Family Members of Patients with Abdominal Aortic Aneurysms are at Increased Risk for Aneurysms: Analysis of 618 Probands and their Families from the Liege AAA Family Study.
SAKALIHASAN, Natzi ; Defraigne, Jean-Olivier ; et al
in Annals of vascular surgery (2014), 28
BACKGROUND: The objectives were to answer the following questions using a well-characterized population in Liege, Belgium: 1) what percentage of abdominal aortic aneurysm (AAA) patients have a positive ... [more ▼]
BACKGROUND: The objectives were to answer the following questions using a well-characterized population in Liege, Belgium: 1) what percentage of abdominal aortic aneurysm (AAA) patients have a positive family history for AAA, 2) what is the prevalence of AAAs among relatives of AAA patients; and 3) do familial and sporadic AAA cases differ in clinical characteristics. METHODS AND RESULTS: Unrelated AAA patients diagnosed at the Cardiovascular Surgery Department, University Hospital of Liege, Belgium, between 1999 and 2012 were invited to the study. A detailed family history was obtained in interviews and recorded using Progeny software. In the initial interview 62 (10%) of the 618 AAA patients reported a positive family history for AAA. We divided the 618 patients into two study groups: Group I: 296 AAA patients (268; 91% males) were followed up with computerized tomography combined with positron emission tomography, and Group II: 322 AAA patients (295; 92% males) whose families were invited to ultrasonography screening. Ultrasonography screening identified 24 new AAAs among 186 relatives (>/= 50 years) of 144 families yielding a prevalence of 13%. The highest prevalence (25%) was found among brothers. By combining the number of AAAs found by ultrasonography screening with those diagnosed previously the observed lifetime prevalence of AAA was estimated to be 32% in brothers. The familial AAA cases were more likely to have a ruptured AAA than the sporadic cases (8% vs. 2.4%; P<0.0001). CONCLUSIONS: The findings confirm previously found high prevalence of AAA among brothers, support genetic contribution to AAA pathogenesis and provide rationale for targeted screening of relatives of AAA patients. [less ▲]Detailed reference viewed: 28 (9 ULg)
Du processus aux soins intégrés : expérience de gestion de projet bottom-up
ERPICUM, Marie ; BASSLEER, Bernard ; Defraigne, Jean-Olivier et al
Conference (2014, July 08)
Implementation of blood conservation strategies is a current issue in a public health view, especially in cardiac surgery. A service project has been initiated in the cardiovascular department of the CHU ... [more ▼]
Implementation of blood conservation strategies is a current issue in a public health view, especially in cardiac surgery. A service project has been initiated in the cardiovascular department of the CHU of Liege aiming to develop a blood conservation program. This project has evolved into the creation of a clinical pathway of the cardiac surgery patient and then into an institutional model for the development of other clinical pathways. This evolution leads to meet with the missions and strategic objectives of the Institution and some national projects. The process of this approach weaves a horizontal and vertical grid. The multidisciplinary membership, supported by medical and nursing leadership and the institutional support, will determine the sustainability of this project. [less ▲]Detailed reference viewed: 23 (7 ULg)
Metabolomics analysis of urine and kidney samples after renal ischemia/reperfusion injury in mouse
JOURET, François ; Poma, Laurence ; Defraigne, Jean-Olivier et al
in Transplant International (2014, May), 27Detailed reference viewed: 27 (12 ULg)
Vascular Endothelial Growth Factor-111 (VEGF-111) and tendon healing: preliminary results in a rat model of tendon injury
Kaux, Jean-François ; Janssen, Lauriane ; Drion, Pierre et al
in Muscles, Ligaments and Tendons Journal (2014), 4(1), 25-28
Tendon lesions are among the most frequent musculoskeletal pathologies. Vascular endothelial growth factor (VEGF) is known to regulate angiogenesis. VEGF-111, a biologically active and proteolysis ... [more ▼]
Tendon lesions are among the most frequent musculoskeletal pathologies. Vascular endothelial growth factor (VEGF) is known to regulate angiogenesis. VEGF-111, a biologically active and proteolysis-resistant splice variant of this family, was recently identified. This study aimed at evaluating whether VEGF-111 could have a therapeutic interest in tendon pathologies. Surgical section of one Achilles tendon of rats was performed before a local injection of either saline or VEGF-111. After 5, 15 and 30 days, the Achilles tendons of 10 rats of both groups were sampled and submitted to a biomechanical tensile test. The force necessary to induce tendon rupture was greater for tendons of the VEGF-111 group (p<0.05) while the section areas of the tendons were similar. The mechanical stress was similar at 5 and 15 days in the both groups but was improved for the VEGF-111 group at day 30 (p <0.001). No difference was observed in the mRNA expression of collagen III, tenomodulin and MMP-9. In conclusion, we observed that a local injection of VEGF-111 improves the early phases of the healing process of rat tendons after a surgical section. Further confirmatory experimentations are needed to consolidate our results. [less ▲]Detailed reference viewed: 39 (5 ULg)
Sex Differences in Abdominal Aortic Aneurysm: the Role of Sex Hormones.
