Living related liver transplantation in adults: First year experience at the University of Liege

in Acta Chirurgica Belgica (2004), 104(2, MAR-APR), 166-171

Living related liver transplantation (LRLT) in adult recipients has been recently developed to overcome the organ donor shortage, but LRLT leaves the healthy donors at risk of serious post-operative ... [more ▼]

Living related liver transplantation (LRLT) in adult recipients has been recently developed to overcome the organ donor shortage, but LRLT leaves the healthy donors at risk of serious post-operative complications, or even death. The aim of this paper is to report the prospective evaluation of the initial experience of adult LRLT at the University of Liege. From March 2002 till March 2003, in a consecutive series of 35 adult liver transplantations, five recipients (mean age : 51 years) underwent LRLT, including one retransplantation. Indications for transplantation were autoimmune hepatitis, hepatitis B virus related cirrhosis with hepatocarcinoma (two cases), hepatitis C virus related cirrhosis with hepatocarcinoma, and ischemic intrahepatic bile duct necrosis 10 years after primary liver transplantation. Mean age of the donors was 34 years (range : 21-53 years). All donation cases were intra familial at first degree. The right lobe was used as a graft in four cases and the left lobe in one case. All right lobe donors developed transient hyperbilirubinemia and hypocoagulation for 4 to 6 days. No severe complication (transfusion, bile duct fistula, reintervention, rehospitalization) nor significant long-term sequelae were observed in the donors. In the recipients, graft function was immediate, and there was no small-for-size syndrome. One recipient developed biliary fistula treated by reoperation. One recipient died from invasive aspergillosis 11 days after the procedure. The four other recipients were alive without recurrence of the disease at follow-up. This report confirmed that LRLT may be a valuable alternative to cadaveric liver transplantation in the era of organ donor shortage. However, even if there was no severe complication for the donors in our preliminary experience, LRLT puts healthy living donors at risk of significant morbidity and even death. [less ▲]

Living related liver transplantation in adults: First year experience at the University of Liege

in Acta Gastro-Enterologica Belgica (2004), 67

Epidural levobupivacaine 0.1 % or ropivacaine 0.1 % combined with morphine provides comparable analgesia after abdominal surgery

in Anesthesia and Analgesia (2004), 98

Prise en charge anesthésique pour chimiothérapie hyperthermique intrapéritonéale peropératoire

in Praticien en Anesthésie Réanimation (Le) (2004), 8(5), 357-362

Prise en charge multimodale de la chirurgie abdominale majeure

in La réhabilitation post-opératoire (2004)

Supplemental oxygen does not reduce postoperative nausea and vomiting after thyroidectomy

in British Journal of Anaesthesia (2003), 91(6), 857-61

Spinal mechanisms contribute to analgesia produced by epidural sufentanil combined with bupivacaine for postoperative analgesia

in Anesthesia and Analgesia (2003), 97

Pièges de la chirurgie coelioscopique: comment faire face aux complications?

in Praticien en Anesthésie Réanimation (Le) (2003), 7(5), 339-345

Strictureplasty in Crohn's disease : Short- and long-term follow-up

in Acta Chirurgica Belgica (2002), 102(4, JUL-AUG), 253-255

Strictureplasty for obstructive Crohn's disease is still controversial because lesions are left in place and the suture is performed on a diseased bowel. Many surgeons prefer to perform bowel resection ... [more ▼]

Strictureplasty for obstructive Crohn's disease is still controversial because lesions are left in place and the suture is performed on a diseased bowel. Many surgeons prefer to perform bowel resection, hoping for fewer complications and a lower recurrence rate. In this paper, the authors reports their strictureplasty experience. They performed a systematic retrospective review of the patients suffering from Crohn's disease who underwent strictureplasties during a 10-year period in the abdominal surgery department of the University Hospital of Liege Sart Tilman, and studied the short- and long-term clinical results of 68 strictureplasties performed in 18 patients. Median follow-up was 63 months (range 12 to 144). Mortality was 0% and septic morbidity was 11% (one wound abscess and one leakage). Among the 16 patients available for the latest follow-up, symptomatic stenotic recurrence had to be medically treated in hospital for 4 patients (25%) with a recurrence delay range of 19 to 49 months. Stenosis recurrence needed re-intervention in one patient 48 months after surgery: stenosis occurred at a distance from the corrected site. These results confirmed that strictureplasty is a safe and efficient procedure in selected patients undergoing surgery for obstructive Crohn's disease. [less ▲]

A comparison of 0.1 % and 0.2 % ropivacaine and bupivacaine associated to morphine for postoperative patient-controlled epidural analgesia after major abdominal surgery

in Anesthesia and Analgesia (2002), 95(2), 444-449