References of "Detry, Olivier"
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See detailAutoimmune pancreatitis mimicking cancer of the pancreas
Detry, Olivier ULg; Servais, Anne; Pestieau, S. R. et al

in Acta Gastro-Enterologica Belgica (2000, January), 63(1), 57

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See detailEffects of cold and warm ischemia on the mitochondrial oxidative phosphorylation of swine lung.
Willet, Katty; Detry, Olivier ULg; Lambermont, Bernard ULg et al

in Transplantation (2000), 69(4), 582-588

BACKGROUND: The aim of the study was to investigate the consequence of warm and cold ischemia on lung mitochondria in order to define bioenergetic limits within lung could be suitable for pulmonary ... [more ▼]

BACKGROUND: The aim of the study was to investigate the consequence of warm and cold ischemia on lung mitochondria in order to define bioenergetic limits within lung could be suitable for pulmonary transplantation. METHODS: Twenty-two pigs underwent lung harvesting after lung flush with Euro-Collins solution. Mitochondria were isolated from fresh lungs, from lungs submitted to 24 or 48 hr of cold ischemia, to 30 or 45 min of warm ischemia, and to 30 min of warm ischemia followed by 24 or 48 hr of cold ischemia. Mitochondrial oxidative phosphorylation parameters were determined in isolated mitochondria by in vitro measurement of oxygen consumption. RESULTS: Relative to controls, mitochondria submitted to cold ischemia showed an alteration in the oxidoreductase activities of the respiratory chain but no membrane permeability alteration. After 48 hr of cold ischemia, there was a decrease in the yield of the oxidative phosphorylation. Thirty minutes of warm ischemia did not alter the mitochondrial respiratory parameters. However, lung submitted to 45 min of warm ischemia showed mitochondrial damage as a decrease in the oxidative phosphorylation efficiency and ADP availability but no change in the oxidoreductase activities. Relative to cold ischemia alone, 30 min of warm ischemia preceding cold ischemia promoted no significant change in the respiratory parameters. CONCLUSIONS: On bioenergetic basis, lung submitted to warm ischemia could be suitable for transplantation if the warm ischemia duration does not exceed 30 min. This could be a major concern in lung procurement from non-heart beating donors. [less ▲]

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See detailClinical use of a bioartificial liver to treat acetaminophen-induced fulminant hepatic failure
Detry, Olivier ULg; Arkadopoulos, N.; Kahaku, E. et al

in Demetriou, A. A.; Watanabe, F. D. (Eds.) Support of the acutely failing liver (2000)

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See detailAcute hepatic encephalopathy: treatment
Detry, Olivier ULg; Margulies, J.; Arkadopoulos, N. et al

in Demetriou, A. A.; Watanabe, F. D. (Eds.) Support of the acutely failing liver (2000)

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See detailCancer in Transplant Recipients
Detry, Olivier ULg; Honore, Pierre ULg; Meurisse, Michel ULg et al

in Transplantation Proceedings (2000), 32(1), 127

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See detailLaparoscopic Live Donor Nephrectomy: Initial Experience
Defechereux, Thierry ULg; Hamoir, Etienne ULg; Detry, Olivier ULg et al

in Acta Chirurgica Belgica (1999), 99(4), 179-81

Transplanting a kidney graft harvested from a live donor has been proposed and used to shorten the waiting time of kidney transplant candidates and to increase the graft pool. Live donor renal transplants ... [more ▼]

Transplanting a kidney graft harvested from a live donor has been proposed and used to shorten the waiting time of kidney transplant candidates and to increase the graft pool. Live donor renal transplants have demonstrated better results in term of graft survival rates, compared to renal transplants harvested from brain dead donor. Recently, laparoscopic live donor nephrectomy has been introduced to reduce the live procurement morbidity. This lower morbidity may result in increased acceptance of the donor operation. We initiated a program of laparoscopic live donor nephrectomy in January 1997 and up until June 1998, three cases were successfully performed in our department. The purpose of this paper was to report the first case of this program and its first year of follow-up. [less ▲]

