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Your search keyword '"Porte, Robert J."' showing total 154 results
Start Over Author "Porte, Robert J." Publisher lippincott williams & wilkins
154 results on '"Porte, Robert J."'

4. Novel Benchmark Values for Redo Liver Transplantation. Does the Outcome Justify the Effort?

Author

UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, Abbassi, Fariba, Gero, Daniel, Muller, Xavier, Bueno, Alba, Figiel, Wojciech, Robin, Fabien, Laroche, Sophie, Picard, Benjamin, Shankar, Sadhana, Ivanics, Tommy, van Reeven, Marjolein, van Leeuwen, Otto B, Braun, Hillary J, Monbaliu, Diethard, Breton, Antoine, Vachharajani, Neeta, Bonaccorsi Riani, Eliano, Nowak, Greg, McMillan, Robert R, Abu-Gazala, Samir, Nair, Amit, Bruballa, Rocio, Paterno, Flavio, Weppler Sears, Deborah, Pinna, Antonio D, Guarrera, James V, de Santibañes, Eduardo, de Santibañes, Martin, Hernandez-Alejandro, Roberto, Olthoff, Kim, Ghobrial, R Mark, Ericzon, Bo-Göran, Ciccarelli, Olga, Chapman, William C, Mabrut, Jean-Yves, Pirenne, Jacques, Müllhaupt, Beat, Ascher, Nancy L, Porte, Robert J, de Meijer, Vincent E, Polak, Wojciech G, Sapisochin, Gonzalo, Attia, Magdy, Weiss, Emmanuel, Adam, René A, Cherqui, Daniel, Boudjema, Karim, Zienewicz, Krzysztof, Jassem, Wayel, Dutkowski, Philipp, Clavien, Pierre-Alain, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, Abbassi, Fariba, Gero, Daniel, Muller, Xavier, Bueno, Alba, Figiel, Wojciech, Robin, Fabien, Laroche, Sophie, Picard, Benjamin, Shankar, Sadhana, Ivanics, Tommy, van Reeven, Marjolein, van Leeuwen, Otto B, Braun, Hillary J, Monbaliu, Diethard, Breton, Antoine, Vachharajani, Neeta, Bonaccorsi Riani, Eliano, Nowak, Greg, McMillan, Robert R, Abu-Gazala, Samir, Nair, Amit, Bruballa, Rocio, Paterno, Flavio, Weppler Sears, Deborah, Pinna, Antonio D, Guarrera, James V, de Santibañes, Eduardo, de Santibañes, Martin, Hernandez-Alejandro, Roberto, Olthoff, Kim, Ghobrial, R Mark, Ericzon, Bo-Göran, Ciccarelli, Olga, Chapman, William C, Mabrut, Jean-Yves, Pirenne, Jacques, Müllhaupt, Beat, Ascher, Nancy L, Porte, Robert J, de Meijer, Vincent E, Polak, Wojciech G, Sapisochin, Gonzalo, Attia, Magdy, Weiss, Emmanuel, Adam, René A, Cherqui, Daniel, Boudjema, Karim, Zienewicz, Krzysztof, Jassem, Wayel, Dutkowski, Philipp, and Clavien, Pierre-Alain

Abstract

To define benchmark cutoffs for redo liver transplantation (redo-LT). In the era of organ shortage, redo-LT is frequently discussed in terms of expected poor outcome and wasteful resources. However, there is a lack of benchmark data to reliably evaluate outcomes after redo-LT. We collected data on redo-LT between January 2010 and December 2018 from 22 high-volume transplant centers. Benchmark cases were defined as recipients with MELD score ≤25, absence of portal vein thrombosis, no mechanical ventilation at the time of surgery, receiving a graft from a donor after brain death. Also, high-urgent priority and early redo-LT including those for primary non-function (PNF) or hepatic artery thrombosis were excluded. Benchmark cutoffs were derived from the 75th percentile of the medians of all benchmark centers. Out of 1110 redo-LT, 373 (34%) cases qualified as benchmark cases. Among these cases, the rate of postoperative complications until discharge was 76%, and increased up to 87% at 1-year, respectively. One-year overall survival rate was excellent with 90%. Benchmark cutoffs included Comprehensive Complication Index (CCI®) at 1-year of ≤72, and in-hospital and 1-year mortality rates of ≤13% and ≤15%, respectively. In contrast, patients who received a redo-LT for PNF showed worse outcomes with some values dramatically outside the redo-LT benchmarks. This study shows that redo-LT achieves good outcome when looking at benchmark scenarios. However, this figure changes in high-risk redo-LT, as for example in PNF. This major analysis objectifies for the first-time results and efforts for redo-LT and can serve as a basis for discussion about the use of scarce resources.

