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M Mourad

Publications and source records attributed to M Mourad.

65 records · Page 4Linked to original sources
PubMedDate not supplied

Simultaneous pancreas-kidney transplantation in a large multicenter study: surgical complications.

UNLABELLED: Simultaneous pancreas-kidney (SPK) transplantation has evolved as an effective treatment modality for patients with end-stage nephropathy owing to type 1 diabetes mellitus. This kidney-pancreas transplant procedure includes a number of risks, one of them being surgical complications, which were analyzed in this large prospective multicenter study. PATIENTS AND METHODS: The analysis included 205 patients randomly assigned to tacrolimus (n = 103) or cyclosporine ME (n = 102) in the Euro-SPK001 study. Surgical complications were defined as any intervention in the postoperative course related to the transplant procedure. RESULTS: The number of patients undergoing relaparotomy was significantly lower among the tacrolimus group (26.2%) as compared to the cyclosporine ME group (43.1%, P = .0109). Relaparotomy was performed earlier in the cyclosporine ME group (day 14 +/- 17) compared to patients in the tacrolimus group (day 26 +/- 26, P = .0506). Graft vessel thrombosis, intra-abdominal hemorrhage, and enteric or ureteral leakage within the first 3 months occurred significantly more frequently in cyclosporine ME-treated patients. Donor age above 45 years showed a negative impact on surgical complications. Relaparotomy had no impact on patient survival but significantly affected pancreas and kidney graft survival in both groups. CONCLUSION: This prospective, randomized, multicenter trial in patients undergoing primary SPK demonstrated a benefit of tacrolimus over cyclosporine ME with regard to the incidence of surgical complications and, consecutively, to kidney and pancreas graft survival.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

Non-heart-beating donor, renewal of an old procedure: a Belgian experience.

The shortage of donated organs has become a problem in transplantation throughout the world. Transplant teams are looking for other ways to increase and improve the donor pool. Non-heart-beating donation may be a source to increase the number of donors, even if some technical, logistical, and emotional problems are encountered. The results obtained by our team should stimulate other centers to implement this kind of donation in their hospitals. We describe our experience in the policy of non-heart-beating donation and encourage transplant centers to develop such a program.

Belgium↗
PubMedDate not supplied

Evaluation of a new immunoassay to measure sirolimus blood concentrations compared to a tandem mass-spectrometric chromatographic analysis.

A new immunoassay of sirolimus based on the microparticle enzyme immunoassay (MEIA) principle has been developed with collaboration of Abbott Diagnostics. Laboratories and Axis-Shield. Our laboratory evaluated this new assay on 153 whole blood samples (EDTA) drawn from a population of renal (n = 141) and hepatic (n = 12) transplant patients. Each blood sample was analyzed simultaneously by MEIA (Y) and by a reference method (X) used routinely in our laboratory, namely, liquid chromatography tandem mass spectrometry (LC-MS/MS). The statistical analysis of Passing-Bablok produced the following results: Spearman r value = 0.95, slope = 1.15 and intercept with the Y axis = +0.2 ng/mL. The observed global overestimation of 15% compared to the reference method could be explained by the cross-reactivity of sirolimus metabolites with the antibody. A complementary analysis taking into account the transplanted organ (kidney versus hepatic) did not show any significant difference between the populations, most likely owing to the low number of hepatic transplantation samples. The analytical performance of the MEIA method showed CV < or =10% and a limit of quantification of 1.5 ng/mL, which were acceptable for routine clinical monitoring. In conclusion, the MEIA method has shown robust, stable, reproducible, features with an excellent correlation with the reference LC-MS/MS method.

Chromatography, Liquid↗
PubMedDate not supplied

Cost of renal transplant in Belgium.

