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Coutance G, Desiré E, Lescroart M, Lebreton G, Combes A, Bouglé A, Varnous S, Leprince P. Impact of the 2018 French Allocation Scheme on the Profile of Heart Transplantation Candidates and Recipients: Insights from a High-Volume Center. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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2
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Abdoul N, Legeai C, Varnous S, Para M, Goeminne C, Pattier S, Kerbaul F, Dorent R. Sex Differences in Heart Transplantation: A National Cohort Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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3
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Desiré E, Assouline-Reinmann M, Lescroart M, Bouglé A, Combes A, Lebreton G, Leprince P, Varnous S, Coutance G. Impact of the 2018 French allocation scheme on the profile of heart transplantation candidates, recipients and donors: Insights from a high-volume center. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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4
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Dib N, Moussa NB, Varnous S, Guillemain R, Iserin L, Belli E, Cohen S. Long-term outcomes after heart transplantation in adult patients with congenital heart disease: Does initial defect and physiology impact survival? Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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5
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Daniel L, Desiré E, Lescroart M, Lebreton G, Leprince P, Varnous S, Coutance G. Application of the new cardiac allograft allocation scheme in clinical practice. Insights from a high-volume heart transplantation center. Archives of Cardiovascular Diseases Supplements 2023. [DOI: 10.1016/j.acvdsp.2022.10.082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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6
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Valyraki N, Maillart E, Pourcher V, Shor N, Tran S, Boudot de la Motte M, Houiller C, Domont F, Morvan E, Touat M, Del Mar Amador M, Aboab J, Mathon B, Hesters A, Vignal-Clermont C, Dehais C, Bonnin S, Lafitte F, Villain N, Varnous S, Gout O, Eloit M, Rodriguez C, Deschamps R. Human pegivirus identified in severe myelitis and optic neuritis in immunocompromised patients: A pathogenic role for a forgotten virus? Rev Neurol (Paris) 2022; 179:361-367. [PMID: 36302709 DOI: 10.1016/j.neurol.2022.06.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/11/2022] [Accepted: 06/08/2022] [Indexed: 11/05/2022]
Abstract
The role of Human pegivirus (HPgV) in patients with encephalitis has been recently questioned. We present cases of 4 patients with similar clinical, biological, and radiological characteristics, including a past history of transplantation with long-term immunosuppression and a progressive course of severe and predominantly myelitis, associated in 3 cases with optic neuropathy causing blindness. Extensive workup was negative but analysis of the CSF by use of pan-microorganism DNA- and RNA-based shotgun metagenomics was positive for HPgV. This case series further supports the hypothesis of HPgV CNS infection and highlights the utility of metagenomic next-generation sequencing of CSF in immunocompromised patients.
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Chaoui I, Dousseaux M, Arzouk N, Varnous S, Sabrina K, Bagnis C, Boffa J, Tostivint I. Comment rompre le cercle vicieux dénutrition/sarcopénie/insuffisance rénale chronique chez un transplanté cœur-rein ? Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Mazzola A, Todesco E, Drouin S, Hazan F, Marot S, Thabut D, Varnous S, Soulié C, Barrou B, Marcelin AG, Conti F. Poor Antibody Response after Two Doses of SARS-CoV-2 vaccine in Transplant Recipients. Clin Infect Dis 2021; 74:1093-1096. [PMID: 34166499 PMCID: PMC8384412 DOI: 10.1093/cid/ciab580] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Indexed: 01/03/2023] Open
Abstract
A low anti-spike antibody response of 28.6% was observed 28 days after BNT162b2
vaccine second dose among 133 solid organ transplant recipients without previous
coronavirus disease 2019 (COVID-19). No serious adverse events were recorded.
Four severe COVID-19 cases were reported between or after the 2 doses. Our data
suggest to change the vaccine strategy.
