440 results on '"P, Grimbert"'
Search Results
2. Belatacept inhibit human B cell germinal center development in immunodeficient mice
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Samson, Chloé, Thiolat, Allan, Moktefi, Anissa, Cohen, José L., Pilon, Caroline, and Grimbert, Philippe
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- 2023
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3. Impact of Switching From Immediate- or Prolonged-Release to Once-Daily Extended-Release Tacrolimus (LCPT) on Tremor in Stable Kidney Transplant Recipients: The Observational ELIT Study
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Magali Giral, Philippe Grimbert, Baptiste Morin, Nicolas Bouvier, Matthias Buchler, Jacques Dantal, Valérie Garrigue, Dominique Bertrand, Nassim Kamar, Paolo Malvezzi, Karine Moreau, Yoni Athea, and Yannick Le Meur
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extended-release tacrolimus ,LCPT ,immunosuppression ,kidney transplantation ,tremor ,C0/D ratio ,Specialties of internal medicine ,RC581-951 - Abstract
Once-daily extended-release tacrolimus (LCPT) exhibits increased bioavailability versus immediate-release (IR-TAC) and prolonged release (PR-TAC) tacrolimus. Improvements in tremor were previously reported in a limited number of kidney transplant patients who switched to LCPT. We conducted a non-interventional, non-randomized, uncontrolled, longitudinal, prospective, multicenter study to assess the impact of switching to LCPT on tremor and quality of life (QoL) in a larger population of stable kidney transplant patients. The primary endpoint was change in The Essential Tremor Rating Assessment Scale (TETRAS) score; secondary endpoints included 12-item Short Form Survey (SF-12) scores, tacrolimus trough concentrations, neurologic symptoms, and safety assessments. Subgroup analyses were conducted to assess change in TETRAS score and tacrolimus trough concentration/dose (C0/D) ratio by prior tacrolimus formulation and tacrolimus metabolizer status. Among 221 patients, the mean decrease of TETRAS score after switch to LCPT was statistically significant (p < 0.0001 vs. baseline). There was no statistically significant difference in change in TETRAS score after switch to LCPT between patients who had received IR-TAC and those who had received PR-TAC before switch, or between fast and slow metabolizers of tacrolimus. The overall increase of C0/D ratio post-switch to LCPT was statistically significant (p < 0.0001) and from baseline to either M1 or M3 (both p < 0.0001) in the mITT population and in all subgroups. In the fast metabolizers group, the C0/D ratio crossed over the threshold of 1.05 ng/mL/mg after the switch to LCPT. Other neurologic symptoms tended to improve, and the SF-12 mental component summary score improved significantly. No new safety concerns were evident. In this observational study, all patients had a significant improvement of tremor, QoL and C0/D ratio post-switch to LCPT irrespective of the previous tacrolimus formulation administered (IR-TAC or PR-TAC) and irrespective from their metabolism status (fast or slow metabolizers).
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- 2024
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4. Beyond the First Year: Epidemiology and Management of Late-Onset Opportunistic Infections After Kidney Transplantation
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V. Esnault, L. Hoisnard, B. Peiffer, V. Fihman, S. Fourati, C. Angebault, C. Champy, S. Gallien, P. Attias, A. Morel, P. Grimbert, G. Melica, and M. Matignon
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kidney transplant ,herpes zoster ,opportunistic infections ,transplant infectious disease ,pneumocystis ,Specialties of internal medicine ,RC581-951 - Abstract
Late opportunistic infections (OI) occurring beyond the first year after kidney transplantation (KT) are poorly described and not targeted by prophylactic strategies. We performed a ten-year retrospective monocentric cohort study describing epidemiology, risk factors and impact of late OI occurring 1 year after KT. We included clinically symptomatic OI requiring treatment besides BK virus nephropathy. Control groups included early OI occurring in the first year after KT, and KT recipients without OI since KT and alive with a functional allograft at 1 year. Among 1066 KT recipients, 185 (19.4%) presented a first episode of OI 21.0 (8.0–45.0) months after KT: 120 late OI (64.9%) and 65 early OI (35.1%). Late OI were mainly viral (N = 83, 69.2%), mostly herpes zoster (HZ) (N = 36, 43.4%). Pneumocystis represented most late fungal infections (N = 12/25, 48%). Compared to early OI, we reported more pneumocystis (p = 0.002) and less invasive aspergillosis (p = 0.01) among late OI. Patients with late OI were significatively younger at KT (54.0 ± 13.3 vs. 60.2 ± 14.3 years, p = 0.05). Patient and allograft survival rates between late OI and control groups were similar. Only age was independently associated with mortality. While late OI were not associated with higher mortality or graft loss, implementing prophylactic strategies might prevent such infections.
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- 2024
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5. Belatacept inhibit human B cell germinal center development in immunodeficient mice
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Chloé Samson, Allan Thiolat, Anissa Moktefi, José L. Cohen, Caroline Pilon, and Philippe Grimbert
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Medicine ,Science - Abstract
Abstract The humoral response mediated by alloantibodies directed against donor HLA molecules (DSAs) is one of the main causes of graft loss in kidney transplantation. Understanding the pathophysiology leading to humoral kidney rejection as the development of therapeutic tools is therefore a main objective in the field of solid organ transplantation and necessitate adapted experimental models. Among the immunosuppressive agents used in renal transplantation, belatacept, a fusion protein targeting T costimulatory molecules has shown its ability to prevent more efficiently the secretion of DSA by different mechanisms including a direct action on plasma cells but also on B lymphocytes and follicular helper T lymphocytes (Tfh) cooperation. This cellular cooperation occurs within germinal centers (GC), the seat of B lymphocytes differentiation. Here, we aimed to develop a dedicated mouse model in which human GC would be functional to study the effect of belatacept on GC formation and the ability of B lymphocytes to secrete immunoglobulin. We next demonstrate that belatacept inhibits the formation of these GCs, by inhibiting the frequency of Tfh and B lymphocytes. This alters the B maturation and therefore the generation of plasma cells and consequently, immunoglobulin secretion.
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- 2023
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6. A Pilot Study on the Use of Generative Adversarial Networks for Data Augmentation of Time Series
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Nicolas Morizet, Matteo Rizzato, David Grimbert, and George Luta
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data augmentation ,deep learning ,generative adversarial networks ,time series ,Electronic computers. Computer science ,QA75.5-76.95 - Abstract
Data augmentation is needed to use Deep Learning methods for the typically small time series datasets. There is limited literature on the evaluation of the performance of the use of Generative Adversarial Networks for time series data augmentation. We describe and discuss the results of a pilot study that extends a recent evaluation study of two families of data augmentation methods for time series (i.e., transformation-based methods and pattern-mixing methods), and provide recommendations for future work in this important area of research.
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- 2022
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7. Adverse events associated with JAK inhibitors in 126,815 reports from the WHO pharmacovigilance database
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Léa Hoisnard, Bénédicte Lebrun-Vignes, Sébastien Maury, Matthieu Mahevas, Khalil El Karoui, Lydia Roy, Anissa Zarour, Marc Michel, José L. Cohen, Aurélien Amiot, Pascal Claudepierre, Pierre Wolkenstein, Philippe Grimbert, and Emilie Sbidian
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Medicine ,Science - Abstract
Abstract Increasing number of Janus kinase (JAK) inhibitors have been approved for chronic haematopoietic neoplasms and inflammatory/autoimmune diseases. We aimed to assess safety of the first three approved JAK inhibitors: ruxolitinib, tofacitinib and baricitinib. In this retrospective observational study, pharmacovigilance data were extracted from the World Health Organization database. Adverse events are classified according to Medical Dictionary for Regulatory Activities hierarchy. Until February 28, 2021, all Individual Case Safety Reports [ICSRs] with the suspected drug ruxolitinib, tofacitinib or baricitinib were included. Disproportionality analysis was performed and the information component (IC) was estimated. Adverse events were considered a significant signal if the lower end of the 95% credibility interval of the IC (IC025) was positive. We identified 126,815 ICSRs involving JAK inhibitors. Ruxolitinib, tofacitinib and baricitinib were associated with infectious adverse events (IC025 1.7, especially with viral [herpes and influenza], fungal, and mycobacterial infectious disorders); musculoskeletal and connective tissue disorders (IC025 1.1); embolism and thrombosis (IC025 0.4); and neoplasms (IC025 0.8, especially malignant skin neoplasms). Tofacitinib was associated with gastrointestinal perforation events (IC025 1.5). We did not find a significant increase in the reporting of major cardiovascular events. We identified significant association between adverse events and ruxolitinib, tofacinitib and baricitinib in international pharmacovigilance database.
