References of "Squifflet, Jean-Paul"
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See detailThe history of Pancreas Transplantation: Past, Present and Future
Squifflet, Jean-Paul ULg; Gruessner, R.; Sutherland, D.

in Acta Chirurgica Belgica (2008), 108

Abstract. The first attempt to cure type 1 diabetes by pancreas transplantation was done at the University of Minnesota, in Minneapolis, on December 17, 1966, followed by a series of whole pancreas ... [more ▼]

Abstract. The first attempt to cure type 1 diabetes by pancreas transplantation was done at the University of Minnesota, in Minneapolis, on December 17, 1966, followed by a series of whole pancreas transplantation. Due to the lack of potent immunosuppressive drugs, rejections and infections, it was concluded that pancreas was less antigenic than the kidney which was less antigenic than the duodenum. It opened the door to a period, between the mid 70’s to mid 80’s where only segmental pancreatic grafts were used in the recipient. Numerous techniques for diverting or dealing with the pancreas juice secretion were described, none of them being satisfactory. In the late 70’s – early 80’s, three major events happened and boosted the development of pancreas transplantation : firstly the introduction of Cyclosporine A in the clinical field, secondly the organization on March 1980, of the first international meeting on Pancreas Transplantation with the first report of the International Pancreas Transplantation Registry (IPTR) and finally in 1982, the organization of the first informal so-called Spitzingsee meetings where pancreas transplantation successes but mainly failures were discussed which precluded the onset of IPITA (International Pancreas and Islet Transplantation Association), EuroSPK (European Study Group for simultaneous Pancreas and Kidney Transplantation) and EPITA (European Pancreas and Islet Transplantation Association). During one of the Spitzingsee meetings, participants had the idea to renew the urinary drainage technique of the exocrine secretion of the pancreatic graft with segmental graft and eventually with whole pancreaticoduodenal transplant. That was clinically achieved during the mid 80’s and remained the mainstay technique during the next decade. In parallel, the Swedish group developed the whole pancreas transplantation technique with enteric diversion. It was the onset of the whole pancreas reign. The enthusiasm for the technique was rather moderated in its early phase due to the rapid development of liver transplantation and the need for sharing vascular structures between both organs, liver and pancreas. During the modern era of immunosuppression, the whole pancreas transplantation technique with enteric diversion became the gold standard for simultaneous pancreas and kidney transplantation (SPK), with portal drainage of the venous effluent of the pancreas, even for pancreas after kidney (PAK) or pancreas transplantation alone (PTA). Today, there remains room for improvement : safety of using the duodeno-duodenal anastomosis technique must be confirmed by prospective analysis while preventing ischemic reperfusion injuries, using specific drugs ; that must be assessed in new trials. [less ▲]

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See detailImmunosuppression in Pancreas Transplantation The Euro SPK Trials and Beyond
Malaise, J.; De Roover, Arnaud ULg; Squifflet, Jean-Paul ULg et al

in Acta Chirurgica Belgica (2008), 108

The Immunosuppression in Pancreas Transplantation was historically based on the fact that the pancreas is an extremely immunogenic organ. Quadruple drug therapy with polyclonal or monoclonal antibodies ... [more ▼]

The Immunosuppression in Pancreas Transplantation was historically based on the fact that the pancreas is an extremely immunogenic organ. Quadruple drug therapy with polyclonal or monoclonal antibodies induction was the mainstay therapy since the introduction of Cyclosporine A. In the modern era of Immunosuppression, Mycophenolate Mofetil replaced Azathioprine while Tacrolimus-another potent calcineurin inhibitor-had-and still has-a difficult challenge to replaced Cyclosporine A, due to its potential diabetogenic effect. Thanks to the first two EuroSPK studies which prospectively tried to answer several questions in that field. But, the future challenge will be in understanding the impact of innate immunity and ischemic reperfusion injuries on the long term graft function. Hopefully, new drugs will be available and tested to block unspecific deleterious reactions to attenuate the proinflammatory response. It will be the aim of the third Euro SPK Stud [less ▲]

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See detailPremier episode de rejet aigu apres transplantation renale: etude des caracteristiques histopathologiques en fonction du risque immunologique du patient.
Ghisdal, Lidia; Touchard, Guy; Goujon, Jean-Michel et al

in Néphrologie & Thérapeutique (2008), 4(3), 173-80

Renal allograft biopsies (n=34) of two different populations of patients according to the immunological risk (high versus low-risk) have been compared retrospectively. The presence of polymorphonuclear ... [more ▼]