Makrygiannis, Georgios ; Courtois, Audrey ; Drion, Pierre et al
in Annals of vascular surgery (2014)
Abdominal aortic aneurysm (AAA) is a complex multifactorial disease with genetic and environmental components. AAA is more common in males, whereas women have a greater risk of rupture and more frequently ... [more ▼]
Abdominal aortic aneurysm (AAA) is a complex multifactorial disease with genetic and environmental components. AAA is more common in males, whereas women have a greater risk of rupture and more frequently have concomitant thoracic aortic aneurysms. Moreover, women are diagnosed with AAA about 10 years later and seem to be protected by female sex hormones. In this MEDLINE-based review of literature we examined human and animal, in vivo and in vitro studies, to further deepen our understanding of the sexual dimorphism of AAA. We focus on the role of sex hormones during the formation and growth of AAA. Endogenous estrogens and exogenous 17beta-estradiol were found to exert favorable actions protecting from AAA in animal models, whereas exogenous hormone replacement therapy in humans had inconclusive results. Androgens, known to have detrimental effects in the vasculature, in sufficient levels maintain the integrity of the aortic wall through their anabolic actions and act differentially in males and females, whereas lower levels of testosterone have been associated with AAA in humans. In conclusion, sex differences remain an important area of AAA research, but further studies especially in humans are needed. Furthermore, differential molecular mechanisms of sex hormones constitute a potential therapeutic target for AAA. [less ▲]Detailed reference viewed: 30 (21 ULg)
Antioxidant capacity and phenolic composition of red wines from various grape varieties: Specificity of Pinot Noir.
; Kevers, Claire ; PINCEMAIL, Joël et al
in Journal of Food Composition and Analysis (2014)
Wines produced from various grape varieties present different properties affecting taste and color. The hypothesis was that grape genotype could have a deep impact on wine antioxidant properties and ... [more ▼]
Wines produced from various grape varieties present different properties affecting taste and color. The hypothesis was that grape genotype could have a deep impact on wine antioxidant properties and phenolic composition. But in this study on 38 different wines of 4 main grape varieties, large variability in the levels of individual phenolic compounds as well as in antioxidant capacity was observed in each grape variety. Comparisons of the wine varieties based on their individual phenolic profile (flavonols, anthocyanidins, flavan-3-ols, phenolic acids, resveratrol…) and antioxidant capacities (ORAC, DPPH, hemolysis, ESR, total phenolics) showed limited differences. An exception was the group of wines made from the grape variety Pinot Noir, in which the range of phenolic compounds was different from the other wines: anthocyanidins (87 mg L-1, 119 to 206 mg L-1 in other grape varieties) and flavonols (17 mg L-1, 20 to 57 mg L-1in others except Primitivo) showed lower levels while flavanols (327 mg L-1, 152 to 244 mg L-1 in others) and phenolic acids (161 mg L-1, 103 to 152 mg L-1 in others) showed levels higher than in the other wines. This different profile was associated with a lower antioxidant capacity (i.e. mean ORAC value: 20988 for Pinot Noir, 27820 to 33651 for others). [less ▲]Detailed reference viewed: 30 (3 ULg)
Comment definir une circulation extracorporelle de qualite ?
