Descriptor: "MESH: kidney transplantation" - Searchworks@Jio Institute Digital Library Search Results

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162 results on '"MESH: kidney transplantation"'

1. Impact pédagogique d’un MOOC de technique chirurgicale de transplantation rénale

Author: Thomas Prudhomme, Georges Karam, Mathieu Roumiguié, Florian Bardet, Féderico Sallusto, Michel Soulié, Xavier Gamé, Nassim Kamar, Véronique Phé, Benjamin Pradère, Gilles Blancho, Éric Lechevallier, Julien Branchereau, Service d'Urologie [Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Institut de Transplantation et de Recherche en Transplantation [CHU Nantes] (ITERT), Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology (U1064 Inserm - CR2TI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de Néphrologie - Immunologie Clinique [Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-PRES Université de Toulouse, Maison de l'Urologie [Paris] (Collège français des enseignants en urologie), and Le Bihan, Sylvie
Subjects: MESH: Education, Distance* / methods, [SDV] Life Sciences [q-bio], Transplantation, Brain death, MESH: Humans, [SDV]Life Sciences [q-bio], Urology, MESH: Educational Measurement, Kidney transplant, MESH: Pilot Projects, MESH: Kidney Transplantation, Organ donation, Islam and organ donation
Abstract: Objective: To evaluate the educational impact of a pilot MOOC (Massive Open Online Course), validated by the French College of Urology Teachers (FCUT), on the surgical technique of kidney transplantation.Materials and methods: We developed a MOOC on the surgical technique of kidney transplantation, based on a video of a surgical procedure, performed by an expert surgeon. The MOOC has been validated by the FCUT. We have created 2 student groups: 1) MOOC-pre-QCM group: visualization of the MOOC then answer to the MCQs and satisfaction questions; 2) MOOC-post-QCM group: answer to the MCQs then visualization of the MOOC then answers to the satisfaction questions. In total, 20 MCQs on the kidney transplantation technique were completed by the 2 groups. The answers were anonymous.Results: A total of 142 people answered the MCQs (MOOC-pre-QCM group (n=66) and MOOC-post-QCM group (n=76)). Twenty-nine percent (41/142) of the participants were fellows and 71 % (101/142) were residents. The proportion of fellows and residents was identical between the 2 groups. The rate of correct answers to the 20 MCQs was statistically higher in the MOOC-pre-QCM group, compared to the MOOC-post-QCM group (88.6 % versus 73.3 %, P, ObjectifÉvaluer l’impact pédagogique d’un MOOC (Massive Open Online Course) pilote, validé par le Collège français des enseignants en urologie (CFEU), sur la technique chirurgicale de transplantation rénale.Matériel et méthodesNous avons réalisé un MOOC sur la technique chirurgicale de transplantation rénale, à partir d’une vidéo d’une intervention chirurgicale, réalisée par un chirurgien expert. Le MOOC a été validé par le CFEU. Nous avons créé 2 groupes d’étudiants : 1) groupe MOOC-pré-QCM : visualisation du MOOC, puis réponse aux QCM et aux questions de satisfaction ; 2) groupe MOOC-post-QCM : réponse aux QCM, puis visualisation du MOOC, puis réponse aux questions de satisfaction. Au total, 20 QCM sur la technique transplantation rénale ont été remplis par les 2 groupes. Les réponses étaient anonymes.RésultatsAu total, 142 personnes ont répondu aux QCM (groupe MOOC-pré-QCM (n = 66) et groupe MOOC-post-QCM (n = 76)). 29 % (41/142) des participants étaient des CCA ou assistants et 71 % (101/142) étaient des internes. La proportion de CCA/assistants et d’internes était identique entre les 2 groupes. Le taux de réponses correctes aux 20 QCM était statistiquement supérieur dans le groupe MOOC-pré-QCM, en comparaison au groupe MOOC post-QCM (88,6 % contre 73,3 %, p < 0,0001). Au total, 91 % des étudiants ont trouvé le MOOC « Très Utile » ou « Utile ». La médiane de la note du MOOC, donnée par les étudiants, était de 8/10.ConclusionCette étude a montré un impact positif du MOOC sur les connaissances théoriques de la technique chirurgicale de transplantation rénale. Ce MOOC pourrait servir de projet pilote pour le développement d’autres MOOC sur la chirurgie urologique.Niveau3.
Published: 2022
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2. Timing of Kidney Clamping and Deceased Donor Kidney Transplant Outcomes

Author: Simon, Ville, Marine, Lorent, Clarisse, Kerleau, Anders, Asberg, Christophe, Legendre, Emmanuel, Morelon, Fanny, Buron, Valérie, Garrigue, Moglie, Le Quintrec, Sophie, Girerd, Marc, Ladrière, Laetitia, Albano, Antoine, Sicard, Denis, Glotz, Carmen, Lefaucheur, Julien, Branchereau, David, Jacobi, Magali, Giral, Etienne, Sicard, Institut de Transplantation et de Recherche en Transplantation [CHU Nantes] (ITERT), Centre hospitalier universitaire de Nantes (CHU Nantes), European cohort for Kidney Transplantation Epidemiology (EKiTE), Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology (U1064 Inserm - CR2TI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Oslo University Hospital [Oslo], Réseau CENTAURE, Service Néphrologie et transplantation rénale Adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Hôpital Lapeyronie [Montpellier] (CHU), Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Département de Néphrologie - Hôpital Pasteur [Nice], Hôpital Pasteur [Nice] (CHU), Service d'Urologie [CHU Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), unité de recherche de l'institut du thorax UMR1087 UMR6291 (ITX), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), and Salvy-Córdoba, Nathalie
Subjects: Graft Rejection, Male, Time Factors, Databases, Factual, Epidemiology, Kidney, Critical Care and Intensive Care Medicine, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Organ transplantation, MESH: Kidney Transplantation, MESH: Delayed Graft Function, Kidney transplantation / nephrology, MESH: Incidence, Prospective Studies, Kidney transplantation, MESH: Aged, MESH: Middle Aged, Norway, Ischemia-reperfusion, Incidence, Graft Survival, Hazard ratio, Middle Aged, Constriction, medicine.anatomical_structure, Nephrology, Cardiology, Female, France, Adult, medicine.medical_specialty, MESH: Circadian Clocks, MESH: Graft Survival, Delayed Graft Function, MESH: Graft Rejection, Cadaver organ transplantation, MESH: Norway, Circadian Clocks, Internal medicine, medicine, Humans, Circadian rhythm, Aged, Transplantation, MESH: Humans, business.industry, MESH: Time Factors, MESH: Adult, Original Articles, Odds ratio, medicine.disease, Organ transplant, MESH: Databases, Factual, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Kidney Transplantation, MESH: Male, MESH: Prospective Studies, Confidence interval, MESH: France, business, MESH: Female
Abstract: International audience; Background and objectives The fact that metabolism and immune function are regulated by an endogenous molecular clock that generates circadian rhythms suggests that the magnitude of ischemia reperfusion, and subsequent inflammation on kidney transplantation, could be affected by the time of the day. Design, setting, participants, & measurements We evaluated 5026 individuals who received their first kidney transplant from deceased heart-beating donors. In a cause-specific multivariable analysis, we compared delayed graft function and graft survival according to the time of kidney clamping and declamping. Participants were divided into those clamped between midnight and noon ( ante meridiem [ am ] clamping group; 65%) or clamped between noon and midnight ( post meridiem [ pm ] clamping group; 35%), and, similarly, those who underwent am declamping (25%) or pm declamping (75%). Results Delayed graft function occurred among 550 participants (27%) with am clamping and 339 (34%) with pm clamping (adjusted odds ratio, 0.81; 95% confidence interval, 0.67 to 0.98; P =0.03). No significant association was observed between clamping time and overall death-censored graft survival (hazard ratio, 0.92; 95% confidence interval, 0.77 to 1.10; P =0.37). No significant association of declamping time with delayed graft function or graft survival was observed. Conclusions Clamping between midnight and noon was associated with a lower incidence of delayed graft function, whereas declamping time was not associated with kidney graft outcomes.
Published: 2021
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3. Living kidney donor evaluation for all candidates with normal estimated GFR for age

Author: Dimitri Titeca-Beauport, Nassim Kamar, Didier Ducloux, Benoit Barrou, Lola Jacquemont, Lionel Couzi, Nicolas Bouvier, Valérie Moal, Fatouma Touré, Bruno Moulin, Yann Le Meur, Cyril Garrouste, Denis Glotz, Lionel Rostaing, Antoine Thierry, Marie Courbebaisse, Hélène Lazareth, Isabelle Etienne, Jonathan M. Chemouny, François Gaillard, Christophe Legendre, Claire Pouteil-Noble, Philippe Rieu, Marc Hazzan, Mathias Büchler, Philippe Grimbert, Laetitia Albano, Michel Delahousse, Maryvonne Hourmant, Pierre Delanaye, Nacera Ouali, Luc Frimat, Christiane Mousson, Moglie Le Quintrec, Alexandre Hertig, Christophe Mariat, Retiveau, Nolwenn, CIC - CHU Bichat, Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Centre hospitalier universitaire de Nantes (CHU Nantes), 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), Centre Hospitalier Universitaire de Nice (CHU Nice), Hôpital Pasteur [Nice] (CHU), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), 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), Hôpital Côte de Nacre [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), CHU Amiens-Picardie, Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Immunology from Concept and Experiments to Translation (ImmunoConcept), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Hôpital Foch [Suresnes], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de Néphrologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Clermont-Ferrand, Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de Néphrologie et Transplantation rénale [CHRU-lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Néphrologie - Immunologie Clinique [Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-PRES Université de Toulouse, Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Hopital de Bohars - CHRU Brest (CHU - BREST ), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CHU Necker - Enfants Malades [AP-HP], Assistance Publique - Hôpitaux de Marseille (APHM), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), CHU Strasbourg, CHU Dijon, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre Hospitalier Universitaire de Reims (CHU Reims), CHU Tenon [AP-HP], Centre Hospitalier Universitaire [Grenoble] (CHU), Centre hospitalier universitaire de Poitiers (CHU Poitiers), 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), CHU Limoges, CHU Pontchaillou [Rennes], Hôpital Universitaire Carémeau [Nîmes] (CHU Nîmes), Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Université de Liège, Institut Necker Enfants-Malades (INEM - UM 111 (UMR 8253 / U1151)), Hôpital Nord (Saint Etienne), CHU Toulouse [Toulouse]-PRES Université de Toulouse, Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Centre Hospitalier Universitaire de Saint-Etienne [CHU Saint-Etienne] (CHU ST-E)
Subjects: medicine.medical_specialty, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, Population, Urology, Renal function, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030230 surgery, Kidney, Nephrectomy, MESH: Kidney Transplantation, 03 medical and health sciences, Age, Living kidney donors, 0302 clinical medicine, Age groups, Living Donors, medicine, Humans, education, MESH: Living Donors, Transplantation, education.field_of_study, MESH: Humans, MESH: Middle Aged, business.industry, Kidney donation, Estimated GFR, MESH: Kidney, Middle Aged, Post-donation GFR, Kidney Transplantation, MESH: Nephrectomy, MESH: Glomerular Filtration Rate, medicine.anatomical_structure, MESH: Kidney Failure, Chronic, Donation, Screening, Kidney Failure, Chronic, 030211 gastroenterology & hepatology, DONOR EVALUATION, business, Glomerular Filtration Rate
Abstract: International audience; Multiple days assessments are frequent for the evaluation of candidates to living kidney donation, combined with an early GFR estimation (eGFR). Living kidney donation is questionable when eGFR is 55 years) in a population of 1825 French living kidney donors with a median follow-up of 5.9 years. In donors younger than 45, postdonation eGFR, absolute- and relative-eGFR variation were not different between the three groups. For older donors, postdonation eGFR was higher in S90 than in S80 or Sage but other comparators were identical. Postdonation eGFR slope was comparable between all groups. Our results are in favour of in-depth screening for all candidates to donation with a normal eGFR for age.
Published: 2021
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4. Arterial abnormalities identified in kidneys transplanted into children during the COVID-19 pandemic

Author: Carmen Capito, Sabine Sarnacki, Yves Heloury, Laurène Dehoux, Olivia Boyer, Marina Charbit, Elisa Zanelli, Florence Lacaille, Thomas Blanc, Sarah Temmam, Nathalie Boddaert, Marianne Leruez-Ville, Marc Eloit, Marion Rabant, C. Chardot, Laureline Berteloot, Cécile Lozach, Myriam Pastural, Isabelle Sermet-Gaudelus, Romain Berthaud, Nicolas Garcelon, Service de radiologie pédiatrique [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), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de néphrologie pédiatrique [CHU Necker], Centre de Référence des Maladies Rénales Héréditaires de l'Enfant et de l'Adulte [CHU-Necker] (MARHEA), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Découverte de pathogènes – Pathogen discovery, Institut Pasteur [Paris] (IP), Université Paris Cité (UPCité), Service de chirurgie et urologie pédiatrique [CHU-Necker], Pediatric Surgery and Urology Department, AP-HP, Hôpital Universitaire Necker-Enfants malades, Plateforme Data Science = Data Science Platform, Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Gastro-Entérologie, Hépatologie et Nutrition pédiatriques (CHU Necker - Enfants Malades [AP-HP]), Agence de la biomédecine [Saint-Denis la Plaine], Département de Pathologie [CHU Necker], Université Sorbonne Paris Cité (USPC)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Cité (UPCité), Laboratoire de Virologie [CHU Necker], National Cystic Fibrosis Reference Center [CHU Necker] (CNR - INSERM U1151), Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Necker - Enfants Malades [AP-HP], Fédération pour la recherche en explorations et thérapeutiques innovantes in utéro (FETUS - EA 7328), Université Paris Descartes - Paris 5 (UPD5), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)
Subjects: Male, kidney disease: immune / inflammatory, medicine.medical_treatment, Constriction, Pathologic, Kidney, MESH: Kidney Transplantation, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Child, clinical research / practice, MESH: COVID-19, Immunology and Allergy, Pharmacology (medical), kidney transplantation / nephrology, Child, Arteries, medicine.anatomical_structure, Female, Vasculitis, Artery, MESH: Pandemics, medicine.medical_specialty, infection and infectious agents - viral, pediatrics, Adolescent, infectious disease, diagnostic techniques and imaging: ultrasound, complication, recipient selection, Anastomosis, MESH: Constriction, Pathologic, medicine, Humans, MESH: Arteries, Pandemics, Dialysis, Retrospective Studies, MESH: Adolescent, Transplantation, MESH: Humans, business.industry, Arterial stenosis, COVID-19, MESH: Retrospective Studies, MESH: Kidney, medicine.disease, Kidney Transplantation, MESH: Male, Surgery, Stenosis, business, Complication, MESH: Female
Abstract: International audience; Graft artery stenosis can have a significant short- and long-term negative impact on renal graft function. From the beginning of the COVID-19 pandemic, we noticed an unusual number of graft arterial anomalies following kidney transplant (KTx) in children. Nine children received a KTx at our center between February and July 2020, eight boys and one girl, of median age of 10 years. Seven presented Doppler features suggesting arterial stenosis, with an unusual extensive pattern. For comparison, over the previous 5-year period, persistent spectral Doppler arterial anomalies (focal anastomotic stenoses) following KTx were seen in 5% of children at our center. We retrospectively evidenced severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in five of seven children with arterial stenosis. The remaining two patients had received a graft from a deceased adolescent donor with a positive serology at D0. These data led us to suspect immune postviral graft vasculitis, triggered by SARS-CoV-2. Because the diagnosis of COVID-19 is challenging in children, we recommend pretransplant monitoring of graft recipients and their parents by monthly RT-PCR and serology. We suggest balancing the risk of postviral graft vasculitis against the risk of prolonged dialysis when considering transplantation in a child during the pandemic.
Published: 2021
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5. Severe relapse of SARS‐CoV‐2 infection in a kidney transplant recipient with negative nasopharyngeal SARS‐CoV‐2 RT‐PCR after rituximab

Author: Antoine Morel, Sandrine Imbeaud, Anne Scemla, Hélène Péré, Jacques Fourgeaud, Lucile Amrouche, Nicolas Robillard, Delphine Planas, Julien Puech, Sylvie Simon, Fanny Lanternier, Laurent Bélec, Julien Zuber, Olivier Schwartz, Dany Anglicheau, Nathalie Chavarot, David Veyer, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École pratique des hautes études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC), Génomique fonctionnelle des tumeurs solides = Functional Genomics of Solid Tumors [CRC] (FunGeST), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPC)-École pratique des hautes études (EPHE), 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), Laboratoire de Microbiologie Clinique [AP-HP Hôpital Necker-Enfants Malades], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Virus et Immunité - Virus and immunity, Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPC), Vaccine Research Institute (VRI), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPC), Institut Necker Enfants-Malades (INEM - UM 111 (UMR 8253 / U1151)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPC), The authors would like to thank AcaciaTools for their proofreading services, École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Virus et Immunité - Virus and immunity (CNRS-UMR3569), Institut Pasteur [Paris] (IP)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Université Paris-Saclay, Service Néphrologie et transplantation rénale Adultes [CHU Necker], Université Sorbonne Paris Cité (USPC), Laboratoire de Virologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Université Paris Descartes - Paris 5 (UPD5), Vaccine Research Institute [Créteil, France] (VRI), Université Paris Cité (UPCité), Université Paris Diderot - Paris 7 (UPD7), Laboratoire de Virologie [Hôpital Européen Georges Pompidou - APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École pratique des hautes études (EPHE), and Institut Pasteur [Paris]-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité)
Subjects: Transplantation, MESH: Humans, infection and infectious agents-viral, translational research/science, [SDV]Life Sciences [q-bio], infectious disease, MESH: COVID-19 Testing, kidney transplantation/nephrology, clinical research/practice, MESH: Kidney Transplantation, MESH: Recurrence, lung disease: infectious, MESH: Reverse Transcriptase Polymerase Chain Reaction, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Immunology and Allergy, MESH: COVID-19, Pharmacology (medical), MESH: SARS-CoV-2, MESH: Rituximab
Abstract: International audience; Immunocompromised patients may experience prolonged viral shedding after their initial SARS-CoV-2 infection, however, symptomatic relapses after remission currently remain rare. We herein describe a severe COVID-19 relapse case of a kidney transplant recipient (KTR) following rituximab therapy, 3 months after a moderate COVID-19 infection, despite viral clearance after recovery of the first episode. During the clinical relapse, the diagnosis was established on a broncho-alveolar lavage specimen (BAL) by RT-PCR. The infectivity of the BAL sample was confirmed on a cell culture assay. Whole genome sequencing confirmed the presence of an identical stain (Clade 20A). However, it had an acquired G142D mutation and a larger deletion of 3-amino-acids at position 143-145. These mutations located within the N-terminal domain are suggested to play a role in viral entry. The diagnosis of a COVID-19 relapse should be considered in the setting of unexplained persistent fever and/or respiratory symptoms in KTRs (especially for those after rituximab therapy), even in patients with previous negative naso-pharyngeal SARS-CoV-2 PCR.
Published: 2022
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6. Cohort study: 'Outcomes of kidney transplantation in patients with prosthetic heart valves'

