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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 detailA comparative, Randomized trial of Concentration-Controlled Sirolimus Combined With Reduced-Dose Tacrolimus or Standard-Dose Tacrolimus in Renal Allograft Recipients
Bechstein, W.O; Paczeck, L; Wramner, L et al

in Transplantation Proceedings (2013), 45

The clinical safety and efficacy of sirolimus plus reduced-dose tacrolimus was evaluated in de novo renal allograft recipients enrolled in a comparative, open-label study. Methods. One hundred twenty ... [more ▼]

The clinical safety and efficacy of sirolimus plus reduced-dose tacrolimus was evaluated in de novo renal allograft recipients enrolled in a comparative, open-label study. Methods. One hundred twenty-eight renal allograft recipients were randomly assigned (1:1) to receive reduced-dose tacrolimus plus sirolimus (rTAC) or standard-dose tacrolimus and sirolimus (sTAC) for 6 months. The primary efficacy endpoint was calculated creatinine clearance values at 6 months. Results. Demographic variables were similar between groups. At 6 months, mean ( standard deviation) calculated creatinine clearance was significantly improved in the rTAC group (63.8 vs 52.7 mL/min, P ¼ .005), although mean serum creatinine values were not significantly different. Patient survival (95.2% and 96.9%) and graft survival (93.7% and 98.5%) were similar between the rTAC and sTAC groups, respectively. Acute rejection rates were 17.5% with rTAC and 7.7% with sTAC (P ¼ .095). Conclusions. The rTAC regimen provided effective immunosuppression and was associated with improved creatinine clearance. Adequate immunosuppressant exposure must be achieved in the early postoperative period to minimize the risk of acute rejection. [less ▲]

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See detailWhat's New in Renal and Pancreatic Transplantation in 2011?
WEEKERS, Laurent ULg

in Transplantation Proceedings (2012), 44(9), 27842786

At the 11th meeting of the SFT Congress in Montpellier, several presentations were devoted to humoral rejection of kidney transplants, new immunosuppressive drugs, cancer after transplantation, and second ... [more ▼]

At the 11th meeting of the SFT Congress in Montpellier, several presentations were devoted to humoral rejection of kidney transplants, new immunosuppressive drugs, cancer after transplantation, and second pancreas transplantations. The main information drawn from these papers is summarized in this brief review. [less ▲]

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See detailCategories of donation after cardiocirculatory death.
DETRY, Olivier ULg; Le Dinh, Hieu ULg; NOTERDAEME, Timothée et al

in Transplantation Proceedings (2012), 44(5), 1189-95

The interest in donation after cardiocirculatory death (DCD) was renewed in the early 1990s, as a means to partially overcome the shortage of donations after brain death. In some European countries and in ... [more ▼]

The interest in donation after cardiocirculatory death (DCD) was renewed in the early 1990s, as a means to partially overcome the shortage of donations after brain death. In some European countries and in the United States, DCD has become an increasingly frequent procedure over the last decade. To improve the results of DCD transplantation, it is important to compare practices, experiences, and results of various teams involved in this field. It is therefore crucial to accurately define the different types of DCD. However, in the literature, various DCD terminologies and classifications have been used, rendering it difficult to compare reported experiences. The authors have presented herein an overview of the various DCD descriptions in the literature, and have proposed an adapted DCD classification to better define the DCD processes, seeking to provide a better tool to compare the results of published reports and to improve current practices. This modified classification may be modified in the future according to ongoing experiences in this field. [less ▲]

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See detailEvolution of Native Kidney Function After Pancreas Transplantation Alone
LE DINH, Hieu; DE ROOVER, Arnaud ULg; COIMBRA MARQUES, Carla ULg et al

in Transplantation Proceedings (2012), 44

Introduction. This study investigated changes in kidney function over time among a cohort of patients undergoing pancreas transplantation alone (PTA) from January 2002 to December 2011. Patients and ... [more ▼]

Introduction. This study investigated changes in kidney function over time among a cohort of patients undergoing pancreas transplantation alone (PTA) from January 2002 to December 2011. Patients and Methods. Ten of eighteen PTA patients bearing functioning grafts for at least 1 year were recruited for the analysis. Primary endpoints were changes in mean serum creatinine (SCr, mg/L) and mean estimated glomerular filtration rate (eGFR) using the 4-variable Levey-MDRD equation (mL/min/1.73 m2) comparing baseline (pretransplantation) to 6-month, 1-year, 3-year, and 5-year posttransplantation values. Mean follow-up time was 75.7 20.5 months (range, 46–106.5). Results. Baseline eGFR was 89.3 27.9 (range, 58–145). eGFR decreased to 75.7 26.2, 71 20.6, 66.5 14.8, and 62.1 11.2 at 6 months, 1, 3, and 5 years representing 15.2%, 20.5%, 15.8%, and 22.6% percentage decreases respectively (P .05 for all pairwise comparisons). The Baseline SCr was 8.6 2.3 mg/L (range, 5–13). SCr progressively increased to 10.1 3, 10.5 3.1, 10.9 3.1, and 11.3 1.7 at 6 months, 1, 3, and 5 years a 17.1%, 22%, 16.6%, and 19.9% increase respectively (P .05 for all pairwise comparisons). One of ten, 2/8, and 3/7 patients displayed an eGFR 60 at transplantation versus 3 and 5 years thereafter, respectively. No patient developed a SCr 25 mg/L or eGFR 30 or needed dialysis or kidney transplantation. Five of ten patients had micro-albuminuria or proteinuria before transplantation. Tacrolimus levels were within recommended therapeutic ranges over time. Conclusion. Kidney function deteriorated significantly after PTA. Understanding of risk factors for the development of renal impairment is important to preserve kidney function and to select appropriate candidates for PTA. [less ▲]

