References of "WEEKERS, Laurent"
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See detailEvolution of Native Kidney Function After Pancreas Transplantation Alone
LE DINH, Hieu; DE ROOVER, Arnaud ULg; COIMBRA MARQUES, Carla ULg et al

in Transplantation Proceedings (2012), 44

Introduction. This study investigated changes in kidney function over time among a cohort of patients undergoing pancreas transplantation alone (PTA) from January 2002 to December 2011. Patients and ... [more ▼]

Introduction. This study investigated changes in kidney function over time among a cohort of patients undergoing pancreas transplantation alone (PTA) from January 2002 to December 2011. Patients and Methods. Ten of eighteen PTA patients bearing functioning grafts for at least 1 year were recruited for the analysis. Primary endpoints were changes in mean serum creatinine (SCr, mg/L) and mean estimated glomerular filtration rate (eGFR) using the 4-variable Levey-MDRD equation (mL/min/1.73 m2) comparing baseline (pretransplantation) to 6-month, 1-year, 3-year, and 5-year posttransplantation values. Mean follow-up time was 75.7 20.5 months (range, 46–106.5). Results. Baseline eGFR was 89.3 27.9 (range, 58–145). eGFR decreased to 75.7 26.2, 71 20.6, 66.5 14.8, and 62.1 11.2 at 6 months, 1, 3, and 5 years representing 15.2%, 20.5%, 15.8%, and 22.6% percentage decreases respectively (P .05 for all pairwise comparisons). The Baseline SCr was 8.6 2.3 mg/L (range, 5–13). SCr progressively increased to 10.1 3, 10.5 3.1, 10.9 3.1, and 11.3 1.7 at 6 months, 1, 3, and 5 years a 17.1%, 22%, 16.6%, and 19.9% increase respectively (P .05 for all pairwise comparisons). One of ten, 2/8, and 3/7 patients displayed an eGFR 60 at transplantation versus 3 and 5 years thereafter, respectively. No patient developed a SCr 25 mg/L or eGFR 30 or needed dialysis or kidney transplantation. Five of ten patients had micro-albuminuria or proteinuria before transplantation. Tacrolimus levels were within recommended therapeutic ranges over time. Conclusion. Kidney function deteriorated significantly after PTA. Understanding of risk factors for the development of renal impairment is important to preserve kidney function and to select appropriate candidates for PTA. [less ▲]

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See detailDelayed graft function does not harm the future of donation-after-cardiac death in kidney transplantation.
Le Dinh, Hieu; WEEKERS, Laurent ULg; BONVOISIN, Catherine ULg et al

in Transplantation Proceedings (2012), 44(9), 2795-802

INTRODUCTION: Delayed graft function (DGF) occurs more frequently in kidney transplants from donation after cardiac death (DCD) than from donation after brain death (DBD). We investigated the effect of ... [more ▼]