Published
2022

6. Liver Transplantation as a New Standard of Care in Patients With Perihilar Cholangiocarcinoma? Results From an International Benchmark Study.

Author

Breuer, Eva, Mueller, Matteo, Doyle, Majella B., Yang, Liu, Darwish Murad, Sarwa, Anwar, Imran J., Merani, Shaheed, Limkemann, Ashley, Jeddou, Heithem, Kim, Steven C., López-López, Victor, Nassar, Ahmed, Hoogwater, Frederik J.H., Vibert, Eric, De Oliveira, Michelle L., Cherqui, Daniel, Porte, Robert J., Magliocca, Joseph F., Fischer, Lutz, and Fondevila, Constantino

Abstract

Objective: To define benchmark values for liver transplantation (LT) in patients with perihilar cholangiocarcinoma (PHC) enabling unbiased comparisons. Background: Transplantation for PHC is used with reluctance in many centers and even contraindicated in several countries. Although benchmark values for LT are available, there is a lack of specific data on LT performed for PHC. Methods: PHC patients considered for LT after Mayo-like protocol were analyzed in 17 reference centers in 2 continents over the recent 5-year period (2014–2018). The minimum follow-up was 1 year. Benchmark patients were defined as operated at high-volume centers (≥50 overall LT/year) after neoadjuvant chemoradiotherapy, with a tumor diameter <3 cm, negative lymph nodes, and with the absence of relevant comorbidities. Benchmark cutoff values were derived from the 75th to 25th percentiles of the median values of all benchmark centers. Results: One hundred thirty-four consecutive patients underwent LT after completion of the neoadjuvant treatment. Of those, 89.6% qualified as benchmark cases. Benchmark cutoffs were 90-day mortality ≤5.2%; comprehensive complication index at 1 year of ≤33.7; grade ≥3 complication rates ≤66.7%. These values were better than benchmark values for other indications of LT. Five-year disease-free survival was largely superior compared with a matched group of nodal negative patients undergoing curative liver resection (n=106) (62% vs 32%, P <0.001). Conclusion: This multicenter benchmark study demonstrates that LT offers excellent outcomes with superior oncological results in early stage PHC patients, even in candidates for surgery. This provocative observation should lead to a change in available therapeutic algorithms for PHC. [ABSTRACT FROM AUTHOR]

Published
2022
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12. Transplantation of High-risk Donor Livers After Ex Situ Resuscitation and Assessment Using Combined Hypo- and Normothermic Machine Perfusion: A Prospective Clinical Trial.

Author

van Leeuwen, Otto B., de Vries, Yvonne, Masato Fujiyoshi, Nijsten, Maarten W. N., Ubbink, Rinse, Pelgrim, Gert Jan, Werner, Maureen J. M., Reyntjens, Koen M. E. M., van den Berg, Aad P., de Boer, Marieke T., de Kleine, Ruben H. J., Lisman, Ton, de Meijer, Vincent E., and Porte, Robert J.

Abstract

Objective: The aim of this study was to evaluate sequential hypothermic and normothermic machine perfusion (NMP) as a tool to resuscitate and assess viability of initially declined donor livers to enable safe transplantation. Summary Background Data: Machine perfusion is increasingly used to resuscitate and test the function of donor livers. Although (dual) hypothermic oxygenated machine perfusion ([D]HOPE) resuscitates livers after cold storage, NMP enables assessment of hepatobiliary function. Methods: In a prospective clinical trial, nationwide declined livers were subjected to ex situ NMP (viability assessment phase), preceded by 1-hour DHOPE (resuscitation phase) and 1 hour of controlled oxygenated rewarming (COR), using a perfusion fluid containing an hemoglobin-based oxygen carrier. During the first 2.5 hours of NMP, hepatobiliary viability was assessed, using predefined criteria: perfusate lactate <1.7 mmol/L, pH 7.35 to 7.45, bile production >10mL, and bile pH >7.45. Livers meeting all criteria were accepted for transplantation. Primary endpoint was 3-month graft survival. Results: Sixteen livers underwent DHOPE--COR--NMP. All livers were from donors after circulatory death, with median age of 63 (range 42-82) years and median Eurotransplant donor risk index of 2.82. During NMP, all livers cleared lactate and produced sufficient bile volume, but in 5 livers bile pH remained <7.45. The 11 (69%) livers that met all viability criteria were successfully transplanted, with 100% patient and graft survival at 3 and 6 months. Introduction of DHOPE--COR--NMP increased the number of deceased donor liver transplants by 20%. Conclusions: Sequential DHOPE--COR--NMP enabled resuscitation and safe selection of initially declined high-risk donor livers, thereby increasing the number of transplantable livers by 20%. Trial registration: www.trialregister.nl; NTR5972. [ABSTRACT FROM AUTHOR]