Author: Ouahmi, Hajar, Moceri, Pamela, Zorzi, Kevin, Albano, Laetitia, Durand, Matthieu, Karimi, Fatimaezzahra, Morelon, Emmanuel, Buron, Fanny, Le Quintrec, Moglie, Pernin, Vincent, Ladriere, Marc, Girerd, Sophie, Dantal, Jacques, Loupy, Alexandre, Couzi, Lionel, Ferrari, Emile, Esnault, Vincent, Merville, Pierre, Legendre, Christophe, Giral, Magali, Sicard, Antoine, Badet, Lionel, Brunet, Maria, Cahen, Rémi, Codas, Ricardo, Daoud, Sameh, Dubois, Valérie, Fournie, Coralie, Grégoire, Arnaud, Koenig, Alice, Lévi, Charlène, Pouteil‐Noble, Claire, Rabeyrin, Maud, Rimmelé, Thomas, Thaunat, Olivier, Abdo, Nicolas, Delmas, Sylvie, Perrochia, Hélène, Serre, Jean‐Emmanuel, Szwarc, Ilan, Aarnink, Alice, Alla, Asma, Eschwege, Pascal, Frimat, Luc, Hubert, Jacques, Kormann, Raphaël, Lagrange, François, Laurain, Emmanuelle, Lecoanet, Pierre, Lemelle, Jean‐Louis, Mannuguerra, Anthony, Mazeaud, Charles, Peres, Michael, Blancho, Gilles, Branchereau, Julien, Cantarovich, Diego, Chapelet, Agnès, Deltombe, Clément, Figueres, Lucile, Garandeau, Claire, Gourraud‐Vercel, Caroline, Hourmant, Maryvonne, Karam, Georges, Kerleau, Clarisse, Meurette, Aurélie, Ville, Simon, Kandell, Christine, Moreau, Anne, Renaudin, Karine, Cesbron, Anne, Delbos, Florent, Walencik, Alexandre, Devis, Anne, Chevallier, Daniel, Tibi, Brannwel, Ahallal, Younes, Amrouche, Lucile, Anglicheau, Dany, Aubert, Olivier, Bererhi, Lynda, Martinez, Frank, Sberro‐Soussan, Rébecca, Scemla, Anne, Tinel, Claire, Zuber, Julien, Glotz, Denis, Lefaucheur, Carmen, Université Côte d'Azur - Faculté de Médecine (UCA Faculté Médecine), Université Côte d'Azur (UCA), Centre Hospitalier Universitaire de Nice (CHU Nice), CIC CHU Lyon (inserm), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM), Réseau CENTAURE, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology (U1064 Inserm - CR2TI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), CHU Bordeaux [Bordeaux], Immunology from Concept and Experiments to Translation (ImmunoConcept), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Laboratoire de PhysioMédecine Moléculaire (LP2M), Université Nice Sophia Antipolis (1965 - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), DIVAT Consortium: Lionel Badet, Maria Brunet, Fanny Buron, Rémi Cahen, Ricardo Codas, Sameh Daoud, Valérie Dubois, Coralie Fournie, Arnaud Grégoire, Alice Koenig, Charlène Lévi, Emmanuel Morelon, Claire Pouteil-Noble, Maud Rabeyrin, Thomas Rimmelé, Olivier Thaunat, Nicolas Abdo, Sylvie Delmas, Moglie Le Quintrec, Vincent Pernin, Hélène Perrochia, Jean-Emmanuel Serre, Ilan Szwarc, Alice Aarnink, Asma Alla, Pascal Eschwege, Luc Frimat, Sophie Girerd, Jacques Hubert, Raphaël Kormann, Marc Ladriere, François Lagrange, Emmanuelle Laurain, Pierre Lecoanet, Jean-Louis Lemelle, Anthony Mannuguerra, Charles Mazeaud, Michael Peres, Gilles Blancho, Julien Branchereau, Diego Cantarovich, Agnès Chapelet, Jacques Dantal, Clément Deltombe, Lucile Figueres, Claire Garandeau, Magali Giral, Caroline Gourraud-Vercel, Maryvonne Hourmant, Georges Karam, Clarisse Kerleau, Aurélie Meurette, Simon Ville, Christine Kandell, Anne Moreau, Karine Renaudin, Anne Cesbron, Florent Delbos, Alexandre Walencik, Anne Devis, Laetitia Albano, Fatimaezzahra Karimi, Antoine Sicard, Hajar Ouahmi, Daniel Chevallier, Brannwel Tibi, Matthieu Durand, Younes Ahallal, Lucile Amrouche, Dany Anglicheau, Olivier Aubert, Lynda Bererhi, Christophe Legendre, Alexandre Loupy, Frank Martinez, Rébecca Sberro-Soussan, Anne Scemla, Claire Tinel, Julien Zuber, Denis Glotz, Carmen Lefaucheur, and Retiveau, Nolwenn
Subjects: medicine.medical_specialty, medicine.medical_treatment, MESH: Heart Valves, Postoperative Hemorrhage, MESH: Kidney Transplantation, Cohort Studies, Diabetes mellitus, Internal medicine, Biological heart valve, Medicine, Endocarditis, Humans, Prospective Studies, MESH: Cohort Studies, Kidney transplantation, Dialysis, Retrospective Studies, Kidney, Transplantation, MESH: Humans, business.industry, Cardiac valve replacement, End-stage kidney disease, MESH: Postoperative Hemorrhage, MESH: Retrospective Studies, medicine.disease, Heart Valves, Kidney Transplantation, MESH: Prospective Studies, [SDV.TOX] Life Sciences [q-bio]/Toxicology, medicine.anatomical_structure, Prosthetic heart valve, Mechanical heart valve, [SDV.TOX]Life Sciences [q-bio]/Toxicology, Cohort, Cardiology, business, Cohort study
Abstract: Main problem The number of kidney transplant candidates with prosthetic heart valves (PHVs) is increasing. Yet, outcomes of kidney transplantation in these patients are still unclear. This is the first report of post-transplant outcomes in patients with PHVs at time of kidney transplantation. Methods We conducted a matched cohort study among recipients from the multicentric and prospective DIVAT cohort to compare outcomes in patients with left-sided PHVs at time of transplantation and a group of recipients without PHV matched according to age, dialysis time, initial disease, pre-transplant DSA, diabetes and cardiovascular events. Results Of 23018 patients, 92 patients with PHVs were included and compared to 276 patients without PHV. Delayed graft function and post-operative bleeding occurred more frequently in patients with PHVs. Kidney graft survival was similar between groups. 5-year overall survival was 68.5 % in patients with PHV versus 87.9 % in patients without PHV (HR, 2.72[1.57-4.70], p=0.0004). Deaths from infection, endocarditis and bleeding were more frequent in patients with PHV. Mechanical valves, but not bioprosthetic valves, were independent risk factors for mortality (HR, 2.89[1.68-4.97], p=0.0001). Conclusions Patients with PHV have high mortality rates after kidney transplantation. These data suggest that mechanical valves, but not biological valves, increase risks of post-transplant mortality.
Published: 2021
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7. Novel Organ Perfusion and Preservation Strategies in Controlled Donation After Circulatory Death in Pancreas and Kidney Transplantation

Author: J. Branchereau, A.E. Ogbemudia, S. Le Bas-Bernardet, T. Prudhomme, J. Rigaud, G. Karam, G. Blancho, B. Mesnard, Nuffield Department of Surgical Sciences [Oxford, UK], University of Oxford, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology (U1064 Inserm - CR2TI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), and Le Bihan, Sylvie
Subjects: MESH: organ preservation, Transplantation, MESH: kidney transplantation, MESH: tissue donors, [SDV]Life Sciences [q-bio], Organ Preservation, MESH: perfusion, Kidney Transplantation, Tissue Donors, [SDV] Life Sciences [q-bio], Perfusion, surgical procedures, operative, MESH: pancreas, Humans, MESH: humans, Surgery, Pancreas
Abstract: International audience; Background. Kidney and pancreatic transplants from controlled donation after circulatory death donors are vulnerable to ischemia-reperfusion injuries. In this context of transplant shortage, there is a need to optimize the function of these transplants and to develop novel perfusion and preservation strategies in controlled donation after circulatory death in kidney and pancreatic transplants. In Situ Perfusion and Preservation Strategies. In situ regional normothermic perfusion improves the outcome of kidney transplants from controlled donation after circulatory death and provides equivalent results for the kidney from brain-dead donors. In situ regional normothermic perfusion is under investigation for pancreatic transplants. Ex Situ Perfusion and Preservation Strategies. Perfusion on hypothermic machine perfusion is highly recommended for the kidney from controlled donation after cardiac death. Hypothermic oxygenated perfusion machine decreases the rate of graft rejection and graft failure in kidney transplantation. Ex situ normothermic perfusion is an easy way to assess renal function. In the future, kidney transplants could benefit from drug therapy during ex situ normothermic perfusion. In pancreas transplantation, hypothermic machine perfusion and ex situ normothermic perfusion present encouraging results in preclinical studies.
Published: 2021
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8. Is COVID‐19 infection more severe in kidney transplant recipients?

Author: Nathalie Chavarot, Bruno Moulin, Valérie Moal, Olivier Thaunat, Marc Hazzan, Jamal Bamoulid, Antoine Durrbach, Christiane Mousson, Nassim Kamar, Yannick Lemeur, Charlotte Kaeuffer, Clarisse Greze, Philippe Grimbert, Ilies Benotmane, Dominique Bertrand, Antoine Thierry, Tristan Legris, Gilles Blancho, Pierre François Westeel, Mariam Jdidou, Hélène François, Sophie Caillard, Marie Matignon, Yvon Ruch, Morgane Solis, Antoine Sicard, Dany Anglicheau, Philippe Gatault, Valentin Goutaudier, François Danion, Lionel Couzi, Charlotte Colosio, Renaud Snanoudj, Christophe Masset, Agnès Duveau, Jonathan M. Chemouny, Luc Frimat, CHU Strasbourg, Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Necker Enfants-Malades (INEM - UM 111 (UMR 8253 / U1151)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), CHU Henri Mondor [Créteil], AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université de Tours (UT), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Aix Marseille Université (AMU), Centre d'Investigation Clinique - Epidemiologie Clinique/essais Cliniques Nancy, Cancéropôle du Grand Est-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), CHU Amiens-Picardie, CHU Montpellier, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Centre Hospitalier Universitaire de Reims (CHU Reims), Unité de Recherche Clinique de la Côte d’Azur (URRIS UR2CA), Centre Hospitalier Universitaire de Nice (CHU Nice)-Université Côte d'Azur (UCA), Hôpital Pasteur [Nice] (CHU), Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Université de Bourgogne (UB), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC), Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Poitiers, Immunology from Concept and Experiments to Translation (ImmunoConcept), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), CHU de Bordeaux Pellegrin [Bordeaux], Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), 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 ), Université d'Angers (UA), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Microbes évolution phylogénie et infections (MEPHI), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Centre National de la Recherche Scientifique (CNRS), Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), CHRU Brest - Service de Nephrologie (CHU - BREST - Nephrologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ), University of Lille, This study was supported by the Strasbourg University Hospital (COVIS-HUS Study- HUS number 7760), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), AP-HP Hôpital Tenon [Paris], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, CHU Toulouse [Toulouse], Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Centre d'Investigation Clinique - Innovation Technologique [Nancy] (CIC-IT), Centre d'investigation clinique [Nancy] (CIC), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), University Hospital of Montpellier, Hôpital Bicêtre, Centre Hospitalier Universitaire de Nice (CHU Nice), CHU Rouen, Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon), Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Bordeaux [Bordeaux], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM), 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 ), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHU Henri Mondor, Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Unité de Recherche Clinique de la Côte d’Azur [Nice] (URRIS UR2CA), Université Côte d'Azur (UCA), Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Tours, Centre National de la Recherche Scientifique (CNRS)-Université de Bordeaux (UB), PINIER, CHRISTINE, 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), and Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Université d'Angers (UA)
Subjects: medicine.medical_treatment, [SDV]Life Sciences [q-bio], MESH: Registries, Aucun, MESH: Comorbidity, 030230 surgery, law.invention, chemistry.chemical_compound, 0302 clinical medicine, law, cardiovascular disease, MESH: Risk Factors, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, clinical research / practice, Immunology and Allergy, Cumulative incidence, Pharmacology (medical), kidney transplantation / nephrology, MESH: Incidence, MESH: Aged, Univariate analysis, MESH: France / epidemiology, MESH: Middle Aged, MESH: Transplant Recipients / statistics & numerical data, Acute kidney injury, Intensive care unit, 3. Good health, MESH: COVID-19 / epidemiology, Cohort, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, glomerular filtration rate (GFR), kidney failure / injury, medicine.medical_specialty, infection and infectious agents - viral, infectious disease, Brief Communication, MESH: Graft Rejection / prevention & control, 03 medical and health sciences, Internal medicine, Diabetes mellitus, MESH: Severity of Illness Index, MESH: COVID-19 / diagnosis, medicine, Humans, MESH: SARS-CoV-2, Mechanical ventilation, Creatinine, Transplantation, MESH: Humans, business.industry, SARS-CoV-2, MESH: Graft Rejection / epidemiology, COVID-19, MESH: Retrospective Studies, medicine.disease, Kidney Transplantation, Transplant Recipients, MESH: Male, immunosuppressive regimens, MESH: Immunosuppressive Agents / therapeutic use, MESH: Pandemics, MESH: Propensity Score, chemistry, Reinfection, MESH: Immunosuppression / methods, MESH: Intensive Care Units, business, MESH: Female, MESH: Kidney Transplantation
Abstract: International audience; There are no studies which have compared the risk of severe Covid-19 and related mortality between transplant recipients and non-transplant patients. We enrolled two groups of patients hospitalized for Covid-19, i.e., kidney transplant recipients from the French Registry of Solid Organ Transplant (n=306) and a single-center cohort of non-transplant patients (n=795). An analysis was performed among subgroups matched for age and risk factors for severe Covid-19 or mortality. Severe Covid-19 was defined as admission (or transfer) to an intensive care unit, need for mechanical ventilation, or death.Transplant recipients were younger and had more comorbidities compared to non-transplant patients. They presented with higher creatinine levels and developed more episodes of acute kidney injury. After matching, the 30-day cumulative incidence of severe Covid-19 did not differ between KTR and non-transplant patients; however, 30-day Covid-19-related mortality was significantly higher in KTR (17.9% versus 11.4%, respectively, p=0.038). Age >60 years, cardiovascular disease, dyspnea, fever, lymphopenia, and C-reactive protein (CRP) were associated with severe Covid-19 in univariate analysis, whereas transplant status and serum creatinine levels were not. Age >60 years, hypertension, cardiovascular disease, diabetes, CRP >60 mg/L, lymphopenia, kidney transplant status (HR=1.55), and creatinine level >115 µmol/L (HR=2.32) were associated with Covid-19-related mortality in univariate analysis. In multivariable analysis, cardiovascular disease, dyspnea, and fever were associated with severe disease, whereas age >60 years, cardiovascular disease, dyspnea, fever, and creatinine level>115 µmol/L retained their independent associations with mortality. Kidney transplant recipients had a higher Covid-19-related mortality compared to non-transplant hospitalized patients.
Published: 2021
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9. FaDA: A web application for regular laboratory data analyses

Author: Danger, Richard, Moiteaux, Quentin, Feseha, Yodit, Geffard, Estelle, Ramstein, Gérard, Brouard, Sophie, Ramstein, Gérard, Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Centre hospitalier universitaire de Nantes (CHU Nantes), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Laboratoire des Sciences du Numérique de Nantes (LS2N), Université de Nantes - UFR des Sciences et des Techniques (UN UFR ST), Université de Nantes (UN)-Université de Nantes (UN)-École Centrale de Nantes (ECN)-Centre National de la Recherche Scientifique (CNRS)-IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT)-Institut Mines-Télécom [Paris] (IMT), IMT Atlantique (IMT Atlantique), Institut Mines-Télécom [Paris] (IMT), Translational ImmunoGenetic in AutoImmunity and Transplantation (Team 5 - U1064 Inserm - CRTI), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), LabEX IGO Immunothérapie Grand Ouest, and Nantes Université (Nantes Univ)
Subjects: Data Analysis, MESH: Data Visualization, Gene Expression, Datasets as Topic, MESH: Flow Cytometry, Computer Applications, MESH: Kidney Transplantation, Database and Informatics Methods, Mathematical and Statistical Techniques, Spectrum Analysis Techniques, MESH: Data Analysis, MESH: Datasets as Topic, Data Management, Statistical Data, [INFO.INFO-BI] Computer Science [cs]/Bioinformatics [q-bio.QM], Principal Component Analysis, Multidisciplinary, Statistics, Software Engineering, Flow Cytometry, MESH: Internet, Spectrophotometry, Data Interpretation, Statistical, Physical Sciences, Web-Based Applications, MESH: Laboratories, Medicine, Engineering and Technology, Cytophotometry, Research Article, Computer and Information Sciences, Bioinformatics, Science, Research and Analysis Methods, MESH: Software, Genetics, Humans, Statistical Methods, Internet, MESH: Humans, Data Visualization, Biology and Life Sciences, Kidney Transplantation, Multivariate Analysis, Programming Languages, [INFO.INFO-BI]Computer Science [cs]/Bioinformatics [q-bio.QM], Laboratories, MESH: Data Interpretation, Statistical, Mathematics, Software
Abstract: Web-based data analysis and visualization tools are mostly designed for specific purposes, such as the analysis of data from whole transcriptome RNA sequencing or single-cell RNA sequencing. However, generic tools designed for the analysis of common laboratory data for noncomputational scientists are also needed. The importance of such web-based tools is emphasized by the continuing increases in the sample capacity of conventional laboratory tools such as quantitative PCR, flow cytometry or ELISA instruments. We present a web-based application FaDA, developed with the R Shiny package that provides users with the ability to perform statistical group comparisons, including parametric and nonparametric tests, with multiple testing corrections suitable for most standard wet-laboratory analyses. FaDA provides data visualizations such as heatmaps, principal component analysis (PCA) plots, correlograms and receiver operating curves (ROCs). Calculations are performed through the R language. The FaDA application provides a free and intuitive interface that allows biologists without bioinformatic skill to easily and quickly perform common laboratory data analyses. The application is freely accessible at https://shiny-bird.univ-nantes.fr/app/Fada.
Published: 2021
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10. Dynamic prediction of renal survival among deeply phenotyped kidney transplant recipients using artificial intelligence: an observational, international, multicohort study

Author: Raynaud, Marc, Aubert, Olivier, Divard, Gillian, Reese, Peter P, Kamar, Nassim, Yoo, Daniel, Chin, Chen-Shan, Bailly, Élodie, Buchler, Matthias, Ladrière, Marc, Le Quintrec, Moglie, Delahousse, Michel, Jurić, Ivana, Bašić-Jukić, Nikolina, Crespo, Marta, Silva, Helio Tedesco, Linhares, Kamilla, Ribeiro de Castro, Maria Cristina, Soler Pujol, Gervasio, Empana, Jean-Philippe, Ulloa, Camilo, Akalin, Enver, Böhmig, Georg, Huang, Edmund, Stegall, Mark D, Bentall, Andrew J, Montgomery, Robert A, Jordan, Stanley C, Oberbauer, Rainer, Segev, Dorry L, Friedewald, John J, Jouven, Xavier, Legendre, Christophe, Lefaucheur, Carmen, Loupy, Alexandre, Paris-Centre de Recherche Cardiovasculaire (PARCC (UMR_S 970/ U970)), 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)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University of Pennsylvania, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Université de Lorraine (UL), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Hôpital Foch [Suresnes], University of Zagreb, University Hospital Centre Zagreb, Partenaires INRAE, IMIM-Hospital del Mar, Generalitat de Catalunya, Universidade Federal de São Paulo, Universidade de São Paulo = University of São Paulo (USP), Albert Einstein College of Medicine [New York], Cedars-Sinai Medical Center, Mayo Clinic [Rochester], New York University Langone Medical Center (NYU Langone Medical Center), NYU System (NYU), Medizinische Universität Wien = Medical University of Vienna, Johns Hopkins University School of Medicine [Baltimore], Northwestern University Feinberg School of Medicine, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Hopital Saint-Louis [AP-HP] (AP-HP), and Herrada, Anthony
Subjects: Male, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, MESH: Allografts, Kidney, MESH: Risk Assessment, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Kidney Transplantation, [INFO.INFO-AI]Computer Science [cs]/Artificial Intelligence [cs.AI], Postoperative Complications, MESH: Postoperative Complications, MESH: Renal Insufficiency, artificial intelligence, kidney transplant, Renal Insufficiency, MESH: Middle Aged, Middle Aged, Allografts, Prognosis, MESH: Reproducibility of Results, Proteinuria, Area Under Curve, Female, Glomerular Filtration Rate, Adult, [INFO.INFO-AI] Computer Science [cs]/Artificial Intelligence [cs.AI], MESH: Transplant Recipients, MESH: Bayes Theorem, Computer applications to medicine. Medical informatics, R858-859.7, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Models, Biological, Risk Assessment, MESH: Prognosis, Artificial Intelligence, MESH: Proteinuria, Humans, MESH: Artificial Intelligence, MESH: Humans, MESH: Models, Biological, Reproducibility of Results, Bayes Theorem, MESH: Adult, MESH: Kidney, Kidney Transplantation, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Transplant Recipients, MESH: Male, MESH: Glomerular Filtration Rate, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Area Under Curve, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, MESH: Female
Abstract: Summary: Background: Kidney allograft failure is a common cause of end-stage renal disease. We aimed to develop a dynamic artificial intelligence approach to enhance risk stratification for kidney transplant recipients by generating continuously refined predictions of survival using updates of clinical data. Methods: In this observational study, we used data from adult recipients of kidney transplants from 18 academic transplant centres in Europe, the USA, and South America, and a cohort of patients from six randomised controlled trials. The development cohort comprised patients from four centres in France, with all other patients included in external validation cohorts. To build deeply phenotyped cohorts of transplant recipients, the following data were collected in the development cohort: clinical, histological, immunological variables, and repeated measurements of estimated glomerular filtration rate (eGFR) and proteinuria (measured using the proteinuria to creatininuria ratio). To develop a dynamic prediction system based on these clinical assessments and repeated measurements, we used a Bayesian joint models—an artificial intelligence approach. The prediction performances of the model were assessed via discrimination, through calculation of the area under the receiver operator curve (AUC), and calibration. This study is registered with ClinicalTrials.gov, NCT04258891. Findings: 13 608 patients were included (3774 in the development cohort and 9834 in the external validation cohorts) and contributed 89 328 patient-years of data, and 416 510 eGFR and proteinuria measurements. Bayesian joint models showed that recipient immunological profile, allograft interstitial fibrosis and tubular atrophy, allograft inflammation, and repeated measurements of eGFR and proteinuria were independent risk factors for allograft survival. The final model showed accurate calibration and very high discrimination in the development cohort (overall dynamic AUC 0·857 [95% CI 0·847–0·866]) with a persistent improvement in AUCs for each new repeated measurement (from 0·780 [0·768–0·794] to 0·926 [0·917–0·932]; p
Published: 2021
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11. IMPact of the COVID-19 epidemic on the moRTAlity of kidney transplant recipients and candidates in a French Nationwide registry sTudy (IMPORTANT)

