References of "Detry, Olivier"
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See detailA consecutive series of 100 controlled DCD liver transplantation
DETRY, Olivier ULg; DE ROOVER, Arnaud ULg; Ledinh, H et al

in Transplant International (2015, November), 28(S4), 109296

Introduction: Donation after circulatory death (DCD) have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of graft loss and ... [more ▼]

Introduction: Donation after circulatory death (DCD) have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of graft loss and retransplantation. The authors retrospectively reviewed a single centre experience with controlled DCD-LT in a 12-year period. Patients and Methods: 100 DCD-LT were consecutively performed between 2003 and 2014. All donation and procurement procedures were performed as controlled DCD in operative rooms. Data are presented as median (ranges). Median donor age was 57 years (16–83). Median DRI was 2.16 (1.4–3.4). Most grafts were flushed with HTK solution. Allocation was centre-based. Median recipient MELD score at LT was 15 (7–40). Mean follow-up was 35 months. No patient was lost to follow-up. Results: Median total DCD warm ischemia was 19 min (10–39). Median cold ischemia was 235 min (113–576). Median peak AST was 1132 U/l (282– 21 928). Median peak bilirubin was 28 mg/dL. Patient survivals were 90.7%, 75.5% and 70.7% at 1.3 and 5 years, respectively. Graft survivals were 88.7%, 72.1% and 67.1% at 1.3 and 5 years, respectively. Biliary complications included mainly anastomotic strictures and extrahepatic main bile duct ischemic obstruction, that were managed either by endoscopy or hepatico- jejunostomy. No PNF or graft loss due to ischemic cholangiopathy was observed in this series. Discussion: In this series, DCD LT appears to provide results similar to classical LT. Short cold ischemia and recipient selection with low MELD score may be the keys to good results in DCD LT, in terms of graft survival and avoidance of ischemic cholangiopathy. If symptomatic ischemic cholangiopa- thy is diagnosed, adequate management with endoscopy and surgical hepaticojejunostomy may avoid graft loss and retransplantation. [less ▲]

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See detailTransfusion needs during liver transplantation at the chu of liege (belgium): characteristics and preoperative predictive factors
PAGE, Isaline ULg; HANS, Grégory ULg; DETRY, Olivier ULg et al

in Transplant International (2015, November), 28(S4), 461272

Introduction: Liver transplantation (LT) can result in significant bleeding requiring transfusion of allogenic blood products, which potentially leads to postoperative morbidity and mortality (1). This ... [more ▼]

Introduction: Liver transplantation (LT) can result in significant bleeding requiring transfusion of allogenic blood products, which potentially leads to postoperative morbidity and mortality (1). This study aimed to determine transfusion needs during LT in our institution and its preoperative predictive factors. Material and Methods: Two hundred LT performed at the CHU Liege between 2006 and 2012 were respectively reviewed (age = 55 ` 11 yo, BMI = 25.5 ` 4.4 kg/m2, F/M = 45/155, MELD score = 19 ` 10). Transfu- sion needs of the different blood products during POD 0, and POD 0–7 were recorded. Parameters associated with the transfusion of more than 2 units of RBC (p ≤ 0.1) were identified using the Kruskal Wallis and chi square tests (table 1). These parameters were then placed into a backward stepwise logistic regression model for the transfusion of more than two units of RBC at POD 0. A p value threshold ≥0.1 was used for leaving the model. Results: Transfusion needs were: RBC = 2[0–4], FFP = 4[2–7], PLT = 1[0– 1] during POD 0; and RBC = 3[0–6], FFP = 6[3–10], PLT = 1[0–2] during POD 0–7. Preoperative factors independently associated with the transfusion of more than two units of RBC were preop Hb (0.6 [0.46–0.79], p < 0.001) and MELD score (1.13 [1.06–1.20], p < 0.001). Discussion: These results suggest that preop Hb and MELD score are associated with blood requirements during LT. [less ▲]

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

in Transplant International (2015, November), 28(S4), 114313

Euthanasia is since 2002 legalized in Belgium for adults under strict conditions. The patient must be in a medically futile condition, of constant and unbearable physical or mental suffering that cannot ... [more ▼]

