References of "Detry, Olivier"
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See detailThe use of mesenchymal stromal cells in solid organ transplantation
GREGOIRE, Céline ULg; DETRY, Olivier ULg; Jouret, François ULg et al

in The Biology and Therapeutic Applications of Mesenchymal Cells (in press)

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See detailDonor Age in Liver Transplantation: Donation after Circulatory Death.
DETRY, Olivier ULg

in Journal of the American College of Surgeons (2015), 221(3), 779

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See detailShould ABO-incompatible deceased liver transplantation be reconsidered?
Detry, Olivier ULg

in Transplant international : official journal of the European Society for Organ Transplantation (2015), 28(7), 788-9

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See detailThird-party mesenchymal stream cell infusion in kidney transplant recipient: 6-month safety interim analysis
WEEKERS, Laurent ULg; ERPICUM, Pauline ULg; DETRY, Olivier ULg et al

in American Journal of Transplantation (2015, May), 15(suppl 3),

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See detailOrgan donation after euthanasia on specific patients' request in Belgium
Ysebaert, Y; DETRY, Olivier ULg; Mikhalski, D et al

Conference (2015, March 28)

Euthanasia is banned in almost countries of the world, although in 2002 Belgium legalized it for adults under strict conditions (in a similar way after The Netherlands in 2001. The patient must be in a ... [more ▼]

Euthanasia is banned in almost countries of the world, although in 2002 Belgium legalized it for adults under strict conditions (in a similar way after The Netherlands in 2001. The patient must be in a medically futile condition, of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident. If the person is not in the terminal phase of his illness, the 2 doctors must consult with a third doctor, either a psychiatrist or a specialist in the disease concerned. From 2005 till 2014 more than 25 patients, suffering from diverse neuropsychiatric diseases, got their request for euthanasia granted, and subsequently asked spontaneously for the possibility of organ donation. The involved physicians, the transplant teams and the Institutional Ethics Committees, had the well-discussed opinion that this strong request for organ donation after euthanasia could not be denied. A clear separation between the euthanasia request, the euthanasia procedure and the organ procurement procedure was judged necessary. After extensive preparation, finally, in Belgium, 17 patients got their wish for organ donation after euthanasia fulfilled, in several academic or non-academic hospitals and in different regions : Antwerpen 6, Leuven 5, Liege 2, Namur 1, Turnhout 1, and Brussels 2. Several requests and negotiations were started for other patients but ultimately failed due to patients’ personal choices (e.g. patient wanted finally to die at home) or logistically reasons (e.g. who would fulfil the euthanasia in case all involving doctors were not employed or connected to a hospital). The euthanasia procedure was carried out by three physicians in the neighborhood of the operating room. After clinical diagnosis of cardiac death, the procurement team came in and performed the organ procurement similar as in a DCD type III procedure. The liver, two kidneys and sometimes lungs and pancreatic islets could be successfully recovered and transplanted, after organ allocation via Eurotransplant. Transplant centers were informed about the nature of the case and the elements of organ procurement. There was primary function of all organs. The possibility of organ donation after their euthanasia provides a very much improved self-image of these patients, and adds something really positive to the euthanasia procedure, and is very well appreciated by the requesting patients, relatives, patient and professional organisations and public media. Some practical and ethical issues still have to be discussed to allow expansion of this possibility of organ donation. [less ▲]

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See detailInfusion of third-party mesenchymal stromal cells after liver transplantation: a phase 1, open-label, clinical study
DETRY, Olivier ULg; VANDERMEULEN, Morgan ULg; DELBOUILLE, Marie-Hélène ULg et al

Poster (2015, March 27)

Transplanted patients have to deal with numerous side effects of life-long dependence on immunosuppressive drugs. Paradoxically these drugs fail to prevent acute and/or chronic rejection in many cases ... [more ▼]

