P Honoré

Publications (123)104.79 Total impact

• Article: Categories of donation after cardiocirculatory death.

  O Detry, H Le Dinh, T Noterdaeme, A De Roover, P Honoré, J-P Squifflet, M Meurisse
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  ABSTRACT: The interest in donation after cardiocirculatory death (DCD) was renewed in the early 1990s, as a means to partially overcome the shortage of donations after brain death. In some European countries and in the United States, DCD has become an increasingly frequent procedure over the last decade. To improve the results of DCD transplantation, it is important to compare practices, experiences, and results of various teams involved in this field. It is therefore crucial to accurately define the different types of DCD. However, in the literature, various DCD terminologies and classifications have been used, rendering it difficult to compare reported experiences. The authors have presented herein an overview of the various DCD descriptions in the literature, and have proposed an adapted DCD classification to better define the DCD processes, seeking to provide a better tool to compare the results of published reports and to improve current practices. This modified classification may be modified in the future according to ongoing experiences in this field.
  Transplantation Proceedings 06/2012; 44(5):1189-95. · 1.00 Impact Factor
• Article: End of life care in the operating room for non-heart-beating donors: organization at the University Hospital of Liège.

  J Joris, A Kaba, S Lauwick, M Lamy, J-F Brichant, P Damas, D Ledoux, F Damas, B Lambermont, P Morimont, P Devos, M-H Delbouille, J Monard, M-F Hans, A DeRoover, P Honoré, J-P Squifflet, M Meurisse, O Detry
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  ABSTRACT: Non-heart-beating (NHB) organ donation has become an alternative source to increase organ supply for transplantation. A NHB donation program was implemented in our institution in 2002. As in many institutions the end of life care of the NHB donor (NHBD) is terminated in the operating room (OR) to reduce warm ischemia time. Herein we have described the organization of end of life care for these patients in our institution, including the problems addressed, the solution proposed, and the remaining issues. Emphasis is given to our protocol elaborated with the different contributors of the chain of the NHB donation program. This protocol specifies the information mandatory in the medical records, the end of life care procedure, the determination of death, and the issue of organ preservation measures before NHBD death. The persisting malaise associated with NHB donation reported by OR nurses is finally documented using an anonymous questionnaire.
  Transplantation Proceedings 11/2011; 43(9):3441-4. · 1.00 Impact Factor
• Article: Renal transplantation from living related donors: a single center experience in Viet Nam.

  H Ledinh, O Detry, M S Pham, H M Truong, T P Tran, P K Nguyen, P D Ta, T Q M Nguyen, T N N Huynh, T V Bach, J Joris, C Bonvoisin, A De Roover, P Honoré, J P Squifflet, M Meurisse
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  ABSTRACT: End-stage renal disease is a major public health problem in Viet Nam. A cooperative project between the University of Liège, Belgium, and the University of Medicine Pham Ngoc Thach, Ho Chi Minh City, Viet Nam, has permitted the establishment of an autonomous program of renal transplantation from living-related donors at the Peoples' Hospital No 115. The aim of this paper was to report the primary results of the project and to draw conclusions for the future. From January 2004 to July 2008, we performed 33 living-related renal transplantations. Mean ages of donors and recipients were 31.8 ± 9.5 and 41.6 ± 13.5 years, respectively. Laparoscopic nephrectomy was performed in 6 donors. The immunosuppressive regimen consisted of three drugs associated with induction therapy using anti-interleukin-2 receptor monoclonal antibody. The 33 donors are in good health at follow-up. Four developed major intra- or postoperative hemorrhage necessitating transfusion, with a surgical re-exploration in 1 donor. Wound infection occurred in 2 donors. Posttransplant recipient and graft survivals at 1 versus 3 years were 82% and 73% versus 82% and 65%, respectively. Eight recipients presented 13 biopsy-proven acute rejection episodes that were reversible in 7, but 1 patient lost his graft due to an irreversible rejection. Two recipients developed cancer. These initial results have encouraged us to continue the program of renal transplantation from living-related donors. However, they also pointed out the need to develop other donor sources.
  Transplantation Proceedings 12/2010; 42(10):4389-91. · 1.00 Impact Factor
• Article: Contribution of donors after cardiac death to the deceased donor pool: 2002 to 2009 University of Liege experience.