Author: Olivier Thaunat, Camille Legeai, Dany Anglicheau, Lionel Couzi, Gilles Blancho, Marc Hazzan, Myriam Pastural, Emilie Savoye, Florian Bayer, Emmanuel Morelon, Yann Le Meur, Olivier Bastien, Sophie Caillard, Charlene Levi, Fanny Buron, Alice Koenig, Thomas Barba, Bruno Moulin, Samira Fafi-Kremer, Anglicheau Dany, Alexandre Hertig, Jérôme Tourret, Benoit Barrou, Pierre Merville, Anna Kaminski, Valérie Moal, Tristan Legris, Pierre-François Westeel, Maïté Jaureguy, Luc Frimat, Didier Ducloux, Jamal Bamoulid, Dominique Bertrand, Michel Tsimaratos, Florentine Garaix-Gilardo, Jérôme Dumortier, Sacha Mussot, Antoine Roux, Laurent Sebbag, Yannick Le Meur, Christophe Masset, Nassim Kamar, Hélène Francois, Eric Rondeau, Nicolas Bouvier, Christiane Mousson, Matthias Buchler, Philippe Gatault, Jean-François Augusto, Agnès Duveau, Cécile Vigneau, Marie-Christine Morin, Jonathan Chemouny, Leonard Golbin, Philippe Grimbert, Marie Matignon, Antoine Durrbach, Clarisse Greze, Renaud Snanoudj, Charlotte Colosio, Betoul Schvartz, Paolo Malvezzi, Christophe Mariat, Antoine Thierry, Moglie Le Quintrec, Antoine Sicard, Jean Philippe Rerolle, Anne-Élisabeth Heng, Cyril Garrouste, Henri Vacher Coponat, Éric Epailly, Olivier Brugiere, Sébastien Dharancy, Éphrem Salame, Faouzi Saliba, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Cellules B normales et pathogéniques - Normal and pathogenic B cell responses (NOPAB), Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Agence de la biomédecine [Saint-Denis la Plaine], Service Néphrologie et transplantation rénale Adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Centre hospitalier universitaire de Nantes (CHU Nantes), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Institute for Translational Research in Inflammation - U 1286 (INFINITE (Ex-Liric)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CHRU Brest - Service de Nephrologie (CHU - BREST - Nephrologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de néphrologie et hémodialyse [CHU de Strasbourg], CHU Strasbourg, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), CHU Lille, French nationwide Registry of Solid Organ Transplant Recipients with COVID-19: Olivier Thaunat, Emmanuel Morelon, Charlene Levi, Fanny Buron, Alice Koenig, Thomas Barba, Sophie Caillard, Bruno Moulin, Samira Fafi-Kremer, Marc Hazzan, Anglicheau Dany, Alexandre Hertig, Jérôme Tourret, Benoit Barrou, Lionel Couzi, Pierre Merville, Anna Kaminski, Valérie Moal, Tristan Legris, Pierre-François Westeel, Maïté Jaureguy, Luc Frimat, Didier Ducloux, Jamal Bamoulid, Dominique Bertrand, Michel Tsimaratos, Florentine Garaix-Gilardo, Jérôme Dumortier, Sacha Mussot, Antoine Roux, Laurent Sebbag, Yannick Le Meur, Gilles Blancho, Christophe Masset, Nassim Kamar, Hélène Francois, Eric Rondeau, Nicolas Bouvier, Christiane Mousson, Matthias Buchler, Philippe Gatault, Jean-François Augusto, Agnès Duveau, Cécile Vigneau, Marie-Christine Morin, Jonathan Chemouny, Leonard Golbin, Philippe Grimbert, Marie Matignon, Antoine Durrbach, Clarisse Greze, Renaud Snanoudj, Charlotte Colosio, Betoul Schvartz, Paolo Malvezzi, Christophe Mariat, Antoine Thierry, Moglie Le Quintrec, Antoine Sicard, Jean Philippe Rerolle, Anne-Élisabeth Heng, Cyril Garrouste, Henri Vacher Coponat, Éric Epailly, Olivier Brugiere, Sébastien Dharancy, Éphrem Salame, Faouzi Saliba, CCSD, Accord Elsevier, École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, 0301 basic medicine, Pediatrics, MESH: Registries, Registry study, 030232 urology & nephrology, Kidney transplant, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Kidney Transplantation, Postoperative Complications, 0302 clinical medicine, MESH: Aged, 80 and over, MESH: Postoperative Complications, Pandemic, MESH: COVID-19, Registries, Wasting, Kidney transplantation, Aged, 80 and over, MESH: Aged, MESH: Middle Aged, Middle Aged, renal transplantation, 3. Good health, MESH: Waiting Lists, Nephrology, Female, France, medicine.symptom, Adult, medicine.medical_specialty, Waiting Lists, Coronavirus disease 2019 (COVID-19), 03 medical and health sciences, Intensive care, medicine, Humans, ESRD, Epidemics, MESH: Epidemics, Aged, Retrospective Studies, MESH: Humans, business.industry, SARS-CoV-2, COVID-19, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, medicine.disease, Kidney Transplantation, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, mortality, MESH: Male, MESH: France, 030104 developmental biology, business, MESH: Female
Abstract: International audience; End stage kidney disease increase the risk of COVID-19 related death but how the kidney replacement strategy should be adapted during the pandemic is unknown. Chronic hemodialysis makes social distancing difficult to achieve. Alternatively, kidney transplantation could increase the severity of COVID-19 due to therapeutic immunosuppression and contribute to saturation of intensive care units. For these reasons, kidney transplantation was suspended in France during the first epidemic wave. Here, we retrospectively evaluated this strategy by comparing the overall and COVID-19 related mortality in kidney transplant recipients and candidates over the last three years. Cross-interrogation of two national registries for the period 1 March and 1 June 2020, identified 275 deaths among the 42812 kidney transplant recipients and 144 deaths among the 16210 candidates. This represents an excess of deaths for both populations, as compared with the same period the two previous years (mean of two previous years: 253 in recipients and 112 in candidates). This difference was integrally explained by COVID-19, which accounted for 44% (122) and 42% (60) of the deaths in recipients and candidates, respectively. Taking into account the size of the two populations and the geographical heterogeneity of virus circulation, we found that the excess of risk of death due to COVID-19 was similar for recipients and candidates in high viral risk area but four-fold higher for candidates in the low viral risk area. Thus, in case of a second epidemic wave, kidney transplantation should be suspended in high viral risk areas but maintained outside those areas, both to reduce the excess of deaths of candidates and avoid wasting precious resources.
Published: 2020
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12. [Use of antiplatelet therapy and direct oral anticoagulants in candidates for renal transplantation: The French guidelines from the CTAFU]

Author: Timsit, M.-O., Branchereau, J., Matillon, X., Verhoest, G., Bessede, T., Lequintrec, M., Boissier, R., Badet, L., Smadja, D.M., 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 Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre hospitalier universitaire de Nantes (CHU Nantes), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Pontchaillou [Rennes], Hôpital Bicêtre, Hôpital Lapeyronie [Montpellier] (CHU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Aix Marseille Université (AMU), and Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)
Subjects: MESH: Humans, Antiplatelet therapy, [SDV]Life Sciences [q-bio], Anticoagulants, MESH: Preoperative Period, Kidney Transplantation, MESH: Kidney Transplantation, Agents antiplaquettaires, MESH: Platelet Aggregation Inhibitors, Preoperative Period, Renal Transplantation, Transplantation rénale, Humans, MESH: Factor Xa Inhibitors, Platelet Aggregation Inhibitors, Factor Xa Inhibitors
Abstract: International audience; Objective: To define guidelines for the use of antiplatelet therapy (AT) and direct oral anticoagulants (DOAC) in candidates for kidney allotransplantation.Method: A review of the medical literature following a systematic approach was conducted by the CTAFU to report the use of AT and DOAC before major surgery and in the setting of advanced chronic kidney disease, defining their managment prior to kidney transplantation with the corresponding level of evidence.Results: DOAC are not recommended in patients under dialysis. Aspirin therapy, but not anti-P2Y12 and DOAC, may be maintained during renal transplantation. Anti-P2Y12 and DOAC should not be use in patients awaiting a kidney transplant, except when a living donor is scheduled, therefore authorizing treatment interruption in optimal conditions. Further data regarding DOAC reversion and monitoring may improve their use in this setting. Global level of evidence is weak.Conclusion: These French recommendations should contribute to improve surgical management of kidney transplant candidates exposed to AT or DOA.
Published: 2020
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13. Complement fragments are biomarkers of antibody-mediated endothelial injury

Author: Erik Stites, Moglie Le Quintrec, Jennifer Laskowski, Brian M. Freed, Brandon Renner, Diana Jalal, James E. Cooper, Zhiying You, Joshua M. Thurman, University of Colorado Anschutz [Aurora], Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), CLINIMMUNE LABS Bioscience, Carver College of Medicine [Iowa City], and University of Iowa [Iowa City]
Subjects: Graft Rejection, Male, 0301 basic medicine, Biopsy, MESH: Allografts, Kidney, Antibody mediated rejection, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Kidney Transplantation, MESH: Biopsy, 0302 clinical medicine, MESH: Endothelial Cells, Complement Activation, Cells, Cultured, MESH: Middle Aged, biology, Microvesicle, [SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology, Middle Aged, Allografts, 3. Good health, medicine.anatomical_structure, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Antibody, MESH: Cells, Cultured, Adult, MESH: Complement Activation, Immunology, MESH: Complement System Proteins, Complement, MESH: Graft Rejection, MESH: Vascular System Injuries, Antibodies, Article, 03 medical and health sciences, medicine, MESH: Transplantation, Homologous, Humans, Transplantation, Homologous, Donor specific antibody, Molecular Biology, Opsonin, MESH: Humans, business.industry, MESH: Antibodies, C4A, Endothelial Cells, MESH: Adult, Complement System Proteins, Biomarker, MESH: Kidney, Vascular System Injuries, Kidney Transplantation, Microvesicles, In vitro, MESH: Male, Complement system, 030104 developmental biology, biology.protein, MESH: Biomarkers, business, MESH: Female, Biomarkers, 030215 immunology
Abstract: International audience; Antibody-mediated rejection (AbMR) adversely affects long-term graft survival in kidney transplantation. Currently, the diagnosis of AbMR requires a kidney biopsy, and detection of complement C4d deposition in the allograft is one of the diagnostic criteria. Complement activation also generates several soluble fragments which could potentially provide non-invasive biomarkers of the process. Furthermore, microvesicles released into the plasma from injured cells can serve as biomarkers of vascular injury. To explore whether soluble complement fragments or complement fragments bound to endothelial microvesicles can be used to non-invasively detect AbMR, we developed an in vitro model in which human endothelial cells were exposed to anti-HLA antibodies and complement sufficient serum. We found that complement fragments C4a and sC5b-9 were increased in the supernatants of cells exposed to complement-sufficient serum compared to cells treated complement-deficient serum. Furthermore, complement activation on the cell surface was associated with the release of microvesicles bearing C4 and C3 fragments. We next measured these analytes in plasma from kidney transplant recipients with biopsy-proven acute AbMR (n = 9) and compared the results with those from transplant recipients who also had impaired allograft function but who did not have AbMR (n = 30). Consistent with the in vitro results, complement fragments C4a and Ba were increased in plasma from patients with AbMR compared to control subjects (P
Published: 2020
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14. Specific organization for in‐hospital belatacept infusion to avoid nosocomial transmission during the SARS‐CoV‐2 pandemic

Author: Arnaud Del Bello, Anne Laure Hebral, Joelle Guitard, Nassim Kamar, Laure Esposito, PINIER, CHRISTINE, Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Néphrologie - Immunologie Clinique [Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-PRES Université de Toulouse, CHU Toulouse [Toulouse]-Hôpital de Rangueil, and CHU Toulouse [Toulouse]-PRES Université de Toulouse
Subjects: Graft Rejection, viruses, immunosuppression/immune modulation, 030230 surgery, MESH: Kidney Transplantation, MESH: Graft Rejection / etiology, 0302 clinical medicine, [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases, Pandemic, Immunology and Allergy, Medicine, MESH: Abatacept / administration & dosage, MESH: COVID-19, Pharmacology (medical), Infusions, Intravenous, Letter to the Editor, Kidney transplantation, health care economics and organizations, MESH: Pneumonia, Viral / epidemiology, Cross Infection, biology, Graft Survival, virus diseases, immunosuppressant-fusion proteins and monoclonal antibodies: belatacept, complication: infectious, 3. Good health, [SDV.MHEP.MI] Life Sciences [q-bio]/Human health and pathology/Infectious diseases, MESH: Betacoronavirus, Coronavirus Infections, Immunosuppressive Agents, medicine.drug, 2019-20 coronavirus outbreak, MESH: Pandemics, MESH: Graft Survival, MESH: Immunosuppressive Agents / administration & dosage, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, education, infectious disease, clinical research/practice, Belatacept, MESH: Graft Rejection / prevention & control, Abatacept, Betacoronavirus, 03 medical and health sciences, Humans, MESH: SARS-CoV-2, MESH: Infusions, Intravenous, Pandemics, MESH: Cross Infection / prevention & control, Transplantation, MESH: Humans, SARS-CoV-2, business.industry, Nosocomial transmission, MESH: Pneumonia, Viral / transmission, COVID-19, medicine.disease, biology.organism_classification, Kidney Transplantation, Virology, Infectious disease (medical specialty), MESH: Coronavirus Infections / epidemiology, business, MESH: Coronavirus Infections / transmission
Abstract: International audience; The first cases of Severe Acute Respiratory Syndrome coronavirus 2 (SARS‐CoV‐2) occurred in France in early February and in our region (Southwest France) in early March 2020.
Published: 2020
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15. Distribution of de novo Donor-Specific Antibody Subclasses Quantified by Mass Spectrometry: High IgG3 Proportion Is Associated With Antibody-Mediated Rejection Occurrence and Severity

Author: Vincent Pernin, Anais Beyze, Ilan Szwarc, Nicole Bec, Céline Salsac, Esther Perez-Garcia, Georges Mourad, Pierre Merville, Jonathan Visentin, Helene Perrochia, Christian Larroque, Lionel Couzi, Moglie Le Quintrec, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), CHU de Bordeaux Pellegrin [Bordeaux], Immunology from Concept and Experiments to Translation (ImmunoConcept), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux (UB), Institut de Recherche en Cancérologie de Montpellier (IRCM - U1194 Inserm - UM), CRLCC Val d'Aurelle - Paul Lamarque-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), A funding was provided by Montpellier University Hospital for this study (AOI 2018)., and Retiveau, Nolwenn
Subjects: 0301 basic medicine, Gastroenterology, [SDV.IMM.II]Life Sciences [q-bio]/Immunology/Innate immunity, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Subclass, MESH: Kidney Transplantation, Kidney transplantation, 0302 clinical medicine, MESH: Risk Factors, Immunology and Allergy, MESH: Treatment Outcome, MESH: Aged, MESH: Immunoglobulin G, Proteinuria, MESH: Middle Aged, biology, MESH: Predictive Value of Tests, [SDV.IMM.IA]Life Sciences [q-bio]/Immunology/Adaptive immunology, [SDV.IMM.IA] Life Sciences [q-bio]/Immunology/Adaptive immunology, Antibody mediated rejection, Antibody, medicine.symptom, lcsh:Immunologic diseases. Allergy, medicine.medical_specialty, Immunology, Renal function, MESH: Graft Rejection, 03 medical and health sciences, IgG subclass, Internal medicine, MESH: Severity of Illness Index, parasitic diseases, medicine, Distribution (pharmacology), Risk factor, [SDV.IMM.II] Life Sciences [q-bio]/Immunology/Innate immunity, MESH: Humans, Mass spectrometry, business.industry, MESH: Tandem Mass Spectrometry, MESH: Adult, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, MESH: Prospective Studies, MESH: Isoantibodies, body regions, MESH: France, 030104 developmental biology, Antibody-mediated rejection, biology.protein, MESH: Biomarkers, De novo DSA, business, lcsh:RC581-607, MESH: Female, 030215 immunology
Abstract: International audience; Donor-specific antibodies (DSAs) are the main risk factor for antibody-mediated rejection (ABMR) and graft loss but could have variable pathogenicity according to their IgG subclass composition. Luminex-based test might lack sensitivity for the detection of IgG subclasses and this test does not allow quantifying the relative abundance of each IgG subclass. We investigated the precise repartition of each DSA subclass and their role in ABMR occurrence and severity, using an innovative mass spectrometry-based method. Between 2014 and 2018, we enrolled 69 patients who developed de novo DSA (n = 29 without ABMR, and n = 40 with ABMR) in two transplant centers. All IgG subclasses were detected in every samples tested: 62.7% were IgG1, 26.6% were IgG2, 6.6% were IgG3, and 4.2% were IgG4. The IgG3 proportion was significantly higher in the ABMR+ compared to the ABMR- group (8.4% vs. 5.6%, p = 0.003). The proportion of IgG1, IgG2, and IgG4 of DSA was similar between the two groups. Higher IgG3 level was associated with higher C4d deposition, higher microvascular inflammation scores, and glomerular filtration rate decline >25%. IgG3 proportion was not correlated with DSA MFI. Multivariate analysis showed that proteinuria and high level of IgG3 DSA were the only two factors independently associated with ABMR. In conclusion, de novo DSA are always composed of the four IgG subclasses, but in different proportions. High IgG3 proportion is associated with ABMR occurrence and severity and with poorer outcome, independently of DSA MFI.
Published: 2020
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16. Re: Long-Term Outcome of Renal Transplantation in Patients with Congenital Lower Urinary Tract Malformations: A Multicenter Study

Author: François Iborra, Nicolas Abdo, L. Broudeur, Georges Karam, Nicolas Kalfa, Rodolphe Thuret, Julien Branchereau, Lionel Badet, Stéphane Marchal, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), and Centre hospitalier universitaire de Nantes (CHU Nantes)
Subjects: Graft Rejection, Male, Pediatrics, Time Factors, Urinary Diversion, 030230 surgery, Kidney, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Kidney Transplantation, 0302 clinical medicine, Medicine, MESH: Renal Dialysis, Young adult, Urinary Tract, MESH: Treatment Outcome, Graft Survival, MESH: Follow-Up Studies, 3. Good health, Treatment Outcome, medicine.anatomical_structure, MESH: Young Adult, MESH: Kidney Failure, Chronic, Female, 030211 gastroenterology & hepatology, France, Adult, medicine.medical_specialty, MESH: Graft Survival, Urology, Urinary system, Urinary Bladder, MEDLINE, MESH: Graft Rejection, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, Young Adult, 03 medical and health sciences, Renal Dialysis, Prune belly syndrome, Humans, In patient, Retrospective Studies, Transplantation, MESH: Humans, Spina bifida, business.industry, MESH: Time Factors, MESH: Urinary Diversion, Retrospective cohort study, MESH: Adult, MESH: Retrospective Studies, medicine.disease, Kidney Transplantation, MESH: Male, Surgery, Term (time), Bladder exstrophy, MESH: France, Multicenter study, Urogenital Abnormalities, MESH: Urogenital Abnormalities, Kidney Failure, Chronic, business, MESH: Female, Follow-Up Studies
Abstract: International audience; Renal insufficiency can occur in patients with congenital lower urinary tract malformations (LUTM) even when managed during infancy. Data in the current literature concerning this subject remain sparse. The aim of this study was to report the feasibility and long-term results of renal transplantation during adulthood in patients with a congenital LUTM.Methods: A retrospective multicenter study from 3 French renal transplant centers was conducted, including 123 transplantations on 112 patients with LUTM (1996-2016). Graft survival, patient survival, and complications were analyzed. Results were stratified according to the underlying uropathy and the type of initial management during childhood or before transplantation.Results: In this study, patients suffering from posterior urethral valves (n = 49), spina bifida (n = 21), central neurogenic bladder (n = 13), bladder exstrophy (n = 14), prune belly syndrome (n = 12), Hinman syndrome (n = 6), urogenital sinus (n = 4), and other pathologies (n = 4) were included. The mean age at transplantation was 32.1 years old (±11.2). The mean follow-up period was 7.2 years. Patient survival at 1, 5, 10, and 15 years was 97.4%, 93.0%, 89.4%, and 80.0%, respectively. Graft survival at 1, 5, 10, 15, and 20 years was 96.6%, 87.6%, 77.3%, 60.6%, and 36.4%, respectively. Enterocystoplasty and continent urinary diversions exposed grafts to more frequent acute pyelonephritis (P = 0.02). There was no difference in graft survival when transplantation was performed on an enterocystoplasty or urinary diversions compared with a native bladder, provided a well-conducted bladder management.Conclusions: Even though enterocystoplasty and continent urinary diversions exposed grafts to more frequent acute graft pyelonephritis, patient and graft survival rates in LUTM at 10 years were similar to other kidney transplantations on native bladders.
Published: 2020
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17. Urinary oxylipin signature as biomarkers to monitor the allograft function during the first six months post-renal transplantation

Author: Valérie Bultel-Poncé, Ignacio De las Heras-Gómez, Angel Gil-Izquierdo, Thierry Durand, Federico Ferreres, Teresa Casas-Pina, Pedro Martínez-Hernández, Jean-Marie Galano, Luisa Jimeno, Santiago Llorente, Sonia Medina, Centro de Edafologia y Biologia aplicada del Segura (CEBAS - CSIC), Consejo Superior de Investigaciones Científicas [Madrid] (CSIC), Hospital Univeristario Virgen de la Arrixaca, Institut des Biomolécules Max Mousseron [Pôle Chimie Balard] (IBMM), and Ecole Nationale Supérieure de Chimie de Montpellier (ENSCM)-Institut de Chimie du CNRS (INC)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS)
Subjects: 0301 basic medicine, Nephrology, medicine.medical_specialty, MESH: Oxylipins, Urinary system, [SDV]Life Sciences [q-bio], MESH: Allografts, Isoprostanes, Prostanoids, Urine, Biochemistry, Gastroenterology, MESH: Kidney Transplantation, 03 medical and health sciences, 0302 clinical medicine, Tandem Mass Spectrometry, Physiology (medical), Internal medicine, medicine, Humans, Oxylipins, chemistry.chemical_classification, Inflammation, Kidney, MESH: Humans, business.industry, MESH: Tandem Mass Spectrometry, Oxylipin, Allografts, Kidney Transplantation, 3. Good health, Transplantation, 030104 developmental biology, medicine.anatomical_structure, Renal transplant, chemistry, Thromboxanes, Oxidative stress, Lipidomics, MESH: Biomarkers, business, 030217 neurology & neurosurgery, Biomarkers, Polyunsaturated fatty acid
Abstract: International audience; Oxylipins such as isoprostanes (IsoPs), prostaglandins (PGs) and thromboxanes (TXs) are lipid mediators derived from the oxidation of polyunsaturated fatty acids, which regulate the magnitude of oxidative stress and inflammation processes and play an important role in pathophysiological processes in the kidney. A total of 36 oxylipins were analyzed by UHPLC-QqQ-MS/MS in the urine of 41 renal recipients from cadaveric donors of the Nephrology Unit of the University Hospital Virgen de la Arrixaca during the first six months after renal transplantation, in order to investigate several candidate oxylipins as more accurate and predictive biomarkers in renal transplantation than classical biological variables. A decrease in nine PGs, mostly from the AA-D pathway (p
Published: 2019
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18. Pronostic des transplantations rénales après reconstruction du bas appareil urinaire avec du tube digestif : étude rétrospective bicentrique