INTRODUCTION: Delayed graft function (DGF) occurs more frequently in kidney transplants from donation after cardiac death (DCD) than from donation after brain death (DBD). We investigated the effect of DGF on posttransplantation outcomes among grafts from controlled DCD kidneys. PATIENTS AND METHODS: This single-center retrospective study recruited 80 controlled DCD kidneys transplanted from January 2005 to December 2011. Mean patient follow-up was 28.5 months. RESULTS: There were no primary nonfunction grafts; the DGF rate was 35.5%. Overall graft survival rates between groups with versus without DGF were 92.4% and 95.2% at 1 year, 92.4% and 87.1% at 3 years, and 84.7% and 87.1% at 5 years, respectively (P = not significant (NS)). Patients with versus without DGF showed the same survival rates at the corresponding time 92.4% vs 97.2%, 92.4% vs 93.9%, and 84.7% vs 93.9% (P = NS). Estimated glomerular filtration rate was significantly lower in the DGF compared with the non-DGF group at hospital discharge (29 vs 42 mL/min; P = .00) and at 6 months posttransplantation (46 vs 52 mL/min; P = .04), but the difference disappeared thereafter: 47 vs 52 mL/min at 1 year, 50 vs 48 mL/min at 3 years, and 54 vs 53 mL/min at 5 years (P = NS). DGF did not increase the risk of an acute rejection episode (29.6% vs 30.6%; P = NS) or rate of surgical complications (33.3% vs 26.5%; P = NS). However, DGF prolonged significantly the length of hospitalization in the DGF versus the non- DGF group (18.9 vs 13 days; P = .00). Donor body mass index (BMI) >/= 30 kg/m(2), recipient BMI >/=30 kg/m(2), and pretransplantation dialysis duration increased the risk of DGF upon multivariate logistic regression analysis. CONCLUSIONS: Apart from the longer hospital stay, DGF had no deleterious impact on the future of kidney allografts from controlled DCD, which showed comparable graft and patient survivals, renal function, rejection rates, and surgical complications as a group without DGF. Therefore, DGF should no longer be considered to be a medical barrier to the use of kidney grafts from controlled DCD. [less ▲]

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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 detailAssociation entre le contrôle de la pression artérielle et le rapport sodium/potassium urinaire chez les transplantés rénaux hypertendus
Saint-Remy, Annie ULg; SOMJA, Mélanie ULg; WEEKERS, Laurent ULg et al

Poster (2011, December 15)

Design and method : Office blood pressure (OBP) and home BP (HBP) were measured in 70 kidney transplant patients (KT) (43 men/27 women;KT>1 year), all were treated with antihypertensive drugs (mean number ... [more ▼]

Design and method : Office blood pressure (OBP) and home BP (HBP) were measured in 70 kidney transplant patients (KT) (43 men/27 women;KT>1 year), all were treated with antihypertensive drugs (mean number: 2±1). Mean age: 56±11 years, mean graft survival: 7±6.6 years, mean GFR: 65.6±24 ml/min, diabetes:27% and current smoking:11.5%. HBP (Omron M6) was measured during 7 days following the OBP measurement, mean HBP was calculated from day 2 to day 7. Uncontrolled BP was defined by OBP>=140-90 (>=130-80 when diabetes) and HBP>=135-85 (>=130-80 when diabetes). The day of the OBP measurement and the last day of HBP, patients collected 24h- urine and recorded at the same time their food and beverage consumption. Sodium and potassium were measured in urines and their intakes were quantified through food records. Urinary and diet Na+, K+ did not differ between the two urine collections 7 days apart. Results: 16 patients(23%) had controlled BP (OBP and HBP) while 34 (49%) remained with sustained hypertension (SHT) despite treatment, 14 (20%) had masked uncontrolled hypertension (MHT, OBP<140-90 and HBP>=135-85,130-80 if diabetes for both).When comparing the controlled and SHT, no differences were found with age, graft survival, BMI, GFR, calcineurin inhibitors or number and type of antihypertensive drugs. The groups did not differ by their sodium excretion (154±93 vs 162±88 mmol/24h) but well by their K excretion significantly higher in controlled patients (68±17 vs 53±20 mmol/24h,p=0.018) giving a Na/K ratio higher in SHT (3.2±1.3 vs2.2±1.2,p=0.03). Diet analysis showed significantly higher intakes of K (fruits, vegetables) in controlled patients (3279±753 vs 2208±720 mg/24h,p=0.010) whereas both groups consumed on average 9 g/24h of salt. When controlled for age, BMI and Na excretion, Home systolic BP was inversely and significantly correlated with urinary potassium (- 0.46;P=0.002) while no correlation was found with urinary Na.Conclusions: KT patients remaining hypertensive and well controlled patients had both high salt consumption. However, well controlled patients differed by significant higher potassium intakes and excretion. Urinary Na/K ratio could be a useful tool contributing to an optimal BP control in KT patients. However, impact of increasing potassium intakes on uncontrolled BP in KT has to be validated by prospective randomized studies [less ▲]

