References of "Squifflet, Jean-Paul"
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See detailKidney donation after circulatory death in a country with a high number of brain dead donors: 10 -year experience in Belgium
Jochmans, Ina; Darius, Tom; Kuypers, Dirk et al

in Transplant International (2012), 25

Worldwide shortage of standard brain dead donors (DBD) has revived the use of kidneys donated after circulatory death (DCD). We reviewed the Belgian DCD kidney transplant (KT) experience since its ... [more ▼]

Worldwide shortage of standard brain dead donors (DBD) has revived the use of kidneys donated after circulatory death (DCD). We reviewed the Belgian DCD kidney transplant (KT) experience since its reintroduction in 2000. Risk factors for delayed graft function (DGF) were identified using multivariate analysis. Five-year patient/graft survival was assessed using Kaplan–Meier curves. The evolution of the kidney donor type and the impact of DCDs on the total KT activity in Belgium were compared with the Netherlands. Between 2000 and 2009, 287 DCD KT were performed. Primary nonfunction occurred in 1% and DGF in 31%. Five-year patient and death-censored graft survival were 93% and 95%, respectively. In multivariate analysis, cold storage (versus machine perfusion), cold ischemic time, and histidine-tryptophan-ketoglutarate solution were independent risk factors for the development of DGF. Despite an increased number of DCD donations and transplantations, the total number of deceased KT did not increase significantly. This could suggest a shift from DBDs to DCDs. To increase KT activity, Belgium should further expand controlled DCD programs while simultaneously improve the identification of all potential DBDs and avoid their referral for donation as DCDs before brain death occurs. Furthermore, living donation remains underused. Transplant International ISSN 0934-0874 ª [less ▲]

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See detailA multicenter, randomized, double-blind study comparing different FK778 doses (manitimus) with tacrolimus and steroids vs. MMF with tacrolimus and steroids in renal transplantation
Wlodarczyk, Zbigniew; Vanrenterghem, Yves; Krämer, Bernhard k et al

in BMC Nephrology (2012), 13

Background: This multicenter phase II study in renal transplantation compared 3 concentration-controlled ranges of FK778 (manitimus) with mycophenolate mofetil (MMF) both given in combination with ... [more ▼]

Background: This multicenter phase II study in renal transplantation compared 3 concentration-controlled ranges of FK778 (manitimus) with mycophenolate mofetil (MMF) both given in combination with tacrolimus and corticosteroids. Methods: 364 patients were randomized to 12-month treatment: high-level FK778 group (H, N = 87) received 4x600mg/day (4 days) followed by 120 mg/day; mid-level FK778 group (M, N = 92) received 3x600mg/day (3 days) followed by 110 mg/day, low-level FK778 group (L, N = 92) received 2x600mg/day (2 days) followed by 100 mg/day, and control group received MMF 1 g/day (MMF, N = 93). After week 6, FK778 doses were adjusted to trough ranges of 75–125 μg/mL (H), 50–100 μg/mL (M) and 25–75 μg/mL (L). Tacrolimus and steroids were administered at the same dose in each of the 4 groups. Results: Biopsy proven acute rejection (BPAR) at 24 weeks, the primary study endpoint, was comparable in the L (22.8%) and MMF (17.2%) groups but higher in the H (34.5%) and M (29.3%) groups. BPAR at 12 months was comparable in the L (23.9%) and MMF (19.4%) groups but higher in the H (34.5%) and M (31.5%) groups. Graft and patient survival were lowest in the H group and renal function was poorest in the H and M groups. Premature study withdrawal was highest in the H group. Conclusions: Efficacy was similar between the low-level FK778 and MMF groups. Increased FK778 exposure was poorly tolerated and did not improve efficacy. [less ▲]

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See detailBELGIAN EXPERIENCE OF DCD KIDNEY TRANSPLANTATION
Darius, Tom; Jochmans, Ina; Ledinh, Hieu et al

in Transplant International (2011, September), 24(2), 43-44

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See detailThe history of kidney transplantation: Past,Present and Future
SQUIFFLET, Jean-Paul ULg

in Understanding the complexities of kidney transplantation (2011)

