References of "Bastens, B"
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See detailControlled DCD donation is part of the solution to liver graft shortage, regardless of donor age
DETRY, Olivier ULg; MEURISSE, Nicolas ULg; DELWAIDE, Jean ULg et al

in Acta Gastro-Enterologica Belgica (2014, March), 77(1), 16

Aim: Results of donation after circulatory death (DCD) liver transplantation (LT) are impaired by ischemic bile duct lesions caused by procurement warm ischemia. Donor age is a risk factor in deceased ... [more ▼]

Aim: Results of donation after circulatory death (DCD) liver transplantation (LT) are impaired by ischemic bile duct lesions caused by procurement warm ischemia. Donor age is a risk factor in deceased donor LT, and particularly in DCD-LT. At the authors institute, age is not an absolute exclusion criterion to discard DCD liver grafts, controlled DCD donors receive comfort therapy before withdrawal, and cold ischemia is minimized. The aim of the present study was to report on the results of the first 10 years of this experience, and particularly on graft survival and the rate of post-transplant biliary complications, according to DCD donor age. 
 Methods: The authors retrospectively studied a consecutive series of 70 DCD-LT performed from 2003 to 2012, with at least one year of follow-up. This series was divided according to donor’s age, including 32 liver grafts from donors <55years, 20 between 56 and 69 years, and 18 from older donors >69 years. The three groups were compared in terms of donor and recipient demographics, procurement and transplantation conditions, peak laboratory values during the first post-transplant 72 hours, and results at one and four years. Median follow-up was 43 months. 
 Results: Overall graft survival was 98.5%, 91.4% and 69.5% at 1 month, 1 year and 4 years, respectively, without graft loss secondary to ischemic bile duct lesions. Cancer was the primary cause of graft loss and patient death. No difference other than age was noted between the three groups in donor and recipient characteristics, and in procurement conditions. There was no primary non-function but one patient needed re-transplantation for artery thrombosis. Biliary complications occurred similarly in the three groups. Graft and patient survival rates were not different at one and four years between the three groups. During the study period, there was an increasing liver procurement and transplantation activity, and in 2012, 30% of performed LT were DCD-LT, allowing a mean LT waiting time of 66 days. 
 Conclusions: This study shows comparable results between controlled DCD-LT from younger and older donors. Donor age >50 years should not be a contraindication to DCD-LT if other donor risk factors (such as warm and cold ischemia time) are minimized. DCD-LT with short cold ischemia may provide a significant source of liver grafts, decreasing waiting time. [less ▲]

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See detailEvolution over a 15 year period of the epidemiological profile of 2884 newly diagnosed HCV patients in Belgium.
LOLY, Jean ULg; GERARD, Christiane ULg; VAIRA, Dolorès ULg et al

in Acta Gastro-Enterologica Belgica (2011, March), 74

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See detailHepatitis C of genotype 2: the role of medical invasive exams.
Putzeys, V.; GERARD, Christiane ULg; Bastens, B. et al

in Acta gastro-enterologica Belgica (2011), 74(2), 277-80

BACKGROUND AND AIM: Hepatitis C virus genotype 2 is the third in order of frequency in Belgium. The aim of this study was to better define the genotype 2 carriers' epidemiology characteristics. METHODS ... [more ▼]

BACKGROUND AND AIM: Hepatitis C virus genotype 2 is the third in order of frequency in Belgium. The aim of this study was to better define the genotype 2 carriers' epidemiology characteristics. METHODS: In a database comprising 1726 viremic hepatitis C virus patient from the south part of Belgium, the files of 98 genotype 2 carriers were reviewed. RESULTS: There was a strong association between genotype 2 and the mode of transmission. The rate of contamination by invasive medical exams was very high (23%), and statistically different from the one of the others genotypes. Eligibility for antiviral therapies and the rate of sustained viral response were high. CONCLUSION: HCV genotype 2 was highly associated with transmission by invasive medical exams. [less ▲]

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See detailEffectiveness and tolerability of pegylated interferon alfa2b in combination with ribavirin for treatment of chronic hepatitis C: the PegIntrust study
Van Vlierberghe, H.; Adler, M.; Bastens, B. et al

in Acta Gastro-Enterologica Belgica (2010), 73

Background and study aims : Large international clinical trials conducted in the past 5 years rapidly improved the treatment of chronic hepatitis C; however, it is unclear whether the advances seen in ... [more ▼]

