References of "Joris, Jean"
     in
Bookmark and Share    
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 17 (5 ULiège)
Full Text
Peer Reviewed
See detailHeart donation after circulatory death
LEDOUX, Didier ULiege; MASSION, Paul ULiege; HANS, Grégory ULiege et al

Conference (2019, March 14)

Detailed reference viewed: 38 (14 ULiège)
Peer Reviewed
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 ▲]

Detailed reference viewed: 33 (7 ULiège)
Full Text
Peer Reviewed
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 ▲]

Detailed reference viewed: 27 (9 ULiège)
Full Text
Peer Reviewed
See detailLiver transplantation in Jehovah’s Witnesses: a single center-experience
VANDERMEULEN, Morgan ULiege; MEURISSE, Nicolas ULiege; DAMAS, Pierre ULiege et al

Conference (2018, March 15)

For religious reasons most of the Jehovah's witnesses (JW) refuse infusions of any blood product, including autologous or homologous pre-donated blood, platelets, fresh frozen plasma. However, they may ... [more ▼]

For religious reasons most of the Jehovah's witnesses (JW) refuse infusions of any blood product, including autologous or homologous pre-donated blood, platelets, fresh frozen plasma. However, they may accept solid organ transplantation. The authors report their experience of liver transplantation (LT) in JW over a 20-year period. [less ▲]

Detailed reference viewed: 64 (20 ULiège)
Full Text
Peer Reviewed
See detailLiver transplantation in Jehovah's witnesses
VANDERMEULEN, Morgan ULiege; MEURISSE, Nicolas ULiege; DAMAS, Pierre ULiege et al

in Acta Gastro-Enterologica Belgica (2018, January), 81(1), 30

Introduction: Liver transplantation (LT) is a major surgical procedure with large dissections and sutures of large vessels in patients with high portal hypertension and low levels of platelets and ... [more ▼]

Introduction: Liver transplantation (LT) is a major surgical procedure with large dissections and sutures of large vessels in patients with high portal hypertension and low levels of platelets and coagulation factors. In consequence, LT often requires large amounts of blood products. For religious reasons, most Jehovah's witnesses (JW) refuse infusions of any blood product, including autologous or homologous pre-donated blood, platelets, fresh frozen plasma, coagulation factor concentrates, or human albumin. However, they may accept solid organ transplantation, including LT. Aim: The authors developed experience in abdominal and oncological surgery in JW and present here their results with LT in JW patients. Methods: Over a 20-year period, 22 LT (16 DBD, 2DCD, and 4 LRLT with JW living donors) were performed in 21 JW patients and were analyzed retrospectively. All patients received perioperative iron supplementation and erythropoietin. Two patients had percutaneous spleen embolization to increase platelet level. Anti-fibrinolytic (aprotinin or tranexamic acid) was administrated during LT and meticulous surgical hemostasis was achieved, helped by argon beam coagulation. Continuous circuit cell salvage and reinfusion whereby scavenged blood was maintained in continuity with the patient's circulation, was used in all patients. Veno-venous bypass was avoided during LT to minimize the coagulation disorders. Results: There were 10 male and 11 female patients whose mean age was 48 years (ranges: 6-70). Indications for LT were HCV with (3) or without (1) HCC, PBC (2), PSC (1), HBV (2), autoimmune hepatitis (1), antitrypsin deficiency (1), sarcoidosis (2), amyloidosis (3), polycystic liver disease (1), alcoholic cirrhosis with HCC (1), cryptogenic (3), hepatic artery thrombosis (1). At transplant, mean pre-operative hematocrit was 41% (ranges: 22-50), mean platelet level was 140x103/mm3 (ranges: 33-355), and mean INR was 1.25 (ranges: 0.84- 2.18).One LRLT recipient died at day 11 from aspergillosis and anemia, and another DBD recipient at day 28 due to complications after hepatic artery thrombosis. One patient finally accepted to be transfused for severe anemia. The mean hospital stay was 31 days (10-137). Kaplan-Maier patient survival was 85%, 72%, 72% at 5, 10 and 15 years, respectively Conclusions: According to the authors' experience, LT may be successful in selected and prepared JW patients who should not be a priori excluded from this life saving procedure. The indications for LT in JW were quite different from the common indications for LT, with a low rate of alcoholic cirrhosis. The experience with this particular group of patients helped the team to reduce transfusion needs in the non-JW patients. [less ▲]