Author: Gueguen, Juliette, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Dany Anglicheau
Subjects: Entérocystoplastie, MESH: Pyelonephritis, Fonction rénale, Transplantation rénale, Bricker, Pyélonéphrites, Mitrofanoff, Uropathies malformatives, MESH: Urologic Diseases, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, MESH: Kidney Transplantation
Abstract: Introduction : la colonisation urinaire et le surrisque infectieux des patients avec un bas appareil urinaire (BAU) reconstruit avec du tube digestif ont longtemps rendu réticents les néphrologues et les urologues à transplanter ces patients, pourtant souvent jeunes et pour lesquels le bénéfice attendu de la transplantation est grand. L’objectif de cette thèse était d’appréhender les résultats de la transplantation rénale des patients avec reconstruction du BAU. Méthodes : les patients transplantés rénaux sur un BAU reconstruit avec du tube digestif issus de 2 centres français entre 2005 et 2016 ont été inclus (n=26). 23 de ces patients ont été appariés à 46 témoins par la méthode des scores de propension. Les survies des greffons et des patients et les fonctions rénales à 3 mois, 1 an, 5 ans et 10 ans ont été comparées. La survenue de pyélonéphrites et la survenue de complications chirurgicales ont été comparées et les facteurs associés à leur survenue ont été recherchés. Résultats : la survie des greffons à 1 an, 5 ans et 10 ans était respectivement de 98%, 88% et 69% dans le groupe avec reconstruction du BAU et de 96%, 89% et 70% dans le groupe appariés (p=0,974). Les patients avec reconstruction faisaient significativement plus de pyélonéphrites (65% vs 17%, p
Published: 2019

19. Osmoregulation Performance and Kidney Transplant Outcome

Author: Christophe Legendre, Jordan Jouffroy, Manal Mazloum, Dominique Prié, Dany Anglicheau, Antoine Neuraz, François Brazier, Nicolas Garcelon, Frank Bienaimé, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'informatique médicale et biostatistiques [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Institut Necker Enfants-Malades (INEM - UM 111 (UMR 8253 / U1151)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Université Paris Cité (UPCité), Imagine - Institut des maladies génétiques (IHU) (Imagine - U1163), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité), Département de Néphrologie [CHU Necker], and Neuraz, Antoine
Subjects: medicine.medical_specialty, Urology, Renal function, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Kidney Transplantation, Osmoregulation, Up Front Matters, MESH: Osmoregulation, MESH: Transplantation, Homologous, medicine, MESH: Sodium, Humans, Transplantation, Homologous, Prospective Studies, Risk factor, Prospective cohort study, Kidney transplantation, MESH: Humans, business.industry, Hazard ratio, Sodium, General Medicine, medicine.disease, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Kidney Transplantation, MESH: Prospective Studies, Confidence interval, Transplantation, MESH: Glomerular Filtration Rate, Nephrology, Hyponatremia, business, Glomerular Filtration Rate
Abstract: International audience; Background Kidney transplant recipients have an impaired ability to dilute urine but seldom develop baseline hyponatremia before ESRD. Although hyponatremia is a risk factor for adverse events in CKD and in kidney transplant recipients, it remains unclear whether subtler alterations in osmoregulation performance are associated with outcome. Methods We studied a single-center prospective cohort of 1258 kidney transplant recipients who underwent a water-loading test 3 months after transplant to determine osmoregulation performance. Measured GFR (mGFR) was performed at the same visit. A group of 164 healthy candidates for kidney donation served as controls. We further evaluated the association of osmoregulation performance with transplantation outcomes and subsequent kidney function. Results Unlike controls, most kidney transplant recipients failed to maintain plasma sodium during water loading (plasma sodium slope of −0.6±0.4 mmol/L per hour in transplant recipients versus −0.12±0.3 mmol/L per hour in controls; P
Published: 2018
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20. Évolution rénale dans la transplantation combinée rein-coeur

Author: toinet, théodore, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Marc-Olivier Timsit
Subjects: HKTx, Greffe combinée, Kidney failure, MESH: Heart Transplantation, MESH: Urology, Combined transplantation, MESH: Kidney Transplantation, Insuffisance cardiaque, Transplantation cardiaque, Rein-coeur, Heart-kidney, Insuffisance rénale, MESH: Heart Failure, MESH: Renal Insufficiency, Transplantation rénale, Urologie, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Introduction : simultaneous heart-kidney transplant (HKTx) is a valid treatment for patients with coexisting heart and renal failure. Preventing postoperative renal failure increases survival after heart transplantation (HTx). The aim of this study was to assess renal outcome in HKTx and to identify predictive factors for renal loss.Methods : a retrospective study was conducted among HKTx recipients at 8 French centers from 1988 to 2017. Donors’ and recipients' medical records were reviewed to evaluate patients’ and renal transplants’ survival and their prognostic factors.Results : 73 recipients were included with a mean follow-up of 5.36 years. Mean ischemia time was 189 and 710 minutes for HTx and renal transplantation (KTx). Renal primary non-function occurred in 2.7%, complications Clavien IIIb or higher were observed in 67.1% including 16 postoperative deaths (22%). Mean 1-year CKD-EPI was 57.4 ml/min. 5-year overall and renal survival were 74.5% and 69.4%. Among survivors, 7 returned to dialysis during follow-up. In multivariate analysis, the use of ECMO (HR=6.04, p=0.006), dialysis (HR=1.04/day, p=0.022) and occurrence of postoperative complications (HR=31.79, p=0.022) were independent predictors of mortality but not the history of previous HTx or KTx nor renal function prior to Tx. History of KTx (HR=2.52, p=0.026) and increased delay between the two Tx (HR=1.25/hour, p=0.018) were associated with renal transplant failure.Conclusion : HKTx provides good renal transplant survival and function among survivors. Early mortality rate of 22% underlines the need for identifying high risk patients who will not benefit from HKTx in order to allocate the renal graft to another recipient.; Introduction : la transplantation (Tx) combinée rein-coeur (TxRC) est un traitement rare de l’insuffisance cardiaque (IC) et rénale (IR) concomitante. La prévention de l’IR en postopératoire augmente la survie après une Tx cardiaque. L’objectif était d’évaluer l’évolution rénale après TxRC et d’identifier les facteurs prédictifs de perte du greffon rénal.Méthodes : les receveurs d’une TxRC parmi 8 centres entre 1988 et 2017 ont été inclus rétrospectivement. Les données des donneurs et des receveurs ont été analysées pour chercher des facteurs prédictifs de mortalité et de perte du greffon.Résultats : 73 patients ont été inclus avec un suivi moyen de 5,36 ans. 39,7% étaient dialysés en préopératoire. L’ischémie moyenne était de 189 et 710 minutes pour le coeur et le rein. Il y a eu 2,7% de non fonctions primaires, des complications Clavien IIIb ou plus pour 67,1% dont 16 décès (21,9%) postopératoires. La clairance rénale (DFG) à 1 an était de 57,4 ml/min. La survie globale et du greffon à 5 ans était de 74,5 et 69,4%. Parmi les survivants, 7 sont retournés en dialyse pendant le suivi. En multivariée l’ECMO postopératoire (HR=6,04, p=0,006), la dialyse (HR=1,04/jour, p=0,022) et les complications postopératoires (HR=31,79, p=0,022) étaient indépendamment prédictifs de mortalité mais pas l’antécédent de Tx rénale ou cardiaque ni le DFG préopératoire. L’antécédent de Tx rénale (HR=2,52, p=0,026) et un délai majoré entre les deux Tx (HR=1,25/heure, p=0,018) étaient associés à une perte du greffon rénal.Conclusion : la TxRC a de bons résultats rénaux, mais sa mortalité postopératoire impose d’identifier les patients à risques qui n’en bénéficieraient pas, pour réallouer ces greffons.
Published: 2018

21. Preemptive second kidney transplantation is associated with better graft survival compared with non-preemptive second transplantation: a multicenter French 2000-2014 cohort study

Author: Nassim Kamar, Fanny Buron, Emmanuel Morelon, Nicolas Girerd, Michèle Kessler, Valérie Garrigue, Luc Frimat, Magali Giral, Marc Ladrière, Arnaud Del Bello, Sophie Girerd, Kevin Duarte, Georges Mourad, Christophe Legendre, Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Cardiovascular and Renal Clinical Trialists [Vandoeuvre-les-Nancy] (INI-CRCT), Institut Lorrain du Coeur et des Vaisseaux Louis Mathieu [Nancy], Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Département de Néphrologie [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), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Département de Néphrologie et Transplantation d'organes, Hôpital de Rangueil, and CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse]
Subjects: Male, Time Factors, medicine.medical_treatment, 030232 urology & nephrology, 030204 cardiovascular system & hematology, second transplantation, MESH: Kidney Transplantation, Cohort Studies, preemptive, 0302 clinical medicine, MESH: Renal Dialysis, MESH: Cohort Studies, Kidney transplantation, MESH: Middle Aged, Graft Survival, Middle Aged, Cohort, Female, France, Cohort study, Adult, Reoperation, medicine.medical_specialty, MESH: Graft Survival, kidney transplantation, living donor, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, survival, MESH: Reoperation, retransplantation, 03 medical and health sciences, Renal Dialysis, Internal medicine, Statistical significance, medicine, Humans, Dialysis, Transplantation, MESH: Humans, business.industry, MESH: Time Factors, MESH: Adult, medicine.disease, MESH: Male, MESH: France, Propensity score matching, Graft survival, business, MESH: Female, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; The impact of preemptive second kidney transplantation (2KT) on graft and patient survival is poorly established. The association between preemptive 2KT (p2KT, N = 93) and outcomes was estimated in a multicenter French cohort of 2KT (N = 1314) recipients using propensity score methods. During the follow-up, there were 274 returns to dialysis and 134 deaths. p2KT was associated with lower death-censored graft loss (HR = 0.39 [0.18-0.88], P = 0.024) and graft failure from any cause including death (HR = 0.42 [0.22-0.80], P = 0.008). Similar associations were observed for death with a functioning graft, although not reaching statistical significance (HR = 0.47 [0.17-1.26], P = 0.13). There was a significant interaction between donor type and p2KT (P for interaction = 0.016). Indeed, p2KT was not significantly associated with the risk of graft failure from any cause including death in living donor 2KT (P = 0.39), whereas the association was substantial in the deceased donor subset (HR = 0.30 [0.14-0.64], P = 0.002). Of note, the adjusted graft survival of p2KT with deceased donor paralleled that of 2KT with living donor, either preemptive or not (93.8% vs. 88.6% at 4 years and 76.1% vs. 70.5% at 8 years, P = 0.13). This large French multicenter study analyzed using propensity scores suggests that p2KT is associated with better graft prognosis.
Published: 2018
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22. Low immunogenicity of quadrivalent meningococcal vaccines in solid organ transplant recipients

Author: Benjamin Wyplosz, H. François, Didier Samuel, Jean-Charles Duclos-Vallée, Daniel Vittecoq, Antoine Durrbach, E. Hong, Lélia Escaut, M. K. Taha, Odile Launay, Ouda Derradji, Service de Maladies Infectieuses et Tropicales [CHU Bicêtre], AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Infections Bactériennes Invasives, Institut Pasteur [Paris], Néphrologie [CHU Bicêtre], Université Paris-Sud - Paris 11 - Faculté de médecine (UP11 UFR Médecine), Université Paris-Sud - Paris 11 (UP11), Centre Hépato-Biliaire [Hôpital Paul Brousse] (CHB), Hôpital Paul Brousse-Assistance Publique - Hôpitaux de Paris, CIC - Biotherapie - AP-HP (cochin - Pasteur), Institut National de la Santé et de la Recherche Médicale (INSERM), and Institut Pasteur [Paris] (IP)
Subjects: Graft Rejection, Male, MESH: Vaccines, Conjugate, Neisseria meningitidis, Serogroup C, Neisseria meningitidis, MESH: Meningococcal Infections, medicine.disease_cause, MESH: Meningococcal Vaccines, MESH: Kidney Transplantation, Cohort Studies, meningococcal vaccine, Neisseria meningitidis, Serogroup A, MESH: Antibodies, Bacterial, MESH: Immunocompromised Host, Prospective Studies, solid organ transplantation, MESH: Cohort Studies, MESH: Aged, education.field_of_study, MESH: Middle Aged, Immunogenicity, Middle Aged, Antibodies, Bacterial, 3. Good health, Vaccination, Infectious Diseases, Female, MESH: Immunosuppressive Agents, Neisseria meningitidis, Serogroup Y, Immunosuppressive Agents, Adult, MESH: Liver Transplantation, MESH: Transplant Recipients, Population, Meningococcal Vaccines, MESH: Graft Rejection, Meningococcal vaccine, immunization, Meningococcal disease, MESH: Neisseria meningitidis, Immunocompromised Host, Neisseria meningitidis, Serogroup W-135, MESH: Neisseria meningitidis, Serogroup A, Conjugate vaccine, MESH: Neisseria meningitidis, Serogroup C, medicine, Humans, education, Aged, Transplantation, Vaccines, Conjugate, MESH: Humans, business.industry, MESH: Adult, antibody response, MESH: Neisseria meningitidis, Serogroup W-135, medicine.disease, Kidney Transplantation, Virology, Transplant Recipients, MESH: Prospective Studies, MESH: Male, Liver Transplantation, Meningococcal Infections, Immunization, Immunology, [SDV.IMM.VAC]Life Sciences [q-bio]/Immunology/Vaccinology, MESH: Neisseria meningitidis, Serogroup Y, business, MESH: Female
Abstract: International audience; Immunization against meningococcal disease is recommended for solid organ transplant (SOT) recipients at high risk for meningococcal disease or travelling to an endemic country. However, the immunogenicity of meningococcal vaccines has not been studied in this population. We analyzed the immune response of quadrivalent (against Neisseria meningitidis serogroups A, C, Y, and W) polysaccharidic non-conjugate and conjugate meningococcal vaccines in kidney- and liver-transplant patients using bactericidal assays against the targeted serogroups. Upon vaccination with a non-conjugate (n = 5) or a conjugate vaccine (n = 10), respectively, 40% and 50% of patients were able to mount an immune response, achieving at least the threshold correlated with protection defined as human serum bactericidal antibody titers of ≥4. Responders showed only partial and low responses (titers ≤64), thus predicting a rapid decline in bactericidal response. Only 1 patient developed a booster response to preexisting immunity. Our data argue for the need of additional measures for SOT recipients, when they are at risk of meningococcal disease.
Published: 2015
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23. Caractéristiques et facteurs de risque de la tuberculose chez les transplantés rénaux : une étude cas-témoins

Author: Gras, Julien, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Nathalie De Castro
Subjects: Cas-témoins, Transplantation, Facteurs de risque, MESH: Risk Factors, Tuberculose, Rein, MESH: Tuberculosis, MESH: Case-Control Studies, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, MESH: Kidney Transplantation
Abstract: The aim of our study was to describe the characteristics and prognosis of tuberculosis in renal transplant recipients, and to identify potential risk factors of developing the infection in this population. We conducted a multicentric retrospective study. All the renal transplant recipients between 2005 and 2015 who were diagnosed with tuberculosis after the transplantation were included. For each case, two controls who did not develop the infection were identified and matched on age, center, date of graft and country of origin. A descriptive and case-control analytic study was made. 32 subjects were diagnosed with tuberculosis after the transplantation during the study period (0.83%). 75% of them were born in high endemic country of tuberculosis. The median delay between the transplantation and diagnosis was 22 months. Pulmonary form was the most frequent (82%); 66% of the cases had a disseminated infection. Median duration of treatment was 9 months. A modification of the immunosuppressive regimen was necessary in all cases due to drug interactions. Clinical cure rate was 94%. Five deaths occurred during follow-up, one of them directly due to the infection. Probability of survival at one year was significantly reduced in transplant recipients who developed the infection (P=0.001). Tuberculosis is rare but severe complication in renal transplant recipients. We did not identify any risk factor of developing the infection. Systematic screening and chemoprophylaxis are necessary in patients at risk of tuberculosis, especially those originating from high endemic countries.; L'’objectif de l’étude était de décrire les caractéristiques et le pronostic des cas de tuberculose chez les patients transplantés rénaux, et d’identifier les facteurs de risque prédictifs de survenue de cette infection au sein de cette population. Il s’agit d’une étude rétrospective multicentrique. Tous les patients ayant transplantés rénaux entre 2005 et 2015 ayant développé une tuberculose en post-greffe ont été inclus. Pour chaque cas, deux témoins n’ayant pas développé l’infection ont été identifiés et appariés sur l’âge, le centre, la date de greffe et le pays d’origine. Une étude descriptive et analytique a été réalisée. 32 sujets ont développé une tuberculose dans les suites de la greffe (0.83%). 75% étaient originaires d’une zone de forte endémie tuberculeuse. Le délai médian de survenue de l’infection après la greffe était de 22 mois. L’atteinte pulmonaire était la plus fréquente (82%) ; 66% des cas étaient des formes disséminées. La durée médiane de traitement était de 9 mois. Tous les cas ont nécessité une adaptation des doses d’immunosuppresseurs du fait d’interactions médicamenteuses. L’issue du traitement était la guérison dans 94% des cas. Cinq décès ont été observés au cours du suivi, dont un attribuable à la tuberculose. La probabilité de survie à 1 an était significativement plus faible chez les cas de tuberculose (P=0.001). La tuberculose est une complication rare mais sévère chez les patients transplantés rénaux. Aucun facteur de risque prédictif de survenue de la tuberculose n’a été identifié dans l’analyse cas-témoins. Un dépistage systématique de l’ITL et une chimioprophylaxie ciblée sont indispensables chez les patients à risque, particulièrement ceux originaires de zone de forte endémie.
Published: 2017

24. Body composition in 98 patients awaiting kidney transplantation

Author: A. Desseix, Philippe Chauveau, Rodolphe Thiébaut, Delphine Morel, Thomas Bachelet, Christine Germain, Pierre Merville, Nicole Barthe, Lionel Couzi, Karine Moreau, Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Epidémiologie et Biostatistique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de médecine nucléaire [Bordeaux], CHU de Bordeaux Pellegrin [Bordeaux], Statistics In System biology and Translational Medicine (SISTM), Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Bordeaux Segalen - Bordeaux 2-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), and AURAD Aquitaine
Subjects: Male, Longitudinal study, [SDV]Life Sciences [q-bio], Endocrinology, Diabetes and Metabolism, 030232 urology & nephrology, 030204 cardiovascular system & hematology, Body Mass Index, MESH: Kidney Transplantation, Absorptiometry, Photon, 0302 clinical medicine, Reference Values, MESH: Postoperative Period, Longitudinal Studies, Postoperative Period, Prospective Studies, MESH: Longitudinal Studies, Kidney transplantation, MESH: Aged, 2. Zero hunger, MESH: Middle Aged, Nutrition and Dietetics, MESH: Reference Values, Nutritional status, Middle Aged, MESH: Nutrition Assessment, MESH: Nutritional Status, MESH: Case-Control Studies, 3. Good health, Adipose Tissue, MESH: Waiting Lists, Preoperative Period, Body Composition, Female, France, MESH: Cholesterol, HDL, MESH: Adipose Tissue, MESH: Cholesterol, LDL, Adult, MESH: Triglycerides, medicine.medical_specialty, Waiting Lists, Nutritional Status, MESH: Absorptiometry, Photon, MESH: Preoperative Period, MESH: Body Mass Index, Fat mass, 03 medical and health sciences, Fat free mass, Internal medicine, medicine, Humans, In patient, Triglycerides, Aged, MESH: Humans, business.industry, Cholesterol, HDL, MESH: Adult, Cholesterol, LDL, MESH: Body Composition, medicine.disease, Kidney Transplantation, MESH: Male, MESH: Prospective Studies, Surgery, MESH: France, Transplantation, Nutrition Assessment, Case-Control Studies, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business, MESH: Female, Body mass index
Abstract: International audience; Recent data suggest that the nutritional status of patients who are on the waiting list for kidney transplantation, influence outcomes after renal transplantation. Body composition (BC) analysis is rarely included in pretransplant evaluation. The aim of this study was to determine how alteration of the BC of these patients could influence pretransplant and post-transplant care. We compared the BC of French patients on a waiting list for kidney transplantation to a sex- and age-matched healthy, European control population. Patients were included when listed for kidney grafting in a prospective longitudinal study (CORPOS). Biological nutritional parameters, fat free mass (FFM) and fat mass (FM) estimated by dual-energy x-ray absorptiometry (DXA) were assessed on the day of wait-list registration. FFM and FM index (FFMi - FMi) are the ratio of FFM and FM to height squared. Results are expressed as median (range). These indexes were compared with previous study values used as a normal range in nutritional assessment and clinical practice. The study included 28 women and 70 men aged 25.3 to 65.9 y. Body mass index ranged from 16.8 kg/m² to 39.4 kg/m². Compared with controls, FMi was higher in women (10.6 kg/m² [3.7-18.6 kg/m²]) than in men (8.1 kg/m² [3.5-13.3 kg/m²] in M) and FFMi was lower in women (14.3 kg/m² [11.8-21.4 kg/m²]) than in men (17.9 kg/m² [13.9-24.2 kg/m²]) (P < 0.01), reflecting an abnormal distribution of body compartments. All biological parameters were within the normal range. BC abnormalities, which can only be detected with the use of DXA, are present in patients on a kidney transplantation waiting list. Detection of these abnormalities could influence the post-transplantation survey in order to prevent the frequent risk for developing metabolic complications after the procedure.
Published: 2014
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25. Pre-transplant CD45RC expression on blood T cells differentiates patients with cancer and rejection after kidney transplantation

