References of "Van Kemseke, Catherine"
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See detailGanglionic tuberculosis in a Crohn’s disease patient treated by infliximab despite anti-tuberculosis chemoprophylaxis
VIEUJEAN, Sophie ULiege; BURY, Thierry ULiege; GASPARD, Laura ULiege et al

Conference (2019, February)

Infliximab is an IgG1κ monoclonal antibody against tumor necrosis factor-α (anti-TNFα) who have significantly improved the management of patients with Inflammatory Bowel Diseases (IBD), but with an ... [more ▼]

Infliximab is an IgG1κ monoclonal antibody against tumor necrosis factor-α (anti-TNFα) who have significantly improved the management of patients with Inflammatory Bowel Diseases (IBD), but with an increased risk of opportunistic infection, especially tuberculosis (TB). We report a case of a 54 years-old man with an ileal Crohn’s disease (CD) diagnosed in July 2014 (Montreal classification at diagnosed: A2L1B1p-). Patient was an active smoker and was treated by budesonide for several flares. Two years after diagnosis, since he has been hospitalised for subocclusion treated with methylprednisolone, combination therapy by mercaptopurine and anti-TNFα was discussed for steroid dependence. Patient was screened for tuberculosis (TB). A latent tuberculosis (LTB) was highlighted based on a positive interferon-gamma release assay (QuantiFERON TB) without clinical, microbiological and radiological evidence of active disease. A nine-month course of isoniazid (INH) 300 mg/day was started 4 weeks before the combination therapy with thiopurine/infliximab at the recommended doses. This treatment allowed a clinical remission and thiopurine could be stopped. Six months after completing INH for LTB and 1 month after cessation of thiopurine, patient was admitted in our emergency department for fever, dyspnoea and cough. Chest tomography showed large lymphadenopathies in the right pulmonary hilum and in the mediastinum. A fibroscopy with a bronchoalveolar lavage (with looking for bacillus of Koch) and an endobronchial ultrasound with biopsies were performed, both negative. Finally, a diagnosis of ganglionic tuberculosis was settled by a positive microscopic exam (auramine coloration) on an excised cervical lymphadenopathy. No resistance to usual anti-tuberculosis treatment was highlighted. Infliximab was immediately discontinued and anti-tuberculosis 4-drug regimen was initiated. Patient received Vedolizumab as IBD treatment 1 month later and he did not present any recurrence of TB infection or new flare of Crohn's disease up until now. This case report emphasizes that chemoprophylaxis for LTB does not completely protect against reactivation of TB in IBD patients treated by anti-TNF. It could be useful to study risk factors for reactivation of LTB in this treated by biologics population (monotherapy or combination therapy) to establish a case-by-case monitoring. [less ▲]

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See detailCurious intra-rectal “laterally spreading tumor” in immunosuppressed patient with ulcerative colitis
VIEUJEAN, Sophie ULiege; LATOUR, Pascale ULiege; COIMBRA MARQUES, Carla ULiege et al

Conference (2018, February)

A 46-year-old man was admitted in June 2015 for the first time in our department for a colonoscopy in a context of ulcerative colitis, diagnosed 4 years earlier (ulcerative proctitis). At time of ... [more ▼]

A 46-year-old man was admitted in June 2015 for the first time in our department for a colonoscopy in a context of ulcerative colitis, diagnosed 4 years earlier (ulcerative proctitis). At time of diagnosis (2011), he was treated by oral Mesalazine, 5ASA suppositories and enema, Budesonide enema and then Azathioprine. Patient was asymptomatic for a long time but no follow-up had been achieved for at least 3 years. A colonoscopy was performed prior to potential immunosuppressive treatment discontinuation. This examination showed a kind of circumferential “laterally spreading tumor” with villous appearance located in the rectum 4 to 7 centimeters from the anal margin with a little triangular extension to the dentate line. Surprisingly rectal biopsies revealed a condyloma acuminatum with very focally high-grade intra-epithelial lesion and an overexpression of the p16 protein (cell marker induced by oncogenic HPV). Azathioprine was stopped and a transanal surgical resection was performed. This led to a scarring rectal substenosis and further rectoscopies permitted destruction of some little condylomatous persistent lesions. At guided anamnesis on sexual behavior, patient confirmed to be an active “men who have sex with men” (MSM). No recurrence of active ulcerative proctitis occured despite Azathioprine discontinuation. Condyloma acuminatum is a manifestation of Human Papillomavirus (HPV) infection and usually occurs in the genital and perianal regions. Involvement of the rectal mucosa is a rare condition and treatment strategy is not well established. This may have been in this case promoted by immunosuppressive treatment. As sexually transmitted anorectal disease may mimic inflammatory bowel disease, first diagnosis of ulcerative proctitis may be questioned even more with absence of recurrence despite treatment. [less ▲]