The history of kidney transplantation is thought to have originated at the early beginning of the previous century with several attempts of Xenografting, and experimental works on vascular sutures (Küss ... [more ▼]

The history of kidney transplantation is thought to have originated at the early beginning of the previous century with several attempts of Xenografting, and experimental works on vascular sutures (Küss & Bourget, 1992)1. But it really started more than 60 years ago with first attempts of deceased donor transplantation (DCD) and the first successful kidney transplantation of homozygote twins in Boston (Toledo-Pereyra et al, 2008)2. Belgian surgeons contributed to that field of medicine by performing in the early sixties the first ever organ procurement on a brain dead heart beating donor (DBD) (June 1963) (Squifflet, 2003)3. Later on, in the eighties, they published a first series of living unrelated donor (LURD) transplantations, as well as ABO-Incompatible living donor (ABO-Inc LD) transplantations. With the advent of Cyclosporine A, and later other calcineurin inhibitors such as Tacrolimus, with the advent of more potent immunosuppressive drugs (IS), the gap between the number of renal transplant candidates and the number of transplanted recipients was and is continuously increasing in Belgium and most countries. It opened the search for other sources of organs such as donors after cardiac death (DCD) defined with the Maastricht conference and the extended criteria donors (ECD) compared to standard criteria donors (SCD). In Belgium another source of DCD was identified after the promulgation in 2002 of a law on euthanasia. The Belgian example and all its historical measures could help others to fight against organ shortage and its consequences, organ trafficking, commercialization and tourism. [less ▲]

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See detailDCD liver transplantation: is donor age an issue?
DETRY, Olivier ULg; le dinh, Hieu; Honoré, Pierre ULg et al

Conference (2011, March 24)

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See detailDCD kidney transplantation from 2000 to 2009: a Belgian review
Darius, T.; Ledinh, H.; Monbaliu, D. et al

Conference (2011, March 24)

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See detailPancreas preservation for pancreas and islet transplantation: a minireview
SQUIFFLET, Jean-Paul ULg; LeDinh, Hieu; DE ROOVER, Arnaud ULg et al

in Transplantation Proceedings (2011), 43

Pancreas preservation by cold storage using University of Wisconsin solution was the <br />mainstay method used for pancreas transplantation during the past 2 decades. Other <br />solutions, such as HTK ... [more ▼]

Pancreas preservation by cold storage using University of Wisconsin solution was the <br />mainstay method used for pancreas transplantation during the past 2 decades. Other <br />solutions, such as HTK, Celsior, and SCOT 15, could not demonstrate any advantage for <br />short preservation periods. But the advent of clinical islet transplantation and the larger <br />use of controlled non–heart-beating donors have prompted the transplantation community <br />to develop methods for increasing pancreas graft quality while preventing ischemic <br />reperfusion damages. Oxygenation by 1- or 2-layer methods during pancreas preservation, <br />as well as the use of perfluorocarbons, might increase the islet yield. Based on the former <br />methods, there is a renewed interest in machine perfusion and oxygenation in pancreas <br />preservation for pancreas transplantation and islet preparation. [less ▲]

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See detailCurrent Practices of Organ Donation and Transplantation Among Different French-Speaking Countries and Regions
SQUIFFLET, Jean-Paul ULg; Barrou, B.; Rifle, G.

in Transplantation Proceedings (2011), 43

The aim of the “Transplantation Sans Frontières” (TSF) questionnaire, which was sent to <br />French-speaking centers in 6 different countries and regions, was to establish the current <br />status of ... [more ▼]

The aim of the “Transplantation Sans Frontières” (TSF) questionnaire, which was sent to <br />French-speaking centers in 6 different countries and regions, was to establish the current <br />status of organ donation and transplantation in their environments. It was also to examine <br />ways to collaborate and exchange scientific information, teaching, and training in the field <br />of organ transplantation. The French Society of Transplantation and the Agency of <br />Biomedicine already offer specific programs to expand local activities, and the World <br />Health Organization (WHO) regulates them. Therefore, TSF could be a coordinating <br />platform in the near future. [less ▲]

