References of "Ledinh, H"
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See detailComparable transplant outcomes between DBD and DCD kidney grafts up to 5 years post-transplant: single centre experience
Ledinh, H; DETRY, Olivier ULg; DE ROOVER, Arnaud ULg et al

in Transplant International (2015, November), 28(S4), 193-194188

Introduction: This study aimed to determine the most recent results of kidney transplantation (KT) from donation after brain death (DBD) and circulatory death (DCD). Primary endpoints were graft and ... [more ▼]

Introduction: This study aimed to determine the most recent results of kidney transplantation (KT) from donation after brain death (DBD) and circulatory death (DCD). Primary endpoints were graft and patient survival, and graft function. Acute rejection and post-operative complications were assessed as secondary endpoints. Patient and Methods: This retrospective mono-center review consisted of 226 DBD- and 104 DCD-KT between 2008 and 2014. Results: Graft survival was comparable between two groups (95.1 vs. 91.1% at 1 year, 92.8 vs. 91.1% at 3 years and 89.2 vs. 91.1% at 5 years). 46% and 40% of graft loss were attributed to patient death with a functioning graft and rejection. Patient survival was comparable between 2 groups (97.8 vs. 95.1% at 1 year, 94.1 vs. 91.2% at 3 years, and 89.6 vs. 82.3% at five years). Etiology of patient death included cardiac arrest (16.7%), infection (16.7%), cancer (13.3%), and unknown cause (46.7%). Delayed graft function occurred in 14.6% of DBD- and 30.8% of DCD-KT (p = 0.001). Primary non function was encountered in 2.6% DBD- and 4.8% DCD-KT (p = ns). Graft function was worse in DCD than DBD up to 3 months post-transplant (p = 0.034), however, no difference existed afterwards. Biopsy-proven acute rejection was found in 12.8% and 13.5% of DBD- and DCD-KT during an average 3 months post- transplant (p = ns). This rate was 7.1% vs. 8.9% on surveillance biopsy performed between 3 and 6 months post-transplant (p = ns). Post-operativecomplication rate was comparable between 2 groups, concerning patient death, reoperation, transfusion, perirenal hematoma, macroscopic hematuria, urinary obstruction, wound problem, and infection. Nevertheless, contamination of preservation solution occurred more commonly in DCD than DBD (0.4% vs. 3.8%, p = 0.036). Conclusions: Despite worse early graft function, DCD-KT was not inferior to that originating from DBD up to 5 years post-transplant, therefore deserves to be used. [less ▲]

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See detailIncreased risk of interstitial fibrosis and tubular atrophy in controlled donation after circulatory death kidney transplantation
WEEKERS, Laurent ULg; Ledinh, H; BONVOISIN, Catherine ULg et al

in Transplant International (2015, November), 28(S4), 49118

Introduction: Comparable transplant outcomes between controlled donation after circulatory death (cDCD) and donation after brain death (DBD) kidney transplantation (KT) have been confirmed. However, few ... [more ▼]