Detailed reference viewed: 36 (6 ULiège)
Full Text
Peer Reviewed
See detailIntravenous infusion of lidocaine significantly reduces propofol dose for colonoscopy: a randomised placebo-controlled study
Forster, C.; VANHAUDENHUYSE, Audrey ULiege; GAST, Pierrette ULiege et al

in British Journal of Anaesthesia (2018), 121(5), 1059-1064

Background: Propofol use during sedation for colonoscopy can result in cardiopulmonary complications. Intravenous lidocaine can alleviate visceral pain and decrease propofol requirements during surgery ... [more ▼]

Background: Propofol use during sedation for colonoscopy can result in cardiopulmonary complications. Intravenous lidocaine can alleviate visceral pain and decrease propofol requirements during surgery. We tested the hypothesis that i.v. lidocaine reduces propofol requirements during colonoscopy and improves post-colonoscopy recovery. Methods: Forty patients undergoing colonoscopy were included in this randomised placebo-controlled study. After titration of propofol to produce unconsciousness, patients were given i.v. lidocaine (1.5 mg kg−1 then 4 mg kg−1 h−1) or the same volume of saline. Sedation was standardised and combined propofol and ketamine. The primary endpoint was propofol requirements. Secondary endpoints were: number of oxygen desaturation episodes, endoscopists’ working conditions, discharge time to the recovery room, post-colonoscopy pain, fatigue. Results: Lidocaine infusion resulted in a significant reduction in propofol requirements: 58 (47) vs 121 (109) mg (P=0.02). Doses of ketamine were similar in the two groups: 19 (2) vs 20 (3) mg in the lidocaine and saline groups, respectively. Number of episodes of oxygen desaturation, endoscopists’ comfort, and times for discharge to the recovery room were similar in both groups. Post-colonoscopy pain (P<0.01) and fatigue (P=0.03) were significantly lower in the lidocaine group. Conclusions: Intravenous infusion of lidocaine resulted in a 50% reduction in propofol dose requirements during colonoscopy. Immediate post-colonoscopy pain and fatigue were also improved by lidocaine. Clinical trial registration: NCT 02784860. © 2018 British Journal of Anaesthesia [less ▲]

Detailed reference viewed: 54 (11 ULiège)
Full Text
Peer Reviewed
See detailSurgical factors and not donor type per se are risk factors for acute kidney injury after liver transplantation
MEURISSE, Nicolas ULiege; Smet, Heloise ULiege; LEDOUX, Didier ULiege et al

in Transplant International (2017, September), 30(S2), 106-107298

Background: Because Liver Transplantation (LT) using DCD has been shown to be risk factor for Acute Kidney Injury (AKI), we reviewed results at our center. Patients and Methods: AKI was defined as ... [more ▼]