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See detailUsability of a home-based test for the measurement of fecal calprotectin in asymptomatic IBD patients.
Bello, Caroline; Roseth, Arne; Guardiola, Jordi et al

in Digestive and Liver Disease (2017), 49(9), 991-996

The aim of our work was to test the usability of fecal calprotectin (FC) home-based test in inflammatory bowel disease (IBD) patients. METHODS: IBD patients were prospectively recruited. They had to ... [more ▼]

The aim of our work was to test the usability of fecal calprotectin (FC) home-based test in inflammatory bowel disease (IBD) patients. METHODS: IBD patients were prospectively recruited. They had to measure FC with a dedicated tool and smartphone application, 5 times at two weeks intervals over an 8 weeks period. They had to fill in a usability questionnaire at the first and the last FC measurement. A System Usability Scale (SUS: 0-100) and the Global Score of Usability (GSU: 0-85) were calculated. FC was also centrally measured by ELISA. RESULTS: Fifty-eight patients were recruited. Forty-two performed at least one FC measurement and 27 performed all the FC requested measurements. The median (IQR) SUS (0-100) at the first and last use were 85 (78-90) and 81 (70-88), respectively; the median (IQR) GSU (0-85) at the first and last use were 74 (69-80) and 77 (68-83), respectively. Adherence to the planned measurements and usability of the tool were higher in females and in less severe disease. The intra-class correlation coefficient between home-based and centrally measured FC was 0.88. CONCLUSION: The adherence to home-based measurement of FC was fair. Usability scores for the home-based test were high. There was a good correlation with the centrally measured FC by ELISA. [less ▲]

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See detailComment j'explore ... la maladie de Crohn par imagerie.
DESIR, Colin ULiege; COIMBRA MARQUES, Carla ULiege; Decker, M. et al

in Revue Médicale de Liège (2017), 72(1), 51-56

Crohn's disease is a chronic inflammatory condition characterized by recurrent and/or chronic lesions, leading to cumulative structural bowel damage. It is established that the correlation between ... [more ▼]

Crohn's disease is a chronic inflammatory condition characterized by recurrent and/or chronic lesions, leading to cumulative structural bowel damage. It is established that the correlation between symptoms and intestinal lesions is weak. Therefore, monitoring by frequent cross-sectional imaging is proposed to assess the disease activity. There is no consensus about the preferred imaging option. Priority is given to non-radiating modalities, such as ultrasonography and MRI. Tomodensitometry will be reserved for emergency cases. Ultrasonography can be useful, in emergency as well as for the monitoring of lesions of known topography. Entero-MRI is henceforth considered the standard imaging technique for the diagnosis and follow-up of Crohn's disease. Its high contrast resolution allows an accurate assessment of disease activity, therapeutic efficacy, cumulative structural bowel damage and complications. [less ▲]

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See detailEndomicroscopie confocale dans la prise en charge des maladies inflammatoires chroniques de l'intestin.
LOLY, Jean-Philippe ULiege; SOMJA, Joan ULiege; REENAERS, Catherine ULiege et al

in Revue Médicale Suisse (2017), 13(571), 1431-1434

Inflammatory bowel diseases are chronic diseases whose long-term evolution depends on the depth of remission. Their clinical and endoscopic evaluation is imperfect. The development of confocal ... [more ▼]

Inflammatory bowel diseases are chronic diseases whose long-term evolution depends on the depth of remission. Their clinical and endoscopic evaluation is imperfect. The development of confocal endomicroscopy allows microscopic images to be obtained in vivo. These microscopic data are correlated with the activity of the disease. They predict a possible relapse of the disease and also predict the response to treatment with a biological agent, which allows to modify the therapy before the relapse or to make a rational choice between the different biological agents before introducing a new treatment. [less ▲]