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Affiliation(s)
- Alessandra Mazzola
- Sorbonne Université, Unité médicale de transplantation hépatique, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris France
| | - Eve Todesco
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, F-75013 Paris, France
| | - Sarah Drouin
- Sorbonne Université, Chirurgie urologique, Transplantation rénale, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Fanny Hazan
- Sorbonne Université, Chirurgie cardiaque et thoracique, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Stéphane Marot
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, F-75013 Paris, France
| | - Dominique Thabut
- Sorbonne Université, Service d'Hépato-gastroentérologie, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Sheida Varnous
- Sorbonne Université, Chirurgie cardiaque et thoracique, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris, France
| | - Cathia Soulié
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, F-75013 Paris, France
| | - Benoît Barrou
- Sorbonne Université, Chirurgie urologique, Transplantation rénale, AP-HP, Hôpital Pitié-Salpêtrière, 75013 Paris, France
| | - Anne-Geneviève Marcelin
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé publique (iPLESP), AP-HP, Hôpital Pitié-Salpêtrière, Laboratoire de virologie, F-75013 Paris, France
| | - Filomena Conti
- Sorbonne Université, Unité médicale de transplantation hépatique, AP-HP, Hôpital Pitié-Salpêtrière, 75013, Paris France
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9
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Bonnet G, Coutance G, Waldmann V, Aubert O, Asselin A, Raynaud M, Bories M, Caudron J, Guillemain R, Varnous S, Leprince P, Marijon E, Loupy A, Jouven X. Determinants of sudden cardiac death after heart transplantation. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Bonnet G, Coutance G, Waldmann V, Aubert O, Asselin A, Raynaud M, Bories M, Caudron J, Rouvier P, Guillemain R, Varnous S, Bruneval P, Leprince P, Marijon E, Loupy A, Jouven X. Incidence of sudden cardiac death after heart transplantation. Archives of Cardiovascular Diseases Supplements 2021. [DOI: 10.1016/j.acvdsp.2020.10.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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11
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Bonnet G, Coutance G, Van Keer J, Raynaud M, Aubert O, Bories M, Bruneval P, Varnous S, Leprince P, Empana J, Naesens M, Patel J, Loupy A, Kobashigawa J, Jouven X. Identification of trajectories of cardiac allograft vasculopathy after heart transplantation: a nationwide comparison. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.2696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac allograft vasculopathy (CAV) is a major contributor of heart transplant recipient's mortality. However, little is known about CAV trajectories at a population level.
Purpose
We aimed to identify the different profiles of CAV trajectories.
Methods
Heart transplant recipients receiving care at 4 academic centers (2004 to 2016) were included. Patients underwent prospective, protocol-based monitoring consisting of repeated coronary angiographies together with systematic assessment of clinical, functional, histological and immunological parameters. The mainoutcome was the CAV trajectories, identified with unsupervised latent class mixed models.
Results
Overall, 1,301 patients were included (609 in France, 206 in Belgium and 486 in the US). The median follow-up post-transplant was 6.6 years (IQR=4.7) with 4,710 coronary angiographies analyzed (3.6±1.6 CAV assessments per patient). In the French development cohort, we identified 4 distinct profiles of CAV trajectories over 10 years that were characterized by i) Patients without CAV at baseline and non-progression (n=317, 52.1%), ii) patients without CAV at baseline and late onset CAV progression (n=52, 8.5%), iii) patients with mild baseline CAV and mild progression (n=151, 24.8%), iv) patients with mild baseline CAV and accelerated CAV progression (n=89, 14.6%, discrimination 0.92). The 4 CAV trajectories were independently validated in the external validation cohorts from Belgium (discrimination=0.92) and the US (discrimination=0.97).
Conclusion
In a large multicentric and highly phenotyped prospective cohort of heart transplant recipients, we identified and validated 4 distinct CAV trajectories corresponding to specific initial CAV grades and subsequent evolutions. Our results provide the basis for a trajectory-based assessment for risk stratification at early-stage post heart transplantation.
Figure 1. Cardiac allograft vasculopathy trajectories in France (n=609), in Belgium (n=206), in USA (n=486). Thick lines represent latent class trajectory; thin lines represent CAV individual patient trajectory.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - G Coutance
- Hospital Pitie-Salpetriere, Paris, France
| | | | - M Raynaud
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - O Aubert
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M.C Bories
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - J.P Empana
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | | | - J.K Patel
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - J Kobashigawa
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - X Jouven
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
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12
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Bonnet G, Coutance G, Van Keer J, Raynaud M, Aubert O, Bories M, Bruneval P, Varnous S, Leprince P, Empana J, Naesens M, Patel J, Loupy A, Kobashigawa J, Jouven X. Trajectories of Cardiac Allograft Vasculopathy After Heart Transplantation and association with mortality: a population-based study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiac allograft vasculopathy (CAV) is a major contributor of heart transplant recipient's mortality. However, the associations between CAV trajectories and mortality remains poorly described.
