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Bonnet G, Racape M, Bories MC, Varnous S, Rouvier P, Guillemain R, Bruneval P, Taupin JL, Lefaucheur C, Loupy A, Jouven X. 3399Determinants and outcomes of cardiac allograft vasculopathy: major role of donor specific antibody. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.3399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vidal C, Pasqualotto R, James A, Bouglé A, Lebreton G, Varnous S, Leprince P, Amour J. Epidemiology and Risk Factors of Post Operative Pneumonias After Heart Transplantation. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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28
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Galeone A, Varnous S, Salem J, Lebreton G, Coutance G, Hulot J, Leprince P. ST2 as a Marker of Primary Graft Dysfunction. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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29
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Goulard S, Coutance G, Belin L, Demondion P, Varnous S, Barthélémy O, Ouldamar S, Leprince P, Helft G. Risk factors for mid-term progression of cardiac allograft vasculopathy after heart transplantation only include donor characteristics in a large single center cohort. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2018. [DOI: 10.1016/j.acvdsp.2017.11.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bonnet N, Kerneis M, Ouldamar S, Huang F, Laveau F, Isnard R, Leprince P, Collet JP, Varnous S, Hammoudi N. P2084Multi-layer longitudinal strain for noninvasive diagnosis of coronary allograft vasculopathy in heart transplant recipients: a comparative study ultrasound versus angiography. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Fedida J, Waintraub X, Duthoit G, Varnous S, Maupain C, Badenco N, Himbert C, Frank R, Chastre T, Dagher-Hayeck Y, Golmard JL, Pavie A, Hidden-Lucet F, Leprince P, Gandjbakhch E. P257Heart transplant patients with pacemaker: predictive factors for pacemaker requirement, for type of bradyarrhythmias, and prognostic factors for survival. Europace 2017. [DOI: 10.1093/ehjci/eux171.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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32
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Coutance G, Van Aelst L, Ouldammar S, Rouvier P, Saheb S, Brechot N, Lebreton G, Bouglé A, Combes A, Amour J, Leprince P, Varnous S. Early Acute Humoral Rejection Does Not Alter Prognosis After Heart Transplantation. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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33
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D'Orio V, Demondion P, Lebreton G, Coutance G, Varnous S, Leprince P. Acquired transdiaphragmatic hernia: an unusual cause of cardiac tamponade. Asian Cardiovasc Thorac Ann 2017; 25:233-236. [PMID: 28325075 DOI: 10.1177/0218492317698326] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transdiaphragmatic peritoneopericardial hernia is a rare complication after peritoneopericardial window formation, coronary artery bypass grafting using the gastroepiploic artery, or subxiphoid epicardial pacemaker insertion. We describe two different clinical presentations of transdiaphragmatic peritoneopericardial hernia in patients who had undergone recent heart transplantation. One was an exceptional case of cardiac tamponade caused by small bowel strangulation through a diaphragmatic defect.
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Aissaoui N, Morshuis M, Maoulida H, Salem J, Brunn M, Varnous S, Gummert J, Durand-Zaleski I, Leprince P, Fagon J. Transplantation versus Ventricular Assist Device for the Management of End-Stage Heart Failure: An Observational Comparison of Clinical and Economic Outcomes. J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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35
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Vidal C, Lebreton G, Djavidi N, Varnous S, Bouglé A, Genton A, Barreda E, Leprince P, Amour J. Heart Transplantation Versus Ventricular Assist Device: Which Therapy for Patient with Refractory Cardiogenic Shock? J Heart Lung Transplant 2016. [DOI: 10.1016/j.healun.2016.01.178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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36
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Loupy A, Toquet C, Rouvier P, Beuscart T, Bories MC, Varnous S, Guillemain R, Pattier S, Suberbielle C, Leprince P, Lefaucheur C, Jouven X, Bruneval P, Duong Van Huyen JP. Late Failing Heart Allografts: Pathology of Cardiac Allograft Vasculopathy and Association With Antibody-Mediated Rejection. Am J Transplant 2016; 16:111-20. [PMID: 26588356 DOI: 10.1111/ajt.13529] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 07/19/2015] [Accepted: 07/20/2015] [Indexed: 01/25/2023]
Abstract
In heart transplantation, there is a lack of robust evidence of the specific causes of late allograft failure. We hypothesized that a substantial fraction of failing heart allografts may be associated with antibody-mediated injury and immune-mediated coronary arteriosclerosis. We included all patients undergoing a retransplantation for late terminal heart allograft failure in three referral centers. We performed an integrative strategy of heart allograft phenotyping by assessing the heart vascular tree including histopathology and immunohistochemistry together with circulating donor-specific antibodies. The main analysis included 40 explanted heart allografts patients and 402 endomyocardial biopsies performed before allograft loss. Overall, antibody-mediated rejection was observed in 19 (47.5%) failing heart allografts including 16 patients (40%) in whom unrecognized previous episodes of subclinical antibody-mediated rejection occurred 4.5 ± 3.5 years before allograft loss. Explanted allografts with evidence of antibody-mediated rejection demonstrated higher endothelitis and microvascular inflammation scores (0.89 ± 0.26 and 2.25 ± 0.28, respectively) compared with explanted allografts without antibody-mediated rejection (0.42 ± 0.11 and 0.36 ± 0.09, p = 0.046 and p < 0.0001, respectively). Antibody-mediated injury was observed in 62.1% of failing allografts with pure coronary arteriosclerosis and mixed (arteriosclerosis and atherosclerosis) pattern, while it was not observed in patients with pure coronary atherosclerosis (p = 0.0076). We demonstrate that antibody-mediated rejection is operating in a substantial fraction of failing heart allografts and is associated with severe coronary arteriosclerosis. Unrecognized subclinical antibody-mediated rejection episodes may be observed years before allograft failure.