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See detailDonor Advocacy with Special Reference to Belgium
SQUIFFLET, Jean-Paul ULg

in Transplantation Proceedings (2011), 43

Before any published Belgian law, EU Directive, and/or EU Action Plan, the donor <br />advocate was naturally a member of the transplantation team performing living kidney <br />donation. The need of ... [more ▼]

Before any published Belgian law, EU Directive, and/or EU Action Plan, the donor <br />advocate was naturally a member of the transplantation team performing living kidney <br />donation. The need of donor advocacy appeared obvious with liver living donation, which <br />was and is still a risky procedure. Today, it is clear that the donor advocacy must not be <br />limited to living donation but extended to brain-dead and cardiac-dead donation. <br />Nevertheless, its complexity will need experienced persons in the field of organ donation <br />as well as transplantation, while remembering that patients’ first right is the right to donate. [less ▲]

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See detailEnd of life care in the operating room for non-heart-beating donors: organization at the University Hospital of Liege.
JORIS, Jean ULg; KABA, Abdourahmane ULg; LAUWICK, Séverine ULg et al

in Transplantation Proceedings (2011), 43(9), 3441-4

Non-heart-beating (NHB) organ donation has become an alternative source to increase organ supply for transplantation. A NHB donation program was implemented in our institution in 2002. As in many ... [more ▼]

Non-heart-beating (NHB) organ donation has become an alternative source to increase organ supply for transplantation. A NHB donation program was implemented in our institution in 2002. As in many institutions the end of life care of the NHB donor (NHBD) is terminated in the operating room (OR) to reduce warm ischemia time. Herein we have described the organization of end of life care for these patients in our institution, including the problems addressed, the solution proposed, and the remaining issues. Emphasis is given to our protocol elaborated with the different contributors of the chain of the NHB donation program. This protocol specifies the information mandatory in the medical records, the end of life care procedure, the determination of death, and the issue of organ preservation measures before NHBD death. The persisting malaise associated with NHB donation reported by OR nurses is finally documented using an anonymous questionnaire. [less ▲]

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See detailThe french speaking society of transplantation and "transplantation sans frontières"
SQUIFFLET, Jean-Paul ULg; BARROU, Benoit; GLOTZ, Denis et al

in Transplantation Proceedings (2011), 43

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See detailThe prognostic value of renal resistance during hypothermic machine perfusion of deceased donor kidneys
Jochmans, I.; Moers, C.; Smits, J. M. et al

in American Journal of Transplantation (2011), 11

Vascular renal resistance (RR) during hypothermic machine perfusion (HMP) is frequently used in kidney graft quality assessment. However, the association between RR and outcome has never been ... [more ▼]

Vascular renal resistance (RR) during hypothermic machine perfusion (HMP) is frequently used in kidney graft quality assessment. However, the association between RR and outcome has never been prospectively validated. Prospectively collected RR values of 302 machine-perfused deceased donor kidneys of all types (standard and extended criteria donor kidneys and kidneys donated after cardiac death), transplanted without prior knowledge of these RR values, were studied. In this cohort, we determined the association between RR and delayed graft function (DGF) and 1-year graft survival. The RR (mmHg/mL/min) at the end of HMP was an independent risk factor for DGF (odds ratio 21.12 [1.03–435.0]; p = 0.048) but the predictive value of RR was low, reflected by a c-statistic of the receiver operator characteristic curve of 0.58. The RR was also found to be an independent risk factor for 1-year graft failure (hazard ratio 12.33 [1.11–136.85]; p = 0.004). Determinants of transplant outcome are multifactorial in nature and this study identifies RR as an additional parameter to take into account when evaluating graft quality and estimating the likelihood of successful outcome. However, RR as a stand-alone quality assessment tool cannot be used to predict outcome with sufficient precision. [less ▲]

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See detailMachine perfusion versus cold storage for preservation of kidneys from expanded criteria donors after brain death
Treckmann, Jürgen; Moers, Cyril; Smits, Jacqueline M et al

in Transplant International (2011), 24

The purpose of this study was to analyze the possible effects of machine perfusion (MP) versus cold storage (CS) on delayed graft function (DGF) and early graft survival in expanded criteria donor kidneys ... [more ▼]

