http://hdl.handle.net/2268/118 Search this channel search http://orbi.ulg.ac.be/simple-search http://hdl.handle.net/2268/148080 Title: Belgian multicentre experience with intestinal transplantation <br/> <br/>Author, co-author: Ceulemans, L; DE ROOVER, Arnaud; DETRY, Olivier; Troisi, R; Rogiers, X; Reding, R; Lerut, J; Ysebaert, D; Chapelle, T; Monbaliu, D; Pirenne, J http://hdl.handle.net/2268/147869 Title: Is ultra-short cold ischemia the key to ischemic cholangiopathy avoidance in DCD-LT? <br/> <br/>Author, co-author: DETRY, Olivier; DE ROOVER, Arnaud; Cheham, S; Ledinh, H; COIMBRA MARQUES, Carla; DECKER, Emmanuel; KOHNEN, Laurent; HANS, Marie-France; JORIS, Jean; LAUWICK, Séverine; KABA, Abdourahmane; DELWAIDE, Jean; MEURISSE, Michel; HONORE, Pierre http://hdl.handle.net/2268/147750 Title: Kidney and Pancreas Transplantation : The history of Surgical Techniques and immunosuppression <br/> <br/>Author, co-author: SQUIFFLET, Jean-Paul <br/> <br/>Abstract: Pancreas Transplantation aims at providing Beta cells replacement in diabetic patients, especially for type 1 diabetes recipients in whom Beta cells had been destroyed by an autoimmune process. The final achievement is to restore a normal physiological control of glucose metabolism in order to halt or reverse the secondary complications of diabetes i.e. retinopathy, neuropathy, nephropathy, micro – and macro - angiopathy [1]. That can be achieved by a vascularised pancreas graft (referred as Pancreas Transplantation, PT) or by islet grafting (referred as Islet Transplantation, IT). The former PT includes transplanting 95% of unuseful cells, the exocrine part from one pancreas, while the last one IP, embolizing into the recipient liver, Islets of Langerhans after digestion and purification of several human pancreases. Three types of PT can be performed: the pancreas and a kidney are simultaneously transplanted with a single induction of immunosuppression (IS) therapy in hoping to correct both uremia and diabetes mellitus (SPK = Simultaneous Pancreas and Kidney Transplantation); the pancreas is transplanted after a successful kidney graft allowing two induction therapies along with the basic IS treatment (PAK = Pancreas After Kidney Transplantation) ; and finally the Pancreas can be transplanted alone in pre-uremic recipients with unawareness hypoglycaemic events or with rapidly evolving secondary complications of diabetes such as proliferative retinopathy, or advanced neuropathy (PTA = Pancreas Transplantation Alone) [1]. Moreover, in SPK, both organs the Pancreas and the Kidney are procured from the same deceased donor, either donor after brain death (DBD) or donor after cardiac death (DCD). In some US institutions, a segmental pancreas and the left kidney, are procured in a living donor [2], using a laparoscopic approach in the more recent year [3]. For PAK, in order to avoid an excessive IS load and two induction therapies, other institutions had proposed whenever possible to keep in stand-by the potential live kidney donor until a cadaver whole pancreatic compatible graft is available [1]. By contrast, the number of PTA remains limited in non uremic recipients with life-threatening complications of diabetes, in whom one might hope to avoid the hypoglycaemic events with a successful graft. That can also be achieved with IT. But except for rare cases, insulin independence with IT requires more than a single human pancreas and is limited over time [1]. Moreover, IT needs costly materials, chambers and rooms for preparation. That’s why IT will not be included in the present report. http://hdl.handle.net/2268/147749 Title: The history of kidney transplantation: Past,Present and Future <br/> <br/>Author, co-author: SQUIFFLET, Jean-Paul <br/> <br/>Abstract: The history of kidney transplantation is thought to have originated at the early beginning of the previous century with several attempts of Xenografting, and experimental works on vascular sutures (Küss & Bourget, 1992)1. But it really started more than 60 years ago with first attempts of deceased donor transplantation (DCD) and the first successful kidney transplantation of homozygote twins in Boston (Toledo-Pereyra et al, 2008)2. Belgian surgeons contributed to that field of medicine by performing in the early sixties the first ever organ procurement on a brain dead heart beating donor (DBD) (June 1963) (Squifflet, 2003)3. Later on, in the eighties, they published a first series of living unrelated donor (LURD) transplantations, as well as ABO-Incompatible living donor (ABO-Inc LD) transplantations. With the advent of