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Belghiti J, Cauchy F, Antoine C, Cheron G, Matignon M. Solid Organ Transplant Litigation at One of Europe's Largest University Hospitals. Transpl Int 2024; 37:12439. [PMID: 38751770 PMCID: PMC11094269 DOI: 10.3389/ti.2024.12439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 04/18/2024] [Indexed: 05/18/2024]
Abstract
Due to its intrinsic complexity and the principle of collective solidarity that governs it, solid organ transplantation (SOT) seems to have been spared from the increase in litigation related to medical activity. Litigation relating to solid organ transplantation that took place in the 29 units of the Assistance Publique-Hôpitaux de Paris and was the subject of a judicial decision between 2015 and 2022 was studied. A total of 52 cases of SOT were recorded, all in adults, representing 1.1% of all cases and increasing from 0.71% to 1.5% over 7 years. The organs transplanted were 25 kidneys (48%), 19 livers (37%), 5 hearts (9%) and 3 lungs (6%). For kidney transplants, 11 complaints (44%) were related to living donor procedures and 6 to donors. The main causes of complaints were early post-operative complications in 31 cases (60%) and late complications in 13 cases (25%). The verdicts were in favour of the institution in 41 cases (79%). Solid organ transplants are increasingly the subject of litigation. Although the medical institution was not held liable in almost 80% of cases, this study makes a strong case for patients, living donors and their relatives to be better informed about SOT.
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Affiliation(s)
- Jacques Belghiti
- Direction des Affaires Juridiques de l’Assistance Publique Hôpitaux de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - François Cauchy
- Department of Hepato-Pancreato-Biliary and Liver Transplantation, Hôpitaux Universitaires de Genève, Genève, Switzerland
| | - Corinne Antoine
- Assistance Publique Hôpitaux de Paris, Service de Néphrologie Transplantation, Hôpital Saint Louis, Paris, France
- Agence de la Biomédecine, Saint Denis, France
| | - Gérard Cheron
- Direction des Affaires Juridiques de l’Assistance Publique Hôpitaux de Paris, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Marie Matignon
- Assistance Publique Hôpitaux de Paris, Service de Néphrologie et de Transplantation Rénale, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », Centre Hospitalo-Universitaire Henri Mondor, Créteil, France
- University of Paris-Est-Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Team 21, Institut Mondor de Recherche Biomédicale, Créteil, France
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Bensaou S, Morel A, Matignon M, Stehle T, Moktefi A. Late Kidney Graft Dysfunction Related to JC Virus Nephropathy. Kidney Med 2024; 6:100807. [PMID: 38595735 PMCID: PMC10999473 DOI: 10.1016/j.xkme.2024.100807] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024] Open
Affiliation(s)
- Sarah Bensaou
- Nephrology and Renal Transplantation Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Univ Paris Est Créteil, Créteil, France
| | - Antoine Morel
- Nephrology and Renal Transplantation Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Univ Paris Est Créteil, Créteil, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Univ Paris Est Créteil, Créteil, France
| | - Thomas Stehle
- Nephrology and Renal Transplantation Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Univ Paris Est Créteil, Créteil, France
| | - Anissa Moktefi
- Pathology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Univ Paris Est Créteil, Créteil, France
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Mauhin W, Dzangue-Tchoupou G, Amelin D, Corneau A, Lamari F, Allenbach Y, Dussol B, Leguy-Seguin V, D'Halluin P, Matignon M, Maillot F, Ly KH, Besson G, Willems M, Labombarda F, Masseau A, Lavigne C, Lacombe D, Maillard H, Lidove O, Benveniste O. Mass cytometry reveals atypical immune profile notably impaired maturation of memory CD4 T with Gb3-related CD27 expression in CD4 T cells in Fabry disease. J Inherit Metab Dis 2024. [PMID: 38623626 DOI: 10.1002/jimd.12727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/14/2024] [Accepted: 02/22/2024] [Indexed: 04/17/2024]
Abstract
Fabry disease (FD) is an X-linked disease characterized by an accumulation of glycosphingolipids, notably of globotriaosylceramide (Gb3) and globotriaosylsphingosine (lysoGb3) leading to renal failure, cardiomyopathy, and cerebral strokes. Inflammatory processes are involved in the pathophysiology. We investigated the immunological phenotype of peripheral blood mononuclear cells in Fabry patients depending on the clinical phenotype, treatment, Gb3, and lysoGb3 levels and the presence of anti-drug antibodies (ADA). Leucocytes from 41 male patients and 20 controls were analyzed with mass cytometry using both unsupervised and supervised algorithms. FD patients had an increased expression of CD27 and CD28 in memory CD45- and CD45 + CCR7-CD4 T cells (respectively p < 0.014 and p < 0.02). Percentage of CD45RA-CCR7-CD27 + CD28+ cells in CD4 T cells was correlated with plasma lysoGb3 (r = 0.60; p = 0.0036) and phenotype (p < 0.003). The correlation between Gb3 and CD27 in CD4 T cells almost reached significance (r = 0.33; p = 0.058). There was no immune profile associated with the presence of ADA. Treatment with agalsidase beta was associated with an increased proportion of Natural Killer cells. These findings provide valuable insights for understanding FD, linking Gb3 accumulation to inflammation, and proposing new prognostic biomarkers.
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Affiliation(s)
- Wladimir Mauhin
- Internal Medicine Department, Reference Center for Lysosomal Diseases, Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris, France
- Centre de Recherche en Myologie, Unité Mixte de Recherche Scientifique 974, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Gaelle Dzangue-Tchoupou
- Centre de Recherche en Myologie, Unité Mixte de Recherche Scientifique 974, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Damien Amelin
- Centre de Recherche en Myologie, Unité Mixte de Recherche Scientifique 974, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Aurélien Corneau
- Plateforme de Cytométrie de la Pitié-Salpétrière (CyPS), UMS037-PASS, Faculté de Médecine, Sorbonne Université, Paris, France
| | - Foudil Lamari
- UF Biochimie des Maladies Neuro-métaboliques, Service de Biochimie Métabolique, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - Yves Allenbach
- Centre de Recherche en Myologie, Unité Mixte de Recherche Scientifique 974, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Paris, France
| | - Bertrand Dussol
- Nephrology Department, Aix Marseille Université et Centre d'Investigation Clinique 1409, INSERM/AMU/AP-HM, Marseille, France
| | - Vanessa Leguy-Seguin
- Internal Medicine and Clinical Immunology Department, Francois Mitterrand Hospital, Dijon, France
| | - Pauline D'Halluin
- Nephrology and Hemodialysis Department, Centre Hospitalier Côte Basque, Bayonne, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Henri-Mondor/Albert-Chenevier University Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France
| | - François Maillot
- Internal Medicine Department, Tours University Hospital, Tours, France
| | - Kim-Heang Ly
- Internal Medicine Department, Dupuytren University Hospital, Limoges, France
| | - Gérard Besson
- Neurology Department, Grenoble University Hospital, Grenoble, France
| | - Marjolaine Willems
- Medical Genetics and Rare Diseases Department, Montpellier University Hospital, Montpellier, France
| | | | - Agathe Masseau
- Internal Medicine Department, Hôtel-Dieu University Hospital, Nantes, France
| | - Christian Lavigne
- Internal Medicine and Clinical Immunology Department, Angers University Hospital, Angers, France
| | - Didier Lacombe
- Medical Genetics Department, CHU de Bordeaux, INSERM U1211, Université de Bordeaux, Bordeaux, France
| | - Hélène Maillard
- Department of Internal Medicine and Clinical Immunology, Referral Centre for rare systemic autoimmune diseases North and North-West of France (CeRAINO), CHU Lille, Lille, France
| | - Olivier Lidove
- Internal Medicine Department, Reference Center for Lysosomal Diseases, Groupe Hospitalier Diaconesses-Croix Saint Simon, Paris, France
| | - Olivier Benveniste
- Centre de Recherche en Myologie, Unité Mixte de Recherche Scientifique 974, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Paris, France
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Paumier M, Coussement J, Matignon M, Chauvet C, Bouvier N, Poncelet A, Dantal J, Scemla A, Ceunen H, Van Wijngaerden E, Kamar N, van der Beek MT, Wunderink HF, De Greef J, Candon S, Bougnoux ME, Lebeaux D. (1-3)-ß-D-glucan for the diagnosis of Nocardia infection in solid organ transplant recipients. Diagn Microbiol Infect Dis 2024; 108:116184. [PMID: 38241921 DOI: 10.1016/j.diagmicrobio.2024.116184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Affiliation(s)
- Margot Paumier
- Unité de Parasitologie-Mycologie. AP-HP, Hôpital Necker enfants malades; 149 rue de Sèvres, Paris 75015, France
| | - Julien Coussement
- University of Melbourne, Sir Peter MacCallum Department of Oncology, Melbourne, Australia
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil 94010, France.; IMRB (Institut Mondor de Recherche Biomédicale), VIC (Virus-Immunité-Cancer), DHU (Département Hospitalo-Universitaire), Université Paris-Est-Créteil (UPEC), INSERM U955, Equipe 21, Créteil 94010, France
| | - Cécile Chauvet
- Service de Transplantation Rénale, Hôpital Edouard HERRIOT, Lyon, France
| | - Nicolas Bouvier
- Service de Néphrologie, Université de Caen - Normandie, Caen, France
| | - Arthur Poncelet
- Department of Infectious Diseases, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Jacques Dantal
- ITUN (Institut de Transplantation, d'Urologie et de Néphrologie), CHU Nantes, Nantes, France
| | - Anne Scemla
- Kidney Transplantation Unit, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes Sorbonne Paris Cité, RTRS Centaure, Labex Transplantex, Paris, France
| | - Helga Ceunen
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Eric Van Wijngaerden
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation,; Toulouse Rangueil University Hospital, INSERM UMR, Toulouse 1291, France; Toulouse Institute for Infectious and Inflammatory Diseases (Infinity), Paul Sabatier University, Toulouse, France
| | - Martha T van der Beek
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Herman F Wunderink
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Julien De Greef
- Service de Médecine interne et Maladies infectieuses, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Sophie Candon
- CHU de Rouen Normandie, Université de Rouen Normandie, Rouen France
| | - Marie-Elisabeth Bougnoux
- Unité de Parasitologie-Mycologie. AP-HP, Hôpital Necker enfants malades; 149 rue de Sèvres, Paris 75015, France; Institut Pasteur, Université Paris Cité, Fungal Biology and Pathogenicity Unit - INRA USC Mycology Department, Paris 75015, France
| | - David Lebeaux
- Institut Pasteur, Université Paris Cité, CNRS UMR 6047, Genetics of Biofilms Laboratory, Paris 75015, France.; Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, 20 rue Leblanc, Paris 75015, France..
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Schwarz C, Georgin-Lavialle S, Lombardi Y, Marion O, Jambon F, Legendre C, Marx D, Levi C, Toure F, Le Quintrec M, Bobot M, Matignon M, Dujardin A, Maanaoui M, Cuozzo S, Jalal-Eddine A, Louis K, Mohamadou I, Brazier F, De Nattes T, Geneste C, Thervet E, Ducloux D, Mayet V, Kormann R, Lanot A, Duveau A, Zaidan M, Mesnard L, Ouali N, Rondeau E, Petit-Hoang C, Audard V, Deshayes A, Moktefi A, Rabant M, Buob D, François H, Luque Y. Kidney Transplantation in Patients With AA Amyloidosis: Outcomes in a French Multicenter Cohort. Am J Kidney Dis 2024; 83:329-339. [PMID: 37741608 DOI: 10.1053/j.ajkd.2023.07.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 06/26/2023] [Accepted: 07/24/2023] [Indexed: 09/25/2023]
Abstract
RATIONALE & OBJECTIVE Outcomes of kidney transplantation for patients with renal AA amyloidosis are uncertain, with reports of poor survival and high rates of disease recurrence. However, the data are inconclusive and mostly based on studies from the early 2000s and earlier. STUDY DESIGN Retrospective multicenter cohort study. SETTING & PARTICIPANTS We searched the French national transplant database to identify all patients with renal AA amyloidosis who underwent kidney transplantation between 2008 and 2018. EXPOSURES Age, cause of amyloidosis, use of biotherapies, and C-reactive protein levels. OUTCOMES Outcomes were all-cause mortality and allograft loss. We also reported amyloidosis allograft recurrence, occurrence of acute rejection episodes, as well as infectious, cardiovascular, and neoplastic disease events. ANALYTICAL APPROACH Kaplan-Meier estimator for mortality and cumulative incidence function method for allograft loss. Factors associated with patient and allograft survival were investigated using a Cox proportional hazards model and a cause-specific hazards model, respectively. RESULTS 86 patients who received kidney transplants for AA amyloidosis at 26 French centers were included. The median age was 49.4 years (IQR, 39.7-61.1). The main cause of amyloidosis was familial Mediterranean fever (37 cases; 43%). 16 (18.6%) patients received biotherapy after transplantation. Patient survival rates were 94.0% (95% CI, 89.1-99.2) at 1 year and 85.5% (77.8-94.0) at 5 years after transplantation. Cumulative incidences of allograft loss were 10.5% (4.0-17.0) at 1 year and 13.0% (5.8-20.1) at 5 years after transplantation. Histologically proven AA amyloidosis recurrence occurred in 5 transplants (5.8%). An infection requiring hospitalization developed in 55.8% of cases, and there was a 27.9% incidence of acute allograft rejection. Multivariable analysis showed that C-reactive protein concentration at the time of transplantation was associated with patient survival (HR, 1.01; 95% CI, 1.00-1.02; P=0.01) and allograft survival (HR, 1.68; 95% CI, 1.10-2.57; P=0.02). LIMITATIONS The study lacked a control group, and the effect of biotherapies on transplantation outcomes could not be explored. CONCLUSIONS This relatively contemporary cohort of patients who received a kidney transplant for AA amyloidosis experienced favorable rates of survival and lower recurrence rates than previously reported. These data support the practice of treating these patients with kidney transplantation for end-stage kidney disease. PLAIN-LANGUAGE SUMMARY AA amyloidosis is a severe and rare disease. Kidney involvement is frequent and leads to end-stage kidney disease. Because of the involvement of other organs, these patients are often frail, which has raised concerns about their suitability for kidney transplantation. We reviewed all patients with AA amyloidosis nephropathy who underwent kidney transplantation in France in the recent era (2008-2018) and found that the outcomes after kidney transplantation were favorable, with 85.5% of patients still alive 5 years after transplantation, a survival rate that is comparable to the outcomes of patients receiving a transplant for other forms of kidney diseases. Recurrence of amyloidosis in the transplanted kidney was infrequent (5.8%). These data support the practice of kidney transplantation for patients with AA amyloidosis who experience kidney failure.