Author: Isabelle Boutin, Jean-François Subra, Agnès Duveau, Jean-François Augusto, Anne Devys, C. Jacquemin, Jérémie Riou, Yves Delneste, Jean-Paul Saint-André, Abdelhadi Saoudi, Martin Planchais, Anne Croue, Anne-Sophie Garnier, Laurence Ordonez, Micro et Nanomédecines Translationnelles (MINT), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Physiopathologie Toulouse Purpan ex IFR 30 et IFR 150 (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre de Recherche en Cancérologie Nantes-Angers (CRCNA), Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM)-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hôpital Laennec-Centre National de la Recherche Scientifique (CNRS)-Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes (CHU Nantes), Service de Néphrologie-Dialyse-Transplantation [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), Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Biothérapies des maladies génétiques et cancers, Université Bordeaux Segalen - Bordeaux 2-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Physiopathologie Toulouse Purpan (CPTP), Laboratoire d’anatomopathologie [CHU Angers], Innate Immunity and Immunotherapy (CRCINA-ÉQUIPE 7), Centre de Recherche en Cancérologie et Immunologie Nantes-Angers (CRCINA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre National de la Recherche Scientifique (CNRS)-Université d'Angers (UA), LabEx IGO 'Immunotherapy, Graft, Oncology' [Nantes], Etablissement Français du Sang [Pays de la Loire] (EFS Pays de la Loire), EFS, Bernardo, Elizabeth, LUNAM Université [Nantes Angers Le Mans], PRES Université Nantes Angers Le Mans (UNAM), Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Université d'Angers (UA)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Centre hospitalier universitaire de Nantes (CHU Nantes), LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ), and Etablissement français du sang [Angers]
Subjects: Graft Rejection, Male, Oncology, MESH: Neoplasms / immunology, Epidemiology, 030230 surgery, acute rejection, DSA, 0302 clinical medicine, Animal Cells, Medicine, Cytotoxic T cell, MESH: Leukocyte Common Antigens / metabolism, AMR, Innate Immune System, MESH: Middle Aged, Cancer Risk Factors, Regulatory T cells, 3. Good health, [SDV] Life Sciences [q-bio], Cytokines, MESH: Neoplasms / complications, Cellular Types, medicine.medical_specialty, Regulatory T cell, Immune Cells, Science, T cell, Immunology, Cytotoxic T cells, Surgical and Invasive Medical Procedures, Urinary System Procedures, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Humans, T Helper Cells, Retrospective Studies, Pharmacology, MESH: Humans, Blood Cells, MESH: Cytokines / metabolism, Biology and Life Sciences, MESH: Adult, MESH: Retrospective Studies, Organ Transplantation, Molecular Development, medicine.disease, body regions, 030104 developmental biology, MESH: Graft Rejection / immunology, MESH: Female, Developmental Biology, AR, 0301 basic medicine, Physiology, T-Lymphocytes, [SDV]Life Sciences [q-bio], MESH: Kidney Transplantation, Cohort Studies, White Blood Cells, Immune Physiology, Neoplasms, Medicine and Health Sciences, Renal Transplantation, MESH: Cohort Studies, Kidney transplantation, Multidisciplinary, T Cells, Drugs, Cell Differentiation, Middle Aged, Immunosuppressives, medicine.anatomical_structure, antibody-mediated rejection, Female, Research Article, MESH: Cell Differentiation, Adult, MESH: T-Lymphocytes / immunology, [SDV.CAN]Life Sciences [q-bio]/Cancer, Immune system, Internal medicine, MESH: T-Lymphocytes / cytology, Transplantation, business.industry, Donor specific anti-HLA, Cancer, Cell Biology, Kidney Transplantation, MESH: Male, Immune System, Medical Risk Factors, Leukocyte Common Antigens, business, CD8
Abstract: BackgroundBiological biomarkers to stratify cancer risk before kidney transplantation are lacking. Several data support that tumor development and growth is associated with a tolerant immune profile. T cells expressing low levels of CD45RC preferentially secrete regulatory cytokines and contain regulatory T cell subset. In contrast, T cells expressing high levels of CD45RC have been shown to secrete proinflammatory cytokines, to drive alloreactivity and to predict acute rejection (AR) in kidney transplant patients. In the present work, we evaluated whether pre-transplant CD45RClow T cell subset was predictive of post-transplant cancer occurrence.MethodsWe performed an observational cohort study of 89 consecutive first time kidney transplant patients whose CD45RC T cell expression was determined by flow cytometry before transplantation. Post-transplant events including cancer, AR, and death were assessed retrospectively.ResultsAfter a mean follow-up of 11.1±4.1 years, cancer occurred in 25 patients (28.1%) and was associated with a decreased pre-transplant proportion of CD4+CD45RChigh T cells, with a frequency below 51.9% conferring a 3.7-fold increased risk of post-transplant malignancy (HR 3.71 [1.24-11.1], p = 0.019). The sensibility, specificity, negative predictive and positive predictive values of CD4+CD45RChigh52.1% were 94.5, 68.0, 34.7 and 98.6% respectively. Frequency of CD4+CD45RChigh T cells was positively correlated with those of CD8+CD45RChigh (pConclusionHigh frequency of CD45RChigh T cells was associated with AR, while low frequency was associated with cancer. Thus, CD45RC expression on T cells appears as a double-edged sword biomarker of promising interest to assess both cancer and AR risk before kidney transplantation.
Published: 2019
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26. Targeting eIF5A Hypusination Prevents Anoxic Cell Death through Mitochondrial Silencing and Improves Kidney Transplant Outcome

Author: Sandra Lacas-Gervais, Baharia Mograbi, Amine Belaid, Christophe Duranton, Marc Cougnon, Sébastien Giraud, Christian Frelin, Didier F. Pisani, Michel Tauc, Nicolas Melis, Nicolas Blondeau, Paul Vigne, Konstantina Fragaki, Stephan M. Huber, Thierry Hauet, Isabelle Rubera, Physiologie cellulaire et moléculaire des systèmes intégrés (PCMSI), Université Nice Sophia Antipolis (... - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Centre National de la Recherche Scientifique (CNRS), Institut de pharmacologie moléculaire et cellulaire (IPMC), Service de Biochimie [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), 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), Institut de Recherche sur le Cancer et le Vieillissement (IRCAN), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Côte d'Azur (UCA), Institut de Biologie Valrose (IBV), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA)-Centre National de la Recherche Scientifique (CNRS), University of Konstanz, Centre Commun de Microscopie Appliquée (CCMA), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA), Service de génétique médicale, Centre Hospitalier Universitaire de Nice (CHU Nice)-Hôpital l'Archet, Neurobiologie Vasculaire, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UCA)-Université Nice Sophia Antipolis (... - 2019) (UNS), and Transport Ionique Aspects Normaux et Pathologiques (TIANP), CNRS
Subjects: 0301 basic medicine, MESH: Cell Death, Male, Swine, [SDV]Life Sciences [q-bio], MESH: Cell Hypoxia, Respiratory chain, DHPS, Mitochondrion, MESH: Kidney Transplantation, Mixed Function Oxygenases, Mice, 0302 clinical medicine, Peptide Initiation Factors, Deoxyhypusine synthase, MESH: Animals, MESH: Peptide Initiation Factors, MESH: Swine, Cells, Cultured, MESH: Treatment Outcome, Kidney, biology, Cell Death, Chemistry, renal cell biology, RNA-Binding Proteins, General Medicine, Deoxyhypusine Hydroxylase, MESH: Mixed Function Oxygenases, Cell Hypoxia, Cell biology, Mitochondria, medicine.anatomical_structure, Treatment Outcome, Nephrology, 030220 oncology & carcinogenesis, Female, MESH: Cells, Cultured, Programmed cell death, MESH: Rats, MESH: Mitochondria, ischemia, cell survival, 03 medical and health sciences, MESH: Mice, Inbred C57BL, medicine, Gene silencing, Animals, MESH: Lysine, Rats, Wistar, MESH: Mice, hypoxia, Lysine, transplant outcomes, MESH: Rats, Wistar, Kidney Transplantation, MESH: Male, Rats, Mice, Inbred C57BL, 030104 developmental biology, MESH: RNA-Binding Proteins, Basic Research, biology.protein, MESH: Female
Abstract: International audience; The eukaryotic initiation factor 5A (eIF5A), which is highly conserved throughout evolution, has the unique characteristic of post-translational activation through hypusination. This modification is catalyzed by two enzymatic steps involving deoxyhypusine synthase (DHPS) and deoxyhypusine hydroxylase (DOHH). Notably, eIF5A may be involved in regulating the lifespan of Drosophila during long-term hypoxia. Therefore, we investigated the possibility of a link between eIF5A hypusination and cellular resistance to hypoxia/anoxia. Pharmacologic targeting of DHPS by N1-guanyl-1,7-diaminoheptane (GC7) or RNA interference-mediated inhibition of DHPS or DOHH induced tolerance to anoxia in immortalized mouse renal proximal cells. Furthermore, GC7 treatment of cells reversibly induced a metabolic shift toward glycolysis as well as mitochondrial remodeling and led to downregulated expression and activity of respiratory chain complexes, features characteristic of mitochondrial silencing. GC7 treatment also attenuated anoxia-induced generation of reactive oxygen species in these cells and in normoxic conditions, decreased the mitochondrial oxygen consumption rate of cultured cells and mice. In rats, intraperitoneal injection of GC7 substantially reduced renal levels of hypusinated eIF5A and protected against ischemia-reperfusion-induced renal injury. Finally, in the preclinical pig kidney transplant model, intravenous injection of GC7 before kidney removal significantly improved graft function recovery and late graft function and reduced interstitial fibrosis after transplant. This unconventional signaling pathway offers an innovative therapeutic target for treating hypoxic-ischemic human diseases and organ transplantation.
Published: 2016
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27. Rejet infraclinique en transplantation rénale : impact sur la survie à long terme des greffons

Author: Laffy, Benjamin, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Carmen Lefaucheur
Subjects: Survie des greffons rénaux, Classification de Banff, Histologie, MESH: Graft Survival, MESH: Transplantation Tolerance, Anticorps anti-HLA, MESH: Histology, MESH: Kidney, Rejet infraclinique médié par anticorps, MESH: HLA-A Antigens, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, MESH: Kidney Transplantation
Abstract: Background: the aim of the study is to assess the consequences of subclinical rejection on long-term kidney allograft survival. Methods: we performed an observational prospective study including 1307 patients who underwent kidney transplantation in Paris (2005-2010). Clinically stable participants underwent prospective screening biopsies at one year post transplant, with concurrent evaluations of circulating anti-HLA antibodies. Results: the main analysis included 1001 patients. Three distinct groups of patients were identified at the 1-year screening: 727 (73%) patients without rejection, 132 (13%) patients with subclinical T cell-mediated rejection (sTCMR) and 142 (14%) patients with subclinical antibody-mediated rejection (sABMR). Patients with sABMR had the poorest graft survival at 8 years post-transplant (56%) compared with subclinical TCMR (88%) and non-rejection (90%) groups (P
Published: 2016

28. Untargeted screening of urinary peptides with liquid chromatography coupled to hybrid linear-ion trap tandem mass spectrometry

Author: Louis Noël Gastinel, François-Ludovic Sauvage, Pierre Marquet, Pharmacologie des Immunosuppresseurs et de la Transplantation (PIST), Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pharmacologie, toxicologie et pharmacovigilance [CHU Limoges], CHU Limoges, and Marquet, Pierre
Subjects: Proteomics, Repetitive Sequences, Amino Acid, Molecular Sequence Data, Analytical chemistry, MESH: Amino Acid Sequence, MESH: Solid Phase Extraction, Tandem mass spectrometry, Mass spectrometry, 01 natural sciences, Biochemistry, MESH: Kidney Transplantation, Analytical Chemistry, Ion, 03 medical and health sciences, Tandem Mass Spectrometry, Humans, Amino Acid Sequence, Solid phase extraction, Quadrupole ion trap, 030304 developmental biology, 0303 health sciences, MESH: Humans, MESH: Molecular Sequence Data, Chromatography, MESH: Repetitive Sequences, Amino Acid, MESH: Peptides, Chemistry, MESH: Proteomics, Solid Phase Extraction, 010401 analytical chemistry, Organic Chemistry, Extraction (chemistry), Library search, MESH: Tandem Mass Spectrometry, General Medicine, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, Kidney Transplantation, MESH: Case-Control Studies, 0104 chemical sciences, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, Case-Control Studies, Peptides, MESH: Chromatography, Liquid, Chromatography, Liquid, Ion trap mass spectrometry
Abstract: International audience; We formerly developed and applied a liquid chromatography coupled with hybrid triple quadrupole-linear ion trap mass spectrometry technique for the detection and identification of exogenous compounds in clinical and forensic toxicology. In this study, we aimed to adapt this technique to the detection and identification of the constituents of the urinary peptidome. After solid-phase extraction, separation was performed using gradient reversed-phase liquid chromatography. The mass spectrometer was operated in the information-dependent acquisition mode, switching between: a survey scan acquired in the enhanced multi-charged scan mode with dynamic subtraction of background noise; and two dependent scans obtained in the enhanced product ion scan mode. The results obtained show that: (i) the present procedure is able to detect and identify peptides which, together with their inferred parent proteins, are similar to those referenced in the related literature; (ii) the structure of some peptides can generally be resolved from their enhanced product ion spectra; and (iii) confirmation of the sequences proposed through library search by in silico verification of the fragments observed in the enhanced product ion spectra seems to be indispensable to avoid misinterpretations.
Published: 2012
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29. A multicenter, randomized trial of increased mycophenolic acid dose using enteric-coated mycophenolate sodium with reduced tacrolimus exposure in maintenance kidney transplant recipients

Author: Benoît Barrou, Kamel Chaouche, Nassim Kamar, Didier Ducloux, Fabienne Di Giambattista, Stéphane Quéré, Lionel Rostaing, François Be, Florence Villemain, Marc Ladrière, Elisabeth Cassuto, Marie-Christine Moal, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service de Néphrologie et transplantation rénale, Hôpital Pasteur [Nice] (CHU), Service de Néphrologie et Transplantation Rénale, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service de Nephrologie et Transplantation Rénale, Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Novartis Pharma SAS, CHU Saint-Etienne, and Saas, Philippe
Subjects: Male, medicine.medical_treatment, 030232 urology & nephrology, 030230 surgery, Pharmacology, Mycophenolate, MESH: Kidney Transplantation, 0302 clinical medicine, Prospective Studies, skin and connective tissue diseases, Kidney transplantation, MESH: Aged, MESH: Middle Aged, Immunosuppression, General Medicine, Middle Aged, 3. Good health, Nephrology, Creatinine, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Tablets, Enteric-Coated, MESH: Immunosuppressive Agents, Immunosuppressive Agents, Glomerular Filtration Rate, medicine.drug, Adult, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Adolescent, Urology, Renal function, MESH: Tablets, Enteric-Coated, MESH: Creatinine, Tacrolimus, Mycophenolic acid, 03 medical and health sciences, MESH: Tacrolimus, medicine, Humans, Adverse effect, Aged, MESH: Mycophenolic Acid, MESH: Adolescent, MESH: Humans, business.industry, Mycophenolate Sodium, MESH: Adult, Mycophenolic Acid, medicine.disease, Kidney Transplantation, MESH: Prospective Studies, MESH: Male, MESH: Glomerular Filtration Rate, business, MESH: Female
Abstract: International audience; Mycophenolic acid (MPA) dose is frequently reduced in tacrolimus-treated kidney transplant patients, but alternatively the recommended MPA dose can be maintained with reduced tacrolimus exposure. In a 6-month, multicenter, randomized, openlabel study, maintenance kidney transplant patients receiving MPA (mycophenolate mofetil 1g/d or enteric-coated mycophenolate sodium (EC-MPS) 720 mg/d) and tacrolimus were randomized to convert to EC-MPS 1,440 mg/d with reduced tacrolimus (n = 46), or receive EC-MPS 720 mg/d with unchanged tacrolimus (n = 48). Mean estimated GFR (eGFR, aMDRD) at Month 6 was 49.1 ± 11.1 and 44.7 ± 11.5 ml/min/1.73 m2 in the EC-MPS 1,440 mg and 720 mg groups, respectively (p = 0.07). The primary endpoint, change in eGFR from Day 0 to Month 6, was 2.48 ± 0.95 ml/min/1.73 m2 with EC-MPS 1,440 mg and -0.48 ± 0.93 ml/min/1.73 m2 with EC-MPS 720 mg (difference 2.96 ml/min/1.73 m2; 95% CI 0.32 - 5.60; p = 0.028). There were no deaths, graft losses or acute rejections. Adverse events were more frequent with EC-MPS 1,440 mg than 720 mg (66.7% vs. 44.7%, p = 0.034). Adverse events with suspected relation to EC-MPS occurred in 26.7% and 21.3% of patients, respectively (p = 0.59). Conversion of kidney transplant patients to increased MPA dosing using EC-MPS 1,440 mg/d, with reduced tacrolimus exposure, appears an effective immunosuppression strategy and may improve renal function. Adverse events overall, but not those with a suspected relation to EC-MPS, were higher with ECMPS 1,440 mg/d.
Published: 2012
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30. Population pharmacokinetics of mycophenolic acid in pediatric renal transplant patients using parametric and nonparametric approaches

Author: Pierre Marquet, Victor W. Armstrong, Annick Rousseau, Lutz T. Weber, Aurélie Prémaud, M. Oellerich, Burkhard Tönshoff, Saik Urien, Marquet, Pierre, Pharmacologie des Immunosuppresseurs et de la Transplantation (PIST), Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de Pharmacologie, toxicologie et pharmacovigilance [CHU Limoges], CHU Limoges, Pediatric Nephrology, Ludwig-Maximilians-Universität München (LMU)-University Children's Hospital, University Children's Hospital, Department of Clinical Chemistry, University Medical Center Göttingen (UMG), Infections à Vih, Réservoirs, Pharmacologie des Antirétroviraux et Prévention de la Transmission Mère Enfant, Université Paris Descartes - Paris 5 (UPD5), Institut National de la Santé et de la Recherche Médicale (INSERM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Université de Limoges (UNILIM)-CHU Limoges, Université de Limoges (UNILIM) - CHU Limoges - Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503) - Institut National de la Santé et de la Recherche Médicale (INSERM), Ludwig-Maximilians-Universität München - University Children's Hospital, and University Medical Center of Göttingen
Subjects: Graft Rejection, Male, MESH : Child, Preschool, Pharmacology, 030226 pharmacology & pharmacy, MESH: Kidney Transplantation, Cohort Studies, MESH : Mycophenolic Acid, 0302 clinical medicine, MESH : Child, Elimination rate constant, population pharmacokinetics, MESH: Child, MESH : Female, nonparametric, Child, MESH: Cohort Studies, MESH: Statistics, Nonparametric, education.field_of_study, Age Factors, MESH : Infant, [CHIM.MATE]Chemical Sciences/Material chemistry, renal transplantation, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, MESH: Infant, 3. Good health, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, Child, Preschool, 030220 oncology & carcinogenesis, Kurtosis, Female, mycophenolic acid, medicine.drug, medicine.medical_specialty, [CHIM.ANAL] Chemical Sciences/Analytical chemistry, Adolescent, MESH : Male, Population, Urology, MESH : Cohort Studies, MESH: Graft Rejection, parametric, Statistics, Nonparametric, Mycophenolic acid, 03 medical and health sciences, Pharmacokinetics, [CHIM.ANAL]Chemical Sciences/Analytical chemistry, MESH : Adolescent, medicine, Humans, Distribution (pharmacology), education, MESH : Statistics, Nonparametric, MESH: Mycophenolic Acid, MESH: Adolescent, MESH: Age Factors, [CHIM.MATE] Chemical Sciences/Material chemistry, MESH: Humans, business.industry, MESH : Humans, MESH: Child, Preschool, Nonparametric statistics, MESH : Graft Rejection, Infant, Kidney Transplantation, MESH: Male, NONMEM, pediatric, MESH : Kidney Transplantation, MESH : Age Factors, business, MESH: Female
Abstract: International audience; Mycophenolic acid (MPA) is an immunosuppressive drug widely used in the prevention of acute rejection in pediatric renal transplant recipients and is characterized by a wide inter-individual variability in its pharmacokinetics. The aim of this study was to compare population pharmacokinetic modeling of MPA in pediatric renal transplant recipients given mycophenolate mofetil, the ester prodrug of MPA, using parametric and nonparametric population methods. The data from 34 pediatric renal transplants (73 full pharmacokinetic profiles obtained on day 21, months 3, 6 and 9 post-transplant) were analyzed using both the nonlinear mixed-effect modeling (NONMEM) and nonparametric adaptive grid (NPAG) approaches, based on a two-compartment model with first order lagged time absorption and first order elimination. The predictive performance of the two models was evaluated in a separate group of 32 patients. Higher mean population parameter values and ranges of individual pharmacokinetic parameters were obtained with NPAG, especially for the elimination constant ke: mean 1.16 h(-1) (0.26-4.33 h(-1)) and 0.78 h(-1) (0.66-1.15 h(-1)) with NPAG and NONMEM, respectively. With NPAG, the skewness and kurtosis values for ke (2.03 and 7.80, respectively) were far from the theoretical values expected for normal distributions. Such a non-normal distribution could explain the high value of shrinkage (35%) obtained for this parameter with the parametric NONMEM method. Bayesian forecasting of mycophenolic acid exposure using the NPAG population pharmacokinetic parameters as priors yielded a better predictive performance, with a significantly smaller bias than with the NONMEM model (-1.68% vs -9.53%, p
Published: 2011
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31. Thymoglobulin Induction and Sirolimus Versus Tacrolimus in Kidney Transplant Recipients Receiving Mycophenolate Mofetil and Steroids

