Pancreas graft drainage in recipient duodenum: Preliminary experience

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 ▲]

Actualités sur les agents immunosuppresseurs utilisés en transplantation rénale

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 ▲]

Cadaveric whole liver transplantation for non-acetaminophen fulminant hepatic failure: A 20-year experience

in Journal of Hepatology (2007), 46(Suppl. 1), 66-67

Why Did it Take so Long to Start a Non-Heart-Beating Donor Program in Belgium ?

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 ▲]

Allergie systémique à l'insuline: traitement médical ou chirurgical (greffe de pancréas vascularisé)?

in Diabète & Métabolisme (2005), 31