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Affiliation(s)
- Chloë Schwarz
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France; Université de Paris, Service de Néphrologie-Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Sophie Georgin-Lavialle
- Sorbonne Université, Internal Medicine Department, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, National Reference Center for Autoinflammatory Diseases and Inflammatory Amyloidosis, Groupe de recherche clinique Amylose AA Sorbonne Université (GRAASU), Paris, France
| | - Yannis Lombardi
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Olivier Marion
- Department of Nephrology and Organ Transplantation, Toulouse Rangueil University Hospital, Toulouse, France
| | - Frédéric Jambon
- Centre Hospitalier Universitaire de Bordeaux, Service de Néphrologie, Transplantation Dialyse, Aphérèses, Hôpital Pellegrin, Place Amélie Raba Léon, Bordeaux, France
| | | | - David Marx
- Department of Nephrology and Transplantation, Strasbourg University Hospital, Strasbourg, France
| | - Charlène Levi
- Service de Transplantation Rénale, Hôpitaux Civils, Lyon, France
| | - Fatouma Toure
- Department of Nephrology, Dialysis and Transplantation, Hospital University of Limoges, Limoges, France
| | - Moglie Le Quintrec
- Service de Transplantation Rénale, Centre Hospitalier Universitaire Montpellier, Montpellier, France
| | - Mickael Bobot
- Centre de Néphrologie et Transplantation Rénale, Assistance Publique-Hôpitaux de Marseille, Hôpital de la Conception, Centre Hospitalier Universitaire de la Conception, Marseille, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Creteil, France
| | - Amaury Dujardin
- Service de Néphrologie et Immunologie Clinique, Nantes Université, Centre Hospitalier Universitaire Nantes, Institut National de la Santé et de la Recherche Médicale, Centre de Recherche en Transplantation et Immunologie, Unité Mixte de Recherche 1064, Institut de Transplantation Urologie Néphrologie, Nantes, France
| | - Mehdi Maanaoui
- Nephrology Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Sébastien Cuozzo
- Department of Nephrology Dialysis and Transplantation, Pasteur 2 Hospital, Nice University Hospital, Nice, France
| | | | - Kévin Louis
- Hôpital Necker, Assistance Publique-Hôpitaux de Paris, Nephrology and Transplantation Department, Saint-Louis Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Inna Mohamadou
- Kidney Transplantation Department, Hôpital Pitié-Salpétriêre, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - François Brazier
- Nephrology, Internal Medicine, Dialysis and Transplantation Department, Centre Hospitalier Universitaire Amiens, Amiens, France
| | - Tristan De Nattes
- Nephrology-Hemodialysis Department, Centre Hospitalier Universitaire Rouen, Rouen, France
| | - Claire Geneste
- Nephrology Department, Centre Hospitalier Universitaire Tours, Tours, France
| | - Eric Thervet
- Nephrology Department, European Georges Pompidou Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Didier Ducloux
- Nephrology Department, Centre Hospitalier Universitaire Besançon, Besançon, France
| | - Valentin Mayet
- Nephrology-Hemodialysis Department, Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - Raphaël Kormann
- Nephrology Department, Centre Hospitalier Universitaire Nancy, Nancy, France
| | - Antoine Lanot
- Nephrology-Dialysis-Kidney Transplantation Department, Centre Hospitalier Universitaire Caen, Caen, France
| | - Agnès Duveau
- Nephrology Department, Centre Hospitalier Universitaire Angers, Angers, France
| | - Mohamad Zaidan
- Université de Paris, Service de Néphrologie-Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Laurent Mesnard
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Nacera Ouali
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Eric Rondeau
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Camille Petit-Hoang
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Vincent Audard
- Nephrology and Renal Transplantation Department, Assistance Publique-Hôpitaux de Paris, Hôpital Henri Mondor, Creteil, France
| | | | - Anissa Moktefi
- Pathology Department, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | | | - David Buob
- Pathology Department, Sorbonne Université, Tenon Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Hélène François
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France
| | - Yosu Luque
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche 1155, Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Assistance Publique-Hôpitaux de Paris, Hôpital Tenon, Paris, France.
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Esnault V, Hoisnard L, Peiffer B, Fihman V, Fourati S, Angebault C, Champy C, Gallien S, Attias P, Morel A, Grimbert P, Melica G, Matignon M. Beyond the First Year: Epidemiology and Management of Late-Onset Opportunistic Infections After Kidney Transplantation. Transpl Int 2024; 37:12065. [PMID: 38468638 PMCID: PMC10926380 DOI: 10.3389/ti.2024.12065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 02/13/2024] [Indexed: 03/13/2024]
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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Affiliation(s)
- V. Esnault
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Maladies Infectieuses et d’Immunologie Clinique, Centre Hospitalo-Universitaire (CHU) Henri Mondor, Créteil, France
| | - L. Hoisnard
- Fédération Hospitalo-Universitaire TRUE InnovaTive theRapy for immUne disordErs, AP-HP, Henri Mondor Hospital, Créteil, France
- INSERM, Centre d’Investigation Clinique 1430, Créteil, France
- EpiDermE Epidemiology in Dermatology and Evaluation of Therapeutics, EA7379, Paris Est Créteil University UPEC, Créteil, France
| | - B. Peiffer
- AP-HP, Département Médico-Universitaire Médecine, CHU Henri Mondor, Créteil, France
| | - V. Fihman
- AP-HP, Service de Microbiologie, Département de Prévention, Diagnostic et Traitement des Infections, CHU Henri Mondor, Créteil, France
| | - S. Fourati
- AP-HP, Service de Microbiologie, Département de Prévention, Diagnostic et Traitement des Infections, CHU Henri Mondor, Créteil, France
| | - C. Angebault
- AP-HP, Service de Microbiologie, Département de Prévention, Diagnostic et Traitement des Infections, CHU Henri Mondor, Créteil, France
- EA DYNAMiC 7380, Faculté de Santé, University Paris-Est Créteil (UPEC), Ecole Nationale Vétérinaire d’Alfort (ENVA), USC Anses, Créteil, France
| | - C. Champy
- AP-HP, Service d’Urologie, CHU Henri Mondor, Créteil, France
| | - S. Gallien
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Maladies Infectieuses et d’Immunologie Clinique, Centre Hospitalo-Universitaire (CHU) Henri Mondor, Créteil, France
- EA DYNAMiC 7380, Faculté de Santé, University Paris-Est Créteil (UPEC), Ecole Nationale Vétérinaire d’Alfort (ENVA), USC Anses, Créteil, France
| | - P. Attias
- AP-HP, Service de Néphrologie et de Transplantation Rénale, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », CHU Henri Mondor, Créteil, France
| | - A. Morel
- AP-HP, Service de Néphrologie et de Transplantation Rénale, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », CHU Henri Mondor, Créteil, France
| | - P. Grimbert
- AP-HP, Service de Néphrologie et de Transplantation Rénale, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », CHU Henri Mondor, Créteil, France
- University of Paris-Est-Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Team 21, Institut Mondor de Recherche Biomédicale, Créteil, France
| | - G. Melica
- Assistance Publique-Hôpitaux de Paris (AP-HP), Service de Maladies Infectieuses et d’Immunologie Clinique, Centre Hospitalo-Universitaire (CHU) Henri Mondor, Créteil, France
| | - M. Matignon
- AP-HP, Service de Néphrologie et de Transplantation Rénale, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », CHU Henri Mondor, Créteil, France
- University of Paris-Est-Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Team 21, Institut Mondor de Recherche Biomédicale, Créteil, France
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7
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Delestre F, Charles P, Karras A, Pagnoux C, Néel A, Cohen P, Aumaître O, Faguer S, Gobert P, Maurier F, Samson M, Godmer P, Bonnotte B, Cottin V, Hanrotel-Saliou C, Le Gallou T, Carron PL, Desmurs-Clavel H, Direz G, Jourde-Chiche N, Lifermann F, Martin-Silva N, Pugnet G, Quéméneur T, Matignon M, Benhamou Y, Daugas E, Lazaro E, Limal N, Ducret M, Huart A, Viallard JF, Hachulla E, Perrodeau E, Puechal X, Guillevin L, Porcher R, Terrier B. Rituximab as maintenance therapy for ANCA-associated vasculitides: pooled analysis and long-term outcome of 277 patients included in the MAINRITSAN trials. Ann Rheum Dis 2024; 83:233-241. [PMID: 37918894 DOI: 10.1136/ard-2023-224623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 10/14/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To compare the long-term efficacy and safety of azathioprine (AZA), 18-month fixed-schedule rituximab (RTX), 18-month tailored RTX and 36-month RTX in preventing relapses in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis who achieved a complete remission after induction therapy. Patients treated with 36-month RTX received either a fixed or a tailored regimen for the first 18 months and a fixed regimen for the last 18 months (36-month fixed/fixed RTX and 36-month tailored/fixed RTX, respectively). METHODS The Maintenance of Remission using Rituximab in Systemic ANCA-associated Vasculitis (MAINRITSAN) trials sequentially compared: 18-month fixed-schedule RTX versus AZA (MAINRITSAN); 18-month fixed-schedule RTX versus 18-month tailored-RTX (MAINRITSAN2); and extended therapy to 36 months with four additional RTX infusions after MAINRITSAN2 versus placebo (MAINRITSAN3). Patients were then followed prospectively through month 84 and their data were pooled to analyse relapses and adverse events. The primary endpoint was relapse-free survival at month 84. RESULTS 277 patients were enrolled and divided in 5 groups: AZA (n=58), 18-month fixed-schedule RTX (n=97), 18-month tailored-RTX (n=40), 36-month tailored/fixed RTX (n=42), 36-month fixed/fixed RTX (n=41). After adjustment for prognostic factors, 18-month fixed-schedule RTX was superior to AZA in preventing major relapses at month 84 (HR 0.38, 95% CI 0.20 to 0.71). The 18-month tailored-RTX regimen was associated with an increased risk of major relapse compared with fixed-schedule regimen (HR 2.92, 95% CI 1.43 to 5.96). The risk of major relapse was similar between 36-month fixed/fixed and 18-month fixed-RTX (HR 0.69, 95% CI 0.38 to 1.25). CONCLUSIONS According to these results, it appears that the 84-month remission rate is higher with an 18-month fixed RTX regimen compared with AZA and 18-month tailored RTX. Also, extending RTX to 36 months does not appear to reduce the long-term relapse rate compared with the 18-month fixed RTX regimen. However, as this study was underpowered to make this comparison, further prospective studies are needed to determine the potential long-term benefits of extending treatment in these patients.
