References of "DETRY, Olivier"
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See detailSuccessful clinical transplantation of hearts donated after circulatory death using normothermic regional perfusion
TCHANA-SATO, Vincent ULiege; LEDOUX, Didier ULiege; DETRY, Olivier ULiege et al

in Journal of Heart and Lung Transplantation (2019), 38(6), 593-598

BACKGROUND: Heart transplantation (HT) from donation after circulatory death (DCD) has yet to achieve wide clinical application despite the encouraging resultsreported recently. In this study we describe ... [more ▼]

BACKGROUND: Heart transplantation (HT) from donation after circulatory death (DCD) has yet to achieve wide clinical application despite the encouraging resultsreported recently. In this study we describe 2 cases of successful adult DCD HT performed at our institution using an original protocol. METHODS: Our local abdominal DCD protocol was updated to allow DCD heart procurement, and was accepted by the institutional ethics committee. The main features of the protocol include: pre-mortem insertion of peripheral venoarterial extracorporeal membrane oxygenation cannulas; thoracoabdominal normothermic regional perfusion (NRP) by clamping the 3 aortic arch vessels to exclude cerebral circu- lation; and in-situ heart resuscitation. The retrieved hearts were directly transplanted into recipients located in an adjoining operating room. RESULTS: The procurement warm ischemic time was 25 minutes for the first donor, and 26 minutes for the second donor. The cold ischemic time was 16 minutes for the first recipient and 17 minutes for the second recipient. The suture time was 30 minutes for the first recipient, and 53 minutes for the second recipient. Both recipients were easily weaned off cardiopulmonary bypass in sinus rhythm and inotro- pic support. Post-operative evaluation of cardiac function was excellent and the patients were subse- quently discharged home. CONCLUSIONS: Transplantation of hearts from DCD donors is now a clinical reality.NRP is a useful tool for resuscitation, reperfusion, and preservation of transplanted hearts. It also offers the opportunity to assess the function and viability of organs before transplantation. However,due to ethical issues, some may object to ante-mortem intervention. [less ▲]

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See detailClinical outcomes of DCD type V liver transplantation: donation after euthanasia
van Reeven, M; Monbaliu, D; van Leeuwen, Olivier et al

Conference (2019, May 16)

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See detailSingle center experience in 157 controlled DCD-liver tranplantation
Schielke, Astrid Anita ULiege; Paolucci, M; MEURISSE, Nicolas ULiege et al

Conference (2019, May 16)

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 15-year period. Patients and Methods: 157 DCD-LT were consecutively performed between 2003 and 2017. All donation and procurement procedures were performed as controlled DCD in the operating theatre. Data are presented as median (ranges). Median donor age was 57 years (16-83). Median DRI was 2.242 (1.322-3.554). Allocation was centre-based. Median recipient MELD score at LT was 15 (6-40). Mean follow-up was 37 months. No patient was lost to follow-up. Results: Median total DCD warm ischemia was 19 min (7-39). Median total ischemia was 313 min (181-586). Patient survivals were 89.8%, 75.5% and 73.1% at 1,3 and 5 years, respectively. Graft survivals were 89%, 73.8% and 69.8% at 1,3 and 5 years, respectively. Biliary complications included mainly anastomotic strictures, that were managed either by endoscopy or hepatico- jejunostomy. Two patients were retransplanted due to intrahepatic ischemic lesions. Conclusion: In this series, DCD LT provides 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. [less ▲]

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See detailBReLLS, Belgian Prospective Registry on consecutive laparoscopic and open liver surgery: Results of the first 18 months enrollment
Troisi, R; Dhondt, M; DETRY, Olivier ULiege et al

Conference (2019, May 10)

Objectives. The BReLLS (Belgian Registry on Laparoscopic Liver Surgery) project is a prospective, non-compulsory, online registry of laparoscopic (LLS) and open (OLS) liver procedures, endorsed by the ... [more ▼]