  H Ledinh, N Meurisse, M-H Delbouille, J Monard, M-F Hans, C Bonvoisin, L Weekers, J Joris, A Kaba, S Lauwick, P Damas, F Damas, B Lambermont, L Kohnen, A Deroover, P Honoré, J-P Squifflet, M Meurisse, O Detry
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  ABSTRACT: In this study, we have evaluated the organ procurement and transplantation activity from donors after cardiac death (DCD) at our institution over an 8-year period. Our aim was to determine whether this program influenced transplantation programs, or donation after brain death (DBD) activity. We prospectively collected our procurement and transplantation statistics in a database for retrospective review. We observed an increasing trend in potential and actual DCD number. The mean conversion rate turning potential into effective donors was 58.1%. DCD accounted for 16.6% of the deceased donor (DD) pool over 8 years. The mean age for effective DCD donors was 53.9 years (range, 3-79). Among the effective donors, 63.3% (n = 31) came from the transplant center and 36.7% (n = 18) were referred from collaborative hospitals. All donors were Maastricht III category. The number of kidney and liver transplants using DCD sources tended to increase. DCD kidney transplants represented 10.8% of the DD kidney pool and DCD liver transplants made up 13.9% of the DD liver pool over 8 years. The DBD program activity increased in the same time period. In 2009, 17 DCD and 33 DBD procurements were performed in a region with a little >1 million inhabitants. The establishment of a DCD program in our institution enlarged the donor pool and did not compromise the development of the DBD program. In our experience, DCD are a valuable source for abdominal organ transplantation.
  Transplantation Proceedings 12/2010; 42(10):4369-72. · 1.00 Impact Factor
• Article: [Clinical case of the month. Cystic lymphangioma of the mesentery].

  V Verdin, B Seydel, O Detry, D Van Daele, P Meunier, P Honoré, M Meurisse, J Belaïche
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  ABSTRACT: Cystic lymphangioma of the mesentery is a benign condition, probably of malformative origin, and frequently appearing in infancy. Its symptomatology can be very polymorphic. Its diagnosis is suspected by ultrasonography and computed tomography, and definitely confirmed by pathology. About a recent case of cystic lymphangioma of the mesentery diagnosed and operated on at the university hospital of Liège in an adult patient, the authors review its classification and its therapeutic strategy. Surgical resection is indicated in symptomatic cystic lymphangioma.
  Revue médicale de Liège 11/2010; 65(11):615-8.
• Article: [Image of the month. Cholecystectomy without a visible scar: laparoscopic cholecystectomy via the umbilicus].

  L Kohnen, C Coimbra, A Deroover, B Nsadi, A Kaba, S Lauwick, J Joris, S Maweja, E Hamoir, M Meurisse, P Honoré, O Detry
  Revue médicale de Liège 10/2010; 65(10):543-4.
• Article: Results of kidney transplantation from donors after cardiac death.

  H Ledinh, C Bonvoisin, L Weekers, A de Roover, P Honoré, J P Squifflet, M Meurisse, O Detry
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  ABSTRACT: Confronting the organ donor shortage, many transplant centers around the world increasingly use donors after cardiac death (DCD). Over the past 20 years, follow-up studies in kidney recipients comparing DCD and donors after brain death (DBD) have shown comparable long-term graft function and survival. As a consequence, DCD programs should be continued and expanded, for these donors constitute a potential solution to the imbalance between the numbers of end-stage kidney disease patients on waiting lists versus available kidney grafts. DCD kidneys do not necessarily signify suboptimal grafts; they may merit to be allocated the same as DBD grafts.
  Transplantation Proceedings 09/2010; 42(7):2407-14. · 1.00 Impact Factor
• Article: Budd-Chiari syndrome complicating hepatic sarcoidosis: definitive treatment by liver transplantation: a case report.