The purpose of this study was to analyze the possible effects of machine perfusion (MP) versus cold storage (CS) on delayed graft function (DGF) and early graft survival in expanded criteria donor kidneys (ECD). As part of the previously reported international randomized controlled trial 91 consecutive heartbeating deceased ECDs – defined according to the United Network of Organ Sharing definition – were included in the study. From each donor one kidney was randomized to MP and the contralateral kidney to CS. All recipients were followed for 1 year. The primary endpoint was DGF. Secondary endpoints included primary nonfunction and graft survival. DGF occurred in 27 patients in the CS group (29.7%) and in 20 patients in the MP group (22%). Using the logistic regression model MP significantly reduced the risk of DGF compared with CS (OR 0.460, P = 0.047). The incidence of nonfunction in the CS group (12%) was four times higher than in the MP group (3%) (P = 0.04). One-year graft survival was significantly higher in machine perfused kidneys compared with cold stored kidneys (92.3% vs. 80.2%, P = 0.02). In the present study, MP preservation clearly reduced the risk of DGF and improved 1-year graft survival and function in ECD kidneys. [less ▲]

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See detailRenal transplantation from living related donors: a single center experience in viet nam.
Ledinh, H.; Detry, Olivier ULg; Pham, M. S. et al

in Transplantation Proceedings (2010), 42(10), 4389-91

INTRODUCTION: End-stage renal disease is a major public health problem in Viet Nam. A cooperative project between the University of Liege, Belgium, and the University of Medicine Pham Ngoc Thach, Ho Chi ... [more ▼]

INTRODUCTION: End-stage renal disease is a major public health problem in Viet Nam. A cooperative project between the University of Liege, Belgium, and the University of Medicine Pham Ngoc Thach, Ho Chi Minh City, Viet Nam, has permitted the establishment of an autonomous program of renal transplantation from living-related donors at the Peoples' Hospital No 115. The aim of this paper was to report the primary results of the project and to draw conclusions for the future. PATIENTS AND METHODS: From January 2004 to July 2008, we performed 33 living-related renal transplantations. Mean ages of donors and recipients were 31.8 +/- 9.5 and 41.6 +/- 13.5 years, respectively. Laparoscopic nephrectomy was performed in 6 donors. The immunosuppressive regimen consisted of three drugs associated with induction therapy using anti-interleukin-2 receptor monoclonal antibody. RESULTS: The 33 donors are in good health at follow-up. Four developed major intra- or postoperative hemorrhage necessitating transfusion, with a surgical re-exploration in 1 donor. Wound infection occurred in 2 donors. Posttransplant recipient and graft survivals at 1 versus 3 years were 82% and 73% versus 82% and 65%, respectively. Eight recipients presented 13 biopsy-proven acute rejection episodes that were reversible in 7, but 1 patient lost his graft due to an irreversible rejection. Two recipients developed cancer. CONCLUSIONS: These initial results have encouraged us to continue the program of renal transplantation from living-related donors. However, they also pointed out the need to develop other donor sources. [less ▲]

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See detailContribution of donors after cardiac death to the deceased donor pool: 2002 to 2009 university of liege experience.
Ledinh, H.; Meurisse, Nicolas ULg; Delbouille, Michèle ULg et al

in Transplantation Proceedings (2010), 42(10), 4369-72

OBJECTIVE: In this study, we have evaluated the organ procurement and transplantation activity from donors after cardiac death (DCD) at our institution over an 8-year period. Our aim was to determine ... [more ▼]