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- 2022
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8. Adverse events associated with JAK inhibitors in 126,815 reports from the WHO pharmacovigilance database
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Hoisnard, Léa, Lebrun-Vignes, Bénédicte, Maury, Sébastien, Mahevas, Matthieu, El Karoui, Khalil, Roy, Lydia, Zarour, Anissa, Michel, Marc, Cohen, José L., Amiot, Aurélien, Claudepierre, Pascal, Wolkenstein, Pierre, Grimbert, Philippe, and Sbidian, Emilie
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- 2022
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9. Myosteatosis as an independent risk factor for mortality after kidney allograft transplantation: a retrospective cohort study
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Antoine Morel, Yaniss Ouamri, Florence Canouï‐Poitrine, Sébastien Mulé, Cécile Maud Champy, Alexandre Ingels, Vincent Audard, Alain Luciani, Philippe Grimbert, Marie Matignon, Frédéric Pigneur, and Thomas Stehlé
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Myosteatosis ,Kidney transplantation ,Mortality risk factors ,Prognosis ,CT scan ,Diseases of the musculoskeletal system ,RC925-935 ,Human anatomy ,QM1-695 - Abstract
Abstract Background Patients with end‐stage renal disease may display both a loss of skeletal muscle mass and an increase in muscle fat deposits. We aimed to analyse the impact of low skeletal muscle mass index (SMI, surrogate marker of sarcopenia) and low muscle density (MD, surrogate marker of myosteatosis) on patient survival after kidney transplantation (KT). Methods In a retrospective cohort of 200 kidney transplant recipients (KTr), we measured on an unenhanced cross‐sectional computed tomography scan taken at the level of the third lumbar vertebra within the previous year or at the time of KT, both SMI (muscle cross‐sectional area normalized for height2, reported in cm2/m2) and MD (mean attenuation of muscle cross‐sectional area, expressed in Hounsfield units). We determined age‐specific and sex‐specific normality thresholds on 130 healthy subjects. The baseline factors associated with low MD were assessed by logistic regression analysis. Cox proportional hazard univariable and multivariable models were constructed to identify predictive factors of patient survival. Results Among the 200 patients of the cohort, 123 were male (62%), and mean age was 54.8 ± 13.8 years. A total of 181 KTr required renal replacement therapy before KT (91%), and 36 KTr (18%) received repeat kidney transplant after previous failed KT. Mean MD was 30.6 ± 9 HU in men and 29.7 ± 8.3 HU in women, whereas SMI was 49.7 ± 8.6 cm2/m2 in men and 42.3 ± 7.3 cm2/m2 in women. MD was below the 2.5th percentile for the healthy population in 49 KTr (25%), defining the myosteatosis group, while SMI was below the 2.5th percentile for the reference population in 10 KTr (5%). Independent risk factors for myosteatosis were two or more KT [adjusted odds ratio (aOR) 5.2, 95% confidence interval (95% CI): 2.22–12.4, P = 0.0001], a history of stroke (aOR 3.7, 95% CI: 1.30–10.7, P = 0.015), and body mass index > 25 kg/m2 (aOR 2.94, 95% CI: 1.4–6.18, P = 0.004). Myosteatosis was independently associated with mortality [adjusted hazard ratio (aHR) 2.12, 95% CI: 1.06–4.24, P = 0.033], as were cardiovascular disease (HR 2.06, 95% CI: 1.02–4.15, P = 0.043) and age (aHR 1.06, 95% CI: 1.03–1.09, P = 0.0003). Low SMI was not associated with mortality. Conclusions Myosteatosis, which was more prevalent than low skeletal muscle mass, might be an important prognostic marker in patients undergoing KT.
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- 2022
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10. ATG-Fresenius increases the risk of red blood cell transfusion after kidney transplantation
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Maria Sebti, Camille Petit-Hoang, Btissam Chami, Étienne Audureau, Catherine Cordonnier-Jourdin, Muriel Paul, Franck Pourcine, Philippe Grimbert, Clément Ourghanlian, and Marie Matignon
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kidney transplantation ,anti-thymocyte globulins ,donor-specific anti-HLA antibodies ,red blood cell transfusion ,induction therapy ,Immunologic diseases. Allergy ,RC581-607 - Abstract
IntroductionIn sensitized deceased donor kidney allograft recipients, the most frequent induction therapy is anti-thymocyte globulins (ATG), including Thymoglobulin® (Thymo) and ATG-Fresenius (ATG-F).MethodsWe conducted a 3-year monocentric observational study to compare the impact of ATGs on hematological parameters. We included adult kidney transplant recipients treated with ATG induction therapy, either Thymo or ATG-F, on a one-in-two basis. The primary endpoint was red blood cell (RBC) transfusions within 14 days after transplantation.ResultsAmong 309 kidney allograft recipients, 177 (57.2%) received ATG induction, 90 (50.8 %) ATG-F, and 87 (49.2%) Thymo. The ATG-F group received significantly more RBC transfusions (63.3% vs. 46% p = 0.02) and in bigger volumes (p = 0.01). Platelet transfusion was similar in both groups. Within 14 and 30 days after transplantation, older age, ATG-F induction, and early surgical complication were independently associated with RBC transfusion. Patient survival rate was 95%, and the death-censored kidney allograft survival rate was 91.5% at 12 months post-transplantation. There was no difference in the incidence of acute rejection and infections or in the prevalence of anti-HLA donor-specific antibodies.DiscussionIn conclusion, after kidney transplantation, ATG-F is an independent risk factor for early RBC transfusion and early thrombocytopenia without clinical and biological consequences. These new data should be clinically considered, and alternatives to ATG should be further explored.
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- 2022
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11. Spatiotemporal AMPKα2 deletion in mice induces cardiac dysfunction, fibrosis and cardiolipin remodeling associated with mitochondrial dysfunction in males only
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Lucile Grimbert, Maria-Nieves Sanz, Mélanie Gressette, Catherine Rucker-Martin, Marta Novotova, Audrey Solgadi, Ahmed Karoui, Susana Gomez, Kaveen Bedouet, Eric Jacquet, Christophe Lemaire, Vladimir Veksler, Mathias Mericskay, Renée Ventura-Clapier, Jérôme Piquereau, and Anne Garnier
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Heart ,AMP-activated protein kinase ,Fibrosis ,Cardiolipins ,Energy metabolism ,Medicine ,Physiology ,QP1-981 - Abstract
Highlights AMPK is a metabolic sensor of cellular energy which regulates energy homeostasis. We generated a cardiac-specific inducible deletion of Ampkα2 and demonstrated that this deletion induces mild cardiac dysfunction in male only. Cardiac dysfunction observed in males was associated with cardiac fibrosis and cardiac cardiolipin remodeling that are not seen in females. Although no significant cardiac function alteration was noticed in ovariectomized female Ampkα2ciKO mice, these latter exhibited cardiac fibrosis and mild cardiolipins remodeling. Our results show a higher dependence on AMPK signaling fibrosis and cardiolipin biosynthesis/maturation in males, either due to the absence of female hormones protection or/and to the action of male hormones. This may contribute to the known difference in cardiovascular risk and outcome between sexes.
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- 2021
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12. Longitudinal evaluation of the impact of immunosuppressive regimen on immune responses to COVID-19 vaccination in kidney transplant recipients
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Aurélie Wiedemann, Céline Pellaton, Manon Dekeyser, Lydia Guillaumat, Marie Déchenaud, Corinne Krief, Christine Lacabaratz, Philippe Grimbert, Giuseppe Pantaleo, Yves Lévy, and Antoine Durrbach
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COVID-19 ,immunocompromised ,immunosuppressive regimen ,mRNA vaccine ,immune responses ,Medicine (General) ,R5-920 - Abstract
Immunocompromised patients have a high risk of death from SARS-CoV-2 infection. Vaccination with an mRNA vaccine may protect these patients against severe COVID-19. Several studies have evaluated the impact of immune-suppressive drug regimens on cellular and humoral responses to SARS-CoV-2 variants of concern in this context. We performed a prospective longitudinal study assessing specific humoral (binding and neutralizing antibodies against spike (S) and T-lymphocyte (cytokine secretion and polyfunctionality) immune responses to anti-COVID-19 vaccination with at least two doses of BNT162b2 mRNA vaccine in stable kidney transplant recipients (KTR) on calcineurin inhibitor (CNI)- or belatacept-based treatment regimens. Fifty-two KTR−31 receiving CNI and 21 receiving belatacept—were enrolled in this study. After two doses of vaccine, 46.9% of patients developed anti-S IgG. Anti-spike IgG antibodies were produced in only 21.4% of the patients in the belatacept group, vs. 83.3% of those in the CNI group. The Beta and Delta variants and, more importantly, the Omicron variant, were less well neutralized than the Wuhan strain. T-cell functions were also much weaker in the belatacept group than in the CNI group. Renal transplant patients have an impaired humoral response to BNT162b2 vaccination. Belatacept-based regimens severely weaken both humoral and cellular vaccine responses. Clinically, careful evaluations of at least binding IgG responses, and prophylactic or post-exposure strategies are strongly recommended for transplant recipients on belatacept-based regimens.
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- 2022
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13. Hypothermia for expanded criteria organ donors in kidney transplantation in France (HYPOREME): a multicentre, randomised controlled trial
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Canet, Emmanuel, Brule, Noëlle, Pere, Morgane, Feuillet, Fanny, Blancho, Gilles, Martin-Lefevre, Laurent, Garandeau, Claire, Asehnoune, Karim, Rozec, Bertrand, Duveau, Agnès, Dube, Laurent, Pierrot, Marc, Humbert, Stanislas, Tirot, Patrice, Boyer, Jean-Marc, Labadie, François, Robert, René, Benard, Thierry, Kerforne, Thomas, Thierry, Antoine, Lesieur, Olivier, Vincent, Jean-François, Lesouhaitier, Mathieu, Larmet, Raphaëlle, Vigneau, Cécile, Goepp, Angélique, Bouju, Pierre, Quentin, Charlotte, Egreteau, Pierre-Yves, Huet, Olivier, Renault, Anne, Le Meur, Yannick, Venhard, Jean-Christophe, Buchler, Matthias, Voellmy, Marie-Hélène, Herve, Fabien, Schnell, David, Courte, Anne, Glotz, Denis, Amrouche, Lucile, Hazzan, Marc, Kamar, Nassim, Moal, Valérie, Bourenne, Jérémy, Le Quintrec, Moglie, Morelon, Emmanuel, Kamel, Toufik, Grimbert, Philippe, Heng, Anne-Elisabeth, Merville, Pierre, Garin, Aude, Hiesse, Christian, Fermier, Brice, Mousson, Christiane, Guyot-Colosio, Charlotte, Bouvier, Nicolas, Rerolle, Jean-Philippe, Durrbach, Antoine, Drouin, Sarah, Caillard, Sophie, Frimat, Luc, Girerd, Sophie, Albano, Laetitia, Rostaing, Lionel, Bertrand, Dominique, Hertig, Alexandre, Westeel, Pierre-François, Montini, Florent, Delpierre, Eric, Dorez, Didier, Alamartine, Eric, Ouisse, Carole, Sébille, Véronique, and Reignier, Jean
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Expanded criteria donors help to increase graft availability, but provide organs with an increased risk of delayed graft function. We aimed to investigate whether donor hypothermia decreases the risk of delayed graft function compared with normothermia.