Background and study aims : Large international clinical trials conducted in the past 5 years rapidly improved the treatment of chronic hepatitis C; however, it is unclear whether the advances seen in clinical trials are being paralleled by similar improvements in routine clinical practice. PegIntrust is a Belgian community based trial evaluating the sustained virological response. Patients and Methods : Observational study of 219 patients receiving pegylated interferon alfa-2b (1.5 μg/kg/wk) and weight-based ribavirin (800-1200 mg/day) for 48 weeks. Primary study end point was sustained virological response (SVR), defined as undetectable HCV RNA 6 months after the completion of treatment. Results : In total, 108 patients (49.3 %) had undetectable HCV RNA at the end of therapy, 91 (41.6%) attaining SVR. Of the 111 patients without an end-of-treatment response, 28 were non-responders, and 21 had virological breakthrough. In total, 134 patients attained early virological response (EVR); 88 (65.7%) of those patients attained SVR. In contrast, 82 (96.5 %) of the 85 patients who did not attain EVR also did not attain SVR. Age, fibrosis score and baseline viral load were identified as important predictors of treatment outcome. The most frequently reported serious adverse events resulting in treatment discontinuation were anemia (n = 10), fatigue/asthenia/malaise (n = 6) and fever (n = 3). Conclusion : Our data indicate that treatment of chronic hepatitis C with PEG-IFN alfa-2b plus weight-based ribavirin results in favourable treatment outcomes in a Belgian cohort of patients treated in community- based clinical practice. [less ▲]

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See detailA randomized, open-label, multicenter study evaluating the efficacy of peginterferon alfa-2a versus interferon alfa-2a, in combination with ribavirin, in naïve and relapsed chronic hepatitis C patients.
Nevens, F.; Van Vlierberghe, H.; D'Heygere, F. et al

in Acta Gastro-Enterologica Belgica (2010), 73

Background/Aims : A large multicenter trial to compare the efficacy of peginterferon alfa-2a with interferon alfa-2a, in combination with ribavirin, in chronic hepatitis C patients. Efficacy data for ... [more ▼]

Background/Aims : A large multicenter trial to compare the efficacy of peginterferon alfa-2a with interferon alfa-2a, in combination with ribavirin, in chronic hepatitis C patients. Efficacy data for prior relapsers are reported because treatment recommendations for this patient population are not well defined. Patients and methods : This study was a multicenter, prospective, randomized clinical trial. The primary efficacy endpoint was sustained virologic response in naïve patients (n = 348) and relapsers (n = 95). Results : Sustained virologic response rates were similar in naïve patients and relapsers, both for non-pegylated and pegylated interferon (respectively 27 and 26% and 54 and 43%). Pegylated interferon given for 48 weeks did not improved the relapse rate : 15.9 and 27.3% for non-pegylated and 16.7 and 30.4% for pegylated interferon, naïve vs relapsers respectively. Stepwise logistic regression analysis revealed a significant association between slow response (detectable HCV RNA at week 12 and undetectable at week 24) and relapse in patients with an end-of-treatment response (55% versus 13% respectively ; p = 0.02 ; odds ratio = 6.07). Conclusions : This trial confirms the value of using peginter - feron alfa-2a in both naïve and relapsed patients and provides support for a more tailored approach to treatment for relapsers and particulary for patients with a slow viral response. (Acta gastro enterol. belg., 2010, 73, 223-228). [less ▲]

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See detailHCV genotype 4 in Belgium: three distinct patterns among patients from European and African origin
Delwaide, Jean ULg; Reenaers, Catherine ULg; Gerard, Christiane ULg et al

in European Journal of Gastroenterology & Hepatology (2006), 18(7), 707-712

Background Considered uncommon in western countries some years ago, hepatitis C virus of genotype 4 is now spreading in some areas of Europe. This is assumed to be due to immigration from a region of high ... [more ▼]

Background Considered uncommon in western countries some years ago, hepatitis C virus of genotype 4 is now spreading in some areas of Europe. This is assumed to be due to immigration from a region of high prevalence for this genotype and to propagation among drug users. In the south of Belgium, genotype 4 currently accounts for 10% of hepatitis C virus patients and its prevalence is increasing with time. Objective To better define the genotype 4 carriers' characteristics. Methods In a database comprising 1726 viraemic hepatitis C virus patients, the files of 85 genotype 4 carriers were reviewed. Results Beside the African (58%) and European drug user (15%) subgroups classically described, a third subgroup consisting of European nondrug users (26%) was identified as peculiar: these patients were older, had been mostly contaminated sporadically, presented a great diversity of subtypes, and were mainly of Italian origin. In this subgroup, contamination was supposed to be ancient, having occurred probably in Italy before immigration into Belgium. By contrast, European drug users were infected with only two subtypes (4c/4d and 4), an observation in favour of recent spread. Africans had a great diversity of subtypes, were young, and were mostly contaminated sporadically in their home countries. Despite their epidemiological differences, the clinical management, and in particular the rates of eligibility for treatment, were similar for these three groups. Conclusions Three different patterns of genotype 4 carriers were observed, corresponding to three different spreading profiles. They did not induce, however, different clinical management. [less ▲]