; Defraigne, Jean-Olivier
in Annales francaises d'anesthesie et de reanimation (2014)
Extracorporeal circulation (ECC) has to ensure homeostasis of the patient and to minimize pathophysiological disorders inherent in the technique. However, we cannot dissociate it from the surgery and ... [more ▼]
Extracorporeal circulation (ECC) has to ensure homeostasis of the patient and to minimize pathophysiological disorders inherent in the technique. However, we cannot dissociate it from the surgery and anesthesia knowing that the discipline involves a close partnership with these stakeholders. The purpose of this publication is to review the essential elements that at present can contribute to the quality of the CEC and suggest improvements and developments to be implemented in this area. [less ▲]Detailed reference viewed: 47 (0 ULg)
Multifactorial Relationship Between 18F-Fluoro-Deoxy-Glucose Positron Emission Tomography Signaling and Biomechanical Properties in Unruptured Aortic Aneurysms
NCHIMI LONGANG, Alain ; CHERAMY-BIEN, Jean-Paul ; et al
in Circulation. Cardiovascular imaging (2014), 7
BACKGROUND: -The relationship between biomechanical properties and biological activities in aortic aneurysms was investigated with finite element simulations (FES) and 18F-fluoro-deoxyglucose (18F-FDG ... [more ▼]
BACKGROUND: -The relationship between biomechanical properties and biological activities in aortic aneurysms was investigated with finite element simulations (FES) and 18F-fluoro-deoxyglucose (18F-FDG) positron emission tomography (PET). METHODS AND RESULTS: -The study included 53 patients (45 males) with aortic aneurysms, 47 infrarenal (AAA) and 6 thoracic (TAA), who had at least one 18F-FDG PET/computed tomography. Over a 30-month period, more clinical events occurred in patients with increased 18F-FDG uptake on their last examination than in those without (5/18 (28%) vs. 2/35 (6%); P=0.03). Wall stress and stress/strength index computed by FES and 18F-FDG uptake were evaluating a total of 68 examinations. 25 (38%) examinations demonstrated at least one aneurysm wall area of increased 18F-FDG uptake. The mean number of these areas per examination was 1.6 (18/11) in TAAs vs. 0.25 (14/57) in AAAs, while the mean number of increased uptake areas co-localizing with highest wall stress and stress/strength index areas was 0.55 (6/11) and 0.02 (1/57), respectively. Quantitatively, 18F-FDG PET uptake correlated positively with both wall stress and stress/strength index (P<0.05). 18F-FDG uptake was particularly high in subjects with personal history of angina pectoris and familial aneurysm. CONCLUSIONS: -Increased 18F-FDG PET uptake in aortic aneurysms is strongly related to aneurysm location, wall stress as derived by FES and patient's risk factors such as acquired and inherited susceptibilities. [less ▲]Detailed reference viewed: 18 (5 ULg)
High Prevalence of Abdominal Aortic Aneurysm in Patients with Three-vessel Coronary Artery Disease.
; VAN DAMME, Hendrik ; et al
in European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery (2014)
OBJECTIVES: Currently, the prevalence of abdominal aortic aneurysm (AAA) in patients with coronary artery disease (CAD) and the correlation between CAD severity and AAA prevalence are not clearly known ... [more ▼]
OBJECTIVES: Currently, the prevalence of abdominal aortic aneurysm (AAA) in patients with coronary artery disease (CAD) and the correlation between CAD severity and AAA prevalence are not clearly known. We conducted a prospective study to determine the prevalence of AAA in patients undergoing coronary angiography and to determine the risk factors and a coronary profile associated with AAA. METHODS: Over an 18-month period, abdominal aortic ultrasound was performed on 1,000 patients undergoing coronary angiography for suspected or known CAD, or prior to valve surgery. Clinical characteristics and coronary profile were collected from the patients. RESULTS: The overall number of previously repaired, already diagnosed, and new cases of AAA in the study population was 42, yielding a prevalence of 4.2%. Among the patients with newly detected AAAs, only two had an AAA diameter of >54 mm and were therefore treated surgically. In men aged >/=65 years, the prevalence reached 8.6%, while in men with three-vessel CAD it was 14.4%. Multivariate analysis showed that age >/=65 years (p = .003), male gender (p = .003), family history of AAA (p = .01), current smoking (p = .002), and three-vessel CAD (p < .001) were significantly associated with a higher prevalence of AAA. CONCLUSION: The prevalence of AAA was high in men aged >/=65 years and in those with three-vessel CAD regardless of age. While our findings do not prove the cost-effectiveness of screening for AAA in these high risk patients, they do support the usefulness of a quick ultrasound examination of the abdominal aorta during routine transthoracic echocardiography in such patients. [less ▲]Detailed reference viewed: 20 (7 ULg)
Antioxidant capacity of small dark fruits. Influence of cultivars and harvest time
Kevers, Claire ; PINCEMAIL, Joël ; Defraigne, Jean-Olivier et al
in Journal of Berry Research (2014)
BACKGROUND: Small dark fruits represent one of the most important sources of bioactive compounds with antioxidant capacity in the human diet. The content of health-promoting antioxidants in these fruits ... [more ▼]
