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5. Bénéfices de la réadaptation cardiaque chez les patients cardio-rénaux : étude rétrospective portant sur 573 patients insuffisants cardiaques à fraction d’éjection réduite

Author

S. Roueff, M.C. Iliou, Hélène Lazareth, A. Mroue, E. Thervet, and O. Kovalska

Subjects
Nephrology
Abstract

Introduction L’insuffisance renale chronique (IRC) s’accompagne d’une sarcopenie qui pourrait limiter les benefices de la readaptation cardiaque (RC) dans le syndrome cardio-renal (SCR). Description L’objectif de cette etude est d’evaluer, chez les IC a fraction d’ejection reduite (ICFEr), l’effet de la RC selon le stade d’IRC sur les capacites physiques evaluees par une epreuve d’effort cardio-respiratoire en debut et fin de programme. Etude retrospective, menee sur 573 patients ICFEr (FE Methodes Les patients etaient divises en 4 groupes (G) selon leur DFG : G 1 ≥ 60 ; G2 : 45-59 ; G3 : 30-44 ; G4 Resultats Dans la population d’ICFEr, 38 % des patients avaient un DFG Conclusion La RC est benefique chez les patients ICFEr ayant une IRC. Le SCR ne doit pas etre un frein a la prescription de la RC.

Published
2021

6. Predictive Modeling of Tacrolimus Dose Requirement Based on High-Throughput Genetic Screening

Author

Pierre Laurent-Puig, L. Toullec, Isabelle Etienne, Gabriel Choukroun, Cécile Vigneau, B. Hurault de Ligny, Mathias Büchler, Anne-Elisabeth Heng, Jean-François Subra, Antoine Thierry, E. Thervet, Anastasia Yartseva, Bruno Moulin, Cécilia Damon, C. Legendre, Dany Anglicheau, A. Monnot, Marie-Anne Loriot, Nicolas Pallet, P Beaune, Mathilde Bateson, Margaux Luck, Génétique, Reproduction et Développement (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020])-Centre National de la Recherche Scientifique (CNRS), Service de néphrologie et immunologie clinique [CHRU Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT), Service de Néphrologie-Dialyse-Transplantation rénale [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Pontchaillou [Rennes], Institut de recherche en santé, environnement et travail (Irset), Université d'Angers (UA)-Université de Rennes (UR)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de Néphrologie - Hémodialyses [CHU Clermont-Ferrand], Pôle RHEUNNIRS [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Service de Néphrologie [Angers], Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Descartes - Paris 5 (UPD5), aucun, AGAETIS, Service de Transplantation Rénale, affiliation inconnue, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Clermont Auvergne [2017-2020] (UCA [2017-2020]), Service de néphrologie et immunologie clinique, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Université de Tours, Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Institut National de la Santé et de la Recherche Médicale (INSERM)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA), Domaines Océaniques (LDO), Institut national des sciences de l'Univers (INSU - CNRS)-Université de Brest (UBO)-Observatoire des Sciences de l'Univers-Institut d'écologie et environnement-Centre National de la Recherche Scientifique (CNRS), Génétique, Reproduction et Développement - Clermont Auvergne (GReD ), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Clermont Auvergne (UCA)-Centre National de la Recherche Scientifique (CNRS), Science et Technologie du Lait et de l'Oeuf (STLO), Institut National de la Recherche Agronomique (INRA)-AGROCAMPUS OUEST, Université d'Angers (UA)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-École des Hautes Études en Santé Publique [EHESP] (EHESP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de Néphrologie, Hôpital Gabriel Montpied, CHU de Clermont-Ferrand, Clermont-Ferrand, France, Centre National de la Recherche Scientifique (CNRS)-Institut d'écologie et environnement-Observatoire des Sciences de l'Univers-Université de Brest (UBO)-Institut national des sciences de l'Univers (INSU - CNRS), and Université de Tours-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)

Subjects
Genetic Markers, Graft Rejection, 0301 basic medicine, Genotype, translational research/science, immunosuppression/immune modulation, Biology, clinical research/practice, Bioinformatics, Polymorphism, Single Nucleotide, 030226 pharmacology & pharmacy, Tacrolimus, ABCC8, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, genomics, Humans, Immunology and Allergy, genetics, Pharmacology (medical), Genetic Testing, Gene, Transplantation, Models, Statistical, Transporter, Kidney Transplantation, Transplant Recipients, High-Throughput Screening Assays, 3. Good health, immunosuppressive regimens, Molecular network, 030104 developmental biology, [SDV.TOX]Life Sciences [q-bio]/Toxicology, biology.protein, Tacrolimus Dose, pharmacology, Immunosuppressive Agents, Drug metabolism
Abstract

International audience; Any biochemical reaction underlying drug metabolism depends on individual gene-drug interactions and on groups of genes interacting together. Based on a high-throughput genetic approach, we sought to identify a set of covariant single-nucleotide polymorphisms predictive of interindividual tacrolimus (Tac) dose requirement variability. Tac blood concentrations (Tac C0 ) of 229 kidney transplant recipients were repeatedly monitored after transplantation over 3 mo. Given the high dimension of the genomic data in comparison to the low number of observations and the high multicolinearity among the variables (gene variants), we developed an original predictive approach that integrates an ensemble variable-selection strategy to reinforce the stability of the variable-selection process and multivariate modeling. Our predictive models explained up to 70% of total variability in Tac C0 per dose with a maximum of 44 gene variants (p-value

Published
2017

8. Évolution de la prise en charge thérapeutique des patients incidents ayant une vascularite associée aux ANCA en France entre 2010 et 2018

Author

E. Thervet, C.A. Durel, P. Bataille, Benjamin Terrier, and Dominique Chauveau

Subjects
Nephrology
Abstract

Introduction/Objectif du travail Decrire l’evolution du traitement des patients ayant une vascularite associee aux ANCA entre 2010 et 2018. Suite a l’obtention de l’AMM pour le rituximab (RTX) en 2013, les patients ont ete separes en 2 groupes, groupe 1 (Gp1), incidents pris en charge entre 1/1/2010 et 31/12/2012 et groupe (Gp2), incidents prise en charge entre 1/1/2013 et 31/12/2017. Methodes Etude menee a partir des bases SNIIRAM, Donnees de Consommation InterRegimes (DCIR) et PMSI pour les patients ayant un diagnostic de granulomatose avec polyangeite (GPA) ou polyangeite microscopique (PAM). Differences statistiques entre les groupes avec le test du Chi2, x p ≤ 0,02, xx p Resultats A l’exception des traitements utilises pour moins de 10 % des patients, sont donnees repartition en % et differences entre Gp1 et Gp2 pour l’induction et la maintenance. Les corticosteroides ont ete associes en induction et entretien pour tous (> 95 %) ( Tableau 1 ). Conclusion Avec le RTX, le recours a l’AZA a ete reduit mais sans changement pour le % eleve de patients sous corticosteroides en induction et entretien.

Published
2020

9. Incidence, prévalence et mortalité des vascularites associées aux ANCA en France entre 2010 et 2018

Author

Benjamin Terrier, Dominique Chauveau, P. Bataille, E. Thervet, and C.A. Durel

Subjects
Nephrology
Abstract

Introduction Les vascularites associees aux ANCA sont des maladies rares pour lesquelles il n’existe pas de donnees epidemiologiques precises a l’echelle de la France. Dans ce travail nous avons documente leur incidence, leur prevalence et leur mortalite sur une periode de 8 ans. Methodes L’etude a ete menee a partir des bases de donnees Systeme national d’information inter-regime de l’Assurance Maladie (SNIRAM), Donnees de Consommation InterRegimes (DCIR) et PMSI entre le 1/1/2010 au 31/12/2017 pour tous les adultes ayant un diagnostic de granulomatose avec polyangeite (GPA) et de polyangeite microscopique (PAM). Les patients avec un diagnostic de GPA ou PAM n’ayant jamais ete hospitalises n’ont pas ete inclus. Le recueil des donnees sur la mortalite n’a ete exhaustif qu’a partir de 2013. Resultats Sur cette periode, l’etude a porte sur 6581 patients prevalent avec un diagnostic de GPA (n = 4445) et PMA (n = 1833), la distinction n’etant pas possible pour 303 patients. Environ 40 % de ces patients etaient des cas incidents (n = 2605). Le Tableau 1 illustre les taux d’incidence, de prevalence et de mortalite normalises pour 100 000 habitants selon les annees pour l’ensemble GPA/PAM. Conclusion La GPA est 2 fois plus frequentes que la PAM en France. L’incidence des vascularites ANCA, comparable a celles de l’Allemagne et de la Grande-Bretagne, est dans les valeurs hautes europeennes et reste stable durant la periode d’etude. On observe une mortalite 2 fois superieure a celle attendue dans la population generale.