Introduction: Comparable transplant outcomes between controlled donation after circulatory death (cDCD) and donation after brain death (DBD) kidney transplantation (KT) have been confirmed. However, few data describes the histology of cDCD-KT which is subjected to prolonged procurement warm ischemia. This study aimed to evaluate the rate of interstitial fibrosis (IF) and tubular atrophy (TA) on the surveillance biopsy performed in our unit between the 2 and 6 months post KT. Acute rejection was considered as secondary endpoint. Patients and Methods: 330 KT (226 DBD and 104 DCD) have been performed between 2008 and 2014. Surveillance or per-cause biopsy was performed in 272 recipients. Among them, the rate of adequate (≥8 glomeruli and ≥1 large-sized artery) was 76.8%. Results: IFTA was found in 11.5% and 25.7% of DBD and cDCD-KT, respectively (p = 0.004). Considering IF and TA separately, the corresponding rates were 20.4% vs 32% (p = 0.04) and 23% vs 36% (p = 0.03), respectively. If acute rejection before routine biopsy was excluded, either IF or TA rate was significantly higher in cDCD- than DBD-KT (12.6% vs 27.1%, p = 0.006; 17.6% vs 31.4%, p = 0.016; and 20.9% vs 35.7%, p = 0.015 in case of IF-TA, IF, and TA, respectively). A cDCD-KT compared to a DBD-KT was 3.11 (95%CI 1.51– 6.43, p = 0.002), 2.34 (95%CI 1.21–4.53, p = 0.011) and 2.29 (95%CI 1.23– 4.27, p = 0.009) times more likely to have IFTA, IF, and TA, respectively. Extended criteria donor (ECD) vs standard criteria donor (SCD) was also an independent risk factor for IFTA (OR = 3.11, 95%CI 1.51–6.43, p = 0.002), IF (OR = 4.86, 95%CI 1.96–12.05, p = 0.001), and TA (OR = 4.09, 95%CI 1.68– 9.93, p = 0.002). The rate of acute rejection diagnosed by SB was 7.1% and 8.9% in DBD and cDCD kidney grafts (p = ns), respectively.Conclusion: KT from cDCD increased the risk of IF-TA between 3 and 6 months post-transplant. Further studies are warranted to investigate the evolution of this phenomenon over time and its effect on graft function. [less ▲]

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See detailA consecutive series of 100 controlled DCD liver transplantation
DETRY, Olivier ULg; DE ROOVER, Arnaud ULg; Ledinh, H et al

in Transplant International (2015, November), 28(S4), 109296

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

Introduction: Donation after circulatory death (DCD) have been proposed to partially overcome the organ donor shortage. DCD-LT remains controversial, with reported increased risk of graft loss and retransplantation. The authors retrospectively reviewed a single centre experience with controlled DCD-LT in a 12-year period. Patients and Methods: 100 DCD-LT were consecutively performed between 2003 and 2014. All donation and procurement procedures were performed as controlled DCD in operative rooms. Data are presented as median (ranges). Median donor age was 57 years (16–83). Median DRI was 2.16 (1.4–3.4). Most grafts were flushed with HTK solution. Allocation was centre-based. Median recipient MELD score at LT was 15 (7–40). Mean follow-up was 35 months. No patient was lost to follow-up. Results: Median total DCD warm ischemia was 19 min (10–39). Median cold ischemia was 235 min (113–576). Median peak AST was 1132 U/l (282– 21 928). Median peak bilirubin was 28 mg/dL. Patient survivals were 90.7%, 75.5% and 70.7% at 1.3 and 5 years, respectively. Graft survivals were 88.7%, 72.1% and 67.1% at 1.3 and 5 years, respectively. Biliary complications included mainly anastomotic strictures and extrahepatic main bile duct ischemic obstruction, that were managed either by endoscopy or hepatico- jejunostomy. No PNF or graft loss due to ischemic cholangiopathy was observed in this series. Discussion: In this series, DCD LT appears to provide results similar 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. If symptomatic ischemic cholangiopa- thy is diagnosed, adequate management with endoscopy and surgical hepaticojejunostomy may avoid graft loss and retransplantation. [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, S et al

in Acta Chirurgica Belgica (2013, May), Supplement 113(3), 6729

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See detailDelayed graft function does not harm the future of donation-after- cardiac-death kidney transplants
LeDinh, H; WEEKERS, Laurent ULg; BONVOISIN, Catherine ULg et al

Conference (2012, March 29)

Introduction: Delayed graft function (DGF) occurs more frequently in kidney transplants from donation after cardiac death (DCD) than from donation after brain death (DBD). We investigated the effect of ... [more ▼]