Author: Jean-Marc Chalopin, Yves Vanrenterghem, Lionel Rostaing, Bernard Bourbigot, François Berthoux, Daniel Abramovicz, Bernard Charpentier, Nicole Lefrançois, Michel Delahousse, Elisabeth Cassuto, Gérard Rifle, Denis Glotz, Philippe Lang, Service de Néphrologie [Saint-Louis], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de néphrologie, AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Service de néphrologie et transplantation, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Institut francilien de recherche en néphrologie et transplantation, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, Service de néphrologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Service de Néphrologie, Centre Hospitalier Régional Universitaire de Brest (CHRU Brest)-Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Service de transplantation rénale, Hôpital Foch [Suresnes], Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Service de transplantation, Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), and Saas, Philippe
Subjects: Male, 030232 urology & nephrology, 030230 surgery, MESH: Kidney Transplantation, MESH: Antibodies, Monoclonal, 0302 clinical medicine, MESH: Antilymphocyte Serum, MESH: Child, Child, Kidney transplantation, MESH: Treatment Outcome, MESH: Aged, MESH: Middle Aged, Calcineurin, Antibodies, Monoclonal, Middle Aged, 3. Good health, Treatment Outcome, Child, Preschool, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Steroids, MESH: Immunosuppressive Agents, MESH: Calcineurin, Immunosuppressive Agents, Glomerular Filtration Rate, medicine.drug, Adult, medicine.medical_specialty, Adolescent, [SDV.IMM] Life Sciences [q-bio]/Immunology, Calcineurin Inhibitors, Urology, Renal function, Tacrolimus, Mycophenolic acid, 03 medical and health sciences, MESH: Tacrolimus, medicine, Humans, Aged, Antilymphocyte Serum, MESH: Mycophenolic Acid, Sirolimus, MESH: Adolescent, Transplantation, MESH: Humans, Thymoglobulin, business.industry, MESH: Child, Preschool, MESH: Adult, Mycophenolic Acid, medicine.disease, Kidney Transplantation, MESH: Male, MESH: Steroids, MESH: Glomerular Filtration Rate, Immunology, MESH: Sirolimus, business, MESH: Female
Abstract: International audience; BACKGROUND: To define the role of mammalian target of rapamycin inhibitors in kidney transplantation, we compared efficacy and safety of two immunosuppressive regimens-a calcineurin inhibitor-free regimen with depletive induction versus a calcineurin inhibitor-based regimen. METHODS: De novo renal allograft recipients were randomized before transplantation to receive sirolimus (SRL; n=71, group A) or tacrolimus (n=70, group B). All patients received mycophenolate mofetil and corticosteroids. In group A, patients received rabbit antithymocyte globulin induction. In group B, antithymocyte globulin therapy could be given in case of delayed graft function. The estimated glomerular filtration rate (GFR) (Nankivell's formula) at month 12 was the primary endpoint. RESULTS: GFR showed no significant difference at month 12, with 56.1 in group A versus 58.4 mL/min/1.73 m in group B. In functioning grafts, renal function was significantly better in the SRL group, with higher GFR values at months 1, 2, 3, 6, and 9 (P
Published: 2010
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32. Hospital Costs of Renal Transplant Management

Author: Hugues Bittard, A. Dussaucy, Jean-Marc Chalopin, N. Chaumard, Philippe Fagnoni, Marie-Christine Woronoff-Lemsi, Samuel Limat, Virginie Nerich, Chim Analyt Lab, Equipe Sci Separat Biol & Pharmaceut, Université de Franche-Comté ( UFC ), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC ( HOTE GREFFON ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Etablissement français du sang [Bourgogne-France-Comté] ( EFS [Bourgogne-France-Comté] ) -Université de Franche-Comté ( UFC ), Service de Néphrologie et Urologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Centre d'Investigation Clinique de Besançon ( CICB ), Etablissement Français du Sang Bourgogne Franche-Comté-Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université de Franche-Comté ( UFC ), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC ( CEF2P / CARCINO ), Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Université Bourgogne Franche-Comté ( UBFC ) -Université de Franche-Comté ( UFC ), Pathologies et épithéliums : prévention, innovation, traitements, évaluation (EA 4267) (PEPITE), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Centre d'Investigation Clinique de Besançon (Inserm CIC 1431), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Carcinogénèse épithéliale : facteurs prédictifs et pronostiques - UFC (EA 3181) (CEF2P / CARCINO), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Subjects: MESH : Retrospective Studies, MESH : Hospital Units, 030232 urology & nephrology, MESH: Hospitalization, MESH: Length of Stay, MESH: Kidney Transplantation, Hospitals, University, 0302 clinical medicine, MESH : Costs and Cost Analysis, 030212 general & internal medicine, MESH: Diagnosis-Related Groups, health care economics and organizations, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, University hospital, 3. Good health, Hospitalization, MESH : Diagnosis-Related Groups, MESH : Length of Stay, Renal transplant, Costs and Cost Analysis, MESH : Hospitalization, MESH: Hospital Units, France, Hospital Units, Medical costs, medicine.medical_specialty, MESH: Costs and Cost Analysis, 03 medical and health sciences, Case mix index, medicine, Humans, MESH : France, Intensive care medicine, Diagnosis-Related Groups, MESH : Hospitals, University, Retrospective Studies, MESH: Hospitals, University, Transplantation, MESH: Humans, business.industry, MESH : Humans, MESH: Retrospective Studies, Retrospective cohort study, Length of Stay, Kidney Transplantation, MESH: France, Actual cost, [ SDV.SP ] Life Sciences [q-bio]/Pharmaceutical sciences, MESH : Kidney Transplantation, Surgery, business, Hospital stay
Abstract: International audience; Renal transplantation is considered to be a cost-effective therapy, but hospital medical costs are not accurately known. The aim of this work was to evaluate the costs of hospital stay for renal transplantation. This retrospective study included all patients who underwent renal transplantation between January 1, 2004, and December 31, 2005, in our University hospital. The incurred costs were determined using our center's analytical accounting (AA). The mean local cost was then compared with the median national cost of hospitalization for renal transplantation, based on a sample of participating centers contributing to the National Cost Scale (NCS) per homogenous diagnosis-related group (DRG). These mean costs were weighed against the financing obtained by national rates of the case-mix based payment system (termed T2A). Data were collected from 77 patients. Their mean length of stay was 19.4 days. AA determined the cost of management to be euro14,100 per patient. National economic approaches were significantly higher: euro16,389 for NCS and euro17,369 for national rates. Thus, the specific DRG rate (case mix index) of renal transplantation covers the expenses incurred by our center. These results are rather interesting; however, it is unlike those obtained for the management of other diseases such as acute myeloid leukemia, where T2A underestimates the actual cost by 2-4 times. Last, the hospital budget and T2A must be considered as a whole. The fact that DRGs with favorable and unfavorable pricing balance out should be taken into account.
Published: 2008
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33. Hepatitis E Virus-Related Cirrhosis in Kidneyand Kidney-Pancreas-Transplant Recipients

Author: Phillippe Otal, Jacques Izopet, Jean-Michel Mansuy, Dominique Durand, Marie Danjoux, Lionel Rostaing, Nassim Kamar, Florence Abravanel, J. Selves, L. Esposito, Olivier Cointault, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Institut de médecine moléculaire de Rangueil (I2MR), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR150-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire de Virologie [Toulouse], Service d'histo-pathologie, CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Radiologie [Rangueil / Larrey], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Service Anatomie et cytologie pathologiques [CHU Toulouse], Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Simon, Marie Francoise
Subjects: Liver Cirrhosis, Male, Pathology, Cirrhosis, medicine.disease_cause, Gastroenterology, MESH: Kidney Transplantation, 0302 clinical medicine, Liver Function Tests, Hepatitis E virus, Ascites, MESH: Liver Function Tests, Immunology and Allergy, Pharmacology (medical), 0303 health sciences, MESH: Middle Aged, medicine.diagnostic_test, virus diseases, Middle Aged, Hepatitis E, 3. Good health, MESH: Pancreas Transplantation, MESH: RNA, Viral, Liver biopsy, RNA, Viral, Portal hypertension, Female, 030211 gastroenterology & hepatology, Pancreas Transplantation, MESH: Liver Cirrhosis, medicine.symptom, MESH: Hepatitis E virus, Adult, medicine.medical_specialty, Virus, 03 medical and health sciences, Internal medicine, medicine, Humans, 030304 developmental biology, Hepatitis, Transplantation, MESH: Humans, business.industry, MESH: Hepatitis E, MESH: Adult, medicine.disease, Kidney Transplantation, MESH: Male, digestive system diseases, business, MESH: Female
Abstract: International audience; Hepatitis E virus (HEV) infection was thought to be responsible for acute hepatitis that did not become chronic. However, we have recently reported that HEV infection can evolve to chronic hepatitis, at least in solid-organ transplant patients. We report on two cases of rapidly progressive of HEV-related cirrhosis that occurred in two organ-transplant patients. Case 1: A kidney-pancreas-transplant patient developed acute HEV hepatitis 60 months after transplantation, which evolved to chronicity as defined by persisting elevated liver-enzyme levels and positive serum HEV RNA. At 22 months after the acute phase, she presented with cirrhosis and portal hypertension, that is ascites and esophagus varices. Case 2: A kidney-transplant patient developed acute hepatitis 36 months after transplantation, which persisted and remained unexplained for 38 months. Then, HEV RNA was searched for in their serum and stools, and was found to be positive in both. Retrospective analysis of available stored serum, mainly the serum obtained at the acute phase, confirmed the diagnosis of chronic hepatitis E. In both cases, a liver biopsy showed cirrhosis. We conclude that HEV infection cannot only evolve to chronic hepatitis, but can also be responsible for rapidly progressing cirrhosis in organ-transplant patients.
Published: 2008
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34. Hepatitis E Virus and Chronic Hepatitis in Organ-Transplant Recipients

Author: Jacques Izopet, Laure Esposito, Janick Selves, Jean-Michel Mansuy, Jean-Pierre Vinel, Jean-Marie Péron, Marie Danjoux, Nassim Kamar, Florence Abravanel, Joelle Guitard, Lionel Rostaing, Leila Ouezzani, Dominique Durand, Olivier Cointault, Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, Institut de médecine moléculaire de Rangueil (I2MR), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées- Institut Fédératif de Recherche Bio-médicale Institution (IFR150)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'anatomie pathologique et histologie-cytologie [Rangueil], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Pôle Maladies de l'appareil digestif [CHU Toulouse], Centre de Physiopathologie Toulouse Purpan (CPTP), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Simon, Marie Francoise, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-IFR150-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées-CHU Toulouse [Toulouse]-Hôpital de Rangueil, Laboratoire de Virologie [Toulouse], Service de Gastro-entérologie - Hépatologie [Purpan], and CHU Toulouse [Toulouse]-Hôpital Purpan [Toulouse]
Subjects: Male, viruses, medicine.disease_cause, Organ transplantation, MESH: Kidney Transplantation, 0302 clinical medicine, Liver Function Tests, Hepatitis E virus, MESH: Liver Function Tests, MESH: Immunocompromised Host, Hepatitis, Chronic, MESH: Aged, 0303 health sciences, MESH: Middle Aged, biology, medicine.diagnostic_test, virus diseases, General Medicine, Middle Aged, Hepatitis E, 3. Good health, Liver, MESH: Pancreas Transplantation, Female, 030211 gastroenterology & hepatology, Pancreas Transplantation, Adult, MESH: Hepatitis E virus, MESH: Liver Transplantation, medicine.medical_specialty, MESH: Hepatitis, Chronic, Virus, Immunocompromised Host, 03 medical and health sciences, medicine, Humans, Aged, 030304 developmental biology, Hepatitis, MESH: Humans, business.industry, MESH: Hepatitis E, MESH: Adult, medicine.disease, biology.organism_classification, Kidney Transplantation, MESH: Male, Caliciviridae, Liver Transplantation, Transplantation, Immunology, business, Liver function tests, MESH: Female, MESH: Liver
Abstract: International audience; Hepatitis E virus (HEV) is considered an agent responsible for acute hepatitis that does not progress to chronic hepatitis. We identified 14 cases of acute HEV infection in three patients receiving liver transplants, nine receiving kidney transplants, and two receiving kidney and pancreas transplants. All patients were positive for serum HEV RNA. Chronic hepatitis developed in eight patients, as confirmed by persistently elevated aminotransferase levels, serum HEV RNA, and histologic features of chronic hepatitis. The time from transplantation to diagnosis was significantly shorter and the total counts of lymphocytes and of CD2, CD3, and CD4 T cells were significantly lower in patients in whom chronic disease developed.
Published: 2008
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35. Estimated glomerular filtration rate as an end point in kidney transplant trial: where do we stand?

Author: Eric Alamartine, Nicolas Maillard, L. Thibaudin, Christophe Mariat, Manolie Phayphet, François Berthoux, Sylvi Laporte, Informatique et Distribution (ID-IMAG), Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National Polytechnique de Grenoble (INPG)-Centre National de la Recherche Scientifique (CNRS), Groupe de recherche sur la thrombose (GRT (EA 3065)), Université Jean Monnet [Saint-Étienne] (UJM), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), Groupe de recherche sur la thrombose, pharmacologie des antithrombotiques et situations à risque (GRT), and Université Jean Monnet - Saint-Étienne (UJM)
Subjects: MESH: Forecasting, medicine.medical_specialty, MESH: Clinical Trials as Topic, medicine.medical_treatment, 030232 urology & nephrology, Urology, Renal function, 030204 cardiovascular system & hematology, Kidney transplant, MESH: Kidney Transplantation, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Intensive care medicine, ComputingMilieux_MISCELLANEOUS, Clinical Trials as Topic, Transplantation, MESH: Humans, End point, business.industry, MESH: Mathematics, medicine.disease, Kidney Transplantation, Clinical trial, MESH: Glomerular Filtration Rate, Nephrology, [SDV.SP.PHARMA]Life Sciences [q-bio]/Pharmaceutical sciences/Pharmacology, Hemodialysis, business, Mathematics, Forecasting, Glomerular Filtration Rate, Kidney disease
Abstract: International audience
Published: 2007
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36. The essential of 2012 results from the French Renal Epidemiology and Information Network (REIN) ESRD registry

Author: Cécile Couchoud, au nom du registre Rein, Carole Ayav, Mathilde Lassalle, Luc Frimat, Christian Jacquelinet, Agence de la biomédecine [Saint-Denis la Plaine], Réseau Lorrain de prise en charge de l’insuffisance rénale chronique : Réseau NEPHROLOR (Nephrolor), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), and Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL)
Subjects: Pediatrics, Survival, MESH: Registries, Epidemiology, medicine.medical_treatment, urologic and male genital diseases, MESH: Kidney Transplantation, MESH: Child, Prevalence, Medicine, MESH: Renal Dialysis, Registries, MESH: Incidence, Young adult, Child, MESH: Aged, MESH: Middle Aged, Mortality rate, Incidence (epidemiology), Incidence, MESH: Infant, Newborn, Middle Aged, MESH: Infant, 3. Good health, Nephrology, MESH: Kidney Failure, Chronic, MESH: Young Adult, Child, Preschool, France, Hemodialysis, Adult, medicine.medical_specialty, Adolescent, MESH: Transplant Recipients, Peritoneal dialysis, Young Adult, Renal Dialysis, Humans, ESRD, Dialysis, MESH: Prevalence, Aged, MESH: Adolescent, Transplantation, MESH: Humans, business.industry, MESH: Child, Preschool, Infant, Newborn, Infant, MESH: Adult, Kidney Transplantation, Transplant Recipients, MESH: France, Kidney Failure, Chronic, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, business
Abstract: International audience; The French Renal Epidemiology and Information Network (REIN) registry began in 2002 to provide a tool for public health decision support, evaluation and research related to renal replacement therapies (RRT) for end-stage renal disease (ESRD). It is relying on a network of nephrologists, epidemiologists, patients and public health representatives. Continuous registration covers all dialysis and transplanted patients. In 2012, in France, 10,048 patients started a RRT (154 per million inhabitants). Elders provided majority of new patients (median age at RRT start: 70 years old). New patients had a high and age increasing rate of comorbidities, especially diabetes (42% of the new patients) and cardiovascular comorbidities (>50% of the new patients). Like previous years, incidence is stabilized. On December 31, 2012, 73,491 patients were receiving a RRT in France (1127 per million inhabitants, 56% on dialysis and 44% living with a functional renal transplant). More than 50% of patients were undergoing in-center hemodialysis with significant variations among regions. An increase in medical satellite unit hemodialysis but a decrease in self-care unit hemodialysis rates were noticed across the time, whereas peritoneal dialysis remained stable at 7%. Five years after starting RRT, the overall survival rate was 51% but only 16% among patients over 85 years. Mortality rate was highly dependent on treatment and age; transplanted patients aged 60-69 had a 27/1000 patients-year mortality rate versus 133 for a dialysis patient. Patients who started dialysis had a probability of first wait-listing of 4.8% at the start of dialysis (pre-emptive registrations) and 27% at 72 months. Whatever their diabetes status was, patients older than 60 had poor access to the waiting list. Seventeen percent of the patients received a first renal transplant within 15.4 month median time; 3% had received a pre-emptive graft. Ten years after the start of the French ESRD registry, this report provides a comprehensive and nation-wide overview of dialysis and transplantation cares in France, including overseas.
Published: 2015
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37. Comparison of two national quality of life surveys for patients with end stage renal disease between 2005-2007 and 2011: indicators slightly decreased

Author: Beauger , Davy, Gentile , Stéphanie, Jacquelinet , Christian, Dussol , Bertrand, Briançon , Serge, Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants (SPMC), Aix Marseille Université (AMU)-Assistance Publique - Hôpitaux de Marseille (APHM), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Agence de la biomédecine [Saint-Denis la Plaine], Centre de néphrologie et transplantation rénale [Hôpital de la Conception - APHM], Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION), Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Assistance Publique - Hôpitaux de Marseille (APHM)-Aix Marseille Université (AMU), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION)-Assistance Publique - Hôpitaux de Marseille (APHM), Santé Publique et maladies Chroniques : Qualité de vie Concepts, Usages et Limites, Déterminants ( SPMC ), Aix Marseille Université ( AMU ) -Assistance Publique - Hôpitaux de Marseille ( APHM ), Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Assistance Publique - Hôpitaux de Marseille ( APHM ) -Hôpital de la Conception [CHU - APHM] ( LA CONCEPTION ), Maladies chroniques, santé perçue, et processus d'adaptation. Approches épidémiologiques et psychologiques. ( APEMAC - EA 4360 ), Université Paris Descartes - Paris 5 ( UPD5 ) -Université de Lorraine ( UL ), Hôpital de la Conception [CHU - APHM] (LA CONCEPTION ), and Assistance Publique - Hôpitaux de Marseille (APHM)-Hôpital de la Conception [CHU - APHM] (LA CONCEPTION )
Subjects: Male, Quality of life, Renal failure, MESH: Registries, MESH : Male, MESH : Aged, MESH : Health Surveys, MESH : Kidney Failure, Chronic, MESH: Kidney Transplantation, MESH : Cross-Sectional Studies, MESH: Cross-Sectional Studies, MESH: Health Surveys, Renal Dialysis, Humans, MESH : Female, MESH: Renal Dialysis, Registries, MESH : France, Cross-sectional study, Aged, MESH: Aged, Transplantation, Dialyse, MESH: Humans, MESH : Humans, Qualité de vie, MESH: Quality of Life, [ SDV.SPEE ] Life Sciences [q-bio]/Santé publique et épidémiologie, MESH : Quality of Life, MESH : Renal Dialysis, Health Surveys, Kidney Transplantation, Étude transversale, MESH: Male, MESH: France, Cross-Sectional Studies, Health evaluation, Insuffisance rénale, MESH: Kidney Failure, Chronic, Évaluation, Kidney Failure, Chronic, MESH : Kidney Transplantation, Female, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, France, Dialysis, MESH: Female, MESH : Registries
Abstract: International audience; BACKGROUND:The Epidemiology Network and Nephrology Information provides since 2001 the epidemiological monitoring of end stage renal disease (ESRD) in France. Two cross-sectional studies to estimate the level of quality of life in ESRD patients were performed in 2005 and 2007 and repeated in 2011. The main objective is to analyze the evolution of the quality of life of ESRD between these two surveys.METHODS:The studies were conducted on a representative sample of subjects aged 18 and over, prevalent dialysis or holders of a functioning kidney transplant last year, followed in center dialysis and/or transplantation in one of the eight French regions selected. The quality of life was measured by a generic questionnaire, and two specifics questionnaires.RESULTS:The evolution of the quality of life deteriorated slightly between 2005-2007 and 2011. There is however few dimensions affected. The variation in scores is not meaningful in general, with maximum decreases less than 4 points according to the statistical methods used. This diminution is not clinically significant.DISCUSSION:The quality of life in dialysis patients or transplant did not evolve between 2005-2007 and 2011. Currently, it is difficult to assess the benefits of the national plan for improving the quality of life of people with chronic diseases because the last data are too close to the end of the plan.; IntroductionLe réseau épidémiologie et information en néphrologie (REIN) assure depuis 2001 le suivi épidémiologique et la prise en charge de l’insuffisance rénale chronique terminale (IRCT) en France. La connaissance d’indicateurs de qualité de vie (QDV) relative à la santé est capitale afin de mieux comprendre les domaines touchés par la maladie et ainsi proposer des actions appropriées visant à mieux vivre avec sa pathologie. Dans ce contexte, deux études transversales visant à estimer le niveau de QDV liée à la santé des patients en IRCT ont été mises en place en 2005 (enquête dialyse) et 2007 (enquête greffe) sur un échantillon de patients français, puis reconduites en 2011. L’objectif de cet article est de comparer ces deux enquêtes et d’analyser l’évolution de la qualité de vie des patients atteints d’IRCT entre ces deux enquêtes.MéthodesLes études ont été réalisées sur un échantillon représentatif de sujets âgés de 18 ans et plus, prévalents dialysés (quelles que soient les modalités de dialyse) ou porteurs d’un greffon rénal fonctionnel depuis un an, suivis dans un centre de dialyse et/ou de transplantation dans l’une des huit régions françaises sélectionnées. Le recueil des données a été réalisé par auto-questionnaire adressé par voie postale au domicile des patients. La qualité de vie (QDV) a été mesurée par un questionnaire générique, le MOS SF-36 et deux questionnaires spécifiques : le Kidney Disease Quality of Life (KDQOL) version courte pour les dialysés et le ReTransQol V2 (RTQ V2) pour les patients greffés. L’évolution des scores a été réalisée par des analyses multivariées, le calcul d’un score de propension et de pondération afin de prendre en compte les différences de profil des patients entre les périodes d’enquêtes.RésultatsLa QDV s’est légèrement dégradée entre 2005–2007 et 2011, et ce, quel que soit le questionnaire utilisé (générique ou spécifique). Il n’y a cependant que peu de dimensions affectées, avec 2 ou 3 domaines par outils de mesure. Pour le SF-36, ce sont les dimensions « santé générale », « douleurs physiques » ainsi que « vie et relation avec les autres » qui diminuent de manière significative (−3,2, −3,7 et −3,8 points). Pour les questionnaires spécifiques, la dimension « traitement » du RTQ V2 est la plus affectée (−2,5 points), ainsi que la dimension « symptôme/problèmes » du KDQOL (−2,4 points). La variation des scores de QDV est peu signifiante dans l’ensemble, allant de −1,6 point à −3,8 points pour la plus forte baisse, selon les méthodes statistiques utilisées. Cette diminution reste toujours inférieure au seuil des 5 points considérés comme cliniquement signifiant.DiscussionLa qualité de vie chez les patients dialysés ou greffés s’est légèrement dégradée entre 2005–2007 et 2011. Le recueil des dernières données de notre étude ayant été réalisé dès la fin du plan pour l’amélioration de la qualité de vie des personnes atteintes de maladies chroniques 2005–2011, le bénéfice du plan paraît donc difficile à évaluer dans sa globalité.
Published: 2015
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38. Registration on the Renal Transplantation Waiting List and Mortality on Dialysis: an Analysis of the French REIN Registry Using a Multi-state Model