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Affiliation(s)
- Florence Delestre
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP.Centre, Hospital Cochin, Paris, France
- Université Paris Cité, Paris, France
| | - Pierre Charles
- Université Paris Cité, Paris, France
- Department of Internal Medicine, Institut Mutualiste Montsouris, Paris, France
| | - Alexandre Karras
- Université Paris Cité, Paris, France
- Department of Nephrology, Hôpital Européen Georges Pompidou, APHP, Paris, France
| | - Christian Pagnoux
- University of Toronto, Toronto, Ontario, Canada
- Vasculitis clinic, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Antoine Néel
- Department of Internal Medicine, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - Pascal Cohen
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP.Centre, Hospital Cochin, Paris, France
| | - Olivier Aumaître
- Department of Internal Medicine, Hôpital Gabriel Montpied, Clermont-Ferrand, France
| | - Stanislas Faguer
- Département de Néphrologie et Transplantation d'Organes, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Pierre Gobert
- Département de médecine, Hopital Général Henri-Duffaut, Avignon, France
| | - François Maurier
- Department of Internal Medicine, Hôpitaux Privés de Metz, Metz, France
| | - Maxime Samson
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Pascal Godmer
- Département de Hématologie Immunologie, Centre Hospitalier Bretagne Atlantique de Vannes, Vannes, France
| | - Bernard Bonnotte
- Département de Médecine Interne et Immunologie Clinique, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Vincent Cottin
- Department of Respiratory Medicine, National Coordinating Reference Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Lyon, France
| | - Catherine Hanrotel-Saliou
- Department of Nephrology, Centre Hospitalier Universitaire de Brest, Hôpital la Cavale Blanche, Brest, France
| | - Thomas Le Gallou
- Department of Internal Medicine, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Pierre-Louis Carron
- Département de néphrologie, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | | | - Guillaume Direz
- Rheumatology Department, Le Mans General Hospital, Le Mans, France
| | - Noémie Jourde-Chiche
- Centre de Néphrologie et Transplantation Rénale, Hôpital de La Conception, Aix-Marseille Université, Marseille, France
| | | | - Nicolas Martin-Silva
- Department of Internal Medicine, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Grégory Pugnet
- Department of Internal Medicine, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Thomas Quéméneur
- Département de Néphrologie et de Médecine Interne, Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Hopitaux Universitaires Henri Mondor, Créteil, France
| | - Ygal Benhamou
- Department of Internal Medicine, Centre Hospitalier Universitaire Charles Nicolle, Rouen, France
| | - Eric Daugas
- Department of Nephrology, Hopital Bichat - Claude-Bernard, Paris, France
| | - Estibaliz Lazaro
- Department of Internal Medicine, Bordeaux University Hospital, Pessac, France
| | - Nicolas Limal
- Department of Internal Medicine, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Maïzé Ducret
- Department of Nephrology, Annecy Hospital, Annecy, France
| | - Antoine Huart
- Department of Nephrology, Hospital Rangueil, Toulouse, France
| | | | - Eric Hachulla
- Département de Médecine Interne et Immunologie Clinique, Centre de Référence des Maladies Systémiques et Auto-Immunes Rares du Nord-Ouest (CERAINO), Centre Hospitalier Universitaire de Lille, Lille, France
| | - Elodie Perrodeau
- Center of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris, France
| | - Xavier Puechal
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP.Centre, Hospital Cochin, Paris, France
- Université Paris Cité, Paris, France
| | - Loïc Guillevin
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP.Centre, Hospital Cochin, Paris, France
- Université Paris Cité, Paris, France
| | - Raphaël Porcher
- Université Paris Cité, Paris, France
- Center of Research in Epidemiology and Statistics Sorbonne Paris Cité, Paris, France
| | - Benjamin Terrier
- Department of Internal Medicine, National Reference Center for Rare Systemic Autoimmune Diseases, AP-HP.Centre, Hospital Cochin, Paris, France
- Université Paris Cité, Paris, France
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8
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Stehlé T, Wei F, Brabant S, Luciani A, Grimbert P, Prié D, Reizine E, Durrbach A, Mulé S, Hulin A, Boueilh A, Blain M, Champy CM, Ingels A, Matignon M, Brasseur P, Canouï-Poitrine F, Pigneur F. Glomerular Filtration Rate Measured Based on Iomeprol Clearance Assessed at CT Urography in Living Kidney Donor Candidates. Radiology 2023; 309:e230567. [PMID: 38085083 DOI: 10.1148/radiol.230567] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background Estimating glomerular filtration rate (GFR) from serum creatinine can be inaccurate, and current procedures for measuring GFR are time-consuming and cumbersome. Purpose To develop a method for measuring GFR based on iomeprol clearance assessed at CT urography in kidney donor candidates and compare this with iohexol clearance (reference standard for measuring GFR). Materials and Methods This cross-sectional retrospective study included data from kidney donor candidates who underwent both iohexol clearance and CT urography between July 2016 and October 2022. CT-measured GFR was calculated as the iomeprol excretion rate in the urinary system between arterial and excretory phases (Hounsfield units times milliliters per minute) divided by a surrogate for serum iomeprol concentration in the aorta at the midpoint (in Hounsfield units). Performance of CT-measured GFR was assessed with use of mean bias (mean difference between CT-measured GFR and iohexol clearance), precision (the distance between quartile 1 and quartile 3 of the bias [quartile 3 minus quartile 1], with a small value indicating high precision), and accuracy (percentage of CT-measured GFR values falling within 10%, 20%, and 30% of iohexol clearance values). Intraobserver agreement was assessed for 30 randomly selected individuals with the Lin concordance correlation coefficient. Results A total of 75 kidney donor candidates were included (mean age, 51 years ± 13 [SD]; 45 female). The CT-measured GFR was unbiased (1.1 mL/min/1.73 m2 [95% CI: -1.9, 4.1]) and highly precise (16.2 mL/min/1.73 m2 [quartiles 1 to 3, -6.6 to 9.6]). The accuracy of CT-measured GFR within 10%, 20%, and 30% was 61.3% (95% CI: 50.3, 72.4), 88.0% (95% CI: 80.7, 95.4), and 100%, respectively. Concordance between CT-based GFR measurements taken 2 months apart was almost perfect (correlation coefficient, 0.99 [95% CI: 0.98, 0.99]). Conclusion In living kidney donors, GFR measured based on iomeprol clearance assessed at CT urography showed good agreement with GFR measured based on iohexol clearance. © RSNA, 2023 Supplemental material is available for this article. See also the editorial by Davenport in this issue.
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Affiliation(s)
- Thomas Stehlé
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Félix Wei
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Séverine Brabant
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Alain Luciani
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Philippe Grimbert
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Dominique Prié
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Edouard Reizine
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Antoine Durrbach
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Sébastien Mulé
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Anne Hulin
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Anna Boueilh
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Maxime Blain
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Cécile-Maud Champy
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Alexandre Ingels
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Marie Matignon
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Paul Brasseur
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Florence Canouï-Poitrine
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
| | - Frédéric Pigneur
- From the Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Université Paris Est Créteil, Institut Mondor de Recherche Biomédicale, Créteil, France (T.S., F.W., A.L., P.G., E.R., S.M., A.H., A.B., M.B., C.M.C., A.I., M.M., P.B., F.C.P., F.P.); Service de Néphrologie et Transplantation (T.S., P.G., A.D., A.B., M.M.), Fédération Hospitalo-Universitaire Innovative Therapy for Immune Disorders (T.S., P.G., A.D., A.B., M.M.), Service d'Imagerie Médicale (F.W., A.L., E.R., S.M., M.B., F.P.), Laboratoire de Pharmacologie (A.H.), Service d'Urologie (C.M.C., A.I.), Service de Santé Publique (P.B., F.C.P.), and Unité de Recherche Clinique (P.B., F.C.P.), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Créteil, France; Service de Physiologie et Explorations Fonctionnelles, AP-HP, Groupe Hospitalier Necker Enfants Malades, Paris, France (S.B., D.P.); Faculté de Médecine, Université de Paris Cité, INSERM U1151, Paris, France (D.P.); Faculté de Médecine, Université Paris-Saclay, Orsay, France (A.D.); and INSERM UMR 1186, Institut Gustave Roussy, Villejuif, France (A.D.)
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9
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Braud P, Joher N, Blancho G, Grimbert P, Anne LB, Garandeau C, Cantarovich D, Houzet A, Giral M, Dantal J, Matignon M, Masset C. Evolution of anti-spike responses to SARS-CoV-2 vaccination within 6 months post-transplantation in patients previously vaccinated while on the transplant waiting list. Clin Transplant 2023; 37:e15120. [PMID: 37658833 DOI: 10.1111/ctr.15120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 08/04/2023] [Accepted: 08/23/2023] [Indexed: 09/05/2023]
Affiliation(s)
- Pierre Braud
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Nizar Joher
- Department of Nephrology and Transplantation, Assistance Publique Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, France
| | - Gilles Blancho
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, Nantes, France
| | - Philippe Grimbert
- Department of Nephrology and Transplantation, Assistance Publique Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, France
| | - Le Bouter Anne
- Laboratory of Virology, Assistance Publique Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, France
| | - Claire Garandeau
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Diego Cantarovich
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Aurélie Houzet
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
| | - Magali Giral
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, Nantes, France
| | - Jacques Dantal
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, Nantes, France
| | - Marie Matignon
- Department of Nephrology and Transplantation, Assistance Publique Hôpitaux de Paris, Hôpital Henri Mondor, Créteil, France
| | - Christophe Masset
- Institut de Transplantation Urologie Néphrologie (ITUN), CHU Nantes, Nantes, France
- Nantes Université, INSERM, Center for Research in Transplantation and Translational Immunology, Nantes, France
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10
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Stehlé T, Letavernier E, Joher N, Mesnard L, Moktefi A, Matignon M. Tolvaptan to prevent calcium oxalate crystal deposition in the kidney allograft after kidney transplantation for primary hyperoxaluria. Kidney Int 2023; 104:398. [PMID: 37479387 DOI: 10.1016/j.kint.2023.05.015] [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] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 05/05/2023] [Accepted: 05/15/2023] [Indexed: 07/23/2023]
Affiliation(s)
- Thomas Stehlé
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale, Créteil, France; Service de Néphrologie et Transplantation, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », Créteil, France.
| | - Emmanuel Letavernier
- Service des Explorations Fonctionnelles Multidisciplinaires, Sorbonne Université, INSERM UMR S 1155, AP-HP, Hôpital Tenon, Paris, France
| | - Nizar Joher
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale, Créteil, France; Service de Néphrologie et Transplantation, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », Créteil, France
| | - Laurent Mesnard
- Service des Soins Intensifs Néphrologiques et Rein Aigu, Sorbonne Université, INSERM UMR S 1155, AP-HP, Hôpital Tenon, Paris, France
| | - Anissa Moktefi
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale, Créteil, France; Département de Pathologie, AP-HP, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Marie Matignon
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale, Créteil, France; Service de Néphrologie et Transplantation, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire « Innovative Therapy for Immune Disorders », Créteil, France
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11
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Schwarz C, Morel A, Matignon M, Grimbert P, Rondeau E, Ouali N, François H, Mesnard L, Petit-Hoang C, Rafat C, Dahan K, Luque Y. Hepatitis B Virus Reactivation in Kidney Transplant Recipients Treated With Belatacept. Kidney Int Rep 2023; 8:1531-1541. [PMID: 37547512 PMCID: PMC10403656 DOI: 10.1016/j.ekir.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 04/30/2023] [Accepted: 05/08/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Hepatitis B virus (HBV) reactivation in kidney transplant recipients has been reported in 3% to 9% of anti-HBc antibody (HBcAb)-positive HBs antigen (HBsAg)-negative patients. It has not been studied in patients receiving belatacept, a selective costimulation blocker. Methods We performed a retrospective study of all transplant recipients receiving belatacept in 2 kidney transplantation centers in France. Among HBcAb-positive patients, we analyzed HBV reactivation rate, outcomes, and risk factors. Results A total of 135 patients treated with belatacept were included: 32 were HBcAb-positive and 2 were HBsAg-positive. Seven patients reactivated HBV (21.9% of HBcAb-positive patients), including 5 HBsAg-negative patients (16.7% of HBcAb-positive HBsAg-negative patients). Reactivation occurred 54.8 (± 70.9) months after transplantation. One patient presented with severe hepatitis and 1 patient developed cirrhosis. There was no significant difference in survival between patients that reactivated HBV and patients that did not: 5-year patient survival of 100% (28.6; 100) and 83.4% (67.6; 100), respectively (P = 0.363); and 5-year graft survival of 100% (28.6; 100) and 79.8% (61.7; 100), respectively (P = 0.335). No factor, including HBsAb positivity and antiviral prophylaxis, was statistically associated with the risk of HBV reactivation. Conclusion HBV reactivation rate was high in patients treated with belatacept when compared with previous transplantation studies. HBV reactivation did not impact survival. Further studies are needed to confirm these results. A systematic antiviral prophylaxis for these patients should be considered and evaluated.
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Affiliation(s)
- Chloë Schwarz
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Antoine Morel
- Service de Néphrologie, Hôpital Henri Mondor, Assistance Publique–Hôpitaux de Paris, Créteil, France
| | - Marie Matignon
- Service de Néphrologie, Hôpital Henri Mondor, Assistance Publique–Hôpitaux de Paris, Créteil, France
| | - Philippe Grimbert
- Service de Néphrologie, Hôpital Henri Mondor, Assistance Publique–Hôpitaux de Paris, Créteil, France
| | - Eric Rondeau
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
- Sorbonne Université, Unité CoRaKid, Inserm, UMR_S1155, Paris, France
| | - Nacera Ouali
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Hélène François
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
- Sorbonne Université, Unité CoRaKid, Inserm, UMR_S1155, Paris, France
| | - Laurent Mesnard
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
- Sorbonne Université, Unité CoRaKid, Inserm, UMR_S1155, Paris, France
| | - Camille Petit-Hoang
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Cédric Rafat
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Karine Dahan
- Néphrologie et Dialyses, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Yosu Luque
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique–Hôpitaux de Paris, Paris, France
- Sorbonne Université, Unité CoRaKid, Inserm, UMR_S1155, Paris, France
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12
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Stehlé T, Ouamri Y, Morel A, Vidal-Petiot E, Fellahi S, Segaux L, Prié D, Grimbert P, Luciani A, Audard V, Haymann JP, Mulé S, De Kerviler E, Peraldi MN, Boutten A, Matignon M, Canouï-Poitrine F, Flamant M, Pigneur F. Development and validation of a new equation based on plasma creatinine and muscle mass assessed by CT scan to estimate glomerular filtration rate: a cross-sectional study. Clin Kidney J 2023; 16:1265-1277. [PMID: 37529645 PMCID: PMC10387393 DOI: 10.1093/ckj/sfad012] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Indexed: 08/03/2023] Open
Abstract
Background Inter-individual variations of non-glomerular filtration rate (GFR) determinants of serum creatinine, such as muscle mass, account for the imperfect performance of estimated GFR (eGFR) equations. We aimed to develop an equation based on creatinine and total lumbar muscle cross-sectional area measured by unenhanced computed tomography scan at the third lumbar vertebra. Methods The muscle mass-based eGFR (MMB-eGFR) equation was developed in 118 kidney donor candidates (iohexol clearance) using linear regression. Validation cohorts included 114 healthy subjects from another center (51Cr-EDTA clearance, validation population 1), 55 patients with chronic diseases (iohexol, validation population 2), and 60 patients with highly discordant creatinine and cystatin C-based eGFR, thus presumed to have atypical non-GFR determinants of creatinine (51Cr-EDTA, validation population 3). Mean bias was the mean difference between eGFR and measured GFR, precision the standard deviation (SD) of the bias, and accuracy the percentage of eGFR values falling within 20% and 30% of measured GFR. Results In validation population 1, performance of MMB-eGFR was not different from those of CKD-EPICr2009 and CKD-EPICr2021. In validation population 2, MMB-eGFR was unbiased and displayed better precision than CKD-EPICr2009, CKD-EPICr2021 and EKFC (SD of the biases: 13.1 vs 16.5, 16.8 and 15.9 mL/min/1.73 m2). In validation population 3, MMB-eGFR had better precision and accuracy {accuracy within 30%: 75.0% [95% confidence interval (CI) 64.0-86.0] vs 51.5% (95% CI 39.0-64.3) for CKD-EPICr2009, 43.3% (95% CI 31.0-55.9) for CKD-EPICr2021, and 53.3% (95% CI 40.7-66.0) for EKFC}. Difference in bias between Black and white subjects was -2.1 mL/min/1.73 m2 (95% CI -7.2 to 3.0), vs -8.4 mL/min/1.73 m2 (95% CI -13.2 to -3.6) for CKD-EPICr2021. Conclusion MMB-eGFR displayed better performances than equations based on demographics, and could be applied to subjects of various ethnic backgrounds.