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See detailLong-term evolution and predictive factors of mild inflammatory bowel disease.
REENAERS, Catherine ULiege; Pirard, C.; VAN KEMSEKE, Catherine ULiege et al

in Scandinavian Journal of Gastroenterology (2016), 51(6), 712-9

BACKGROUND: Crohn's disease (CD) and ulcerative colitis (UC) are potentially progressive diseases. Few data are available on the prevalence and the factors associated with mild inflammatory bowel diseases ... [more ▼]

BACKGROUND: Crohn's disease (CD) and ulcerative colitis (UC) are potentially progressive diseases. Few data are available on the prevalence and the factors associated with mild inflammatory bowel diseases (IBD). AIM: Our aim was to assess the natural history of mild CD and mild UC and to identify predictive factors of mild evolution over the long term. METHODS: Retrospective study of IBD patients registered in the database of the university hospital CHU of Liege, Belgium. Mild CD was defined as an inflammatory luminal disease (no stricture, abdominal or perianal fistulae) requiring no immunomodulator (IM), anti-TNF and no surgery. Mild UC was defined as no requirement for IM, anti-TNF and no colectomy. RESULTS: Four hundred and seventy-three CD and 189 UC were included (median follow-up: 13 and 11 years respectively). At 1 year, 147 patients had mild CD. At 5 years and the maximum follow-up, 56% and 13% patients still had mild CD, respectively. At 1 year, 142 patients had mild UC. At 5 years and the maximum follow-up, 72% and 44% still had a mild UC, respectively. Factors associated with long-term mild CD and UC were older age at diagnosis and absence of corticosteroids in the first year. In UC proctitis location was associated with mild UC. CONCLUSIONS: In this cohort, 90% of CD patients and 3/4 of UC with mild disease at 1 year lost their mild disease status over time. An old age at diagnosis was predictive of the persistence of a mild CD and UC. [less ▲]

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See detailLE MEDICAMENT DU MOIS. Vedolizumab (Entyvio(R)), nouveau traitement des maladies inflammatoires intestinales.
Van Kemseke, Catherine ULiege; Louis, Edouard ULiege; REENAERS, Catherine ULiege

in Revue Médicale de Liège (2015), 70(11), 575-82

Anti-TNF agents are highly effective in treating inflammatory bowel diseases, but loss of response and side-effects leading to drug interruption are often reported. New molecules are needed to treat these ... [more ▼]

Anti-TNF agents are highly effective in treating inflammatory bowel diseases, but loss of response and side-effects leading to drug interruption are often reported. New molecules are needed to treat these patients. Vedolizumab is a fully humanized anti-body inhibiting the migration of circulating lymphocytes to the gut by binding the integrin alpha4beta7. In ulcerative colitis, clinical response, remission and mucosal healing were observed at 6 weeks in 47%, 17% and 40% of the patients, respectively. The maintenance study demonstrated 42% and 52% of clinical remission and response at week 52. In Crohn's disease, clinical response and remission were respectively observed in 15% and 31% of the patients at 6 weeks. Clinical remission at week 52 was 39%. The time to clinical response was longer in patients who had failed anti-TNF. The safety profile is excellent with the same proportion of side-effects in the placebo and in the treated groups. The most frequently reported adverse events were pharyngitis and headaches. [less ▲]

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See detailPrise en charge actuelle du lymphome de la zone marginale
Bonnet, Christophe ULiege; LEJEUNE, Marie ULiege; VAN KEMSEKE, Catherine ULiege et al

in Revue Médicale Suisse (2015), 11

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See detailDe l'"Evidence-based Medecine" à la médecine personnalisée dans la maladie de Crohn
Louis, Edouard ULiege; REENAERS, Catherine ULiege; VAN KEMSEKE, Catherine ULiege et al

in Revue Médicale de Liège (2015), 70(5-6), 316-320

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See detailPersisting signs of disease activity at magnetic resonance enterocolonography predict clinical relapse and disease progression in quiescent Crohn's disease
MEUNIER, Paul ULiege; COUSIN, François ULiege; VAN KEMSEKE, Catherine ULiege et al

in Acta Gastro-Enterologica Belgica (2015), 73(3), 274-81

INTRODUCTION: Deep remission including clinical remission and tissue healing has been advocated as the therapeutic target in Crohn's disease. Yet, the definition of deep remission remains unclear. The aim ... [more ▼]