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See detailAssociation entre le contrôle de la pression artérielle et le rapport sodium/potassium urinaire chez les transplantés rénaux hypertendus
Saint-Remy, Annie ULg; SOMJA, Mélanie ULg; WEEKERS, Laurent ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (2011, December), Hors série 3

Etude de la relation entre le contrôle de la pression artérielle (PA) mesurée en clinique et/ou à domicile chez des transplantés rénaux (Tr) hypertendus et l'excrétion urinaire du sodium (Na), potassium ... [more ▼]

Etude de la relation entre le contrôle de la pression artérielle (PA) mesurée en clinique et/ou à domicile chez des transplantés rénaux (Tr) hypertendus et l'excrétion urinaire du sodium (Na), potassium (K) et de leur rapport (Na/K urinaire et alimentaire) qui pourrait être un indice utile à prendre en compte dans la recherche d'un contrôle efficace de la PA chez les transplantés rénaux. [less ▲]

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See detailContrôle de la pression artérielle (PA) et mesure de la rigidité artérielle (RA) chez des transplantés rénaux (TR) (étude EPARA)
Gellner, Karen; Saint-Remy, Annie ULg; BONVOISIN, Catherine ULg et al

in Archives des Maladies du Coeur et des Vaisseaux (2011, December), Hors série 3

EPARA a étudié le contrôle de la PA au cabinet de consultation et en dehors, et l'état de rigidité artérielle chez des transplantés rénaux stables, greffés depuis plus d'un an. Le contrôle de la PA est ... [more ▼]

EPARA a étudié le contrôle de la PA au cabinet de consultation et en dehors, et l'état de rigidité artérielle chez des transplantés rénaux stables, greffés depuis plus d'un an. Le contrôle de la PA est loin d‘être satisfaisant dans cette population de TR hypertendus, traîtés pour la plupart, particulièrement à domicile. L‘HTA masquée est fréquente, associée à un risque cardio-vasculaire élevé et une rigidité accrue des grosses artères. La PAS centrale est d‘autant plus élevée que la fonction rénale est mauvaise. Proposer de recourir systématiquement à des mesures ambulatoires de PA est hautement conseillé chez ce type de patients! [less ▲]

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See detailReproducibility of blood pressure (BP) measurement techniques in late kidney transplantation (KT): the EPARA study
Gellner, Karen; Saint-Remy, Annie ULg; WEEKERS, Laurent ULg et al

Conference (2011, October 08)

There has been a long debate about appropriate BP measurement techniques for evaluating the quality of BP control, especially in kidney transplantation (KT). Thus, one aim of the present study was to ... [more ▼]

There has been a long debate about appropriate BP measurement techniques for evaluating the quality of BP control, especially in kidney transplantation (KT). Thus, one aim of the present study was to examine 3 methods of BP measurement and their reproducibility over a short period of 8 weeks. Conclusion: Home blood pressure monitoring (HBPM) and ambulatory blood pressure monitoring (ABPM) should be applied more often also in KT, among others for reasons of better reproducibility over time than office blood pressure monitoring (OBPM). [less ▲]

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See detailWhich factors might explain the divergence between clinic and out-of-clinic blood pressure (BP) in kidney transplantation (KT): the EPARA study?
Gellner, Karen; Saint-Remy, Annie ULg; BONVOISIN, Catherine ULg et al

Conference (2011, October 08)

Differences between clinic and out-of-clinic BP, defined as white coat effect (WCE), white coat hypertension (WCH) or masked hypertension (MH), can leat to misdiagnosis and -handling when decisions are ... [more ▼]