BACKGROUND: Small dark fruits represent one of the most important sources of bioactive compounds with antioxidant capacity in the human diet. The content of health-promoting antioxidants in these fruits may be important information to take into account when a fruit producer has to choose which cultivar to grow. OBJECTIVE: It is important to know how antioxidant capacity and antioxidant compounds as total phenolics and ascorbic acid vary between 9 small dark fruit species and for each species among cultivars (2 to 10 per species). METHODS: The antioxidant capacity (ORAC assay), total phenolic (Folin-Ciocalteu) and ascorbic acid content were measured in 9 fruits (plums, blackcurrants, blackberries, blueberries, cherries, redcurrants, raspberries, white currants and gooseberries) / 42 cultivars harvested at maturity during their high production period. RESULTS: The comparison of the average of the various cultivars of each small fruits showed that blackcurrants had the best antioxidant capacity (with plums), the highest ascorbic acid content and the highest total phenolic content (with blackberries). The present study shows that total phenolic compounds, ascorbic acid and antioxidant capacity strongly differed between genotypes of each small dark fruits. Other parameters as harvest time, culture conditions and maturity degree at the harvest may also influence the antioxidant capacity of small fruits. CONCLUSION: Among small dark fruits, blackcurrants have high qualities. Choices of variety, harvest time and maturity degree are important for all fruits. [less ▲]Detailed reference viewed: 81 (19 ULg)
Deriving a global antioxidant score for commercial juices by multivariate graphical and scoring techniques: applications to blackcurrant juice
; Kevers, Claire ; Dardenne, Nadia et al
in Preedy (Ed.) Processing and Impact on Antioxidants in Beverages (2014)
Blackcurrants constitute an important source of potential health promoting phytochemicals (e.g. phenolic compounds, ascorbic acid) due to their antioxidant properties. Only small portions of berries are ... [more ▼]
Blackcurrants constitute an important source of potential health promoting phytochemicals (e.g. phenolic compounds, ascorbic acid) due to their antioxidant properties. Only small portions of berries are consumed fresh, most of their intake coming from processed foods, such as juices. Seven techniques were used to measure antioxidant capacity and antioxidant compounds of 10 juices. This yielded a large disparity of results. No single test, even the most popular ORAC assay, is able to compare the antioxidant capacity of similar food matrix such as blackcurrant juices. By combining tests from a large battery of « antioxidant » assays, it is possible to improve the discrimination of a food matrix by establishing a Global Antioxidant Score (GAS) which correlates well with graphical representations like Chernoff faces or stars. The latter approaches may help food industry managers and authorities to compare their « antioxidant » products with those existing on the market. [less ▲]Detailed reference viewed: 52 (20 ULg)
Effects of Parecoxib on The Prevention of Postoperative Peritoneal Adhesions in Rats.
; ; et al
in Journal of Investigative Surgery : The Official Journal of the Academy of Surgical Research (2013), 26(6), 340-346
ABSTRACT Background: No systemic preventive therapy has been successful in inhibiting the development of postoperative peritoneal adhesions (PPAs). Objective: The aim of this study was to evaluate the ... [more ▼]
ABSTRACT Background: No systemic preventive therapy has been successful in inhibiting the development of postoperative peritoneal adhesions (PPAs). Objective: The aim of this study was to evaluate the potential effects of 5 day administration of parecoxib, on PPA prevention and on suture or wound healing in rats. Methods: In a model of PPAs induced by peritoneal electrical burn, 30 rats were randomized into 3 groups according to parecoxib administration route (control; intraperitoneal (IP); intramuscular (IM)). Plasma and peritoneal levels of PAI-1 and tPA were measured at T0, after 90 min of surgery (T90), and on postoperative day 10 (D10). In a cecum resection model, 20 rats were randomized into two groups (control and IP parecoxib), and abdominal wound healing and suture leakage were assessed at D10. In both models, PPAs were evaluated quantitatively and qualitatively on D10. Results: Administration of parecoxib significantly decreased the quantity (p < .05) and the severity (p < .01) of PPAs in both models. In addition, parecoxib administration did not cause healing defects or infectious complications in the two models. In the peritoneal burn model, IP or IM parecoxib administration inhibited the increase of postoperative plasma and peritoneum PAI-1 levels, an increase that was observed in the control group (p < .01). No anastomosis leakage could be demonstrated in both groups in the cecum resection model. Conclusion: This study showed that, in these rat models, parecoxib might reduce PPA formation. Confirmation of the safety of parecoxib on intestinal anastomoses is required and should be investigated in further animal models. [less ▲]Detailed reference viewed: 29 (5 ULg)
Competitive interaction of a synthetic polycation (PDMAEMA) to human platelets and erythrocytes
Flebus, Luca ; Lombart, François ; et al
Poster (2013, October)Detailed reference viewed: 23 (5 ULg)
CLINICAL AND FUNCTIONAL CHARACTERISTICS OF NONAGENARIANS HOSPITALIZED IN A GERIATRIC UNIT: A DESCRIPTIVE STUDY
Petermans, Jean ; ; ALLEPAERTS, Sophie et al
in Journal of Aging Research and Clinical Practice (2013), 2(3), 303-309Detailed reference viewed: 46 (12 ULg)
18F-FDG Uptake Assessed by PET/CT in Abdominal Aortic Aneurysms Is Associated with Cellular and Molecular Alterations Prefacing Wall Deterioration and Rupture.