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- 2024
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14. Comparison of the iliac, vaginal and umbilical graft extraction in robot-assisted laparoscopic living donor nephrectomy
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Abdessater, Maher, Champy, Cécile M., da Costa, José Batista, Courcier, Jean, Yiou, René, Hoznek, Andras, Vordos, Dimitri, Grimbert, Philippe, Matignon, Marie, Londero, Tiphanie, le Corvoisier, Philippe, Salomon, Laurent, De la Taille, Alexandre, and Ingels, Alexandre
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- 2021
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15. Heart Transplantation, Either Alone or Combined With Liver and Kidney, a Viable Treatment Option for Selected Patients With Severe Cardiac Amyloidosis
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Soulef Guendouz, MD, Philippe Grimbert, MD, PhD, Costin Radu, MD, PhD, Daniel Cherqui, MD, PhD, Chady Salloum, MD, Nicolas Mongardon, MD, PhD, Sami Maghrebi, MD, Karim Belhadj, MD, Fabien Le Bras, MD, Emmanuel Teiger, MD, PhD, Jean-Paul Couetil, MD, PhD, Adriana Balan, MD, Mounira Kharoubi, MSc, Mélanie Bézard, MSc, Silvia Oghina, MD, Diane Bodez, MD, PhD, Luc Hittinger, MD, PhD, Vincent Audard, MD, PhD, Violaine Planté-Bordeneuve, MD, PhD, Alexandre De la Taille, MD, PhD, Eric Bergoend, MD, Valerie Frenkel, MD, PhD, Pascale Fanen, MD, PhD, Vincent Leroy, MD, PhD, Christophe Duvoux, MD, PhD, Maryvonnick Carmagnat, PharmD, Thierry Folliguet, MD, PhD, and Thibaud Damy, MD, PhD
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Surgery ,RD1-811 - Abstract
Background. Heart transplantation in cardiac amyloidosis (CA) patients is possible and generally considered for transplantation if other organs are not affected. In this study, we aimed to describe and assess outcome in patients following heart transplantations at our CA referral center. Methods. We assessed all CA patients that had heart transplantations at our center between 2005 and 2018. Patients with New York Heart Association status 3 out of 4, with poor short-term prognosis due to heart failure, despite treatment, and without multiple myeloma, systemic disease, severe neuropathic/digestive comorbidities, cancer, or worsening infections were eligible for transplantation. Hearts were transplanted by bicaval technique. Standard induction and immunosuppressive therapies were used. Survival outcome of CA patients after transplantation was compared with recipients with nonamyloid pathologies in France. Results. Between 2005 and 2018, 23 CA patients had heart transplants: 17 (74%) had light chain (light chain amyloidosis [AL]) and 6 (26%) had hereditary transthyretin (hereditary transthyretin amyloidosis [ATTRv]) CA. Also, 13 (57%) were male, and the mean age at diagnosis was 56.5 y (range, 47.7–62.8). Among AL patients, 13 had heart-only and 5 had heart-kidney transplantations. Among ATTRv patients, 1 had heart-only and 5 had heart-liver transplantations. The 1-y survival rate after transplantation was 78%, 70% with AL, and 100% with ATTRv. At 2 y, 74% were alive: 65% with AL and 100% with ATTRv. Conclusion. After heart transplantation, French CA and nonamyloid patients have similar survival outcomes. Among CA patients, ATTRv patients have better prognosis than those with AL, possibly due to the combined heart-liver transplantation. Selected CA patients should be considered for heart transplantations.
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- 2022
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16. Coagulation disorders during treatment with cefazolin and rifampicin: rare but dangerous
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I. Kouki, C. Montagner, W. Mauhin, J. London, T. Lazard, S. Grimbert, V. Zeller, and O. Lidove
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Orthopedic surgery ,RD701-811 - Abstract
We describe a 79-year-old man with spondylodiscitis and unknown pathogen, treated with cefazolin and rifampicin. He developed a massive digestive hemorrhage. Prothrombin time was prolonged with severe vitamin-K-dependent clotting-factor deficiency. Severe bleeding can occur during cefazolin and rifampicin use. This deficiency should be assessed before prescribing cefazolin–rifampicin and prothrombin time monitored.
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- 2021
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17. Continuous positive airway pressure for respiratory support during COVID-19 pandemic: a frugal approach from bench to bedside
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Guillaume Carteaux, Manuella Pons, François Morin, Samuel Tuffet, Arnaud Lesimple, Bilal Badat, Anne-Fleur Haudebourg, François Perier, Yvon Deplante, Constance Guillaud, Frédéric Schlemmer, Elena Fois, Nicolas Mongardon, Mehdi Khellaf, Karim Jaffal, Camille Deguillard, Philippe Grimbert, Raphaëlle Huguet, Keyvan Razazi, Nicolas de Prost, François Templier, François Beloncle, Alain Mercat, Laurent Brochard, Vincent Audard, Pascal Lim, Jean-Christophe Richard, Dominique Savary, and Armand Mekontso Dessap
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COVID-19 ,Acute hypoxemic respiratory failure ,Continuous positive airway pressure ,Frugal innovation ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background We describe a frugal approach (focusing on needs, performance, and costs) to manage a massive influx of COVID-19 patients with acute hypoxemic respiratory failure (AHRF) using the Boussignac valve protected by a filter (“Filter Frugal CPAP”, FF-CPAP) in and out the ICU. Methods (1) A bench study measured the impact of two filters with different mechanical properties on CPAP performances, and pressures were also measured in patients. (2) Non-ICU healthcare staff working in COVID-19 intermediate care units were trained with a video tutorial posted on a massive open online course. (3) A clinical study assessed the feasibility and safety of using FF-CPAP to maintain oxygenation and manage patients out of the ICU during a massive outbreak. Results Bench assessments showed that adding a filter did not affect the effective pressure delivered to the patient. The resistive load induced by the filter variably increased the simulated patient’s work of breathing (6–34%) needed to sustain the tidal volume, depending on the filter’s resistance, respiratory mechanics and basal inspiratory effort. In patients, FF-CPAP achieved pressures similar to those obtained on the bench. The massive training tool provided precious information on the use of Boussignac FF-CPAP on COVID-19 patients. Then 85 COVID-19 patients with ICU admission criteria over a 1-month period were studied upon FF-CPAP initiation for AHRF. FF-CPAP significantly decreased respiratory rate and increased SpO2. Thirty-six (43%) patients presented with respiratory indications for intubation prior to FF-CPAP initiation, and 13 (36%) of them improved without intubation. Overall, 31 patients (36%) improved with FF-CPAP alone and 17 patients (20%) did not require ICU admission. Patients with a respiratory rate > 32 breaths/min upon FF-CPAP initiation had a higher cumulative probability of intubation (p
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- 2021
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18. Impact of targeted hypothermia in expanded-criteria organ donors on recipient kidney-graft function: study protocol for a multicentre randomised controlled trial (HYPOREME)
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Thomas Kerforne, Christiane Mousson, Karim Asehnoune, Fanny Feuillet, Olivier Huet, Bertrand Rozec, Aude Garin, Alexandre Hertig, Jeremy Bourenne, Nassim Kamar, Emmanuel Morelon, Denis Glotz, Morgane Péré, Thierry Boulain, Jean Reignier, René Robert, Dominique Bertrand, Pierre-Yves Egreteau, Thierry Benard, Raphaëlle Larmet, Luc Frimat, Sophie Girerd, Mathias Büchler, Anne Renault, Patrice Tirot, Cécile Vigneau, Eric Delpierre, David Schnell, Olivier Lesieur, Lionel Rostaing, Mathieu Lesouhaitier, Laurent Martin-Lefevre, Antoine Durrbach, Noëlle Brulé, Emmanuel Canet, Maryvonne Hourmant, Agnes Duveau, Laurent Dube, Marc Pierrot, Stanislas Humbert, Jean-Marc Boyer, François Labadie, Antoine Thierry, Jean-François Vincent, Angelique Goepp, Pierre Bouju, Charlotte Quentin, Yannick Le Meur, Jean-Christophe Venhard, Olivier Michel, Marie-Hélène Voellmy, Fabien Herve, Anne Courte, Lucile Amrouche, Marc Hazzan, Valerie Moal, Moglie Le Quintrec-Donnette, Philippe Grimbert, Anne Elisabeth Heng, Pierre Merville, Christian Hiesse, Brice Fermier, Charlotte Guyot-Colosio, Nicolas Bouvier, Jean-Philippe Rerolle, Sarah Drouin, Sophie Caillard, Laetitia Albano, Pierre-Francois Westeel, Florent Montini, Dider Dorez, Eric Alamartine, Carole Ouisse, and Veronique Sebille
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Medicine - Abstract
Introduction Expanded-criteria donors (ECDs) are used to reduce the shortage of kidneys for transplantation. However, kidneys from ECDs are associated with an increased risk of delayed graft function (DGF), a risk factor for allograft loss and mortality. HYPOREME will be a multicentre randomised controlled trial (RCT) comparing targeted hypothermia to normothermia in ECDs, in a country where the use of machine perfusion for organ storage is the standard of care. We hypothesise that hypothermia will decrease the incidence of DGF.Methods and analysis HYPOREME is a multicentre RCT comparing the effect on kidney function in recipients of targeted hypothermia (34°C–35°C) and normothermia (36.5°C–37.5°C) in the ECDs. The temperature intervention starts from randomisation and is maintained until aortic clamping in the operating room. We aim to enrol 289 ECDs in order to analyse the kidney function of 516 recipients in the 53 participating centres. The primary outcome is the occurrence of DGF in kidney recipients, defined as a requirement for renal replacement therapy within 7 days after transplantation (not counting a single session for hyperkalemia during the first 24 hours). Secondary outcomes include the proportion of patients with individual organs transplanted in each group; the number of organs transplanted from each ECD and the vital status and kidney function of the recipients 7 days, 28 days, 3 months and 1 year after transplantation. An interim analysis is planned after the enrolment of 258 kidney recipients.Ethics and dissemination The trial was approved by the ethics committee of the French Intensive Care Society (CE-SRLF-16-07) on 26 April 2016 and by the competent French authorities on 20 April 2016 (Comité de Protection des Personnes-TOURS-Région Centre-Ouest 1, registration #2016-S3). Findings will be published in peer-reviewed journals and presented during national and international scientific meetings.Trial registration number NCT03098706.
