References of "Jochmans, I"
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See detailFLUSHING PORCINE DCD LIVERS WITH CYCLO-DEXTRIN COMPLEXED CURCUMIN DOES NOT REDUCE ISCHEMIA REPERFUSION INJURY
MEURISSE, Nicolas ULg; PARKINNEN, J; CEULEMANS, L et al

Poster (2014, April)

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See detailEARLY ALLOGRAFT DYSFUNCTION DECREASES PATIENT SURVIVAL AFTER LIVER TRANSPLANTATION
MEURISSE, Nicolas ULg; FIEUWS, S; JOCHMANS, I et al

Poster (2014, April)

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See detailSeptuagenarian and octogenarian Donors Provide Excellent Liver Grafts for Transplantation
DARIUS, T; MONBALIU, D; JOCHMANS, I et al

in Transplantation Proceedings (2012), 44

Background. Wider utilization of liver grafts from donors 70 years old could substan- tially expand the organ pool, but their use remains limited by fear of poorer outcomes. We examined the results at our ... [more ▼]

Background. Wider utilization of liver grafts from donors 70 years old could substan- tially expand the organ pool, but their use remains limited by fear of poorer outcomes. We examined the results at our center of liver transplantation (OLT) using livers from donors 70 years old. Methods. From February 2003 to August 2010, we performed 450 OLT including 58 (13%) using donors 70 whose outcomes were compared with those using donors 70 years old. Results. Cerebrovascular causes of death predominated among donors 70 (85% vs 47% in donors 70; P .001). In contrast, traumatic causes of death predominated among donors 70 (36% vs 14% in donors 70; P .002). Unlike grafts from donors 70 years old, grafts from older individuals had no additional risk factors (steatosis, high sodium, or hemodynamic instability). Both groups were comparable for cold and warm ischemia times. No difference was noted in posttransplant peak transaminases, incidence of primary nonfunction, hepatic artery thrombosis, biliary strictures, or retransplantation rates between groups. The 1- and 5-year patient survivals were 88% and 82% in recipients of livers 70 versus 90% and 84% in those from 70 years old ( P .705). Recipients of older grafts, who were 6 years older than recipients of younger grafts ( P .001), tended to have a lower laboratory Model for End-Stage Liver Disease score ( P .074). Conclusions. Short and mid-term survival following OLT using donors 70 yo can be excellent provided that there is adequate donor and recipient selection. Septuagenarians and octogenarians with cerebrovascular ischemic and bleeding accidents represent a large pool of potential donors whose wider use could substantially reduce mortality on the OLT waiting list. [less ▲]

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See detailGastric Outlet Obtruction by a Donor Aortic Tube After En Bloc Liver Pancreas Transplantation : A Case Report
DEYLGAT, B; TOPAL, H; MEURISSE, Nicolas ULg et al

in Transplantation Proceedings (2012), 44

We present the case of a 30-years-old female suffering from a type five maturity onset diabetes of the young deficiency, resulting in type 1 diabetes and terminal renal inssufficiency. She also had ... [more ▼]

We present the case of a 30-years-old female suffering from a type five maturity onset diabetes of the young deficiency, resulting in type 1 diabetes and terminal renal inssufficiency. She also had chronic and refractory pruritis due to primary sclerosing cholangitis _like fibrosis. She underwent combined en bloc liver and pancreas transplantation and kidney transplantation.The postoperative course was complicated by a gastric outlet obstruction due to compression of the native gastroduodenal junction by the donor aortic tube . This was treated by construction of a roux-en-y gastrojejunostomy at posttransplant day 24. To our knowledge, compression of the gastroduodenal junction by a donor aortic tube after combined liver and pancreas (or multivisceral) transplantation has not been reported previously. [less ▲]

