References of "Laleman, W"
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See detailImpact of intensive enteral nutrition in association with corticosteroïds in the treatment of severe alcoholic hepatitis: a multicenter randomized controlled trial
Moreno, C; Trepo, E; Louvet, A et al

in Hepatology (Baltimore, Md.) (2014, October), 60(S1),

Intensive enteral nutrition by feeding tube does not improve 6-month survival in patients with severe alcoholic hepatitis. However, adequate nutritional support is associated with a better short-term ... [more ▼]

Intensive enteral nutrition by feeding tube does not improve 6-month survival in patients with severe alcoholic hepatitis. However, adequate nutritional support is associated with a better short-term prognosis. Adequate nutritional intake should be targeted in alcoholic hepatitis patients treated with corticosteroids. [less ▲]

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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 detailHepatitis B virus and hepatitis C virus infection in Belgium: similarities and differences in epidemic and initial management
De Vroey, B; Moreno, C; Laleman, W et al

in European Journal of Gastroenterology & Hepatology (2013), 25(5), 613-619

Introduction Nationwide studies comparing patients with hepatitis B and C virus (HBV and HCV) infections are mandatory for assessing changes in epidemiology. Aim The aim of this study was to compare ... [more ▼]

Introduction Nationwide studies comparing patients with hepatitis B and C virus (HBV and HCV) infections are mandatory for assessing changes in epidemiology. Aim The aim of this study was to compare epidemiological data and initial management of newly diagnosed patients with persistent HBV (HBsAg positive) or HCV (detectable HCV RNA) infection in Belgium. Patients and methods Data were extracted from two Belgian observational databases. Results A total of 655 patients (387 HBV and 268 HCV) were included. Compared with HCV patients, HBV patients were younger, more frequently men, more often of Asian or African origin (43 vs. 10%, P < 0.0001), and less frequently contaminated by transfusion or intravenous drug use (9 and 6% vs. 34 and 44%, P< 0.0001). Viral replication was assessed in 89% of HBV patients. Compared with HCV patients, HBV patients more frequently had normal alanine aminotransferase (ALT) levels (65 vs. 29%, P < 0.0001), less frequently underwent liver biopsy (29 vs. 67%, P < 0.0001), and were less often considered for antiviral therapy (25 vs. 54%, P < 0.0001). When taking only HBV patients with detectable viral replication into consideration, results remained unchanged. During the multivariate analysis, ALT was a major factor for performing liver biopsy or considering antiviral therapy in both groups. Conclusion HBV and HCV screening policies should be targeted toward immigrants and intravenous drug users, respectively. Guidelines recommending systematic search for viral replication should be reinforced in HBV patients. HBV patients less frequently underwent liver biopsy and were less often considered for antiviral therapy compared with HCV patients. Despite the lack of sensitivity and specificity, ALT remains a pivotal decision-making tool for liver biopsy and antiviral therapy in both infections. [less ▲]

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See detailUpdate of the Belgian Association for the Study of the Liver Guidelines for the treatment of chronic hepatitis C genotype 1 with protease inhibitors.
Orlent, H; Deltenre, P; Francque, S et al

in Acta Gastro-Enterologica Belgica (2012), 75(2), 245-259

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See detailHBV infection in Belgium: results of the BASL observatory of 1456 HBsAg carriers.
Deltenre, P.; Laleman, W.; Van Gossum, M. et al

in Acta Gastro-Enterologica Belgica (2012), 75(1), 35-41

Introduction : Nationwide studies are mandatory to assess changes in the epidemiology of HBV infection in Europe. Aim : To describe epidemiological characteristics of HBsAgpositive patients, especially ... [more ▼]

Introduction : Nationwide studies are mandatory to assess changes in the epidemiology of HBV infection in Europe. Aim : To describe epidemiological characteristics of HBsAgpositive patients, especially inactive carriers, and to evaluate how practitioners manage HBV patients in real life. Methods : Belgian physicians were asked to report all chronically infected HBV patients during a one-year period. Results : Among 1,456 patients included, 1,035 (71%) were classified into one of four phases of chronic infection : immune tolerance (n = 10), HBeAg-positive hepatitis (n = 248), HBeAgnegative hepatitis (n = 420) and inactive carrier state (n = 357 HBeAg-negative patients with ALT < upper limit of normal (ULN) and HBV DNA < 2,000 IU/mL). Using less restrictive criteria for ALT (1-2 ULN) or HBV DNA (2,000-20,000 IU/mL), 93 unclassified patients were added to the group of inactive carriers. These 93 additional inactive carriers were younger, more frequently males, with similar risk factors for HBV infection and histological features compared to inactive carriers according to recent guidelines. Recent guidelines on management of HBV patients were generally followed, but systematic HBV DNA measurements and HDV coinfection screening should be reinforced. Conclusion : In Belgium, an inactive carrier state was a common form of chronic HBV infection. Using less restrictive criteria for classification of inactive carriers did not modify their main characteristics and seemed better adapted to clinical practice. Recent guidelines on management of HBV patients should be reinforced. [less ▲]

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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 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 detailAre patients with HBV and HCV infection different? Comparison between 2 cohorts of newly diagnosed cases included in prospective registries of the Belgian Association for the Study of the Liver
De Vroey, B.; Moreno, C.; Laleman, W. et al

in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 21

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