References of "Delwaide, Jean"
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See detailDonation after Cardiac Death In Liver Transplantation :is donor age an issue?
Detry, Olivier ULg; De Roover, Arnaud ULg; Squifflet, Jean-Paul ULg et al

in Transplant International (2010, July), 23(Suppl. 1), 415

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See detailDéfis pour réduire la mortalité liée à l'hépatite C: améliorer l'accessibilité au traitement et l'observance thérapeutique
Delwaide, Jean ULg; Lamproye, Anne ULg; Belaiche, Jacques ULg

in Revue Médicale de Liège (2010), 65(5-6), 354-357

Current therapies with pegylated interferon and ribavirin are effective to eradicate the virus C. Improvements in the treatment are foreseen in the near future with combination of the current treatment ... [more ▼]

Current therapies with pegylated interferon and ribavirin are effective to eradicate the virus C. Improvements in the treatment are foreseen in the near future with combination of the current treatment with antiviral therapies (antiproteases, antipolymerases). Eradication of the virus, when obtained, has a favorable impact on an individual basis. However, to reduce the mortality related to the virus C at a population level, an important point is the accessibility to the therapy. It has been calculated that the impact of better management of hepatitis C to reduce mortality is minimal, due to a poor accessibility to the therapy. To obtain a significant additional reduction of mortality, a better screening, a better access to therapy and a better compliance are crucial. [less ▲]

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See detailDonation after Cardiac Death In Liver Transplantation :is donor age an issue?
Detry, Olivier ULg; De Roover, Arnaud ULg; Squifflet, Jean-Paul ULg et al

in Acta Gastro-Enterologica Belgica (2010), 35(1), 25

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See detailEffectiveness and tolerability of pegylated interferon alfa2b in combination with ribavirin for treatment of chronic hepatitis C: the PegIntrust study
Van Vlierberghe, H.; Adler, M.; Bastens, B. et al

in Acta Gastro-Enterologica Belgica (2010), 73

Background and study aims : Large international clinical trials conducted in the past 5 years rapidly improved the treatment of chronic hepatitis C; however, it is unclear whether the advances seen in ... [more ▼]

Background and study aims : Large international clinical trials conducted in the past 5 years rapidly improved the treatment of chronic hepatitis C; however, it is unclear whether the advances seen in clinical trials are being paralleled by similar improvements in routine clinical practice. PegIntrust is a Belgian community based trial evaluating the sustained virological response. Patients and Methods : Observational study of 219 patients receiving pegylated interferon alfa-2b (1.5 μg/kg/wk) and weight-based ribavirin (800-1200 mg/day) for 48 weeks. Primary study end point was sustained virological response (SVR), defined as undetectable HCV RNA 6 months after the completion of treatment. Results : In total, 108 patients (49.3 %) had undetectable HCV RNA at the end of therapy, 91 (41.6%) attaining SVR. Of the 111 patients without an end-of-treatment response, 28 were non-responders, and 21 had virological breakthrough. In total, 134 patients attained early virological response (EVR); 88 (65.7%) of those patients attained SVR. In contrast, 82 (96.5 %) of the 85 patients who did not attain EVR also did not attain SVR. Age, fibrosis score and baseline viral load were identified as important predictors of treatment outcome. The most frequently reported serious adverse events resulting in treatment discontinuation were anemia (n = 10), fatigue/asthenia/malaise (n = 6) and fever (n = 3). Conclusion : Our data indicate that treatment of chronic hepatitis C with PEG-IFN alfa-2b plus weight-based ribavirin results in favourable treatment outcomes in a Belgian cohort of patients treated in community- based clinical practice. [less ▲]

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See detailHepatitis C genotype 4 response rate to pegylated interferon and ribavirin treatment in Belgium is similar to genotype 1
de Galocsy, C.; Kaufman, L.; Tomasovic, S. et al

in Acta Gastro-Enterologica Belgica (2010), 73

Background and aims : Patients with genotype 4 (G4) chronic hepatitis C from the Middle East respond better to treatment than genotype 1 (G1) patients. There are few data on the response rates to ... [more ▼]