Objectives. The BReLLS (Belgian Registry on Laparoscopic Liver Surgery) project is a prospective, non-compulsory, online registry of laparoscopic (LLS) and open (OLS) liver procedures, endorsed by the Belgian Section of Hepato-Biliary and Pancreatic Surgery in 2016. The primary aim is to monitor the evolution and spreading of LLS in Belgium. The secondary aim is to evaluate the cost/benefit ratio of LLS in order to allow appropriate reimbursement. Methods. The BReLLS is accessible through a secured SSL server (www.brells.org). Participating centers prospectively record pre-operative, intra-operative and postoperative (90-day morbidity and follow-up) data of all consecutive LLS and OLS. Statistics are generated real-time and are available to each participating center. An audit is planned after the first 2-years of patients enrollment with early oncological follow-up. Results. From February 2017 to October 2018, 12 centers have joint the BReLLS reporting data of 630 procedures (390 LLS and 240 OLS). Indication for LLS were colorectal metastases (46.4%), hepatocellular-carcinoma (17.2%), benign diseases (17%), other metastases (14.1%) and mixed various pathologies (5.3%). LLS encompassed major hepatectomies (16.5%), sectionectomies (14.1%), mono or bi-segmentectomies (20.3%) and sub-segmentectomies (49.1%). LLS were converted to OLS in 4.1% of cases. Overall morbidity was 9.7% for LLS and 29.7% for OLS (p=.0001). Major morbidity (Clavien-Dindo ≥ IIIb) occurred in 1.5% and 5.8% of LLS and OLS (p=.004). 90-days mortality following LLS was nihil vs 1.6% (n=4) for OLS (p=.027). Conclusions. LLS are wide spreading in Belgium. In selected patients, LLS are safe, advantageous and reproducible in major HPB centers. A low morbidity has been prospectively confirmed. Further (ongoing) evaluation will focus on the selection criteria for patients undergoing LLS eventually defining the limits of the minimally invasive approach for malignant diseases. [less ▲]

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See detailEarly listeriosis after liver transplantation: report of two cases
Piette, E; VANDERMEULEN, Morgan ULiege; MEURISSE, Nicolas ULiege et al

in Transplant Infectious Disease (2019)

Listeria monocytogenes is a rare cause of potentially lethal infection and sepsis in transplant recipients. Listeriosis is usually described after kidney or bone marrow transplant, and has been less ... [more ▼]

Listeria monocytogenes is a rare cause of potentially lethal infection and sepsis in transplant recipients. Listeriosis is usually described after kidney or bone marrow transplant, and has been less frequently reported after liver transplantation. Here, the authors present two cases of severe Listeria infection occurring within four months after complicated liver transplantation in patients still recovering on the ward. The patients were successfully treated by intravenous ampicillin. These cases should remind transplant physicians that listeriosis may develop in liver transplant recipients, that food safety advice should be provided, and that intravenous ampicillin might be an effective treatment for systemic listeriosis in solid organ recipients. It is likely that trimethoprim-sulfamethoxazole prophylaxis might help prevent early listeriosis after solid organ transplantation. [less ▲]

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See detailBook review: Hernia Surgery
DETRY, Olivier ULiege

in Acta Chirurgica Belgica (2019), 119(3), 207

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See detailValidation d’un score pré-opératoire prédisant la survie à long terme du cholangiocarcinome intra-hépatique réséqué : étude de cohorte multicentrique internationale
Brustia, R; Serena, L; Kawai, T et al

Poster (2019, March 23)

IntroductionRécemment, un score pré-opératoire en 5 classes (SCORE_CCIH) capable de prédire le taux de survie à 5 ans après hépatectomie pour cholangiocarcinome intrahépatique (CCIH) et derivé d'une ... [more ▼]

IntroductionRécemment, un score pré-opératoire en 5 classes (SCORE_CCIH) capable de prédire le taux de survie à 5 ans après hépatectomie pour cholangiocarcinome intrahépatique (CCIH) et derivé d'une cohorte internationale de 250 malades, a été proposé (1). Le but de ce travail était de valider ce score sur une cohorte externe afin qu’il soit utilisé en pratique clinique. Patients et Methodes Tous les malades opérés d’un CCIH depuis 2001 dans 9 centres internationaux ont été inclus. Les données minimales du SCORE-CCIH étaient : albumine, leucocytes/neutrophiles, CA19-9 et diamètre tumoral pré-opératoire. Le critère de jugement principal était la précision de discrimination du SCORE_CCIH par l’aire sous la courbe ROC. Une analyse de survie et un modèle de COX ont été réalisés pour déterminer les facteurs prédictifs indépendants de mortalité. Résultats Parmi 330 patients inclus, la survie moyenne était de 64±4 mois. La précision de discrimination du SCORE_CCIH (AUROC) sur la survie était de 0,63 (95%CI:0,57-0,69) (fig.1). Le taux de survie à 5 ans observée était de 35,2%, 29,5%, 15,2%, 15,7% et 0% en fonction des classes (fig.2). Après ajustement dans le modèle de Cox, les variables significativement prédictives de mortalité étaient le taux d’albumine (HR:0,671, IC95%:0,461-0,976 p=0,04), le rapport leucocytes/neutrophiles (HR: 1,091, IC95%:1,012- 1,176 p=0,02) et le taux de CA19-9 (HR :1, IC95%:1-1, p=0,015). Discussion La précision du CCIH_SCORE sur la discrimination de la survie à long terme est modérée. Les prédicteurs indépendants associés à la mortalité étaient albumine, leucocytes/neutrophiles, CA19-9 mais pas le diamètre tumoral. Conclusion Le SCORE_CCIH peut etre consideré en pratique clinique comme aide à la décision en cas de malades complexes. [less ▲]