Background: Because Liver Transplantation (LT) using DCD has been shown to be risk factor for Acute Kidney Injury (AKI), we reviewed results at our center. Patients and Methods: AKI was defined as decrease >50% eGFR (CKD- EPI) within 48 h postreperfusion (RIFLE). 106 first LT-only [63 DBD (59%) & 43 DCD (41%)] without pre-existing renal dysfunction (eGFR>60 ml/min/1,73 m2, no renal replacement therapy) were performed from 2012 to 2016. Incidence/ risk factors for AKI were assessed. Data: mean (IQR). Results: Incidence of AKI was 33% (35/106). AKI-patients were more hospitalized before LT [9/16 (56%) vs 26/89 (29%), p < 0.01], with higher labMELD [16 (10–23) vs 12 (8–16), p = 0.01]. Donor type [11/43 DCD (25%) vs 24/63 DBD (39%), p = 0.16], donor hepatectomy time [38 min (26–50) vs 35 (25–42), p = 0.37], cold ischemic time [6 h (4.1–7.6) vs 5.1 (3.4–6.4), p = 0.21], time for anastomosis [44 min (35–49) vs 42 (38–48), p = 0.53], postreperfusion syndrome [19/46 (42%) vs 27/46 (58%), p = 0.07] were similar between AKI & non-AKI groups. AKI was more frequent if lungs were procured first in the donor [23/48 (48%) vs 11/56 (19%), p < 0.01]. Recipient surgery was longer in the AKI group [5.2 h (3.9–6.3) vs 4.3 (3.4–4.8), p < 0.01]. AKI was more frequent if platelets were transfused during LT [19/42 (56%) vs 15/59 (44%), p = 0.03]. Blood volume administrated from the cellsaver was larger in the AKI-patients [834 ml (300–750) vs 408 (0–550), p = 0.03]. AKI-patients have a higher peak AST [1235 U/L (310–1858) vs 812 (429–978), p = 0.04]. Haemoglobin [8.8 g/dl (7.4–9.9) vs 10 (8.5–11.7)] & platelets [69x103 (50 9 103–87 9 103) vs 89 9 103 (50 9 103–118 9 103)] at day 1 postreperfusion were significantly lower if AKI occurred. After multivariable analysis, thoracic procurement before liver [OR 5.75 (1.76–18.77), p = 0.004] & recipient surgery duration [OR 1.64 (1.15–2.32), p = 0.006] were only risk factors for AKI. Conclusion: Rapid donor/recipient surgery and not donor type are key factors to prevent AKI-post-LT. [less ▲]

Detailed reference viewed: 71 (8 ULiège)
Full Text
Peer Reviewed
See detailUne série consécutive de 125 greffes hépatiques à partir de donneurs cadavériques en mort circulatoire
DETRY, Olivier ULiege; MEURISSE, Nicolas ULiege; HANS, Marie-France ULiege et al

in Transplant International (2017, January), 30(Suppl 1), 2481

Introduction: Donation after circulatory death (DCD) has 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) has 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 14-year period. Patients and Methods: 125 DCD-LT were consecutively performed between 2003 and 2016. All donation and procurement procedures were performed as controlled DCD in operative rooms. Data are presented as median (ranges). Median donor age was 56 years (16–84). Most grafts were flushed with HTK solution in the first part of experience, and more recently with IGL1. Allocation was centre-based. Median follow-up was 52 (1–164) months. No patient was lost to follow-up. Results: Median total DCD warm ischemia was 19 min (9–39). Median cold ischemia was 238 min (105–576). Patient survivals were 90.2%, 77.5% and 74.5 % at 1.3 and 5 years, respectively. Graft survivals were 87.7%, 76.3% and 73.2% at 1.3 and 5 years, respectively. Biliary complications included anas- tomotic strictures and extrahepatic main bile duct ischemic obstruction, that were managed either by endoscopy or hepatico-jejunostomy. No PNF was observed in this series and one graft was lost due to ischemic cholangiopathy. 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. [less ▲]

Detailed reference viewed: 71 (23 ULiège)
Full Text
Peer Reviewed
See detailSevoflurane modulates the release of reactive oxygen species, myeloperoxidase, and elastase in human whole blood: Effects of different stimuli on neutrophil response to volatile anesthetic in vitro
MINGUET, Grégory ULiege; Franck, Thierry ULiege; JORIS, Jean ULiege et al

in International Journal of Immunopathology and Pharmacology (2017), 30(4), 362-370

Volatile anesthetics have been shown to modulate polymorphonuclear neutrophil (PMN) functions. The aim of this study was to examine the impact of clinically relevant concentrations of sevoflurane (SEVO ... [more ▼]