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Affiliation(s)
| | - Yaniss Ouamri
- Univ. Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service d'Imagerie Médicale, Créteil, France
| | - Antoine Morel
- Univ. Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France
| | - Emmanuelle Vidal-Petiot
- Université Paris Cité, Institut National de la Santé et de la Recherche Médicale (INSERM), U1149, Paris, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Département de Physiologie-Explorations Fonctionnelles, Hôpital Bichat, Paris, France
| | - Soraya Fellahi
- Université Pierre et Marie Curie Paris 6, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris (APHP), Paris, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Département de Biochimie, Créteil, France
| | - Lauriane Segaux
- Univ. Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France
| | - Dominique Prié
- Université de Paris Cité, Faculté de Médecine, Institut National de la Santé et de la Recherche Médicale (INSERM) U1151, Paris, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Groupe Hospitalier Necker Enfants Malades, Service de Physiologie et Explorations Fonctionnelles, Paris, France
| | - Philippe Grimbert
- Univ. Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
| | - Alain Luciani
- Univ. Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service d'Imagerie Médicale, Créteil, France
| | - Vincent Audard
- Univ. Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
| | - Jean Philippe Haymann
- Univ. Paris Diderot, Sorbonne Paris Cité, Institut National de la Santé et de la Recherche Médicale (INSERM), U1155
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux de Paris, hôpital Tenon, Département de Physiologie-Explorations Fonctionnelles, Paris, France
| | - Sébastien Mulé
- Univ. Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service d'Imagerie Médicale, Créteil, France
| | - Eric De Kerviler
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux de Paris, Hôpital Tenon, Département de Physiologie-Explorations Fonctionnelles, Paris, France
| | - Marie-Noëlle Peraldi
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpital Saint Louis, Service de Néphrologie, Paris, France
| | - Anne Boutten
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux de Paris, hôpital Bichat, Département de Biochimie Clinique, Paris, France
| | - Marie Matignon
- Univ. Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
| | - Florence Canouï-Poitrine
- Univ. Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service de Santé Publique, Créteil, France
| | - Martin Flamant
- Université Paris Cité, Institut National de la Santé et de la Recherche Médicale (INSERM), U1149, Paris, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Département de Physiologie-Explorations Fonctionnelles, Hôpital Bichat, Paris, France
| | - Frédéric Pigneur
- Univ. Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service d'Imagerie Médicale, Créteil, France
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13
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Moktefi A, Mulé S, Joher N, Blanc-Durand P, Oniszczuk J, Matignon M, Le Bras F, El Karoui K. IgG4-related disease and small lymphocytic lymphoma. QJM 2023; 116:523-524. [PMID: 36749002 DOI: 10.1093/qjmed/hcad019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 02/05/2023] [Indexed: 02/08/2023] Open
Affiliation(s)
- Anissa Moktefi
- Pathology Department, Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Sébastien Mulé
- Medical Imaging Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Nizar Joher
- Nephrology and Renal Transplantation Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Paul Blanc-Durand
- Nuclear Medicine Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Julie Oniszczuk
- Nephrology and Renal Transplantation Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Fabien Le Bras
- Lymphoid Malignancies Unit, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
| | - Khalil El Karoui
- Nephrology and Renal Transplantation Department, AP-HP, Hôpitaux Universitaires Henri Mondor, Univ. Paris Est Créteil, Créteil F-94010, France
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14
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Mohamadou I, Matignon M, Malard S, Lombardi Y, Buob D, Moktefi A, Jamme M, Ouali N, Rafat C, François H, Petit-Hoang C, Rondeau E, Mesnard L, Grimbert P, Taupin JL, Luque Y. Additional Benefits of Rituximab and Plasma Exchange on Top of Standard Induction Therapy in Kidney Transplant Recipients With a Negative CDC Crossmatch but High Preformed Donor Specific Antibody Titer. Transpl Int 2023; 36:10844. [PMID: 37056357 PMCID: PMC10088221 DOI: 10.3389/ti.2023.10844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 02/28/2023] [Indexed: 03/30/2023]
Abstract
Optimal induction strategy in highly sensitized kidney transplant recipients (KTRs) is still a matter of debate. The place of therapies, such as plasma exchange and rituximab, with potential side effects and high cost, is not clearly established. We compared two induction strategies with (intensive) or without (standard) rituximab and plasma exchange in KTRs with high levels of preformed DSA transplanted between 2012 and 2019. Sixty KTRs with a mean age of 52.2 ± 12.2 years were included, 36 receiving standard and 24 intensive induction. Mean fluorescence intensity of immunodominant DSA in the cohort was 8,903 ± 5,469 pre-transplantation and similar in both groups. DSA level decrease was similar at 3 and 12 months after transplantation in the two groups. An intensive induction strategy was not associated with better graft or patient survival, nor more infectious complications. The proportion of patients with rejection during the first year was similar (33% in each group), but rejection occurred later in the intensive group (211 ± 188 days, vs. 79 ± 158 days in the standard group, p < 0.01). Our study suggests that an intensive induction therapy including rituximab and plasma exchanges in highly sensitized kidney recipients is not associated with better graft survival but may delay biopsy-proven rejection.
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Affiliation(s)
- Inna Mohamadou
- Service de Transplantation Rénale, Hôpital Pitié-Salpêtrière, Assistance Publique – Hôpitaux de Paris, Paris, France
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- *Correspondence: Inna Mohamadou,
| | - Marie Matignon
- Service de Néphrologie, Hôpitaux Universitaires Henri Mondor, Créteil, France
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Stéphanie Malard
- Laboratoire d’Immunologie et d’Histocompatibilité, Hôpital Saint-Louis, Paris, France
| | - Yannis Lombardi
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - David Buob
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- Anatomie Pathologique, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Pairs, France
| | - Anissa Moktefi
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
- Département de Pathologie, Hôpitaux Universitaires Henri Mondor, Assistance Publique – Hôpitaux de Paris, Créteil, France
| | - Matthieu Jamme
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Nacera Ouali
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Cedric Rafat
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Hélène François
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Camille Petit-Hoang
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Eric Rondeau
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Laurent Mesnard
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
| | - Philippe Grimbert
- Service de Néphrologie, Hôpitaux Universitaires Henri Mondor, Créteil, France
- INSERM U955 Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - Jean-Luc Taupin
- Laboratoire d’Immunologie et d’Histocompatibilité, Hôpital Saint-Louis, Paris, France
| | - Yosu Luque
- Sorbonne Université, Paris, France
- INSERM U1155 Des Maladies Rénales Rares Aux Maladies Fréquentes, Remodelage Et Réparation, Paris, France
- Soins Intensifs Néphrologiques et Rein Aigu, Département de Néphrologie, Hôpital Tenon, Assistance Publique – Hôpitaux de Paris, Paris, France
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15
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Bertrand D, Matignon M, Morel A, Ludivine L, Lemoine M, Hanoy M, Roy FL, Nezam D, Hamzaoui M, de Nattes T, Moktefi A, François A, Laurent C, Etienne I, Guerrot D. Belatacept rescue conversion in kidney transplant recipients with vascular lesions (Banff cv score >2): a retrospective cohort study. Nephrol Dial Transplant 2023; 38:481-490. [PMID: 35544123 DOI: 10.1093/ndt/gfac178] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 10/06/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Immunosuppression in kidney transplant recipients with decreased graft function and histological vascular changes can be particularly challenging. The impact of a late rescue conversion to belatacept on kidney graft survival in this context has never been studied. METHODS We report a bicentric retrospective cohort study comparing a calcineurin inhibitor (CNI) to belatacept switch versus CNI continuation in 139 kidney transplant recipients with histological kidney vascular damage (cv ≥2, g + cpt ≤1, i + t ≤1) and low estimated glomerular filtration rate (≤40 mL/min/1.73 m²). Primary outcome was death-censored graft survival. RESULTS During the study follow-up, 10 graft losses (14.5%) occurred in the belatacept group (n = 69) versus 26 (37.1%) in the matched CNI group (n = 70) (P = .005). Death-censored graft survival was significantly higher in the belatacept group (P = .001). At 3 years, graft survival was 84.0% in the belatacept group compared with 65.1% in the control group. Continuing CNI was an independent risk factor for graft loss [hazard ratio (HR) 3.46; P < .005]. The incidence of cellular rejection after the conversion was low (4.3% in both groups) and not significantly different between groups (P = .84). Patients switched to belatacept developed significantly less donor-specific antibodies de novo. Belatacept was an independent risk factor for the occurrence of opportunistic infections (HR 4.84; P < .005). CONCLUSION The replacement of CNI with belatacept in patients with decreased allograft function and vascular lesions is associated with an improvement in graft survival and represents a valuable option in a context of organ shortage. Caution should be exercised regarding the increased risk of opportunistic infection.
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Affiliation(s)
- Dominique Bertrand
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Marie Matignon
- Nephrology and Transplantation Department, Cancerology-Immunity-Transplantation-Infectiology, Clinical Investigation Center-Biotherapies, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, INSERM U955, Paris-Est-Créteil University, Paris, France
| | - Antoine Morel
- Nephrology and Transplantation Department, Cancerology-Immunity-Transplantation-Infectiology, Clinical Investigation Center-Biotherapies, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, INSERM U955, Paris-Est-Créteil University, Paris, France
| | - Lebourg Ludivine
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mathilde Lemoine
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mélanie Hanoy
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Frank Le Roy
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dorian Nezam
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Mouad Hamzaoui
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Tristan de Nattes
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Anissa Moktefi
- Department of Pathology, Henri Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est-Créteil University, Paris, France
| | | | - Charlotte Laurent
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Isabelle Etienne
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France
| | - Dominique Guerrot
- Department of Nephrology, Kidney Transplantation and Hemodialysis, Rouen University Hospital, Rouen, France.,INSERM U1096, Normandie Univ, UNIROUEN, Rouen, France
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16
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Tamzali Y, Scemla A, Bonduelle T, Garandeau C, Gilbert M, Randhawa S, De Nattes T, Hachad H, Pourcher V, Taupin P, Kaminski H, Hazzan M, Moal V, Matignon M, Fihman V, Levi C, Le Quintrec M, Chemouny JM, Rondeau E, Bertrand D, Thervet E, Tezenas Du Montcel S, Savoye E, Barrou B, Kamar N, Tourret J. Specificities of Meningitis and Meningo-Encephalitis After Kidney Transplantation: A French Retrospective Cohort Study. Transpl Int 2023; 36:10765. [PMID: 36744053 PMCID: PMC9889366 DOI: 10.3389/ti.2023.10765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 01/03/2023] [Indexed: 01/20/2023]
Abstract
Kidney transplant recipients develop atypical infections in their epidemiology, presentation and outcome. Among these, meningitis and meningoencephalitis require urgent and adapted anti-infectious therapy, but published data is scarce in KTRs. The aim of this study was to describe their epidemiology, presentation and outcome, in order to improve their diagnostic and management. We performed a retrospective, multicentric cohort study in 15 French hospitals that included all 199 cases of M/ME in KTRs between 2007 and 2018 (0.9 case per 1,000 KTRs annually). Epidemiology was different from that in the general population: 20% were due to Cryptococcus neoformans, 13.5% to varicella-zoster virus, 5.5% to Mycobacterium tuberculosis, and 4.5% to Enterobacteria (half of which produced extended spectrum beta-lactamases), and 5% were Post Transplant Lymphoproliferative Disorders. Microorganisms causing M/ME in the general population were infrequent (2%, for Streptococcus pneumoniae) or absent (Neisseria meningitidis). M/ME caused by Enterobacteria, Staphylococci or filamentous fungi were associated with high and early mortality (50%-70% at 1 year). Graft survival was not associated with the etiology of M/ME, nor was impacted by immunosuppression reduction. Based on these results, we suggest international studies to adapt guidelines in order to improve the diagnosis and the probabilistic treatment of M/ME in SOTRs.