  V Delfosse, L de Leval, A De Roover, J Delwaide, P Honoré, J Boniver, O Detry
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  ABSTRACT: Sarcoidotic involvement of the liver is frequent, albeit uncommonly symptomatic. Severe complications are rare, but may seldom require liver transplantation. Budd-Chiari syndrome has been described in a few patients with hepatic sarcoidosis. Herein we have reported the case of a young woman suffering from hepatic sarcoidosis who developed severe cholestasis and chronic Budd-Chiari syndrome. She successfully underwent orthotopic liver transplantation (OLT) and is asymptomatic with normal liver function at 3 years follow-up. Histopathological assessment of the liver explant demonstrated a florid granulomatous process, with involvement of the large intrahepatic veins, providing an anatomical basis for the vascular flow disturbances. This case adds further evidence that liver transplantation may be the curative treatment for complicated sarcoidotic liver disease.
  Transplantation Proceedings 10/2009; 41(8):3432-4. · 1.00 Impact Factor
• Source

  Available from: Jean-Paul Squifflet

  Article: A retrospective monocenter review of simultaneous pancreas-kidney transplantation.

  E Decker, C Coimbra, L Weekers, O Detry, P Honoré, J-P Squifflet, M Meurisse, A De Roover
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  ABSTRACT: Herein we have reviewed a consecutive series of simultaneous pancreas-kidney (SPK) transplantations performed at our institution over a 6-year period. The study population included 22 patients (15 males and 7 females) who underwent SPK transplantation between 2001 and 2007. The mean recipient age was 47 years (range, 26-63 years). Eighteen patients suffered type 1 and 4 type 2 diabetes mellitus. The mean donor age was 33 years (range, 14-56 years). The mean HLA match was 2.1 (range, 1-5). Immunosuppressive treatment consisted of basiliximab induction followed by tacrolimus, mycophenolate mofetil, and prednisone. The mean hospital stay was 20 days (range, 11-52 days). After a mean follow-up of 44 months (range, 17-88 months), patient, kidney, and pancreas graft survivals were 86%, 82%, and 73%, respectively. Two patients died in the immediate postoperative period due to, respectively, disseminated intravascular coagulation and pulmonary embolism. A kidney graft was lost due to early hyperacute rejection. Other early complications associated with the pancreas graft included 2 cases of immediate reperfusion defects that led to early vascular thrombosis in 1 patient and a duodenal graft fistula in the other patient; a third patient developed type 2 diabetes mellitus. Beyond the postoperative period, graft loss was limited to 1 case of noncompliance to the immunosuppressive medications and 1 death secondary to pulmonary infection with a functional allograft after 4 years. SPK transplantation is a valid therapeutic option for patients with insulin-dependent diabetes mellitus and renal failure due to diabetic nephropathy. The main complications of SPK transplantation occur in the immediate postoperative period consequent to vascular or rejection processes.
  Transplantation Proceedings 10/2009; 41(8):3389-92. · 1.00 Impact Factor
• Article: Fulminant hepatic failure induced by venlafaxine and trazodone therapy: a case report.

  O Detry, J Delwaide, A De Roover, M F Hans, M H Delbouille, J Monard, P Honoré
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  ABSTRACT: Although acute hepatitis may be a side effect of many medications, most cases are reversible after treatment interruption, and fulminant hepatic failure (FHF) is rare. Venlafaxine and trazodone are 2 popular antidepressant agents. Alteration of liver enzyme levels has been reported as a side effect of these drugs at normal doses. Herein we have reported the case of a 48-year-old woman without any previous history of liver disease, who developed fulminant liver failure after 4 months of venlafaxine and trazodone therapy. She required liver transplantation, a procedure that was successful with full patient recovery. The first 5 years of follow-up were uneventful. This case documented that venlafaxine and trazodone at normal doses can produce severe liver toxicity. Liver tests should be monitored regularly in patients who receive this therapy.
  Transplantation Proceedings 10/2009; 41(8):3435-6. · 1.00 Impact Factor
• Article: Liver transplant donation after cardiac death: experience at the University of Liege.