Volatile anesthetics have been shown to modulate polymorphonuclear neutrophil (PMN) functions. The aim of this study was to examine the impact of clinically relevant concentrations of sevoflurane (SEVO), a volatile anesthetic, on the release of reactive oxygen species (ROS), myeloperoxidase (MPO), and elastase (EL) from human activated PMNs. For this purpose, samples of whole blood were collected from healthy volunteers and exposed in vitro to 2.3% or 4.6% SEVO in air. To assess for a stimulus-dependent effect of the volatile anesthetic, PMNs were activated using different validated protocols. Artificial stimulation of neutrophils involved either a combination of cytochalasin B (CB) and N-formyl-methionyl-leucyl-phenylalanine (fMLP) or phorbol 12-myristate 13-acetate (PMA). In addition, a combination of lipopolysaccharide (LPS) and tumor necrosis factor alpha (TNF-α) was also tested as a natural activation mean of PMNs. The production of ROS by PMNs was assessed by L-012 chemiluminescence. Total MPO and EL released in supernatant were measured by enzyme-linked immunosorbent assay (ELISA). Furthermore, degranulation of the active fraction of MPO was also measured by specific immunological extraction followed by enzymatic detection (SIEFED). Overall, SEVO enhanced the release of ROS, MPO, and EL following artificial stimulation of PMNs but the volatile anesthetic inhibited the degranulation of active MPO and EL after neutrophil exposure to LPS and TNF-α. This study highlighted that the effect of SEVO on activated PMNs is dependent on the conditions of cell stimulation. These properties should be taken into consideration in future studies investigating immunomodulatory effects of volatile anesthetics. © 2017, © The Author(s) 2017. [less ▲]

Detailed reference viewed: 12 (1 ULiège)
Full Text
Peer Reviewed
See detailIncidence and risk factors for early renal dysfunction after liver transplantation.
WIESEN, Patricia ULiege; MASSION, Paul ULiege; JORIS, Jean ULiege et al

in World journal of transplantation (2016), 6(1), 220-232

AIM: To determine renal dysfunction post liver transplantation, its incidence and risk factors in patients from a Belgian University Hospital. METHODS: Orthotopic liver transplantations performed from ... [more ▼]

AIM: To determine renal dysfunction post liver transplantation, its incidence and risk factors in patients from a Belgian University Hospital. METHODS: Orthotopic liver transplantations performed from January 2006 until September 2012 were retrospectively reviewed (n = 187). Patients with no renal replacement therapy (RRT) before transplantation were classified into four groups according to their highest creatinine plasma level during the first postoperative week. The first group had a peak creatinine level below 12 mg/L, the second group between 12 and 20 mg/L, the third group between 20 and 35 mg/L, and the fourth above 35 mg/L. In addition, patients who needed RRT during the first week after transplantation were also classified into the fourth group. Perioperative parameters were recorded as risk factors, namely age, sex, body mass index (BMI), length of preoperative hospital stay, prior bacterial infection within one month, preoperative ascites, preoperative treatment with beta-blocker, angiotensin-converting enzyme inhibitor or non steroidal anti-inflammatory drugs, preoperative creatinine and bilirubin levels, donor status (cardiac death or brain death), postoperative lactate level, need for intraoperative vasopressive drugs, surgical revision, mechanical ventilation for more than 24 h, postoperative bilirubin and transaminase peak levels, postoperative hemoglobin level, amount of perioperative blood transfusions and type of immunosuppression. Univariate and multivariate analysis were performed using logistic ordinal regression method. Post hoc analysis of the hemostatic agent used was also done. RESULTS: There were 78 patients in group 1 (41.7%), 46 in group 2 (24.6%), 38 in group 3 (20.3%) and 25 in group 4 (13.4%). Twenty patients required RRT: 13 (7%) during the first week after transplantation. Using univariate analysis, the severity of renal dysfunction was correlated with presence of ascites and prior bacterial infection, preoperative bilirubin, urea and creatinine level, need for surgical revision, use of vasopressor, postoperative mechanical ventilation, postoperative bilirubin and urea, aspartate aminotransferase (ASAT), and hemoglobin levels and the need for transfusion. The multivariate analysis showed that BMI (OR = 1.1, P = 0.004), preoperative creatinine level (OR = 11.1, P < 0.0001), use of vasopressor (OR = 3.31, P = 0.0002), maximal postoperative bilirubin level (OR = 1.44, P = 0.044) and minimal postoperative hemoglobin level (OR = 0.059, P = 0.0005) were independent predictors of early post-liver transplantation renal dysfunction. Neither donor status nor ASAT levels had significant impact on early postoperative renal dysfunction in multivariate analysis. Absence of renal dysfunction (group 1) was also predicted by the intraoperative hemostatic agent used, independently of the extent of bleeding and of the preoperative creatinine level. CONCLUSION: More than half of receivers experienced some degree of early renal dysfunction after liver transplantation. Main predictors were preoperative renal dysfunction, postoperative anemia and vasopressor requirement. [less ▲]