Purpose
We aimed to identify the different evolutive profiles of CAV and to determine the respective association with all-cause mortality.
Methods
Heart transplant recipients receiving care at 4 academic centers were included. Patients underwent prospective, protocol-based monitoring consisting of repeated coronary angiographies together with systematic assessment of clinical, functional, histological and immunological parameters. The mainoutcome was a prediction for CAV trajectories using unsupervised latent class mixed models. We then identified their association with all-cause mortality (NCT04117152).
Results
Overall, 1,301 patients were included (815 and 486 in the development and validation cohorts, respectively). The median follow-up post-transplant was 6.6 years (IQR=4.7) with 4,710 coronary angiographies analyzed (3.6±1.6 CAV assessments per patient). We identified 4 distinct profiles of CAV trajectories over 10 years that were characterized by i)Patients without CAV at baseline and non-progression (n=823, 63.3%), ii) patients without CAV at baseline and late onset CAV progression (n=79, 6.1%), iii) patients with mild baseline CAV and mild progression (n=261, 20.1), iv) patients with mild baseline CAV and accelerated CAV progression (n=138, 10.6%, discrimination 0.95). The 4 CAV trajectories showed gradient for all-cause mortality (p<0.001). Trajectories #3 and #4 were associated with higher mortality rates (10-year patient survival of 73.43% [95% CI 65.18–80.02] and 51.89% [95% CI 38.76–63.51], respectively) as compared with trajectories #1, and #2 that were characterized by 10-year patient survival of 80.01 [95% CI 76.38–84.82] and 83.49% [95% CI 71.34–90.80], respectively (p<0.001).
Conclusion
In a large multicentric and highly phenotyped prospective cohort of heart transplant recipients, we identified 4 robust CAV trajectories. These different profiles were associated with distinct prognosis. Our results provide the basis for a trajectory-based assessment of heart transplant patients for early patient risk stratification and patient monitoring.
Figure 1. Overall 10-year survival probability according to the CAV trajectory in the overall cohort (n=1,301). The left part represents the main profiles CAV grades identified with latent class mixed models. Thick lines represent latent class trajectory; thin lines represent CAV individual patient trajectory. The right part represent the Kaplan Meier curves of the different trajectories.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - G Coutance
- Hospital Pitie-Salpetriere, Paris, France
| | | | - M Raynaud
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - O Aubert
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M.C Bories
- Hopital Europeen Georges Pompidou - University Paris Descartes, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou - University Paris Descartes, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - J.P Empana
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | | | - J.K Patel
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - J Kobashigawa
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - X Jouven
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
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13
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Bonnet G, Coutance G, Van Keer J, Raynaud M, Aubert O, Bories M, Bruneval P, Varnous S, Leprince P, Empana J, Naesens M, Patel J, Loupy A, Kobashigawa J, Jouven X. Determinants of trajectories of cardiac allograft vasculopathy after heart transplantation: a population based study. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Cardiac allograft vasculopathy (CAV) is a major contributor of heart transplant recipient's mortality. Little is known about determinants of CAV trajectories at a population level.
Purpose
We aimed to identify the respective contribution of immune and non-immune factors in the different evolutive profiles of CAV.
Methods
Heart transplant recipients receiving care at 2 academic centers (2004 to 2016) were included. Patients underwent prospective, protocol-based monitoring consisting of repeated coronary angiographies together with systematic assessment of clinical, functional, histological and immunological parameters. The outcome was CAV trajectories, identified with unsupervised latent class mixed models. The independent, predictive factors of CAV trajectories were investigated with multinomial regressions (NCT04117152).
Results
Overall, 815 patients were included. The median follow-up post-transplant was 7.7 years (IQR=5.14) with 2,742 coronary angiographies analyzed. We identified 4 distinct profiles of CAV trajectories over 10 years that were characterized by i) Patients without CAV at baseline and non-progression (n=459, 56.3%), ii) patients without CAV at baseline and late onset CAV progression (n=62, 7.6%), iii) patients with mild baseline CAV and mild progression (n=188 23.1%), iv) patients with mild baseline CAV and accelerated CAV progression (n=106, 13.0%, discrimination 0.92). Six early independent predictors of CAV trajectories were identified: donor age (p<0.001), donor male gender (p<0.001), donor tobacco consumption (p=0.001), recipient post-transplant dyslipidemia (p=0.009), preexisting or de novo class II anti-HLA donor-specific antibodies (p=0.004) and episode of acute cellular rejection ≥2R during the first year post transplantation (p=0.028).