Courtois, Audrey ; Richelle, Betty ; Hustinx, Roland et al
in Journal of Nuclear Medicine (The) (2013), 54
Rupture of abdominal aortic aneurysms (AAAs) leads to a significant morbidity and mortality in aging populations, and its prediction would be most beneficial to public health. Spots of positive uptake of ... [more ▼]
Rupture of abdominal aortic aneurysms (AAAs) leads to a significant morbidity and mortality in aging populations, and its prediction would be most beneficial to public health. Spots of positive uptake of 18F-FDG detected by PET are found in 12% of AAA patients (PET+), who are most often symptomatic and at high rupture risk. Comparing the 18F-FDG-positive site with a negative site from the same aneurysm and with samples collected from AAA patients with no 18F-FDG uptake should allow the discrimination of biologic alterations that would help in identifying markers predictive of rupture. METHODS: Biopsies of the AAA wall were obtained from patients with no 18F-FDG uptake (PET0, n = 10) and from PET+ patients (n = 8), both at the site of positive uptake and at a distant negative site of the aneurysmal wall. Samples were analyzed by immunohistochemistry, quantitative real-time polymerase chain reaction, and zymography. RESULTS: The sites of the aneurysmal wall with a positive 18F-FDG uptake were characterized by a strikingly increased number of adventitial inflammatory cells, highly proliferative, and by a drastic reduction of smooth muscle cells (SMCs) in the media as compared with their negative counterpart and with the PET0 wall. The expression of a series of genes involved in the maintenance and remodeling of the wall was significantly modified in the negative sites of PET+, compared with the PET0 wall, suggesting a systemic alteration of the aneurysmal wall. Furthermore, a striking increase of several matrix metalloproteinases (MMPs), notably the MMP1 and MMP13 collagenases, was observed in the positive sites, mainly in the adventitia. Moreover, PET+ patients were characterized by a higher circulating C-reactive protein. CONCLUSION: Positive 18F-FDG uptake in the aneurysmal wall is associated with an active inflammatory process characterized by a dense infiltrate of proliferating leukocytes in the adventitia and an increased circulating C-reactive protein. Moreover, a loss of SMC in the media and alterations of the expression of genes involved in the remodeling of adventitia and collagen degradation potentially participate in the weakening of the aneurysmal wall preceding rupture. [less ▲]Detailed reference viewed: 75 (37 ULg)
Study of the specific interaction between fluorescent PDMAEMA and Platelets compared to Erythrocytes
Flebus, Luca ; Lombart, François ; et al
Poster (2013, June 18)
Nowadays synthetic polymers provide more and more functionalities in the biomedical world, in particular as part of medical devices and drug delivery systems. Looking for new applications in the ... [more ▼]
Nowadays synthetic polymers provide more and more functionalities in the biomedical world, in particular as part of medical devices and drug delivery systems. Looking for new applications in the cardiovascular field, our attention has been focused on the well-known poly(2-(dimethylamino)ethyl methacrylate polymer (PDMAEMA). This synthetic polycation has particularly been studied as a potential DNA carrier to promote cell transfection. However and surprisingly enough relative few studies have been published in order to better understand its hemoreactivity under a free form (thus not based on “PolyElectrolyte Complex”), but also its biodistribution and clearance kinetics. In order to facilitate the in vitro and in vivo monitoring of this polycation and especially to follow its reactivity with whole blood we have labeled it with fluorescein adopting a new chemical route of synthesis. After its thorough purification and full-characterization (NMR, SEC, fluorescent spectroscopy), we followed its interaction with erythrocytes and platelets using flow cytometry. Dose-response curves were established in whole blood and within incubation times ranging between 5 min to 3 h. Considering the largest area and more negative Zeta potential developed by red blood cells compared to platelets, we initially hypothesized that RBC should interact more quickly and efficiently with the polycation. Unexpectedly, platelets presented a higher affinity for the polycation with a saturation binding curve whilst a linear profile was observed for the erythrocyte adsorption curve. Aggregometry analyses also revealed this phenomenon, although displaying a weaker effect in whole blood compared to washed platelets. Ongoing research seeks to understand the molecular mechanism of interaction of this polymer with platelets. [less ▲]Detailed reference viewed: 25 (4 ULg)
A modified surgical model of fulminant hepatic failure in the rat.