INTRODUCTION: Deep remission including clinical remission and tissue healing has been advocated as the therapeutic target in Crohn's disease. Yet, the definition of deep remission remains unclear. The aim of this study was to assess the persisting lesions at magnetic resonance enterocolonography (MREC) in clinically quiescent Crohn's disease as well as their relapse predictive value. METHODS: we performed a prospective monocentre cohort study. We included patients with clinical remission. At baseline, these patients had blood tests, the measurement of fecal calprotectin and underwent a MREC. They were then followed up clinically for a minimum of 1 year. A relapse was defined by a HBI > 4 with an increase of at least 3 points. Correlations between clinical, demographic, biological parameters and MREC signs were assessed as well as the time-to-relapse predictive value of the studied variables. RESULTS: Twenty seven patients were recruited. Fourteen out of 27 had persisting disease activity at MREC. MREC signs only partly correlated with biomarkers. Ten out of 27 patients relapsed over a median follow up of 25 months. In univariate analysis, relative contrast enhancement of the most affected segment (HR: 2.56; P = 0.046), ulcers (HR: 12.5; P = 0.039), fistulas (HR: 14.1; P = 0.009) and target sign (HR: 3.63; P = 0.049) were associated with relapse. In multivariate analysis, fistula was the only one. CONCLUSIONS: Half of the patients with clinically quiescent Crohn's disease had persisting signs of disease activity at MREC. These signs predicted time-to-relapse. [less ▲]

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See detailDepth of remission in Crohn's disease patients seen in a referral centre : associated factors and impact on disease outcome.
Poncin, Maxime ULiege; REENAERS, Catherine ULiege; VAN KEMSEKE, Catherine ULiege et al

in Acta Gastro-Enterologica Belgica (2014), 77(1), 41-6

INTRODUCTION: Our goals were to assess the prevalence of biological and tissue remission in routine practice in Crohn's disease, and to evaluate the correlation between biological or tissue remission and ... [more ▼]

INTRODUCTION: Our goals were to assess the prevalence of biological and tissue remission in routine practice in Crohn's disease, and to evaluate the correlation between biological or tissue remission and clinical or demographic characteristics as well as their impact on disease outcome. METHODS: We performed a retrospective monocenter study. Biological remission was defined by a CRP < 5 mg/I. Tissue remission was defined by the absence of ulcer at endoscopy and/or absence of signs of acute inflammation at MRI. Association with demographic, clinical and laboratory markers was studied by logistic regression models and rates of relapses, hospitalizations and surgeries were compared using the logrank test. RESULTS: Among the 263 patients included, 147 were in clinical remission; 102/147 (69%) were in biological remission. Fifty-six patients also had morphological evaluation: 37 (66%) were in tissue remission. Biological remission was associated with older age, higher hemoglobin and lower BMI. Tissue remission was associated with older age, lower platelets count, absence of previous surgery, and the use of immunosuppressant. Time-to-relapse was significantly longer in patients with biological remission and in patients with tissue remission as compared to patients without biological or tissue remission. CONCLUSIONS: Among the patients in clinical remission seen as outpatients, two thirds were either in biological and/or tissue remission. Biological and/or tissue remission was associated with a better outcome than clinical remission alone. [less ▲]

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See detailConstipation et troubles de la continence fécale chez le sujet âgé
VAN KEMSEKE, Catherine ULiege

in Revue Médicale de Liège (2014), 69(5-6), 337-42

Alterations of anorectal functions (constipation and fecal incontinence) are very frequent in the elderly. The patient's global evaluation with his past medical history, comorbidities, medications, as ... [more ▼]

Alterations of anorectal functions (constipation and fecal incontinence) are very frequent in the elderly. The patient's global evaluation with his past medical history, comorbidities, medications, as well as social environment and physical dependence, is more than ever necessary in this high risk population to guide the explorations and the medical care of these disorders. [less ▲]