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- 2022
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19. Impact of a Dedicated Pretransplant Infectious Disease Consultation on Respiratory Tract Infections in Kidney Allograft Recipients: A Retrospective Study of 516 Recipients
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Elsa Feredj, Etienne Audureau, Anna Boueilh, Vincent Fihman, Slim Fourati, Jean-Daniel Lelièvre, Sébastien Gallien, Philippe Grimbert, Marie Matignon, and Giovanna Melica
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vaccination ,pneumonia ,kidney transplantation ,Medicine - Abstract
Background: Respiratory tract infections (RTIs) are a leading cause of death after kidney transplant. Preventive strategies may be implemented during a dedicated infectious disease consultation (IDC) before transplantation. Impact of IDC on RTIs after transplant has not been determined. Methods: We conducted a monocentric retrospective cohort analysis including all kidney transplant recipients from January 2015 to December 2019. We evaluated the impact of IDC on RTIs and identified risk and protective factors associated with RTIs. Results: We included 516 kidney transplant recipients. Among these, 145 had an IDC before transplant. Ninety-five patients presented 123 RTIs, including 75 (61%) with pneumonia. Patient that benefited from IDC presented significantly less RTIs (p = 0.049). RTIs were an independent risk factor of mortality (HR = 3.64 (1.97–6.73)). Independent risk factors for RTIs included HIV (OR = 3.33 (1.43–7.74)) and HCV (OR = 3.76 (1.58–8.96)). IDC was identified as an independent protective factor (OR = 0.48 (0.26–0.88)). IDC prior to transplantation is associated with diminished RTIs and is an independent protective factor. RTIs after kidney transplant are an independent risk factor of death. Implementing systematic IDC may have an important impact on reducing RTIs and related morbidity and mortality.
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- 2023
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20. Spatiotemporal AMPKα2 deletion in mice induces cardiac dysfunction, fibrosis and cardiolipin remodeling associated with mitochondrial dysfunction in males only
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Grimbert, Lucile, Sanz, Maria-Nieves, Gressette, Mélanie, Rucker-Martin, Catherine, Novotova, Marta, Solgadi, Audrey, Karoui, Ahmed, Gomez, Susana, Bedouet, Kaveen, Jacquet, Eric, Lemaire, Christophe, Veksler, Vladimir, Mericskay, Mathias, Ventura-Clapier, Renée, Piquereau, Jérôme, and Garnier, Anne
- Published
- 2021
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21. Continuous positive airway pressure for respiratory support during COVID-19 pandemic: a frugal approach from bench to bedside
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Carteaux, Guillaume, Pons, Manuella, Morin, François, Tuffet, Samuel, Lesimple, Arnaud, Badat, Bilal, Haudebourg, Anne-Fleur, Perier, François, Deplante, Yvon, Guillaud, Constance, Schlemmer, Frédéric, Fois, Elena, Mongardon, Nicolas, Khellaf, Mehdi, Jaffal, Karim, Deguillard, Camille, Grimbert, Philippe, Huguet, Raphaëlle, Razazi, Keyvan, de Prost, Nicolas, Templier, François, Beloncle, François, Mercat, Alain, Brochard, Laurent, Audard, Vincent, Lim, Pascal, Richard, Jean-Christophe, Savary, Dominique, and Mekontso Dessap, Armand
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- 2021
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22. HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers
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Nizar Joher, Marie Matignon, and Philippe Grimbert
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anti-CD38 ,daratumumab ,HLA desensitization ,DSA ,solid organ transplantation ,Immunologic diseases. Allergy ,RC581-607 - Abstract
The presence of anti-human leucocyte antigen (HLA) antibodies in the potential solid organ transplant recipient’s blood is one of the main barriers to access to a transplantation. The HLA sensitization is associated with longer waitlist time, antibody mediated rejection and transplant lost leading to increased recipient’s morbidity and mortality. However, solid organ transplantation across the HLA immunological barriers have been reported in recipients who were highly sensitized to HLA using desensitization protocols. These desensitization regimens are focused on the reduction of circulating HLA antibodies. Despite those strategies improve rates of transplantation, it remains several limitations including persistent high rejection rate and worse long-term outcomes when compare with non-sensitized recipient population. Currently, interest is growing in the development of new desensitization approaches which, beyond targeting antibodies, would be based on the modulation of alloimmune pathways. Plasma cells appears as an interesting target given their critical role in antibody production. In the last decade, CD38-targeting immunotherapies, such as daratumumab, have been recognized as a key component in the treatment of myeloma by inducing an important plasma cell depletion. This review focuses on an emerging concept based on targeting CD38 to desensitize in the field of transplantation.
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- 2021
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23. Phenotypic and Transcriptomic Lymphocytes Changes in Allograft Recipients After Intravenous Immunoglobulin Therapy in Kidney Transplant Recipients
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Caroline Pilon, Jeremy Bigot, Cynthia Grondin, Allan Thiolat, Philippe Lang, José L. Cohen, Philippe Grimbert, and Marie Matignon
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kidney transplantation ,high-dose intravenous immunoglobulin ,donor specific antibodies ,lymphocytes phenotype ,immunomodulation ,Immunologic diseases. Allergy ,RC581-607 - Abstract
High dose intravenous immunoglobulin (IVIG) are widely used after kidney transplantation and its biological effect on T and B cell phenotype in the context of maintenance immunosuppression was not documented yet. We designed a monocentric prospective cohort study of kidney allograft recipients with anti-HLA donor specific antibodies (DSA) without acute rejection on screening biopsies treated with prophylactic high-dose IVIG (2 g/kg) monthly for 2 months. Any previous treatment with Rituximab was an exclusion criterion. We performed an extensive analysis of phenotypic and transcriptomic T and B lymphocytes changes and serum cytokines after treatment (day 60). Twelve kidney transplant recipients who completed at least two courses of high-dose IVIG (2 g/kg) were included in a median time of 45 (12–132) months after transplant. Anti-HLA DSA characteristics were similar before and after treatment. At D60, PBMC population distribution was similar to the day before the first infusion. CD8+ CD45RA+ T cells and naïve B-cells (Bm2+) decreased (P = 0.03 and P = 0.012, respectively) whereas Bm1 (mature B-cells) increased (P = 0.004). RORγt serum mRNA transcription factor and CD3 serum mRNA increased 60 days after IVIG (P = 0.02 for both). Among the 25 cytokines tested, only IL-18 serum concentration significantly decreased at D60 (P = 0.03). In conclusion, high dose IVIG induced limited B cell and T cell phenotype modifications that could lead to anti-HLA DSA decrease. However, no clinical effect has been isolated and the real benefit of prophylactic use of IVIG after kidney transplantation merits to be questioned.
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- 2020
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24. Physiological Starvation Promotes Caenorhabditis elegans Vulval Induction
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Stéphanie Grimbert, Amhed Missael Vargas Velazquez, and Christian Braendle
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Caenorhabditis ,LIN-3 ,mutational penetrance ,TOR-S6K ,vulval cell fate patterning ,Genetics ,QH426-470 - Abstract
Studying how molecular pathways respond to ecologically relevant environmental variation is fundamental to understand organismal development and its evolution. Here we characterize how starvation modulates Caenorhabditis elegans vulval cell fate patterning – an environmentally sensitive process, with a nevertheless robust output. Past research has shown many vulval mutants affecting EGF-Ras-MAPK, Delta-Notch and Wnt pathways to be suppressed by environmental factors, such as starvation. Here we aimed to resolve previous, seemingly contradictory, observations on how starvation modulates levels of vulval induction. Using the strong starvation suppression of the Vulvaless phenotype of lin-3/egf reduction-of-function mutations as an experimental paradigm, we first tested for a possible involvement of the sensory system in relaying starvation signals to affect vulval induction: mutation of various sensory inputs, DAF-2/Insulin or DAF-7/TGF-β signaling did not abolish lin-3(rf) starvation suppression. In contrast, nutrient deprivation induced by mutation of the intestinal peptide transporter gene pept-1 or the TOR pathway component rsks-1 (the ortholog of mammalian P70S6K) very strongly suppressed lin-3(rf) mutant phenotypes. Therefore, physiologically starved animals induced by these mutations tightly recapitulated the effects of external starvation on vulval induction. While both starvation and pept-1 RNAi were sufficient to increase Ras and Notch pathway activities in vulval cells, the highly penetrant Vulvaless phenotype of a tissue-specific null allele of lin-3 was not suppressed by either condition. This and additional results indicate that partial lin-3 expression is required for starvation to affect vulval induction. These results suggest a cross-talk between nutrient deprivation, TOR-S6K and EGF-Ras-MAPK signaling during C. elegans vulval induction.