Published
2020

10. PRIMARY AND SECONDARY GLOMERULONEPHRITIDES 2

Author

D. Monova, S. Monov, T. Todorov, D. Soderberg, T. Kurz, M. Weiner, P. Eriksson, M. Segelmark, K. Jakuszko, A. Sebastian, Z. Bednarz, M. Krajewska, P. Wiland, K. Madziarska, W. Weyde, M. Klinger, J. Naidoo, N. Wearne, E. Jones, C. Swanepoel, B. Rayner, I. Okpechi, N. Endo, N. Tsuboi, K. Furuhashi, S. Matsuo, S. Maruyama, M. Clerte, C. Levi, M. Touzot, F. Fakhouri, C. Monge, C. Lebas, I. Abboud, A. Huart, P. Durieux, E. Charlin, E. Thervet, A. Karras, K. Smykal-Jankowiak, Z. I. Niemir, M. Polcyn-Adamczak, S. Whatmough, N. Sweeney, S. Fernandez, M. Hussain, A. Dhaygude, K. Gniewek, L. Manenti, M. L. Urban, A. Vaglio, E. Gintoli, M. Galletti, C. Buzio, T. Argirova, I. Wong, F. H. Ibrahim, B. L. Goh, T. S. Lim, M. W. Chan, R. Hiramtasu, Y. Ubara, J. Hoshino, K. Takaichi, V. Ghafoor, M. Sahay, J. Soma, I. Nakaya, N. Sasaki, K. Yoshikawa, H. Sato, V. Kaminskyy, M. ZAbi Ska, K. Ko Cielska-Kasprzak, Z. Niemir, K. Wozniczka, A. Swierzko, M. Cedzynski, A. Sokolowska, A. Szala, A. Arjunan, A. Mikhail, R. Shrivastava, C. Parker, S. Aithal, M. Gursu, M. Ozari, E. Yucetas, A. Sumnu, B. Doner, E. Cebeci, O. Ozkan, M. B. Aktuglu, Z. Karaali, M. Koldas, S. Ozturk, H. Marco, M. Picazo, I. Da Silva, A. Gonzalez, Y. Arce, S. Gracia, M. Corica, J. Llobet, M. Diaz, J. Ballarin, U. Schonermarck, H. Hagele, A. Baumgartner, M. Fischereder, S. Muller, C. B. L. Oliveira, A. S. A. Oliveira, C. J. B. Carvalho, C. T. B. C. Pessoa, L. H. B. C. Sette, G. V. Fernandes, M. A. G. M. Cavalcante, L. M. Valente, Q. Wan, H. Hu, Y. He, T. Li, N. Aazair, Z. Houmaid, A. Rhair, N. Bennani, A. Demin, O. Petrova, O. Kotova, L. Demina, D. Roccatello, S. Sciascia, D. Rossi, C. Naretto, S. Baldovino, M. Alpa, I. Salussola, V. Modena, E. V. Zakharova, O. V. Vinogradova, E. S. Stolyarevich, D. Y. H. Yap, T. M. Chan, V. Thanaraj, A. Ponnusamy, S. Pillai, L. Argentiero, A. Schena, M. Rossini, C. Manno, G. Castellano, M. Martino, A. Mitrotti, M. Giliberti, C. Digiorgio, A. M. Di Palma, M. Battaglia, P. Ditonno, G. Grandaliano, L. Gesualdo, N. Neprintseva, N. Tchebotareva, I. Bobkova, L. Kozlovskaya, V. Rabrenovi, Z. Kova Evi, D. Jovanovi, M. Rabrenovi, S. Anti, L. Ignjatovi, M. Petrovi, S. Longhi, L. Del Vecchio, S. Vigano, D. Casartelli, M. C. Bigi, M. Corti, M. Limardo, F. Tentori, G. Pontoriero, A. A. Zeraati, Z. Shariati Sarabi, A. Davoudabadi Farahani, Z. Mirfeizi, and E. Bae

Subjects
Transplantation, medicine.medical_specialty, Primary (chemistry), Nephrology, business.industry, Internal medicine, medicine, business
Published
2014

11. TRANSPLANTATION BASIC SCIENCE, ALLOGENIC AND XENOGENIC TOLERANCE

Author

L. Berthelot, T. Robert, T. Tabary, V. Vuiblet, M. Drame, O. Toupance, P. Rieu, R. C. Monteiro, F. Toure, S. Ferrario, V. Cantaluppi, M. De Lena, S. Dellepiane, S. Beltramo, M. Rossetti, A. M. Manzione, M. Messina, M. Gai, C. Dolla, L. Biancone, G. Camussi, P. Pontrelli, A. R. Oranger, M. Accetturo, F. Rascio, M. Gigante, G. Castellano, A. Schena, M. Fiorentino, A. Zito, G. Zaza, G. Stallone, L. Gesualdo, G. Grandaliano, E. F. Pattonieri, M. Gregorini, V. Corradetti, C. Rocca, S. Milanesi, A. Peloso, J. Ferrario, M. Cannone, F. Bosio, N. Maggi, M. A. Avanzini, P. Minutillo, M. Paulli, M. Maestri, T. Rampino, A. Dal Canton, K. S. T. Wu, O. Coxall, Y. Luque, S. Candon, M. Rabant, L.-H. Noel, E. Thervet, L. Chatenoud, R. Snanoudj, D. Anglicheau, C. Legendre, J. Zuber, P. Hruba, I. Brabcova, E. Krepsova, J. Slatinska, A. Sekerkova, I. Striz, R. Zachoval, O. Viklicky, T. M. Scholbach, H.-K. Wang, C.-C. Loong, A.-H. Yang, T.-H. Wu, H. Guberina, V. Rebmann, P. Dziallas, S. Dolff, J. Wohlschlaeger, F. M. Heinemann, O. Witzke, Y. M. Zoet, F. H. J. Claas, P. A. Horn, A. Kribben, I. I. N. Doxiadis, N. Prasad, B. Yadav, V. Agarwal, A. Jaiswal, M. Rai, C. M. Hope, P. T. Coates, P. S. Heeger, R. Carroll, V. Masola, M. F. Secchi, M. Onisto, G. Gambaro, A. Lupo, M. Matsuyama, T. Kobayashi, Y. Yoneda, J. Chargui, J. L. Touraine, R. Yoshimura, D. Vizza, A. Perri, S. Lupinacci, G. Toteda, D. Lofaro, F. Leone, P. Gigliotti, A. La Russa, T. Papalia, R. Bonofilgio, A. Sentis Fuster, J. Kers, U. Yapici, N. Claessen, F. J. Bemelman, I. J. M. Ten Berge, S. Florquin, D. Glotz, L. Rostaing, J.-P. Squifflet, P. Merville, C. Belmokhtar, G. Le Ny, Y. Lebranchu, D. A. Papazova, M. Friederich-Persson, M. P. Koeners, J. A. Joles, M. C. Verhaar, H. L. Trivedi, A. V. Vanikar, S. D. Dave, B. Suarez Alvarez, S. Garcia Melendreras, R. Carvajal Palao, C. Diaz Corte, M. Ruiz Ortega, C. Lopez-Larrea, A. K. Yadav, D. Bansal, V. Kumar, M. Minz, V. Jha, D. Kaminska, K. Koscielska-Kasprzak, P. Chudoba, O. Mazanowska, M. Banasik, M. Zabinska, M. Boratynska, A. Lepiesza, K. Korta, M. Klinger, R. Csohany, A. Prokai, D. Pap, N. Balicza-Himer, A. Vannay, A. Fekete, K. Kis-Petik, J. Peti-Peterdi, A. Szabo, A. Masajtis-Zagajewska, K. Muras, M. Niewodniczy, M. Nowicki, J. Pascual, T. R. Srinivas, S. Chadban, F. Citterio, M. Henry, F. Oppenheimer, P.-C. Lee, H. Tedesco-Silva, M. Zeier, Y. Watarai, G. Dong, M. Hexham, P. Bernhardt, F. Vincenti, M. T. Rocchetti, J. Su owicz, A. Wojas-Pelc, E. Ignacak, K. Janda, M. Krzanowski, W. Su owicz, M. Mitsuhashi, T. Murakami, A. Benso, D. Leuning, M. Reinders, E. Lievers, J. Duijs, A. J. Van Zonneveld, C. Van Kooten, M. Engelse, T. Rabelink, A. Assounga, S. Omarjee, Z. Ngema, A. Ersoy, A. Gultepe, E. Isiktas Sayilar, H. Akalin, F. Coskun, M. Oner Torlak, Y. Ayar, M. Riegersperger, M. Plischke, C. Steinhauser, A. Jallitsch-Halper, G. Sengoelge, W. C. Winkelmayer, G. Sunder-Plassmann, M. Foedinger, M. Kaziuk, M. Kuz'Niewski, A. B Tkowska- Prokop, K. Pa Ka, P. Dumnicka, W. Kolber, and W. Su Owicz

Subjects
Transplantation, medicine.medical_specialty, Nephrology, business.industry, Basic science, medicine, Intensive care medicine, business
Published
2014

12. Treating diabetes with islet transplantation: Lessons from the past decade in Lille

Author

M.-C. Vantyghem, F. Defrance, D. Quintin, C. Leroy, V. Raverdi, G. Prévost, R. Caiazzo, J. Kerr-Conte, F. Glowacki, M. Hazzan, C. Noel, F. Pattou, A.S. Balavoine, R. Bresson, M.F. Bourdelle-Hego, M. Cazaubiel, M. Cordonnier, D. Delefosse, F. Dorey, A. Fayard, C. Fermon, P. Fontaine, C. Gillot, S. Haye, A.C. Le Guillou, W. Karrouz, C. Lemaire, M. Lepeut, R. Leroy, B. Mycinski, E. Parent, C. Siame, A. Sterkers, F. Torres, O. Verier-Mine, E. Verlet, R. Desailloud, A. Dürrbach, M. Godin, J.D. Lalau, C. Lukas-Croisier, E. Thervet, O. Toupance, Y. Reznik, and P.F. Westeel

Subjects
Blood Glucose, Male, medicine.medical_specialty, endocrine system diseases, Edmonton protocol, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Islets of Langerhans Transplantation, Risk Assessment, Endocrinology, Insulin resistance, Insulin-Secreting Cells, Diabetes mellitus, Internal Medicine, medicine, Humans, Intensive care medicine, Glycated Hemoglobin, Type 1 diabetes, geography, geography.geographical_feature_category, business.industry, Patient Selection, Microangiopathy, Reproducibility of Results, General Medicine, Prognosis, medicine.disease, Islet, Surgery, Transplantation, Regimen, C-Reactive Protein, Diabetes Mellitus, Type 1, Treatment Outcome, Practice Guidelines as Topic, Quality of Life, Female, business, Immunosuppressive Agents
Abstract

Type 1 diabetes (T1D) is due to the loss of both beta-cell insulin secretion and glucose sensing, leading to glucose variability and a lack of predictability, a daily issue for patients. Guidelines for the treatment of T1D have become stricter as results from the Diabetes Control and Complications Trial (DCCT) demonstrated the close relationship between microangiopathy and HbA1c levels. In this regard, glucometers, ambulatory continuous glucose monitoring, and subcutaneous and intraperitoneal pumps have been major developments in the management of glucose imbalance. Besides this technological approach, islet transplantation (IT) has emerged as an acceptable safe procedure with results that continue to improve. Research in the last decade of the 20th century focused on the feasibility of islet isolation and transplantation and, since 2000, the success and reproducibility of the Edmonton protocol have been proven, and the mid-term (5-year) benefit-risk ratio evaluated. Currently, a 5-year 50% rate of insulin independence can be expected, with stabilization of microangiopathy and macroangiopathy, but the possible side-effects of immunosuppressants, limited availability of islets and still limited duration of insulin independence restrict the procedure to cases of brittle diabetes in patients who are not overweight or have no associated insulin resistance. However, various prognostic factors have been identified that may extend islet graft survival and reduce the number of islet injections required; these include graft quality, autoimmunity, immunosuppressant regimen and non-specific inflammatory reactions. Finally, alternative injection sites and unlimited sources of islets are likely to make IT a routine procedure in the future.