Detailed reference viewed: 54 (12 ULiège)
Full Text
Peer Reviewed
See detailWhat mediates postoperative risk in obstructive sleep apnea: airway obstruction, nocturnal hypoxia or both ?
DEFLANDRE, Eric; BONHOMME, Vincent ULiege; BRICHANT, Jean-François ULiege et al

in Canadian Journal of Anaesthesia (2016)

Detailed reference viewed: 32 (3 ULiège)
Full Text
Peer Reviewed
See detailTransfusion needs during liver transplantation at the CHU of Liege (Belgium): characteristics and preoperative predictive factors
PAGE, Isaline ULiege; HANS, Grégory ULiege; DETRY, Olivier ULiege et al

in Transplant International (2015, November), 28(S4), 461272

Introduction: Liver transplantation (LT) can result in significant bleeding requiring transfusion of allogenic blood products, which potentially leads to postoperative morbidity and mortality (1). This ... [more ▼]

Introduction: Liver transplantation (LT) can result in significant bleeding requiring transfusion of allogenic blood products, which potentially leads to postoperative morbidity and mortality (1). This study aimed to determine transfusion needs during LT in our institution and its preoperative predictive factors. Material and Methods: Two hundred LT performed at the CHU Liege between 2006 and 2012 were respectively reviewed (age = 55 ` 11 yo, BMI = 25.5 ` 4.4 kg/m2, F/M = 45/155, MELD score = 19 ` 10). Transfu- sion needs of the different blood products during POD 0, and POD 0–7 were recorded. Parameters associated with the transfusion of more than 2 units of RBC (p ≤ 0.1) were identified using the Kruskal Wallis and chi square tests (table 1). These parameters were then placed into a backward stepwise logistic regression model for the transfusion of more than two units of RBC at POD 0. A p value threshold ≥0.1 was used for leaving the model. Results: Transfusion needs were: RBC = 2[0–4], FFP = 4[2–7], PLT = 1[0– 1] during POD 0; and RBC = 3[0–6], FFP = 6[3–10], PLT = 1[0–2] during POD 0–7. Preoperative factors independently associated with the transfusion of more than two units of RBC were preop Hb (0.6 [0.46–0.79], p < 0.001) and MELD score (1.13 [1.06–1.20], p < 0.001). Discussion: These results suggest that preop Hb and MELD score are associated with blood requirements during LT. [less ▲]

Detailed reference viewed: 42 (11 ULiège)
Full Text
Peer Reviewed
See detailA consecutive series of 100 controlled DCD liver transplantation
DETRY, Olivier ULiege; DE ROOVER, Arnaud ULiege; 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 ▲]

Detailed reference viewed: 47 (3 ULiège)
Full Text
Peer Reviewed
See detailPrevalence, characteristics and risk factors of chronic post surgical pain after laparoscopic colorectal surgery: retrospective analysis
JORIS, Jean ULiege; GEORGES, MATHIEU; MEDJAHED, KAMEL et al

in European Journal of Anaesthesiology (2015)