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- 2018
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25. Human Apoptotic Cells, Generated by Extracorporeal Photopheresis, Modulate Allogeneic Immune Response
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Caroline Pilon, Thomas Stehlé, Asma Beldi-Ferchiou, Marie Matignon, Allan Thiolat, Aude Burlion, Cynthia Grondin, Brigitte Birebent, France Pirenne, Hélène Rouard, Philippe Lang, Gilles Marodon, Philippe Grimbert, and José L. Cohen
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tolerance ,NSG mice ,immunomodulation ,transplantation ,apoptotic cell ,Immunologic diseases. Allergy ,RC581-607 - Abstract
The induction of specific and sustainable tolerance is a challenging issue in organ transplantation. The discovery of the immunosuppressive properties of apoptotic cells in animal models has paved the way for their use in human transplantation. In this work, we aimed to define a stable, reproducible, and clinically compatible production procedure of human apoptotic cells (Apo-cells). Using a clinically approved extracorporeal photopheresis technique, we have produced and characterized phenotypically and functionally human apoptotic cells. These Apo-cells have immunosuppressive properties proved in vitro and in vivo in NOD/SCID/γC mice by their capacity to modulate an allogeneic response following both a direct and an indirect antigen presentation. These results brought the rationale for the use of Apo-cells in tolerance induction protocol for organ transplantation.
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- 2019
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26. Robotic-assisted laparoscopy living donor nephrectomy: Technique and results of a monocentric retrospective series
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T, Pelegrin, C M, Champy, F, Gerbaud, M, Miro-Padovani, P, Grimbert, M-B, Matignon, A, Durrbach, A, De La Taille, and A, Ingels
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Robotic Surgical Procedures ,Urology ,Living Donors ,Tissue and Organ Harvesting ,Humans ,Female ,Laparoscopy ,Kidney ,Nephrectomy ,Retrospective Studies - Abstract
Robot-assisted nephrectomy for living kidney donation (LKD) has been described in the literature as a safe and reproducible technique in high volume centers with extensive robotic surgery experience. Any surgical procedure in a healthy individual ought to be safe in regards to complications. The objective of this study was to evaluate the Robotic-assisted Living Donor Nephrectomy (RLDN) experience in a robotic surgery expert center.This is a retrospective study from 11/2011 and 12/2019. In total, 118 consecutive Living Donor (LD) kidney transplants were performed at our institution. All the procedures were performed by robotic-assisted laparoscopic approach. Extraction was performed by iliac (IE), vaginal (VE) or umbilical extraction (UE). The left kidney was preferred even if the vascular anatomy was not modal.For donors: the median operative time was 120min with 50mL of blood loss. The median warm ischemia time was 4min, with a non-significant shorter duration with the UE (4min) in comparison with IE or VE (5min). Nine patients had postoperative complications including 1 grade II (blood transfusion) and 1 grade IIIb (vaginal bleeding after VE). None of our procedures were converted to open surgeries and no deaths were reported. For the recipients: 1.7% presented delayed graft function; their median GFR at 1 year was 61mL/min/1.73mRLDN in an expert center appears to be a safe technique. The advantages of the robot device in terms of ergonomy don't hamper the surgical outcomes. Donor, recipient and graft survivals seem comparable to the reported laparoscopic outcomes in the literature.
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- 2022
27. Pech Piélat (Séniergues, Lot) : un relais routier antique en pays cadurque
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Laurent Grimbert, Vivien Mathé, and Marion Druez
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Archaeology ,CC1-960 - Abstract
The Pech Piélat digs (Séniergues, Lot) of Autumn 1998 have revealed the existence of an antique edifice and road that were hitherto unknown. Situated in a proto-historical location from the Iron Age, the edifice dates from the end of the 1st century AD, followed by a phase of renovations, notably the addition of a thermal wing at the beginning of the 2nd century AD. The date at which the site was abandoned is, however, difficult to determine (perhaps the 5th century AD). During the excavation phase, the restricted surface area of the project meant that it was difficult to assess its purpose. In order to resolve a number of questions, a programmed operation of electrical resistivity tomography (ULR Valor and UMR 6250 CNRS, La Rochelle University) was conducted in March 2008 (financed by the DRAC Midi-Pyrénées) on areas that were not accessible during the digs. The principal findings are presented in this study. A comparison of the archaeological data and the results of the tomography has enabled the identification and description of a small relay station along the Divona-Augustoritum route. The presence of the road, a particularly rare example of an antique route clearly identified in the Cadurci region, provides new elements for the mapping of the ancient routes.
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- 2016
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28. Bédier et la légende tristanienne
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Joan Tasker Grimbert
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Histoire de la philologie romane ,Bédier, Joseph ,Tristan et Iseut ,Béroul ,Thomas d’Angleterre ,Marie de France ,Fachgeschichte ,Romanische Philologie ,Romanic languages ,PC1-5498 ,French literature - Italian literature - Spanish literature - Portuguese literature ,PQ1-3999 - Abstract
Le Roman de Tristan et Iseutde Bédier a propagé le concept wagnérien que la légende était « un conte d’amour et de mort ». Mais l’accord amour/mort n’était-il pas déjà présent dans les textes médiévaux ? En confrontant le roman de Bédier avec des textes et images datant du Moyen Âge on découvre que pour les poètes et artistes médiévaux l’essence de la passion tristanienne n’était point mortifère. En effet, les qualités que les poètes médiévaux associaient avec les amants cornouaillais – et qu’ils appréciaient avant tout – étaient l’intensité de leur passion, leur aptitude pour la ruse et leur fidélité à toute épreuve. eRoman de Tristan et Iseut de Bédier a propagé le concept wagnérien que la légende était « un conte d’amour et de mort ». Mais l’accord amour/mort n’était-il pas déjà présent dans les textes médiévaux ? En confrontant le roman de Bédier avec des textes et images datant du Moyen Âge on découvre que pour les poètes et artistes médiévaux l’essence de la passion tristanienne n’était point mortifère. En effet, les qualités que les poètes médiévaux associaient avec les amants cornouaillais – et qu’ils appréciaient avant tout – étaient l’intensité de leur passion, leur aptitude pour la ruse et leur fidélité à toute épreuve.
- Published
- 2019
29. Évaluation des pratiques professionnelles concernant les inhibiteurs de la pompe à protons en médecine générale
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Rudelle, Karen, Kazmierczak, Camille, Grimbert, Dimitri, Dumoitier, Nathalie, and Pfender, Elodie
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- 2023
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30. Gallium nitride MEMS resonators: how residual stress impacts design and performances
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Morelle, Christophe, Théron, Didier, Derluyn, Joff, Degroote, Stefan, Germain, Marianne, Zhang, Victor, Buchaillot, Lionel, Grimbert, Bertrand, Tilmant, Pascal, Vaurette, François, Roch-Jeune, Isabelle, Brandli, Virginie, Avramovic, Vanessa, Okada, Etienne, and Faucher, Marc
- Published
- 2017
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31. Intravenous immunoglobulin therapy in kidney transplant recipients with de novo DSA: Results of an observational study.
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Marie Matignon, Caroline Pilon, Morgane Commereuc, Cynthia Grondin, Claire Leibler, Tomek Kofman, Vincent Audard, José Cohen, Florence Canoui-Poitrine, and Philippe Grimbert
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Medicine ,Science - Abstract
Approximately 25% of kidney transplant recipients develop de novo anti-HLA donor-specific antibodies (dnDSA) leading to acute antibody-mediated rejection (ABMR) in 30% of patients. Preemptive therapeutic strategies are not available.We conducted a prospective observational study including 11 kidney transplant recipients. Inclusion criteria were dnDSA occurring within the first year after transplant and normal allograft biopsy. All patients were treated with high-dose IVIG (2 g/kg 0, 1 and 2 months post-dnDSA). The primary efficacy outcome was incidence of clinical and subclinical acute ABMR within 12 months after dnDSA detection as compared to a historical control group (IVIG-).Acute ABMR occurred in 2 or 11 patients in the IVIG+ group and in 1 of 9 patients in the IVIG- group. IVIG treatment did not affect either class I or class II DSA, as observed at the end of the follow-up. IVIG treatment significantly decreased FcγRIIA mRNA expression in circulating leukocytes, but did not affect the expression of any other markers of B cell activation.In this first pilot study including kidney allograft recipients with early dnDSA, preemptive treatment with high-dose IVIG alone did not prevent acute ABMR and had minimal effects on DSA outcome and B cell phenotype.
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- 2017
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32. Renal artery fibromuscular dysplasia in Pompe disease: A case report
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Evangelia Pappa, Constantinos Papadopoulos, Philippe Grimbert, Pascal Laforêt, and Guillaume Bassez
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Medicine (General) ,R5-920 ,Biology (General) ,QH301-705.5 - Abstract
Vascular involvement in Late Onset Pompe Disease, glycogen storage disease type II characterized by limb-girdle muscle and diaphragmatic weakness, is well documented. Abnormalities of posterior cerebral circulation have mostly been reported, whereas there are also cases of associated extracerebral arteriopathy. We report the case of a 42-year-old man diagnosed with LOPD a year after renal infarct due to renal artery fibromuscular dysplasia. We propose that the association of LOPD and arteriopathy should always be considered in clinical practice. Keywords: Muscle disease, Glycogenoses, Metabolic disease (inherited), All clinical neurology
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- 2018
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33. Inducible Cardiac-Specific Deletion of Sirt1 in Male Mice Reveals Progressive Cardiac Dysfunction and Sensitization of the Heart to Pressure Overload
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Maria-Nieves Sanz, Lucile Grimbert, Maryline Moulin, Mélanie Gressette, Catherine Rucker-Martin, Christophe Lemaire, Mathias Mericskay, Vladimir Veksler, Renée Ventura-Clapier, Anne Garnier, and Jérôme Piquereau
- Subjects
sirtuin 1 ,heart ,mitochondria ,cardiac function ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Heart failure is associated with profound alterations of energy metabolism thought to play a major role in the progression of this syndrome. SIRT1 is a metabolic sensor of cellular energy and exerts essential functions on energy metabolism, oxidative stress response, apoptosis, or aging. Importantly, SIRT1 deacetylates the peroxisome proliferator-activated receptor gamma co-activator 1α (PGC-1α), the master regulator of energy metabolism involved in mitochondrial biogenesis and fatty acid utilization. However, the exact role of SIRT1 in controlling cardiac energy metabolism is still incompletely understood and conflicting results have been obtained. We generated a cardio-specific inducible model of Sirt1 gene deletion in mice (Sirt1ciKO) to decipher the role of SIRT1 in control conditions and following cardiac stress induced by pressure overload. SIRT1 deficiency induced a progressive cardiac dysfunction, without overt alteration in mitochondrial content or properties. Sixteen weeks after Sirt1 deletion an increase in mitochondrial reactive oxygen species (ROS) production and a higher rate of oxidative damage were observed, suggesting disruption of the ROS production/detoxification balance. Following pressure overload, cardiac dysfunction and alteration in mitochondrial properties were exacerbated in Sirt1ciKO mice. Overall the results demonstrate that SIRT1 plays a cardioprotective role on cardiac energy metabolism and thereby on cardiac function.