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See detailAtypical symptoms of GORD in Belgium: Epidemiological features, current management and open label treatment with 40 mg esomeprazole for one month
Louis, Edouard ULg; Jorissen, P.; Bastens, B. et al

in Acta Gastro-Enterologica Belgica (2006), 69(2, Apr-Jun), 203-208

Frequency of atypical symptoms in patients suffering from gastro-oesophageal reflux disease (GORD) is not well known, and the optimal management of such symptoms has not been well established. Our aims ... [more ▼]

Frequency of atypical symptoms in patients suffering from gastro-oesophageal reflux disease (GORD) is not well known, and the optimal management of such symptoms has not been well established. Our aims were to set up an observatory of these atypical symptoms of GORD in Belgium and to study the efficacy of one month treatment with esomeprazole 40 mg. Patients and methods : Gastroenterologists; participating in this observational survey were asked to register every new outpatient with symptoms of GORD during a period of 20 consecutive working days. All patients who reported predominant presence of atypical manifestations of GORD were documented and characterized more in detail. In patients with dominant chest pain or ENT symptoms, a treatment with esomeprazole 40 mg daily during 4 weeks was proposed. Results : 90 gastroenterologists included 2864 patients consulting for symptoms suggestive of GORD, including 776 (27.1%) with dominant atypical symptoms. Endoscopy (performed in 2800 patients) showed significantly less oesophagitis in atypical than in typical GORD patients (68% vs. 81.1%; P < 0.0001). Management of atypical GORD patients appeared to be very heterogeneous. Overall 516/776 patients were included in the open phase of treatment with esomeprazole 40 mg, but data for analysis are only available in 228 patients. After one month, symptoms had disappeared in 57.1% and significantly improved in 26.6%. Conclusion : Atypical GORD represents a large number of consultations in gastroenterology in Belgium. It is associated with less endoscopic lesions than typical GORD. Its management is heterogeneous reflecting the lack of guidelines on this topic. Response rate after esomeprazole 40 mg for one month in this open uncontrolled trial was high. This result warrants confirmation in a placebo-controlled trial. [less ▲]

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See detailHepatitis C virus genotype 5 in southern Belgium: Epidemiological characteristics and response to therapy
Delwaide, Jean ULg; Gerard, Christiane ULg; Reenaers, Catherine ULg et al

in Digestive Diseases & Sciences (2005), 50(12), 2348-2351

Data are scarce on patients infected with hepatitis C virus of genotype 5, due to the low prevalence of this genotype around the world. To better define the characteristics of these patients, we reviewed ... [more ▼]

Data are scarce on patients infected with hepatitis C virus of genotype 5, due to the low prevalence of this genotype around the world. To better define the characteristics of these patients, we reviewed the files of 16 genotype 5 patients. Mean age was 38 +/- 14. All patients were of European origin. Most of them (75%) had been contaminated by transfusion within a short time period (between 1980 and 1991). There were no intravenous drug addicts. Seven patients received treatment. One patient did not respond to interferon (IFN) monotherapy. Of four patients treated with IFN and ribavirin, three became sustained viral responders. Two patients treated with pegylated IFN and ribavirin became sustained viral responders. In our region, genotype 5 patients seem to have been contaminated within a relatively short time period. Treatment with IFN or pegylated IFN and ribavirin gave a high rate (83%) of sustained viral responses. [less ▲]

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See detailHCV genotypes 2 and 3: the predominant genotypes at the horizon 2020?
Delwaide, Jean ULg; Gerard, Christiane ULg; Vaira, Dolorès ULg et al

in Acta Gastro-Enterologica Belgica (2005, January), 68(1), 25

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See detailTreatment of acute hepatitis C with interferon alpha-2b: early initiation of treatment is the most effective predictive factor of sustained viral response
Delwaide, Jean ULg; Bourgeois, N.; Gerard, Christiane ULg et al

in Alimentary Pharmacology & Therapeutics (2004), 20(1), 15-22

AIM: To evaluate the efficacy of early interferon alpha-2b in non-post-transfusion acute hepatitis C virus: a prospective study with historical comparison. PATIENTS: Group A: 28 patients prospectively ... [more ▼]