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See detailBilateral neck exploration under hypnosedation. A new standard of care in primary hyperparathyroidism?
Meurisse, Michel ULg; Hamoir, Etienne ULg; Defechereux, Thierry ULg et al

in Annals of Surgery (1999), 229

OBJECTIVE: The authors review their experience with initial bilateral neck exploration under local anesthesia and hypnosedation for primary hyperparathyroidism. Efficacy, safety, and cost effectiveness of ... [more ▼]

OBJECTIVE: The authors review their experience with initial bilateral neck exploration under local anesthesia and hypnosedation for primary hyperparathyroidism. Efficacy, safety, and cost effectiveness of this new approach are examined. BACKGROUND: Standard bilateral parathyroid exploration under general anesthesia is associated with significant risk, especially in an elderly population. Image-guided unilateral approaches, although theoretically less invasive, expose patients to the potential risk of missing multiple adenomas or asymmetric hyperplasia. Initial bilateral neck exploration under hypnosedation may maximize the strengths of both approaches while minimizing their weaknesses. METHODS: In a consecutive series of 121 initial cervicotomies for primary hyperparathyroidism performed between 1995 and 1997, 31 patients were selected on the basis of their own request to undergo a conventional bilateral neck exploration under local anesthesia and hypnosedation. Neither preoperative testing of hypnotic susceptibility nor expensive localization studies were done. A hypnotic state (immobility, subjective well-being, and increased pain thresholds) was induced within 10 minutes; restoration of a fully conscious state was obtained within several seconds. Patient comfort and quiet surgical conditions were ensured by local anesthesia of the collar incision and minimal intravenous sedation titrated throughout surgery. Both peri- and postoperative records were examined to assess the safety and efficacy of this new approach. RESULTS: No conversion to general anesthesia was needed. No complications were observed. All the patients were cured with a mean follow-up of 18 +/- 12 months. Mean operating time was <1 hour. Four glands were identified in 84% of cases, three glands in 9.7%. Adenomas were found in 26 cases; among these, 6 were ectopic. Hyperplasia, requiring subtotal parathyroidectomy and transcervical thymectomy, was found in five cases (16.1%), all of which had gone undetected by localization studies when requested by the referring physicians. Concomitant thyroid lobectomy was performed in four cases. Patient comfort and recovery and surgical conditions were evaluated on visual analog scales as excellent. Postoperative analgesic consumption was minimal. Mean length of hospital stay was 1.5 +/- 0.5 days. CONCLUSIONS: Initial bilateral neck exploration for primary hyperparathyroidism can be performed safely, efficiently, and cost-effectively under hypnosedation, which may therefore be proposed as a new standard of care. [less ▲]

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See detailResults of liver transplantation in adults: our experience
Honoré, Pierre ULg; Detry, Olivier ULg; Meurisse, Michel ULg et al

in Acta Gastro-Enterologica Belgica (1999, January), 62(1), 69

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See detailSurgical management of hepatic cystic echinococcosis
Detry, Olivier ULg; Kanakou, A.; Honoré, Pierre ULg et al

in Acta Gastro-Enterologica Belgica (1999, January), 62(1), 64

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See detailDevelopment of a new rat model of fulminant hepatic failure
Detry, Olivier ULg; Gaspard, Yves; Defraigne, Jean-Olivier ULg et al

in Acta Gastro-Enterologica Belgica (1999, January), 62(1), 43

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See detailAnalysis of Endotoxin Effects on the Intact Pulmonary Circulation
Lambermont, Bernard ULg; Kolh, Philippe ULg; Detry, Olivier ULg et al

in Cardiovascular Research (1999), 41(1), 275-81

OBJECTIVE: The mechanism of sustained alterations in pulmonary hemodynamics during endotoxin shock remains unclear. To gain more detailed knowledge we used the four-element windkessel model as a ... [more ▼]