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- 2019
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34. Immune Responses after a Third Dose of mRNA Vaccine Differ in Virus-Naive versus SARS-CoV-2? Recovered Dialysis Patients
- Author
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Attias, Philippe, Azzaoui, Imane, El Karoui, Khalil, de La Selle, Andr?a, Sokal, Aur?lien, Chappert, Pascal, Grimbert, Philippe, Fernandez, Ignacio, Bouvier, Magali, Samson, Chlo?, Dahmane, Djamal, Rieu, Philippe, Nizard, Patrice, Fourati, Slim, Sakhi, Hamza, Mah?vas, Matthieu, Audard, Vincent, Bentaarit, Boutheina, Boueilh, Anna, Gallien, S?bastien, Grimbert, Philippe, Hue, Sophie, Joher, Nizar, Jouan, Narindra, Lamriben, Larbi, Leli?vre, Jean-Daniel, Lepeule, Rapha?l, Mah?vas, Matthieu, Matignon, Marie, Melica, Giovanna, Oniszczuk, Julie, Pawlotsky, Jean-Michel, Stehl?, Thomas, Vindrios, William, and Wemmert, Charlotte
- Published
- 2022
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35. Nonskeletal and skeletal effects of high doses versus low doses of vitamin D3in renal transplant recipients: Results of the VITALE (VITamin D supplementation in renAL transplant recipients) study, a randomized clinical trial
- Author
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Courbebaisse, Marie, Bourmaud, Aurelie, Souberbielle, Jean-Claude, Sberro-Soussan, Rebecca, Moal, Valérie, Le Meur, Yannick, Kamar, Nassim, Albano, Laetitia, Thierry, Antoine, Dantal, Jacques, Danthu, Clément, Moreau, Karine, Morelon, Emmanuel, Heng, Anne-Elisabeth, Bertrand, Dominique, Arzouk, Nadia, Perrin, Peggy, Morin, Marie-Pascale, Rieu, Philippe, Presne, Claire, Grimbert, Philippe, Ducloux, Didier, Büchler, Matthias, Le Quintrec, Moglie, Ouali, Nacéra, Pernin, Vincent, Bouvier, Nicolas, Durrbach, Antoine, Alamartine, Eric, Randoux, Christine, Besson, Virginie, Hazzan, Marc, Pages, Justine, Colas, Sandra, Piketty, Marie-Liesse, Friedlander, Gérard, Prié, Dominique, Alberti, Corinne, and Thervet, Eric
- Abstract
Vitamin D sufficiency is associated with a reduced risk of fractures, diabetes mellitus, cardiovascular events, and cancers, which are frequent complications after renal transplantation. The VITALE (VITamin D supplementation in renAL transplant recipients) study is a multicenter double-blind randomized trial, including nondiabetic adult renal transplant recipients with serum 25-hydroxy vitamin D (25(OH) vitamin D) levels of <30 ng/mL, which is randomized 12 to 48 months after transplantation to receive high (100 000 IU) or low doses (12 000 IU) of cholecalciferol every 2 weeks for 2 months and then monthly for 22 months. The primary outcome was a composite endpoint, including diabetes mellitus, major cardiovascular events, cancer, and death. Of 536 inclusions (50.8 [13.7] years, 335 men), 269 and 267 inclusions were in the high-dose and low-dose groups, respectively. The serum 25(OH) vitamin D levels increased by 23 versus 6 ng/mL in the high-dose and low-dose groups, respectively (P< .0001). In the intent-to-treat analysis, 15% versus 16% of the patients in the high-dose and low-dose groups, respectively, experienced a first event of the composite endpoint (hazard ratio, 0.94 [0.60-1.48]; P= .78), whereas 1% and 4% of patients in the high-dose and low-dose groups, respectively, experienced an incident symptomatic fracture (odds ratio, 0.24 [0.07-0.86], P= .03). The incidence of adverse events was similar between the groups. After renal transplantation, high doses of cholecalciferol are safe but do not reduce extraskeletal complications (trial registration: ClinicalTrials.gov; identifier: NCT01431430).
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- 2023
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36. Low incidence of acute rejection within 6 months of kidney transplantation in HIV‐infected recipients treated with raltegravir: the Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS) 153 TREVE trial
- Author
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M, Matignon, J-D, Lelièvre, A, Lahiani, K, Abbassi, D, Desvaux, A, Diallo, M-N, Peraldi, A-M, Taburet, J, Saillard, C, Delaugerre, D, Costagliola, L, Assoumou, P, Grimbert, François, Dabis, Department of Cancer Services and Clinical Oncology, Charing Cross Hospital, Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Sorbonne Université (SU), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-IFR10, Unité de la recherche fondamentale et clinique sur l' hépatite virale, France Recherche Nord & Sud Asdi-VIH Hépatites, Agence Nationale de Recherche sur le Sida, Agence Nationale de Recherches sur le Sida et les Hépatites Virales (ANRS), 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), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)
- Subjects
Adult ,Graft Rejection ,Male ,0301 basic medicine ,medicine.medical_specialty ,Anti-HIV Agents ,kidney transplantation ,HIV Infections ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases ,Raltegravir Potassium ,Internal medicine ,end-stage kidney disease ,medicine ,Humans ,Pharmacology (medical) ,Prospective Studies ,030212 general & internal medicine ,Sida ,Kidney transplantation ,biology ,business.industry ,Incidence ,Health Policy ,Incidence (epidemiology) ,HIV ,Middle Aged ,Viral Load ,medicine.disease ,Raltegravir ,biology.organism_classification ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,030112 virology ,3. Good health ,Transplantation ,Regimen ,[SDV.MP]Life Sciences [q-bio]/Microbiology and Parasitology ,Infectious Diseases ,HIV-associated nephropathy ,[SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology ,HIV-1 ,Female ,raltegravir ,business ,Viral load ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,medicine.drug - Abstract
International audience; Objectives: High rates of clinical acute rejection after kidney transplantation have been reported in people living with HIV (PLHIV), probably as a consequence of drug interactions. We therefore investigated the incidence of acute rejection within 6 months of transplantation in HIV-infected recipients treated with a protease-inhibitor-free raltegravir-based regimen.Methods: The Agence Nationale de Recherche sur le Sida et les Hépatites Virales (ANRS) 153 TREVE (NCT01453192) study was a prospective multicentre single-arm trial in adult PLHIV awaiting kidney transplantation, with viral load < 50 HIV-1 RNA copies/mL, CD4 T-cell count > 200 cells/μL, and HIV-1 strains sensitive to raltegravir, aiming to demonstrate 6-month clinical acute rejection rates < 30%. Time to transplantation was compared with that for uninfected subjects matched for age, sex and registration date.Results: In total, 61 participants were enrolled in the study, and 26 underwent kidney transplantation. Two participants experienced clinical acute rejection, corresponding to an estimated clinical acute rejection rate of 8% [95% confidence interval (CI) 2-24%] at 6 and 12 months post-transplantation. HIV infection remained under control in all but one participant, who temporarily stopped antiretroviral treatment. Median time to transplantation was longer in PLHIV than in controls (4.3 versus 2.8 years, respectively; P = 0.002) and was not influenced by blood group.Conclusions: Acute rejection rates were low after kidney transplantation in PLHIV treated with a raltegravir-based regimen. However, PLHIV have poorer access to transplantation than HIV-uninfected individuals after registration on the waiting list.
- Published
- 2019
37. Evidence of surface states for AlGaN/GaN/SiC HEMTs passivated Si3N4 by CDLTS
- Author
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Gassoumi, M., Grimbert, B., Gaquiere, C., and Maaref, H.
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- 2012
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38. In vitro study and semiempirical model for aerosol delivery control during mechanical ventilation
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Vecellio, Laurent, Guérin, Claude, Grimbert, Daniel, De Monte, Michele, and Diot, Patrice
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- 2005
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39. LP-MOCVD growth of GaAlN/GaN heterostructures on Silicon Carbide. Application to HEMT’s devices.
- Author
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di FortePoisson, M.-A., Magis, M., Tordjman, M., Aubry, R., Peschang, M., Delage, S. L., di Persio, J., Grimbert, B., Hoel, V., Delos, E., Ducatteau, D., and Gaquiere, C.