Renal allograft biopsies (n=34) of two different populations of patients according to the immunological risk (high versus low-risk) have been compared retrospectively. The presence of polymorphonuclear leukocytes in peritubular capillaries was more frequent in the high-risk group. The C4d staining was positive in 10% of the low-risk patients and in 50% of the high-risk patients (P=0.03). There were more early graft loss, renal infarctions, interstitial hemorrhage, severe glomerulitis, neutrophilic glomerulitis and Banff III grade rejection in the positive C4d group. In conclusion, half of the immunized patients had a humoral rejection, patients with a C4d positive rejection had more early graft loss and more severe histological lesions. [less ▲]

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See detailPancreas graft drainage in recipient duodenum: Preliminary experience
De Roover, Arnaud ULg; Coimbra Marques, Carla ULg; Detry, Olivier ULg et al

in Transplantation (2007), 84(6), 795-797

Pancreas graft survival has continuously improved over the years to become a main treatment option of uncontrolled complicated diabetes. Rejection remains the major challenge as it often goes unnoticed ... [more ▼]

Pancreas graft survival has continuously improved over the years to become a main treatment option of uncontrolled complicated diabetes. Rejection remains the major challenge as it often goes unnoticed until severe damage of the graft manifests itself by elevated blood sugar. Pancreas enzymes monitoring in the blood and in the urine is a sensitive marker of rejection but lack of specificity. Biopsy remains the gold standard. Cystoscopy-guided biopsy of bladder-drained pancreas has a good success rate for obtaining tissue but the vesical drainage exposes to metabolic and urologic morbidity. Percutaneous pancreas biopsy can be performed with a low morbidity rate but severe complications can occur. We discuss a technique of pancreas transplantation with the drainage of exocrine secretions of the pancreatic graft in the recipient duodenum, which permits easy monitoring of the graft by upper endoscopy of the duodenum. [less ▲]

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See detailBloodless liver transplantation: Experience with Jehovah's witnesses
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in Transplant International (2007, September), 20(Supplement 2), 291812

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See detailBistouri ultracision en chirurgie thyroïdienne
COIMBRA MARQUES, Carla ULg; Defechereux, thierry; Meurisse, Nicolas ULg et al

in Revue Médicale de Liège (2007), 62 Spec No

The thyroid gland is highly vascularized and, in all Thyroid surgery, a special attention must be paid to haemos. tasis and coagulation. Any carelessness in the control of thyroid vessels can indeed ... [more ▼]

The thyroid gland is highly vascularized and, in all Thyroid surgery, a special attention must be paid to haemos. tasis and coagulation. Any carelessness in the control of thyroid vessels can indeed entail serious consequences. In this respect, the ultrasonic scalpel represents a significant progress. In this paper, the ultrasonic dissector will first be presented. Then a prospective, randomized trial comparing the results obtained with this apparatus to those obtained with the conventional method of hemostasis in a series of 34 patients submitted to total thyroidectomy for multinodular goiter will be summarized. Without increasing the costs, the ultrasonic dissector allows a saving of operative time as well as a reduction of peroperative bleeding and of postoperative use of antalgics. Finally, the results of 1696 total thyroidectomies performed with the use of the ultrasonic dissector will be briefly outlined. [less ▲]

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See detailActualités sur les agents immunosuppresseurs utilisés en transplantation rénale
Milicevic, Martina; Krzesinski, Jean-Marie ULg; Squifflet, Jean-Paul ULg

in Revue Médicale de Liège (2007), 62

The goal of immunosuppression in transplantation is to prevent acute rejection and, more recently, chronic renal graft rejection related in part to sdide-effects of immunosuppressive therapy (hypertension ... [more ▼]

The goal of immunosuppression in transplantation is to prevent acute rejection and, more recently, chronic renal graft rejection related in part to sdide-effects of immunosuppressive therapy (hypertension, diabetes, dyslipidemia, ...). The development of new drugs in renal transplantation has improved graft survival, but also the patient's quality of life. A better understanding of the side-effects of immunosuppressive therapy and the observation of optimal drug associations to reduce these side-effects have often led to propose modifications of the immunosuppressive regimen, mainly at the end of the first trimester after renal transplantation.The aim of this overview is to describe the available oral immunosuppressive agents, especially the new ones, their advantages, but also the danger when different drugs are added in acute illness. [less ▲]

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See detailComplications in living liver donor according to Clavien's classification: An European experience
De Roover, Arnaud ULg; Detry, Olivier ULg; Meurisse, Nicolas ULg et al

in Journal of Hepatology (2007), 46(Suppl. 1), 66

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See detailBloodless cadaveric liver transplantation: Experience with Jehovah's witness recipients
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in Journal of Hepatology (2007), 46(Suppl. 1), 67

