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Rationale for the potential use of mesenchymal stromal cells in liver transplantation

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World Journal of Gastroenterology 2014年第44期20卷 16418-16432页

作者： Morgan Vandermeulen Céline Grégoire Alexandra Briquet Chantal Lechanteur Yves Beguin olivier detry Department of Abdominal Surgery and Transplantation CHU Liege University of Liege Department of Hematology CHU Liege University of Liege Laboratory of Cell and Gene Therapy CHU Liege University of Liege

Mesenchymal stromal cells (MSCs) are multipotent and self-renewing cells that reside essentially in the bone marrow as a non-hematopoietic cell population, but may also be isolated from the connective tissues of most organs. MSCs represent a heterogeneous population of adult, fibroblast-like cells characterized by their ability to differentiate into tissues of mesodermal lineages including adipocytes, chondrocytes and osteocytes. For several years now, MSCs have been evaluated for their in vivo and in vitro immunomodulatory and ‘tissue reconstruction’ properties, which could make them interesting in various clinical settings, and particularly in organ transplantation. This paper aims to review current knowledge on the properties of MSCs and their use in pre-clinical and clinical studies in solid organ transplantation, and particularly in the field of liver transplantation. The first available clinical data seem to show that MSCs are safe to use, at least in the medium-term, but more time is needed to evaluate the potential adverse effects of long-term use. Many issues must be resolved on the correct use of MSCs. Intensive in vitro and pre-clinical research are the keys to a better understanding of the way that MSCs act, and to eventually lead to clinical success.

关键词： Mesenchymal stem cells Organ transplantation Complication Immunosuppression Tolerance

Pathophysiology and prevention of postoperative peritoneal adhesions

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World Journal of Gastroenterology 2011年第41期17卷 4545-4553页

作者： Willy Arung Michel Meurisse olivier detry Department of General Surgery Cliniques Universitaires de LubumbashiUniversity of Lubumbashi Department of Abdominal Surgery and Transplantation CHU de LiègeUniversity of Liege

Peritoneal adhesions represent an important clinical challenge in gastrointestinal surgery. Peritoneal adhesions are a consequence of peritoneal irritation by infection or surgical trauma, and may be considered as the pathological part of healing following any peritoneal injury, particularly due to abdominal surgery. The balance between fi brin deposition and degradation is critical in determining normal peritoneal healing or adhesion formation. Postoperative peritoneal adhesions are a major cause of morbidity resulting in multiple complications, many of which may manifest several years after the initial surgical procedure. In addition to acute small bowel obstruction, peritoneal adhesions may cause pelvic or abdominal pain, and infertility. In this paper, the authors reviewed the epidemiology, pathogenesis and various prevention strategies of adhesion formation, using Medline and PubMed search. Several preventive agents against postoperative peri-toneal adhesions have been investigated. Their role aims in activating fi brinolysis, hampering coagulation, diminishing the inflammatory response, inhibiting col-lagen synthesis or creating a barrier between adjacentwound surfaces. Their results are encouraging but most of them are contradictory and achieved mostly in animal model. Until additional fi ndings from future clinical researches, only a meticulous surgery can be recommended to reduce unnecessary morbidity and mortality rates from these untoward effects of surgery. In the current state of knowledge, pre-clinical or clini-cal studies are still necessary to evaluate the effective-ness of the several proposed prevention strategies of postoperative peritoneal adhesions.

关键词： Abdominal surgery Laparoscopy Complica-tion Occlusion Abdominal pain

18-Fluoro-deoxyglucose uptake in inflammatory hepatic adenoma:A case report

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World Journal of Hepatology 2017年第11期9卷 562-566页

作者： Willy Liu Jean Delwaide Noella Bletard Philippe Delvenne Paul Meunier Roland Hustinx olivier detry Department of Abdominal Surgery and Transplantation CHU Liege (CHU-ULg) Department of Hepato-gastroenterology CHU Liege (CHU-ULg) Department of Pathology CHU Liege(CHU-ULg) Department of Pathology CHU Liege (CHU-ULg) Department of Radiology CHU Liege (CHUULg) Department of Nuclear Imaging CHU Liege (CHU-ULg)