Published
2014

13. Renal histopathology

Author

E. J. Kim, J. H. Han, H. M. Koo, F. M. Doh, C. H. Kim, K. I. Ko, M. J. Lee, H. J. Oh, T.-H. Yoo, S.-W. Kang, K. H. Choi, S. H. Han, S. Assady, M. Tchirkov, R. Nasser, T. Mashiach, O. Ben Izhak, P. Housset, R. Guillemain, D. Nochy, M. Roland, C. Amrein, A. Karras, V. Boussaud, V. Pezzela, E. Thervet, S. P. Simic Ogrizovic, G. Basta Jovanovic, S. Radojevic, S. Bojic, R. Naumovic, Z. Karim, K. Cyrine, G. Rim, A. Ezzeddine, H. Hafedh, K. Hayet, B. Soumaya, O. Mondher, B. H. Fethi, E. Y. Fethi, B. A. Taieb, B. M. Hedi, B. M. Fatma, K. Adel, M. Penescu, E. Mandache, A. Zumrutdal, R. Ozelsancak, T. Canpolat, S. Barbouch, I. Mami, M. Mayara, M. Jerbi, A. Harzallah, R. Goucha, H. Ben Maiz, A. Kedher, N. Comi, P. Cianfrone, V. Piraina, R. Talarico, K. Giannakakis, G. Fuiano, G. Lucisano, K. Konat, M. Szotowska, H. Karkoszka, M. Adamczak, A. Wiecek, K. Kwiecien, O. Jercan, L. Mogoanta, I. Miller, X. Pan, J. Xu, H. Ren, W. Zhang, Y. Xu, P. Shen, X. Chen, X. Feng, and N. Chen

Subjects
Transplantation, Nephrology
Published
2013

14. Long-term clinical impact of adaptation of initial tacrolimus dosing to CYP3A5 genotype

Author

B. Moulin, Cécile Vigneau, Mathias Büchler, B. Hurault de Ligny, Y. Le Meur, Isabelle Etienne, E. Thervet, Marie-Anne Loriot, Gabriel Choukroun, E. Bailly, Anne-Elisabeth Heng, Antoine Thierry, Philippe Beaune, Charlotte Colosio, Nicolas Pallet, C. Legendre, Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique (MEPPOT - U1147), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Rouen, Normandie Université (NU), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Amiens-Picardie, Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 (MP3CV), Université de Picardie Jules Verne (UPJV)-CHU Amiens-Picardie, Centre Hospitalier Universitaire de Reims (CHU Reims), Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques ( IRTOMIT), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de néphrologie - hémodialyse et transplantation rénale, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de néphrologie [Rennes], Université de Rennes (UR)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service de Néphrologie et Transplantation, CHU Strasbourg, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), CHU Estaing [Clermont-Ferrand], CHU Clermont-Ferrand, Service de néphrologie adultes [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Jonchère, Laurent, Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre hospitalier universitaire d'Amiens (CHU Amiens-Picardie), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service de néphrologie, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Necker - Enfants Malades [AP-HP], Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique ( MEPPOT - U1147 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Hôpital Européen Georges Pompidou [APHP] ( HEGP ), CHRU Tours, Centre hospitalier universitaire d'Amiens ( CHU Amiens-Picardie ), Université de Picardie Jules Verne ( UPJV ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Centre Hospitalier Universitaire de Reims ( CHU Reims ), Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques ( IRTOMIT ), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Poitiers-Centre hospitalier universitaire de Poitiers ( CHU Poitiers ), Institut de Génétique et Développement de Rennes ( IGDR ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Centre National de la Recherche Scientifique ( CNRS ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), and Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP]

Subjects
[ SDV.MHEP.UN ] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Graft Rejection, Male, immunosuppressant, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, translational research/science, kidney transplantation/nephrology, immunosuppression/immune modulation, Pharmacology, Kidney Function Tests, 030226 pharmacology & pharmacy, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 0302 clinical medicine, Risk Factors, Cytochrome P-450 CYP3A, Immunology and Allergy, Medicine, Tissue Distribution, Pharmacology (medical), genetics, Prospective Studies, [ SDV.MHEP.CHI ] Life Sciences [q-bio]/Human health and pathology/Surgery, Prospective cohort study, Kidney transplantation, Incidence (epidemiology), Graft Survival, Middle Aged, Prognosis, 3. Good health, surgical procedures, operative, 030220 oncology & carcinogenesis, [SDV.SP.PHARMA] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Female, pharmacokinetics/pharmacodynamics, Immunosuppressive Agents, Glomerular Filtration Rate, medicine.medical_specialty, Genotype, Renal function, chemical and pharmacologic phenomena, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, clinical research/practice, Tacrolimus, calcineurin inhibitor: tacrolimus, 03 medical and health sciences, patient survival, Internal medicine, Humans, Dosing, CYP3A5, Transplantation, Dose-Response Relationship, Drug, business.industry, [ SDV.SP.PHARMA ] Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, medicine.disease, Kidney Transplantation, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Pharmacogenetics, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Kidney Failure, Chronic, business, Follow-Up Studies
Abstract

International audience; Pretransplantation adaptation of the daily dose of tacrolimus to CYP3A5 genotype is associated with improved achievement of target trough concentration (C0 ), but whether this improvement affects clinical outcomes is unknown. In the present study, we have evaluated the long-term clinical impact of the adaptation of initial tacrolimus dosing according to CYP3A5 genotype: the transplantation outcomes of the 236 kidney transplant recipients included in the Tactique study were retrospectively investigated over a period of more than 5 years. In the Tactique study, patients were randomly assigned to receive tacrolimus at either a fixed dosage or a dosage determined by their genotype, and the primary efficacy end point was the proportion of patients for whom tacrolimus C0 was within target range (10-15 ng/ml) at day 10. Our results indicate that the incidence of biopsy proven acute rejection and graft survival were similar between the control and the adapted tacrolimus dose groups, as well as between the patients who achieve the tacrolimus C0 target ranges earlier. Parients death, cancer, cardiovascular events and infections were also similar, and renal function did not change. We conclude that optimization of initial tacrolimus dose using pharmacogenetic testing does not improve clinical outcomes.