Transplanted patients have to deal with numerous side effects of life-long dependence on immunosuppressive drugs. Paradoxically these drugs fail to prevent acute and/or chronic rejection in many cases. Mesenchymal stromal cells (MSC) are multipotent and self-renewing bone marrow progenitors that have been shown both in vitro and in vivo as capable of (i) immunomodulation, (ii) anti-inflammation in case of ischemia/reperfusion injury, and (ii) stimulation of tissue repair. MSC could therefore be very interesting in organ recipients to limit chronic graft damage and to allow tolerance. This study aimed to be the first clinical evaluation of the safety and tolerability of MSC infusion after liver transplantation in a prospective, controlled, phase I study. Clinical grade MSCs were locally collected from the bone marrow of unrelated healthy donors. They were cultured in a GMP-compliant lab, underwent extensive quality controls and were frozen for storage in a MSC bank. When needed for patient treatment, MSC were thawed and intravenously injected into patients. 10 liver transplant recipients under standard immunosuppression (TAC-MMF-low dose steroids until day 30) received 1.5-3x106/kg MSC on post- operative day 3 ± 2. These patients were prospectively compared to a group of 10 control (MSC-) liver recipients. Primary endpoints were MSC infusion toxicity, and incidence of cancer and opportunistic infections at month 6. Secondary endpoints were patient and graft survivals and rejection at month 6, as well as the effects of MSC on recipients’ immune function and on immunohistology of at month 6 graft biopsies. No MSC infusional toxicity was observed. Both groups were comparable in terms of donor and recipient characteristics. There was no difference in primary end-points between control and MSC groups. No patient developed de novo cancer. There was no statistical difference in patient and graft survivals or in rejection rates. There was no graft rejection in the MSC group. Month-6 graft biopsies were not different according to Banff and fibrosis scores. This phase I study showed excellent tolerability and safety of a single infusion of third-party MSC after liver transplantation. There were no graft safety issues and no excess of immunosuppression after MSC injection. Further analyses of consequences of MSC injection on the immune profile are needed. The possibility of avoiding calcineurin-inhibitors with repeated MSC injections as main immunosuppressive therapy and/of tolerance induction by MSC infusion should be investigated by further studies. [less ▲]

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See detailPrognostic value of (18)F-FDG PET/CT in liver transplantation for hepatocarcinoma.
Detry, Olivier ULg; Govaerts, Laurence; De Roover, Arnaud ULg et al

in World journal of gastroenterology : WJG (2015), 21(10), 3049-54

AIM: To evaluate the prognostic value of pretreatment FDG positron emission tomography computed tomography (PET-CT) in patients with hepatocarcinoma treated by liver transplantation (LT). METHODS: The ... [more ▼]

AIM: To evaluate the prognostic value of pretreatment FDG positron emission tomography computed tomography (PET-CT) in patients with hepatocarcinoma treated by liver transplantation (LT). METHODS: The authors retrospectively analyzed the data of 27 patients (mean age 58 +/- 9 years) who underwent FDG PET-CT before LT for hepatocarcinoma. Mean follow-up was 26 +/- 18 mo. The FDG PET/CT was performed according to a standard clinical protocol: 4 MBqFDG/kg body weight, uptake 60 min, low-dose non-enhanced CT. The authors measured the SUVmax and SUVmean of the tumor and the normal liver. The tumor/liver activity ratios (RSUVmax and RSUVmean) were tested as prognostic factors and compared to the following conventional prognostic factors: MILAN, CLIP, OKUDA, TNM stage, alphafoetoprotein level, portal thrombosis, size of the largest nodule, tumor differentiation, microvascular invasion, underlying cirrhosis and liver function. RESULTS: Overall and recurrence free survivals were 80.7% and 67.4% at 3 years, and 70.6% and 67.4% at 5 years, respectively. According to a multivariate Cox model, only FDG PET/CT RSUVmax predicted recurrence free survival. Even though the MILAN criteria alone were not predictive, it is worth noting that none of the patients outside the MILAN criteria and with RSUVmax < 1.15 relapsed. CONCLUSION: FDG PET/CT with an RSUVmax cut-off value of 1.15 is a strong prognostic factor for recurrence and death in patients with HCC treated by LT in this retrospective series. Further prospective studies should test whether this metabolic index should be systematically included in the preoperative assessment. [less ▲]