OBJECTIVE: The mechanism of sustained alterations in pulmonary hemodynamics during endotoxin shock remains unclear. To gain more detailed knowledge we used the four-element windkessel model as a descriptor of the pulmonary circuit. METHODS: Consecutive changes in characteristic resistance (R1), vascular compliance (C), input resistance (R2) and inductance (L) were continuously assessed following injection of endotoxin in 6 anaesthetised pigs, and were compared with the corresponding values measured in a similar group of sham-operated animals. RESULTS: Endotoxin challenge resulted in a biphasic pulmonary artery pressure response. Blood flow decreased progressively from 2.8 +/- 0.2 l/min to 2 +/- 0.2 l/min. Ohmic pulmonary vascular resistance (PVR) increased gradually from 0.2 +/- 0.04 to 0.76 +/- 0.1 mm Hg s ml-1. The early increase in PAP (from 14 +/- 2 to 27 +/- 4 mm Hg) was mediated by changes in both R1 (from 0.04 +/- 0.01 to 0.06 +/- 0.01 mm Hg s ml-1) and R2 (from 0.16 +/- 0.04 to 0.61 +/- 0.2 mm Hg s ml-1). These responses, in turn, altered the proximal vascular compliance. A subsequent increase in PAP (from 27 +/- 2 to 32 +/- 3 mm Hg) paralleled the specific decline in distal pulmonary vasculature compliance from 0.84 +/- 0.1 to 0.65 +/- 0.1 ml/mmHg. Analysis of the time course of PVR did not allow us to distinguish between vasoconstriction and stiffening of the vascular tree as mechanisms accounting for PAP changes. CONCLUSIONS: Endotoxemia leads to pulmonary hypertension, which is a result of constriction of proximal pulmonary arteries during the early phase, whereas the late phase is characterised by a decline in distal pulmonary vasculature compliance. [less ▲]

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See detailModifications fonctionelles et tissulaires induites par la préservation et la reperfusion des greffons pulmonaires
Detry, Olivier ULg

Doctoral thesis (1999)

The lungs are organs whose sensitivity to ischaemia and reperfusion is well known. In a rabbit model of lung ischaemia, we showed that the cold ischaemia longer than 6 hours is accompanied by a ... [more ▼]