Introduction: Delayed graft function (DGF) occurs more frequently in kidney transplants from donation after cardiac death (DCD) than from donation after brain death (DBD). We investigated the effect of DGF on post-transplant outcomes in controlled DCD kidney grafts. Patients and Methods: This single-center retrospective study recruited 80 controlled DCD kidney allo- grafts which have been performed at the University Hospital of Sart Tilman, University of Liège, from Jan 2005 to Dec 2011. Results: Mean patient follow-up was 28.5 months. No primary non-function grafts were encountered. DGF rate was 36%. Overall graft survivals between groups with and without DGF were 92.4% and 95.1% at 1 year, 92.4% and 91.7% at 3 years, and 84.7% and 91.7% at 5 years (p=ns), respectively. Patients with and without DGF had the same survival rates at the corresponding time points (92.4% and 97.1%, 92.4% and 93.7%, and 84.7% and 93.7%, p=ns, respectively). Estimated glomerular filtration rate (eGFR) was significantly lower in DGF group compared to non-DGF group at hospital discharge (29 vs 42 ml/min, p=0.001) and up to 1 year post-transplant (46 vs 53 ml/min, p=0.045), but the differ- ence disappeared afterwards (50 vs 48 ml/min at 3 years, and 54 vs 53 ml/min at 5 years, p=ns). DGF did not increase the risk of acute rejection or surgical complications. 29.6% of recipients with DGF de- veloped acute rejection (biopsy-proven rejection and clinically suspected rejection) compared with 29.2% of recipients without DGF (p=ns). The rate of all surgical complications was 33.3% and 25% in recipients with and without DGF (p=ns). However, DGF prolonged significantly the length of hospitaliza- tion in DGF than non-DGF group (18.9 vs 13 days, p=0.000). Donor BMI 􏰤 30 kg/m2􏰁􏰀􏰚􏰌􏰈􏰏􏰥􏰏􏰌􏰝􏰣􏰀􏰕􏰉􏰂􏰀􏰤 30 kg/m2 and pre-transplant dialysis duration increased the risk of DGF in a multivariate logistic regression analysis. Conclusions: Apart from longer hospital stay, DGF had no deleterious impact on the future of DCD kidney allografts. Comparable graft and patient survival, renal function, rejection rate and surgical com- plications were observed between groups with and without DGF. [less ▲]

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See detailResults of kidney transplantation from controlled donors after cardio-circulatory death: a single center experience.
Ledinh, H.; WEEKERS, Laurent ULg; BONVOISIN, Catherine ULg et al

in Transplant International (2012), 25

The aim of this study was to determine results of kidney transplantation (KT) from controlled donation after cardio-circulatory death (DCD). Primary end-points were graft and patient survival, and post ... [more ▼]

The aim of this study was to determine results of kidney transplantation (KT) from controlled donation after cardio-circulatory death (DCD). Primary end-points were graft and patient survival, and post-transplant complications. The influence of delayed graft function (DGF) on graft survival and DGF risk factors were analyzed as secondary end-points. This is a retrospective mono-center review of a consecutive series of 59 DCD-KT performed between 2005 and 2010. Overall graft survival was 96.6%, 94.6%, and 90.7% at 3 months, 1 and 3 years, respectively. Main cause of graft loss was patient's death with a functioning graft. No primary nonfunction grafts. Renal graft function was suboptimal at hospital discharge, but nearly normalized at 3 months. DGF was observed in 45.6% of all DCD-KT. DGF significantly increased postoperative length of hospitalization, but had no deleterious impact on graft function or survival. Donor body mass index >/=30 was the only donor factor that was found to significantly increase the risk of DGF (P < 0.05). Despite a higher rate of DGF, controlled DCD-KT offers a valuable contribution to the pool of deceased donor kidney grafts, with comparable mid-term results to those procured after brain death. [less ▲]

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See detailLiver transplantation for donation after cardiocirculatory death donors: Belgian experience 2003-2009
DE ROOVER, Arnaud ULg; Ledinh, H.; Donckier, V. et al

Conference (2011, March 24)

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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 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 detailRenal transplantation from living related donors: a single center experience in viet nam.
Ledinh, H.; Detry, Olivier ULg; Pham, M. S. et al

in Transplantation Proceedings (2010), 42(10), 4389-91

INTRODUCTION: End-stage renal disease is a major public health problem in Viet Nam. A cooperative project between the University of Liege, Belgium, and the University of Medicine Pham Ngoc Thach, Ho Chi ... [more ▼]