Euthanasia is since 2002 legalized in Belgium for adults under strict conditions. 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. This implies that also non-terminal not-cancer patients can request for euthanasia for instance in case of debilitating neurological disorder. From 2005 till 2015 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 Commit- tees, 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. Several requests and preparations were started for other patients but ultimately did not lead to organ donation due to patients’ personal choices or logistically reasons. The euthanasia procedure was carried out by three physicians involved in the euthanasia granting. After clinical diagnosis of cardiac death, the procurement team came in and performed the organ procurement similar as in a DCD type III procedure. Almost always, liver, two kidneys and sometimes lungs and pancreatic islets were successfully recovered and transplanted, after allocation by Eurotransplant. 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 unfortunate end-of-life of these patients. [less ▲]

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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 stem 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 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 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 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 detailFirst steps of laparoscopic surgery in Lubumbashi: problems encountered and preliminary results.
Arung, Willy; Dinganga, Nathalie; Ngoie, Emmanuel et al

in The Pan African medical journal (2015), 21

For many reasons, laparoscopic surgery has been performed worldwide. Due to logistical constraints its first steps occurred in Lubumbashi only in 2008. The aim of this presentation was to report authors ... [more ▼]

For many reasons, laparoscopic surgery has been performed worldwide. Due to logistical constraints its first steps occurred in Lubumbashi only in 2008. The aim of this presentation was to report authors' ten-month experience of laparoscopic surgery at Lubumbashi Don Bosco Missionary Hospital (LDBMH): problems encountered and preliminary results. The study was a transsectional descriptive work with a convenient sampling. It only took in account patients with abdominal surgical condition who consented to undergo laparoscopic surgery and when logistical constraints of the procedure were found. Independent variables were patients' demographic parameters, staff, equipments and consumable. Dependent parameters included surgical abdominal diseases, intra-operative circumstances and postoperative short term mortality and morbidity. Between 1(st)April 2009 and 28(th) February 2010, 75 patients underwent laparoscopic surgery at the LDBMH making 1.5% of all abdominal surgical activities performed at this institution. The most performed procedure was appendicectomy for acute appendicitis (64%) followed by exploratory laparoscopy for various abdominal chronic pain (9.3%), adhesiolysis for repeated periods of subacute intestinal obstruction in previously laparotomised patients (9.3%), laparoscopic cholecystectomy for post acute cholecystitis on gall stone (5.3%) and partial colectomy for symptomatic redundant sigmoid colon (2.7%). There were 4% of conversion to laparotomy. Laparoscopic surgery consumed more time than laparotomy, mostly when dealing with appendicitis. However, postoperatively, patients did quite well. There was no death in this series. Nursing care was minimal with early discharge. These results are encouraging to pursue laparoscopic surgery with DRC Government and NGO's supports. [less ▲]

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See detailBelgian multicenter experience with intestinal transplantation.
Ceulemans, Laurens J.; Monbaliu, Diethard; DE ROOVER, Arnaud ULg et al

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

Intestinal transplantation (ITx) has evolved from an experimental procedure towards a clinical reality but remains a challenging procedure. The aim of this survey was to analyze the multicenter Belgian ... [more ▼]

Intestinal transplantation (ITx) has evolved from an experimental procedure towards a clinical reality but remains a challenging procedure. The aim of this survey was to analyze the multicenter Belgian ITx-experience. From 1999-2014, 24 ITx in 23 patients were performed in Belgium, divided over 5 centers. Median recipient age was 38 years (8 months-57 years); male/female ratio was 13/10; 6 were children and 17 adults. Intestinal failure was related to intestinal ischemia(n=5), volvulus(n=5), splanchnic thrombosis(n=4), Crohn(n=2), pseudo-obstruction(n=2), microvillus inclusion(n=2), Churg-Strauss(n=1), necrotizing enterocolitis(n=1), intestinal atresia(n=1) and chronic rejection(n=1). Graft-type was isolated ITx(n=9), combined liver-ITx(n=11) and multivisceralTx(n=4). One was a living donor-related transplantation and five patients received simultaneously a kidney graft. Early acute rejection occurred in 8; late acute rejection in 4 and chronic rejection in 2. Two patients developed a post-transplant lymphoproliferative disease. Nine patients have died. Among 14 survivors at last follow-up, 11 have been transplanted for more than 1 year. None of the latter has developed renal failure and all were nutritionally independent with a Karnofsky score >90%. 1-/5-year patient and graft survivals were 71.1%/62.8% and 58.7%/53.1%, respectively. Based on this experience, ITx has come of age in Belgium as a life-saving and potentially quality of life restoring therapy. This article is protected by copyright. All rights reserved. [less ▲]

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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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