Positron emission tomography computed tomography (PET-CT) using 18-Fluoro-deoxyglucose (18FDG) is an imaging modality that reflects cellular glucose metabolism. Most cancers show an uptake of 18FDG and benign tumors do not usually behave in such a way. The authors report herein the case of a 38-year-old female patient with a past medical history of cervical intraepithelial neoplasia and pheochromocytoma, in whom a liver lesion had been detected with PET-CT. The tumor was laparoscopically resected and the diagnosis of inflammatory hepatic adenoma was confirmed. This is the first description of an inflammatory hepatic adenoma with an 18FDG up-take.

关键词： Liver surgery Liver tumor Liver cancer Benign tumor Laparoscopy Prognosis

Liver transplantation for acute hepatic failure due to chemotherapy-induced HBV reactivation in lymphoma patients

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World Journal of Gastroenterology 2011年第25期17卷 3069-3072页

作者： Timothée Noterdaeme Luc Longrée Christian Bataille Arnaud Deroover Anne Lamproye Jean Delwaide Yves Beguin Pierre Honoré olivier detry Department of Abdominal Surgery and Transplantation CHU de LiègeUniversity of Liège Department of Medicine Division of Hematology and OncologyCHC LiègeUniversity of Liège Department of Internal Medicine CHR HuyUniversity of Liège Department of Hepatogastroenterology CHU de LiègeUniversity of Liège Department of Medicine Division of HematologyCHU LiègeUniversity of Liège

Hepatitis B （HBV） reactivation induced by chemotherapy is problem encountered recently in the management of malignant diseases. Chemotherapy-induced HBV reacti- vation may ultimately lead to terminal acute liver failure. Liver transplantation （LT） currently remains the only definitive treatment option for such cases, but is generally denied to patients suffering from malignancy. Here, the authors describe 2 cases of cancer-free and HBV graft renfection-free survival after LT performed for terminal liver failure arising from HBV reactivation induced by chemotherapy for advanced stage lymphoma. These 2 cases, and some other reports in the literature, may suggest that patients suffering from hematologic malignan- cies and terminal liver disease can be considered for LT if the prognosis of their hematologic malignancy is good.

关键词： Liver transplantation Contraindication Cancer Liver failure Chemotherapy Hepatitis 13 virus

Donation after cardio-circulatory death liver transplantation

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World Journal of Gastroenterology 2012年第33期18卷 4491-4506页

作者： Hieu Le Dinh Arnaud de Roover Abdour Kaba Séverine Lauwick Jean Joris Jean Delwaide Pierre Honoré Michel Meurisse olivier detry Department of Abdominal Surgery and Transplantation University Hospital of Liège University of Liège 4000 Liège Belgium Department of Anesthesia and Intensive Care Medicine University Hospital of Liège University of Liège 4000 Liège Belgium Department of Hepatology and Gastroenterol-ogy University Hospital of Liège University of Liège 4000 Liège Belgium

The renewed interest in donation after cardio-circulatory death (DCD) started in the 1990s following the limited success of the transplant community to expand the donation after brain-death (DBD) organ supply and following the request of potential DCD families. Since then, DCD organ procurement and transplantation activities have rapidly expanded, particularly for nonvital organs, like kidneys. In liver transplantation (LT), DCD donors are a valuable organ source that helps to decrease the mortality rate on the waiting lists and to increase the availability of organs for transplantation despite a higher risk of early graft dysfunction, more frequent vascular and ischemia-type biliary lesions, higher rates of re-listing and re-transplantation and lower graft survival, which are obviously due to theinevitable warm ischemia occurring during the declaration of death and organ retrieval process. Experimental strategies intervening in both donors and recipients at different phases of the transplantation process have focused on the attenuation of ischemia-reperfusion injury and already gained encouraging results, and some of them have found their way from pre-clinical success into clinical reality. The future of DCD-LT is promising. Concerted efforts should concentrate on the identification of suitable donors (probably Maastricht category Ⅲ DCD donors), better donor and recipient matching (high risk donors to low risk recipients), use of advanced organ preservation techniques (oxygenated hypothermic machine perfusion, normothermic machine perfusion, venous systemic oxygen persufflation), and pharmacological modulation (probably a multi-factorial biologic modulation strategy) so that DCD liver allografts could be safely utilized and attain equivalent results as DBD-LT.