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See detailDelayed graft function does not harm the future of donation-after-cardiac death in kidney transplantation.
Le Dinh, Hieu; WEEKERS, Laurent ULg; BONVOISIN, Catherine ULg et al

in Transplantation Proceedings (2012), 44(9), 2795-802

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 posttransplantation outcomes among grafts from controlled DCD kidneys. PATIENTS AND METHODS: This single-center retrospective study recruited 80 controlled DCD kidneys transplanted from January 2005 to December 2011. Mean patient follow-up was 28.5 months. RESULTS: There were no primary nonfunction grafts; the DGF rate was 35.5%. Overall graft survival rates between groups with versus without DGF were 92.4% and 95.2% at 1 year, 92.4% and 87.1% at 3 years, and 84.7% and 87.1% at 5 years, respectively (P = not significant (NS)). Patients with versus without DGF showed the same survival rates at the corresponding time 92.4% vs 97.2%, 92.4% vs 93.9%, and 84.7% vs 93.9% (P = NS). Estimated glomerular filtration rate was significantly lower in the DGF compared with the non-DGF group at hospital discharge (29 vs 42 mL/min; P = .00) and at 6 months posttransplantation (46 vs 52 mL/min; P = .04), but the difference disappeared thereafter: 47 vs 52 mL/min at 1 year, 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 an acute rejection episode (29.6% vs 30.6%; P = NS) or rate of surgical complications (33.3% vs 26.5%; P = NS). However, DGF prolonged significantly the length of hospitalization in the DGF versus the non- DGF group (18.9 vs 13 days; P = .00). Donor body mass index (BMI) >/= 30 kg/m(2), recipient BMI >/=30 kg/m(2), and pretransplantation dialysis duration increased the risk of DGF upon multivariate logistic regression analysis. CONCLUSIONS: Apart from the longer hospital stay, DGF had no deleterious impact on the future of kidney allografts from controlled DCD, which showed comparable graft and patient survivals, renal function, rejection rates, and surgical complications as a group without DGF. Therefore, DGF should no longer be considered to be a medical barrier to the use of kidney grafts from controlled DCD. [less ▲]

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See detailThe french speaking society of transplantation and "transplantation sans frontières"
SQUIFFLET, Jean-Paul ULg; BARROU, Benoit; GLOTZ, Denis et al

in Transplantation Proceedings (2011), 43

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See detailAttempt to rescue discarded human liver grafts by end ischemic hypothermic oxygenated machine perfusion.
Vekemans, K.; van Pelt, J.; Komuta, M. et al

in Transplantation Proceedings (2011), 43(9), 3455-9

In a porcine liver transplant model, a brief period of oxygenated hypothermic machine perfusion (HMP) at the end of simple cold storage (SCS) has been shown to improve the viability of damaged liver ... [more ▼]

In a porcine liver transplant model, a brief period of oxygenated hypothermic machine perfusion (HMP) at the end of simple cold storage (SCS) has been shown to improve the viability of damaged liver grafts. To test the clinical validity of this strategy, we randomized SCS-discarded human liver grafts to either 4 hours of HMP (n = 13) or an additional 4 hours of SCS (n = 14). All livers were then warm reperfused to mimic ischemia-reperfusion injury ex vivo. The settings for HMP were: portal vein: 3 mm Hg, 300 mL/min and hepatic artery: 20 mm Hg, po(2): 300 mm Hg. Perfusion used Kidney Machine Perfusion Solution at 4 degrees C to 8 degrees C. During warm reperfusion, aspartate aminotransferase (AST) and lactate dehydrogenase (LDH) values were higher (P < .015) among the SCS versus HMP methods at all times. The AST slope was lower in HMP versus SCS (P = .01). The LDH slope tended to be lower for HMP versus SCS (P = .07). Morphological scores were not different between HMP and SCS. At the start of warm reperfusion, MAPK was lower in HMP versus SCS (P = .02). Endothelin-1 (EDN1) and ICAM-1 tended to be lower in HMP versus SCS (P = .1 and .07, respectively). No difference was noted in MAPK, EDN1, and ICAM-1 after 60 or 120 minutes of warm reperfusion. In conclusion, HMP down-regulated MAPK and tended to reduce EDN1 and ICAM-1 mRNA in human liver grafts. During warm reperfusion, HMP versus SCS livers showed reduced AST and LDH release but no morphological difference. Further optimization of liver HMP may require different timing/duration of perfusion and/or an higher perfusion temperature. [less ▲]