Cyclosporine A, and later other calcineurin inhibitors such as Tacrolimus, with the advent of more potent immunosuppressive drugs (IS), the gap between the number of renal transplant candidates and the number of transplanted recipients was and is continuously increasing in Belgium and most countries. It opened the search for other sources of organs such as donors after cardiac death (DCD) defined with the Maastricht conference and the extended criteria donors (ECD) compared to standard criteria donors (SCD). In Belgium another source of DCD was identified after the promulgation in 2002 of a law on euthanasia. The Belgian example and all its historical measures could help others to fight against organ shortage and its consequences, organ trafficking, commercialization and tourism. http://hdl.handle.net/2268/147695 Title: Chirurgie et cancer en 2013 <br/> <br/>Author, co-author: DETRY, Olivier http://hdl.handle.net/2268/147680 Title: Retrospective analysis of Belgian experience with intestinal transplantation <br/> <br/>Author, co-author: Ceulemans, L.J.; DE ROOVER, Arnaud; DETRY, Olivier; Troisi, R; Rogiers, X; Reding, R; Lerut, J; Ysebaert, D; Chapelle, T; Monbaliu, D; Pirenne, J <br/> <br/>Abstract: Aim: The only alternative to Total Parenteral Nutrition (TPN) for complicated intestinal failure is Intesti- nal Transplantation (ITx) which is perceived as a high-risk procedure with inferior results compared to other organ Tx. Therefore ITx has been rarely applied in Belgium. In a multicenter retrospective review, we analyzed the overall Belgian experience with ITx. Methods: The Belgium Liver Intestine Committee organized a survey among all Belgian Tx centers, based on the patient-specific data form of the international ITx registry. Overall activity and indications were reviewed. Patient/graft survival was calculated (Kaplan-Meier). Nutritional (TPN) independence and Quality of Life (QoL) (Karnofsky score) were analyzed. Results: 21 ITx were performed in 20 patients (03/99-11/12), distributed among 5 centers: KUL (12), ULg (5), UZG (2), UCL (1), UZA (1). Median age was 38y(8mo-56y). Male/female ratio was 10/10. 5 were pediatrics (<18y) and 15 adults. Indications were anatomical or functional short bowel syndrome: intestinal ischemia(5), volvulus(5), Crohn(2), chronic intestinal pseudo-obstruction(2), splanchnic thrombosis(2), Churg-Strauss(1), necrotizing enterocolitis(1), microvillus inclusion(1), intestinal atresia(1) and chronic rejection of a first ITx(1). Most patients also suffered from TPN-associated com- plications (infection/shortage of venous access or liver failure). An isolated small bowel was trans- planted in 9 patients (plus kidney Tx in 2; plus pancreas Tx in 1); 10 received a combined liver and ITx; 2 received a multivisceral Tx. At time of Tx, 11 patients were hospitalized and 10 at home. 20 grafts were procured from deceased donors; one segmental intestinal graft was procured from a living donor. ABO blood group was identical in 63%, compatible in 37%. Median cold ischemia time was 5h30 ́(3h17 ́-9h31 ́). All patients received tacrolimus-based immunosuppression. Basiliximab (anti-IL2 receptor antibody) induction was administered in 16 patients. In 11 patients donor specific blood was transfused as part of an immunomodulatory protocol. 5-year patient and graft survival is 59% and 55.6%, respectively. 8 patients died: 6 to sepsis, 1 to intracerebral hemorrhage; 1 sudden death re- mained unexplained. 1 patient developed postTx lymphoma. 2 chronic rejections occured for which one reTx was performed. Of 12 survivors (median follow-up 1870 days), 11 are nutritionally independent (TPN-free) and 10 have a Karnofsky score >90%. Conclusions: ITx has come of age in Belgium. During the last 13 years, 21 ITx were performed in 5 centers. A 5-year patient/graft survival of 59%/55.6% is achieved, which is similar to results reported by the International ITx registry. In Belgium, awareness should grow that ITx represents a life-saving (and QoL improving) treatment in selected patients with reduced life expectancy due to significant complica- tions from TPN and intestinal failure. http://hdl.handle.net/2268/147580 Title: L'équilibre sagittal dans la pathologie rachidienne. <br/> <br/>Author, co-author: RACARU, Tudor; MARTIN, Didier http://hdl.handle.net/2268/147579 Title: La fatigue motrice et ses implications dans les pathologies du système nerveux <br/> <br/>Author, co-author: PHAN BA, Remy; MARTIN, Didier http://hdl.handle.net/2268/147578 Title: Malformations vasculaires du système nerveux central : que faire quand on en