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See detailOUTCOMES OF LIVER TRANSPLANTATION USING DONATIONS AFTER CIRCULATORY DEATH : A SINGLE-CENTER EXPERIENCE
MEURISSE, Nicolas ULg; VANDEN BUSSCHE, S; JOCHMANS, I et al

in Transplantation Proceedings (2012), 44

Introduction Orthotopic liver transplantation (OLT) (LTx) using donation after circulatory death (DCD) donors is increasingly performed, but still considered to risk of poorer outcomes compared with ... [more ▼]

Introduction Orthotopic liver transplantation (OLT) (LTx) using donation after circulatory death (DCD) donors is increasingly performed, but still considered to risk of poorer outcomes compared with standard donations after brain death (DBD)-OLT. Therefore we reviewed our results of DCD-OLT. Patients and Methods Between 2003 and 2010, we performed 30 DCD-OLT (6% of all OLT). We retrospectively reviewed medical records of donors and recipients after DCD versus DBD-OLT to analyze biliary complications, retransplantation rates, and patient/graft survivals. Results Median donor age was similar for DCD and DBD-OLT: 51 versus 53 years (P = .244). Median donor warm ischemia time (stop ventilation to cold perfusion in DCD donors) was 24 minutes. Median cold ischemia time was shorter for DCD (6 hours 54 minutes) compared with DBD-OLT (8 hours 36 minutes; P < .0001). Median laboratory model of end-stage liver disease score was 15 for DCD, and 16 for DBD-OLT (P = .59). Median post-OLT Aspartate Aminotransferase (AST) peak was higher after DCD: 1178 versus DBD-OLT 651 IU/L (P = .005). The incidence of nonanastomotic strictures was different: 33.3% for DCD versus 12.5% for DBD-OLT (P = .001). The overall retransplantation rate was 3% after both DCD and DBD-OLT. After DCD-LTx actuarial 1, 3- and 5-year patient survivals were 93, 85 and 85%, and corresponding graft survivals, 90%, 82%, and 82% respectively, and not different compared with DBD-OLT: 88%, 78%, and 72% (P = .348) and 85%, 74%, and 68% (P = .524) respectively. Conclusion Despite substantial ischemic injury (high peak AST and biliary strictures) short- and long-term survival after DCD-OLT was comparable to DBD-OLT. Rapid donor surgery, careful donor and recipient selection, as well as short warm and cold ischemia times are key factors to optimize outcomes after DCD-OLT. However, strategies to reduce biliary complications remain warranted. [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 detailThe prognostic value of renal resistance during hypothermic machine perfusion of deceased donor kidneys
Jochmans, I.; Moers, C.; Smits, J. M. et al

in American Journal of Transplantation (2011), 11

Vascular renal resistance (RR) during hypothermic machine perfusion (HMP) is frequently used in kidney graft quality assessment. However, the association between RR and outcome has never been ... [more ▼]

Vascular renal resistance (RR) during hypothermic machine perfusion (HMP) is frequently used in kidney graft quality assessment. However, the association between RR and outcome has never been prospectively validated. Prospectively collected RR values of 302 machine-perfused deceased donor kidneys of all types (standard and extended criteria donor kidneys and kidneys donated after cardiac death), transplanted without prior knowledge of these RR values, were studied. In this cohort, we determined the association between RR and delayed graft function (DGF) and 1-year graft survival. The RR (mmHg/mL/min) at the end of HMP was an independent risk factor for DGF (odds ratio 21.12 [1.03–435.0]; p = 0.048) but the predictive value of RR was low, reflected by a c-statistic of the receiver operator characteristic curve of 0.58. The RR was also found to be an independent risk factor for 1-year graft failure (hazard ratio 12.33 [1.11–136.85]; p = 0.004). Determinants of transplant outcome are multifactorial in nature and this study identifies RR as an additional parameter to take into account when evaluating graft quality and estimating the likelihood of successful outcome. However, RR as a stand-alone quality assessment tool cannot be used to predict outcome with sufficient precision. [less ▲]

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