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Raphalen J, Haroche J, Waintraub X, Kerneis M, Cheikh-Khalifa R, Fouret P, Varnous S, Montalescot G, Guiochon Mantel A, Redheuil A, Cluzel P, Amoura Z, Cohen Aubart F. Le séquençage du gène de la transthyrétine est un examen rentable et non invasif qui peut être demandé en première intention devant une cardiopathie présumée amyloïde sans argument biologique sérique pour une amylose AL ou AA. Rev Med Interne 2015. [DOI: 10.1016/j.revmed.2015.03.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Meurin P, Tabet JY, Weber H, Guendouz S, Varnous S, Renaud N, Dumaine R, Driss A, Grosdemouge A, Ly C. 0012: Rehabilitation early after heart transplantation: modalities and feasibility. ARCHIVES OF CARDIOVASCULAR DISEASES SUPPLEMENTS 2015. [DOI: 10.1016/s1878-6480(15)71730-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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39
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Galeone A, Varnous S, Barreda E, Hariri S, Pavie A, Leprince P. Impact of Cardiac Arrest Resuscitated Donors on Heart Recipients Outcome. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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40
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Coutance G, Ouldamar S, Rouvier P, Suberbielle C, Saheb S, Hariri S, Brechot N, Lebreton G, Leprince P, Varnous S. Late Antibody-Mediated Rejection Due To De-Novo Donor-Specific Anti-HLA Antibodies in Heart Transplant Recipients: A Cohort of 20 Consecutive Patients. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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41
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Varnous S, Vidal C, Bories M, Boissel-Suberbielle C, Ouldamar S, Rouvier P, LePrince P, Amour J. Intravenous Immunoglobulin and Plasmapheresis in Prevention of Antibody Mediated Rejection in Sensitized Recipients in Cardiac Allograft. “Before - After” Treatment Study. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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42
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Choquet S, Varnous S, Deback C, Golmard JL, Leblond V. Adapted treatment of Epstein-Barr virus infection to prevent posttransplant lymphoproliferative disorder after heart transplantation. Am J Transplant 2014; 14:857-66. [PMID: 24666832 DOI: 10.1111/ajt.12640] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 12/03/2013] [Accepted: 12/18/2013] [Indexed: 01/25/2023]
Abstract
Up to 35% of posttransplant lymphoproliferative disorder (PTLD) cases occur within 1 year of transplantation, and over 50% are associated with Epstein-Barr virus (EBV). EBV primary infection and reactivation are PTLD predictive factors, but there is no consensus for their treatment. We conducted a prospective single-center study on 299 consecutive heart-transplant patients treated with the same immunosuppressive regimen and monitored by repetitive EBV viral-load measurements and endomyocardial biopsies to detect graft rejection. Immunosuppression was tapered on EBV reactivation with EBV viral loads >10(5) copies/mL or primary infection. In the absence of response at 1 month or a viral load >10(6) copies/mL, patients received one rituximab infusion (375 mg/m(2) ). All patients responded to treatment without increased graft rejection. One primary infection case developed a possible PTLD, which completely responded to diminution of immunosuppression, and one patient, whose EBV load was unevaluable, died of respiratory complications secondary to PTLD. Compared with a historical cohort of 820 patients, PTLD incidence was decreased (p = 0.033) by a per-protocol analysis. This is the largest study on EBV primary infection/reactivation treatment, the first using rituximab following solid organ transplantation to prevent PTLD and the first to demonstrate an acceptable tolerability profile in this setting.