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See detailHeart donation after circulatory death
LEDOUX, Didier ULiege; MASSION, Paul ULiege; HANS, Grégory ULiege et al

Conference (2019, March 14)

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See detailA single center experience with 157 controlled DCD liver transplantation
Schielke, Astrid Anita ULiege; Paolucci, M; MEURISSE, Nicolas ULiege et al

Conference (2019, March 14)

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 15-year period. Patients and Methods: 157 DCD-LT were consecutively performed between 2003 and 2017. All donation and procurement procedures were performed as controlled DCD in the operating theatre. Data are presented as median (ranges). Median donor age was 57 years (16-83). Median DRI was 2.242 (1.322-3.554). Allocation was centre-based. Median recipient MELD score at LT was 15 (6-40). Mean follow-up was 37 months. No patient was lost to follow-up. Results: Median total DCD warm ischemia was 19 min (7-39). Median total ischemia was 313 min (181-586). Patient survivals were 89.8%, 75.5% and 73.1% at 1,3 and 5 years, respectively. Graft survivals were 89%, 73.8% and 69.8% at 1,3 and 5 years, respectively. Biliary complications included mainly anastomotic strictures, that were managed either by endoscopy or hepatico-jejunostomy. Two patients were retransplanted due to intrahepatic ischemic lesions. Discussion: In this series, DCD LT provides 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. [less ▲]

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See detailEarly listeriosis after liver transplantation: report of 2 cases
PIETTE, E; VANDERMEULEN, Morgan ULiege; MEURISSE, Nicolas ULiege et al

Poster (2019, March 14)

Listeria monocytogenes is a rare cause of potentially lethal infection and sepsis in transplant patients. Listeriosis is usually described after kidney or bone marrow transplant, and has rarely been ... [more ▼]

Listeria monocytogenes is a rare cause of potentially lethal infection and sepsis in transplant patients. Listeriosis is usually described after kidney or bone marrow transplant, and has rarely been reported after liver transplantation. Here, the authors present two cases of severe Listeria infection occurring within three months after complicated liver transplantation in patients still recovering on the ward. The patients were successfully treated by intravenous ampicillin. These cases should remind transplant physicians that listeriosis may develop in liver recipients, that food safety advice should be provided, and that intravenous ampicillin might be an effective treatment for systemic listeriosis in solid organ recipients. [less ▲]

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See detailMesenchymal stem cells: a future in hepatology and liver transplantation?
DETRY, Olivier ULiege

Conference (2019, February 20)

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See detailOutcome of liver transplantation for hepatopulmonary syndrome: a Eurotransplant experience.
Raevens, Sarah; Rogiers, Xavier; Geerts, Anja et al

in European Respiratory Journal (2019), 53(pii: 1801096), 1-4

Hepatopulmonary syndrome (HPS) is a pulmonary vascular complication of liver disease that affects up to 30% of patients with cirrhosis [1]. Intrapulmonary vascular dilatations and shunts result in gas ... [more ▼]

