohofic cirrhosis are more frequently subjected to trauma and bone fractures. Ascites leads to umbilical hernia which can be strangulated or ruptured. Emergency surgery may be needed in this context. Finally, a significant proportion of patients with cirrhosis develop hepatocellular carcinoma (HCC) during the course of the disease. Surgical resection remains a first line option for HCC. While reliable guidefines have been proposed for surgical resection of HCC and liver transplantation, no precise guidelines are available for other aspects of surgical management during cirrhosis. Specific surgical procedures such as hepatectomy and transplantation are concentrated in highly speciafised centres, where detailed evaluation is relatively easy to obtain. In contrast, more general surgical procedures, either abdominal or non abdominal, are performed in various centres, making it more difficult to obtain detailed evaluation and draw recommendations. General surveys are still needed to precisely assess the risk of non-specifie surgery in patients with cirrhosis, to identify risk factors and to propose reliable guidelines. [less ▲]

Detailed reference viewed: 21 (0 ULg)
Full Text
Peer Reviewed
See detailL'hépatite E : une hépatite du tiers-monde présente en Belgique
Seivert, Maxime ULg; Belaiche, Jacques ULg; Delwaide, Jean ULg

in Revue Médicale de Liège (2008), 63

Detailed reference viewed: 126 (14 ULg)
Full Text
Peer Reviewed
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

Detailed reference viewed: 75 (20 ULg)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 76 (9 ULg)
Full Text
Peer Reviewed
See detailActualites therapeutiques en hepato-gastroenterologie
Belaiche, Jacques ULg; Delwaide, Jean ULg; Polus, Marc ULg et al

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 303-9

During the last decade, advances in molecular biology and biotechnology allowed, the development of biological treatments aimed at more precise targets. New algorithms in inflammatory bowel diseases ... [more ▼]

During the last decade, advances in molecular biology and biotechnology allowed, the development of biological treatments aimed at more precise targets. New algorithms in inflammatory bowel diseases, chronic hepatitis C and digestive oncology are examples of the marked progress achieved by these therapies. [less ▲]

Detailed reference viewed: 91 (2 ULg)
Full Text
Peer Reviewed
See detailLe Fibroscan: une nouvelle méthode d’évaluation non invasive de la fibrose hépatique
Lamproye, Anne ULg; Belaiche, Jacques ULg; Delwaide, Jean ULg

in Revue Médicale de Liège (2007), 62 Spec No

The FibroScan is a device allowing a non invasive diagnosis and quantification of liver fibrosis. The procedure is based on transient elastography and allows to record liver stiffness by measuring the ... [more ▼]

The FibroScan is a device allowing a non invasive diagnosis and quantification of liver fibrosis. The procedure is based on transient elastography and allows to record liver stiffness by measuring the velocity of shear wave across liver parenchyma. The elasticity is directly correlated to velocity of the wave. In chronic hepatitis C, there is a good correlation between liver elasticity and stage of fibrosis. The FibroScan has also been studied in other chronic liver diseases, such as hepatitis B, primary biliary cirrhosis, sclerosing cholangitis, auto-immune hepatitis, alcohol, steatosis, hemachromatosis with reproductible results. In a cirrhotic patient, it also allows to assess the severity of cirrhosis and to evaluate the risk of complication. It is a painless procedure, with a good acceptability by the patients. Therefore, the FibroScan can be regularly performed, allowing the follow up of fibrosis evolution over time. [less ▲]

Detailed reference viewed: 71 (3 ULg)
Full Text
Peer Reviewed
See detailPeginterferon alpha-2b is safe and effective in HBeAg-positive chronic hepatitis B patients with advanced fibrosis.
Buster, Erik H C J; Hansen, Bettina E; Buti, Maria et al

in Hepatology (Baltimore, Md.) (2007), 46(2), 388-94

Chronic hepatitis B (CHB) patients with advanced fibrosis are often not considered for treatment with peginterferon (PEG-IFN) because IFN therapy may precipitate immunological flares, potentially inducing ... [more ▼]