  O Detry, B Seydel, M-H Delbouille, J Monard, M-F Hans, A De Roover, C Coimbra, S Lauwick, J Joris, A Kaba, P Damas, F Damas, A Lamproye, J Delwaide, J-P Squifflet, M Meurisse, P Honoré
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  ABSTRACT: Donation after cardiac death (DCD) has been proposed to overcome in part the organ donor shortage. In liver transplantation, the additional warm ischemia time associated with DCD procurement may promote higher rates of primary nonfunction and ischemic biliary lesions. We reviewed the results of liver transplantation from DCD. From 2003 to 2007, we consecutively performed 13 controlled DCD liver transplantations. The medical records of all donors and recipients were retrospectively reviewed, evaluating in particular the outcome and occurrence of biliary complications. Mean follow-up was 25 months. Mean donor age was 51 years, and mean intensive care unit stay was 5.4 days. Mean time between ventilation arrest and cardiac arrest was 9.3 minutes. Mean time between cardiac arrest and arterial flushing was 7.7 minutes. No-touch period was 2 to 5 minutes. Mean graft cold ischemia time was 295 minutes, and mean suture warm ischemia time was 38 minutes. Postoperatively, there was no primary nonfunction. Mean peak transaminase level was 2546 UI/mL. Patient and graft survival was 100% at 1 year. Two of 13 patients (15%) developed main bile duct stenosis and underwent endoscopic management of the graft. No patient developed symptomatic intrahepatic bile duct strictures or needed a second transplantation. Our experience confirms that controlled DCD donors may be a valuable source of transplantable liver grafts in cases of short warm ischemia at procurement and minimal cold ischemia time.
  Transplantation Proceedings 04/2009; 41(2):582-4. · 1.00 Impact Factor
• Article: [Treatment of (unresectable) hepatocellular carcinoma at an intermediate or advanced stage].

  D Van Daele, J Belaiche, J Delwaide, P Piront, A De Roover, O Detry, P Honoré, M Polus
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  ABSTRACT: Hepatocellular carcinoma is the main primitive tumor of the liver. It occurs in the setting of liver cirrhosis in more than 90% of the cases in developing countries. The prognosis depends on the size, number and extension of the tumor as well as on the severity of the underlying liver disease. The Barcelona Clinic Classification takes into account these different parameters and helps the clinician in the therapeutic decision. Some patients (around 25%) are amenable to therapy with a curative intent (liver transplantation, resection, destruction by radiofrequency). In patients with hepatocellular carcinoma at an intermediate stage, lipiodolized chemoembolization gives a survival advantage in comparison with placebo. No conventional regimen of chemotherapy has a proven survival benefit. In patients with a hepatocellular carcinoma at an advanced stage, sorafenib, an oral multi-targeted kinase inhibitor, is the first compound to demonstrate a significant effect on survival free of disease progression in a selected group of patients. Its toxicity profile is particularly favourable. Combination of surgical and medical therapies should be properly evaluated in clinical trials in the near future.
  Revue médicale de Liège 04/2009; 64(3):140-7.
• Article: [Palliative management of hepatocarcinoma with sorafenib (Nexavar). Results of the SHARP study (sorafenib hepatocarcinoma assessment randomized protocol trial)].