INTRODUCTION: End-stage renal disease is a major public health problem in Viet Nam. A cooperative project between the University of Liege, Belgium, and the University of Medicine Pham Ngoc Thach, Ho Chi Minh City, Viet Nam, has permitted the establishment of an autonomous program of renal transplantation from living-related donors at the Peoples' Hospital No 115. The aim of this paper was to report the primary results of the project and to draw conclusions for the future. PATIENTS AND METHODS: From January 2004 to July 2008, we performed 33 living-related renal transplantations. Mean ages of donors and recipients were 31.8 +/- 9.5 and 41.6 +/- 13.5 years, respectively. Laparoscopic nephrectomy was performed in 6 donors. The immunosuppressive regimen consisted of three drugs associated with induction therapy using anti-interleukin-2 receptor monoclonal antibody. RESULTS: The 33 donors are in good health at follow-up. Four developed major intra- or postoperative hemorrhage necessitating transfusion, with a surgical re-exploration in 1 donor. Wound infection occurred in 2 donors. Posttransplant recipient and graft survivals at 1 versus 3 years were 82% and 73% versus 82% and 65%, respectively. Eight recipients presented 13 biopsy-proven acute rejection episodes that were reversible in 7, but 1 patient lost his graft due to an irreversible rejection. Two recipients developed cancer. CONCLUSIONS: These initial results have encouraged us to continue the program of renal transplantation from living-related donors. However, they also pointed out the need to develop other donor sources. [less ▲]

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See detailContribution of donors after cardiac death to the deceased donor pool: 2002 to 2009 university of liege experience.
Ledinh, H.; Meurisse, Nicolas ULg; Delbouille, Michèle ULg et al

in Transplantation Proceedings (2010), 42(10), 4369-72

OBJECTIVE: In this study, we have evaluated the organ procurement and transplantation activity from donors after cardiac death (DCD) at our institution over an 8-year period. Our aim was to determine ... [more ▼]

OBJECTIVE: In this study, we have evaluated the organ procurement and transplantation activity from donors after cardiac death (DCD) at our institution over an 8-year period. Our aim was to determine whether this program influenced transplantation programs, or donation after brain death (DBD) activity. METHODS: We prospectively collected our procurement and transplantation statistics in a database for retrospective review. RESULTS: We observed an increasing trend in potential and actual DCD number. The mean conversion rate turning potential into effective donors was 58.1%. DCD accounted for 16.6% of the deceased donor (DD) pool over 8 years. The mean age for effective DCD donors was 53.9 years (range, 3-79). Among the effective donors, 63.3% (n = 31) came from the transplant center and 36.7% (n = 18) were referred from collaborative hospitals. All donors were Maastricht III category. The number of kidney and liver transplants using DCD sources tended to increase. DCD kidney transplants represented 10.8% of the DD kidney pool and DCD liver transplants made up 13.9% of the DD liver pool over 8 years. The DBD program activity increased in the same time period. In 2009, 17 DCD and 33 DBD procurements were performed in a region with a little >1 million inhabitants. CONCLUSION: The establishment of a DCD program in our institution enlarged the donor pool and did not compromise the development of the DBD program. In our experience, DCD are a valuable source for abdominal organ transplantation. [less ▲]

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See detailResults of kidney transplantation from donors after cardiac death.
Ledinh, H.; Bonvoisin, Catherine ULg; Weekers, Laurent ULg et al

in Transplantation Proceedings (2010), 42(7), 2407-14

Confronting the organ donor shortage, many transplant centers around the world increasingly use donors after cardiac death (DCD). Over the past 20 years, follow-up studies in kidney recipients comparing ... [more ▼]

Confronting the organ donor shortage, many transplant centers around the world increasingly use donors after cardiac death (DCD). Over the past 20 years, follow-up studies in kidney recipients comparing DCD and donors after brain death (DBD) have shown comparable long-term graft function and survival. As a consequence, DCD programs should be continued and expanded, for these donors constitute a potential solution to the imbalance between the numbers of end-stage kidney disease patients on waiting lists versus available kidney grafts. DCD kidneys do not necessarily signify suboptimal grafts; they may merit to be allocated the same as DBD grafts. [less ▲]

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