Conclusion
In a large multicentric and highly phenotyped prospective cohort of heart transplant recipients, we identified 4 robust CAV trajectories and their respective immune and non-immune determinants. Our results provide the basis for a trajectory-based assessment of heart transplant patients for early patient risk stratification and patient monitoring.
Factors associated CAV trajectories in multivariate analyses in the derivation cohort. This table shows the association of clinical, immunological, functional and structural parameters associated with CAV trajectories in multivariate multinomial regression analysis. The trajectory of reference was trajectory #1, including patients with no CAV at baseline and stable CAV grade over time.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - G Coutance
- Hospital Pitie-Salpetriere, Paris, France
| | | | - M Raynaud
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - O Aubert
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M.C Bories
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - J.P Empana
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | | | - J.K Patel
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - J Kobashigawa
- Cedars-Sinai Medical Center, Los Angeles, United States of America
| | - X Jouven
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
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Bonnet G, Coutance G, Waldmann V, Aubert O, Asselin A, Raynaud M, Racape M, Bories M, Varnous S, Bruneval P, Leprince P, Marijon E, Loupy A, Jouven X. Determinants of sudden cardiac death after heart transplantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.1110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
Heart transplant recipients are at high-risk of sudden cardiac death (SCD). However, risk factors of SCD in heart recipients remained poorly described.
Objective
To assess the predictors of SCD beyond the first-year post-transplant.
Methods
We enrolled consecutive patients transplanted between 2004 and 2017 in two French referral centers. We excluded patients deceased during the first year. Patients underwent an evaluation at the day of transplantation and during the first year, comprising clinical, biological, histological, immunological (circulating anti-HLA DSA) and interventional (cardiac allograft vasculopathy assessment) parameters. Echocardiographies were routinely performed in all included patients according to a prespecified protocol. According to the last consensus, SCD was defined as an unexpected out-of-hospital cardiac arrest without obvious non-cardiac cause, in the first hour after initiation of symptoms. Cox model analysis was used to determine the parameters associated with sudden death risk.
Results
A total of 913 patients were included. The median follow-up post-HT was 5.9 years (IQR=2.9–8.5). Among the 213 deaths after one year, 44 patients (21%) died from SCD. In this population, the incidence rate of SCD was 0,82 per 100 person-year (95% CI: 0,51–2,05). Among the 60 parameters tested in univariate analysis, we identified 2 independent factors of sudden death after 1 year post-HT: left ventricular ejection fraction (LVEF) ≤55% any time after transplantation ( HR 4.07, 95% CI 1.94–8.53, p<0.001) and the presence of circulating anti-HLA DSA at the time of transplantation (HR 2.79, 95% CI 1.37–5.68, p=0.005). The incidence rate of SCD was 2.17 per 100 person-year (95% CI: 1.42; 4.60) and 1.21 per 100 person-year (95% CI: 0.80; 2.58) in patients with FEVG<55% (n=73) and in patients with pre-formed DSA (n=260), respectively.
Conclusion
In a large multicentric and highly phenotyped cohort of heart transplant recipients, we identified two independent factors associated with SCD beyond the first year. This study provides fresh evidence of SCD assessment for improving risk stratification of HT recipients.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - G Coutance
- Hospital Pitie-Salpetriere, Paris, France
| | - V Waldmann
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - O Aubert
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - A Asselin
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M Raynaud
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M Racape
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M.C Bories
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - E Marijon
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - X Jouven
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
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15
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Bonnet G, Coutance G, Waldmann V, Aubert O, Asselin A, Raynaud M, Racape M, Bories M, Varnous S, Rouvier P, Bruneval P, Leprince P, Marijon E, Loupy A, Jouven X. Incidence of sudden cardiac death after heart transplantation. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Sudden cardiac death (SCD) is a major contributor to the rate of mortality after heart transplantation. However, little is known about the incidence of SCD in heart recipients.