Published
2016

15. Primary and secondary glomerulonephritis I

Author

N. Miyazaki, J. Matsumoto, F. Alberici, A. Palmisano, F. Maritati, E. Oliva, C. Buzio, A. Vaglio, G. Mjoen, G. E. Norby, B. E. Vikse, E. Svarstad, B. Rune, A. Knut, M. Szymczak, J. Kuzniar, W. Kopec, Z. Marchewka, M. Klinger, P. Arrizabalaga, R. Silvarino, F. Sant, G. Espinosa, M. Sole, R. Cervera, D. Gude, S. Chennamsetty, A. Demin, V. Kozlov, I. Lisukov, O. Kotova, A. Sizikov, V. Sergeevicheva, L. Demina, O. Borjesson, M. Wendt, A. Avik, A. R. Qureshi, J. Bratt, E. J. Miller, I. Gunnarsson, A. Bruchfeld, K. Sugiyama, M. Hasegawa, K. Yamamoto, H. Hayashi, S. Koide, K. Murakami, M. Tomita, S. Yoshida, Y. Yuzawa, S. Yew, D. Jayne, K. Westman, P. Hoglund, O. Flossman, A. Mahr, R. Luqmani, J. Robson, E. Thervet, C. Levi, E. Guiard, M. Roland, D. Nochy, C. Daniliuc, L. Guillevin, L. Mouthon, C. Jacquot, A. Karras, Y. Kimura, H. Morita, H. Debiec, H. Yamada, N. Miura, S. Banno, P. Ronco, H. Imai, D. H. Shin, D. Famee, H. M. Koo, S. H. Han, K. H. Choi, T.-H. Yoo, S.-W. Kang, C. Fofi, L. Scabbia, F. Festuccia, A. Stoppacciaro, P. Mene', A. Shimizu, M. Fukui, A. MII, T. Kaneko, Y. Masuda, Y. Iino, Y. Katayama, Y. Fukuda, A. Kuroki, K. Matsumoto, T. Akizawa, R. Jurubita, G. Ismail, R. Bobeica, E. Rusu, D. Zilisteanu, A. Andronesi, O. Motoi, V. Ditoiu, I. Copaci, M. Voiculescu, M. V. Irazabal, A. Eirin, J. C. Lieske, L. H. Beck, J. J. Dillon, P. H. Nachman, S. Sethi, S. B. Erickson, D. C. Cattran, F. C. Fervenza, B. Svobodova, Z. Hruskova, I. Janatkova, E. Jancova, V. Tesar, M. S. Seo, S. H. Kwon, E. B. Lee, J. Y. You, Y. K. Hyun, S. A. Woo, M. Y. Park, S. J. Choi, J. S. Jeon, H. Noh, J. G. Kim, D. C. Han, S. D. Hwang, T. Y. Choi, S. Y. Jin, E. Loiacono, D. Defedele, M. P. Puccinelli, R. Camilla, R. Gallo, L. Peruzzi, C. Rollino, G. Beltrame, M. Ferro, L. Vergano, F. Campolo, A. Amore, R. Coppo, T. Knoop, L. Bostad, T. Leivestad, R. Bjorneklett, J. Teranishi, R. Yamamoto, Y. Nagasawa, T. Shoji, H. Iwatani, N. Okada, T. Moriyama, A. Yamauchi, Y. Tsubakihara, E. Imai, H. Rakugi, Y. Isaka, F. M. Doh, S. J. Kim, D. S. Han, Y. Suzuki, K. Matsuzaki, H. Suzuki, K. Okazaki, H. Yanagawa, M. Maiguma, M. Muto, T. Sato, S. Horikoshi, J. Novak, O. Hotta, Y. Tomino, E. Gutierrez, I. Zamora, J. Ballarin, Y. Arce, S. Jimenez, C. Quereda, T. Olea, J. Martinez-Ara, A. Segarra, C. Bernis, A. Garcia, M. Goicoechea, S. Garcia de Vinuesa, J. Rojas, M. Praga, V. Ristovska, G. Petrushevska, L. Grcevska, K. Satake, Y. Shimizu, N. Mugitani, S. Honda, K. Shibuya, A. Shibuya, M. Papale, M. T. Rocchetti, S. DI Paolo, I. V. Suriano, A. D'apollo, G. Vocino, E. Montemurno, L. Varraso, G. Grandaliano, L. Gesualdo, A. Huerta, A. S. Bomback, P. A. Canetta, J. Radhakrishnan, L. Herlitz, B. Stokes, V. D'agati, G. Markowitz, G. B. Appel, H. Mouna, B. D. Nasr, I. Mrabet, L. Ahmed, A. Sabra, F. Mohamed Ammeur, E. Mezri, S. Habib, M. Innocenti, A. Pasquariello, G. Pasquariello, P. Mattei, A. Bottai, G. Fumagalli, L. Bozzoli, S. Samoni, A. Cupisti, B. Caldin, J. Hung, L. Repizo, D. M. Malheiros, R. Barros, V. Woronik, C. Giammarresi, L. Bono, A. Ferrantelli, C. Tortorici, G. Licavoli, U. Rotolo, X. Huang, Q. Wang, M. Shi, W. Chen, Z. Liu, R. Scarpioni, L. Cantarini, A. Lazzaro, M. Ricardi, V. Albertazzi, L. Melfa, C. Concesi, D. Vallisa, L. Cavanna, G. Gungor, H. Ataseven, A. Demir, Y. Solak, M. Biyik, B. Ozturk, I. Polat, A. Kiyici, O. Ozer Cakir, H. Polat, I. Castillo, V. Carreno, A. Aguilar, R. Madero, E. Hernandez, J. Bartolome, F. Gea, R. Selgas, H. A. M. El Aggan, H. S. El Banawy, E. Wagdy, N. Tchebotareva, O. LI, I. Bobkova, L. Kozlovskaya, V. Varshavskiy, E. Golicina, Y. Chen, Z. Gong, X. Chen, L. Tang, J. Zhou, X. Cao, R. Wei, E. H. Koo, J. H. Park, H. K. Kim, M. S. Kim, H. R. Jang, J. E. Lee, W. Huh, D. J. Kim, H. Y. Oh, Y.-G. Kim, O. Eskova, M. Shvetsov, E. Golytsina, O. Popova, M. Quaglia, S. Monti, R. Fenoglio, A. Menegotto, A. Airoldi, C. Izzo, M. A. Rizzo, U. Dianzani, P. Stratta, and D. Gianfreda

Subjects
Transplantation, Nephrology
Published
2012

16. Genetic diseases

Author

T. Inazu, T. Kawahara, H. Endou, N. Anzai, I. Sebesta, B. Stiburkova, K. Ichida, M. Hosoyamada, A. Testa, D. Leonardis, F. Catalano, A. Pisano, A. Mafrica, B. Spoto, M. C. Sanguedolce, R. M. Parlongo, G. Tripepi, M. Postorino, G. Enia, C. Zoccali, F. Mallamaci, M. Working Group, A. Luque de Pablos, V. Garcia-Nieto, J. C. Lopez-Menchero, E. Ramos-Trujillo, H. Gonzalez-Acosta, F. Claverie-Martin, M. Arsali, P. Demosthenous, L. Papazachariou, Y. Athanasiou, K. Voskarides, C. Deltas, A. Pierides, S. Lee, K. H. Jeong, C. Ihm, T. W. Lee, S. H. Lee, J. Y. Moon, J. G. Wi, H. J. Lee, E. Y. Kim, K. Rogacev, A. Friedrich, B. Hummel, J. Berg, A. Zawada, D. Fliser, J. Geisel, G. H. Heine, I. Brabcova, S. Dusilova-Sulkova, Z. Krejcik, V. Stranecky, K. Lipar, T. Marada, J. Stepankova, O. Viklicky, M. Buraczynska, P. Zukowski, W. Zaluska, A. Kuczmaszewska, A. Ksiazek, M. Gaggl, S. Weidner, M. Hofer, J. Kleinert, G. Fauler, M. Wallner, P. Kotanko, G. Sunder-Plassmann, E. Paschke, R. Heguilen, L. Albarracin, J. Politei, A. A. Liste, A. Bernasconi, E. Kusano, R. Russo, A. Pisani, G. Messalli, M. Imbriaco, L. Prikhodina, O. Ryzhkova, V. Polyakov, K. Lipkowska, D. Ostalska-Nowicka, M. Smiech, M. Jaroniec, K. Zaorska, W. Szaflarski, M. Nowicki, J. Zachwieja, G. D'arrigo, J. Moskowitz, S. Piret, A. Tashman, E. Velez, K. Lhotta, R. Thakker, J. Cox, J. Kingswood, J. Mbundi, G. Attard, U. Patel, A. Saggar, F. Elmslie, T. Doyle, A. Jansen, S. Jozwiak, E. Belousova, M. Frost, R. Kuperman, M. Bebin, B. Korf, R. Flamini, M. Kohrman, S. Sparagana, J. Wu, J. Ford, G. Shah, D. Franz, B. Zonnenberg, W. Cheung, S. Urva, J. Wang, C. Kingswood, K. Budde, T. Kofman, C. Narjoz, Q. Raimbourg, M. Roland, M.-A. Loriot, A. Karras, G. S. Hill, C. Jacquot, D. Nochy, E. Thervet, P. Jagodzinski, M. Mostowska, A. Oko, N. Nicolaou, S. Kevelam, M. Lilien, M. Oosterveld, R. Goldschmeding, A. Van Eerde, R. Pfundt, A. Sonnenberg, P. Ter Hal, N. Knoers, K. Renkema, T. Storm, R. Nielsen, E. Christensen, C. Frykholm, L. Tranebjaerg, H. Birn, P. Verroust, T. Neveus, B. Sundelin, J. M. Hertz, G. Holmstrom, K. Ericson, A. Fabris, D. Cremasco, A. Zambon, E. Muraro, M. Alessi, A. D'angelo, F. Anglani, D. Del Prete, A. Alkmim Teixeira, B. M. Quinto, C. Jose Rodrigues, A. Beltrame Ribeiro, M. Batista, A. Kerti, R. Csohany, A. Szabo, O. Arkossy, P. Sallai, V. Moriniere, V. Vega-Warner, O. Lakatos, T. Szabo, G. Reusz, K. Tory, M. Addis, E. Tosetto, C. Meloni, M. Ceol, R. Cristofaro, M. A. Melis, P. Vercelloni, G. Marra, S. Kaniuka, M. Nagel, W. Wolyniec, L. Obolonczyk, R. Swiatkowska-Stodulska, K. Sworczak, B. Rutkowski, C. Chen, L. Jiang, L. Chen, L. Fang, M. Mozes M., M. Boosi, L. Rosivall, G. Kokeny, R. Diana, O. Gross, T. Johanna, G. Rainer, C. Ayse, H. Henrik, M. Gerhard-Anton, M. Nabil, E. Intissar, H. Belge, J. Bloch, K. Dahan, Y. Pirson, P. Vanhille, and N. Demoulin

Subjects
Transplantation, Nephrology
Published
2012

17. Renal histopathology

Author

F. Marie-Lucile, N. Laure-Helene, C. Yosr, M. Anne, F. Fadi, C. Levi, V. Meas-Yedid, C. Daniliuc, A. Karras, J. C. Olivo-Marin, L. Mouthon, E. Guiard, M. Roland, L. Guillevin, C. Jacquot, D. Nochy, E. Thervet, Q. Chen, C. Skerka, B. Uzonyi, S. Lindner, C. Licht, B. Hoppe, M. Riedl, M. Kirschfink, S. Habbich, G. Wolf, L. Strain, T. H. Goodship, P. F. Zipfel, H. Kfoury, A. Alsuwaida, K. Alsaad, F. Alhejaili, M. Alghonaim, J. Alwakeel, S. Husain, N. Aloudah, L. Besso, M. Tamagnone, G. Daidola, M. Burdese, L. Repetto, G. Pasquale, L. Colla, L. Biancone, P. Stratta, G. P. Segoloni, J. Bacalja, A. M. Bauer Segvic, S. Bulimbasic, A. Pacic, M. Knotek, M. Sabljar Matovinovic, K. Galesic, D. Galesic Ljubanovic, E. Zakharova, E. Stolyarevich, O. Vorobjova, H. Tamouza, J. M. Chemouny, M. Flamant, L. Raskova Kafkova, M. Demion, M. Laurent, F. Walker, B. A. Julian, E. Tissandie, M. K. Tiwari, J. Novak, N. O. Camara, M. Benhamou, F. Vrtovsnik, R. C. Monteiro, I. C. Moura, S. Samavat, P. Ahmadpoor, P. Torbati, R. Ghaderi, F. Poorrezagholi, F. Samadian, M. Nafar, A. MII, A. Shimizu, T. Kaneko, F. Yasuda, M. Fukui, Y. Masuda, Y. Iino, Y. Katayama, C. Muller, J. Markovic-Lipkovski, S. Simic-Ogrizovic, R. Naumovic, S. Cirovic, D. Mitrovic, G. Muller, A. Wozniak, M. Janicka-Jedynska, J. Zurawski, E. Kaczmarek, J. Zachwieja, S. Khilji, T. Dorman, P. O'kelly, L. Lampty, K. Leung, A. Shadivan, C. Varghese, J. Walshe, T. Saito, M. Kawano, T. Saeki, I. Mizushima, Y. Yamaguchi, N. Imai, H. Nakashima, H. Umehara, M. Shvetsov, O. Popova, N. Chebotareva, A. Ivanov, I. Bobkova, D. Cremasco, M. Ceol, L. Peruzzi, G. Mazzucco, M. Giuseppina, G. Vezzoli, R. Cristofaro, A. D'angelo, F. Anglani, D. Del Prete, G. Coppolino, N. Comi, D. Bolignano, V. Piraina, R. Talarico, A. Colombo, G. Lucisano, G. Fuiano, P. Bernich, A. Lupo, T. R. Of Renal Biopsies, M. P. Rastaldi, O. C. Jercan, P. Messa, D. Alexandru, L. Mogoanta, and V. Uribe Villegas