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See detailExpel: a novel non-destructive method for mining soluble tumor biomarkers
Costanza, B; Blomme, A; MUTIJIMA NZARAMBA, Eugène ULg et al

in Acta Gastro-Enterologica Belgica (2015, March), 78(1), 13

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See detailInfusion of third-party mesenchymal stream cells after liver transplantation: a phase-1, open-label, clinical study
DETRY, Olivier ULg; VANDERMEULEN, Morgan ULg; DELBOUILLE, Marie-Hélène ULg et al

in Acta Gastro-Enterologica Belgica (2015, March), 78(1), 29

Background: Mesenchymal stromal cells (MSC) are multipotent bone marrow progenitors that have demonstrated significant immunosuppressive effects in various in vivo and in vitro studies. This study aimed ... [more ▼]

Background: Mesenchymal stromal cells (MSC) are multipotent bone marrow progenitors that have demonstrated significant immunosuppressive effects in various in vivo and in vitro studies. This study aimed to be the first evaluation of the safety and tolerability of MSC infusion after liver transplantation in a prospective, controlled phase-1 study. This study aimed to be the first evaluation of the safety and tolerability of MSC infusion after liver transplantation in a prospective, controlled phase-1 study. Patients & Methods: Clinical grade MSCs were locally collected from the bone marrow of unrelated healthy donors. They were cultured in a GMP-compliant lab, underwent extensive quality controls and were frozen for storage in a MSC bank. When needed for patient treatment, MSC were thawed and intravenously injected into patients. 10 liver transplant recipients under standard immunosuppression (TAC-MMF-low dose steroids until day 30) received 1.5-3x106/kg MSC on post-operative day 3±2. These patients were prospectively compared to a group of 10 control (MSC-) liver recipients. Primary endpoints were MSC infusion toxicity, and incidence of cancer and opportunistic infections at month 6. Secondary endpoints were patient and graft survivals and rejection at month 6, as well as the effects of MSC on recipients’ immune function and on immunohistology of at month 6 graft biopsies. Results: No MSC infusional toxicity was observed. Both groups were comparable in terms of donor and recipient characteristics. There was no difference in primary end-points between control and MSC groups. No patient developed de novo cancer. There was no statistical difference in patient and graft survivals or in rejection rates. There was no graft rejection in the MSC group. Month-6 graft biopsies were not different according to Banff and fibrosis scores. Discussion: This phase 1 study showed excellent tolerability and safety of a single infusion of third-party MSC after liver transplantation. There were no graft safety issues and no excess of immunosuppression after MSC injection. Further analyses of consequences of MSC injection on the immune profile are needed. The possibility of avoiding calcineurin-inhibitors with repeated MSC injections as main immunosuppressive therapy and/of tolerance induction by MSC infusion should be investigated by further studies. [less ▲]

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See detailMetabolomic, proteomic and preclinical imaging of patient-derived tumor xenografts for improving treatment of liver metastases patients
Perez Palacios, A; Blomme, A; Boutry, S et al

in Acta Gastro-Enterologica Belgica (2015, March), 78(1), 134

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See detailUmbilical hernia under local anaesthesia: tips and tricks
DETRY, Olivier ULg

Conference (2014, December 12)

Despite many studies confirming the feasibility and the interest of local anaesthesia for umbilical repair, its use is not generalized amongst the abdominal surgeons. The advantages of local anaesthesia ... [more ▼]