Published
2019
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25. Multifactorial biological modulation of warm ischemia reperfusion injury in liver transplantation from non-heart-beating donors eliminates primary nonfunction and reduces bile salt toxicity

Author

[KUL], Monbaliu, Diethard, Vekemans, Katrien, Hoekstra, Harm, Vaahtera, Lauri, Libbrecht, Louis, Derveaux, Katelijne, Parkkinen, Jaakko, Liu, Qiang, Heedfeld, Veerle, Wylin, Tine, Deckx, Hugo, Zeegers, Marcel, Balligand, Erika, Buurman, Wim, van Pelt, Jos, Porte, Robert J, Pirenne, Jacques, [KUL], Monbaliu, Diethard, Vekemans, Katrien, Hoekstra, Harm, Vaahtera, Lauri, Libbrecht, Louis, Derveaux, Katelijne, Parkkinen, Jaakko, Liu, Qiang, Heedfeld, Veerle, Wylin, Tine, Deckx, Hugo, Zeegers, Marcel, Balligand, Erika, Buurman, Wim, van Pelt, Jos, Porte, Robert J, and Pirenne, Jacques

Abstract

OBJECTIVE: To design a multifactorial biological modulation approach targeting ischemia reperfusion injury to augment viability of porcine liver grafts from non-heart-beating donors (NHBD). BACKGROUND DATA: Liver Transplantation (LTx) from NHBD is associated with an increased risk of primary nonfunction (PNF) and biliary complications. In porcine NHBD-LTx, we previously reported a 50% risk of PNF and toxic bile formation in grafts exposed to > or =30' warm ischemia (WI). METHODS: Porcine livers exposed to 45' WI were cold stored, transplanted and either modulated (n = 6) or not (controls, n = 9). In the modulation group, donor livers were flushed with warm Ringers (avoiding cold-induced vasoconstriction), streptokinase (eliminating stagnating thrombi), and epoprostenol (vasodilator, platelet aggregation inhibitor) prior to cold storage. In recipients, glycine (Kupffer cell stabilizer), alpha1-acid-glycoprotein (anti-inflammatory protein), MAPKinase-inhibitor (pro-inflammatory cytokine generation inhibitor), alpha-tocopherol and glutathione (anti-oxidants), and apotransferrin (iron chelator) were administrated intravenously. PNF, survival, lactate, transaminase, TNF-alpha, redox-active iron, and biliary bile salt-to-phospholipid ratio were monitored. RESULTS: No PNF was observed in modulated versus 55% in control pigs (P = 0.025). Survival was 83% in modulated versus 22% in control pigs (P = 0.02). At 180' postreperfusion, lactate was lower in modulated (5.4 +/- 1.9 mmol/L) versus control pigs (9.4 +/- 2.2 mmol/L; P = 0.011). At 60' postreperfusion, there was a trend for lower AST in modulated versus control pigs at 60' (939 +/- 578 vs. 1683 +/- 873 IU/L; P = 0.089). Postreperfusion, TNF-alpha remained stable in modulated pigs (49 +/- 27 pg/mL at 15' and 85 +/- 26 pg/mL at 180'; P = 0.399) but increased in control pigs (107 +/- 36 pg/mL at 15' and 499 +/- 216 pg/mL at 180'; P = 0.023). At 180' postreperfusion, redox-active iron was higher in control pigs versus modul

Published
2009

37. Hepatic Hemangiosarcoma.

Author

Orlando, Giuseppe, Adam, Rene, Mirza, Darius, Soderdahl, Goran, Porte, Robert J., Paul, Andreas, Burroughs, Andrew K., Seiler, Christian A., Colledan, Michele, Graziadei, Ivo, Garcia Valdecasas, Juan-Carlos, Pruvot, François-René, Karam, Vincent, and Lerut, Jan

Published
2013
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43. Three ulcerative colitis susceptibility loci are associated with primary sclerosing cholangitis and indicate a role for IL2, REL, and CARD9.