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Affiliation(s)
- Y. Tamzali
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, France,Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Infectious and Tropical Diseases, Paris, France,*Correspondence: Y. Tamzali,
| | - A. Scemla
- Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Nephrology and Kidney Transplantation, Hôpital Necker, Paris, France
| | - T. Bonduelle
- Neurology Department, Epilepsy Unit, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | - C. Garandeau
- Nephrology Department, Centre Hospitalier Universitaire de Nantes, Nantes, France
| | - M. Gilbert
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - S. Randhawa
- Aix-Marseille Université, Hôpitaux Universitaires de Marseille, Hôpital Conception, Center of Nephrology and Kidney Transplantation, Marseille, France
| | - T. De Nattes
- Department of Nephrology Dialysis and Kidney Transplantation, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - H. Hachad
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, France
| | - V. Pourcher
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Department of Infectious and Tropical Diseases, Paris, France
| | - P. Taupin
- University Paris-Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Biostatistics, Necker Hospital, Paris, France
| | - H. Kaminski
- Department of Nephrology, Transplantation, Dialysis and Apheresis, CHU Bordeaux, Bordeaux, France
| | - M. Hazzan
- Nephrology and Transplantation Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - V. Moal
- Aix-Marseille Université, Hôpitaux Universitaires de Marseille, Hôpital Conception, Center of Nephrology and Kidney Transplantation, Marseille, France
| | - M. Matignon
- Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire, Innovative Therapy for Immune Disorders, Créteil, France
| | - V. Fihman
- Bacteriology and Infection Control Unit, Department of Prevention, Diagnosis, and Treatment of Infections, Henri-Mondor University Hospital, Assistance Publique des Hôpitaux de Paris (AP-HP), Créteil, France,EA 7380 Dynamyc, EnvA, Paris-Est University (UPEC), Créteil, France
| | - C. Levi
- Department of Nephrology Immunology and Kidney Transplantation, Centre Hospitalier Univeristaire Edouard Herriot, Lyon, France
| | - M. Le Quintrec
- Department of Nephrology Dialysis and Kidney Transplantation, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
| | - J. M. Chemouny
- Université de Rennes, CHU Rennes, INSERM, EHESP, IRSET—UMR_S 1085, CIC‐P 1414, Rennes, France
| | - E. Rondeau
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Nephrology, SINRA, Hôpital Tenon, GHEP, Paris, France
| | - D. Bertrand
- Department of Nephrology Dialysis and Kidney Transplantation, Centre Hospitalier Universitaire de Rouen, Rouen, France
| | - E. Thervet
- Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris (AP-HP), Department of Nephrology, Hôpital Europeen Georges Pompidou, Paris, France
| | - S. Tezenas Du Montcel
- Sorbonne Université, INSERM, Pierre Louis Epidemiology and Public Health Institute, Assistance Publique-Hopitaux de Paris (AP-HP), Medical Information Department, Pitié Salpêtrière-Charles Foix University Hospital, Paris, France
| | - E. Savoye
- Agence de la Biomédecine, Saint Denis, France
| | - B. Barrou
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, INSERM, UMR 1082, Paris, France
| | - N. Kamar
- Department of Nephrology and Organ, INFINITY-INSERM U1291-CNRS U5051, Université Paul Sabatier, Toulouse, France
| | - J. Tourret
- Sorbonne Université, Assistance Publique-Hôpitaux de Paris (AP-HP), Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, INSERM, UMR 1138, Paris, France
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17
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Feredj E, Audureau E, Boueilh A, Fihman V, Fourati S, Lelièvre JD, Gallien S, Grimbert P, Matignon M, Melica G. Impact of a Dedicated Pretransplant Infectious Disease Consultation on Respiratory Tract Infections in Kidney Allograft Recipients: A Retrospective Study of 516 Recipients. Pathogens 2023; 12:pathogens12010074. [PMID: 36678422 PMCID: PMC9867402 DOI: 10.3390/pathogens12010074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/19/2022] [Accepted: 12/24/2022] [Indexed: 01/04/2023] Open
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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Affiliation(s)
- Elsa Feredj
- Infectious Disease Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France
- IMRB (Institut Mondor de Recherche Biomédicale), Université Paris-Est-Créteil (UPEC), INSERM U955, Equipe 16, 94010 Créteil, France
- Correspondence:
| | - Etienne Audureau
- Department of Public Health, Hôpitaux Universitaires Henri Mondor, Assistance Publique—Hôpitaux de Paris, 94010 Créteil, France
| | - Anna Boueilh
- Nephrology and Renal Transplantation Department, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France
| | - Vincent Fihman
- Virology, Bacteriology and Infection Control Units, Clinical Microbiology Department, AP-HP (Assistance Publique-Hôpitaux de Paris, 94010 Créteil, France
- IMRB (Institut Mondor de Recherche Biomédicale), VIC (Virologie Immunité Cancer), DHU (Département Hospitalo-Universitaire), Université Paris-Est-Créteil (UPEC), INSERM U955, Equipe 18, 94010 Créteil, France
- Ecole Vétérinaire de Maison Alfort, EA Dynamyc, Université Paris Est Créteil, 94000 Créteil, France
| | - Slim Fourati
- Virology, Bacteriology and Infection Control Units, Clinical Microbiology Department, AP-HP (Assistance Publique-Hôpitaux de Paris, 94010 Créteil, France
- IMRB (Institut Mondor de Recherche Biomédicale), VIC (Virologie Immunité Cancer), DHU (Département Hospitalo-Universitaire), Université Paris-Est-Créteil (UPEC), INSERM U955, Equipe 18, 94010 Créteil, France
| | - Jean-Daniel Lelièvre
- Infectious Disease Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France
- IMRB (Institut Mondor de Recherche Biomédicale), Université Paris-Est-Créteil (UPEC), INSERM U955, Equipe 16, 94010 Créteil, France
| | - Sébastien Gallien
- Infectious Disease Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France
- Ecole Vétérinaire de Maison Alfort, EA Dynamyc, Université Paris Est Créteil, 94000 Créteil, France
| | - Philippe Grimbert
- Nephrology and Renal Transplantation Department, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France
- IMRB (Institut Mondor de Recherche Biomédicale), VIC (Virus-Immunité-Cancer), DHU (Département Hospitalo-Universitaire), Université Paris-Est-Créteil (UPEC), INSERM U955, Equipe 21, 94010 Créteil, France
- Clinical Investigation Center-Biotherapies 504, Groupe Hospitalier Henri-Mondor/Albert Chenevier Assistance Publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France
- IMRB (Institut Mondor de Recherche Biomédicale), VIC (Virus-Immunité-Cancer), DHU (Département Hospitalo-Universitaire), Université Paris-Est-Créteil (UPEC), INSERM U955, Equipe 21, 94010 Créteil, France
| | - Giovanna Melica
- Infectious Disease Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), 94010 Créteil, France
- IMRB (Institut Mondor de Recherche Biomédicale), Université Paris-Est-Créteil (UPEC), INSERM U955, Equipe 16, 94010 Créteil, France
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18
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Sebti M, Petit-Hoang C, Chami B, Audureau É, Cordonnier-Jourdin C, Paul M, Pourcine F, Grimbert P, Ourghanlian C, Matignon M. ATG-Fresenius increases the risk of red blood cell transfusion after kidney transplantation. Front Immunol 2022; 13:1045580. [PMID: 36532030 PMCID: PMC9753326 DOI: 10.3389/fimmu.2022.1045580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 11/08/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction In sensitized deceased donor kidney allograft recipients, the most frequent induction therapy is anti-thymocyte globulins (ATG), including Thymoglobulin® (Thymo) and ATG-Fresenius (ATG-F). Methods We 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. Results Among 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. Discussion In 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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Affiliation(s)
- Maria Sebti
- Pharmacy Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Camille Petit-Hoang
- Nephrology and Renal Transplantation Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Btissam Chami
- Etablissement Français du Sang (EFS) - Ile de France, Créteil, France
| | - Étienne Audureau
- Public Health Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Catherine Cordonnier-Jourdin
- Pharmacy Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Muriel Paul
- Pharmacy Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Franck Pourcine
- Nephrology and Renal Transplantation Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Philippe Grimbert
- Nephrology and Renal Transplantation Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France,AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire TRUE (InnovaTive theRapy for immUne disordErs), Créteil, France,Université Paris-Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France,AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, CIC biotherapy, Créteil, France
| | - Clément Ourghanlian
- Pharmacy Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France,Prevention, Diagnosis and Treatment of Infections Department, Unité Transversale de Traitement des Infections, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Hôpitaux Universitaires Henri Mondor-Albert Chenevier, Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France,AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire TRUE (InnovaTive theRapy for immUne disordErs), Créteil, France,Université Paris-Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France,*Correspondence: Marie Matignon,
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19
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Hazzan M, Kamar N, Francois H, Matignon M, Greze C, Gatault P, Frimat L, Westeel PF, Goutaudier V, Snanoudj R, Colosio C, Sicard A, Bertrand D, Mousson C, Bamoulid J, Thierry A, Anglicheau D, Couzi L, Chemouny JM, Duveau A, Moal V, Le Meur Y, Blancho G, Tourret J, Malvezzi P, Mariat C, Rerolle JP, Bouvier N, Caillard S, Thaunat O. Absence of Mortality Differences Between the First and Second COVID-19 Waves in Kidney Transplant Recipients. Kidney Int Rep 2022; 7:2617-2629. [PMID: 36159445 PMCID: PMC9489985 DOI: 10.1016/j.ekir.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/05/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction SARS-CoV-2 pandemic evolved in 2 consecutive waves during 2020. Improvements in the management of COVID-19 led to a reduction in mortality rates among hospitalized patients during the second wave. Whether this progress benefited kidney transplant recipients (KTRs), a population particularly vulnerable to severe COVID-19, remained unclear. Methods In France, 957 KTRs were hospitalized for COVID-19 in 2020 and their data were prospectively collected into the French Solid Organ Transplant (SOT) COVID registry. The presentation, management, and outcomes of the 359 KTRs diagnosed during the first wave were compared to those of the 598 of the second wave. Results Baseline comorbidities were similar between KTRs of the 2 waves. Maintenance immunosuppression was reduced in most patients but withdrawal of antimetabolite (73.7% vs. 58.4%, P < 0.001) or calcineurin inhibitor (32.1% vs. 16.6%, P < 0.001) was less frequent during the second wave. Hydroxychloroquine and azithromycin that were commonly used during the first wave (21.7% and 30.9%, respectively) but were almost abandoned during the second wave. In contrast, the use of high dose corticosteroids doubled (19.5% vs. 41.6%, P < 0.001). Despite these changing trends in COVID-19 management, 60-day mortality was not statistically different between the 2 waves (25.3% vs. 23.9%; Log Rank, P = 0.48) and COVID-19 hospitalization period was not associated with death due to COVID-19 in multivariate analysis (Hazard ratio 0.89, 95% confidence interval 0.67–1.17, P = 0.4). Conclusion We conclude that changing of therapeutic trends during 2020 did not reduce COVID-19 related mortality among KTRs. Our data indirectly support the importance of vaccination and neutralizing monoclonal anti-SARS-CoV-2 antibodies to protect KTRS from severe COVID-19.
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20
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Lemoine H, Raud L, Foulquier F, Sayer JA, Lambert B, Olinger E, Lefèvre S, Knebelmann B, Harris PC, Trouvé P, Desprès A, Duneau G, Matignon M, Poyet A, Jourde-Chiche N, Guerrot D, Lemoine S, Seret G, Barroso-Gil M, Bingham C, Gilbert R, Le Meur Y, Audrézet MP, Cornec-Le Gall E. Monoallelic pathogenic ALG5 variants cause atypical polycystic kidney disease and interstitial fibrosis. Am J Hum Genet 2022; 109:1484-1499. [PMID: 35896117 PMCID: PMC9388391 DOI: 10.1016/j.ajhg.2022.06.013] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/23/2022] [Indexed: 02/06/2023] Open
Abstract
Disorders of the autosomal dominant polycystic kidney disease (ADPKD) spectrum are characterized by the development of kidney cysts and progressive kidney function decline. PKD1 and PKD2, encoding polycystin (PC)1 and 2, are the two major genes associated with ADPKD; other genes include IFT140, GANAB, DNAJB11, and ALG9. Genetic testing remains inconclusive in ∼7% of the families. We performed whole-exome sequencing in a large multiplex genetically unresolved (GUR) family affected by ADPKD-like symptoms and identified a monoallelic frameshift variant (c.703_704delCA) in ALG5. ALG5 encodes an endoplasmic-reticulum-resident enzyme required for addition of glucose molecules to the assembling N-glycan precursors. To identify additional families, we screened a cohort of 1,213 families with ADPKD-like and/or autosomal-dominant tubulointerstitial kidney diseases (ADTKD), GUR (n = 137) or naive to genetic testing (n = 1,076), by targeted massively parallel sequencing, and we accessed Genomics England 100,000 Genomes Project data. Four additional families with pathogenic variants in ALG5 were identified. Clinical presentation was consistent in the 23 affected members, with non-enlarged cystic kidneys and few or no liver cysts; 8 subjects reached end-stage kidney disease from 62 to 91 years of age. We demonstrate that ALG5 haploinsufficiency is sufficient to alter the synthesis of the N-glycan chain in renal epithelial cells. We also show that ALG5 is required for PC1 maturation and membrane and ciliary localization and that heterozygous loss of ALG5 affects PC1 maturation. Overall, our results indicate that monoallelic variants of ALG5 lead to a disorder of the ADPKD-spectrum characterized by multiple small kidney cysts, progressive interstitial fibrosis, and kidney function decline.