Chronic hepatitis B (CHB) patients with advanced fibrosis are often not considered for treatment with peginterferon (PEG-IFN) because IFN therapy may precipitate immunological flares, potentially inducing hepatic decompensation. We investigated the efficacy and safety of treating hepatitis B e antigen (HBeAg)-positive CHB patients with 52 weeks of PEG-IFN-alpha-2b (100 microg weekly) alone or in combination with lamivudine (100 mg daily). Seventy patients with advanced fibrosis (Ishak fibrosis score 4-6) and 169 patients without advanced fibrosis, all with compensated liver disease, participated in the study. Virologic response, defined as HBeAg seroconversion and hepatitis B virus (HBV) DNA < 10,000 copies/ml at week 78, occurred significantly more often in patients with advanced fibrosis than in those without (25% versus 12%, respectively; P = 0.02). Also patients with cirrhosis (n = 24) exhibited a virologic response more frequently than did patients without cirrhosis (30% versus 14%, respectively; P = 0.02). Improvement in liver fibrosis occurred more frequently in patients with advanced fibrosis (66% versus 26%, P < 0.001). HBV genotype A was more prevalent among patients with advanced fibrosis than among those without (57% versus 24%, P < 0.001). Most adverse events, including serious adverse events, were observed equally as frequently in patients with advanced fibrosis and those without. Fatigue, anorexia, and thrombocytopenia occurred more often in patients with advanced fibrosis than in those without (P < 0.01). Necessary dose reduction or discontinuation of therapy was comparable for both patient groups (P = 0.92 and P = 0.47, respectively). CONCLUSION: PEG-IFN is effective and safe for HBeAg-positive patients with advanced fibrosis. Because PEG-IFN therapy results in a high rate of sustained off-therapy response, patients with advanced fibrosis or cirrhosis but compensated liver disease should not be excluded from PEG-IFN treatment. [less ▲]

Detailed reference viewed: 38 (3 ULg)
Full Text
Peer Reviewed
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

Detailed reference viewed: 54 (3 ULg)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 80 (21 ULg)
Full Text
Peer Reviewed
See detailBloodless cadaveric liver transplantation: Experience with Jehovah's witness recipients
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in Journal of Hepatology (2007), 46(Suppl. 1), 67

Detailed reference viewed: 37 (16 ULg)
Full Text
Peer Reviewed
See detailActualites en chirurgie et transplantation hepatique
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in Revue Médicale de Liège (2007), 62(5-6, May-Jun), 310-6

Over the last 20 years, significant improvements in hepatic surgery and transplantation have allowed better results. Better patients selection, new preoperative modalities aiming at modifying the volume ... [more ▼]

Over the last 20 years, significant improvements in hepatic surgery and transplantation have allowed better results. Better patients selection, new preoperative modalities aiming at modifying the volume of the liver or the tumour, new surgical techniques, and better postoperative management are the keys to improved outcome. These progresses are reviewed in this article. In hepatic surgery, the latest surgical improvements are the possibility of laparoscopic hepatic resection and of radiofrequency ablation. Modern neoadjuvant chemotherapy may in some cases allow a reduction of large liver colorectal metastases and render them resectable. Improved radiological techniques allow better planning of the surgical resections, reduction of the risks by calculation of the residual liver mass, and induction of liver hypertrophy by preoperative portal embolisation. In liver transplantation, the most significant changes were the use of living related liver donors and of non-heart beating donors to overcome the cadaveric organ donor shortage. [less ▲]

Detailed reference viewed: 167 (18 ULg)
Full Text
Peer Reviewed
See detailComment interpréter une élévation de la ferritine sérique?
Langlet, P.; Delwaide, Jean ULg

in Revue Médicale de Bruxelles (2007), 28(4), 265-269

The presence of hyperferritinemia has to rule out acquired causes such as chronic inflammatory disorders, hemolytic anemia, liver diseases as hepatitis B or C, alcohol abuse and non alcoholic fatty liver ... [more ▼]

The presence of hyperferritinemia has to rule out acquired causes such as chronic inflammatory disorders, hemolytic anemia, liver diseases as hepatitis B or C, alcohol abuse and non alcoholic fatty liver disease, specially in patients with normal transferrine saturation. Genetic testing for hemochromatosis is systematically indicated in all patients with elevated transferrine saturation. When an iron overload is demonstrated in the absence of these classic causes, second-line genetic testing should be considered to exclude non HFE hemochromatosis. The aim of this paper is to propose a practical algorithm in the diagnosis of hyperferritinemia and to precise the diagnostic and therapeutic management of genetic hemochromatosis. [less ▲]

