References of "Schielke, Astrid Anita"
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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 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 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 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

Detailed reference viewed: 48 (10 ULiège)