Subjects
Transplantation, Nephrology
Published
2012

18. Transplantation - clinical I

Author

M. Bonani, J. Brockmann, C. D. Cohen, T. Fehr, A. Nocito, M. Schiesser, A. L. Serra, M. Blum, M. Struker, D. F. Frey, R. P. Wuthrich, Y. W. Kim, S. J. Park, T. H. Kim, Y.-H. Kim, S. W. Kang, L. Webb, A. Casula, C. Tomson, Y. Ben-Shlomo, H. Mansour, A. Akl, E. Wafa, M. El Shahawy, R. Palma, S. Swaminathan, A. B. Irish, A. Kolonko, J. Chudek, A. Wiecek, Y. Vanrenterghem, D. Kuypers, D. V. Katrien, P. Evenepoel, K. Claes, B. Bammens, B. Meijers, M. Naesens, S. Lo, C.-K. Chan, D. Yong, P.-N. Wong, T.-H. Kwan, Y.-L. Cheng, K.-S. Fung, B.-Y. Choy, K.-F. Chau, C.-B. Leung, J. Ebben, J. Liu, S.-C. Chen, A. Collins, Y.-W. Ho, M. Abelli, A. Ferrario DI Torvajana, E. Ticozzelli, B. Maiga, A. Patane, P. Albrizio, M. Gregorini, C. Libetta, T. Rampino, P. Geraci, A. Dal Canton, M.-T. Rotter, J. Jacobi, K. Pressmar, K. Amann, K.-U. Eckardt, A. Weidemann, K. Muller, M. Stein, C. Diezemann, A. Sefrin, N. Babel, P. Reinke, T. Schachtner, C. Costa, G. A. Touscoz, F. Sidoti, F. Sinesi, S. Mantovani, S. Simeone, C. Balloco, E. Piasentin Alessio, M. Messina, G. Segoloni, R. Cavallo, R. .K. Sharma, D. A. Kaul, R. K. Gupta, A. Gupta, N. Prasad, D. Bhadhuria, K. J. Suresh, S. Benaboud, D. Prie, E. Thervet, S. Urien, C. Legendre, J.-C. Souberbielle, D. Hirt, G. Friedlander, J.-M. Treluyer, M. Courbebaisse, M. Arias, J. Campistol, J. Pascual, J. M. Grinyo, D. Hernandez, J. M. Morales, L. M. Pallardo, D. Seron, L. Senecal, A. Boucher, R. Dandavino, S. Colette, M. Vallee, J.-P. Lafrance, Y. Tung-Min, W. Min-Ju, C. Cheng-Hsu, C. Chi-Hung, S. Kuo-Hsiung, W. Mei-Chin, S. Direkze, M. Khorsavi, S. Stuart, A. Goode, G. Jones, C. Massimetti, I. Napoletano, G. Imperato, M. T. Muratore, S. Fazio, G. Pessina, F. Brescia, S. Feriozzi, K. Tanaka, K. Sakai, A. Futaki, Y. Hyoudo, M. Muramatsu, T. Kawamura, S. Shishido, S. Hara, A. Kushiyama, A. Aikawa, K. Jankowski, J. Gozdowska, D. Lewandowska, A. Kwiatkowski, M. Durlik, P. Pruszczyk, Y. Obi, N. Ichimaru, T. Kato, M. Okumi, J. Kaimori, K. Yazawa, N. Nonomura, Y. Isaka, S. Takahara, M. Aimele, R. Christophe, D. Geraldine, R. Eric, H. Alexandre, I. Masson, M. Nicolas, T. Ivan, J. Acil, T. Lise, H.-A. Aoumeur, D. Laurence, D. Pierre, C. Etienne, R. Lionel, K. Nassim, M. Emmanuel, A. Eric, M. Christophe, K. Alexandre, B. Pierre, H. Jean-Philippe, P. Dominique, L. Christophe, G. Alexei, D. Michel, P. Shah, V. B. Kute, A. Vanikar, M. Gumber, P. Modi, H. Trivedi, J. GoIebiewska, A. Debska-Slizien, B. Rutkowski, L. Domanski, G. Dutkiewicz, K. Kloda, A. Pawlik, A. Ciechanowicz, A. Binczak-Kuleta, J. Rozanski, M. Myslak, K. Safranow, K. Ciechanowski, C. S. Aline, T. Basset, X. Delavenne, E. Alamartine, C. Mariat, K. Bobrek-Lesiakowska, M. Wisniewska, M. Romanowski, M. Kurzawski, M. De Borst, L. Baia, G. Navis, S. Bakker, A. Ranghino, G. Tognarelli, E. Basso, A. M. Manzione, G. Daidola, G. P. Segoloni, T. Kimura, T. Yagisawa, N. Ishikawa, Y. Sakuma, T. Hujiwara, A. Nukui, M. Yashi, J. H. Kim, S.-S. Kim, D. J. Han, S.-K. Park, G. Randhawa, H. Patel, S. Taheri, O. Goker-Alpan, J. Ibrahim, K. Nedd, S. Shankar, H. Lein, B. Barshop, E. Boyd, M. Holida, R. Hillman, R. Mardach, N. Wienreb, B. Rever, R. Forte, A. Desai, A. Wijatyk, P. Chang, and R. Martin

Subjects
Transplantation, Nephrology
Published
2012

19. Kidney Transplant Recipients Carrying the CYP3A4*22 Allelic Variant Have Reduced Tacrolimus Clearance and Often Reach Supratherapeutic Tacrolimus Concentrations

Author

Isabelle Etienne, Mathias Büchler, P. Beaune, Marie-Anne Loriot, Y. Le Meur, M. El Bahri, Anne-Elisabeth Heng, Cécile Vigneau, Antoine Thierry, Charlotte Colosio, Jean-François Subra, B. H. de Ligny, Gabriel Choukroun, Nicolas Pallet, B. Moulin, A.-S. Jannot, C. Legendre, Corinne Alberti, E. Thervet, Université Grenoble Alpes - UFR Médecine (UGA UFRM), Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Service de Néphrologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Mécanismes physiologiques et conséquences des calcifications cardiovasculaires: rôle des remodelages cardiovasculaires et osseux, Université de Picardie Jules Verne (UPJV)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Immunologie et Pathologie (EA2216), Université de Brest (UBO)-IFR148, LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ), Unité de Nutrition Humaine (UNH), Institut National de la Recherche Agronomique (INRA)-Université d'Auvergne - Clermont-Ferrand I (UdA)-Clermont Université, Service de Néphrologie [Angers], Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique (MEPPOT - U1147), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Transplantation Rénale, affiliation inconnue, Université Grenoble Alpes (UGA), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Clermont Université-Université d'Auvergne - Clermont-Ferrand I (UdA)-Institut National de la Recherche Agronomique (INRA), Université Grenoble Alpes - UFR Médecine ( UGA UFRM ), Université Grenoble Alpes ( UGA ), CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Université de Picardie Jules Verne ( UPJV ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Institut de Génétique et Développement de Rennes ( IGDR ), Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Centre National de la Recherche Scientifique ( CNRS ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Immunologie et Pathologie ( EA2216 ), Université de Brest ( UBO ) -IFR148, Unité de Nutrition Humaine ( UNH ), Institut National de la Recherche Agronomique ( INRA ) -Université d'Auvergne - Clermont-Ferrand I ( UdA ) -Clermont Université, Université d'Angers ( UA ) -CHU Angers, Section clinique, Université Paris 8 Vincennes-Saint-Denis ( UP8 ), Médecine Personnalisée, Pharmacogénomique, Optimisation Thérapeutique ( MEPPOT - U1147 ), and Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM )

Subjects
Adult, Male, medicine.medical_specialty, immunosuppressant, [SDV]Life Sciences [q-bio], Population, nephrology, kidney transplantation, Pharmacology, Gastroenterology, Tacrolimus, Clinical research, calcineurin inhibitor: tacrolimus, Polymorphism (computer science), Internal medicine, Genotype, medicine, pharmacodynamics, Immunology and Allergy, Cytochrome P-450 CYP3A, Humans, Pharmacology (medical), genetics, Allele, education, Allele frequency, Alleles, ComputingMilieux_MISCELLANEOUS, Transplantation, education.field_of_study, immune modulation, immunosuppression, CYP3A4, [ SDV ] Life Sciences [q-bio], business.industry, Middle Aged, practice, Female, pharmacology, business, pharmacokinetics, Immunosuppressive Agents
Abstract

International audience; CYP3A4*22 is an allelic variant of the cytochrome P450 3A4 associated with a decreased activity. Carriers of this polymorphism may require reduced tacrolimus (Tac) doses to reach the target residual concentrations (Co). We tested this hypothesis in a population of kidney transplant recipients extracted from a multicenter, prospective and randomized study. Among the 186 kidney transplant recipients included, 9.3% (18 patients) were heterozygous for the CYP3A4*22 genotype and none were homozygous (allele frequency of 4.8%). Ten days after transplantation (3 days after starting treatment with Tac), 11% of the CYP3A4*22 carriers were within the target range of Tac Co (10–15 ng/mL), whereas among the CYP3A4*1/*1 carriers, 40% were within the target range (p = 0.02, OR = 0.19 [0.03; 0.69]). The mean Tac Co at day 10 in the CYP3A4*1/*22 group was 23.5 ng/mL (16.6–30.9) compared with 15.1 ng/mL (14–16.3) in the CYP3A4*1/*1 group, p

Published
2015

22. [Spot urinary protein to creatinine ratio: Which role in preeclampsia diagnosis?]