  O Detry, J Delwaide, A De Roover, P Meunier, D Van Daele, A Lamproye, P Honoré, M Polus
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  ABSTRACT: Curative management of early-stage hepatocarcinoma may include partial hepatic resection, liver transplantation or tumoral necrosis using radiofrequency ablation or alcoholisation. Until recently, no efficient therapeutic mean was available for advanced hepatocarcinoma. Sorafenib (Nexavar, Bayer) is a multikinase inhibitor that decreases tumoral proliferation and angiogenesis, and increases apoptosis in many cancer models. The results of a phase 3 randomized, multicentric, study, entitled SHARP, have now demonstrated that sorafenib increases survival in patients with advanced hepatocarcinoma developed in Child A cirrhosis. Mean survival gain was a little less than 3 months, without any radiologic response or improvement in the delay before symptomatic progression of the disease. The monthly cost of sorafenib is a little more than 5,000 euros. It is now crucial to evaluate the potential role of sorafenib in adjuvant therapy after liver resection or radiofrequency ablation of hepatocarcinoma. The CHU of Liège is taking part to a randomized, multicentric study evaluating the use of sorafenib after liver resection or radiofrequency ablation for hepatocarcinoma. Another future evaluation could be the association of sorafenib with other antitumoral agents.
  Revue médicale de Liège 04/2009; 64(3):168-70.
• Article: [Clinical case of the month. Liver transplantation for hepatic epithelioid hemangioendothelioma].

  M Tonglet, V Delfosse, O Detry, A De Roover, I Scagnol, B Delhougne, C Brixko, D Dresse, V Fridman, J L Lismonde, M Meurisse, P Honoré
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  ABSTRACT: The epithelioid hemangioendothelioma is a rare malignant vascular lesion that may occur within the liver. In the hepatic multifocal and bilobar forms, liver transplantation is indicated as the curative management. In this case report, the authors describe the diagnosis and the management of a 52-year-old woman who was diagnosed with hepatic epithelioid hemangioendothelioma and who underwent successful liver transplantation.
  Revue médicale de Liège 03/2009; 64(2):68-70.
• Article: [Targeted therapy: toward a clean and effective war against cancer].

  V Castronovo, D Waltregny, O Detry, C Coimbra Marques, A De Roover, P Honoré, E De Pauw, A Turtoi
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  ABSTRACT: One promising avenue towards the development of more selective, better anticancer drugs consists in the targeted delivery of bioactive compounds to the tumor environment by means of binding molecules specific for tumor-associated biomarkers. Eligibility of such markers for therapeutic use implies ideally three criteria : (i) accessibility from the bloodstream, (ii) expression at sufficient level and (iii) no (or much lower) expression in normal tissues. Most current discovery strategies (such as biomarker searching into body fluids) provide no clue as to whether proteins of interest are accessible, in human tissues, to suitable high-affinity ligands, such as systemically delivered monoclonal antibodies. Innovative proteomic technologies are able to identify such accessible biomarkers and represent a key step in the clinical development of such target therapies.
  Revue médicale de Liège 01/2009; 64 Spec No:20-3.
• Article: [When should we resect colorectal liver metastases?].

  C Honoré, O Detry, A Deroover, P Piront, M Polus, P Honoré, M Meurisse
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  ABSTRACT: 6000 new cases of colorectal cancer are diagnosed each year in Belgium. 50% of these patients shall develop liver metastasis. Resection remains the only chance of long term survival and must be considered as an endpoint from the beginning of the treatment. It is the result of a multidisciplinary discussion and a global approach of the disease. It is rarely directly feasible, but there are many techniques which may make it achievable in the end. Today, resection criteria are exclusively technical and neither bad prognosis factors, nor the presence of extra-hepatic metastases should exclude liver resection. This resection must be assessed by a confirmed hepatobiliary surgeon and must be proposed to all patients whatever their age as long as their general state of health is good.
  Revue médicale de Liège 11/2008; 63(10):595-9.
• Article: [Alveolar echinococcosis].