关键词： Non-heart-beating donation Complication Bile duct Allocation Ischemia Ischemia-reperfusion injury Liver disease

Carcinoid tumor of the appendix: A consecutive series from 1237 appendectomies

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World Journal of Gastroenterology 2006年第41期12卷 6699-6701页

作者： Vincent Tchana-Sato olivier detry Marc Polus Albert Thiry Bernard Detroz Sylvie Maweja Etienne Hamoir Thierry Defechereux Carla Coimbra Arnaud De Roover Michel Meurisse Pierre Honoré Department of Abdominal Surgery and Transplantation University of LiègeCHU Sart Tilman B35Liège B4000Belgium Department of Gastroenterology University of LiègeCHU Sart Tilman B35Liège B4000Belgium Department of Pathology University of LiègeCHU Sart Tilman B35Liège B4000Belgium

AIM： To report the experience of the CHU Sart Tilman, University of Liege, Belgium, in the management of appendiceal carinoid tumor. METHODS： A retrospective review of 1237 appendectomies performed in one single centre from January 2000 to May 2004, was undertaken. Analysis of demographic data, clinical presentation, histopathology, operative reports and outcome was presented. RESULTS： Among the 1237 appendectomies, 5 appendiceal carcinoid tumors were identified （0.4%） in 4 male and 1 female patients, with a mean age of 29.2 years （range： 6-82 years）. Acute appendicitis was the clinical presentation for all patients. Four patients underwent open appendectomy and one a laparoscopic procedure. One patient was reoperated to complete the excision of mesoappendix. All tumors were located at the tip of the appendix with a mean diameter of 0.6 cm （range： 0.3-1.0 cm）. No adjuvant therapy was performed. All patients were alive and disease-free during a mean follow-up of 33 mo. CONCLUSION： Appendiceal carcinoid tumor most of-ten presents as appendicitis. In most cases, it is found incidentally during appendectomies and its diagnosis is rarely suspected before histological examination. Appendiceal carcinoid tumor can be managed by simple appendectomy and resection of the mesoappendix, if its size is ≤ 1cm.

关键词： Surgery Digestive cancer Laparoscopy Review

Cadaveric liver transplantation for non-acetaminophen fulminant hepatic failure:A 20-year experience

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World Journal of Gastroenterology 2007年第9期13卷 1427-1430页

作者： olivier detry Arnaud De Roover Carla Coimbra Jean Delwaide Marie-France Hans Marie Hélène Delbouille Joseé Monard Jean Joris Pierre Damas Jacques Belache Michel Meurisse Pierre Honoré Department of Liver Surgery and Transplantation University of Liège CHU Sart Tilman B35Liège B4000 Belgium Department of Hepato- gastroenterology University of Liège CHU Sart Tilman B35 Liège B4000 Belgium Department of Anaesthesia and Intensive Care University of Liège CHU Sart Tilman B35Liège B4000Belgium

AIM: To investigate the long-term results of liver transplantation (LT) for non-acetaminophen fulminant hepatic failure (FHF). METHODS: Over a 20-year period, 29 FHF patients underwent cadaveric whole LT. Most frequent causes of FHF were hepatitis B virus and drug-related (not acetaminophen) liver failure. All surviving patients were regularly controlled at the out-patient clinic and none was lost to follow-up. Mean follow-up was 101 mo. RESULTS: One month, one-, five- and ten-year patient survival was 79%, 72%, 68% and 68%, respectively. One month, one-, five- and ten-year graft survival was 69%, 65%, 51% and 38%, respectively. Six patients needed early (< 2 mo) retransplantation, four for primary non-function, one for early acute refractory rejection because of ABO blood group incompatibility, and one for a malignant tumor found in the donor. Two patients with hepatitis B FHF developed cerebral lesions peri-transplantion: One developed irreversible and extensive brain damage leading to death, and one suffered from deep deficits leading to continuous medical care in a specialized institution. CONCLUSION: Long-term outcome of patients transplanted for non-acetaminophen FHF may be excellent. As the quality of life of these patients is also particularly good, LT for FHF is clearly justified, despite lower graft survival compared with LT for other liver diseases.