Author

L, Bejjani, S, Nedellec, J, Taïeb, E, Thervet, and A, Benachi

Subjects
Proteinuria, Pre-Eclampsia, Pregnancy, Creatinine, Humans, Female
Abstract

Preeclampsia remains a serious and feared complication of pregnancy. Its diagnosis is confirmed upon detection of hypertension and significant proteinuria starting from 20 weeks of gestation. The 24-hour urine collection is considered to be the gold standard test for quantitative diagnosis of proteinuria despite its downsides. Recent studies have brought into question its accuracy during pregnancy as complete samples are hard to get, but above all, as this time consuming procedure often delays treatment and may preclude optimal management. Several publications looked at the spot urinary protein to creatinine ratio (PCR) as a replacement to the 24-hour urine collection. Largely used outside pregnancy, this fast and less invasive test seems a compelling alternative. In this paper, data from previous meta-analysis and guidelines have been reviewed in an attempt to clarify the role of the PCR in clinical practice and elaborate an algorithm in case of suspicion of preeclampsia. Thus, this test seems a valid "rule-out test" when using the optimal threshold of 30mg/mmol. Higher values require a 24-hour urine collection for confirmation.

Published
2014

23. Définition et classification des maladies héréditaires du métabolisme

Author

E. Thervet

Abstract

Les maladies hereditaires du metabolisme (« Inborn Errors of Metabolism », en anglais) regroupent des affections multiples. Leurs points communs sont d’etre en relation avec des maladies genetiques qui impliquent des desordres du metabolisme. La majorite de ces pathologies sont dues a un defaut d’un gene unique qui code pour des enzymes impliques dans la conversion d’un substrat en un produit. Dans la plupart des cas, ce defaut va entrainer une gene a l’elimination du substrat, et de ce fait une accumulation de celui-ci qui peut etre toxique directement ou interferer avec la fonction normale d’un organe.

Published
2013

24. Kidney transplantation at Necker Hospital: the most recent 5-year period (2004-2009)

Author

Ch, Legendre, H, Kreis, F, Martinez, R, Snanoudj, M F, Mamzer, R, Sberro, L, Bererhi, D, Anglicheau, J, Zuber, A, Loupy, E, Thervet, N, Pallet, A, Sartorius, D, Bertrand, G, Canaud, L H, Noël, M, Rabant, M O, Timsit, and A, Méjean

Subjects
Adult, Aged, 80 and over, Graft Rejection, Male, Paris, Time Factors, Adolescent, National Health Programs, Hospitals, Public, Graft Survival, Middle Aged, Kidney Transplantation, Risk Assessment, Tissue Donors, Young Adult, Treatment Outcome, Risk Factors, Humans, Female, Immunosuppressive Agents, Aged
Abstract

The results of our last 5 years activity in kidney transplantation clearly show that it is possible to perform high-risk transplantations with very acceptable results: ECD kidneys, dual transplantation, recipients with DSAs. In depth statistical analysis of these data should allow a clearer definition of the best strategies to use in these situations.

Published
2011

25. PATHOLOGY

Author

R. Inagi, S. Motonishi, M. Nangaku, E. M. Buhl, S. Djudjaj, B. M. Klinkhammer, U. Eriksson, J. Floege, P. Boor, R. Kramann, S. Fleig, S. Fabian, D. Dirocco, B. D. Humphreys, M. Jasiek, A. Karras, B. Terrier, R. Mesbah, S. Faguer, N. Jourde, P. Remy, P. Ronco, X. Mariette, R. Seror, E. Thervet, V. Le Guern, H. Francois, I. Grgic, M. Krautzberger, A. Hofmeister, M. Lalli, J. Liu, J. S. Duffield, A. P. McMahon, and B. Aronow

Subjects
Transplantation, Nephrology
Published
2014

27. [Effect of vitamin D deficiency on cardiovascular risk]

Author

C, Cormier, M, Courbebaisse, E, Maury, E, Thervet, and J-C, Souberbielle

Subjects
Cardiovascular Diseases, Incidence, Humans, Documentation, Vitamin D Deficiency, Risk Assessment
Abstract

Vitamin D deficiency affects almost 50 % of the population worldwide. Besides its classical effects on bone and calcium metabolism, vitamin D displays a wide spectrum of non classical effects. Among these effects, those targeting the cardiovascular system are mostly documented by observational, experimental and small intervention trials that most often evaluated intermediate parameters. The time has now come for large placebo-controlled trials targeting clinical endpoints such as the incidence of major cardiovascular events and mortality.

Published
2009

28. [Screening biopsies in kidney transplantation: from subclinical acute rejection to chronic allograft lesions]

Author

R, Snanoudj, F, Martinez, R, Sberro Soussan, E, Thervet, and C, Legendre

Subjects
Graft Rejection, Biopsy, Graft Survival, Prognosis, Kidney Transplantation, Early Diagnosis, Isoantibodies, Acute Disease, Chronic Disease, Humans, Multicenter Studies as Topic, Transplantation, Homologous, Prospective Studies, Primary Graft Dysfunction, Biomarkers, Immunosuppressive Agents, Randomized Controlled Trials as Topic
Abstract

Kidney biopsies for screening purposes have the advantage of revealing the early appearance of lesions having a poor prognosis before kidney function is altered. Early screening of subclinical rejections allows preventive treatment of kidney transplantation in patients taking cyclosporine or azathioprine, thus improving their renal function and reducing the incidence of chronic histological lesions. However, this benefit has yet to be demonstrated in patients taking tacrolimus or mycophenolic acid. As for interstitial fibrosis lesions and tubular atrophy, biopsies can screen subclinical immunological lesions or those related to nephrotoxicity of anticalcineurins, which have a negative prognostic value in terms of graft survival. In addition, detection of these lesions could be a very useful criterion of efficacy in clinical studies. Moreover, they could help decide on modifying immunosuppressor treatment and evaluate the therapeutic strategies in patients at risk for humoral rejection. Finally, given the cost of biopsies and the inconvenience for the patient, the question of the timing and the number of screening biopsies is crucial. However, interventional studies evaluating notably immunosuppressor treatment modifications based on histological data are necessary to justify the daily use of screening biopsies.

Published
2008

29. [Immunosuppression in kidney transplantation]

Author

C, Legendre, J, Zuber, D, Anglicheau, M, Le Quintrec, F, Martinez, M F, Mamzer-Bruneel, and E, Thervet

Subjects
Graft Rejection, Immunosuppression Therapy, Models, Immunological, Antibodies, Monoclonal, Graft vs Host Disease, Infections, Kidney Transplantation, Adrenal Cortex Hormones, T-Lymphocyte Subsets, Neoplasms, Humans, Kidney Diseases, Disease Susceptibility, Immunosuppressive Agents, Antilymphocyte Serum, Signal Transduction
Abstract

Kidney transplantation has become the treatment of choice in end-stage chronic renal failure since it significantly improves both the quality of life and the life duration of affected patients, when compared with dialysis. Some of these better results that were observed over the last thirty years are obviously due to significant improvements in the quality of immunosuppression. In the first part of this chapter, the allo-immune response is schematically described regarding the various signals. Then, the mechanisms of action of the available or future immunosuppressive therapies are described in the same order as the allo-immune response. In the third part, the various combinations of immunosuppressive regimens are presented from a historical perspective, outlining not only the positive aspects of each class of drugs but also their side effects and consequences on the practical use of immunosuppression over time. Finally, a brief review of current and future perspectives regarding the improvement of both efficacy and tolerability of immunosuppression in kidney transplantation is presented.

Published
2008

30. Quantification of interstitial fibrosis by image analysis on routine renal biopsy 1 year after transplantation in patients managed by C2 monitoring of cyclosporine microemulsion

Author

Vannary Meas-Yedid, Jean-Christophe Olivo-Marin, E. Morelon, E. Thervet, Aude Servais, and M. Buchler

Subjects
Adult, Male, medicine.medical_specialty, Biopsy, chemistry.chemical_compound, Chronic allograft nephropathy, Multicenter trial, medicine, Image Processing, Computer-Assisted, Humans, Kidney transplantation, Monitoring, Physiologic, Transplantation, Creatinine, medicine.diagnostic_test, Surrogate endpoint, business.industry, Histocompatibility Testing, Middle Aged, medicine.disease, Fibrosis, Kidney Transplantation, Surgery, chemistry, Cyclosporine, Emulsions, Female, Renal biopsy, Radiology, business, Immunosuppressive Agents, Follow-Up Studies
Abstract

Background Renal interstitial fibrosis (IF), the main histopathologic feature of chronic allograft nephropathy (CAN), may be an important surrogate endpoint for patient follow-up. IF is currently assessed by semiquantitative analysis, but automatic color image analysis may be a more reliable, reproducible method to evaluate IF. We performed a retrospective analysis to calculate IF on routine renal biopsies 1 year after transplantation. Methods Data were obtained from MO2ART, a prospective multicenter trial in which the cyclosporine microemulsion dose was adjusted based on C2 levels. We included 26 patients in whom routine renal biopsy at 1 year was available from two centers. For each biopsy, a section was analyzed by a program of color segmentation image that automatically extracted green-colored areas characteristic of IF. Results were expressed as percent IF and grade namely grade I, 50%. The results were compared according to clinical and biological data. Results The 26 patients had a mean IF score of 0.35 ± 0.04. We observed 34.6% CAN grade I; 46.1%, grade II; and 19.2%, grade III. Serum creatinine at 3 years was greater in the higher grade of automated IF by repeated ANOVA. Conclusion Automatic quantification of IF on routine biopsy at 1 year after transplantation was predictive of renal outcome. This technique may provide an interesting tool for the early diagnosis of CAN after renal transplantation.