Author: Jean-Baptiste Beuscart, Dominique Pagniez, Alain Duhamel, Eric Boulanger, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 (METRICS), Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Interface sang vaisseaux et réparation cardiovasculaire, Université de Lille, Droit et Santé-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), We would like to thank the Scientific Committee and the people in charge of the REIN Registry for their invaluable assistance, in particular Dr. Cécile Couchoud, Mathilde Delasalle, and Dr. Christian Jacquelinet. We are also extremely grateful to all of the nephrologists and centers involved in this study for their kind cooperation and for providing high-quality data., Inserm, Université de Lille, CHU Lille, Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS], Centre Hospitalier Régional Universitaire [Lille] [CHRU Lille], Lille Inflammation Research International Center - U 995 [LIRIC], Santé publique : épidémiologie et qualité des soins-EA 2694 (CERIM), Lille Inflammation Research International Center (LIRIC), Institut Pasteur de Lille, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lille-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), and Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille)-Université de Lille
Subjects: Male, Pediatrics, Epidemiology, medicine.medical_treatment, [SDV]Life Sciences [q-bio], MESH: Registries, 030232 urology & nephrology, MESH: waiting list, MESH: Comorbidity, Comorbidity, 01 natural sciences, MESH: Regression Analysis, MESH: Renal Dialysis/mortality, 010104 statistics & probability, 0302 clinical medicine, Risk Factors, MESH: Risk Factors, MESH: Models, Clinical Epidemiology, Registries, Kidney transplantation, MESH: Waiting Lists, MESH: Aged, MESH: Middle Aged, MESH: France/epidemiology, MESH: kidney transplantation, Hazard ratio, General Medicine, MESH: Follow-Up Studies, waiting list, Middle Aged, 3. Good health, MESH: Survival Analysis, Cohort, Regression Analysis, MESH: renal dialysis, Original Article, Female, France, Hemodialysis, medicine.medical_specialty, Waiting Lists, Mesh:Female, Mesh:Comorbidity, Mesh:Follow-Up Studies, Mesh:France/epidemiology, Mesh:Humans, Mesh:Kidney Transplantation, Mesh:Male, Mesh:Middle Aged, Mesh:Models, Mesh:Statistical, Mesh:Registries, Mesh:Regression Analysis, Mesh:Renal Dialysis/mortality, Mesh:Risk Factors, Mesh:Survival Analysis, Mesh:Waiting Lists, Mesh:Aged, survival analysis, multi-state model, renal dialysis, kidney transplantation, 03 medical and health sciences, Renal Dialysis, medicine, Humans, MESH: multi-state model, 0101 mathematics, MESH: Statistical, Dialysis, Survival analysis, Aged, Models, Statistical, MESH: Humans, business.industry, medicine.disease, Survival Analysis, MESH: Male, Transplantation, business, MESH: Female, MESH: Kidney Transplantation, Follow-Up Studies
Abstract: International audience; AbstractBackground: Access to the renal transplantation (RT) waiting list depends on factors related to lower mortality rates and often occurs after dialysis initiation. The aim of the study was to use a flexible regression model to determine if registration on the RT waiting list is associated with mortality on dialysis, independent of the comorbidities associated with such registration.Methods: Data from the French REIN registry on 7138 incident hemodialysis (HD) patients were analyzed. A multi-state model including four states (‘HD, not wait-listed’, ‘HD, wait-listed’, ‘death’, and ‘RT’) was used to estimate the effect of being wait-listed on the probability of death.Results: During the study, 1392 (19.5%) patients were wait-listed. Of the 2954 deaths observed in the entire cohort during follow-up, 2921 (98.9%) were observed in the not wait-listed group compared with only 33 (1.1%) in the wait-listed group. In the multivariable analysis, the adjusted hazard ratio for death associated with non-registration on the waiting list was 3.52 (95% CI, 1.70–7.30). The risk factors for death identified for not wait-listed patients were not found to be significant risk factors for wait-listed patients, with the exception of age.Conclusions: The use of a multi-state model allowed a flexible analysis of mortality on dialysis. Patients who were not wait-listed had a much higher risk of death, regardless of co-morbidities associated with being wait-listed, and did not share the same risk factors of death as wait-listed patients. Registration on the waiting list should therefore be taken into account in survival analysis of patients on dialysis.
Published: 2015
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39. Urinary cytotoxic molecular markers for a noninvasive diagnosis in acute renal transplant rejection*

Author: Sophie Felix, Gérard Rifle, Christophe Ferrand, Jean-Michel Rebibou, Philippe Saas, Jean-Marc Chalopin, Pierre Tiberghien, Maria Yannaraki, Patrick Hervé, Anne Duperrier, Didier Ducloux, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Plateforme de Biomonitoring, Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service d'Anatomie pathologique [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de néphrologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Saas, Philippe, and Hôpital Saint-Jacques-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)
Subjects: Graft Rejection, Male, Nephrology, Pathology, MESH: Membrane Glycoproteins, 030232 urology & nephrology, MESH: Urinary Tract Infections, 030230 surgery, Gastroenterology, Granzymes, MESH: Kidney Transplantation, Postoperative Complications, 0302 clinical medicine, Chronic allograft nephropathy, MESH: Postoperative Complications, MESH: Reverse Transcriptase Polymerase Chain Reaction, Lymphocytes, MESH: Serine Endopeptidases, Kidney transplantation, Kidney, Membrane Glycoproteins, MESH: Middle Aged, MESH: Pore Forming Cytotoxic Proteins, Reverse Transcriptase Polymerase Chain Reaction, Serine Endopeptidases, MESH: Tumor Necrosis Factors, Middle Aged, MESH: Predictive Value of Tests, 3. Good health, MESH: Reproducibility of Results, medicine.anatomical_structure, Real-time polymerase chain reaction, Acute Disease, Cytomegalovirus Infections, Tumor Necrosis Factors, Urinary Tract Infections, MESH: Acute Disease, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Pore Forming Cytotoxic Proteins, medicine.medical_specialty, Fas Ligand Protein, [SDV.IMM] Life Sciences [q-bio]/Immunology, Urinary system, MESH: Graft Rejection, Sensitivity and Specificity, 03 medical and health sciences, Predictive Value of Tests, Internal medicine, MESH: Transplantation, Homologous, medicine, Humans, Transplantation, Homologous, RNA, Messenger, MESH: RNA, Messenger, MESH: Granzymes, Transplantation, MESH: Humans, Perforin, business.industry, MESH: Biological Markers, Reproducibility of Results, MESH: Cytomegalovirus Infections, medicine.disease, Kidney Transplantation, MESH: Male, MESH: Sensitivity and Specificity, MESH: Fas Ligand Protein, MESH: Perforin, MESH: Lymphocytes, Complication, business, MESH: Female, Biomarkers
Abstract: International audience; Perforin (P), Granzyme B (GB) and Fas-Ligand (FAS-L) are cytotoxic molecules involved in acute rejection (AR) after renal transplantation. A noninvasive diagnostic test to monitor AR and other complications could improve clinical management. We investigated the predictive and diagnostic interest of target mRNA measurements, with a quantitative PCR assay, in AR, as well as in other clinical complications recurrent in kidney transplantation. One hundred and sixty-two urine specimens from 37 allograft recipients were investigated. Clinical settings were AR, urinary tract infection (UTI), cytomegalovirus infection (CMVi) or disease (CMVd), chronic allograft nephropathy (CAN), delayed graft function (DGF) and stable graft course (controls). In the case of AR, mRNA levels of all three molecules were significantly higher than in recipients not showing any clinically evident signs of complication. Indeed, it was observed that expression levels of P, GB and Fas-L mRNA also increase in other clinical situations such as UTI, CMV and DGF. Finally, kinetic studies in three patients with AR revealed that increased P, GB and Fas-L mRNA levels could precede or were concomitant with increased serum creatinin levels. P, GB and Fas-L gene expression in urine specimens were upregulated in AR episodes but also in UTI, CMV infection and DGF. Therefore, this technique would appear to be of limited clinical value as a noninvasive method of diagnosing AR.
Published: 2006
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40. No Evidence of Association between NOD2/CARD15 Gene Polymorphism and Atherosclerotic Events after Renal Transplantation

Author: Anne Duperrier, Cécile Courivaud, Didier Ducloux, Philippe Saas, Christophe Ferrand, Pierre Tiberghien, Marina Deschamps, Jean-Marc Chalopin, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Plateforme de Biomonitoring, Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), Centre d'Investigation Clinique de Besançon (Inserm CIC 1431), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté]), This study is supported by grants from the Fondation Transplantation. CC received financial support from the Fondation transplantation (#ET-050320). MD received financial support from the Comité Départemental de la Ligue contre le Cancer du Jura., Saas, Philippe, Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), and Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC)
Subjects: Adult, Male, [SDV.IMM] Life Sciences [q-bio]/Immunology, Nod2 Signaling Adaptor Protein, Single-nucleotide polymorphism, 030204 cardiovascular system & hematology, Biology, Polymorphism, Single Nucleotide, Article, MESH: Atherosclerosis, MESH: Kidney Transplantation, Pathogenesis, 03 medical and health sciences, 0302 clinical medicine, MESH: Intracellular Signaling Peptides and Proteins, Genotype, medicine, Humans, MESH: Nod2 Signaling Adaptor Protein, SNP, innate immunity, Kidney transplantation, 030304 developmental biology, 0303 health sciences, Transplantation, Kidney, MESH: Humans, MESH: Middle Aged, MESH: Polymorphism, Single Nucleotide, Intracellular Signaling Peptides and Proteins, MESH: Adult, MESH: Toll-Like Receptor 4, Middle Aged, medicine.disease, Kidney Transplantation, MESH: Male, digestive system diseases, Toll-Like Receptor 4, medicine.anatomical_structure, inflammation, Immunology, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Gene polymorphism, atherosclerosis, MESH: Female
Abstract: International audience; Stable renal transplant recipients (RTR) display high rates of atherosclerotic events (AE). Innate immunity and especially vascular inflammation play a role in the pathogenesis of atherosclerosis. It is illustrated both by an increased occurrence of postrenal transplant cardiovascular events in patients with elevated levels of C-reactive protein and by a correlation between posttransplant AE and Toll-like receptor-4 Asp299Gly polymorphism. Here, we analyze the influence NOD2/CARD15 gene polymorphism since NOD2 can modulate macrophage pro-inflammatory activity and macrophage is present in early atherosclerotic lesions. The incidence of single nucleotide polymorphism (SNP) in the three major polymorphic region of NOD2 gene (SNP8, SNP12 and SNP13) was assessed in 182 RTR and the correlation between such polymorphism and the development of AE was analyzed. No correlation was observed between NOD2 gene polymorphism and the occurrence of AE after renal transplantation. NOD2 gene polymorphism thus does not appear to influence cardiovascular complications in RTR.
Published: 2006
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41. Successful Hepatorenal Transplantation in Hereditary Amyloidosis Caused by a Frame-Shift Mutation in Fibrinogen Aa -Chain Gene

Author: Christiane Mousson, Bruno Heyd, Y. Tanter, Jean-Philippe Miguet, Gérard Rifle, Jean-Michel Rebibou, Eve Justrabo, Service de néphrologie (CHU de Dijon), Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand (CHU Dijon), Service de chirurgie viscérale et digestive - Unité de transplantation hépatique, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Laboratoire de pathologie, Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service d'hépatologie, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Hôpital Saint-Jacques-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), and Saas, Philippe
Subjects: Adult, Male, MESH: Liver Transplantation, Pathology, medicine.medical_specialty, [SDV.IMM] Life Sciences [q-bio]/Immunology, Biopsy, medicine.medical_treatment, 030232 urology & nephrology, 030204 cardiovascular system & hematology, Liver transplantation, Fibrinogen, Renal amyloidosis, MESH: Kidney Transplantation, Frameshift mutation, MESH: Biopsy, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Immunology and Allergy, Pharmacology (medical), Frameshift Mutation, Kidney transplantation, Transplantation, Kidney, MESH: Humans, business.industry, Amyloidosis, MESH: DNA, MESH: Frameshift Mutation, MESH: Adult, DNA, MESH: Follow-Up Studies, MESH: Amyloidosis, Familial, medicine.disease, Kidney Transplantation, MESH: Male, Liver Transplantation, 3. Good health, medicine.anatomical_structure, MESH: Fibrinogen, [SDV.IMM]Life Sciences [q-bio]/Immunology, business, Amyloidosis, Familial, Follow-Up Studies, medicine.drug
Abstract: International audience; Hereditary systemic amyloidosis comprises several autosomal dominant diseases caused by mutations in a number of plasma proteins, including the fibrinogen Aalpha-chain. Four mutations in the fibrinogen Aalpha-chain that are able to induce amyloidosis have been identified so far, the most common being the Glu526Val mutation. We have observed a family in which the father and his son reached end-stage renal failure because of renal amyloidosis induced by a frame-shift mutation in the fibrinogen Aalpha-chain gene producing a novel amyloid protein. Two kidney transplantations in the father and one in the son resulted in fast graft loss caused by recurrence of amyloid deposition. We then performed hepatorenal transplantation in the son. Three years later, liver and kidney functions are normal without recurrence of amyloid deposition. This case, together with three others with the Glu526Val mutation in the extensive literature, suggests that liver transplantation can cure hereditary fibrinogen amyloidosis, whatever the mutation may be.
Published: 2006
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42. INFLUENCE OF HOST-RECIPIENT ORIGIN ON CLINICAL ASPECTS OF POSTTRANSPLANTATION LYMPHOPROLIFERATIVE DISORDERS IN KIDNEY TRANSPLANTATION

Author: François Labrousse, Arnaud Jaccard, Dominique Bordessoule, Barbara Petit, Yann Le Meur, Mireille Drouet, François Paraf, Claude Leroux Robert, Physiologie Moléculaire de la Réponse Immune et des Lymphoproliférations (PMRIL), and Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS)
Subjects: Male, Pathology, medicine.medical_treatment, Genes, MHC Class I, Histocompatibility Testing, 030230 surgery, Cell morphology, MESH: Kidney Transplantation, MESH: Lymphoproliferative Disorders, 0302 clinical medicine, Isoantibodies, hemic and lymphatic diseases, HLA-DRB1, Kidney transplantation, MESH: Aged, MESH: Middle Aged, MESH: DNA, Immunosuppression, Middle Aged, MESH: Genes, MHC Class I, Immunohistochemistry, 3. Good health, surgical procedures, operative, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Adult, medicine.medical_specialty, NLM, Lymphoproliferative disorders, MESH: Histocompatibility Testing, 03 medical and health sciences, medicine, Humans, Aged, Transplantation, MESH: Humans, business.industry, MESH: Adult, MESH: Immunohistochemistry, DNA, HLA-DR Antigens, MESH: HLA-DR Antigens, medicine.disease, Kidney Transplantation, MESH: Male, MESH: Isoantibodies, Lymphoproliferative Disorders, Complication, business, MESH: Female, HLA-DRB1 Chains
Abstract: Background Posttransplantation lymphoproliferative disorder (PTLD) is a well-known complication of immunosuppression associated with solid organ transplantation. The donor or host origin of PTLD may influence the outcome of the disease as it has been reported that a donor origin may be associated with a better prognosis. The aim of the study was to determine the origin (recipient or donor) of 12 PTLD occurring in kidney transplant recipients and to correlate the results with clinical findings. Methods Origin of PTLD was determined using HLA DRB1 molecular typing, analysis of multiple short-tandem repeat microsatellite loci, and HLA class I antigen expression by immunohistochemistry. Results Combining the three techniques, we found that eight cases originated from the recipient and four cases originated from the donor. The results of the three techniques were concordant and altogether assigned the origin of the tumors. All the donor-origin PTLD were strictly localized to the kidney graft, developed after a mean time of 5 months after transplantation, and regressed after reduction of immunosuppression. In contrast, seven of the eight recipient-origin PTLD presented as multisystemic disease, occurred a mean time of 75.7 months after the transplantation, and had a worse outcome (mortality, five deaths of eight patients, 62.5%). Conclusions These results suggest that PTLD originating from the donor arise in the first year after transplantation into the graft, and that recipient-origin PTLD develop later as an invasive disease. Because it permits simultaneously the analysis of cell morphology and tumor origin, immunohistochemistry is a more reliable technique in the case of graft tumors associated with allograft rejection. The determination of the origin of the tumors seems to be of value in the management of PTLD to predict the outcome and to adapt therapy.
Published: 2002
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43. Renal transplantation in light chain amyloidosis: coming out of the cupboard

Author: Franck Bridoux, Jean-Paul Fermand, Pierre Ronco, Julian D. Gillmore, Contrôle de la Réponse Immune B et des Lymphoproliférations (CRIBL), Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Centre National de la Recherche Scientifique (CNRS), Service de néphrologie - hémodialyse et transplantation rénale, Centre hospitalier universitaire de Poitiers (CHU Poitiers), Remodelage et Reparation du Tissu Renal, Université Pierre et Marie Curie - Paris 6 (UPMC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'hématologie clinique et de thérapie cellulaire [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Saint-Antoine [APHP], Centre National de la Recherche Scientifique (CNRS)-Université de Limoges (UNILIM)-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: MESH: Immunoglobulin Light Chains, medicine.medical_specialty, 030204 cardiovascular system & hematology, Immunoglobulin light chain, MESH: Kidney Transplantation, 03 medical and health sciences, 0302 clinical medicine, medicine, Coming out, AL amyloidosis, MESH: Amyloidosis, ComputingMilieux_MISCELLANEOUS, MESH: Treatment Outcome, Transplantation, MESH: Humans, business.industry, Amyloidosis, medicine.disease, Dermatology, Cupboard, Nephrology, 030220 oncology & carcinogenesis, [SDV.IMM]Life Sciences [q-bio]/Immunology, MESH: Stem Cell Transplantation, business
Abstract: International audience
Published: 2011
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44. Résultats des transplantations rénales réalisées à partir de donneurs à critères élargis : expérience multicentrique sur 10 années de greffe