- Published
- 2003
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40. Long-term results of a prospective randomized study comparing two immunosuppressive regimens, one with and one without CsA, in low-risk renal transplant recipients
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Grimbert, Philippe, Baron, Christophe, Fruchaud, Ghislaine, Hemery, François, Desvaux, Dominique, Buisson, Claude, Chopin, Dominique, Dahmane, Djamel, Remy, Philippe, Pastural, Myriam, Abbou, Claude, Weil, Bertrand, and Lang, Philippe
- Published
- 2002
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41. Association Between Maintenance Immunosuppressive Regimens and COVID-19 Mortality in Kidney Transplant Recipients
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Gérard, Alexandre O., Barbosa, Susana, Anglicheau, Dany, Couzi, Lionel, Hazzan, Marc, Thaunat, Olivier, Blancho, Gilles, Caillard, Sophie, Sicard, Antoine, Caillard, Sophie, Moulin, Bruno, Fafi-Kremer, Samira, Hazzan, Marc, Anglicheau, Dany, Hertig, Alexandre, Tourret, Jérôme, Barrou, Benoit, Morelon, Emmanuel, Thaunat, Olivier, Couzi, Lionel, Merville, Pierre, Moal, Valérie, Legris, Tristan, Westeel, Pierre-François, Jaureguy, Maïté, Frimat, Luc, Ducloux, Didier, Bamoulid, Jamal, Bertr, Dominique, Tsimaratos, Michel, Garaix-Gilardo, Florentine, Dumortier, Jérôme, Mussot, Sacha, Roux, Antoine, Sebbag, Laurent, Le Meur, Yannick, Blancho, Gilles, Masset, Christophe, Kamar, Nassim, Francois, Hélène, Rondeau, Eric, Bouvier, Nicolas, Mousson, Christiane, Buchler, Matthias, Gatault, Philippe, Augusto, Jean-François, Duveau, Agnès, Vigneau, Cécile, Morin, Marie-Christine, Chemouny, Jonathan, Golbin, Leonard, Grimbert, Philippe, Matignon, Marie, Durrbach, Antoine, Greze, Clarisse, Snanoudj, Renaud, Colosio, Charlotte, Schvartz, Betoul, Malvezzi, Paolo, Mariat, Christophe, Thierry, Antoine, Le Quintrec, Moglie, Sicard, Antoine, Rerolle, Jean Philippe, Heng, Anne-Élisabeth, Garrouste, Cyril, Coponat, Henri Vacher, Epailly, Éric, Brugiere, Olivier, Dharancy, Sébastien, Salame, Éphrem, and Saliba, Faouzi
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- 2022
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42. Bumps and waves in a two-dimensional multilayer neural field model
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Faugeras Olivier and Grimbert François
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Neurosciences. Biological psychiatry. Neuropsychiatry ,RC321-571 ,Neurophysiology and neuropsychology ,QP351-495 - Published
- 2007
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43. Long-term survival benefit with dual kidney transplantation: analysis of French cohort between 2002 and 2014 and strategies to optimize the allocation of very extended criteria donor kidneys
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C. Legeai, Yann Neuzillet, M. Peraldi, P. Grimbert, Emilie Savoye, R. Snanoudj, Matthieu Durand, F. Kerbaul, Lionel Badet, M. Macher, N. Ouali, M. Pastural, and C. Legendre
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Pediatrics ,medicine.medical_specialty ,Dual kidney transplantation ,business.industry ,Urology ,Cohort ,Long term survival ,medicine ,Extended criteria ,business - Published
- 2021
44. La consultation d’infectiologie avant transplantation rénale est un moyen d’optimiser la prévention vaccinale et le traitement de la tuberculose latente : une étude de cohorte prospective
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Etienne Audureau, P. Grimbert, F. Runyo, C. Gomart, A. Boueilh, W. Vindrios, Giovanna Melica, S. Gallien, and Marie Matignon
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Infectious Diseases - Abstract
Introduction Les infections sont la principale cause de mortalite non cardiovasculaire apres transplantation renale (TR). Malgre l’existence de recommandations de prevention avant TR, celles-ci restent peu appliquees. Nous decrivons l’interet d’une consultation d’infectiologie avant la TR comme outil pour ameliorer la prevention anti-infectieuse dans ce contexte. Materiels et methodes Il s’agit d’une etude mono centrique prospective de cohorte ayant interesse tous les patients adultes en liste d’attente de TR entre janvier 2014 et decembre 2018. A l’inclusion, les donnees demographiques et nephrologiques des patients etaient recueillies, ainsi que celles relatives aux vaccinations recues avant la consultation d’infectiologie. Les serologies suivantes etaient realisees : hepatites A et B, fievre jaune (si prealablement vaccines), rougeole, VZV. Chez tous les patients, une imagerie pulmonaire etait realisee ainsi qu’un test de depistage de l’infection tuberculose latente (ITL) par detection de production d’interferon gamma (IGRA). Resultats Parmi les 994 patients sur liste de transplantation, 467 (47 %) ont eu une consultation d’infectiologie pre-greffe. Parmi eux, 302 (65 %) etaient des hommes (sex ratio 1,83), l’âge median etait de 58 ans (46–66), 333 (71 %) etaient dialyses. Une immunosuppression (greffe anterieure, traitement immunosuppresseur) etait presente chez 107 (23 %) patients. Pour l’etat vaccinal a l’inclusion : 109 (24 %) et 27 (6 %) patients avaient une vaccination diphterie-tetanos-polio-coqueluche (dTPc) et anti-pneumocoque a jour respectivement, 51 % des patients (228) avaient ete vaccines contre la grippe l’annee precedente. Les patients non dialyses etaient significativement moins vaccines contre l’hepatite B que ceux dialyses (46 % vs. 57 %, p = 0,0001), mais leur vaccination contre dTPc etait plus frequemment a jour (33 % vs. 20 %, p = 0,005). Les patients vaccines contre le pneumocoque etaient plus immunodeprimes (33 % vs 17 %, p = 0,028), avaient plus de vaccinations a jour contre dTPc (41 % vs 23 %, p = 0,040) et grippe (70 % vs 50 % p = 0,038) que les patients non vaccines contre le pneumocoque. Soixante-quinze patients (16 %) avaient un IGRA positif et 26 avaient des lesions pulmonaires sequellaires (6 %). Un traitement de l’ITL (INH ou INH/RMP) a ete initie chez 78 (16 %) patients, complique d’effets secondaires chez 9 (11 %), dont une neurotoxicite centrale a l’INH. L’acceptabilite de la mise a jour vaccinale et du traitement de la TL, proposes au cours la consultation, etait excellente (2 refus de vaccinations sur 467). Conclusion Une consultation d’infectiologie avant TR optimise l’application des mesures recommandees de prevention anti-infectieuse.
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- 2020
45. A multisystem-compatible deep learning-based algorithm for detection and characterization of angiectasias in small-bowel capsule endoscopy. A proof-of-concept study.
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Houdeville, Charles, Souchaud, Marc, Leenhardt, Romain, Beaumont, Hanneke, Benamouzig, Robert, McAlindon, Mark, Grimbert, Sylvie, Lamarque, Dominique, Makins, Richard, Saurin, Jean-Christophe, Histace, Aymeric, and Dray, Xavier
- Abstract
Current artificial intelligence (AI)-based solutions for capsule endoscopy (CE) interpretation are proprietary. We aimed to evaluate an AI solution trained on a specific CE system (Pillcam®, Medtronic) for the detection of angiectasias on images captured by a different proprietary system (MiroCam®, Intromedic). An advanced AI solution (Axaro®, Augmented Endoscopy), previously trained on Pillcam® small bowell images, was evaluated on independent datasets with more than 1200 Pillcam® and MiroCam® still frames (equally distributed, with or without angiectasias). Images were reviewed by experts before and after AI interpretation. Sensitivity for the diagnosis of angiectasia was 97.4% with Pillcam® images and 96.1% with Mirocam® images, with specificity of 98.8% and 97.8%, respectively. Performances regarding the delineation of regions of interest and the characterization of angiectasias were similar in both groups (all above 95%). Processing time was significantly shorter with Mirocam® (20.7 ms) than with Pillcam® images (24.6 ms, p <0.0001), possibly related to technical differences between systems. This proof-of-concept study on still images paves the way for the development of resource-sparing, "universal" CE databases and AI solutions for CE interpretation. [ABSTRACT FROM AUTHOR]
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- 2021
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46. Évaluation de la présence d'une infirmière en pratique avancée dans la prise en charge des transplantés rénaux.
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Boncourt, Cécile, Londero, Tiphanie, Grimbert, Philippe, and Matignon, Marie
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L'implantation d'une nouvelle profession nécessite d'anticiper sa plus-value et de définir son domaine d'intervention. Cet article explore les besoins d'un modèle de soin en transplantation rénale par l'étude de données épidémiologiques et d'une enquête exploratoire au sein d'un centre hospitalier universitaire d'Île-de-France. Les résultats définissent les limites de la prise en charge actuelle et affirment la place de l'infirmière en pratique avancée dans le secteur de la transplantation rénale. Son rôle s'établit auprès du patient et de son entourage, du centre de greffe et des professionnels de ville. The establishment of a new profession requires anticipating its added value and defining its field of intervention. This article explores the needs of a model of care in kidney transplantation through the study of epidemiological data and an exploratory survey within a university hospital center in Île-de-France. The results define the limits of current care and assert the place of the advanced practice nurse in the renal transplantation sector. Her role is established with the patient and his entourage, the transplant center and the professionals of the city. [ABSTRACT FROM AUTHOR]
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- 2021
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47. A Case of Enterocytozoon bieneusi Infection in an HIV-Negative Renal Transplant Recipient
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Metge, S., Tran Van Nhieu, J., Dahmane, D., Grimbert, P., Foulet, F., Sarfati, C., and Bretagne, S.