Published
2007

31. Successful organ transplantation after treatment of fatal cyanide poisoning with hydroxocobalamin

Author

J L Fortin, S Ferlicot, M Ruttimann, G Capellier, E Thervet, and A Bigorie

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Antidotes, Liver transplantation, Toxicology, Organ transplantation, Hydroxocobalamin, Medicine, Humans, Kidney transplantation, Heart transplantation, Cyanides, business.industry, General Medicine, Middle Aged, medicine.disease, Kidney Transplantation, Tissue Donors, Surgery, Heart Arrest, Liver Transplantation, Transplantation, B vitamins, Anesthesia, Cyanide poisoning, Heart Transplantation, Female, business, medicine.drug
Abstract

Background. Cyanide-poisoned patients are potential organ donors provided that organs are not damaged by the poison or by antidotal treatment. Case study. A patient with third-degree burns and smoke inhalation-associated cyanide poisoning confirmed by measurements of whole blood cyanide was found in cardiac arrest and administered epinephrine and hydroxocobalamin (5 g + 5 g). Cardiac activity resumed, but the patient was declared brain dead on the third day of hospitalization when coma deteriorated to a shock state with refractory hypoxemia. Kidneys, heart, and liver were removed and transplanted into four patients. Gross pre-transplantation inspection of the donor organs and renal histology showed no evidence that hydroxocobalamin caused organ toxicity. Donor organs functioned normally through follow-up periods of several months. Conclusion. Anoxic cardiac arrest following acute cyanide poisoning treated with hydroxocobalamin (5 g + 5 g) was not a contraindication to organ transplantation after confirmed...

Published
2007

33. Lowering immunosuppression is safe and effective to treat altered pattern of CMV infection in renal transplant recipients on valaciclovir prophylaxis

Author

F Martinez, Christophe Legendre, F Morinet, C Scieux, A Lautrette, E Thervet, D Anglicheau, and M. Flamant

Subjects
Human cytomegalovirus, medicine.medical_specialty, Opportunistic infection, medicine.medical_treatment, Acyclovir, Gastroenterology, Antiviral Agents, Betaherpesvirinae, Internal medicine, medicine, Humans, Prodrugs, Antigens, Viral, Kidney transplantation, Immunosuppression Therapy, Transplantation, Kidney, biology, Dose-Response Relationship, Drug, business.industry, Immunosuppression, Valine, medicine.disease, biology.organism_classification, Kidney Transplantation, Valaciclovir, medicine.anatomical_structure, Valacyclovir, Immunology, Cytomegalovirus Infections, Surgery, Drug Therapy, Combination, business, Immunosuppressive Agents, medicine.drug
Published
2002

34. [Minimization of immunosuppression]

Author

E, Thervet

Subjects
Graft Rejection, Immunosuppression Therapy, Adrenal Cortex Hormones, Cyclosporine, Humans, Drug Therapy, Combination, Organ Transplantation, Mycophenolic Acid, Kidney, Immunosuppressive Agents, Tacrolimus
Abstract

Minimization protocols: The goal of minimization protocols is to reduce the load of immunosuppressant agents after transplantation. Besides the basic medical objective of reduced deleterious effects of long-term immunosuppression, minimization also has an economic impact. Discontinuation of corticosteroid therapy: Results obtained with different minimization protocols have shown that any interruption of corticosteroid therapy, even if associated with the new immunosuppressants, should be conducted carefully in selected patients, tapering off late after transplantation. Mycophenolate-mofetil (MMF): MMF withdraw may be risked and the beneficial effect of discontinuation remains to be demonstrated. Calcineurin inhibitors: Most immunosuppression protocols use cyclosporine. The benefit obtained by totally discontinuing cyclosporine in stabilized patients does not outbalance the risks induced by withdrawal. However, in this population, MMF can be useful for tapering down cyclosporine. In patients with altered renal function, introduction of MMF or sirolimus can allow a reduction in dosage or complete withdrawal of cyclosporine.

Published
2001

35. [Hand-assisted laparoscopic bi-nephrectomy for refractory arterial hypertension in kidney transplantation]

Author

M, Peyromaure, O, Cappele, F, Desgrandchamps, J, Bedrossian, E, Thervet, C, Legendre, P, Teillac, and A, Le Duc

Subjects
Adult, Male, Hypertension, Humans, Laparoscopy, Middle Aged, Kidney Transplantation, Nephrectomy
Abstract

The authors report their preliminary experience of a manually assisted laparoscopic bilateral nephrectomy technique for refractory hypertension in renal transplant recipients.Between April and May 1999, 2 laparoscopic bilateral nephrectomies were performed with manual assistance using the Hand-Port. One patient was operated 4 months before renal transplantation and the other was operated 13 months after renal transplantation. Both patients presented severe hypertension refractory to several antihypertensive drugs. An 8 cm midline supra-umbilical incision and 3 trocars were necessary. One hand was introduced into the abdominal cavity via the Hand-Port at the beginning of the operation. The intra-abdominal hand assisted all phases of dissection of the kidney and control of vessels. The renal vessels and ureter were clipped. The kidneys were removed by the intra-abdominal hand through the supra-umbilical incision.Operating times were 200 min and 130 min. Blood loss was 220 ml. No conversion was performed. The duration of major postoperative analgesics was 3 days. Length of hospital stay was 6 days and 7 days. There were no complications. Blood pressure was controlled by bilateral nephrectomy in both cases, with significant reduction of antihypertensive therapy. One year after the operation, both patients were satisfied with the aesthetic result.Laparoscopic bilateral nephrectomy manually assisted by the Hand-Port is an alternative to open bilateral nephrectomy. Larger series are necessary to evaluate the morbidity of this technique.

Published
2001

36. [New immunosuppressive drugs and diabetes]

Author

C, Legendre, E, Thervet, and J, Bédrossian

Subjects
Immunosuppression Therapy, Transplantation Immunology, Incidence, Diabetes Mellitus, Humans, Insulin Resistance, Immunosuppressive Agents
Abstract

Glucocorticoïds, calcineurin inhibitors (especially tacrolimus) and the combination of both are responsible for the occurrence of diabetes mellitus after organ transplantation. These drugs induce both insulin resistance and insulinopenia. Risks factors are well identified: high doses of immunosuppressive drugs, genetic background, age and weight excess. Long-term consequences seem to be as deleterious as those of other types of diabetes mellitus. Modulating the doses of immunosuppressive drugs is efficient in decreasing insulin requirement in transplant recipients but only individualization of immunosuppression taking risks factors into account will permit to decrease the incidence of this side-effect.

Published
2001

38. [Kidney harvesting in living donors with manually assisted laparoscopy: technique and results]

Author

M, Peyromaure, O, Cappele, F, Desgrandchamps, A, el Ghoneimi, J, Bedrossian, E, Thervet, C, Legendre, P, Teillac, and A, Le Duc

Subjects
Adult, Living Donors, Tissue and Organ Harvesting, Feasibility Studies, Humans, Laparoscopy, Kidney Transplantation
Abstract

To evaluate the feasibility and complications of manually assisted laparoscopic live donor kidney harvesting.Since June 1999, all related live donor kidney harvests have been performed by manually assisted laparoscopy. The patient is placed in the lumbotomy position and an 8 cm midline periumbilical incision is made. The assistant's hand is introduced through a watertight port (HandPort). Three trocars are used. The assistant presents the structures to be dissected and controls the ureter. The artery is clipped and the vein is stapled or clipped, depending on its diameter. The kidney is extracted via the midline incision and washed.Five kidney harvests were performed (three right kidneys and two left kidneys) with a mean operating time of 220 +/- 30 minutes. Conversion was necessary in one case following the intraoperative discovery of two right renal veins. Warm ischaemia lasted 5 minutes for the first patient and one to two minutes for the other four non-converted patients. Blood losses were minimal. The mean duration of major analgesia was 2.4 days and the mean length of hospital stay was 7.2 days. Complications were: bacteriuria in 2 cases and prolonged lymphorrhoea in 1 case. One transplanted kidney had to be removed because of immediate thrombosis of the recipient iliac artery. With a mean follow-up of 6 months (1 to 12 months), no ureteric or venous complications have been observed in the 4 evaluable transplanted kidneys.An intra-abdominal hand during laparoscopic live donor kidney harvesting simplifies dissection, ensures intraoperative security and allows rapid extraction of the kidney.