Author: Aubert, Olivier, Université Paris Descartes - Faculté de Médecine (UPD5 Médecine), Université Paris Descartes - Paris 5 (UPD5), and Alexandre Loupy
Subjects: [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Donneurs à critères élargis, Anticorps anti-HLA, MESH : HLA antigens, MESH: Graft survival, MESH : Kidney transplantation, MESH: Donors, Survie du greffon, MESH : Graft survival, MESH : Donors, Fonction rénale, MESH: Kidney transplantation, Transplantation rénale, MESH: HLA antigens, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Background: Since 2002, allocation policies have changed to allow transplantation using expanded criteria donors (ECD). The aim of this thesis is to assess the outcomes of transplantation using kidneys from expanded criteria donor.Methods: Patients who received kidney allografts on three transplantation centers in Paris between January 1, 2004 and January 1, 2011, were included in this study (N=1613). The type of donor was defined as standard (SCD) or expanded criteria donors (ECD). Clinical, biological, histological parameters and the presence of circulating donor-specific anti-HLA antibodies were screened for all the recipients at the time of transplantation. The main outcome was the kidney allograft loss. Results were replicated in an external validation cohort of 1150 kidneys recipients (Toulouse).Results: The 7-years kidney allograft survival was 80.7% for ECD recipients and 90.9% for SCD recipients (pConclusion: The excellent kidney allograft survival of ECD kidneys incites allocation policies of these kidneys in particular if the recipient has no DSA at the time of transplantation.; Rationnel : Depuis 2002 les politiques d’attribution des greffons ont évolué, permettant la transplantation de greffons rénaux issus de donneurs à critères élargis (ECD). L’objectif de cette thèse est d’étudier les résultats de la transplantation rénale chez les patients recevant un greffon ECD en comparaison des greffons standard (SCD).Méthodes : Les patients ayant reçu un greffon rénal dans 3 centres parisiens entre janvier 2004 et janvier 2011 ont été inclus dans cette étude (n=1613). Les paramètres cliniques, biologiques, histologiques et les anticorps anti-HLA dirigés contre le donneur (DSA) ont été recherchés pour tous les receveurs le jour de la transplantation. Le critère d’évaluation principal était la perte de greffon. Les résultats ont été évalués sur une cohorte indépendante de 1150 patients (Toulouse).Résultats : La survie à 7 ans post-transplantation des greffons issus de donneurs ECD était de 80,8% contre 90,9% dans le groupe de patients greffés avec des reins issus de donneurs SCD (pConclusion : La survie excellente des greffons issus des reins ECD encourage les politiques d’attribution de ces reins et ce d’autant plus que le receveur n’a pas de DSA circulant le jour de la transplantation.
Published: 2014

45. Impact of graft nephrectomy on outcomes of second kidney transplantation

Author: Fadli, Saad Ed Dine, Pernin, Vincent, Nogue, Erika, Macioce, Valérie, Picot, Marie-Christine, Ramounau-Pigot, Annie, Garrigue, Valérie, Iborra, François, Mourad, Georges, Thuret, Rodolphe, Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département d'Hépato-Gastroentérologie et de Transplantation Hépatique [CHU Saint-Eloi], Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université de Montpellier (UM), Département d'Information Médicale [CHRU Montpellier], CHU Montpellier, Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), and Retiveau, Nolwenn
Subjects: MESH: Humans, MESH: Middle Aged, MESH: Graft Survival, Graft survival, MESH: Adult, MESH: Retrospective Studies, Graft nephrectomy, MESH: Reoperation, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, MESH: Male, MESH: Kidney Transplantation, Kidney transplantation, MESH: Nephrectomy, Acute renal failure, surgical procedures, operative, MESH: Female
Abstract: International audience; Objectives: To determine the impact of renal graft nephrectomy on second kidney transplantation survival.Methods: We carried out a retrospective single-center study by analyzing cases performed from January 2000 to December 2011. Retransplanted patients who underwent previous allograft nephrectomy more than 3 months post-transplantation (group 1) were compared with those who did not (group 2) in terms of graft survival, incidences of acute rejection and delayed graft function. Multivariate Cox proportional hazard models were used to assess risk factors of graft loss after retransplantation.Results: Overall, 146 patients were analyzed, including 52 (35.6%) in group 1 and 94 (64.4%) in group 2. Group 1 patients presented a significantly shorter first graft survival (0.8 vs 8.6 years, P < 0.001) and more anti-class I antibodies (90.5% vs 74.2%, P = 0.03). A total of 10 patients (19%) in group 1 and 16 patients (17%) in group 2 had at least one acute rejection episode (P = 0.74). Delayed graft function was observed in 13 patients (25%) in group 1 and 17 patients (18%) in group 2 (P = 0.32). Graft survival at 1, 5 and 10 years was, respectively, 94%, 81% and 58% in group 1, and 99%, 93% and 66% in group 2 (P = 0.10). Graft survival was decreased by increased donor age and serum creatinine, and tended to be associated with post-transplantation presence of anti-class I and II antibodies. Graft nephrectomy was not associated with graft survival in multivariate analysis.Conclusions: Graft nephrectomy, probably a marker of high immunological risk patients, is not a risk factor of increased retransplant failure.
Published: 2014
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46. APOL1 polymorphisms and development of CKD in an identical twin donor and recipient pair. : Kidney donation in twins with APOL1 variant

Author: Kofman, Tomek, Audard, Vincent, Narjoz, Céline, Gribouval, Olivier, Matignon, Marie, Leibler, Claire, Desvaux, Dominique, Lang, Philippe, Grimbert, Philippe, Institut Mondor de Recherche Biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Bases moléculaires de la réponse aux xénobiotiques ( U775 (IFR95) ), Université Paris Descartes - Paris 5 ( UPD5 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre National de la Recherche Scientifique ( CNRS ), Néphropathies héréditaires et rein en développement ( UMR_S 983 ), CHU Necker - Enfants Malades [AP-HP]-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Assistance publique - Hôpitaux de Paris (AP-HP), Imagine - Institut des maladies génétiques ( IMAGINE - U1163 ), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Bases moléculaires de la réponse aux xénobiotiques (U775 (IFR95)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Néphropathies héréditaires et rein en développement (UMR_S 983), CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Necker - Enfants Malades [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: MESH : Polymorphism, Genetic, MESH : Male, MESH: Renal Insufficiency, Chronic, MESH : Young Adult, APOL1 polymorphism, kidney transplantation, MESH : Genotype, MESH : Renal Insufficiency, Chronic, MESH: Lipoproteins, HDL, MESH : Diseases in Twins, MESH: Kidney Transplantation, MESH: Genotype, MESH: Biopsy, MESH: Apolipoproteins, MESH: Polymorphism, Genetic, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, [ SDV.BBM ] Life Sciences [q-bio]/Biochemistry, Molecular Biology, donor, MESH: Living Donors, MESH: Humans, urogenital system, MESH : Humans, MESH: Genetic Predisposition to Disease, MESH : Follow-Up Studies, MESH: Follow-Up Studies, MESH: Kidney, MESH: Male, MESH : Kidney, MESH : Twins, Monozygotic, MESH: Young Adult, MESH : Biopsy, MESH : Living Donors, outcome, MESH : Lipoproteins, HDL, MESH : Kidney Transplantation, MESH : Genetic Predisposition to Disease, MESH: Twins, Monozygotic, MESH: Diseases in Twins, MESH : Apolipoproteins
Abstract: International audience; We report an occurrence of progressive loss of transplant function and ultimately transplant failure after living related kidney transplantation involving monozygotic twin brothers of Afro-Caribbean origin who were both heterozygous for the G1 and G2 kidney disease risk alleles in the APOL1 gene, which encodes apolipoprotein L-I. A 21-year-old man with end-stage kidney disease of unknown cause received a kidney from his brother, who was confirmed as a monozygotic twin by microsatellite analysis. Thirty months after transplantation, the patient presented with proteinuria and decreased estimated glomerular filtration rate; a biopsy of the transplant showed typical focal segmental glomerulosclerosis lesions. He received steroid therapy, but progressed to kidney failure 5 years later. The twin brother had normal kidney function without proteinuria at the time of transplantation; however, 7 years later, he was found to have decreased estimated glomerular filtration rate (40mL/min/1.73m(2)) and proteinuria (protein excretion of 2.5g/d). APOL1 genotyping revealed that both donor and recipient were heterozygous for the G1 and G2 alleles. This case is in stark contrast to the expected course of kidney transplantation in identical twins and suggests a role for APOL1 polymorphisms in both the donor and recipient.
Published: 2014
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47. APOL1 polymorphisms and development of CKD in an identical twin donor and recipient pair.: Kidney donation in twins with APOL1 variant

Author: Kofman, Tomek, Audard, Vincent, Narjoz, Céline, Gribouval, Olivier, Matignon, Marie, Leibler, Claire, Desvaux, Dominique, Lang, Philippe, Grimbert, Philippe, Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Bases moléculaires de la réponse aux xénobiotiques (U775 (IFR95)), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Néphropathies héréditaires et rein en développement (UMR_S 983), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Imagine - Institut des maladies génétiques (IMAGINE - U1163), Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM), and Guellaen, Georges
Subjects: MESH: Living Donors, MESH: Humans, urogenital system, MESH: Renal Insufficiency, Chronic, MESH: Genetic Predisposition to Disease, APOL1 polymorphism, kidney transplantation, MESH: Follow-Up Studies, MESH: Kidney, MESH: Lipoproteins, HDL, MESH: Male, MESH: Kidney Transplantation, MESH: Genotype, MESH: Biopsy, MESH: Apolipoproteins, MESH: Young Adult, MESH: Polymorphism, Genetic, outcome, [SDV.BBM] Life Sciences [q-bio]/Biochemistry, Molecular Biology, [SDV.BBM]Life Sciences [q-bio]/Biochemistry, Molecular Biology, MESH: Twins, Monozygotic, MESH: Diseases in Twins, donor
Abstract: International audience; We report an occurrence of progressive loss of transplant function and ultimately transplant failure after living related kidney transplantation involving monozygotic twin brothers of Afro-Caribbean origin who were both heterozygous for the G1 and G2 kidney disease risk alleles in the APOL1 gene, which encodes apolipoprotein L-I. A 21-year-old man with end-stage kidney disease of unknown cause received a kidney from his brother, who was confirmed as a monozygotic twin by microsatellite analysis. Thirty months after transplantation, the patient presented with proteinuria and decreased estimated glomerular filtration rate; a biopsy of the transplant showed typical focal segmental glomerulosclerosis lesions. He received steroid therapy, but progressed to kidney failure 5 years later. The twin brother had normal kidney function without proteinuria at the time of transplantation; however, 7 years later, he was found to have decreased estimated glomerular filtration rate (40mL/min/1.73m(2)) and proteinuria (protein excretion of 2.5g/d). APOL1 genotyping revealed that both donor and recipient were heterozygous for the G1 and G2 alleles. This case is in stark contrast to the expected course of kidney transplantation in identical twins and suggests a role for APOL1 polymorphisms in both the donor and recipient.
Published: 2014
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48. Analysis of perfusates during hypothermic machine perfusion by NMR spectroscopy: a potential tool for predicting kidney graft outcome

Author: Delphine, Bon, Claire, Billault, Billault, Claire, Raphaël, Thuillier, William, Hebrard, Nadège, Boildieu, Olivier, Celhay, Jacques, Irani, François, Seguin, Thierry, Hauet, Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques ( IRTOMIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Poitiers, Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Consortium for Organ Preservation in Europe, COPE, Service de Biochimie [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Groupement Scientifique - Ibisa (Ibisa), Institut National de la Recherche Agronomique (INRA), Service d'Urologie, Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Groupement Scientifique - Ibisa (IBISA), and Bon, Delphine
Subjects: Male, Magnetic Resonance Spectroscopy, MESH: Amino Acids, Sus scrofa, 030232 urology & nephrology, 030230 surgery, Kidney, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Choline, MESH: Kidney Transplantation, Kidney transplantation, chemistry.chemical_compound, 0302 clinical medicine, Deceased-donor kidney, Hypothermia, Induced, Medicine, MESH: Warm Ischemia, MESH: Animals, Warm Ischemia, Amino Acids, MESH: Metabolomics, Diminution, MESH: Glutathione, Graft Survival, MESH: Choline, Nuclear magnetic resonance spectroscopy, Glutathione, MESH: Predictive Value of Tests, MESH: Transplantation, Autologous, 3. Good health, Perfusion, medicine.anatomical_structure, MESH: Models, Animal, Anesthesia, Models, Animal, medicine.symptom, MESH: Perfusion, medicine.medical_specialty, MESH: Graft Survival, Urology, Transplantation, Autologous, Lesion, 03 medical and health sciences, Predictive Value of Tests, Animals, Metabolomics, Lactic Acid, Transplantation, Machine perfusion, MESH: Hypothermia, Induced, business.industry, MESH: Magnetic Resonance Spectroscopy, MESH: Biological Markers, MESH: Kidney, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Organ appraisal, MESH: Male, MESH: Sus scrofa, chemistry, MESH: Lactic Acid, business, Biomarkers
Abstract: International audience; BACKGROUND: Machine perfusion use has been reported to promote graft outcome in case of donation after cardiac death. Our objective was to evaluate the potential for nuclear magnetic resonance (NMR) to predict graft outcome by analyzing perfusates during machine perfusion time. METHOD: We used a renal autotransplantation model mimicking deceased after cardiac death donors with pigs. Organs were subjected to 60 min of warm ischemia before the hypothermic machine preservation during 22 hr. We studied the correlation between creatinemia after transplantation and the NMR data from perfusates. RESULTS: A metabonomic analysis allowed us to highlight the evolution of several metabolites during perfusion: the concentration of lactate, choline, or amino acids such as valine, glycine, or glutamate increased with time, whereas there was a diminution of total glutathione during this period. The changes in these biomarkers were less severe in the group with the better outcome. Statistical analysis revealed a strong association between the level of those metabolites during machine perfusion and function recovery (Spearman rank ≥0.89; P
Published: 2014
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49. Le syndrome des antiphospholipides en néphrologie. Atteinte rénale et aspects pratiques de la prise en charge

Author: Dekeyser, Manon, Zuily, Stéphane, Champigneulle, Jacqueline, Eschwège, Valérie, Frimat, Luc, Perret-Guillaume, Christine, Wahl, Denis, Service de néphrologie-hémodialyse-transplantation [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Défaillance Cardiovasculaire Aiguë et Chronique (DCAC), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre régional de compétence des Maladies systémiques et auto-immunes rares de l'adulte et Maladies vasculaires rares, Service d’Anatomie Pathologique [CHRU Nancy], Service d'Hématologie Biologique [CHRU Nancy], Maladies chroniques, santé perçue, et processus d'adaptation (APEMAC), Université Paris Descartes - Paris 5 (UPD5)-Université de Lorraine (UL), Service de Gérontologie [CHRU Nancy], and Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL)
Subjects: Biopsy, Renal Veins, MESH: Kidney Transplantation, MESH: Biopsy, Renal Artery, Antiphospholipid syndrome, Thrombophilia, MESH: Renal Dialysis, Traitement, Dialyse, MESH: Middle Aged, MESH: Arterial Occlusive Diseases, Disease Management, Middle Aged, Cardiovascular Diseases, MESH: Platelet Aggregation Inhibitors, MESH: Renal Circulation, Female, Kidney Diseases, Arterial Occlusive Diseases, MESH: Anticoagulants, MESH: Disease Management, MESH: Nervous System Diseases, MESH: Renal Artery, Renal Circulation, Renal Dialysis, MESH: Antiphospholipid Syndrome, Humans, MESH: Thrombosis, MESH: Contraindications, Antihypertensive Agents, MESH: Thrombocytopenia, Transplantation, MESH: Antihypertensive Agents, MESH: Kidney Diseases, MESH: Humans, Thrombotic Microangiopathies, Contraindications, MESH: Thrombotic Microangiopathies, MESH: Thrombophilia, Anticoagulants, MESH: Cardiovascular Diseases, Thrombosis, Kidney Transplantation, Thrombocytopenia, Néphropathie associée au syndrome des antiphospholipides, Treatment, MESH: Renal Veins, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Nervous System Diseases, Dialysis, MESH: Female, Platelet Aggregation Inhibitors, Syndrome des antiphospholipides, Antiphospholipid syndrome nephropathy
Abstract: International audience; The antiphospholipid syndrome is a thrombophilia characterized by the combination of arterial and/or venous thrombotic events or obstetric clinical events, associated with persistent presence of antiphospholipid antibodies. In this syndrome, thromboses may affect all of the vascular tree, renal damage is frequently associated with a specific antiphospholipid syndrome nephropathy. We propose in this review to provide updated recommendations on the management of antiphospholipid syndrome in nephrology. Treatment is based on long-term anticoagulant therapy with or without antiplatelet agents according to clinical events. The use of a conventional nephroprotection must not be forgotten (strict control of blood pressure with drugs blocking the renin-angiotensin-aldosterone system). Catastrophic antiphospholipid syndrome is an extremely severe complication which can threaten the vital prognosis of the patient. This justifies particular surveillance, as well as prevention in high-risk situations. We also illustrate the difficulties of long-term management in these patients, both in dialysis or kidney transplantation.; Le syndrome des antiphospholipides est une thrombophilie caractérisée par l’association d’un événement clinique thrombotique (artériel et/ou veineux) ou obstétrical, associé à la présence durable d’anticorps antiphospholipides. L’atteinte pouvant toucher l’ensemble de l’arbre vasculaire, une atteinte rénale est fréquemment associée avec la description maintenant bien codifiée de la néphropathie associée au syndrome des antiphospholipides. Nous proposons dans cette revue des recommandations actualisées sur la prise en charge du syndrome des antiphospholipides en néphrologie. La thérapeutique se base sur une anticoagulation plus ou moins une antiagrégation à long terme en fonction des événements cliniques sans oublier le recours à une néphroprotection classique (contrôle strict de la pression artérielle avec notamment des thérapeutiques bloquant le système rénine–angiotensine–aldostérone). Le syndrome catastrophique des antiphospholipides est une complication extrêmement grave pouvant mettre en jeu le pronostic vital du patient. Celui-ci justifie une attention toute particulière, ainsi qu’une prévention dans les situations à risque. Nous illustrons également les difficultés de prise en charge au long cours de ces patients, tant en dialyse qu’en transplantation rénale.
Published: 2014
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50. Conversion from everolimus with low-exposure cyclosporine to everolimus with mycophenolate sodium maintenance therapy in kidney transplant recipients: a randomized, open-label multicenter study

Author: Pierre Merville, Marie-Christine Moal, Jacques Dantal, Christophe Legendre, Nassim Kamar, Stéphane Quéré, Jean Philippe Rerolle, Bruno Moulin, Fabienne Di Giambattista, Laetitia Albano, Rachel Tetaz, Olivier Toupance, Arara Terpereau, Eric Alamartine, Service de néphrologie, Hôpital Pasteur [Nice] ( CHU ), Centre de cytométrie en flux ( CCF ), Université Jean Monnet [Saint-Étienne] ( UJM ), Université de Reims Champagne-Ardenne ( URCA ), Service de Néphrologie et Transplantation, CHU Strasbourg, Service de Néphrologie-transplantation-dialyse [Bordeaux], CHU Bordeaux [Bordeaux], Service de transplantation rénale, Hôpital Foch [Suresnes], Pharmacologie des Immunosuppresseurs et de la Transplantation ( PIST ), Université de Limoges ( UNILIM ) -CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique ( GEIST FR CNRS 3503 ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Service de néphrologie adultes [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Service de Nephrologie et Transplantation Rénale, Hôpital de la Cavale Blanche - CHRU Brest ( CHU - BREST ), Service de Néphrologie - Hypertension Artérielle Dialyse - Transplantation, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Novartis Pharma SAS, Centre de Recherche en Transplantation et Immunologie ( U1064 Inserm - CRTI - CHU Nantes ), Université de Nantes ( UN ) -Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Centre hospitalier universitaire de Nantes ( CHU Nantes ), Hôpital Pasteur [Nice] (CHU), Centre de cytométrie en flux (CCF), Université Jean Monnet [Saint-Étienne] (UJM), Université de Reims Champagne-Ardenne (URCA), Pharmacologie des Immunosuppresseurs et de la Transplantation (PIST), Université de Limoges (UNILIM)-CHU Limoges-Génomique, Environnement, Immunité, Santé, Thérapeutique (GEIST FR CNRS 3503)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital de la Cavale Blanche - CHRU Brest (CHU - BREST ), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), and Marquet, Pierre
Subjects: Male, Time Factors, 030232 urology & nephrology, MESH : Aged, MESH : Prospective Studies, MESH: Cyclosporine, MESH: Kidney Transplantation, chemistry.chemical_compound, MESH : Mycophenolic Acid, 0302 clinical medicine, Maintenance therapy, MESH : Female, Prospective Studies, MESH : Immunosuppressive Agents, MESH: Aged, MESH: Middle Aged, TOR Serine-Threonine Kinases, General Medicine, [SDV.SP]Life Sciences [q-bio]/Pharmaceutical sciences, Middle Aged, MESH : Adult, 3. Good health, [SDV.SP] Life Sciences [q-bio]/Pharmaceutical sciences, MESH : Calcineurin, Creatinine, 030220 oncology & carcinogenesis, Cyclosporine, MESH : TOR Serine-Threonine Kinases, Drug Therapy, Combination, Female, MESH: Immunosuppressive Agents, MESH: Calcineurin, France, Immunosuppressive Agents, Glomerular Filtration Rate, medicine.drug, MESH : Time Factors, Adult, medicine.medical_specialty, MESH : Male, Calcineurin Inhibitors, Urology, Renal function, MESH: Creatinine, Mycophenolic acid, 03 medical and health sciences, MESH : Cyclosporine, medicine, Humans, MESH : Middle Aged, Everolimus, MESH : France, MESH: TOR Serine-Threonine Kinases, MESH: Mycophenolic Acid, Aged, Sirolimus, Transplantation, MESH: Humans, business.industry, MESH : Sirolimus, MESH : Drug Therapy, Combination, MESH: Time Factors, MESH : Humans, MESH : Creatinine, MESH : Glomerular Filtration Rate, MESH: Adult, Mycophenolic Acid, Kidney Transplantation, MESH: Male, MESH: Prospective Studies, Surgery, MESH: France, Calcineurin, MESH: Drug Therapy, Combination, MESH: Glomerular Filtration Rate, Regimen, [ SDV.SP ] Life Sciences [q-bio]/Pharmaceutical sciences, chemistry, MESH : Kidney Transplantation, MESH: Sirolimus, business, MESH: Female
Abstract: International audience; BACKGROUND: Data in kidney transplant recipients regarding elimination of calcineurin inhibitor (CNI) therapy from a de novo regimen based on low CNI exposure and an mTOR inhibitor are sparse, and restricted to CNI elimination within the first six months post-transplant. MATERIAL/METHODS: In a 12-month, randomized, multicenter, open-label study, kidney transplant patients who had received everolimus, low-exposure cyclosporine and corticosteroids from transplantation to month 12 (with proteinuria
Published: 2014

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