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- 2000
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48. An initial report from the French SOT COVID Registry suggests high mortality due to COVID-19 in recipients of kidney transplants
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Caillard, Sophie, Anglicheau, Dany, Matignon, Marie, Durrbach, Antoine, Greze, Clarisse, Frimat, Luc, Thaunat, Olivier, Legris, Tristan, Moal, Valerie, Westeel, Pierre Francois, Kamar, Nassim, Gatault, Philippe, Snanoudj, Renaud, Sicard, Antoine, Bertrand, Dominique, Colosio, Charlotte, Couzi, Lionel, Chemouny, Jonathan M., Masset, Christophe, Blancho, Gilles, Bamoulid, Jamal, Duveau, Agnes, Bouvier, Nicolas, Chavarot, Nathalie, Grimbert, Philippe, Moulin, Bruno, Le Meur, Yannick, Hazzan, Marc, Caillard, Sophie, Moulin, Bruno, Fafi-Kremer, Samira, Hazzan, Marc, Anglicheau, Dany, Hertig, Alexandre, Tourret, Jérôme, Barrou, Benoit, Morelon, Emmanuel, Thaunat, Olivier, Couzi, Lionel, Merville, Pierre, Moal, Valérie, Legris, Tristan, Westeel, Pierre-François, Jaureguy, Maïté, Frimat, Luc, Ducloux, Didier, Bamoulid, Jamal, Bertrand, Dominique, Tsimaratos, Michel, Garaix-Gilardo, Florentine, Dumortier, Jérôme, Mussot, Sacha, Roux, Antoine, Sebbag, Laurent, Le Meur, Yannick, Blancho, Gilles, Masset, Christophe, Kamar, Nassim, Francois, Hélène, Rondeau, Eric, Bouvier, Nicolas, Mousson, Christiane, Buchler, Matthias, Gatault, Philippe, Augusto, Jean-François, Duveau, Agnès, Vigneau, Cécile, Morin, Marie-Christine, Chemouny, Jonathan, Golbin, Leonard, Grimbert, Philippe, Matignon, Marie, Durrbach, Antoine, Greze, Clarisse, Snanoudj, Renaud, Colosio, Charlotte, Schvartz, Betoul, Malvezzi, Paolo, Mariat, Christophe, Thierry, Antoine, Le Quintrec, Moglie, Sicard, Antoine, Rerolle, Jean Philippe, Heng, Anne-Élisabeth, Garrouste, Cyril, Coponat, Henri Vacher, Epailly, Éric, Brugiere, Olivier, Dharancy, Sébastien, Salame, Éphrem, and Saliba, Faouzi
- Abstract
Notwithstanding the ongoing coronavirus disease-2019 (Covid-19) pandemic, information on its clinical presentation and prognosis in recipients of a kidney transplant remain scanty. The aim of this registry-based observational study was to explore characteristics and clinical outcomes of recipients of kidney transplants included in the French nationwide Registry of Solid Organ Transplant Recipients with Covid-19. Covid-19 was diagnosed in symptomatic patients who had a positive PCR assay for SARS-CoV-2 or having typical lung lesions on imaging. Clinical and laboratory characteristics, management of immunosuppression, treatment for Covid-19, and clinical outcomes (hospitalization, admission to intensive care unit, mechanical ventilation, or death) were recorded. Risk factors for severe disease or death were determined. Of the 279 patients, 243 were admitted to hospital and 36 were managed at home. The median age of hospitalized patients was 61.6 years; most had comorbidities (hypertension, 90.1%; overweight, 63.8%; diabetes, 41.3%; cardiovascular disease, 36.2%). Fever, cough, dyspnea, and diarrhea were the most common symptoms on admission. Laboratory findings revealed mild inflammation frequently accompanied by lymphopenia. Immunosuppressive drugs were generally withdrawn (calcineurin inhibitors: 28.7%; antimetabolites: 70.8%). Treatment was mainly based on hydroxychloroquine (24.7%), antiviral drugs (7.8%), and tocilizumab (5.3%). Severe Covid-19 occurred in 106 patients (46%). Forty-three hospitalized patients died (30-day mortality 22.8%). Multivariable analysis identified overweight, fever, and dyspnea as independent risk factors for severe disease, whereas age over 60 years, cardiovascular disease, and dyspnea were independently associated with mortality. Thus, Covid-19 in recipients of kidney transplants portends a high mortality rate. Proper management of immunosuppression and tailored treatment of this population remain challenging.
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- 2020
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49. Myosteatosis as an independent risk factor for mortality after kidney allograft transplantation: a retrospective cohort study
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Morel, Antoine, Ouamri, Yaniss, Canouï‐Poitrine, Florence, Mulé, Sébastien, Champy, Cécile Maud, Ingels, Alexandre, Audard, Vincent, Luciani, Alain, Grimbert, Philippe, Matignon, Marie, Pigneur, Frédéric, and Stehlé, Thomas
- Abstract
Patients with end‐stage renal disease may display both a loss of skeletal muscle mass and an increase in muscle fat deposits. We aimed to analyse the impact of low skeletal muscle mass index (SMI, surrogate marker of sarcopenia) and low muscle density (MD, surrogate marker of myosteatosis) on patient survival after kidney transplantation (KT). In a retrospective cohort of 200 kidney transplant recipients (KTr), we measured on an unenhanced cross‐sectional computed tomography scan taken at the level of the third lumbar vertebra within the previous year or at the time of KT, both SMI (muscle cross‐sectional area normalized for height2, reported in cm2/m2) and MD (mean attenuation of muscle cross‐sectional area, expressed in Hounsfield units). We determined age‐specific and sex‐specific normality thresholds on 130 healthy subjects. The baseline factors associated with low MD were assessed by logistic regression analysis. Cox proportional hazard univariable and multivariable models were constructed to identify predictive factors of patient survival. Among the 200 patients of the cohort, 123 were male (62%), and mean age was 54.8 ± 13.8 years. A total of 181 KTr required renal replacement therapy before KT (91%), and 36 KTr (18%) received repeat kidney transplant after previous failed KT. Mean MD was 30.6 ± 9 HU in men and 29.7 ± 8.3 HU in women, whereas SMI was 49.7 ± 8.6 cm2/m2in men and 42.3 ± 7.3 cm2/m2in women. MD was below the 2.5th percentile for the healthy population in 49 KTr (25%), defining the myosteatosis group, while SMI was below the 2.5th percentile for the reference population in 10 KTr (5%). Independent risk factors for myosteatosis were two or more KT [adjusted odds ratio (aOR) 5.2, 95% confidence interval (95% CI): 2.22–12.4, P= 0.0001], a history of stroke (aOR 3.7, 95% CI: 1.30–10.7, P= 0.015), and body mass index > 25 kg/m2(aOR 2.94, 95% CI: 1.4–6.18, P= 0.004). Myosteatosis was independently associated with mortality [adjusted hazard ratio (aHR) 2.12, 95% CI: 1.06–4.24, P= 0.033], as were cardiovascular disease (HR 2.06, 95% CI: 1.02–4.15, P= 0.043) and age (aHR 1.06, 95% CI: 1.03–1.09, P= 0.0003). Low SMI was not associated with mortality. Myosteatosis, which was more prevalent than low skeletal muscle mass, might be an important prognostic marker in patients undergoing KT.
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- 2022
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50. Sévérité de l’infection COVID-19 chez les patients transplantés rénaux d’un centre francilien
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W. Vindrios, Thomas Stehlé, N. Joher, Marie Matignon, P. Grimbert, Giovanna Melica, S. Gallien, E. Andureau, and S. Gressens
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Gynecology ,2019-20 coronavirus outbreak ,medicine.medical_specialty ,Infectious Diseases ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Medicine ,business ,Article - Abstract
Introduction Le phenotype du COVID-19 est tres variable. Identifier et caracteriser les populations a risque d’evolution defavorable est cruciale. L’objectif de cette etude est de decrire l’infection COVID-19 dans une population de transplantes renaux (TR). Materiels et methodes Il s’agit d’une etude retrospective monocentrique des TR atteints de COVID-19 de fevrier a mai 2020. Les cas confirmes par PCR et les cas possibles (clinique et lesions pulmonaires scanographiques compatibles) ont ete inclus. La mortalite a ete comparee avec celle de la population generale non transplantee dans le meme centre. Resultats Parmi 1004 TR, 34 dont 26 hommes ont ete atteints de COVID-19, avec un delai median de 6 ans [2,2–10,3] apres la transplantation. Deux patients avaient ete transplantes dans les 6 mois precedents. L’âge moyen etait de 61 ans [23–81]. Les principales comorbidites etaient une hypertension arterielle (31 cas, 94 %), une cardiopathie (16 cas, 47 %) et un diabete (14 cas, 41 %). Le traitement de maintenance associait les inhibiteurs de la calcineurine, les anti-metabolites et les corticoides chez 22 patients (65 %). Le debit de filtration glomerulaire estime etait de 40 mL/min/1,73 m2 [32–52]. Neuf patients (26,5 %) avaient deja presente des complications infectieuses pulmonaires apres la greffe. Trente patients (88 %) ont ete hospitalises avec un delai median de 7,7 jours [3–9,5] apres le debut des symptomes. Les signes cliniques initiaux principaux etaient une fievre (n = 28,82 %), une toux (n = 23, 68 %), une dyspnee (n = 16, 47 %) et une diarrhee (n = 12, 35 %). A l’admission on observait une lymphopenie chez 18 patients (53 %), une CRP mediane a 84 mg/L [31,2–99,8] et une PCT mediane a 0,25 μg/L [0,19–0,4]. Sept patients sur 18 (39 %) presentaient une atteinte parenchymateuse pulmonaire severe (plus de 50 %) au scanner. Les traitements specifiques comprenaient l’hydroxychloroquine (n = 6, 18 %), l’association lopinavir/ritonavir (n = 1, 3 %), les anti-IL6 (n = 2, 6 %). L’arret d’un des immunosuppresseurs a ete effectue chez 20 patients. Une forme clinique severe (admission en reanimation ou oxygenotherapie ≥ 9 L/min) est survenue chez 20 patients (61 %). Le delai d’admission en reanimation etait de 2,5 jours [0–6,5] depuis l’hospitalisation. Vingt patients (61 %) ont presente une insuffisance renale aigue dont 6 necessitant de l’hemodialyse. Quinze patients (44 %) sont decedes dans un delai de 11 jours [7–16] apres l’hospitalisation. Le taux de deces chez les patients hospitalises pour COVID-19 non TR etait de 15,4 %. Conclusion Les patients transplantes renaux sont une population a haut risque de forme severe de COVID-19 avec un taux de mortalite approchant 50 % dans cette etude. Le renforcement des strategies preventives et de depistage semble primordial chez ces patients immunodeprimes et a fort risque cardiovasculaire.
- Published
- 2020
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