关键词： Liver transplantation Liver failure Surgery Hepatitis B Liver support

Prognostic value of ^(18)F-FDG PET/CT in liver transplantation for hepatocarcinoma

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World Journal of Gastroenterology 2015年第10期21卷 3049-3054页

作者： olivier detry Laurence Govaerts Arnaud Deroover Morgan Vandermeulen Nicolas Meurisse Serge Malenga Noella Bletard Charles Mbendi Anne Lamproye Pierre Honoré Paul Meunier Jean Delwaide Roland Hustinx Department of Abdominal Surgery and Transplantation CHU LiegeB4000 LiegeBelgium Department of Nuclear Medicine CHU Liege University of Liege ULg CHU B4000 LiegeBelgium Department of Radiology CHU LiegeUniversity of LiegeULg CHUB4000 LiegeBelgium Department of Pathology CHU LiegeUniversity of LiegeULg CHUB4000 LiegeBelgium Department of Hepato-Gastroenterology CHU LiegeUniversity of LiegeULg CHUB4000 LiegeBelgium

AIM:To evaluate the prognostic value of pretreatment F D G p o s i t r o n e m i s s i o n t o m o g ra p h y c o m p u t e d tomography(PET-CT) in patients with hepatocarcinoma treated by liver transplantation(LT).METHODS:The authors retrospectively analyzed the data of 27 patients(mean age 58 ± 9 years) who underwent FDG PET-CT before LT for *** follow-up was 26 ± 18 *** FDG PET/CT was performed according to a standard clinical protocol:4 MBq FDG/kg body weight,uptake 60 min,low-dose non-enhanced *** authors measured the SUVmax and SUVmean of the tumor and the normal *** tumor/liver activity ratios(RSUVmax and RSUVmean) were tested as prognostic factors and compared to the following conventional prognostic factors:MILAN,CLIP,OKUDA,TNM stage,alphafoetoprotein level,portal thrombosis,size of the largest nodule,tumor differentiation,microvascular invasion,underlying cirrhosis and liver ***:Overall and recurrence free survivals were80.7%and 67.4%at 3 years,and 70.6%and 67.4%at 5 years,*** to a multivariate Cox model,only FDG PET/CT RSUVmax predicted recurrence free *** though the MILAN criteria alone were not predictive,it is worth noting that none of the patients outside the MILAN criteria and with RSUVmax<1.15 ***:FDG PET/CT with an RSUVmax cutoff value of 1.15 is a strong prognostic factor for recurrence and death in patients with HCC treated by LT in this retrospective *** prospectivestudies should test whether this metabolic index should be systematically included in the preoperative assessment.

关键词： Cancer Hepatoma Hepatocellular cancer Liver transp

Incidence and risk factors for early renal dysfunction after liver transplantation

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World Journal of Transplantation 2016年第1期6卷 220-232页

作者： Patricia Wiesen Paul B Massion Jean Joris olivier detry Pierre Damas Department of General Intensive Care University Hospital of Liege Department of Anaesthesiology and Intensive Care Medicine University Hospital of Liege Department of Abdominal Surgery and Transplantation CHU Liege University of Liege (CHU ULg)

AIM: To determine renal dysfunction post liver transplantation, its incidence and risk factors in patients from a Belgian University ***: 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, bodymass index(BMI), length of preoperative hospital stay, prior bacterial infection within one month, preoperative ascites, preoperative treatment with β-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 ***: 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 le

关键词： Liver transplantation Acute kidney injury incidence Perioperative complications Acute kidney injury risk factors Creatinine/blood Severity renal failure