Despite many studies confirming the feasibility and the interest of local anaesthesia for umbilical repair, its use is not generalized amongst the abdominal surgeons. The advantages of local anaesthesia are indeed clear, including reduced costs, reduced hospital stay and reduced post operative pain. The success of the procedure depends on the skills and the motivation of the surgeon, of the nursing teams, and of the patient him/herself. The Mayo repair is ideally performed under local anaesthesia, but should be proposed to patients suffering from limited umbilical hernia with small defects. Prosthetic repairs might also be proposed under local anaesthesia, but large defects with rectus diastasis might require a full Rives/Stoppa repair in which local anaesthesia could not be sufficient. In obese patients, laparoscopic repair might be beneficial despite higher cost and longer hospital stay. Practically local anaesthesia requires some patience and quiet in the operative room. Operators should be aware that the action of local anaesthesia is delayed after injection. Local anaesthetics should be buffered and at body temperature at time of injection. Local anaesthetics containing Adrenalin allow longer pain control, with limitation of bleeding and less toxicity. Large and brutal movements should be avoided. Ligature and section of parts of greater omentum are feasible under local anaesthesia without patient discomfort. Tension free repair should be favoured, and during Mayo repair, the only painful part of the repair is often the closure of the defect with the different stiches. The surgical and anaesthetic techniques for umbilical hernia repair should be tailored to the specific characteristics of the umbilical hernia and of the patient. There is no method of choice that might fit for every patient. [less ▲]

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See detailCellules stromales mésenchymateuses et transplantation d'organes
DETRY, Olivier ULg; JOURET, François ULg; VANDERMEULEN, Morgan ULg et al

in Revue Médicale de Liège (2014), 69

Mesenchymal stromal cells (MSC) are multipotent and self-renewing cells. MSC are studied for their in vivo and in vitro immunomodulatory effects, in the prevention or the treatment of ischemic injury, and ... [more ▼]

Mesenchymal stromal cells (MSC) are multipotent and self-renewing cells. MSC are studied for their in vivo and in vitro immunomodulatory effects, in the prevention or the treatment of ischemic injury, and for their potential properties of tissue or organ reconstruction. Over the last few years, the potential role of MSC in organ transplantation has been studied both in vitro and in vivo, and their properties make them an ideal potential cell therapy after solid organ transplantation. A prospective, controlled, phase 1-2 study has been initiated at the CHU of Liege, Belgium. This study assesses the potential risks and benefits of MSC infusion after liver or kidney transplantation. Even if the preliminary results of this study look promising, solely a prospective, randomized, large scale, phase 3 study will allow the clinical confirmation of the theoretical benefits of MSC in solid organ transplantation. [less ▲]

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See detailIs there a role for intra-arterial therapy or isolated liver perfusion?
DETRY, Olivier ULg

Conference (2014, October 10)

IS THERE A ROLE FOR INTRA-ARTERIAL THERAPY OR ISOLATED LIVER PERFUSION? Pr Olivier Detry, Dpt of Abdominal Surgery and Transplantation, CHU Liege, University of Liege, The liver is the most common ... [more ▼]

IS THERE A ROLE FOR INTRA-ARTERIAL THERAPY OR ISOLATED LIVER PERFUSION? Pr Olivier Detry, Dpt of Abdominal Surgery and Transplantation, CHU Liege, University of Liege, The liver is the most common visceral site of colorectal cancer (CRC) metastasis and recurrence. Approximately 25% of CRC patients present with synchronous hepatic metastases at time of initial diagnosis, and further 50% will develop metachronous metastases during the course of their illness. Unfortunately, only 25% of patients with hepatic CRC metastases are suitable for R0 resection at time of diagnosis or after chemotherapy. Intra‐arterial locoregional therapies are evolving tools in the management of CRC liver metastases. Although these therapies were initially used for salvage and palliation, they are becoming therapeutic options earlier in the course of disease in selected populations, to increase the rate of curative surgical resection, and to improve survival and quality of life. Furthermore, intra‐arterial therapies may serve as viable first‐line treatments for the large majority of patients who present with unresectable liver metastases, and as neoadjuvant chemotherapy prior to hepatectomy to minimize systemic effects. Hyperthermic isolated liver perfusion (HILP) has also been proposed by some groups as a mean to treat patients with unresectable liver metastases. Significant anti-tumoral effect has been demonstrated but HILP is a complicated procedure with a high morbidity. There remains a lack of robust, prospective randomized data for fair and balanced comparisons to be made between locoregional and modern systemic therapeutic modalities, as well as between locoregional therapies. Future RCTs addressing overall patient survival, tumor response and toxicity are required before any of these locoregional intra‐arterial treatments can be definitively recommended as the standard of care for hepatic colorectal liver mestastases. At the CHU of Liege, intra-arterial chemotherapy is now the usual way of administrating chemotherapy in patients with multiple CRC metastases limited to the liver after R0 liver resection. [less ▲]

