References of "DELBOUILLE, Marie-Hélène"
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See detailA More Than 20% Increase in Deceased-Donor Organ Procurement and Transplantation Activity After the Use of Donation After Circulatory Death.
Le Dinh, H.; MONARD, Josée ULg; DELBOUILLE, Marie-Hélène ULg et al

in Transplantation proceedings (2014), 46(1), 9-13

BACKGROUND: Organ procurement and transplant activity from controlled donation after circulatory death (DCD) was evaluated over an 11-year period to determine whether this program influenced the ... [more ▼]

BACKGROUND: Organ procurement and transplant activity from controlled donation after circulatory death (DCD) was evaluated over an 11-year period to determine whether this program influenced the transplant and donation after brain death (DBD) activities. MATERIAL AND METHODS: Deceased donor (DD) procurement and transplant data were prospectively collected in a local database for retrospective review. RESULTS: There was an increasing trend in the potential and actual DCD numbers over time. DCD accounted for 21.9% of the DD pool over 11 years, representing 23.7% and 24.2% of the DD kidney and liver pool, respectively. The DBD retrieval and transplant activity increased during the same time period. Mean conversion rate turning potential into effective DCD donors was 47.3%. Mean DCD donor age was 54.6 years (range, 3-83). Donors >/=60 years old made up 44.1% of the DCD pool. Among referred donors, reasons for nondonation were medical contraindications (33.7%) and family refusals (19%). Mean organ yield per DCD donor was 2.3 organs. Mean total procurement warm ischemia time was 19.5 minutes (range, 6-39). In 2012, 17 DCD and 37 DBD procurements were performed in the Liege region, which has slightly >1 million inhabitants. CONCLUSIONS: This DCD program implementation enlarged the DD pool and did not compromise the development of DBD programs. The potential DCD pool might be underused and seems to be a valuable organ donor source. [less ▲]

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See detailDoes comfort therapy during controlled donation after circulatory death shorten the life of potential donors?
LEDOUX, Didier ULg; DELBOUILLE, Marie-Hélène ULg; DE ROOVER, Arnaud ULg et al

in Clinical transplantation (2014), 28(1), 47-51

INTRODUCTION: Controlled donation after circulatory death (DCD) remains ethically controversial. The authors developed a controlled DCD protocol in which comfort therapy is regularly used. The aim of this ... [more ▼]

INTRODUCTION: Controlled donation after circulatory death (DCD) remains ethically controversial. The authors developed a controlled DCD protocol in which comfort therapy is regularly used. The aim of this study was to determine whether this policy shortens the DCD donors' life. METHODS: The authors retrospectively analyzed prospectively collected data on patients proposed for DCD at the University Hospital of Liege, Belgium, over a 56-month period. The survival duration of these patients, defined as duration between the time of proposal for DCD and the time of circulatory arrest, was compared between patients who actually donated organs and those who did not. RESULTS: About 128 patients were considered for controlled DCD and 54 (43%) became donors. Among the 74 non-donor patients, 34 (46%) objected to organ donation, 38 patients (51%) were denied by the transplant team for various medical reasons, and two potential DCD donors did not undergo procurement due to logistical and organizational reasons. The survival durations were similar in the DCD donor and non-donor groups. No non-donor patient survived. CONCLUSIONS: Survival of DCD donors is not shortened when compared with non-donor patients. These data support the ethical and respectful approach to potential DCD donors in the authors' center, including regular comfort therapy. [less ▲]

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See detailIS ULTRA-SHORT COLD ISCHEMIA THE KEY TO ISCHEMIC CHOLANGIOPATHY AVOIDANCE IN DCD- LT?
DETRY, Olivier ULg; DE ROOVER, Arnaud ULg; Cheham, Samir et al

in Transplant International (2013, December), 26(S2), 53-98

Introduction: Donation after circulatory death (DCD) donors have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of ischemic ... [more ▼]