Published
2001

39. Histologic evolution of kidney graft after combined pancreas-kidney transplantation

Author

Dominique Nochy, J.P Rerolle, P Passa, J Bedrossian, E. Thervet, François Desgrandchamps, S. Fornairon, C. Legendre, and Anne Janin

Subjects
Adult, Graft Rejection, medicine.medical_specialty, Time Factors, Biopsy, MEDLINE, Renal function, medicine, Humans, Observer Variation, Transplantation, Kidney, medicine.diagnostic_test, business.industry, Graft Survival, Kidney Transplantation, Surgery, Pancreas kidney transplantation, medicine.anatomical_structure, Creatinine, Histopathology, Pancreas Transplantation, Pancreas, business
Published
2000

40. Cyclosporine withdrawal in stable renal transplant recipients after azathioprine-mycophenolate mofetil conversion

Author

E, Thervet, E, Morelon, D, Ducloux, L, Bererhi, L H, Noël, A, Janin, J, Bedrossian, S, Puget, J M, Chalopin, M, Mihatsch, C, Legendre, and H, Kreis

Subjects
Adult, Graft Rejection, Male, Biopsy, Inulin, Middle Aged, Mycophenolic Acid, Kidney, Kidney Transplantation, Azathioprine, Cyclosporine, Humans, Female, Immunosuppressive Agents
Abstract

Cyclosporine A (CsA) nephrotoxicity is a nonimmunologic factor of chronic allograft dysfunction (CAD) in kidney transplant recipients. Mycophenolate mofetil (MMF) may allow CsA dosage reduction or even complete withdrawal in selected populations with CsA nephrotoxicity or CAD. The aim of the present study was to evaluate the efficacy and safety of CsA withdrawal after azathioprine (AZA)-MMF conversion in a population of stable renal transplant recipients.Twenty-eight first cadaver kidney recipients were included. AZA was then discontinued, MMF was introduced and after 4 months CsA was completely withdrawn. All patients underwent inuline clearance measurement and renal biopsy at inclusion and at the end of the follow-up (40 wk).CsA was completely discontinued in 20 patients. No patient lost his graft during the study period, but 1 patient experienced a reversible acute rejection episode. Inuline clearance improved significantly in the whole series. At the end of follow-up, histological worsening was observed in 50% of patients without any specific risk factor. In these patients, inuline clearance did not improve. Systolic blood pressure, the need for anti-hypertensive drugs and HDL cholesterol improved.In stable kidney transplant recipients, CsA withdrawal after AZA replacement by MMF switch was safe with regard to acute rejection. It improved blood pressure and the lipid profile, but, in 50% of patients was associated with histologic deterioration.

Published
2000

41. [New immunosuppressive agents]

Author

G, Socié and E, Thervet

Subjects
Graft Rejection, T-Lymphocytes, Cytokines, Humans, Cell Division, Immunosuppressive Agents, Bone Marrow Transplantation, Nucleic Acid Synthesis Inhibitors, Signal Transduction
Abstract

Over the last few years, improved knowledge of the immunological mechanisms underlying transplant rejection have resulted in the development of new immunosuppressive agents capable of selectively blocking various steps of the immune response. It is anticipated that these agents will prove useful in the treatment of autoimmune disease and graft-versus-host disease. Neoral is a cyclosporin microemulsion characterized by better and more consistent absorption as compared to the conventional galenic form. Tacrolimus shares with cyclosporin an ability to inhibit calcineurin and may have similar indications. Rapamycin and RAD are two related molecules that inhibit signal transduction by cytokines to T-cells, although they have not yet been proved clinically effective in large studies of solid organ transplant recipients. Mycophenolate mofetil selectively inhibits purine synthesis and lymphocyte proliferation; it is easy to use and has been found effective in a number of autoimmune disorders. Further clinical work is needed to determine the therapeutic indications for each of these new drugs. Elucidation of their mechanisms of action may help to identify drug combinations providing both enhanced efficacy and improved safety.

Published
1999

42. Placebo-controlled study of a humanized anti-TAC monoclonal antibody in dual therapy for prevention of acute rejection after renal transplantation

Author

B Charpentier and E Thervet

Subjects
Graft Rejection, medicine.medical_specialty, Daclizumab, medicine.drug_class, Placebo-controlled study, Monoclonal antibody, Antibodies, Monoclonal, Humanized, Gastroenterology, Placebos, Double-Blind Method, Adrenal Cortex Hormones, Internal medicine, medicine, Cadaver, Humans, Transplantation, Kidney, business.industry, Antibodies, Monoclonal, Ciclosporin, Kidney Transplantation, Tissue Donors, Clinical trial, medicine.anatomical_structure, Immunoglobulin G, Chemoprophylaxis, Immunology, Acute Disease, Cyclosporine, Surgery, business, Immunosuppressive Agents, medicine.drug
Published
1998

43. Cryptococcosis after renal transplantation

Author

B, Page, E, Thervet, C, Legendre, and H, Kreis

Subjects
Adult, Male, Postoperative Complications, Amphotericin B, Flucytosine, Humans, Cryptococcosis, Middle Aged, Fluconazole, Kidney Transplantation, Retrospective Studies
Published
1995

44. Prospective serial evaluation of cell adhesion molecule expression in transplanted kidneys

Author

E, Thervet, N, Patey, C, Legendre, L H, Noël, and H, Kreis

Subjects
Time Factors, Biopsy, Needle, Gene Expression, Vascular Cell Adhesion Molecule-1, Intercellular Adhesion Molecule-1, Kidney, Kidney Transplantation, Treatment Outcome, Humans, Transplantation, Homologous, Prospective Studies, E-Selectin, Cell Adhesion Molecules, Follow-Up Studies
Published
1995

45. Renal allograft necrosis: value of color Doppler ultrasound and Gd-DOTA-enhanced magnetic resonance imaging

Author

O, Hélénon, E, Thervet, J M, Corréas, L H, Noel, C, Legendre, H, Kreis, and J F, Moreau

Subjects
Thrombosis, Kidney, Renal Artery Obstruction, Kidney Transplantation, Magnetic Resonance Imaging, Sensitivity and Specificity, Necrosis, Evaluation Studies as Topic, Heterocyclic Compounds, Infarction, Organometallic Compounds, Humans, Radionuclide Imaging, Ultrasonography
Published
1994

48. [Imaging of vascular complications of renal transplantation]

Author

O, Hélénon, J M, Corréas, E, Thervet, P, Melki, J, Chabriais, H, Kreis, and J F, Moreau

Subjects
Diagnostic Imaging, Angiography, Thrombosis, Renal Artery Obstruction, Aneurysm, Kidney Transplantation, Magnetic Resonance Imaging, Renal Circulation, Infarction, Arteriovenous Fistula, Humans, Kidney Cortex Necrosis, Vascular Diseases, Ultrasonography
Abstract

The accuracy of color Doppler US (CDUS) for the detection of main renal transplant artery stenoses is excellent (Se 92%; SP 99%). Whereas the sensitivity of CDUS is still unsatisfactory for the detection of arterial branch stenosis (Se 70%), it has become higher than previously reported because of the ability of color flow images to identify hemodynamic changes at the site of stenosis and focal downstream repercussions in the case of tight stenosis. Color Doppler US is a valuable method in the detection of segmental infarction or large areas of cortical necrosis. However, small superficial cortical perfusion defects are usually undetectable by color Doppler. Contrast-enhanced MRI appears to be more accurate than color Doppler US; it is useful in confirming the diagnosis of infarction and detecting small infarcts missed by color Doppler US, and provides an accurate evaluation of the extent of the infarct; Spectral features (reflux during the whole diastole) obtained from renal arteries in case of acute renal vein thrombosis are suggestive but not specific since they can be observed in the case of severe acute rejection with cortical necrosis. Such findings associated with a lack of venous Doppler signals in the whole kidney are highly suggestive of renal transplant vein thrombosis. Post-biopsy arteriovenous fistulas and false arterial aneurysms are accurately detected by color Doppler Imaging. Color Doppler appears to be the primary Imaging modality for early detection of renal allograft vascular complications.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1994

50. PO36 Les inhibiteurs de mTOR ont-ils un rôle spécifique en thérapie cellulaire du diabète ?

Author

Julia Salleron, M. Labalette, C. Lucas-Croisier, C. Bocquet, Julie Kerr-Conte, C. Fermon, Christian Noel, C. Vercruysse, I. Fajardy, François Pattou, Marie-Christine Vantyghem, and E. Thervet

Subjects
Endocrinology, Endocrinology, Diabetes and Metabolism, Internal Medicine, General Medicine
Abstract

Introduction La therapie cellulaire est proposee chez le DT1 instable ou greffe renal dans le cadre d’essais cliniques. Depuis l’essai princeps d’Edmonton comportant du sirolimus, du tacrolimus et du daclizumab, de nombreux protocoles d’immunosuppression ont ete proposes. Le role propre des inhibiteurs de mTOR reste discute. Le but de cette etude est d’evaluer l’effet des concentrations d’immunosuppresseurs sur les resultats de la greffe d’ilots. Patients et Methodes 14 patients ont recu une greffe d’ilots seuls (âge 43 ± 8 ans, poids : 70 ± 9 kg) et 11 une greffe d’ilots 22 ± 9 mois apres greffe de rein (âge 45 ± 6 ans, poids 64 ± 8 kg) selon le protocole d’Edmonton. Les concentrations plasmatiques de sirolimus, de tacrolimus, l’HbA1c, la glycemie et le C-peptide, le s score, et les anticorps anti-GAD, ICA et IA2 ont ete mesures. Resultats Respectivement 1 et 3 ans apres « Ilots seuls », les taux d’insulino-independance avec HbA1c 3 ans). Tous malades confondus, il existe une correlation significative 1) negative entre entre sirolimus et tacrolimus d’une part, HbA1c, glycemie a jeun et post prandiale d’autre part ; 2) positive entre sirolimus et tacrolimus d’une part et C-peptide a jeun, post-prandial et sscore d’autre part. Il n’y a pas de relation entre sirolimus ou tacrolimus et creatininemie, clearance en MDRD, GAD, ICA, IA2. La relation est a la limite de la signification entre sirolimus et μalbuminurie. Les concentrations de tacrolimus et de sirolimus, varient significativement en fonction du temps mais seules les concentrations de tacrolimus varient en fonction du type de greffe (plus basses ans le groupe ilots seuls). En analyse univariee, l’augmentation des GAD et des ICA est un facteur pronostique pejoratif, tandis que les concentrations de sirolimus ont un effet pronostique plutot favorable (p = 0,06), a la difference du tacrolimus, Discussion Ces constatations sont en accord avec un certain nombre de donnees obtenues sur des cellules beta en culture ou chez le gros animal montrant un effet insulino-secreteur et antiapoptotique du sirolimus a dose therapeutique. Conclusion Ces resultats arguent en faveur d’un role favorable propre du sirolimus sur le pronostic de la greffe d’ilots tandis que la double association n’a pas d’effet nettement deletere sur le plan renal.

Published
2010

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