Author

Janse, Marcel, Lamberts, Laetitia E., Franke, Lude, Raychaudhuri, Soumya, Ellinghaus, Eva, Muri Boberg, Kirsten, Melum, Espen, Folseraas, Trine, Schrumpf, Erik, Bergquist, Annika, Björnsson, Einar, Fu, Jingyuan, Jan Westra, Harm, Groen, Harry J.M., Fehrmann, Rudolf S.N., Smolonska, Joanna, van den Berg, Leonard H., Ophoff, Roel A., Porte, Robert J., and Weismüller, Tobias J.

Published
2011
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47. Multifactorial Biological Modulation of Warm Ischemia Reperfusion Injury in Liver Transplantation From Non-Heart-Beating Donors Eliminates Primary Nonfunction and Reduces Bile Salt Toxicity.

Author

Monbaliu, Diethard, Vekemans, Katrien, Hoekstra, Harm, Vaahtera, Lauri, Libbrecht, Louis, Derveaux, Katelijne, Parkkinen, Jaakko, Liu, Qiang, Heedfeld, Veerle, Wylin, Tine, Deckx, Hugo, Zeegers, Marcel, Balligand, Erika, Buurman, Wim, van Pelt, Jos, Porte, Robert J., and Pirenne, Jacques

Abstract

To design a multifactorial biological modulation approach targeting ischemia reperfusion injury to augment viability of porcine liver grafts from non-heart-beating donors (NHBD).Liver Transplantation (LTx) from NHBD is associated with an increased risk of primary nonfunction (PNF) and biliary complications. In porcine NHBD-LTx, we previously reported a 50% risk of PNF and toxic bile formation in grafts exposed to ≥30′ warm ischemia (WI).Porcine livers exposed to 45′ WI were cold stored, transplanted and either modulated (n = 6) or not (controls, n = 9). In the modulation group, donor livers were flushed with warm Ringers (avoiding cold-induced vasoconstriction), streptokinase (eliminating stagnating thrombi), and epoprostenol (vasodilator, platelet aggregation inhibitor) prior to cold storage. In recipients, glycine (Kupffer cell stabilizer), α1-acid-glycoprotein (anti-inflammatory protein), MAPKinase-inhibitor (pro-inflammatory cytokine generation inhibitor), α-tocopherol and glutathione (anti-oxidants), and apotransferrin (iron chelator) were administrated intravenously. PNF, survival, lactate, transaminase, TNF-α, redox-active iron, and biliary bile salt-to-phospholipid ratio were monitored.No PNF was observed in modulated versus 55% in control pigs (P = 0.025). Survival was 83% in modulated versus 22% in control pigs (P = 0.02). At 180′ postreperfusion, lactate was lower in modulated (5.4 ± 1.9 mmol/L) versus control pigs (9.4 ± 2.2 mmol/L; P = 0.011). At 60′ postreperfusion, there was a trend for lower AST in modulated versus control pigs at 60′ (939 ± 578 vs. 1683 ± 873 IU/L; P = 0.089). Postreperfusion, TNF-α remained stable in modulated pigs (49 ± 27 pg/mL at 15′ and 85 ± 26 pg/mL at 180′; P = 0.399) but increased in control pigs (107 ± 36pg/mL at 15′ and 499 ± 216 pg/mL at 180′; P = 0.023). At 180′ postreperfusion, redox-active iron was higher in control pigs versus modulated pigs (0.21±0.18 vs. 0.042±0.062 μm; P = 0.038). Biliary bile salt-to-phospholipid ratio post-LTx was lower in modulated versus control pigs (1128 ± 447 vs. 4836 ± 4619; P = 0.05).A multifactorial biological modulation eliminates PNF, improves liver function and increases survival. Biochemically, TNF-α and redox-active iron are suppressed and biliary bile salt toxicity is reduced. Translating this strategy clinically may lead to wider and safer use of NHBD. [ABSTRACT FROM AUTHOR]

Published
2009
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