AIM: To evaluate the efficacy of early interferon alpha-2b in non-post-transfusion acute hepatitis C virus: a prospective study with historical comparison. PATIENTS: Group A: 28 patients prospectively treated for acute hepatitis C virus with daily regimen of interferon 5 million units for 2 months. Group B: historical series of 16 patients with untreated acute hepatitis C virus. RESULTS: There was no significant difference between the two groups with regard to gender, age, icterus, alanine aminotransferase, or genotypes. In group B, hepatitis spontaneously resolved in three of 16 (19%) patients (follow-up 1-7 years). In group A, 21 of 25 patients became sustained viral responders (75%; P = 0.0003 vs. group B). Factors include not predictive of sustained viral response: age, gender, sources of infection, presence of icterus, alanine aminotransferase peak, bilirubin peak, incubation period, presence of hepatitis C virus antibodies at presentation, or genotypes. The time from presentation to the start of therapy was, however, significantly shorter in sustained viral responders (43 +/- 31 days) than in relapsers or non-responders (88 +/- 52 days) (P = 0.016). CONCLUSIONS: Early treatment of acute hepatitis C virus with interferon prevents chronicity. A short waiting time from presentation to treatment appears as the most relevant predictive factor for sustained response. [less ▲]

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See detailHCV genotype 5: an easy to treat population
REENAERS, Catherine ULg; DELWAIDE, Jean ULg; GERARD, Christiane ULg et al

in Acta Gastro-Enterologica Belgica (2004), 67

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See detailHCV genotype 4 in Belgium: epidemiological characteristics
REENAERS, Catherine ULg; DELWAIDE, Jean ULg; GERARD, Christiane ULg et al

in Acta Gastro-Enterologica Belgica (2004), (67), 03

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See detailDaily induction combination treatment with alpha 2b interferon and ribavirin or standard combination treatment in naive chronic hepatitis C patients. A multicentre randomized controlled trial
Van Vlierberghe, H.; Leroux-Roels, G.; Adler, M. et al

in Journal of Viral Hepatitis (2003), 10(6), 460-466

The standard treatment for patients with chronic hepatitis C is a 6-12-month combination therapy with interferon alpha and ribavirin. Induction treatment could result in a faster early decline of the ... [more ▼]

The standard treatment for patients with chronic hepatitis C is a 6-12-month combination therapy with interferon alpha and ribavirin. Induction treatment could result in a faster early decline of the hepatitis C virus (HCV) load and a better response rate. Naive chronically infected HCV patients (n = 454) were randomized into two arms to receive either induction treatment with interferon alpha 2b 5 million units (MU) subcutaneously (s.c.) daily during a period of 8 weeks (arm A); or treatment with interferon alpha 2b 5 MU s.c. three times a week (TIW) for a period of 8 weeks (arm B). After week 8, interferon treatment in both arms was 3 MU s.c. TIW for a total period of 12 months. In both arms, ribavirin (1000-1200 mg orally per day) was added at week 4. Induction treatment resulted in a higher virological response at week 8 of treatment (66%vs 47%; P < 0.01). However, response at the end of treatment and at 6 months follow-up was not different (53%vs 50%, 41%vs 33%). The occurrence of adverse events and the drop-out rate were similar in both arms. Although an early virological response is observed more frequently in the induction treatment, end of treatment response and sustained responses did not differ. [less ▲]

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See detailEfficacite d'une technique standardisee de MRCP pour la detection de choledocholithiase: experience d'un an chez des sujets symptomatiques.
Brisbois, D.; Plomteux, O.; NCHIMI LONGANG, Alain ULg et al

in JBR-BTR : organe de la Societe royale belge de radiologie (SRBR) = orgaan van de Koninklijke Belgische Vereniging voor Radiologie (KBVR) (2001), 84(6), 258-61

In our institution, MRCP is actually replacing diagnostic ERCP. This study is addressing its accuracy in the diagnosis of symptomatic choledocholithiasis. 137 MRCP were performed in patients with upper ... [more ▼]

In our institution, MRCP is actually replacing diagnostic ERCP. This study is addressing its accuracy in the diagnosis of symptomatic choledocholithiasis. 137 MRCP were performed in patients with upper abdominal pain and biological anomalies (n = 48), pain with cholelithiasis at sonography (n = 69) or non-alcoholic acute pancreatitis (n = 20) on a 1.5 T system with high gradients using a standardized combination of breath-hold HASTE and RARE sequences. We included in our study 74 patients who underwent as second test ERCP (n = 36), peroperative cholangiography (n = 13), or extensive follow-up with laboratory tests and/or sonography (n = 25). All examinations were judged as diagnostic, discrepancies between direct cholangiography and MRCP being noted in 4 patients (5.4%). Lithiasis was misinterpreted on MRCP as bubbles in 2 patients after sphincterotomy or surgery. We had two false positive diagnoses on MRCP: in one patient peroperative cholangiography was negative and in the other one ERCP was negative. With a sensitivity and PPV of 92%, a specificity and NPV of 96% MRCP in our experience is shown as an accurate diagnostic tool for the detection of stone in the common bile duct replacing ERCP. [less ▲]

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See detailTreatment of acute hepatitis C with interferon alpha 2b prevents chronicity.
Delwaide, Jean ULg; Bourgeois, N.; Gerard, Christiane ULg et al

in Gut (2000), 47(3), 14

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