DETRY, Olivier ; ; CHERAMY-BIEN, Jean-Paul et al
in Journal of Surgical Research (2013), 181
BACKGROUND: There is a need for better animal models of fulminant liver failure (FHF). Eguchi et al described an interesting surgical model of FHF in the rat. This model includes 68% partial hepatectomy ... [more ▼]
BACKGROUND: There is a need for better animal models of fulminant liver failure (FHF). Eguchi et al described an interesting surgical model of FHF in the rat. This model includes 68% partial hepatectomy, ischemia of 24% of the liver mass, and 8% of remnant liver left intact. In the original description by Eguchi et al, rats were administered subcutaneous glucose. However, the authors found that normothermic FHF rats with subcutaneous glucose died from deep hypoglycemia. In this report, we describe a modification of that model, and show that administration of intravenous glucose allows better survival and development of intracranial hypertension. METHODS: We operated on FHF rats using the procedure described by Eguchi et al, kept them normothermic, and maintained normoglycemia by continuous intravenous glucose injection (glucose 10%, 1 mL/h). At 24 h, we monitored liver blood tests (n = 5), intracranial pressure (n = 5), clinical encephalopathy, and survival (n = 10), and compared them with sham and 68% hepatectomy rats. RESULTS: The FHF rats developed acute cytolysis, cholestasis, and liver failure, as demonstrated by the liver blood tests. They experienced progressive encephalopathy and intracranial hypertension leading to death. Mean survival was 45.9 h. Of 10 FHF rats from the survival evaluation cohort, one survived 7 d. Laparotomy showed necrosis of lateral liver lobes and enlargement of omental lobes with a normal hepatic aspect, suggesting liver recovery. CONCLUSIONS: This surgical rat model mimics the features of human FHF and seems interesting for further research into the pathophysiology and therapeutic management of the disease. [less ▲]Detailed reference viewed: 38 (7 ULg)
What is the potential increase in the heart graft pool by cardiac donation after circulatory death?
; HANS, Marie-France ; NELLESSEN, Eric et al
Conference (2013, February 09)Detailed reference viewed: 19 (4 ULg)
Le coût du monitoring est-il compensé par le bénéfice offert au patient?
BLAFFART, Francine ; Defraigne, Jean-Olivier
Conference (2013, February)Detailed reference viewed: 16 (1 ULg)
What is the potential increase in the heart graft pool by cardiac donation after circulatory death?
; DETRY, Olivier ; HANS, Marie-France et al
in Transplant International (2013), 26(1), 61-66
Heart transplantation remains the only definite treatment option for end-stage heart diseases. The use of hearts procured after donation after circulatory death (DCD) could help decrease the heart graft ... [more ▼]
Heart transplantation remains the only definite treatment option for end-stage heart diseases. The use of hearts procured after donation after circulatory death (DCD) could help decrease the heart graft shortage. The aim of this study was to evaluate the potential increase in heart graft pool by developing DCD heart transplantation. We retrospectively reviewed our local donor database from 2006 to 2011, and screened the complete controlled DCD donor population for potential heart donors, using the same criteria as for donation after brain death (DBD) heart transplantation. Acceptable donation warm ischemic time (DWIT) was limited to 30 min. During this period 177 DBD and 70 DCD were performed. From the 177 DBD, a total of 70 (39.5%) hearts were procured and transplanted. Of the 70 DCD, eight (11%) donors fulfilled the criteria for heart procurement with a DWIT of under 30 min. Within the same period, 82 patients were newly listed for heart transplantation, of which 53 were transplanted, 20 died or were unlisted, and 9 were waiting. It could be estimated that 11% of the DCD might be heart donors, representing a 15% increase in heart transplant activity, as well as potential reduction in the deaths on the waiting list by 40%. [less ▲]Detailed reference viewed: 37 (5 ULg)