Background and aims : Patients with genotype 4 (G4) chronic hepatitis C from the Middle East respond better to treatment than genotype 1 (G1) patients. There are few data on the response rates to treatment of G4 patients living in Western Europe. Many G4 patients in Belgium originate from Central Africa, and their response to treatment seems lower. Methods : We analysed the data from 2 randomized phase III studies conducted in Belgium, BerNar-1 and BerNar-2, comparing the sustained virological response (SVR) to pegylated interferon and ribavirin of 78 G4 patients (34 Caucasians, 44 Blacks) and 477 G1 patients (455 Caucasians, 12 Blacks), and assessing the predictors of SVR. Results : Baseline characteristics of G4 and G1 patients were similar except mainly for race. Complete early virological response (cEVR) was similar in G4 (73.2%) and G1 (68.1%). cEVR was also similar between Black and Caucasian G4 and between Black and Caucasian G1 patients. Partial early virological response was similar for G4 and G1. SVR was similar for G4 (51.3%) and G1 (51.8%). There was a trend for a higher SVR in Caucasians than in Blacks. In multivariate analysis, the only predictors for SVR were the presence of cirrhosis, HCV viral load, age < 40 vs 40 yrs, and treatment status (relapsers vs naïve). Conclusions : G4 patients in Belgium have the same SVR as G1 patients. It is lower than the SVR described in Arab countries, especially for Black G4 patients. (Acta gastro enterol. belg., 2010, 73, 229-234). [less ▲]

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See detailA randomized, open-label, multicenter study evaluating the efficacy of peginterferon alfa-2a versus interferon alfa-2a, in combination with ribavirin, in naïve and relapsed chronic hepatitis C patients.
Nevens, F.; Van Vlierberghe, H.; D'Heygere, F. et al

in Acta Gastro-Enterologica Belgica (2010), 73

Background/Aims : A large multicenter trial to compare the efficacy of peginterferon alfa-2a with interferon alfa-2a, in combination with ribavirin, in chronic hepatitis C patients. Efficacy data for ... [more ▼]

Background/Aims : A large multicenter trial to compare the efficacy of peginterferon alfa-2a with interferon alfa-2a, in combination with ribavirin, in chronic hepatitis C patients. Efficacy data for prior relapsers are reported because treatment recommendations for this patient population are not well defined. Patients and methods : This study was a multicenter, prospective, randomized clinical trial. The primary efficacy endpoint was sustained virologic response in naïve patients (n = 348) and relapsers (n = 95). Results : Sustained virologic response rates were similar in naïve patients and relapsers, both for non-pegylated and pegylated interferon (respectively 27 and 26% and 54 and 43%). Pegylated interferon given for 48 weeks did not improved the relapse rate : 15.9 and 27.3% for non-pegylated and 16.7 and 30.4% for pegylated interferon, naïve vs relapsers respectively. Stepwise logistic regression analysis revealed a significant association between slow response (detectable HCV RNA at week 12 and undetectable at week 24) and relapse in patients with an end-of-treatment response (55% versus 13% respectively ; p = 0.02 ; odds ratio = 6.07). Conclusions : This trial confirms the value of using peginter - feron alfa-2a in both naïve and relapsed patients and provides support for a more tailored approach to treatment for relapsers and particulary for patients with a slow viral response. (Acta gastro enterol. belg., 2010, 73, 223-228). [less ▲]

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See detailL'hippocratisme digital.
Salerno, D.; Delwaide, Jean ULg; Detry, Olivier ULg

in Revue Médicale de Liège (2010), 65(2), 88-92

Digital clubbing is a clinical sign known for centuries. Though, no theory could yet explain this entire phenomenon, neither in its primary nor its secondary form. This article reviews the actual ... [more ▼]

Digital clubbing is a clinical sign known for centuries. Though, no theory could yet explain this entire phenomenon, neither in its primary nor its secondary form. This article reviews the actual hypotheses bringing a plausible explanation, regarding the most current pathologies associated with digital clubbing. A focus is made on pulmonary and digestive pathologies, and particularly cirrhosis. The knowledge of the mechanisms underlying finger clubbing might lead, in the future, to an effective treatment. [less ▲]