Detailed reference viewed: 138 (1 ULg)
Full Text
Peer Reviewed
See detailManagement and treatment of chronic hepatitis B virus: Belgian Association for the Study of the Liver (BASL) 2007 guidelines
Colle, I.; Adler, M.; Brenard, R. et al

in Acta Gastro-Enterologica Belgica (2007), 70(4), 389-420

1. Introduction Chronic hepatitis B virus (HBV) infection currently affects about 400 million people and is responsible for 500,000 to 1,000,000 deaths annually worldwide from cirrhosis and hepatocellular ... [more ▼]

1. Introduction Chronic hepatitis B virus (HBV) infection currently affects about 400 million people and is responsible for 500,000 to 1,000,000 deaths annually worldwide from cirrhosis and hepatocellular carcinoma (HCC) (1). For this reason, screening high risk populations to identify HBV infected persons is important so that guidelines for treatment and prevention of transmission can be given in this specific group. Recently, new drugs became available for HBV and new insights in resistance and definitions came up. So, the purpose of this paper is providing an update of the recent literature and guidelines concerning 1. screening for chronic hepatitis B (CHB) 2. management of patients with CHB 3. treatment of CHB in mono-infected patients and in special patient populations (co-infected, transplanted and immunosuppressed patients). The recommendations are based onpublished information and the level of evidence is reported with each recommendation. The level of evidence is graded as :grade 1 : randomized controlled trials ; grade II-1 : controlled trials without randomization ; grade 11-2 : cohort or case-control analytic study ; grade 11-3 : multiple time series, dramatic uncontrolled experiments ; grade III : descriptive epidemiology, expert opinions. [less ▲]

Detailed reference viewed: 27 (0 ULg)
Full Text
Peer Reviewed
See detailHCV genotype 4 in Belgium: three distinct patterns among patients from European and African origin
Delwaide, Jean ULg; Reenaers, Catherine ULg; Gerard, Christiane ULg et al

in European Journal of Gastroenterology & Hepatology (2006), 18(7), 707-712

Background Considered uncommon in western countries some years ago, hepatitis C virus of genotype 4 is now spreading in some areas of Europe. This is assumed to be due to immigration from a region of high ... [more ▼]

Background Considered uncommon in western countries some years ago, hepatitis C virus of genotype 4 is now spreading in some areas of Europe. This is assumed to be due to immigration from a region of high prevalence for this genotype and to propagation among drug users. In the south of Belgium, genotype 4 currently accounts for 10% of hepatitis C virus patients and its prevalence is increasing with time. Objective To better define the genotype 4 carriers' characteristics. Methods In a database comprising 1726 viraemic hepatitis C virus patients, the files of 85 genotype 4 carriers were reviewed. Results Beside the African (58%) and European drug user (15%) subgroups classically described, a third subgroup consisting of European nondrug users (26%) was identified as peculiar: these patients were older, had been mostly contaminated sporadically, presented a great diversity of subtypes, and were mainly of Italian origin. In this subgroup, contamination was supposed to be ancient, having occurred probably in Italy before immigration into Belgium. By contrast, European drug users were infected with only two subtypes (4c/4d and 4), an observation in favour of recent spread. Africans had a great diversity of subtypes, were young, and were mostly contaminated sporadically in their home countries. Despite their epidemiological differences, the clinical management, and in particular the rates of eligibility for treatment, were similar for these three groups. Conclusions Three different patterns of genotype 4 carriers were observed, corresponding to three different spreading profiles. They did not induce, however, different clinical management. [less ▲]

Detailed reference viewed: 46 (15 ULg)
Full Text
Peer Reviewed
See detailEmergency graft removal after liver transplantation
Detry, Olivier ULg; De Roover, Arnaud ULg; Delwaide, Jean ULg et al

in Liver Transplantation (2006, May), 12(5), 72

Detailed reference viewed: 21 (4 ULg)