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See detailRole of endoscopy, cross-sectional imaging and biomarkers in Crohn's disease monitoring.
Benitez, Jose-Manuel; Meuwis, Marie-Alice ULiege; REENAERS, Catherine ULiege et al

in Gut (2013), 62(12), 1806-16

Crohn's disease is characterised by recurrent and/or chronic inflammation of the gastrointestinal tract leading to cumulative intestinal tissue damage. Treatment tailoring to try to prevent this tissue ... [more ▼]

Crohn's disease is characterised by recurrent and/or chronic inflammation of the gastrointestinal tract leading to cumulative intestinal tissue damage. Treatment tailoring to try to prevent this tissue damage as well as achieve optimal benefit/risk ratio over the whole disease course is becoming an important aspect of Crohn's disease management. For decades, clinical symptoms have been the main trigger for diagnostic procedures and treatment strategy adaptations. However, the correlation between symptoms and intestinal lesions is only weak. Furthermore, preliminary evidence suggests that a state of remission beyond the simple control of clinical symptoms, and including mucosal healing, may be associated with better disease outcome. Therefore monitoring the disease through the use of endoscopy and cross-sectional imaging is proposed. However, the degree of mucosal or bowel wall healing that needs to be reached to improve disease outcome has not been appropriately studied. Furthermore, owing to their invasive nature and cost, endoscopy and cross-sectional imaging are not optimal tools for the patients or the payers. The use of biomarkers as surrogate markers of intestinal and systemic inflammation might help. Two biomarkers have been most broadly assessed in Crohn's disease: C-reactive protein and faecal calprotectin. These markers correlate significantly with endoscopic lesions, with the risk of relapse and with response to therapy. They could be used to help make decisions about diagnostic procedures and treatment. In particular, with the use of appropriate threshold values, they could determine the need for endoscopic or medical imaging procedures to confirm the disease activity state. [less ▲]

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See detailQuinze ans d'anti-TNF dans la maladie de Crohn: comment tirer le meilleur de cette revolution therapeutique?
Louis, Edouard ULiege; REENAERS, Catherine ULiege; Meuwis, Marie-Alice ULiege et al

in Revue Médicale de Liège (2012), 67 Spec No

After fifteen years of use, the anti-TNF antibodies have become the corner stone of the treatment of moderate and severe Crohn's disease. The skill acquired over the years through experimental trials and ... [more ▼]

After fifteen years of use, the anti-TNF antibodies have become the corner stone of the treatment of moderate and severe Crohn's disease. The skill acquired over the years through experimental trials and clinical experience leads to increased therapeutic efficacy and minimized risks. These antibodies are introduced increasingly earlier in Crohn's disease as well as in a broader range of patients, aiming at changing the natural history of the diseases by avoiding the development of intestinal tissue damage and complications. [less ▲]

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See detailCommentary: endoscopic dilatation for stricturing Crohn's disease.
Louis, Edouard ULiege; GAST, Pierrette ULiege; VAN KEMSEKE, Catherine ULiege et al

in Alimentary Pharmacology and Therapeutics (2012), 36(5), 494-6

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See detailGenetique et environnement dans les maladies inflammatoires chroniques de l'intestin.
Louis, Edouard ULiege; VAN KEMSEKE, Catherine ULiege; LATOUR, Pascale ULiege et al

in Revue Médicale de Liège (2012), 67(5-6), 298-304

Inflammatory bowel diseases are both environmental and genetic illnesses. More than one hundred genes or loci involved in the regulation of innate or acquired immune response as well as intestinal mucosa ... [more ▼]

Inflammatory bowel diseases are both environmental and genetic illnesses. More than one hundred genes or loci involved in the regulation of innate or acquired immune response as well as intestinal mucosa homeostasis have been identified. Environmental studies have been less numerous up to now and only smoking and appendectomy have been validated, as protector for ulcerative colitis, while smoking is clearly associated with an increased risk and more severe forms of Crohn's disease. An important role is also currently suspected for the intestinal flora and the dysbiosis described in inflammatory bowel disease could contribute to the triggering or the persistence of the inflammation. New therapeutic strategies are currently studied, particularly aiming at targeting immune, inflammatory or homeostatic pathways corresponding to the predisposing gene variants. [less ▲]