OBJECTIVE: In this study, we have evaluated the organ procurement and transplantation activity from donors after cardiac death (DCD) at our institution over an 8-year period. Our aim was to determine whether this program influenced transplantation programs, or donation after brain death (DBD) activity. METHODS: We prospectively collected our procurement and transplantation statistics in a database for retrospective review. RESULTS: We observed an increasing trend in potential and actual DCD number. The mean conversion rate turning potential into effective donors was 58.1%. DCD accounted for 16.6% of the deceased donor (DD) pool over 8 years. The mean age for effective DCD donors was 53.9 years (range, 3-79). Among the effective donors, 63.3% (n = 31) came from the transplant center and 36.7% (n = 18) were referred from collaborative hospitals. All donors were Maastricht III category. The number of kidney and liver transplants using DCD sources tended to increase. DCD kidney transplants represented 10.8% of the DD kidney pool and DCD liver transplants made up 13.9% of the DD liver pool over 8 years. The DBD program activity increased in the same time period. In 2009, 17 DCD and 33 DBD procurements were performed in a region with a little >1 million inhabitants. CONCLUSION: The establishment of a DCD program in our institution enlarged the donor pool and did not compromise the development of the DBD program. In our experience, DCD are a valuable source for abdominal organ transplantation. [less ▲]

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See detailThe value of machine perfusion perfusate biomakers for predicting kidney transplant outcome
Moers, Cyril; Varnay, Oana C; Van Heurn, Ernest et al

in Transplantation (2010), 90

Background. Retrospective evidence suggests that lactate dehydrogenase, aspartate aminotransferase, total glutathione-S-transferase (GST), alanine-aminopeptidase, N-acetyl- -D-glucosaminidase (NAG), and ... [more ▼]

Background. Retrospective evidence suggests that lactate dehydrogenase, aspartate aminotransferase, total glutathione-S-transferase (GST), alanine-aminopeptidase, N-acetyl- -D-glucosaminidase (NAG), and hearttype fatty acid binding protein (H-FABP) measured during kidney machine perfusion (MP) could have predictive value for posttransplant outcome. However, these data may be biased due to organ discard based on biomarker measurements, and previous analyses were not adjusted for likely confounding factors.Noreliable prospective evidence has been available so far. Nevertheless, some centers already use these biomarkers to aid decisions on accepting or discarding a donor kidney. Methods. From 306 deceased-donor kidneys donated after brain death or controlled cardiac death and included in an international randomized controlled trial, these six biomarkers were measured in the MP perfusate. In this unselected prospective data set, we tested whether concentrations were associated with delayed graft function, primary nonfunction, and graft survival. Multivariate regression models investigated whether the biomarkers remained independent predictors when adjusted for relevant confounding factors. Results. GST, NAG, and H-FABP were independent predictors of delayed graft function but not of primary nonfunction and graft survival. Lactate dehydrogenase, aspartate aminotransferase, and alanine-aminopeptidase had no independent prognostic potential for any of the endpoints. Perfusate biomarker concentrations had no relevant correlation with cold ischemic time or renal vascular resistance on the pump. Conclusions. Increased GST, NAG, or H-FABP concentrations during MP are an indication to adjust posttransplant recipient management. However, this study shows for the first time that perfusate biomarker measurements should not lead to kidney discard. Keywords: Machine perfusion, Kidney transplantation, Perfusate biomarkers, Delayed graft function, Graft survival [less ▲]

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See detailResults of kidney transplantation from donors after cardiac death.
Ledinh, H.; Bonvoisin, Catherine ULg; Weekers, Laurent ULg et al

in Transplantation Proceedings (2010), 42(7), 2407-14

Confronting the organ donor shortage, many transplant centers around the world increasingly use donors after cardiac death (DCD). Over the past 20 years, follow-up studies in kidney recipients comparing ... [more ▼]

Confronting the organ donor shortage, many transplant centers around the world increasingly use donors after cardiac death (DCD). Over the past 20 years, follow-up studies in kidney recipients comparing DCD and donors after brain death (DBD) have shown comparable long-term graft function and survival. As a consequence, DCD programs should be continued and expanded, for these donors constitute a potential solution to the imbalance between the numbers of end-stage kidney disease patients on waiting lists versus available kidney grafts. DCD kidneys do not necessarily signify suboptimal grafts; they may merit to be allocated the same as DBD grafts. [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 Transplant International (2010, July), 23(Suppl. 1), 415

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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 Chirurgica Belgica (2010, April), 110

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