Detailed reference viewed: 45 (15 ULiège)
Full Text
Peer Reviewed
See detailEtat prothrombotique des patients atteints du syndrome d'apnées et d'hypopnées obstructives du sommeil
DEFLANDRE, E.; KEMPENEER, D.; BRICHANT, Jean-François ULiege et al

in Praticien en Anesthésie Réanimation (2015)

Detailed reference viewed: 41 (3 ULiège)
Full Text
Peer Reviewed
See detailEffects of isoflurane and sevoflurane on the neutrophil myeloperoxidase system of horses
MINGUET, Grégory ULiege; Franck, Thierry ULiege; JORIS, Jean ULiege et al

in Veterinary Immunology and Immunopathology (2015)

Detailed reference viewed: 41 (13 ULiège)
Full Text
Peer Reviewed
See detailINCIDENCE AND RISK FACTORS FOR EARLY RENAL DYSFUNCTION AFTER LIVER TRANSPLANTATION
WIESEN, Patricia ULiege; GOERGANTA, Elmina; VAN CAUWENBERGE, Isabelle ULiege et al

in Intensive Care Medicine (2014, October), 40(S1), 1740628

INTRODUCTION. Renal dysfunction often occurred after liver transplantation. OBJECTIVES. The aim of the study was to determine its incidence and its risk factors in a clinical series at the University ... [more ▼]

INTRODUCTION. Renal dysfunction often occurred after liver transplantation. OBJECTIVES. The aim of the study was to determine its incidence and its risk factors in a clinical series at the University Hospital of Liege, Belgium. METHODS. Orthotopic liver transplantations performed from January 2006 until Sep- tember 2012 were retrospectively reviewed (n = 187). Patients, with no renal replacement therapy (RRT) before transplantation were classified in four groups according to their highest creatinine plasma level during the first postoperative week. First group had a cre- atinine level below 12 mg/l, the second group between 12 and 20 mg/l, the third group between 20 and 35 mg/l, and the fourth above 35 mg/l. In addition, patients who needed RRT during the first week after transplantation were also classified in the fourth group. Preoperative and perioperative parameters were tested as risk factors: age, sex, body mass index (BMI), length of hospital preoperative stay, prior bacterial infection within one month, preoperative ascites, preoperative treatment with ß-blocker, converting enzyme inhibitor, or non steroidal antiinflammatory drugs, preoperative creatinine and bilirubine level, postop- erative lactate level, need for postoperative vasopressive drugs, surgical revision, mechanical ventilation for more than 24 h, postoperative peaks in bilirubine and transam- inase levels, postoperative hemoglobin level, amount of perioperative blood transfusions, type of immunosuppression. Univariate and multivariate analysis were performed using logistic ordinal regression method. RESULTS. There were 78 patients in group 1 (41.7 %), 46 in group 2 (24.6 %), 38 in group 3 (20.3 %) and 25 in group 4 (13.4 %). Eighteen patients required RRT: 13 (7 %) during the first week after transplantation (group 4), the 5 others after the first week after transplan- tation (2 in group 1 and 2, and 1 in group 3). There were 7 (3.7 %) early deaths within 28 days after transplantation. Using univariate analysis, the severity of renal dysfunction was correlated with presence of ascites and prior bacterial infection, preoperative bilirubin and creatinine level, need for surgical revision, use of vasopressor, postoperative mechanical ventilation, postoperative bilirubine, transaminase, and hemoglobin levels. The need for transfusion of each type of products also affected renal dysfunction. The ordinal logistic analysis pointed out the BMI (OR = 1.1, p = 0.004), preoperative creatinine level (OR = 11.1, p \ 0.0001), use of vasopressor (OR = 3.31, p = 0.0002), maximal postop- erative bilirubine level (OR = 1.44, p = 0.044) and minimal postoperative hemoglobin level (OR 0.059 p = 0.0005). CONCLUSIONS. More than half of liver transplanted patients experienced some degree of early renal dysfunction after transplantation. Risk factors are preoperative renal dysfunction, and mainly perioperative circulatory instability requiring the use of vasopressor and post- operative anemia. [less ▲]

Detailed reference viewed: 62 (17 ULiège)