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See detailINCIDENCE AND RISK FACTORS FOR EARLY RENAL DYSFUNCTION AFTER LIVER TRANSPLANTATION
WIESEN, Patricia ULg; Georganta, E; VAN CAUWENBERGE, Isabelle ULg et al

in Intensive Care Medicine (2014, October), 40(S1), 1740628

INTRODUCTION. Renal dysfunction often occurred after liver transplantation. OBJECTIVES. The aim of the study was to determine its incidence and its risk factors in a clinical series at the University ... [more ▼]

INTRODUCTION. Renal dysfunction often occurred after liver transplantation. OBJECTIVES. The aim of the study was to determine its incidence and its risk factors in a clinical series at the University Hospital of Liege, Belgium. METHODS. Orthotopic liver transplantations performed from January 2006 until Sep- tember 2012 were retrospectively reviewed (n = 187). Patients, with no renal replacement therapy (RRT) before transplantation were classified in four groups according to their highest creatinine plasma level during the first postoperative week. First group had a cre- atinine level below 12 mg/l, the second group between 12 and 20 mg/l, the third group between 20 and 35 mg/l, and the fourth above 35 mg/l. In addition, patients who needed RRT during the first week after transplantation were also classified in the fourth group. Preoperative and perioperative parameters were tested as risk factors: age, sex, body mass index (BMI), length of hospital preoperative stay, prior bacterial infection within one month, preoperative ascites, preoperative treatment with ß-blocker, converting enzyme inhibitor, or non steroidal antiinflammatory drugs, preoperative creatinine and bilirubine level, postop- erative lactate level, need for postoperative vasopressive drugs, surgical revision, mechanical ventilation for more than 24 h, postoperative peaks in bilirubine and transam- inase levels, postoperative hemoglobin level, amount of perioperative blood transfusions, type of immunosuppression. Univariate and multivariate analysis were performed using logistic ordinal regression method. RESULTS. There were 78 patients in group 1 (41.7 %), 46 in group 2 (24.6 %), 38 in group 3 (20.3 %) and 25 in group 4 (13.4 %). Eighteen patients required RRT: 13 (7 %) during the first week after transplantation (group 4), the 5 others after the first week after transplan- tation (2 in group 1 and 2, and 1 in group 3). There were 7 (3.7 %) early deaths within 28 days after transplantation. Using univariate analysis, the severity of renal dysfunction was correlated with presence of ascites and prior bacterial infection, preoperative bilirubin and creatinine level, need for surgical revision, use of vasopressor, postoperative mechanical ventilation, postoperative bilirubine, transaminase, and hemoglobin levels. The need for transfusion of each type of products also affected renal dysfunction. The ordinal logistic analysis pointed out the BMI (OR = 1.1, p = 0.004), preoperative creatinine level (OR = 11.1, p \ 0.0001), use of vasopressor (OR = 3.31, p = 0.0002), maximal postop- erative bilirubine level (OR = 1.44, p = 0.044) and minimal postoperative hemoglobin level (OR 0.059 p = 0.0005). CONCLUSIONS. More than half of liver transplanted patients experienced some degree of early renal dysfunction after transplantation. Risk factors are preoperative renal dysfunction, and mainly perioperative circulatory instability requiring the use of vasopressor and post- operative anemia. [less ▲]