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See detailL’étude du mois. Traitement de l’hépatocarcinome au stade palliatif par Sorafenib (Nexavar) :Résultats de l’étude SHARP (Sorafenib Hepatocarcinoma Assessment Randomized Protocol)
Detry, Olivier ULg; Delwaide, Jean ULg; Deroover, Arnaud ULg et al

in Revue Médicale de Liège (2009), 64(3), 168-170

Curative management of early-stage hepatocarcinoma may include partial hepatic resection, liver transplantation or tumoral necrosis using radiofrequency ablation or alcoholisation. Until recently, no ... [more ▼]

Curative management of early-stage hepatocarcinoma may include partial hepatic resection, liver transplantation or tumoral necrosis using radiofrequency ablation or alcoholisation. Until recently, no efficient therapeutic mean was available for advanced hepatocarcinoma. Sorafenib is a multikinase inhibitor that decreases tumoral proliferation and angiogenesis, and increases apoptosis in many cancer models. The results of a phase 3 randomized, multicentric, study, entitled SHARP, have now demonstrated that Sorafenib increases survival in patients with advanced hepatocarcinoma developed in Child A cirrhosis. Mean survival gain was a little less than 3 months, without any radiologic response or improvement in the delay before symptomatic progression of the disease. The monthly cost of Sorafenib is a little more than 5,000 euros. It is now crucial to evaluate the potential role of Sorafenib in adjuvant therapy after liver resection or radiofrequency ablation of hepatocarcinoma. The CHU of Liège is taking part to a randomized, multicentric study evaluating the use of Sorafenib after liver resection or radiofrequency ablation for hepatocarcinoma. Another future evaluation could be the association of Sorafenib with other antitumoral agents. [less ▲]

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See detailTraitement des carcinomes hépatocellulaires à un stade avancé
Van Daele, Daniel ULg; Belaiche, Jacques ULg; Delwaide, Jean ULg et al

in Revue Médicale de Liège (2009), 64(3), 140-147

Hepatocellular carcinoma is the main primitive tumor of the liver. It occurs in the setting of liver cirrhosis in more than 90% of the cases in developping countries. The prognosis depends on the size ... [more ▼]

Hepatocellular carcinoma is the main primitive tumor of the liver. It occurs in the setting of liver cirrhosis in more than 90% of the cases in developping countries. The prognosis depends on the size, number and extension of the tumor as well as on the severity of the underlying liver disease. The Barcelona Clinic Classification takes into account these different parameters and helps the clinician in the therapeutic decision. Some patients (around 25%) are amenable to therapy with a curative intent (liver transplantation, resection, destruction by radiofrequency). In patients with hepatocellular carcinoma at an intermediate stage, lipiodolized chemoembolization gives a survival advantage in comparison with placebo. No conventional regimen of chemotherapy has a proven survival benefit. In patients with a hepatocellular carcinoma at an advanced stage, sorafenib, an oral multi-targeted kinase inhibitor, is the first coumpound to demonstrate a significant effect on survival free of disease progression in a selected group of patients. Its toxicity profile is particularly favourable. Combination of surgical and medical therapies should be properly evaluated in clinical trials in the near future. [less ▲]

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See detailLiver transplant donation after cardiac death : experience at the University of Liège
Detry, Olivier ULg; Seydel, Benoît ULg; Delbouille, Marie-Hélène ULg et al

in Transplantation Proceedings (2009), 41(2), 582-4

Aim: Donation after cardiac death (DCD) has been proposed to partly overcome the organ donor shortage. In liver transplantation, the additional warm ischemia linked to DCD procurement may promote higher ... [more ▼]