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Affiliation(s)
- Hugo Lemoine
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France
| | - Loann Raud
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France
| | - François Foulquier
- Univ. Lille, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, 59000 Lille, France
| | - John A Sayer
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 3BZ, UK; The Newcastle upon Tyne Hospitals NHS Foundation Trust, Renal Services, Freeman Road, Newcastle Upon Tyne NE7 7DN, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle Upon Tyne NE4 5PL, UK
| | - Baptiste Lambert
- Univ. Lille, CNRS, UMR 8576 - UGSF - Unité de Glycobiologie Structurale et Fonctionnelle, 59000 Lille, France
| | - Eric Olinger
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 3BZ, UK
| | - Siriane Lefèvre
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France; Service de Néphrologie, Hôpital de Lorient, 56322 Lorient, France
| | - Bertrand Knebelmann
- Service de Néphrologie et Transplantation rénale, Hôpital Necker, APHP, Université de Paris, Paris, France
| | - Peter C Harris
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55902, USA
| | - Pascal Trouvé
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France
| | - Aurore Desprès
- Service de Génétique moléculaire, CHRU Brest, 29609 Brest, France
| | | | - Marie Matignon
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Anais Poyet
- Association Régionale d'Aide aux Urémiques du Centre Ouest (ARAUCO), Bourges, France
| | - Noémie Jourde-Chiche
- Centre de Néphrologie et Transplantation Rénale, Hôpital de la Conception (APHM), Marseille, France
| | - Dominique Guerrot
- Service de Néphrologie, Dialyse et Transplantation, CHU de Rouen, Rouen, France
| | - Sandrine Lemoine
- Néphrologie, Dialyse, Hypertension artérielle et Exploration Fonctionnelle rénale, Groupement Hospitalier Edouard Herriot, Hospices Civils de Lyon, Lyon, France
| | | | - Miguel Barroso-Gil
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne NE1 3BZ, UK
| | - Coralie Bingham
- Royal Devon and Exeter NHS Foundation Trust, Exeter EX2 5DW, UK
| | - Rodney Gilbert
- Southampton Children's Hospital, University of Southampton, Southampton SO16 6YD, UK
| | - Yannick Le Meur
- Univ Brest, UMR 1227, LBAI, Labex IGO, 29200 Brest, France; Service de Néphrologie, Hémodialyse et Transplantation rénale, CHRU Brest, 29609 Brest, France
| | - Marie-Pierre Audrézet
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France; Service de Génétique moléculaire, CHRU Brest, 29609 Brest, France
| | - Emilie Cornec-Le Gall
- Univ. Brest, Inserm, UMR 1078, GGB, 29200 Brest, France; Service de Néphrologie, Hémodialyse et Transplantation rénale, CHRU Brest, 29609 Brest, France.
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Joher N, Moktefi A, Grimbert P, Pagot E, Jouan N, El Karoui K, Champy CM, Matignon M, Stehlé T. The authors reply. Kidney Int 2022; 102:446-447. [PMID: 35870817 DOI: 10.1016/j.kint.2022.04.044] [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] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 04/29/2022] [Indexed: 10/17/2022]
Affiliation(s)
- Nizar Joher
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Anissa Moktefi
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Département de Pathologie, Créteil, France
| | - Philippe Grimbert
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Eléonore Pagot
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Narindra Jouan
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Khalil El Karoui
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Cécile Maud Champy
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service d'Urologie et Transplantation, Créteil, France
| | - Marie Matignon
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Thomas Stehlé
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale, Institut Mondor de Recherche Biomédicale, Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France.
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22
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Moryoussef M, Mulé S, Gerbaud F, Haroche J, Matignon M, Joher N. Retroperitoneal fibrosis: carcinoid recurrence or histiocytosis? Lancet Oncol 2022; 23:e402. [DOI: 10.1016/s1470-2045(22)00267-4] [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] [Received: 03/17/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022]
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23
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Morel A, Hoisnard L, Dudreuilh C, Moktefi A, Kheav D, Pimentel A, Sakhi H, Mokrani D, Attias P, El Sakhawi K, Champy CM, Remy P, Sbidian E, Grimbert P, Matignon M. Three-Year Outcomes in Kidney Transplant Recipients Switched From Calcineurin Inhibitor-Based Regimens to Belatacept as a Rescue Therapy. Transpl Int 2022; 35:10228. [PMID: 35497889 PMCID: PMC9043102 DOI: 10.3389/ti.2022.10228] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 03/18/2022] [Indexed: 01/05/2023]
Abstract
Background: The long-term benefits of conversion from calcineurin inhibitors (CNIs) to belatacept in kidney transplant recipients (KTr) are poorly documented. Methods: A single-center retrospective work to study first-time CNI to belatacept conversion as a rescue therapy [eGFR <30 ml/min/1.73 m2, chronic histological lesions, or CNI-induced thrombotic microangiopathy (TMA)]. Patient and kidney allograft survivals, eGFR, severe adverse events, donor-specific antibodies (DSA), and histological data were recorded over 36 months after conversion. Results: We included N = 115 KTr. The leading cause for switching was chronic histological lesions with non-optimal eGFR (56.5%). Three years after conversion, patient, and death-censored kidney allograft survivals were 88% and 92%, respectively, eGFR increased significantly from 31.5 ± 17.5 to 36.7 ± 15.7 ml/min/1.73 m2 (p < 0.01), the rejection rate was 10.4%, OI incidence was 5.2 (2.9–7.6) per 100 person-years. Older age was associated with death, eGFR was not associated with death nor allograft loss. No patient developed dnDSA at M36 after conversion. CNI-induced TMA disappeared in all cases without eculizumab use. Microvascular inflammation and chronic lesions remained stable. Conclusion: Post-KT conversion from CNIs to belatacept, as rescue therapy, is safe and beneficial irrespective of the switch timing and could represent a good compromise facing organ shortage. Age and eGFR at conversion should be considered in the decision whether to switch.
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Affiliation(s)
- Antoine Morel
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Léa Hoisnard
- AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Centre d'Investigation Clinique and Fédération Hospitalo-Universitaire TRUE (InnovaTive theRapy for immUne disordErs), Créteil, France.,Université Paris Est Créteil (UPEC), EpiDermE (Epidemiology in Dermatology and Evaluation of therapeutics), Créteil, France
| | - Caroline Dudreuilh
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Anissa Moktefi
- Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Pathology Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil, Créteil, France
| | - David Kheav
- AP-HP (Assistance Publique-Hôpitaux de Paris), Laboratoire Régional d'histocompatibilité, Hôpital Saint Louis, Vellefaux, Paris
| | - Ana Pimentel
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Hamza Sakhi
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - David Mokrani
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Philippe Attias
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Karim El Sakhawi
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Cécile Maud Champy
- Groupe Hospitalier Henri-Mondor/Albert Chenevier, Urology department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Philippe Remy
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil, Créteil, France
| | - Emilie Sbidian
- AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Centre d'Investigation Clinique and Fédération Hospitalo-Universitaire TRUE (InnovaTive theRapy for immUne disordErs), Créteil, France.,Université Paris Est Créteil (UPEC), EpiDermE (Epidemiology in Dermatology and Evaluation of therapeutics), Créteil, France.,Department of Dermatology, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France.,INSERM, Centre d'Investigation Clinique 1430, Créteil, France
| | - Philippe Grimbert
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France.,AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Centre d'Investigation Clinique and Fédération Hospitalo-Universitaire TRUE (InnovaTive theRapy for immUne disordErs), Créteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil, Créteil, France.,AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, CIC biotherapy, Créteil, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, AP-HP (Assistance Publique-Hôpitaux de Paris), Hôpitaux Universitaires Henri Mondor, Créteil, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U955, Institut Mondor de Recherche Biomédicale (IMRB), Université Paris-Est Créteil, Créteil, France
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Morel A, Ouamri Y, Canouï-Poitrine F, Mulé S, Champy CM, Ingels A, Audard V, Luciani A, Grimbert P, Matignon M, Pigneur F, Stehlé T. Myosteatosis as an independent risk factor for mortality after kidney allograft transplantation: a retrospective cohort study. J Cachexia Sarcopenia Muscle 2022; 13:386-396. [PMID: 34738343 PMCID: PMC8818595 DOI: 10.1002/jcsm.12853] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/27/2021] [Accepted: 09/30/2021] [Indexed: 12/30/2022] Open
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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Affiliation(s)
- Antoine Morel
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Yaniss Ouamri
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service d'Imagerie Médicale, Créteil, France
| | - Florence Canouï-Poitrine
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Clinical Epidemiology and Ageing Unit (CEpiA), Institut Mondor de Recherche Biomédicale, Paris-Est University, Créteil, France
| | - Sébastien Mulé
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service d'Imagerie Médicale, Créteil, France
| | - Cécile Maud Champy
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service d'Urologie, Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France
| | - Alexandre Ingels
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service d'Urologie, Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France
| | - Vincent Audard
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Alain Luciani
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service d'Imagerie Médicale, Créteil, France
| | - Philippe Grimbert
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Marie Matignon
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
| | - Frédéric Pigneur
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri-Mondor, Service d'Imagerie Médicale, Créteil, France
| | - Thomas Stehlé
- Univ Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire "Innovative Therapy for Immune Disorders", Créteil, France
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Joher N, Moktefi A, Grimbert P, Pagot E, Jouan N, El Karoui K, Champy CM, Matignon M, Stehlé T. Early post-transplant recurrence of oxalate nephropathy in a patient with primary hyperoxaluria type 1, despite pretransplant lumasiran therapy. Kidney Int 2022; 101:185-186. [PMID: 34991805 DOI: 10.1016/j.kint.2021.10.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/08/2021] [Accepted: 10/27/2021] [Indexed: 11/16/2022]
Affiliation(s)
- Nizar Joher
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
| | - Anissa Moktefi
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Département de Pathologie, Créteil, France
| | - Philippe Grimbert
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
| | - Eléonore Pagot
- Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
| | - Narindra Jouan
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
| | - Khalil El Karoui
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
| | - Cécile Maud Champy
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service d'Urologie et Transplantation, Créteil, France
| | - Marie Matignon
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France
| | - Thomas Stehlé
- University Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France; Assistance Publique des Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire « Innovative therapy for immune disorders », Créteil, France.
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Morel A, Hoisnard L, Dudreuilh C, Moktefi A, Kheav D, Attias P, Champy C, Remy P, Grimbert P, Matignon M. Conséquences à 3 ans de la conversion des inhibiteurs de la calcineurine au belatacept en thérapie de sauvetage chez les patients transplantés rénaux : une étude de cohorte retrospective. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.109] [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: 10/20/2022]
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Conan PL, Matignon M, Bleibtreu A, Guillot H, Van Laecke S, Brenier H, Crochette R, Melica G, Fernández-Ruiz M, Dantal J, Walti LN, Levi C, Chauvet C, De Greef J, Marbus SD, Mueller NJ, Ieven M, Vuotto F, Lortholary O, Coussement J, Lebeaux D. Trimethoprim/sulfamethoxazole for nocardiosis in solid organ transplant recipients: Real-life data from a multicentre retrospective study. Transpl Infect Dis 2021; 23:e13669. [PMID: 34143917 DOI: 10.1111/tid.13669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 02/21/2021] [Revised: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Little is known regarding the optimal management of nocardiosis among solid organ transplant (SOT) recipients. It is often suggested to avoid trimethoprim/sulfamethoxazole (TMP-SMX) monotherapy in heavily immunocompromised patients (such as SOT recipients) and/or in case of severe or disseminated nocardiosis. Our aim was to report our experience with TMP-SMX monotherapy in SOT recipients with nocardiosis. METHODS Using data from a previously published European study, we assessed the incidence of adverse events in SOT recipients receiving TMP-SMX monotherapy and assessed its effectiveness. RESULTS Thirty-one SOT recipients with nocardiosis were included, mostly kidney transplant recipients (20/31, 65%). Eleven (36%) had disseminated infection, and four (13%) had brain nocardiosis. Most patients had lung and/or pleural involvement (26/31, 84%). Daily dose of trimethoprim at initiation was 10 [6.4-14.8] mg/kg. The median estimated glomerular filtration rate at time of diagnosis of nocardiosis was 44 [30-62] ml/min/1.73 m². TMP-SMX was discontinued prematurely in one third of the patients (10/31, 32%, mostly for hematological toxicity [n = 3] or increased serum creatinine [n = 3]). Focusing on the 24 (77%) patients who completed at least 30 days of TMP-SMX monotherapy, 4 had late (>30 days) drug discontinuation, 1 experienced treatment failure, and 19 completed planned TMP-SMX monotherapy. Clinical outcome was favorable in these 19 patients, despite the fact that 8 (42%) had disseminated infection and 2 (11%) brain nocardiosis. Overall, all-cause 1-year mortality was 10% (3/31). CONCLUSIONS TMP-SMX monotherapy appears to be effective for the treatment of most nocardiosis among SOT recipients. Interventional studies are needed to compare its safety and effectiveness with those of other regimens used to treat posttransplant nocardiosis.