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See detailOrthotopic liver transplantation for hepatocellular car- cinoma after successful downstaging: results from the Belgian multicentre cohort
Schreiber, J.; Lerut, J; Verslype, C et al

in Hepatology (Baltimore, Md.) (2014, October), 60(S1), 468550

Purpose: Successful downstaging of hepatocellular carcinoma (HCC) into the Milan criteria (MC) remains a controversial indication for orthotopic liver transplantation (OLT). In Belgium, successful ... [more ▼]

Purpose: Successful downstaging of hepatocellular carcinoma (HCC) into the Milan criteria (MC) remains a controversial indication for orthotopic liver transplantation (OLT). In Belgium, successful downstaging of HCC is an accepted non-standard- ized exception (NSE) for liver allocation. This NSE group rep- resents a unique cohort to analyse if OLT can be safely offered to patients with those extended allocation criteria. The aim of this study is to compare the overall and recurrence free survival after cadaveric OLT between patients with successful downstaging (MILDOWN) and patients always inside the MC (MILIN) from all Belgian transplant centres. Methods: We ret- rospectively analysed all patients listed for OLT with HCC and underlying cirrhosis between 12/2006 and 12/2011 from all Belgian liver transplant centres. Successful downstaging was defined as bringing a patient who was outside the MC into the MC after locoregional therapy (LRT). Results: Overall 381 patients were listed in Belgium during the study period. Of these, 320 received OLT. 248 were MILIN, 62 were MIL- DOWN and 10 were transplanted outside MC. Downstaging treatment included transarterial chemoembolization (TACE; n=26), radiofrequency (RF; n=9), transarterial radioembolisa- tion (TARE; n=4), resection (n=3), percutaneous ethanol injec- tion (n=2) and a combination of the above-mentioned therapies in 18 cases. In the MILIN group 67.3% received locoregional therapy before transplantation, with no significant differences in the distribution of treatment type compared to the MIL- DOWN group. At listing there were no significant differences between the MILIN and MILDOWN group for age, gender and underlying liver disease. Median time on waiting list between the two groups was similar (120 days vs. 115.5 days). Overall survival at 1 year was not significantly different between MILIN and MILDOWN (87.1% vs. 79%; p=0.120). 1.6% of patients were lost to follow-up in both groups. Although not significant, recurrence free survival at 1 year tended to be higher in the MILIN group than in the MILDOWN group (83.9% vs. 74.2%; p=0.073). Conclusion: In this large Belgian multicentre cohort, overall and recurrence free survival at 1 year are not signifi- cantly different between patients who have been downstaged successfully and patients who were always inside the Milan criteria. However, a longer follow up period will define, if the trend of lower survival in the successfully downstaged group becomes significant. Factors associated with HCC recurrence have to be identified. [less ▲]

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See detailPREVENTION OF INCISIONAL HERNIA AFTER MIDLINE LAPAROTOMY FOR ABDOMINAL AORTIC ANEURYSM TREATMENT: A RANDOMIZED CONTROLLED TRIAL
Muysoms, F; Vierendeels, T; Huyghe, M et al

Conference (2014, September 11)

Background: The incidence of incisional hernias (IH) after open abdominal aortic aneurysm (AAA) repair is high. Prophylactic mesh augmentation (PMA) during laparotomy closure has been proposed in high ... [more ▼]

Background: The incidence of incisional hernias (IH) after open abdominal aortic aneurysm (AAA) repair is high. Prophylactic mesh augmentation (PMA) during laparotomy closure has been proposed in high-risk patients. Methods: A multicenter prospective randomized controlled study was conducted on patients undergoing elective repair of AAA through midline laparotomy (Clinical.Trials.gov: NCT00757133). In the study group a retro-muscular PMA was performed with a large-pore polypropylene mesh (Ultrapro™, width 7.5 cm). The primary endpoint was the incidence of IH at 24 months. Results: Between February 2009 and January 2013, 120 patients were recruited at 8 Belgian centers. Patients' characteristics at baseline were similar between the groups. Operative and postoperative characteristics showed no difference in morbidity or mortality. A highly significant reduction of IH incidence was found after PMA compared to conventional closure, respectively 0% (CI: 0 % - 5.5%) versus 27.6% (CI: 16.7% - 40.9%) (P<0.0001; Fisher's exact test). The estimated "freedom of IH" curves (Kaplan-Meier estimate) were significantly different across study arms (X2=18.93, P<0.0001; Mantel-Cox test). No adverse effects were observed, apart from an increased mean (SD) time to close the abdominal wall for PMA: 46.2 min (18.6) versus 29.6 min (18.5) (P<0.001; Mann-Whitney U test). Conclusion: Prophylactic retro-muscular mesh augmentation of a midline laparotomy in AAA patients is safe and effectively prevents the development of IH, with an extra time investment of 17 minutes. [less ▲]