  O Wauters, C Honoré, O Detry, J Delwaide, J Demonty, P Léonard, A Thiry, M P Hayette, A De Roover, P Honoré, J Boniver, J Belaïche, M Meurisse
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  ABSTRACT: Alveolar echinococcosis is a serious parasitic disease, leading to large hepatic lesions. It must be distinguished from cystic echinococcosis, or hydatic cyst, caused by Echinococcus granulosus. Early diagnosis may allow surgical removal of the lesions by segmental hepatectomy, the only curative treatment. Parasitostatic medical treatment with albendazole may promote stabilization of the disease. Until recently, Belgium was considered a country at very low risk for alveolar echinococcosis, as no human case was reported, despite up to 51% of fox infection in southern Belgium autopsy series. Recently four patients presented with alveolar echinococcosis at the University Hospital Center of Liege, leading to the fear of a possible alveolar echinococcosis endemy in southern Belgium. Two of these patients underwent curative hepatectomy, but the other two had already pulmonary metastases at diagnosis and received palliative albendazole therapy. This article presents these cases, and reviews the clinical features of this parasitic disease.
  Revue médicale de Liège 12/2005; 60(11):867-74.
• Article: [Laparoscopic liver resection of a hydatid cyst].

  O Detry, P Léonard, J Delwaide, L de Leval, V Radermacher, A De Roover, M Meurisse, P Honoré
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  ABSTRACT: Most of the echinococcosis cases treated in Belgium are contracted in African and Mediterranean countries. In this paper the authors describe the case of a Mediterranean patient suffering from a hepatic hydatid cyst treated by oral albendazole and laparoscopic liver resection.
  Revue médicale de Liège 10/2005; 60(9):700-2.
• Article: [Endoscopic mucosa resection for superficial esophageal carcinoma: an alternative to radical surgery?].

  P Gast, M Polus, P Honoré, J Belaiche
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  ABSTRACT: Radical surgery is the standard of care for resectable esophagus cancers, with mortality less than 5% in heavily trained surgical teams. Nevertheless, the morbidity of surgery is quite high due to the procedure and due to the poor status of these patients. Endoscopic mucosal resection seems effective for the resection of superficial malignant lesions of esophagus with an acceptable morbidity profile. A correct staging has to confirm the superficial character of the lesion and exclude deeper infiltration into the digestive wall or nodal involvement. This technique might be an acceptable alternative to surgery or superficial lesions, particularly for patients at high risk for aggressive surgical procedure.
  Revue médicale de Liège 04/2005; 60(3):154-62.
• Source

  Available from: ulg.ac.be

  Article: Laparoscopic sigmoidectomy for fistulized diverticulitis.

  S R Laurent, B Detroz, O Detry, C Degauque, P Honoré, M Meurisse
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  ABSTRACT: Nowadays laparoscopic colorectal surgery has demonstrated its advantages, including reduced postoperative pain, decreased duration of ileus, and shorter hospital stay. Few studies report results of laparoscopic surgery in complicated diverticulitis. This study was designed to analyze the results of laparoscopic sigmoidectomy in patients with fistulized sigmoiditis. The authors retrospectively reviewed 16 patients who had laparoscopic sigmoidectomy for fistulized diverticulitis between 1992 and 2003 in a series of 247 laparoscopic colectomies. Eleven patients presented with colovesical, four with colovaginal, and one with colocutaneous fistulas; all were caused by sigmoiditis. The procedure always consisted of celioscopic sigmoidectomy with stapled transanal suture and, when indicated, closure of the cystic or vaginal fistula orifice. Mean age was 60 (range, 39-78) years. Mean number of episodes of diverticulitis before operation was three (range, 1-5). Mean time between the last episode and operation was 46 (range, 2-250) weeks. In our first three years of experience, three cases (18.7 percent) were converted to laparotomy. Reasons for conversion were the necessity for intestinal resection, splenectomy, and a wound of the anterior rectum. The mean operative time was 172 (range, 100-280) minutes. Mean hospital stay was 5.7 (range, 3-12) days. There was no mortality. Postoperative morbidity (2 patients, 12.5 percent) consisted of one pulmonary infection and one splenectomy. Long-term follow-up revealed no recurrence of diverticulitis and one incisional hernia. In experienced hands, laparoscopic sigmoidectomy may be a safe and effective procedure for fistulized sigmoiditis.
  Diseases of the Colon & Rectum 02/2005; 48(1):148-52. · 3.13 Impact Factor