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Affiliation(s)
- Pierre-Louis Conan
- Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, Paris, France
| | - Marie Matignon
- Nephrology and Transplantation Department, Centre d'investigation Clinique-biotherapies 504 and Institut national de la santé et de la recherche médicale U955, Université paris-Est, groupe Henri Mondor-Albert Chenevier, Créteil, France
| | - Alexandre Bleibtreu
- Service de maladies infectieuses et tropicales, Hôpitaux universitaires Pitié-Salpêtrière-Charles-Foix, Paris, France
| | - Hélène Guillot
- Service de maladies infectieuses et tropicales, Hôpitaux universitaires Pitié-Salpêtrière-Charles-Foix, Paris, France
| | | | - Henri Brenier
- Service de néphrologie, Centre hospitalier Universitaire Pontchaillou, Université de Rennes, Rennes, France
| | - Romain Crochette
- Service de néphrologie, Centre hospitalier Universitaire Pontchaillou, Université de Rennes, Rennes, France
| | - Giovanna Melica
- Immunologie clinique et maladies infectieuses, Centre Hospitalier Universitaire Henri Mondor, Créteil, France
| | - Mario Fernández-Ruiz
- Unit of Infectious Diseases, University Hospital, Instituto de Investigación Hospital, Madrid, Spain
| | - Jacques Dantal
- Institut de Transplantation, d'Urologie et de Néphrologie, Centre hospitalier Universitaire, Nantes, France
| | - Laura N Walti
- Department of Infectious Diseases, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Charlène Levi
- Service de transplantation, néphrologie et immunologie Clinique, Hospices civils de Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Cécile Chauvet
- Service de transplantation, néphrologie et immunologie Clinique, Hospices civils de Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Julien De Greef
- Service de médecine interne et maladies infectieuses, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Sierk D Marbus
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Nicolas J Mueller
- Division of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Swiss Transplant Cohort Study, Zurich, Switzerland
| | - Margareta Ieven
- Department of Medical Microbiology, Antwerp University Hospital (UZA), Edegem, Belgium
| | - Fanny Vuotto
- Infectious Diseases Unit, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Olivier Lortholary
- Université de Paris, AP-HP, Hôpital Necker Enfants Malades, Centre d'Infectiologie Necker-Pasteur and Institut Imagine, Paris, France
| | - Julien Coussement
- Division of Infectious Diseases, CUB-Hôpital Erasme, Université libre de Bruxelles, Brussels, Belgium
| | - David Lebeaux
- Service de Microbiologie, Unité Mobile d'Infectiologie, AP-HP, Hôpital Européen Georges Pompidou, Paris, France.,Université de Paris, AP-HP, Hôpital Necker Enfants Malades, Centre d'Infectiologie Necker-Pasteur and Institut Imagine, Paris, France.,Université de Paris, Paris, France
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Joher N, Matignon M, Grimbert P. HLA Desensitization in Solid Organ Transplantation: Anti-CD38 to Across the Immunological Barriers. Front Immunol 2021; 12:688301. [PMID: 34093594 PMCID: PMC8173048 DOI: 10.3389/fimmu.2021.688301] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 05/04/2021] [Indexed: 12/23/2022] Open
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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Affiliation(s)
- Nizar Joher
- Assistance Publique-Hôpitaux de Paris AP-HP, Hôpital Universitaire Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire (Innovative Therapy for Immune Disorders), Créteil, France.,Université Paris Est Créteil UPEC, Institut National de la Santé et de la Recherche Médicale INSERM U955, Institut Mondor de Recherche Biomédicale IMRB, Équipe 21, Créteil, France
| | - Marie Matignon
- Assistance Publique-Hôpitaux de Paris AP-HP, Hôpital Universitaire Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire (Innovative Therapy for Immune Disorders), Créteil, France.,Université Paris Est Créteil UPEC, Institut National de la Santé et de la Recherche Médicale INSERM U955, Institut Mondor de Recherche Biomédicale IMRB, Équipe 21, Créteil, France
| | - Philippe Grimbert
- Assistance Publique-Hôpitaux de Paris AP-HP, Hôpital Universitaire Henri Mondor, Service de Néphrologie et Transplantation, Fédération Hospitalo-Universitaire (Innovative Therapy for Immune Disorders), Créteil, France.,Université Paris Est Créteil UPEC, Institut National de la Santé et de la Recherche Médicale INSERM U955, Institut Mondor de Recherche Biomédicale IMRB, Équipe 21, Créteil, France
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29
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Martins M, Morel A, Laurent C, Kamar N, Anglicheau D, Matignon M, Vigneau C, Guerrot D, Chavarot N, Chemouny JM. Belatacept as maintenance therapy in kidney transplant recipients with ANCA-associated vasculitis. Clin Exp Rheumatol 2021; 39 Suppl 129:194-195. [DOI: 10.55563/clinexprheumatol/7jue09] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 12/14/2020] [Indexed: 11/13/2022]
Affiliation(s)
- Manon Martins
- University of Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France
| | - Antoine Morel
- APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Service de Néphrologie et Transplantation, Créteil, France
| | | | - Nassim Kamar
- Service de Néphrologie et de Transplantation d'Organes, CHU Toulouse, France
| | - Dany Anglicheau
- Service de Néphrologie et Transplantation Adulte, Hôpital Necker-Enfants Malades, Université de Paris, Assistance Publique-Hôpitaux de Paris, France
| | - Marie Matignon
- APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Service de Néphrologie et Transplantation, Créteil, France
| | - Cécile Vigneau
- University of Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France
| | | | - Nathalie Chavarot
- Service de Néphrologie et Transplantation Adulte, Hôpital Necker-Enfants Malades, Université de Paris, Assistance Publique-Hôpitaux de Paris, France
| | - Jonathan M. Chemouny
- University of Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, Rennes, France.
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30
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Kamar N, Abravanel F, Behrendt P, Hofmann J, Pageaux GP, Barbet C, Moal V, Couzi L, Horvatits T, De Man RA, Cassuto E, Elsharkawy AM, Riezebos-Brilman A, Scemla A, Hillaire S, Donnelly MC, Radenne S, Sayegh J, Garrouste C, Dumortier J, Glowaki F, Matignon M, Coilly A, Figueres L, Mousson C, Minello A, Dharancy S, Rerolle JP, Lebray P, Etienne I, Perrin P, Choi M, Marion O, Izopet J, Cointault O, Del Bello A, Espostio L, Hebral AL, Lavayssière L, Lhomme S, Mansuy JM, Wedemeyer H, Nickel P, Bismuth M, Stefic K, Büchler M, D’Alteroche L, Colson P, Bufton S, Ramière C, Trimoulet P, Pischke S, Todesco E, Sberro Soussan R, Legendre C, Mallet V, Johannessen I, Simpson K. Ribavirin for Hepatitis E Virus Infection After Organ Transplantation: A Large European Retrospective Multicenter Study. Clin Infect Dis 2021; 71:1204-1211. [PMID: 31793638 DOI: 10.1093/cid/ciz953] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [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: 03/23/2019] [Accepted: 10/01/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Ribavirin is currently recommended for treating chronic hepatitis E virus (HEV) infection. This retrospective European multicenter study aimed to assess the sustained virological response (SVR) in a large cohort of solid organ transplant (SOT) recipients with chronic HEV infection treated with ribavirin monotherapy (N = 255), to identify the predictive factors for SVR, and to evaluate the impact of HEV RNA mutations on virological response. METHODS Data from 255 SOT recipients with chronic HEV infection from 30 European centers were analyzed. Ribavirin was given at the median dose of 600 (range, 29-1200) mg/day (mean, 8.6 ± 3.6 mg/kg/day) for a median duration of 3 (range, 0.25-18) months. RESULTS After a first course of ribavirin, the SVR rate was 81.2%. It increased to 89.8% when some patients were offered a second course of ribavirin. An increased lymphocyte count at the initiation of therapy was a predictive factor for SVR, while poor hematological tolerance of ribavirin requiring its dose reduction (28%) and blood transfusion (15.7%) were associated with more relapse after ribavirin cessation. Pretreatment HEV polymerase mutations and de novo mutations under ribavirin did not have a negative impact on HEV clearance. Anemia was the main adverse event. CONCLUSIONS This large-scale retrospective study confirms that ribavirin is highly efficient for treating chronic HEV infection in SOT recipients and shows that the predominant HEV RNA polymerase mutations found in this study do not affect the rate of HEV clearance.This large-scale retrospective study that included 255 solid organ transplant recipients confirms that ribavirin is highly efficient for treating chronic hepatitis E virus (HEV) infection and shows that HEV RNA polymerase mutations do not play a role in HEV clearance.
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Affiliation(s)
- Nassim Kamar
- Department of Nephrology, Dialysis and Organ Transplantation, Centre Hospitalier Universitaire (CHU) Rangueil, Institut National de la Santé et de la Recherche Médicale (INSERM) U1043, Institut Fédératif de Recherche Bio-médicale de Toulouse (IFR-BMT), University Paul Sabatier, Toulouse, France
| | - Florence Abravanel
- Department of Virology, INSERM U1043, IFR-BMT, University Paul Sabatier, Toulouse, France
| | - Patrick Behrendt
- Department of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, and Institute of Experimental Virology, TWINCORE, Centre for Experimental and Clinical Infection Research, a joint venture between the Medical School Hannover and the Helmholtz Centre for Infection Research, German Centre for Infection Research, Hannover, Germany
| | - Jörg Hofmann
- Charité Universitätsmedizin Berlin, Department of Nephrology and Intensive Care and Institute of Virology, Labor Berlin Charité-Vivantes-GmbH, Berlin, Germany
| | | | - Christelle Barbet
- Department of Nephrology and Clinical Immunology, Bretonneau Hospital, University Hospital, Tours, France
| | - Valérie Moal
- Aix Marseille Université, Asistance Publique Hôpitaux de Marseille, Institut Pour la Recherche Pour le Développement, Microbes, Evolution, Phylogénie et Infection, Institut Hospitalo-Universitaire-Méditerranée Infection, Hôpital Conception, Centre de Néphrologie et Transplantation Rénale, Marseille, France
| | - Lionel Couzi
- Department of Nephrology and Transplantation, CHU Bordeaux, Bordeaux, France
| | - Thomas Horvatits
- Department of Medicine I, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Robert A De Man
- Departments of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | | | - Annelies Riezebos-Brilman
- Department of Medical Microbiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Anne Scemla
- Service de néphrologie-transplantation, Hôpital Necker, Assitance publique- Hôpitaux de Paris (AP-HP), Paris et Université Paris Descartes, Paris, France
| | | | - Mhairi C Donnelly
- Department of Hepatology and Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, United Kingdom
| | - Sylvie Radenne
- Department of Hepatology and Liver Transplantation, CHU de la Croix Rousse, Lyon, France
| | - Johnny Sayegh
- Department of Nephrology and Transplantation, CHU Angers, Angers, France
| | - Cyril Garrouste
- Department of Nephrology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Jérôme Dumortier
- Department of Hepatology, Edouard Herriot Hospital, CHU Lyon, Lyon, France
| | | | - Marie Matignon
- Assistance Publique-Hôpitaux de Paris, Nephrology and Renal Transplantation Department, Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Université Paris-Est-Créteil, Département Hospitalo-Universitaire Virus-Immunité-Cancer, Institut Mondor de Recherche Biomédicale, Equipe 21, INSERM U 955, Créteil, France
| | - Audrey Coilly
- Centre Hépato-Biliaire, Hôpital Paul Brousse, AP-HP, INSERM U1193, Université Paris-Sud Paris-Saclay, Villejuif, France
| | - Lucile Figueres
- Department of Nephrology and Clinical Immunology, CHU Nantes, Nantes, France
| | | | - Anne Minello
- Department of Hepatogastroenterology and Digestive Oncology, CHU François Mitterrand, Dijon, France
| | - Sébastien Dharancy
- Hôpital Claude Huriez, Services Maladies de l'Appareil Digestif, INSERM Unité 995, Lille, France
| | | | - Pascal Lebray
- Department of Hepatology, Pitié Salpétrière Hospital, Paris, France
| | | | - Peggy Perrin
- Department of Nephrology, CHU Strasbourg, Strasbourg, France
| | - Mira Choi
- Charité Universitätsmedizin Berlin, Department of Nephrology and Intensive Care and Institute of Virology, Labor Berlin Charité-Vivantes-GmbH, Berlin, Germany
| | - Olivier Marion
- Department of Virology, INSERM U1043, IFR-BMT, University Paul Sabatier, Toulouse, France
| | - Jacques Izopet
- Department of Virology, INSERM U1043, IFR-BMT, University Paul Sabatier, Toulouse, France
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Runyo F, Matignon M, Audureau E, Vindrios W, Boueilh A, Gomart C, Grimbert P, Gallien S, Melica G. Infectious disease consultation is effective in boosting vaccine coverage in patients awaiting kidney transplantation: A French prospective study. Transpl Infect Dis 2021; 23:e13607. [PMID: 33773002 DOI: 10.1111/tid.13607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 07/30/2020] [Revised: 02/11/2021] [Accepted: 03/14/2021] [Indexed: 01/23/2023]
Abstract
Recommended preventive strategies before kidney transplantation include screening and treatment of latent tuberculosis infection (LTBI), and updating of the recommended vaccines. We prospectively evaluated in dedicated infectious diseases consultations, from 2014 to 2018, the clinical and vaccination data of new adult kidney allograft candidates. Patients were offered an updated vaccination schedule, if appropriate, and were screened for LTBI using chest imaging and interferon gamma release assay (IGRA). Overall, 467 patients with median age of 58 [46-66] years were evaluated, of whom 302 patients (65%) were men (sex ratio 1.83), and 333 (71%) were on dialysis. Main causes of renal insufficiency were diabetes (25%) and autoimmune nephropathies (18%). The vaccination coverage was low and varied according to the different types of vaccines and patients. Vaccination or immunization rates were 24%, 6%, 54%, and 51% for tetanus-diphtheria-polio-acellular pertussis, Pneumococcus, hepatitis B, and seasonal influenza, respectively. ID consultation successfully rose patients' vaccinations coverage, in fulfillment with recommendations, in 465 (99%) patients. LTBI treatment was administered in 78 (16.7%) patients and caused drug-related adverse events in 9 (11%). A dedicated infectious disease consultation should become a critical tool for coordinating infection prevention strategies.