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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 detailDonor Advocacy with Special Reference to Belgium
SQUIFFLET, Jean-Paul ULg

in Transplantation Proceedings (2011), 43

Before any published Belgian law, EU Directive, and/or EU Action Plan, the donor <br />advocate was naturally a member of the transplantation team performing living kidney <br />donation. The need of ... [more ▼]

Before any published Belgian law, EU Directive, and/or EU Action Plan, the donor <br />advocate was naturally a member of the transplantation team performing living kidney <br />donation. The need of donor advocacy appeared obvious with liver living donation, which <br />was and is still a risky procedure. Today, it is clear that the donor advocacy must not be <br />limited to living donation but extended to brain-dead and cardiac-dead donation. <br />Nevertheless, its complexity will need experienced persons in the field of organ donation <br />as well as transplantation, while remembering that patients’ first right is the right to donate. [less ▲]

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See detailCurrent Practices of Organ Donation and Transplantation Among Different French-Speaking Countries and Regions
SQUIFFLET, Jean-Paul ULg; Barrou, B.; Rifle, G.

in Transplantation Proceedings (2011), 43

The aim of the “Transplantation Sans Frontières” (TSF) questionnaire, which was sent to <br />French-speaking centers in 6 different countries and regions, was to establish the current <br />status of ... [more ▼]

The aim of the “Transplantation Sans Frontières” (TSF) questionnaire, which was sent to <br />French-speaking centers in 6 different countries and regions, was to establish the current <br />status of organ donation and transplantation in their environments. It was also to examine <br />ways to collaborate and exchange scientific information, teaching, and training in the field <br />of organ transplantation. The French Society of Transplantation and the Agency of <br />Biomedicine already offer specific programs to expand local activities, and the World <br />Health Organization (WHO) regulates them. Therefore, TSF could be a coordinating <br />platform in the near future. [less ▲]

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See detailPancreas Preservation for Pancreas and Islet Transplantation : A Minirevieuw
SQUIFFLET, Jean-Paul ULg; LeDinh, Hieu; DE ROOVER, Arnaud ULg et al

in Transplantation Proceedings (2011), 43

Pancreas preservation by cold storage using University of Wisconsin solution was the <br />mainstay method used for pancreas transplantation during the past 2 decades. Other <br />solutions, such as HTK ... [more ▼]

Pancreas preservation by cold storage using University of Wisconsin solution was the <br />mainstay method used for pancreas transplantation during the past 2 decades. Other <br />solutions, such as HTK, Celsior, and SCOT 15, could not demonstrate any advantage for <br />short preservation periods. But the advent of clinical islet transplantation and the larger <br />use of controlled non–heart-beating donors have prompted the transplantation community <br />to develop methods for increasing pancreas graft quality while preventing ischemic <br />reperfusion damages. Oxygenation by 1- or 2-layer methods during pancreas preservation, <br />as well as the use of perfluorocarbons, might increase the islet yield. Based on the former <br />methods, there is a renewed interest in machine perfusion and oxygenation in pancreas <br />preservation for pancreas transplantation and islet preparation. [less ▲]

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See detailOrgan donation in Belgium 2009: 20% of donation after cardiocirculatory death.
Detry, Olivier ULg; Troisi, Roberto

in Transplantation Proceedings (2010), 42(10), 4365-6

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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 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 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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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 detailBelgium and organ donation: a further increase in organ donation in 2007! Preface to the 15(th) Annual Meeting of the Belgian Transplantation Society.
Detry, Olivier ULg; Donckier, Vincent

in Transplantation Proceedings (2009), 41(2), 565

In 2007, the Belgian annual rate of effective cadaveric organ donors further increased to 28.1 per million inhabitants, up from 26.2% in 2006 (http://www.transplant.be/donor/TxCoord.pdf). In numbers, 541 ... [more ▼]

In 2007, the Belgian annual rate of effective cadaveric organ donors further increased to 28.1 per million inhabitants, up from 26.2% in 2006 (http://www.transplant.be/donor/TxCoord.pdf). In numbers, 541 potential cadaveric organ donors were referred to the different transplant centers, resulting in 291 effective organ donors. The main reason for no organ retrieval was medical contraindications (34% of the total referrals). Family refusals dropped to less than 13%. Mean organ yielding was 3.55 per donation after brain death (DBD) donors and 2.28 per donation after cardiac death (DCD) donors, allowing a retrieval of 97.82 transplantable organs per million inhabitants, one of the highest so far to the best of our knowledge. This high rate of organ donation is certainly linked to the opting-out (or presumed consent) Belgian transplantation law, to the high motivation of the different Belgian transplant programs and intensive care units, to the confidence of the Belgian population in the Belgian medicine, and to the federal and regional political incentives to organ donation, as the Beldonor or the GIFT projects. This high rate of donation, in addition to active programs of living donation in kidney and liver transplantation and to MELD allocation, allowed to a significant decrease in the number of patients on the liver and kidney waiting lists( -34% and -18% in two years, respectively). [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 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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