The lungs are organs whose sensitivity to ischaemia and reperfusion is well known. In a rabbit model of lung ischaemia, we showed that the cold ischaemia longer than 6 hours is accompanied by a significant reduction in tissue contents in vitamins E and C, two important protectors against the lesions appearing at the time of ischaemia and the reperfusion (Pincemail 1999). Moreover, lungs are different from the other transplanted organs by the importance of a fragile structure, the alveole, zone of exchange between the alveolar air and the capillary blood. It was shown that among the alveolar cells, the type II pneumatocytes, secreting the surfactant, is of primary importance for the post-transplant function. It was shown that the quality of surfactant decreases after conservation and reperfusion of the lungs, and that, in vitro, the effectiveness of surfactant continuously decreases with the prolongation of the duration of ischaemia (Erasmus 1994). Moreover the administration of surfactant before the pulmonary reperfusion improves the postoperative function of the grafts in the rat (Erasmus 1996). It is known that, if all the pulmonary cells contain mitochondria, more than 50% of the mitochondria isolated from lungs come from type II pneumatocytes (Fisher, 1976). We chose to study the mitochondrial respiratory function of these important alveolar cells for the pulmonary function after ischaemia and reperfusion. In this work, we developed a porcine model of ischaemia (hypo- and/or normothermic) and of normothermic reperfusion. This reperfusion was accompanied by a postoperative non-function, objectified by aerodynamic and hemodynamic parameters, as by the appearance of pulmonary oedema. This non-function was observed after 24 hours a hypothermic ischaemia, which is incompatible with a normal function of the pulmonary grafts in clinical transplantation. The reperfusion with a solution of Krebs-Henseleit bicarbonate remove any immunological artefact and any influence of the circulating blood cells in the pulmonary lesions appearing at the time of the reperfusion. On the other hand, this solution is different from blood to a significant degree, by not containing protectors against the production of free radicals at reperfusion. It is thus possible that our model exacerbates this production of free radicals, more especially as the lung is a tissue particularly rich in polymorphonuclear cells. In this model, we could show that after 24 hours of cold ischaemia the mitochondria underwent a moderate deterioration of the oxidoreductases but without decrease in the effectiveness of oxidative phosphorylation, decrease that could be demonstrated after 48 hours of cold ischaemia. These lesions are comparable to the mitochondrial lesions that we had observed after cold ischaemia of rabbit kidney (Willet 1995). After reperfusion, the mitochondrial lesions are more severe, with a decrease in the effectiveness of oxidative phosphorylation. Concerning normothermic ischaemia, the first 30 minutes did not cause significant mitochondrial lesions. These results at least corroborate the literature data on the relative good pulmonary tolerance to normothermic ischaemia, explained in theory by the persistence of oxygen in the airways and thus of the persistence of aerobic metabolism in spite of the circulatory arrest. For the other organs, the circulatory arrest implies anoxia, that is not really the case of lung, as oxygen is present in airways. Pulmonary transplantation could thus profit from an increase in graft pool available by harvesting lung graft from non-heart beating donors. After 45 minutes of normothermic ischaemia, mitochondrial oxidative phosphorylation dysfunction appears, related to a significant deterioration in the ATP synthase function. These results confirm that the cellular metabolism is then disturbed by the appearance of cellular anoxia because of the progressive consumption of oxygen present in the alveoles, or of the substrates necessary to the cellular metabolism. The description and the discussion of the importance of these mitochondrial alterations in the genesis of lung graft dysfunction after transplantation must be integrated with the very broad framework of the disturbances appearing at the time of tissue ischaemia and reperfusion. From our study it comes out that hypothermia at 4°C protects effectively the pulmonary mitochondrial function since significant deteriorations do not appear before 24 hours of hypothermic ischaemia. To determine if mitochondrial deteriorations appearing after normothermic reperfusion are the cause or the consequence of the non-function of the lung appears difficult. On the other hand the lesions appearing after 45 minutes of normothermic ischaemia deserve in an unquestionable way a later study, with evaluation of the mitochondrial function after circulatory arrest in normothermy (30 and 45 minutes) and normothermic reperfusion, and with evaluation of the mitochondrial function after 30 and 45 minutes (or more) of circulatory arrest normothermic but continuation of pulmonary ventilation, or conservation of the lungs in inflation with air or pure oxygen. Our mitochondrial data should also be compared with a study of the pulmonary function by a model of transplantation with survival of the receiver pig. [less ▲]

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See detailTransplantation combinée du foie et du coeur chez un patient souffrant de thalassémie majeure
Detry, Olivier ULg; Defechereux, Thierry ULg; Honore, Pierre ULg et al

in Médecine & Chirurgie Digestives (1999), 28(3), 109-110

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See detailLiver transplantation in a Jehovah's witness
Detry, Olivier ULg; Honoré, Pierre ULg; Delwaide, Jean ULg et al

in Lancet (1999), 353

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See detailIntracranial pressure during liver transplantation for fulminant hepatic failure.
Detry, Olivier ULg; Arkadopoulos, N.; Ting, P. et al

in Transplantation (1999), 67(5), 767-70

During orthotopic liver transplantation (OLT) for fulminant hepatic failure (FHF), some patients develop cerebral injury secondary to intracranial hypertension. We monitored intracranial pressure (ICP ... [more ▼]

During orthotopic liver transplantation (OLT) for fulminant hepatic failure (FHF), some patients develop cerebral injury secondary to intracranial hypertension. We monitored intracranial pressure (ICP) and cerebral perfusion pressure (CPP) before and during OLT in 12 FHF patients undergoing transplantation. All four patients who had normal ICP preoperatively maintained normal ICP/CPP throughout OLT. During OLT, four of the eight patients with pretransplant intracranial hypertension had six episodes of ICP increase. These episodes of intracranial hypertension occurred during failing liver dissection (n=3) and graft reperfusion (n=3). At the end of the anhepatic phase, the ICP was lower than the preoperative ICP in all patients, and was below 15 mmHg in all but one patient. These data suggest that in FHF patients who develop intracranial hypertension before OLT, dissection of the native liver and graft reperfusion are associated with a risk of brain injury resulting from intracranial hypertension and cerebral hypoperfusion. [less ▲]