Aim: Donation after cardiac death (DCD) has been proposed to partly overcome the organ donor shortage. In liver transplantation, the additional warm ischemia linked to DCD procurement may promote higher rate of primary non-function and ischemic type biliary lesions. In this study we reviewed the results of DCD liver transplantation at the University of Liège. Patients and Methods: From 2003 to 2007, 13 controlled DCD liver transplantations were consecutively performed. The records of all donors and recipients were retrospectively reviewed, particularly evaluating the outcome and the occurrence of biliary complications. Mean follow-up was 25 months. Results: Mean donor age was 51 years and their mean intensive care stay was 5.4 days. Mean time between ventilation arrest and cardiac arrest was 9.3 min. Mean time between cardiac arrest and arterial flush was 7.7 min. No touch period was 2 to 5 min. Mean graft cold ischemia was 295 min and mean suture warm ischemia was 38 min. Postoperatively there was no primary non-function. Mean peak transaminase was 2,546 UI/ml. Patient and graft survival was 100% at one year. Two patients (15%) developed graft main bile duct stenosis and underwent endoscopic management. No patient developed symptomatic intrahepatic bile duct strictures or needed retransplantation in the follow-up. Conclusions: The experience of the transplantation department of the University of Liege confirms that controlled DCD donors may be a valuable source of transplantable liver grafts, in case of short procurement warm ischemia and short transplant cold ischemia. [less ▲]

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See detailResults of liver transplantation from controlled donation after cardiac death (DCD) donors: a single center experience
Detry, Olivier ULg; Seydel, Benoît ULg; Veys, C. et al

in Acta Gastro-Enterologica Belgica (2009, January), 72(1), 25

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See detailSevere liver dysfunction in a patient with multiple sclerosis: the guilty party is not always the disease-modifying therapy
Hotermans, C.; Belachew, Shibeshih ULg; Moonen, Gustave ULg et al

in Multiple Sclerosis : Clinical & Laboratory Research (2009), 15(11), 1378-1379

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See detailGuillain-Barré syndrome following hepatitis E
Loly, Jean-Philippe ULg; Rikir, Estelle ULg; Seivert, Maxime ULg et al

in World Journal of Gastroenterology (2009), 15(13), 1645-1647

Guillain-Barré syndrome (GBS) is often triggered by a preceding bacterial or viral infection. Occasionally, it has been observed in association with acute hepatitis A, B and C, and three cases have been ... [more ▼]

Guillain-Barré syndrome (GBS) is often triggered by a preceding bacterial or viral infection. Occasionally, it has been observed in association with acute hepatitis A, B and C, and three cases have been previously described in India in which GBS was associated with acute hepatitis E. A molecular mimicry mechanism is supposed to be involved in the pathogenesis of GBS triggered by infectious agents, although the nature of the shared epitopes has not been characterized in most instances, including that in the case of hepatotropic viruses. We report a case of GBS following acute hepatitis E in a European individual. The presence of antiganglioside GM2 antibodies in this patient suggested molecular mimicry involving ganglioside GM2 in the pathogenesis of GBS associated with hepatitis E. [less ▲]

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See detailA randomized trial of pegylated-interferon alpha 2a plus ribavirin with or without amantadine in treatment-naïve or relapsing chronic hepatitis C patients
Langlet, P.; D'Heygere, F.; Henrion, J. et al

in Alimentary Pharmacology & Therapeutics (2009), 30

Background The combination therapy of pegylated-interferon-a2a plus ribavirin is considered as the standard of care for patients with chronic hepatitis C. A sustained viral response is obtained in 40–50 ... [more ▼]

Background The combination therapy of pegylated-interferon-a2a plus ribavirin is considered as the standard of care for patients with chronic hepatitis C. A sustained viral response is obtained in 40–50% of naı¨ve patients with genotype 1 and in around 80% of naı¨ve patients with genotype 2 or 3. Aim To assess whether amantadine, added to the conventional combination therapy, could improve the treatment efficacy. Methods In all, 630 patients (intent-to-treat population) with chronic hepatitis C were randomized into two groups: 316 patients (treatment group) received pegylated-interferon-a2a (180 lg once weekly) plus ribavirin (1000–1200 mg⁄ daily) with amantadine (200 mg⁄ daily); 314 patients (control group) received pegylated-interferon-a2a (180 lg once weekly) plus ribavirin (1000–1200 mg⁄ daily) without amantadine. The duration of the treatment was 48 weeks for genotypes 1, 4, 5 and 6, and 24 weeks for genotypes 2 and 3. Results There was no statistically significant difference between treatments groups for any of the variables tested for. Subgroups of patients likely to take advantage of the addition of amantadine were not identified. Conclusions This large study definitely excludes the role of amantadine in addition of conventional combination therapy in the treatment of chronic hepatitis C patients. [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 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 ▲]

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