The objective of this study was to analyze 1-year direct medical costs of kidney transplantation in Belgium. The analysis included the last 150 patients who received a kidney transplant, were treated with cyclosporine, and had 1 year follow-up data. All patient were adults (>18 years) at the time of transplantation. Patient files were retrospectively analyzed. Key clinical events, such as primary hospitalization for transplantation; immunosuppressive drug use; patient survival; graft survival; acute rejection; CMV infection; adverse events and serious complications; treatment of adverse events; treatment of complications; repeat hospitalization; and follow-up hospital consultations were recorded. Total length of stay in the hospital was also recorded. For each patient, information up to 1 year following renal transplantation (or until death if death occurred before 1 year posttransplantation) was collected. Cost information was obtained from anonymous hospital bills that provided amounts paid by the health care payer and patient. Two perspectives are considered in this study: health care payer (INAMI/RIZIV) perspective and patient perspective. For the whole population (n = 143), 7 patients with graft failure were excluded. The mean direct medical costs from the health care payer's perspective, and patient's perspective were 37,792 Euro, and 2,034 Euro, respectively. During this 1-year period, patients were hospitalized for an average of 29 days. One-year direct medical costs of kidney transplantation are substantial. In Belgium, most of the direct medical costs are borne by the health care payer.

Adult↗
PubMedDate not supplied

[Delayed perforation of the sigmoid colon following closed abdominal trauma. Apropos of a case report].

Blunt abdominal trauma and delayed colon perforations are not common and usually occur in patients sustaining other injuries, but also as isolated event. We report a case of delayed perforation of sigmoid colon, three days after a blunt abdominal trauma in a male adult. It was caused by disinsertion of sigmoid colon mesentery for about ten centimeters. This condition is discussed with literature review.

Abdominal Injuries↗
PubMedDate not supplied

[Gastric schwannoma. Observations apropos of a case report of an schwannosarcoma with lymph node metastasis].

Schwannomas as neurofibromas are neurogenic mesenchymal tumors of the stomach. They arise from the Schwann cells of nerves of th gastric wall and are usually benign. The incidence of malignant schwannomas is uncertain because of the variable pathologic criteria used. Immunohistochemistry is a diagnostic tool used to distinguish between schwannomas and leiomyomas both constituted by spindle-cells. In this issue we report a case of malignant schwannoma with lymph node involvement. The clinical and histological features of gastric schwannomas are discussed with evaluation of their diagnostic and therapeutic modalities.

Humans↗
PubMedDate not supplied

Acute colonic complications after kidney transplantation.

Over a 30-year period (1963-1993), 12 patients out of 2091 renal allograft recipients (0.5%) were identified for an acute colonic complication. They were 7 males and 5 females with a mean age of 43 years. The mean elapsed time from transplantation to symptoms was 55 months. Peritonitis was diagnosed in all cases, requiring an emergency laparotomy in 6 patients (50%); delayed surgery was possible in 4 patients (33%) after failure of conservative treatment. One patient (9%) was operated electively later on while the last patient died before any surgery from sepsis after diffuse bowel ischaemia. Aetiology included complicated diverticulitis in 9 instances (75%), one colon perforation caused by faecal impaction, one cytomegalovirus colitis and one bowel ischaemia. Another patient died postoperatively after colon resection for perforated diverticulitis. The use of cyclosporine since 1985 did not reduce the incidence of colonic complication. In conclusion aggressive medical support and early surgical exploration are mandatory for renal recipients presenting with an acute colonic complication.

Abdomen, Acute↗
PubMedDate not supplied

Incidence of thyroid carcinoma in a common surgical practice: the problems.

Over a two-year period, seven hundred twenty-three operations for thyroid disease were performed in the department of endocrine surgery on 717 patients; 7.1% of these patients had neoplastic lesions. If we consider only the solitary nodules, the incidence is 8.8%; while it is only 5.0% in patients with diffuse goiter. In 27.5% of the cases of thyroid neoplasm, peroperative analysis on thyroid tissue is falsely encouraging; yet, on the whole, such analysis reassures 98% patients. Preoperative fine needle aspiration and cytology--of little impact in that series--can bring interesting informations in particular circumstances, while keeping in mind that microscopic diagnosis of follicular carcinoma of the thyroid is histological and not cytological.

Humans↗