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See detailClinical use of a bioartificial liver to treat acetaminophen-induced fulminant hepatic failure
Detry, Olivier ULg; Arkadopoulos, N.; Kahaku, E. et al

in American Surgeon (1999), 65

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See detailAquaporin-4 water channel plays a role in the pathogenesis of cerebral edema in fulminant hepatic failure
Margulies, J. E.; Thompson, R. C.; Wycoff, K. et al

in Surgical Forum (1999), 46

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See detailDiverticulosis and Diverticulitis in the Immunocompromised Patients
Detry, Olivier ULg; Honore, Pierre ULg; Meurisse, Michel ULg et al

in Acta Chirurgica Belgica (1999), 99(3, May-Jun), 100-2

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See detailTransplantation hépatique: expérience et résultats du programme de l'Université de Liège
Honore, Pierre ULg; Detry, Olivier ULg; Meurisse, Michel ULg et al

in Revue Médicale de Liège (1998), 53(12), 735-7

The orthotopic liver transplantation (OLT) program of the University of Liege was initiated in 1986. Between 1986 and December 1998, 150 adult OLT have been performed in our institution, including 18 ... [more ▼]

The orthotopic liver transplantation (OLT) program of the University of Liege was initiated in 1986. Between 1986 and December 1998, 150 adult OLT have been performed in our institution, including 18 liver retransplantations, 1 combined heart and liver transplantation and 3 combined liver and kidney transplantations. The aim of this study was to report the last 3 years of our experience. From January 1996 to November 1998, we performed 50 OLT on 49 patients. Three were retransplantations and two were combined liver and kidney transplantations. Fourty-three patients were transplanted for chronic liver disease and 6 for acute or subacute hepatopathy. Mean waiting time on the list was 4 weeks. Immunosuppression was based on triple therapy (cyclosporin A/tacrolimus, steroids, azathioprine), with steroid and azathioprine withdrawal in most of the patients after 3 months. In the chronic liver disease group, operative (< 30 days) survival was 95% (peroperative myocardial infarction in 2 patients). In the acute liver disease group, postoperative survival was 66%. No perioperative death occurred in 1997 and 1998. Actuarial one year survival was 87%. In our experience, OLT has become a safe procedure. [less ▲]

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See detailManagement of Recipients of Hepatic Allografts Harvested from Donors with Malignancy Diagnosed Shortly after Transplantation
Detry, Olivier ULg; Honore, Pierre ULg; Jacquet, Nicolas et al

in Clinical Transplantation (1998), 12(6), 579-81

Transmission of undiagnosed malignancy with the graft is a dramatic complication of liver transplantation. Alternatives in the management of the recipients of livers, harvested from donors with malignancy ... [more ▼]

Transmission of undiagnosed malignancy with the graft is a dramatic complication of liver transplantation. Alternatives in the management of the recipients of livers, harvested from donors with malignancy diagnosed shortly after transplantation, are either early re-transplantation or close follow-up without re-operation. We reported 4 cases of liver recipients whose allografts were harvested from donors who were diagnosed with malignancy shortly after the liver transplantation. One recipient underwent re-transplantation, and the three other allografts were not removed. No recipient developed recurrence in the follow-up. While graft removal may be the only way to avoid tumor recurrence in recipients of liver graft harvested from donor with malignancy, close follow-up without re-operation may also be considered. The risk of tumor transferral may depend on the histopathological aggressiveness and metastatic potential of the donor tumor, and may be low for low-grade, local tumors. This risk should be evaluated by analyzing large series, using databases of Eurotransplant or United Network for Organ Sharing. [less ▲]

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