trouve ? <br/> <br/>Author, co-author: SCHOLTES, Félix; MARTIN, Didier http://hdl.handle.net/2268/147577 Title: Signification évolutive du sommeil <br/> <br/>Author, co-author: Poirrier, Robert; MARTIN, Didier http://hdl.handle.net/2268/147574 Title: Merkel cell carcinoma of the central nervous system. Case report and review of the literature. <br/> <br/>Author, co-author: DE MARNEFFE, Mikaël; DUBUISSON, Annie; MARTIN, Didier http://hdl.handle.net/2268/147572 Title: Glioblastoma metastases:case report and literature review <br/> <br/>Author, co-author: REUTER, Gilles; Lombard, Arnaud; SCHOLTES, Félix; Martin, Didier http://hdl.handle.net/2268/147571 Title: Spinal paraganglioma: case report and review of the literature. <br/> <br/>Author, co-author: HENROTEAUX, Adrienne; SALADO, Anne-Laure; LENELLE, Jacques; MARTIN, Didier http://hdl.handle.net/2268/147464 Title: Epargne sanguine en chirurgie cardiaque : Etude rétrospective des pratiques <br/> <br/>Author, co-author: ERPICUM, Marie; DEFRAIGNE, Jean; LARBUISSON, Robert <br/> <br/>Abstract: Cette étude rétrospective s’inscrit dans le cadre des recherches de la thèse de doctorat sur l’épargne sanguine à travers l’itinéraire clinique du patient opéré cardiaque. Son objectif est de dresser un état des lieux de la prise en charge des patients opérés cardiaques au CHU de Liège, des pratiques d’épargne sanguine qui y sont employées et de leur impact sur le recours à la transfusion, les durées de séjour et la mortalité. Cet audit devrait permettre de 1) mettre en évidence les éléments pouvant être améliorés dans l’organisation actuelle de la prise en charge de ces patients afin de concourir aux objectifs d’épargne sanguine 2) servir de base à l’élaboration d’un itinéraire clinique du patient opéré cardiaque. http://hdl.handle.net/2268/146772 Title: Utilisation du système CardioPAT® en postopératoire de chirurgie cardiaque <br/> <br/>Author, co-author: ERPICUM, Marie; FLECHE, Jérôme; SENARD, Marc; LARBUISSON, Robert; DEFRAIGNE, Jean http://hdl.handle.net/2268/144879 Title: CPB AND AORTIC SURGERY: From a Theoritical to a Practical Approach <br/> <br/>Author, co-author: LAGNY, Marc-Gilbert; BLAFFART, Francine <br/> <br/>Abstract: Background Despite recent improvements in prevention, medical treatment [1]and endovascular aortic repair , invasive surgery associated with cardiopulmonary bypass (CPB) remains the best option of treatment for some patients. The aim of this study is to make a review of the specific CPB protocols associated with these invasive surgical approaches, based on our clinical experience and according to the recent literature. Up to now, these protocols are not supported by evidence based in medicine (EBM) [2] or in perfusion (EBP). Discrepancies can be observed regarding target temperature , selective cerebral protection , CPB circuit concept and arterial cannulation sites . Variables guidelines are suggested concerning regional flow , transfusion requirements [3], coagulation monitoring blood gas management[4] as for cerebral and CPB monitoring tools. Conclusions In the absence of EBM and EBP in the aortic surgery field, the short and long terms clinical outcomes of the patients elected to invasive surgery for aortic diseases must guide and substantiate our choices of techniques and of CPB protocols. http://hdl.handle.net/2268/144494 Title: What is the potential increase in the heart graft pool by cardiac donation after circulatory death? <br/> <br/>Author, co-author: Noterdaeme, Timothée; HANS, Marie-France; NELLESSEN, Eric; LEDOUX, Didier; JORIS, Jean; MEURISSE, Michel; Defraigne, Jean-Olivier; DETRY, Olivier http://hdl.handle.net/2268/144493 Title: Is ultra-short cold ischemia the key to IBDL avoidance in DCD-LT? <br/> <br/>Author, co-author: DETRY, Olivier; DE ROOVER, Arnaud; Ledinh, Hieu; HANS, Marie-France; LAUWICK, Séverine; MEURISSE, Michel; DELWAIDE, Jean; HONORE, Pierre http://hdl.handle.net/2268/144492 Title: Delayed graft function (DGF) does not harm the results of controlled donation-after-cardiovascular death (DCD) in kidney transplantation. <br/> <br/>Author, co-author: Ledinh, Hieu; WEEKERS, Laurent; BONVOISIN, Catherine; KRZESINSKI, Jean-Marie; MONARD, Josée; DE ROOVER, Arnaud; SQUIFFLET, Jean-Paul; MEURISSE, Michel; DETRY, Olivier http://hdl.handle.net/2268/144491 Title: Do Maastricht category III donation after cardiovascular death (DCD) donors experience end-of-life shortening? <br/> <br/>Author, co-author: LEDOUX, Didier; DELBOUILLE, Marie-Hélène; DE ROOVER, Arnaud; LAMBERMONT, Bernard; MEURISSE, Michel; DAMAS, Pierre; JORIS, Jean; DETRY, Olivier