Differences between clinic and out-of-clinic BP, defined as white coat effect (WCE), white coat hypertension (WCH) or masked hypertension (MH), can leat to misdiagnosis and -handling when decisions are solely based on clinic BP measurement. One aim of the study was to examine the risk factors of WCE and MH in late KT. Conclusion:Out-of-clinic BP monitoring should be encouraged to be applied more often in high risk-populations such as KT, especially when risk factors for WCE or MH are present. [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 detailControl of hypertension in renal transplantation : the EPARA study
Gellner, Karen; SAINT-REMY, Annie ULg; WEEKERS, Laurent ULg et al

Conference (2011, June 26)

Blood pressure (BP) is a cardiovascular but also kidney disease risk factor, especially in high risk populations such as kidney transplantated one (KT). Therefore it must be accurately measured. The aim ... [more ▼]

Blood pressure (BP) is a cardiovascular but also kidney disease risk factor, especially in high risk populations such as kidney transplantated one (KT). Therefore it must be accurately measured. The aim of the current study was to evaluate the quality of BP control in such a population followed at the CHU Liège. [less ▲]

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See detailNative vitamin D in dialysis patients : safety and biological effects
WEEKERS, Laurent ULg; Warling, Xavier; Moonen, Martial et al

Conference (2011, June 25)

Native vitamine D (VTD) supplementation is recommended by the last KDIGO guidelines in CKD patients including dialysis patients. However, this recommendation is based on a low level of evidence. We ... [more ▼]

Native vitamine D (VTD) supplementation is recommended by the last KDIGO guidelines in CKD patients including dialysis patients. However, this recommendation is based on a low level of evidence. We designed a randomized double-blind prospective study comparing the effects of VTD and placebo in dialysis patients on mortality, vascular calcifications and different paremeters: 25-OH vitamine D- 25(OH)D -, parathormone (PTH), calcium and phosphorus. [less ▲]

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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 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 detailControl of hypertension in a kidney transplanted population : the EPARA study
Gellner, Karen; Saint-Remy, Annie ULg; Weekers, Laurent ULg et al

in Acta Clinica Belgica (2010, November 27), 66(1), 79

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See detailControl of hypertension in a kidney transplanted population : the EPARA study”.
Gellner, Karen ULg; Saint-Remy, Annie ULg; Weekers, Laurent ULg et al

Scientific conference (2010, November 27)

The prevalence of hypertension in this specific KT population remains high in spite of different antiHTA drugs use and the well known deleterious effect of HTA on kidney function and cardiovascular risk ... [more ▼]

The prevalence of hypertension in this specific KT population remains high in spite of different antiHTA drugs use and the well known deleterious effect of HTA on kidney function and cardiovascular risk. Home BP (and/or ABPM) should thus be recommended to identify this situation and secondary to adapt the treatment. [less ▲]

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See detailQuels paramètres cliniques et biologiques peuvent être considérés comme prédictifs des calcifications vasculaires chez le patient hémodialysé?
Delanaye, Pierre ULg; Warling, X.; Moonen, M. et al

in Néphrologie & Thérapeutique (2010, September), 6(5), 296

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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 detailL'observance thérapeutique en transplantation d'organe - L'exemple de la greffe de rein
Milicevic, Martina ULg; Grosch, Stéphanie ULg; Weekers, Laurent ULg et al

in Revue Médicale de Liège (2010), 65(5-6), 386-390

A successful transplantation implies that immunosuppressive drugs will have to be taken during the whole patient’s life. Poor drug compliance is a multifactorial problem, that is particularly dangerous in ... [more ▼]

A successful transplantation implies that immunosuppressive drugs will have to be taken during the whole patient’s life. Poor drug compliance is a multifactorial problem, that is particularly dangerous in organ transplantation as it can lead to loss of graft function and return to dialysis treatment. The medical doctor must stimulate the patient’s adherence to the strict therapeutic drug protocol. The patient must also be reminded at each medical consultation of the importance of such rigorous drug intake. This bad (or non) compliance is particularly well demonstrated a long time after transplantation. The medical staff, all the health participants, but also the family members must continuously fight against non compliance, which is inherent to any chronic disease. [less ▲]

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