Objective
To assess the incidence of SCD after heart transplantation.
Methods
We enrolled consecutive patients transplanted between 2004 and 2017 in two French referral centers. We defined 7 main groups of causes of deaths: SCD, cardiovascular (including Cardiac allograft vasculopathy), infection, primary graft dysfunction, graft failure (including late graft dysfunction, rejection), malignancy and others. Causes of deaths were independently adjudicated by two senior cardiologists based on the analysis of death certificates and medical records. Discrepancies were resolved by discussion until a consensus was made. SCD was defined as an unexpected out-of-hospital cardiac arrest without obvious non-cardiac cause, in the first hour after initiation of symptoms.
Results
A total of 1,363 patients were included. The median follow-up post-transplant was 3.99 years (IQR=0.49–7.49). 450 patients (33%) deceased during the first year. The leading cumulative causes of death in the first year after transplantation were infection, primary graft failure, multiple organ failure during the period in intensiv car unit. Beyond the post-operativ high-risk period of the first year, the leading cumulative cause of death was SCD: among the 213 deaths that occurred beyond the first year, 44 patients (21%) died from SCD. In this period, the incidence rate of SCD reached 0,82 per 100 person-year (95% CI: 0.51–2.05).
Conclusion
In a large multicentric and highly phenotyped cohort of heart transplant recipients, the leading cumulative cause of death beyond the first-year post transplant was sudden cardiac death. Our results open discussion on management of heart recipient, such as the implementation of cardioverter-defibrillators.
Figure 1. Cumulative incidence of causes of death in heart transplant recipients beyond the first year (n=913).
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - G Coutance
- Hospital Pitie-Salpetriere, Paris, France
| | - V Waldmann
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - O Aubert
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - A Asselin
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M Raynaud
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M Racape
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M.C Bories
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Rouvier
- Hospital Pitie-Salpetriere, Paris, France
| | - P Bruneval
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Paris, France
| | - E Marijon
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - X Jouven
- Hopital Europeen Georges Pompidou- University Paris Descartes, Paris, France
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16
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Coutance G, Boutolleau D, Rouvier P, Leprince P, Varnous S. Cytomegalovirus Infections are Frequent after Heart Transplantation but Do Not Increase the Risk of Biopsy-Proven Allograft Rejection in the Modern Era. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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17
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Coutance G, Lebreton G, Jacob N, Bréchot N, Demondion P, Bouglé A, Nguyen L, Varnous S, Combes A, Leprince P. A Direct Heart-Transplantation Strategy in Selected Patients on Extra-Corporeal Membrane Oxygenation Achieved Favorable Post-Transplant Outcomes. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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18
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Coutance G, Bonnet G, Van Keer J, Racapé M, Bruneval P, Van Huyen JD, Taupin J, Varnous S, Lecuyer L, Rouvier P, Jouven X, Loupy A. Identification of Risk Factors for Biopsy-Proven Rejection during the First Year Post Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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19
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Coutance G, Racapé M, Bonnet G, Van Keer J, Duong Van Huyen J, Bruneval P, Lecuyer L, Varnous S, Rouvier P, Taupin J, Jouven X, Loupy A. Risk Factors for Cellular and Antibody-Mediated Rejections in the First-Year Post-Transplant: A Population-Based Study. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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20
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Coutance G, Racapé M, Duong Van Huyen J, Bonnet G, Bruneval P, Taupin J, Varnous S, Guillemain R, Jouven X, Loupy A. Identification of latent classes of CAV trajectories after heart transplantation and their determinants. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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21
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Coutance G, Lebreton G, Demondion P, Jacob N, Nguyen L, Combes A, Amour J, Ouldamar S, Varnous S, Leprince P. Survival after heart transplantation in patients on ECMO support at the time of transplant improved over time in a high-volume center. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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22
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Coutance G, Nguyen L, Lebreton G, Ouldamar S, Rouvier P, Saheb S, Bouglé A, Bréchot N, Leprince P, Varnous S. Pre-formed donor specific antibodies > 3000 MFI managed at the time of transplantation predicts early antibody-mediated rejection after heart transplantation in a large cohort of patients. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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23
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Fedida J, Waintraub X, Duthoit G, Badenco N, Chastre T, Maupain C, Himbert C, Frank R, Pavie A, Varnous S, Hidden-Lucet F, Le Prince P, Gandjbakhch E. Contribution of electrophysiogical study for syncope in heart transplant patient: Retrospective analysis of 9 cases. Archives of Cardiovascular Diseases Supplements 2019. [DOI: 10.1016/j.acvdsp.2018.10.205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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24