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See detailWhy Did it Take so Long to Start a Non-Heart-Beating Donor Program in Belgium ?
Squifflet, Jean-Paul ULg

in Acta Chirurgica Belgica (2006), 106

The first cadaver kidney transplant, performed in June 1963 in Belgium, was from a heart beating donor (HBD). It was the first ever in the world. Since that period, almost all cadaver organs were procured ... [more ▼]

The first cadaver kidney transplant, performed in June 1963 in Belgium, was from a heart beating donor (HBD). It was the first ever in the world. Since that period, almost all cadaver organs were procured from brain death donors. When the Belgian law on organ donation and transplantation was published on February 1987, with its opting-out principle, no emphasis was placed on procuring organs after cardiac death. Based on the Maastricht experience, in the early nineties, the transplant community interpellated the National Belgian Council of Physicians to facilitate organ procurement in Non-Heart-Beating Donors (NHBD) following the law. But, the transplant community had to wait for the impulse of the first International Congress on NHBD in 1995,where the 4 categories of Maastricht NHBD were defined. It also published 12 Statements and Recommendations which were eventually approved by the European Council. Then all local Ethical Committees received queries for approving local NHBD programs. Almost all centres requested viability testing assessment of the NHBD organ prior to implantation, and proposed the introduction of machine perfusion technology. Finally, all centres joined their efforts and made a collaborative agreement with Organ Recovery Systems for a 24/7 machine perfusion service from a central laboratory. During a three year period (2003-2005), 46 NHBD kidneys were recovered. Among these kidneys, 32 were perfused in the Organ Recovery Systems central laboratory. The Delayed Graft Function (DGF) rate for these perfused kidneys was 25%. Only one graft was lost in this subgroup. Livers, pancreases (for islet preparation) and lungs (for experimental ex-vivo evaluation) were also recovered from these non-heart-beating donors. [less ▲]

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See detailAllergie systémique à l’insuline: traitement médical ou chirurgical (greffe de pancréas vascularisé).
Leonet, J; RADERMECKER, Régis ULg; Malaise, J et al

in Diabète & Métabolisme (2005), 31

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See detailAllergie systémique à l'insuline: traitement médical ou chirurgical (greffe de pancréas vascularisé)?
Leonet, J.; RADERMECKER, Régis ULg; Malaise, J. et al

in Diabète & Métabolisme (2005), 31

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See detailEfficacy and cardiovascular safety of daclizumab, mycophenolate mofetil,tacrolimus, and early steroid withdrawal in renal transplant recipients: a multicenter,prospective, pilot trial
Abramowicz, Daniel; Vanrenterghem, Yves; Squifflet, Jean-Paul ULg et al

in Clinical Transplantation (2005), 19

This single-arm, open-label, pilot study was designed to assess the efficacy and cardiovascular safety profile of daclizumab, a humanized monoclonal interleukin (IL)-2Ra antibody, in combination with ... [more ▼]

This single-arm, open-label, pilot study was designed to assess the efficacy and cardiovascular safety profile of daclizumab, a humanized monoclonal interleukin (IL)-2Ra antibody, in combination with mycophenolate mofetil (MMF), tacrolimus, and early corticosteroid withdrawal in renal transplant recipients. Seventy-nine renal allograft recipients were treated with daclizumab (1 mg/kg; five doses starting on the day before transplant and then every two weeks), MMF (1 g b.i.d.), tacrolimus (0.2 mg/kg/d), and low-dose prednisolone, which was withdrawn at day 150 after transplant. The rate of acute rejection was determined at 12 months. Lipid profile, oral glucose tolerance, and adverse events were monitored. Of the 76 patients eligible for analysis, eight (10.5%) developed biopsyproven acute rejection (BPAR). Ten (13.2%) experienced clinical and/or BPAR. Corticosteroids were withdrawn completely in 91% of patients at 12 months. Graft and patient survival were 97.5% and 98.7% respectively. Mean total cholesterol and triglycerides were significantly lower at 12 months post-transplant than at baseline (201 ± 47.5 vs. 190.8 ± 43.6 mg/dL, p ¼ 0.005 and 196.2 ± 133.2 vs. 144.5 ± 76.8 mg/ dL, p < 0.001, respectively). Mean hemoglobin A1c levels did not differ between baseline (5.54%) and 12 months (5.48%). New-onset posttransplant diabetes mellitus occurred in 6.6% of the non-diabetic transplanted patients. The proportion of patients with abnormal oral glucose tolerance test (OGTT) was 47% at 3 months and 39% at 12 months (p ¼ NS). Daclizumab induction in combination with MMF, tacrolimus, and low-dose (followed by withdrawal) prednisolone appears to be effective and safe in patients receiving renal allografts. The regimen appears to be associated with a favorable cardiovascular profile. [less ▲]

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