Introduction: Donation after circulatory death (DCD) donors have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of ischemic cholangiopathy leading to graft loss. The authors retrospectively reviewed a single centre experience with DCD-LT in a 9-year period. Patients and Methods: 70 DCD-LT were performed from 2003 to November 2012. All DCD procedures were performed in operative rooms. Median donor age was 59 years. Most grafts were flushed with HTK solution. Allocation was centre-based. Median total DCD warm ischemia was 19.5 min. Mean follow-up was 36 months. No patient was lost to follow-up. Results: Median MELD score at LT was 15. Median cold ischemia was 235 min. Median peak AST was 1,162 U/L. Median peak bilirubin was 31.2 mg/dL. Patient and graft survivals were 92.8% and 91.3% at one year and 79% and 77.7% at 3 years, respectively. One graft was lost due to hepatic artery thrombosis. No PNF or graft loss due to ischemic cholangiopathy was observed in this series. Causes of death were malignancies in 8 cases. Discussion: In this series, DCD LT appears to provide results equal to classical LT. Short cold ischemia and recipient selection with low MELD score may be the keys to good results in DCD LT, in terms of graft survival and avoidance of ischemic cholangiopathy. [less ▲]

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See detailINFUSION OF THIRD-PARTY MESENCHYMAL STEM CELLS (MSC) AFTER KIDNEY AND LIVER TRANSPLANTATION: A PHASE I-II, OPEN-LABEL, CLINICAL STUDY (EudraCT 2011-001822-81 & NCT01429038)
DETRY, Olivier ULg; DELBOUILLE, Marie-Hélène ULg; LECHANTEUR, Chantal ULg et al

Poster (2013, May 30)

MSC cells have demonstrated significant immunosuppressive effects in various in vivo and in vitro studies. This study aims to be the first evaluation of the safety and tolerability of third party MSC ... [more ▼]

MSC cells have demonstrated significant immunosuppressive effects in various in vivo and in vitro studies. This study aims to be the first evaluation of the safety and tolerability of third party MSC infusion after cadaveric kidney and liver transplantation in a prospective phase I-II study, taking advantage of our centre expertise and experience in MSC use in graft-versus-host disease (GVHD) after bone marrow transplantation and using an already functioning GMP-compliant laboratory producing clinical-grade MSC. Secondary end-points will help to evaluate the immunosuppressive potential of MSC after organ transplantation, and the opportunity to develop larger randomised, controlled, phase III trials. After successful transplantation, 10 liver and 10 kidney transplant recipients under standard immunosuppression (tacrolimus, MMF, steroids) will receive an intravenous infusion of 1.5-3x106/kg of third-party MSC on post-operative day 3±2. These patients will be prospectively compared to 10 liver and 10 kidney recipients who meet the inclusion criteria but deny MSC infusion. Safety will be assessed by recording side effects, including opportunistic infections and cancers. Immunosuppressive potential will be evaluated by rejection episode rates, by graft/patient survivals, by immunohistology of 3-months kidney and 6-month liver graft biopsies and by in vitro evaluation of the immunity profile of the recipients. In a second step, reduction (kidney) and progressive weaning (liver) of immunosuppression will be attempted in recipients who received MSC. This ongoing study is supported by research grants from the CHU of Liège, University of Liège, and by the Senior Clinical Research Grant from ESOT. The first patients were included and treated in early 2012, and final results expected in late 2013. [less ▲]

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See detailInfusion of third party mesenchymal stem cells (MSC) after kidney and liver transplantation: a phase I-II, open-label, clinical study
DETRY, Olivier ULg; DELBOUILLE, Marie-Hélène ULg; LECHANTEUR, Chantal ULg et al

Conference (2012, October 19)

MSC cells have demonstrated significant immunosuppressive effects in various in vivo and in vitro studies. This study aims to be the first evaluation of the safety and tolerability of third party MSC ... [more ▼]

MSC cells have demonstrated significant immunosuppressive effects in various in vivo and in vitro studies. This study aims to be the first evaluation of the safety and tolerability of third party MSC infusion after cadaveric kidney and liver transplantation in a prospective phase I-II study, taking advantage of our centre expertise and experience in MSC use in graft-versus-host disease (GVHD) after bone marrow transplantation and using an already functioning GMP-compliant laboratory producing clinical-grade MSC. Secondary end-points will help to evaluate the immunosuppressive potential of MSC after organ transplantation, and the opportunity to develop larger randomised, controlled, phase III trials. After successful transplantation, 10 liver and 10 kidney transplant recipients under standard immunosuppression (tacrolimus, MMF, steroids) will receive an intravenous infusion of 1.5-3x106/kg of third-party MSC on post-operative day 3±2. These patients will be prospectively compared to 10 liver and 10 kidney recipients who meet the inclusion criteria but deny MSC infusion. Safety will be assessed by recording side effects, including opportunistic infections and cancers. Immunosuppressive potential will be evaluated by rejection episode rates, by graft/patient survivals, by immunohistology of 3-months kidney and 6-month liver graft biopsies and by in vitro evaluation of the immunity profile of the recipients. In a second step, reduction (kidney) and progressive weaning (liver) of immunosuppression will be attempted in recipients who received MSC. This ongoing study is supported by research grants from the CHU of Liège, University of Liège, and by the Senior Clinical Research Grant from ESOT. The first patients were included and treated in early 2012, and final results expected in late 2013. [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 detailDonation after Cardiac Death increases the number of liver grafts for liver transplantation
Ledinh, H.; HANS, Marie-France ULg; MONARD, Josée ULg et al