Hepatopulmonary syndrome (HPS) is a pulmonary vascular complication of liver disease that affects up to 30% of patients with cirrhosis [1]. Intrapulmonary vascular dilatations and shunts result in gas exchange abnormalities, ranging from elevated alveolar–arterial oxygen gradients with no hypoxaemia to very severe hypoxaemia [1, 2]. Currently, liver transplantation (LT) is the only treatment option [3]. The Model for End-Stage Liver Disease (MELD) is a scoring system for assessing liver disease severity that has been validated to predict the 3-month waiting list mortality and is used by Eurotransplant for prioritising allocation of liver transplants [4]. However, this score poorly predicts overall and post-transplant survival, and does not take into account complications that affect outcomes independent of liver disease severity Copyright ©ERS 2019 https://doi.org/10.1183/13993003.01096-2018 Eur Respir J 2019; 53: 1801096 [5]. Hypoxaemia in HPS is generally progressive and mortality is highest in advanced stages [6, 7]. In this sense, a standard exception (SE) policy has been established to prioritise patients with severe HPS (arterial oxygen tension (PaO2) <60 mmHg), as their severity of illness is not properly reflected by the MELD score. In the pre-SE MELD era, FALLON et al. [1] reported that HPS is associated with a doubled risk of mortality compared to patients without HPS. In 2014, GOLDBERG et al. [5] reviewed SE LT outcomes in HPS patients in the USA and found that LT candidates with SE for HPS had decreased pre-transplantation mortality and superior overall survival compared to non-HPS patients. The European outcomes for patients with SE for HPS have never been explored. In this retrospective study, we analysed overall, pre-transplant and post-transplant survival in LT candidates with SE for HPS within Eurotransplant, and determined whether the intent of the exception policy is being met. [less ▲]

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See detailInfusion of third-party mesenchymal stromal cells after kidney transplantation: a phase I-II, open-label, clinical study.
ERPICUM, Pauline ULiege; WEEKERS, Laurent ULiege; DETRY, Olivier ULiege et al

in Kidney International (2019), 95

Mesenchymal stromal cells (MSCs) exhibit anti-inflammatory and immune-regulatory properties, and preclinical studies suggest a potential benefit in solid organ transplantation. We report on the 1-year ... [more ▼]

Mesenchymal stromal cells (MSCs) exhibit anti-inflammatory and immune-regulatory properties, and preclinical studies suggest a potential benefit in solid organ transplantation. We report on the 1-year follow-up of an open-label phase I-II trial of a single infusion of third-party MSC post-kidney transplantation, in addition to standard immunosuppression. Ten kidney transplant recipients from deceased donors received third-party bone marrow MSCs ( approximately 2 x 10(6)/kg) on day 3 +/- 2 post-transplant and were compared to 10 concurrent controls. No adverse effects were noted at MSC injection. One participant with a history of cardiac disease had a non-ST-elevation myocardial infarction approximately 3 hours after MSC infusion. Incidences of opportunistic infections and acute rejection were similar. At day 7 post-transplant, estimated glomerular filtration rate (eGFR) in MSC-treated recipients reached 48.6 ml/min/1.73m(2), compared to 32.5 ml/min/1.73m(2)in controls and 29.3 ml/min/1.73m(2)in our overall cohort of kidney transplant recipients. No difference in eGFR was found at 1 year. MSC-treated recipients showed increased frequencies of regulatory T cells at day 30, with no significant change in B cell frequencies compared to concurrent controls. Four MSC-treated participants developed antibodies against MSC or shared kidney-MSC HLA, with only 1 with MFI >1500. A single infusion of third-party MSC following kidney transplantation appears to be safe, with one cardiac event of unclear relationship to the intervention. MSC therapy is associated with increased regulatory T cell proportion and with improved early allograft function. Long-term effects, including potential immunization against MSC, remain to be studied. [less ▲]

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See detailThe role of FDG PET in detecting rejection after liver transplantation.
Lovinfosse, Pierre; Hustinx, Roland ULiege; Weekers, Laurent et al

in Surgery (2019), 165

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See detailHepatic alveolar echinococcosis.
DETRY, Olivier ULiege; MEURISSE, Nicolas ULiege; Delwaide, Jean ULiege et al

in Acta Chirurgica Belgica (2018), 118(3), 200-201

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See detailA SINGLE CENTER EXPERIENCE WITH 157 CONTROLED DCD-LIVER TRANSPLANTATIONS
Schielke, Astrid Anita ULiege; Paolucci, Maite; MEURISSE, Nicolas ULiege et al

Conference (2018, November 29)

But du travail: Rapporter une expérience monocentrique de 14 ans de transplantation hépatique (TH) à partir de donneurs en mort circulatoire de type III (DMC III) de Maastricht. Méthodes : 157 TH DMC III ... [more ▼]