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Chazal T, Varnous S, Guihaire J, Launay D, Fouret P, Grenier P, Amoura Z, Aubart FC. Sarcoïdose diagnostiquée sur les cœurs explantés après transplantation cardiaque : résultats d’une étude nationale multicentrique. Rev Med Interne 2018. [DOI: 10.1016/j.revmed.2018.10.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Coutance G, Leprince P, Demondion P, Jacob N, Nguyen L, Combes A, Amour J, Ouldamar S, Varnous S, Lebreton G. P4222Pre-heart transplantation ECMO support achieved favorable post-transplant outcomes in selected patients. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p4222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- G Coutance
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - P Leprince
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - P Demondion
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - N Jacob
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - L Nguyen
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - A Combes
- Hospital Pitie-Salpetriere, Intensive Care Unit, Paris, France
| | - J Amour
- Hospital Pitie-Salpetriere, Anesthesiology, Paris, France
| | - S Ouldamar
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
| | - G Lebreton
- Hospital Pitie-Salpetriere, Cardiovascular and Thoracic surgery, Paris, France
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26
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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] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- G Bonnet
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M Racape
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - M C Bories
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - S Varnous
- Hospital Pitie-Salpetriere, Paris, France
| | - P Rouvier
- Hospital Pitie-Salpetriere, Paris, France
| | - R Guillemain
- Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France
| | - P Bruneval
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | | | - C Lefaucheur
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - A Loupy
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
| | - X Jouven
- Paris Cardiovascular Research Center (PARCC), Paris Transplant Group, Paris, France
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27
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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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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31
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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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- Virginie D'Orio
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | - Pierre Demondion
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | - Guillaume Lebreton
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | - Guillaume Coutance
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | - Sheida Varnous
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
| | - Pascal Leprince
- Department of Thoracic and Cardiovascular Surgery, La Pitié Salpêtrière Hospital, Pierre et Marie Curie University, Paris, France
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34
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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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- A Loupy
- Paris Translational Research Center for Organ Transplantation, Paris, France.,University Paris Descartes, Paris, France
| | - C Toquet
- Department of Pathology, Hôpital Laennec, Nantes, France
| | - P Rouvier
- Department of Pathology, Hôpital La Pitié, Paris, France
| | - T Beuscart
- Paris Translational Research Center for Organ Transplantation, Paris, France
| | - M C Bories
- Paris Translational Research Center for Organ Transplantation, Paris, France
| | - S Varnous
- Department of Cardiac Surgery, Hôpital La Pitié, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - R Guillemain
- Cardiothoracic Transplantation Unit, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - S Pattier
- Department of Cardiac Surgery, Hôpital Laennec, Nantes, France
| | - C Suberbielle
- Histocompatibility Laboratory, Hôpital Saint Louis, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - P Leprince
- Department of Cardiac Surgery, Hôpital La Pitié, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - C Lefaucheur
- Paris Translational Research Center for Organ Transplantation, Paris, France
| | - X Jouven
- Paris Translational Research Center for Organ Transplantation, Paris, France.,University Paris Descartes, Paris, France.,Department of Cardiology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - P Bruneval
- Paris Translational Research Center for Organ Transplantation, Paris, France.,University Paris Descartes, Paris, France.,Department of Pathology, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - J P Duong Van Huyen
- Paris Translational Research Center for Organ Transplantation, Paris, France.,University Paris Descartes, Paris, France.,Department of Pathology, Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Paris, France
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37
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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38
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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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- S Choquet
- Clinical Hematology Unit, CHU La Pitié Salpêtrière Hospital, APHP, Paris, France
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43
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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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 08/30/2013] [Indexed: 11/27/2022]
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44
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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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [Affiliation(s)] [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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Affiliation(s)
- C Lebbe
- Assistance Publique-Hôpitaux de Paris, Department of Dermatology, Université Paris Diderot, INSERM U, Hôpital Saint Louis, France.
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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] [What about the content of this article? (0)] [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] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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