in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 10

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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 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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See detailLes prélèvements à coeur arrêté: une source d'organes trop souvent oubliée?
Detry, Olivier ULg; De Roover, Arnaud ULg; Damas, Pierre ULg et al

in Hospitals.be (2010), 8(1), 7-12

La transplantation est aujourd’hui victime de son succès. Les procédures de prélèvement à coeur arrêté se doivent de respecter les règles d’éthique et les dispositions légales en la matière. La pénurie ... [more ▼]

La transplantation est aujourd’hui victime de son succès. Les procédures de prélèvement à coeur arrêté se doivent de respecter les règles d’éthique et les dispositions légales en la matière. La pénurie relative d’organes sera partiellement comblée lorsqu’elles seront appliquées dans une majorité d'hôpitaux du pays. [less ▲]

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See detailOrgan Procurement After Euthanasia: Belgian Experience
Ysebaert, dirk; Van Beeumen, G.; De Greef, K. et al

in Transplantation Proceedings (2009), 41

Euthanasia was legalized in Belgium in 2002 for adults under strict conditions. The patient must be in a medically futile condition and of constant and unbearable physical or mental suffering that cannot ... [more ▼]

Euthanasia was legalized in Belgium in 2002 for adults under strict conditions. The patient must be in a medically futile condition and of constant and unbearable physical or mental suffering that cannot be alleviated, resulting from a serious and incurable disorder caused by illness or accident. Between 2005 and 2007, 4 patients (3 in Antwerp and 1 in Liège) expressed their will for organ donation after their request for euthanasia was granted. Patients were aged 43 to 50 years and had a debilitating neurologic disease, either after severe cerebrovascular accident or primary progressive multiple sclerosis. Ethical boards requested complete written scenario with informed consent of donor and relatives, clear separation between euthanasia and organ procurement procedure, and all procedures to be performed by senior staff members and nursing staff on a voluntary basis. The euthanasia procedure was performed by three independent physicians in the operating room. After clinical diagnosis of cardiac death, organ procurement was performed by femoral vessel cannulation or quick laparotomy. In 2 patients, the liver, both kidneys, and pancreatic islets (one case) were procured and transplanted; in the other 2 patients, there was additional lung procurement and transplantation. Transplant centers were informed of the nature of the case and the elements of organ procurement. There was primary function of all organs. The involved physicians and transplant teams had the well-discussed opinion that this strong request for organ donation after euthanasia could not be waived. A clear separation between the euthanasia request, the euthanasia procedure, and the organ procurement procedure is necessary. [less ▲]

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See detailLiver transplant donation after cardiac death : experience at the University of Liège
Detry, Olivier ULg; Seydel, Benoît ULg; Delbouille, Marie-Hélène ULg et al

in Transplantation Proceedings (2009), 41(2), 582-4

Aim: Donation after cardiac death (DCD) has been proposed to partly overcome the organ donor shortage. In liver transplantation, the additional warm ischemia linked to DCD procurement may promote higher ... [more ▼]

Aim: Donation after cardiac death (DCD) has been proposed to partly overcome the organ donor shortage. In liver transplantation, the additional warm ischemia linked to DCD procurement may promote higher rate of primary non-function and ischemic type biliary lesions. In this study we reviewed the results of DCD liver transplantation at the University of Liège. Patients and Methods: From 2003 to 2007, 13 controlled DCD liver transplantations were consecutively performed. The records of all donors and recipients were retrospectively reviewed, particularly evaluating the outcome and the occurrence of biliary complications. Mean follow-up was 25 months. Results: Mean donor age was 51 years and their mean intensive care stay was 5.4 days. Mean time between ventilation arrest and cardiac arrest was 9.3 min. Mean time between cardiac arrest and arterial flush was 7.7 min. No touch period was 2 to 5 min. Mean graft cold ischemia was 295 min and mean suture warm ischemia was 38 min. Postoperatively there was no primary non-function. Mean peak transaminase was 2,546 UI/ml. Patient and graft survival was 100% at one year. Two patients (15%) developed graft main bile duct stenosis and underwent endoscopic management. No patient developed symptomatic intrahepatic bile duct strictures or needed retransplantation in the follow-up. Conclusions: The experience of the transplantation department of the University of Liege confirms that controlled DCD donors may be a valuable source of transplantable liver grafts, in case of short procurement warm ischemia and short transplant cold ischemia. [less ▲]