But du travail: Rapporter une expérience monocentrique de 14 ans de transplantation hépatique (TH) à partir de donneurs en mort circulatoire de type III (DMC III) de Maastricht. Méthodes : 157 TH DMC III ont été réalisées entre 2003 et 2017. Tous les prélèvements ont été réalisés sur des DMC III dont les soins ont été interrompus en salle d’opération. Aucune perfusion normothermique n’a été utilisée dans cette série. Les données sont présentées en médiane et extrêmes. L’âge des donneurs étaient de 57 ans (16-84). L’âge des receveurs était de 60 ans (21-74), avec un score MELD de 15 (6-40). Le suivi était de 37 mois (6-180). Résultats : L’ischémie chaude totale de prélèvement (de l’arrêt du support respiratoire à la perfusion aortique) était de 19 min (7-39). L’ischémie froide était de 237 min (105-576). Le pic d’ASAT était de 978 U/L (67-21.510). La survie des patients et de greffons étaient de 89,8%, 75,5% and 73,1 % et 89%, 73,8% and 69,8%, à 1, 3 et 5 ans, respectivement. La plupart des complications biliaires ont été des sténoses anastomotiques traitées par voie endoscopique, et 2 patients ont été re-transplantés pour des lésions ischémiques intra-hépatiques diffuses. La majorité des décès étaient dus à des causes néoplasiques (récidive de carcinome hépatocellulaire ou tumeur de novo). Conclusions : cette expérience nous encourage à continuer l’utilisation des DMC III pour la TH. Une ischémie froide courte et une sélection des patients avec des MELD peu élevé peut en partie expliquer ces bons résultats. [less ▲]

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See detailValidation d'un score pré-opératoire prédisant la survie à long terme du cholangiocarcinome intrahépatique réséqué: étude de cohorte multicentrique internationale
Brustia, R; Langella, S; Kawai, T et al

Poster (2018, November)

PURPOSE To predict outcome of patients with intrahepatic cholangiocarcinoma (ICC) treated by liver surgery (LS), a preoperative risk score (PRS) could be clinically relevant. External validation on ... [more ▼]

PURPOSE To predict outcome of patients with intrahepatic cholangiocarcinoma (ICC) treated by liver surgery (LS), a preoperative risk score (PRS) could be clinically relevant. External validation on independent datasets is crucial for evaluating accuracy and generalizability of these models. The objective of this study was to externally validate the PRS developed by Sasaki et al. on 250 patients for prediction of long-term outcomes after LS for ICC, and based on preoperative albumin, neutrophil-on-lymphocites-ratio, CA19-9 and tumor size. METHODS Patients treated by LS for ICC from 10 international high-volume HPB centers from 2001 to 2018 were included in the external validation cohort. Harrell’s c-index and a calibration plot were used to test discrimination and calibration performance of PRS. Kaplan–Meier curve for risk groups as described in the original study were displayed. RESULTS A total of 355 patients with 174 deaths during the follow-up period (median=41.7 months, IQR 32.8-50.6) were included in this external-validation cohort. The median PRS value was 14.7 (IQR 10.7 – 20.6), with normal distribution across the cohort. A Cox regression on PRS covariates found coefficients similar to those of the derivation cohort, except for tumor size. Measures of discrimination estimated by Harrell’s c-index was 0.61(95%CI:0.56-0.67). The Kaplan-Meyer estimation showed reasonable discrimination across risk groups, with 5y survival rate ranging from 20.1% to 0%. CONCLUSION In this external validation cohort, the PRS has mild discrimination and poor calibration performance, similarly to the original publication. Nevertheless, given its clinical usefulness, a weak model is better than no model at all. [less ▲]

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See detailGastrointestinal hemorrhage in a liver transplant recipient.
Schielke, Astrid Anita ULiege; Dondelinger, Robert ULiege; MEURISSE, Nicolas ULiege et al

in American Journal of Transplantation (2018), 18(10), 2599-2601

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See detailImages in surgery - Gallstone ileus.
Stiennon, Laurie ULiege; DETRY, Olivier ULiege

in Acta Chirurgica Belgica (2018), 118(3), 200-201

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See detailAlveolar echinococcosis in southern Belgium: retrospective experience of a tertiary center.
Cambier, Audrey ULiege; LEONARD, Philippe ULiege; Losson, Bertrand ULiege et al

in European Journal of Clinical Microbiology and Infectious Diseases (2018), 37(6), 1195-1196

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