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See detailPrognostic value of (18)F-FDG PET/CT in liver transplantation for hepatocarcinoma.
MEURISSE, Nicolas ULg; DETRY, Olivier ULg; Govaerts, L et al

in Transplant International (2014, September), 27(S2), 18-17

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See detailIntérêt des cellules stromales mésenchymateuses en transplantation d’organes solides
Delens, Loic ULg; Jouret, François ULg; DETRY, Olivier ULg et al

in Revue Médicale Suisse (2014), 10

Solid organ transplantation (SOT) currently represents the best therapeutic option in end-stage diseases caused by the irrevocable functional loss of an organ. Still, SOT is associated with immunological ... [more ▼]

Solid organ transplantation (SOT) currently represents the best therapeutic option in end-stage diseases caused by the irrevocable functional loss of an organ. Still, SOT is associated with immunological and non-immunological injuries, whose severity impacts on early functional recovery and long-term survival of the transplant. Current research focuses on the identification of innovative approaches to 1) attenuate ischemia/reperfusion-induced damage, 2) accelerate processes of tissue repair, and 3) induce in fine graft tolerance. Encouraging observations from both preclinical studies and clinical trials suggest that the administration of mesenchymal stromal cells at the time of SOT might be beneficial, as a result of theirs immunomodulatory, anti-inflammatory and regenerative properties. [less ▲]

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See detailDonor age as a risk factor in donation after circulatory death liver transplantation in a controlled withdrawal protocol programme.
DETRY, Olivier ULg; DE ROOVER, Arnaud ULg; MEURISSE, Nicolas ULg et al

in The British journal of surgery (2014), 10(7), 784-792

BACKGROUND: Results of donation after circulatory death (DCD) liver transplantation are impaired by graft loss, resulting mainly from non-anastomotic biliary stricture. Donor age is a risk factor in ... [more ▼]

BACKGROUND: Results of donation after circulatory death (DCD) liver transplantation are impaired by graft loss, resulting mainly from non-anastomotic biliary stricture. Donor age is a risk factor in deceased donor liver transplantation, and particularly in DCD liver transplantation. At the authors' institute, age is not an absolute exclusion criterion for discarding DCD liver grafts, DCD donors receive comfort therapy before withdrawal, and cold ischaemia is minimized. METHODS: All consecutive DCD liver transplantations performed from 2003 to 2012 were studied retrospectively. Three age groups were compared in terms of donor and recipient demographics, procurement and transplantation conditions, peak laboratory values during the first post-transplant 72 h, and results at 1 and 3 years. RESULTS: A total of 70 DCD liver transplants were performed, including 32 liver grafts from donors aged 55 years or less, 20 aged 56-69 years, and 18 aged 70 years or more. The overall graft survival rate at 1 month, 1 and 3 years was 99, 91 and 72 per cent respectively, with no graft lost secondary to non-anastomotic stricture. No difference other than age was noted between the three groups for donor or recipient characteristics, or procurement conditions. No primary non-function occurred, but one patient needed retransplantation for artery thrombosis. Biliary complications were similar in the three groups. Graft and patient survival rates were no different at 1 and 3 years between the three groups (P = 0.605). CONCLUSION: Results for DCD liver transplantation from younger and older donors were similar. Donor age above 50 years should not be a contraindication to DCD liver transplantation if other donor risk factors (such as warm and cold ischaemia time) are minimized. [less ▲]

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