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See detailResults of liver transplantation from controlled donation after cardiac death (DCD) donors: a single center experience
Detry, Olivier ULg; Seydel, Benoît ULg; Veys, C. et al

in Acta Gastro-Enterologica Belgica (2009, January), 72(1), 25

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See detailAn 11 - Year Overview of the belgian donor and transplant statistics bsed on a consecutive yearly data follow-up and comparing two periods : 1997 to 2005 versus 2006 to 2007
Van Gelder, F.; Delbouille, Marie-Hélène ULg; Vandervennet, M. et al

in Transplantation Proceedings (2009), 41

Background. The Belgian Transplant Coordinators Section is responsible for the yearly data follow-up concerning donor and transplantation statistics in Belgium and presents herein a 10-year overview ... [more ▼]

Background. The Belgian Transplant Coordinators Section is responsible for the yearly data follow-up concerning donor and transplantation statistics in Belgium and presents herein a 10-year overview. Methods. The procurement and transplant statistics were compared between 2 periods: Period 1 (P1, 1997–2005) versus Period 2 (P2, 2006–2007). Results. The kidney and liver waiting lists (P1 vs P2) showed an overall decrease for a period of 2 consecutive years in P2; kidney ( 170 patients; 18%), and liver ( 83 patients; 34%). All other waiting lists (heart, lung, pancreas) remained stable. Mean ED further increased (P1 vs P2); 229 (P1) versus 280 (P2, 22.27%). Non–heart-beating donors were significantly ( 288%) more often procured in P2. Mean donor age was 37.9 17.8 years (P1) versus 46.5 19.9 years (P2), and mean organ yield per donor was 3.48 1.7 (P1) versus 3.38 1.8 (P2). Overall transplant activity per million inhabitants increased 21.1%. Conclusion. For 2 consecutive years, the Belgian statistics showed significantly increased donor activity with an impact on waiting list dynamics and transplantation. The mean organ yield per donor was not influenced despite an increased average age and change in reason for death. [less ▲]

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See detailOverview of the Belgian Donor and Transplant Statistics 2006: Results of Consecutive Yearly Data Follow-up by the Belgian Section of Transplant Coordinators
Van Gelder, F.; Delbouille, Marie-Hélène ULg; Vandervennet, M. et al

in Transplantation Proceedings (2007), 39

Background. The Belgian Section of Transplant Coordinators, created in 1997 under the auspices of the Belgian Transplant Society, is in charge of the collection of the national data about donor ... [more ▼]

Background. The Belgian Section of Transplant Coordinators, created in 1997 under the auspices of the Belgian Transplant Society, is in charge of the collection of the national data about donor/procurement activities. Methods. Data are collected in all Belgian transplant centers. An annual report is finalized by combining these data with data from the Eurotransplant database. Results. An increase of both potential donors (n 501, 14.4%) and effective donors (n 273, 16.7%) was observed in 2006 versus 2005. Among effective donors, 28 were non–heart-beating donors (10.25%). Overall donor ratio was 26.26 donors per million inhabitants. Within potential donors, absence of organ harvesting was due to medical contraindications (28%), family refusal (13%), or legal refusal (2%). Donor mean age was 46.4 years and mean organs/donor was 3.21 1.7. An overall reduction of Belgian waiting lists was observed in 2006 as compared with 2005 ( 5.7% for kidney, 25.7% for liver, 9.4% for heart, 6.7% for lung, and 11.7% for pancreas), while waiting list mortality was 18% for liver, 11% for heart, and 7% for lung. As compared with 2005, transplant activities increased for kidney (n 485, 24.3%), heart lungs (n 73, 7.3%), and lungs (n 83, 39.4%) but decreased for liver (n 236, 2.1%). Living donation represented 8.45% for kidney ( 28.1% vs 2005) and 8% for liver transplantation ( 29.6%). Conclusion. Globally, a marked increase of procurement and transplant activities was observed in 2006, allowing to limit waiting list and waiting list mortality. Further increase of living donor activity and non–heart-beating donation remains necessary to extend the donor pool. [less ▲]

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