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See detailNecessity of phenotypic classification of inflammatory bowel disease.
Louis, Edouard ULiege; VAN KEMSEKE, Catherine ULiege; Reenaers, Catherine ULiege

in Best Practice and Research. Clinical Gastroenterology (2011), 25 Suppl 1

Inflammatory bowel diseases (IBD) are classically divided in Crohn's disease (CD) and ulcerative colitis (UC). However, these two entities are still heterogeneous and a further classification in ... [more ▼]

Inflammatory bowel diseases (IBD) are classically divided in Crohn's disease (CD) and ulcerative colitis (UC). However, these two entities are still heterogeneous and a further classification in subphenotypes is necessary. Clinical subphenotypes are easy to use, do not necessitate complicated tests and can already give very important information for the management of the patients. In CD, clinical subphenotypes are based on age at diagnosis, disease location and disease behaviour. Age at diagnosis allows to differentiating paediatric CD, classical young adult onset and more seldom CD of the elderly. These categories are associated with a different risk of development of complications and disabling disease and may have partly different pathophysiology. The classification on disease behaviour, including stricturin, penetrating or uncomplicated disease may have an impact on reponse to medical treatment and need for surgery. Finally the classification based on location is particularly relevant since it has been associated with different types of complications. Particularly ileal disease has been associated with the risk of surgery and colonic (particularly rectal) disease, with the risk of perianal disease. In UC, the classification in subphenotypes is essentially based on disease location, distinguishing proctitis, left-sided colitis and extensive colitis. This subclassification also has a very significant clinical relevance since extensive colitis has been associated with and increased risk of colon cancer, colectomy and even in some studies, mortality. [less ▲]

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See detailSexually transmitted diseases and anorectum.
Van Kemseke, Catherine ULiege

in Acta Gastro-Enterologica Belgica (2009), 72(4), 413-9

Sexually transmitted diseases (STD) are a major public health problem because their incidence is increasing worldwide despite prevention campaigns and because they raise the risk of HIV infection ... [more ▼]

Sexually transmitted diseases (STD) are a major public health problem because their incidence is increasing worldwide despite prevention campaigns and because they raise the risk of HIV infection. Anorectal localisations of STD are common among men who have sex with men (MSM) but can also be seen among heterosexuals (men or women). Transmission of such infections is due to anal sex or to other sexual behaviours like "fisting". Although some pathogens (like Human Papillomavirus-HPV) are common in gastroenterologist/proctologist consultations, others are not so well-known. Furthermore during the last years, sexual risky behaviours have led to resurgence of old affections (like syphilis) or to emergence of unknown diseases (like lymphogranuloma venereum) in our countries. This presentation tends to focus on clinical manifestation, diagnosis and treatment of different STD: HPV, Herpes Simplex Virus, Neisseria gonorrhoeae, Chlamydia trachomatis (in particularly lymphogranuloma venereum) and Treponema pallidum. [less ▲]

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See detailPancreas graft drainage in recipient duodenum: Preliminary experience
De Roover, Arnaud ULiege; Coimbra Marques, Carla ULiege; Detry, Olivier ULiege et al

in Transplantation (2007), 84(6), 795-797

Pancreas graft survival has continuously improved over the years to become a main treatment option of uncontrolled complicated diabetes. Rejection remains the major challenge as it often goes unnoticed ... [more ▼]

Pancreas graft survival has continuously improved over the years to become a main treatment option of uncontrolled complicated diabetes. Rejection remains the major challenge as it often goes unnoticed until severe damage of the graft manifests itself by elevated blood sugar. Pancreas enzymes monitoring in the blood and in the urine is a sensitive marker of rejection but lack of specificity. Biopsy remains the gold standard. Cystoscopy-guided biopsy of bladder-drained pancreas has a good success rate for obtaining tissue but the vesical drainage exposes to metabolic and urologic morbidity. Percutaneous pancreas biopsy can be performed with a low morbidity rate but severe complications can occur. We discuss a technique of pancreas transplantation with the drainage of exocrine secretions of the pancreatic graft in the recipient duodenum, which permits easy monitoring of the graft by upper endoscopy of the duodenum. [less ▲]

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