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Pozzi M, d'Alessandro C, Fernandez F, Nguyen A, Pavie A, Leprince P, Varnous S, Kirsch M. Who Gets a Second Heart? A Current Picture of Cardiac Retransplantation. Transplant Proc 2014; 46:202-7. [DOI: 10.1016/j.transproceed.2013.08.109] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 08/30/2013] [Indexed: 11/27/2022]
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Cohen S, Aubailly C, Danchin N, Varnous S, Pavie A. The effect of age on long-term outcomes after heart transplantation. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p5099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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45
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Cohen S, Houyel L, Guillemain R, Varnous S, Golmard JL, Iserin L. Long-term outcomes after heart transplantation in adult patients with cardiac congenital heart disease: impact of initial defect and repair: a collaboratve study on 97 patients. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht308.1720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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46
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Lebray P, Varnous S, Leprince P, Luyt C, Rousseau G, Pascale A, Thabut D, Ratziu V, Vaillant J, Chastre J, Pavie A. Influence of Liver and Renal Impairments on Early Mortality in Heart Transplant Patients. J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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47
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Toquet C, Loupy A, Rouvier P, Varnous S, Cazes A, Tible M, Beuscart T, Jouven X, Bruneval P, Duong Van Huyen JP. A Specific Mechanism for Late Loss of Cardiac Allograft: The Antibody Mediated Rejection (AMR) as a Major Factor of Cardiac Allograft Vasculopathy (CAV). J Heart Lung Transplant 2013. [DOI: 10.1016/j.healun.2013.01.626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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48
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Lebbe C, Porcher R, Marcelin AG, Agbalika F, Dussaix E, Samuel D, Varnous S, Euvrard S, Bigorie A, Creusvaux H, Legendre C, Frances C. Human herpesvirus 8 (HHV8) transmission and related morbidity in organ recipients. Am J Transplant 2013; 13:207-13. [PMID: 23057808 DOI: 10.1111/j.1600-6143.2012.04290.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 08/13/2012] [Accepted: 08/14/2012] [Indexed: 01/25/2023]
Abstract
The aims of the study were to assess the risk of HHV8 transmission resulting from organ transplantation, and related morbidity in liver, heart and kidney transplant recipients. Donor and recipient serologies were screened between January 1, 2004 and January 1, 2005 using HHV8 indirect immunofluorescence latent assay (latent IFA) and indirect immunofluorescent lytic assay (lytic IFA). Recipients negative for latent IFA with a donor positive for at least one test were sequentially monitored for HHV8 viremia and underwent serological tests over a period of 2 years. The results showed that among 2354 donors, HHV8 seroprevalence was 9.9% (lytic IFA) and 4.4% (latent IFA). A total of 454 organ recipients (281 renal, 116 liver and 57 heart) were monitored over a 2-year period. Seroconversion was observed in 12 patients (cumulative incidence 28%) whose donor had positive latent IFA and in 36 patients (cumulative incidence 29%) whose donors were positive only for lytic IFA, without differences across types of transplants. Positive HHV8 viremia was detected in only 4 out of 89 liver transplant recipients during follow-up and not in recipients of other types of transplant. Two liver transplant recipients and one kidney transplant recipient developed KS. In conclusion, although HHV8 transmission is a frequent event after organ transplantation, HHV8-related morbidity is rather rare but can be life threatening. Donor screening is advisable for monitoring HHV8 seronegative liver transplant recipients.
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Cattin M, Schlossarek S, Decostre V, Maron S, Skov Jensen S, Le Bihan M, Bertand A, Crocini C, Lainé J, Mougenot N, Varnous S, Fromes Y, Hansen A, Eschenhagen T, Carrier L, Bonne G. G.P.122 Heterozygous LmnadelK32 mutant mice showed alterations of the ubiquitin–proteasome system and developed dilated cardiomyopathy. Neuromuscul Disord 2012. [DOI: 10.1016/j.nmd.2012.06.328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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50
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Saheb S, Varnous S, Mercadale L, Bendriss A, Milleron O, Ouldamar S, Barrou B, Arzoug N, Boissel CS, Carmagnat M, Herson S, Ridel C. O-08 DILATED CARDIOMYOPATHY, ANTI-HLA ANTIBODIES, DESENSITIZATION, HEART AND KIDNEY DOUBLE TRANSPLANT. Transfus Apher Sci 2012. [DOI: 10.1016/s1473-0502(12)70009-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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