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Affiliation(s)
- Florence Runyo
- Infectious Diseases Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France.,Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France.,DHU (Département Hospitalo-Universitaire) A-TVB, IMRB (Institut Mondor de Recherche Biomédicale) - EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), Université Paris-Est-Créteil, UPEC, Créteil, France
| | - Etienne Audureau
- Public Health Deparment, Groupe Hospitalier Henri-Mondor/Albert Chenevier, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France
| | - William Vindrios
- Infectious Diseases Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France.,INSERM U955, Team 16, IMRB Créteil, Créteil, France
| | - Anna Boueilh
- Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France
| | - Camille Gomart
- Microbiology Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France
| | - Philippe Grimbert
- Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France.,DHU (Département Hospitalo-Universitaire) A-TVB, IMRB (Institut Mondor de Recherche Biomédicale) - EA 7376 CEpiA (Clinical Epidemiology And Ageing Unit), Université Paris-Est-Créteil, UPEC, Créteil, France
| | - Sébastien Gallien
- Infectious Diseases Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France.,INSERM U955, Team 16, IMRB Créteil, Créteil, France
| | - Giovanna Melica
- Infectious Diseases Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, AP-HP (Assistance Publique-Hôpitaux de Paris), Créteil, France.,INSERM U955, Team 16, IMRB Créteil, Créteil, France
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32
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Caillard S, Chavarot N, Francois H, Matignon M, Greze C, Kamar N, Gatault P, Thaunat O, Legris T, Frimat L, Westeel PF, Goutaudier V, Jdidou M, Snanoudj R, Colosio C, Sicard A, Bertrand D, Mousson C, Bamoulid J, Masset C, Thierry A, Couzi L, Chemouny JM, Duveau A, Moal V, Blancho G, Grimbert P, Durrbach A, Moulin B, Anglicheau D, Ruch Y, Kaeuffer C, Benotmane I, Solis M, LeMeur Y, Hazzan M, Danion F. Is COVID-19 infection more severe in kidney transplant recipients? Am J Transplant 2021; 21:1295-1303. [PMID: 33259686 PMCID: PMC7753418 DOI: 10.1111/ajt.16424] [Citation(s) in RCA: 156] [Impact Index Per Article: 52.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 01/25/2023]
Abstract
There are no studies which have compared the risk of severe COVID-19 and related mortality between transplant recipients and nontransplant patients. We enrolled two groups of patients hospitalized for COVID-19, that is, kidney transplant recipients (KTR) from the French Registry of Solid Organ Transplant (n = 306) and a single-center cohort of nontransplant patients (n = 795). An analysis was performed among subgroups matched for age and risk factors for severe COVID-19 or mortality. Severe COVID-19 was defined as admission (or transfer) to an intensive care unit, need for mechanical ventilation, or death. Transplant recipients were younger and had more comorbidities compared to nontransplant patients. They presented with higher creatinine levels and developed more episodes of acute kidney injury. After matching, the 30-day cumulative incidence of severe COVID-19 did not differ between KTR and nontransplant patients; however, 30-day COVID-19-related mortality was significantly higher in KTR (17.9% vs 11.4%, respectively, p = .038). Age >60 years, cardiovascular disease, dyspnea, fever, lymphopenia, and C-reactive protein (CRP) were associated with severe COVID-19 in univariate analysis, whereas transplant status and serum creatinine levels were not. Age >60 years, hypertension, cardiovascular disease, diabetes, CRP >60 mg/L, lymphopenia, kidney transplant status (HR = 1.55), and creatinine level >115 µmol/L (HR = 2.32) were associated with COVID-19-related mortality in univariate analysis. In multivariable analysis, cardiovascular disease, dyspnea, and fever were associated with severe disease, whereas age >60 years, cardiovascular disease, dyspnea, fever, and creatinine level>115 µmol/L retained their independent associations with mortality. KTR had a higher COVID-19-related mortality compared to nontransplant hospitalized patients.
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Affiliation(s)
- Sophie Caillard
- Department of Nephrology and TransplantationStrasbourg University HospitalINSERMUMR‐S 1109StrasbourgFrance
| | - Nathalie Chavarot
- Department of Nephrology and TransplantationHôpital Universitaire NeckerAPHP CenterUniversité de Paris INEM INSERM U 1151CNRS UMR 8253ParisFrance
| | - Hélène Francois
- AP‐HP (Assistance Publique‐Hôpitaux de Paris)Department of Nephrology and TransplantationHopital TenonParisFrance
| | - Marie Matignon
- AP‐HP, Nephrology and Renal Transplantation DepartmentInstitut Francilien de Recherche en Néphrologie et Transplantation (IFRNT)Groupe Hospitalier Henri‐Mondor/Albert‐ChenevierUniversité Paris‐Est‐Créteil, (UPEC)DHU (Département Hospitalo‐Universitaire) VIC (Virus‐Immunité‐Cancer)IMRB (Institut Mondor de Recherche Biomédicale)Equipe 21, INSERM U 955CréteilFrance
| | - Clarisse Greze
- Department of Nephrology and TransplantationHôpital BichatParisFrance
| | - Nassim Kamar
- Department of Nephrology and TransplantationUniversity of ToulouseToulouseFrance
| | - Philippe Gatault
- Department of Nephrology and TransplantationUniversity of ToursToursFrance
| | - Olivier Thaunat
- Department of Transplantation, Nephrology and Clinical ImmunologyHôpital Edouard HerriotHospices Civils de LyonUniversité Claude Bernard Lyon 1LyonFrance
| | - Tristan Legris
- Aix Marseille UniversitéHôpitaux Universitaires de MarseilleHôpital ConceptionCentre de Néphrologie et Transplantation RénaleMarseilleFrance
| | - Luc Frimat
- Department of NephrologyUniversity of LorraineCHRU‐NancyVandoeuvreFrance,INSERM CIC‐EC CIE6NancyFrance
| | - Pierre F. Westeel
- Department of Nephrology and TransplantationUniversity of AmiensAmiensFrance
| | - Valentin Goutaudier
- Department of Nephrology and TransplantationUniversity of MontpellierMontpellierFrance
| | - Mariam Jdidou
- Department of Nephrology and TransplantationHôpital BicêtreLe Kremlin‐BicêtreFrance
| | - Renaud Snanoudj
- Department of Nephrology and TransplantationHôpital BicêtreLe Kremlin‐BicêtreFrance
| | - Charlotte Colosio
- Department of Nephrology and TransplantationUniversity of ReimsReimsFrance
| | - Antoine Sicard
- Department of Nephrology, Dialysis, and TransplantationHopital Pasteur 2C.H.U. de NiceUnité de Recherche Clinique Côte d’Azur (UR2CA)Université Côte d’AzurNiceFrance
| | - Dominique Bertrand
- Department of Nephrology and TransplantationUniversity of RouenRouenFrance
| | - Christiane Mousson
- Department of Nephrology and TransplantationUniversity of DijonDijonFrance
| | - Jamal Bamoulid
- Department of NephrologyUniversity of BesançonBesançonFrance
| | - Christophe Masset
- Department of Nephrology and TransplantationCenter Hospitalier Universitaire de NantesNantesFrance
| | - Antoine Thierry
- Department of NephrologyUniversity of PoitiersPoitiersFrance
| | - Lionel Couzi
- Department of Nephrology‐Transplantation‐Dialysis‐ApheresisHôpital PellegrinCHU de Bordeaux PellegrinUnité Mixte de Recherche “ImmunoConcEpT” 5164 − Université de BordeauxBordeauxFrance
| | - Jonathan M. Chemouny
- University of RennesCHU RennesInsermEHESP, Irset (Institut de recherche en santéenvironnement et travail) UMR_S 1085, CIC – P 1414RennesFrance
| | - Agnes Duveau
- Department of Nephrology and TransplantationUniversity of AngersAngersFrance
| | - Valerie Moal
- Aix Marseille UniversitéHôpitaux Universitaires de MarseilleHôpital ConceptionCentre de Néphrologie et Transplantation RénaleMarseilleFrance
| | - Gilles Blancho
- Department of Nephrology and TransplantationCenter Hospitalier Universitaire de NantesNantesFrance
| | - Philippe Grimbert
- AP‐HP, Nephrology and Renal Transplantation DepartmentInstitut Francilien de Recherche en Néphrologie et Transplantation (IFRNT)Groupe Hospitalier Henri‐Mondor/Albert‐ChenevierUniversité Paris‐Est‐Créteil, (UPEC)DHU (Département Hospitalo‐Universitaire) VIC (Virus‐Immunité‐Cancer)IMRB (Institut Mondor de Recherche Biomédicale)Equipe 21, INSERM U 955CréteilFrance
| | - Antoine Durrbach
- AP‐HP, Nephrology and Renal Transplantation DepartmentInstitut Francilien de Recherche en Néphrologie et Transplantation (IFRNT)Groupe Hospitalier Henri‐Mondor/Albert‐ChenevierUniversité Paris‐Est‐Créteil, (UPEC)DHU (Département Hospitalo‐Universitaire) VIC (Virus‐Immunité‐Cancer)IMRB (Institut Mondor de Recherche Biomédicale)Equipe 21, INSERM U 955CréteilFrance
| | - Bruno Moulin
- Department of Nephrology and TransplantationStrasbourg University HospitalINSERMUMR‐S 1109StrasbourgFrance
| | - Dany Anglicheau
- Department of Nephrology and TransplantationHôpital Universitaire NeckerAPHP CenterUniversité de Paris INEM INSERM U 1151CNRS UMR 8253ParisFrance
| | - Yvon Ruch
- Department of Infectious DiseasesStrasbourg University HospitalStrasbourgFrance
| | - Charlotte Kaeuffer
- Department of Infectious DiseasesStrasbourg University HospitalStrasbourgFrance
| | - Ilies Benotmane
- Department of Nephrology and TransplantationStrasbourg University HospitalINSERMUMR‐S 1109StrasbourgFrance
| | - Morgane Solis
- Department of VirologyStrasbourg University HospitalINSERMUMR‐S 1109StrasbourgFrance
| | - Yannick LeMeur
- Department of NephrologyCHU de BrestUMR1227Lymphocytes B et AutoimmunitéUniversité de BrestInsermLabex IGOBrestFrance
| | - Marc Hazzan
- Department of Nephrology and TransplantationUniversity of LilleLilleFrance
| | - Francois Danion
- Department of Infectious DiseasesStrasbourg University HospitalStrasbourgFrance
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El Sakhawi K, Melica G, Scemla A, Bertrand D, Garrouste C, Malvezzi P, Rémy P, Moktefi A, Ingels A, Champy C, Lelièvre JD, Kheav D, Morel A, Mokrani D, Attias P, Grimbert P, Matignon M. Belatacept-based immunosuppressive regimen in HIV-positive kidney transplant recipients. Clin Kidney J 2020; 14:1908-1914. [PMID: 34345414 PMCID: PMC8323145 DOI: 10.1093/ckj/sfaa231] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Indexed: 12/11/2022] Open
Abstract
Background Kidney allograft survival in human immunodeficiency virus (HIV)-positive patients is lower than that in the general population. Belatacept increases long-term patient and allograft survival rates when compared with calcineurin inhibitors (CNIs). Its use in HIV-positive recipients remains poorly documented. Methods We retrospectively report a French cohort of HIV-positive kidney allograft recipients who were switched from CNI to belatacept, between June 2012 and December 2018. Patient and allograft survival rates, HIV immunovirological and clinical outcomes, acute rejection, opportunistic infections (OIs) and HLA donor-specific antibodies (DSAs) were analysed at 3 and 12 months, and at the end of follow-up (last clinical visit attended after transplantation). Results were compared with HIV-positive recipients group treated with CNI. Results Twelve patients were switched to belatacept 10 (2–25) months after transplantation. One year after belatacept therapy, patient and allograft survival rates scored 92% for both, two (17%) HIV virological rebounds occurred due to antiretroviral therapy non-compliance, and CD4+ and CD8+ T-cell counts remained stable over time. Serious adverse events included two (17%) acute steroid-resistant T-cell-mediated rejections and three (25%) OIs. Kidney allograft function significantly increased over the 12 post-switch months (P = 0.009), and DSAs remained stable at 12 months after treatment. The control group showed similar results in terms of patient and kidney allograft survival rates, DSA characteristics and proteinuria Conclusions Switch from CNI to belatacept can be considered safe and may increase long-term kidney allograft survival in HIV-positive kidney allograft recipients. These results need to be confirmed in a larger cohort.
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Affiliation(s)
- Karim El Sakhawi
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
| | - Giovanna Melica
- Department of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
| | - Anne Scemla
- Service de Néphrologie et Transplantation Adulte, Hôpital Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France.,Immunology Department, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Dominique Bertrand
- Department of Nephrology, Centre Hospitalo-Universitaire de Rouen, Rouen, France
| | - Cyril Garrouste
- Department of Nephrology, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Paolo Malvezzi
- Department of Nephrology, Dialysis and Transplantation, Centre Hospitalier Universitaire Grenoble-Alpes, Grenoble, France
| | - Philippe Rémy
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
| | - Anissa Moktefi
- Department of Pathology, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France
| | - Alexandre Ingels
- Department of Urology, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France
| | - Cécile Champy
- Department of Urology, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France
| | - Jean-Daniel Lelièvre
- Department of Immunology, Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France.,Département Hospitalo-Universitaire (DHU), Virus-Immunité-Cancer (VIC), Université Paris-Est-Créteil (UPEC), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
| | - David Kheav
- Assistance Publique-Hôpitaux de Paris (AP-HP), Laboratoire Régional d' Histocompatibilité, Hôpital Saint Louis, Paris, France
| | - Antoine Morel
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
| | - David Mokrani
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
| | - Philippe Attias
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
| | - Philippe Grimbert
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France.,Département Hospitalo-Universitaire (DHU), Université Paris-Est-Créteil (UPEC), Virus-Immunité-Cancer (VIC), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France.,Assistance Publique-Hôpitaux de Paris (AP-HP), Créteil, France
| | - Marie Matignon
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris (AP-HP), Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France.,Département Hospitalo-Universitaire (DHU), Université Paris-Est-Créteil (UPEC), Virus-Immunité-Cancer (VIC), Institut Mondor de Recherche Biomédicale (IMRB), Créteil, France
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Flateau C, Aït-Ammar N, Angebault C, Salomon L, Matignon M, Lepeule R, Melica G, Grimbert P, Lelièvre JD, Gallien S, Botterel F. Risk factors for intra-abdominal fungal infection after simultaneous pancreas-kidney transplantation: A single-center retrospective experience. Transpl Infect Dis 2020; 23:e13486. [PMID: 33047447 DOI: 10.1111/tid.13486] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 03/24/2020] [Revised: 08/17/2020] [Accepted: 09/20/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Data on the risk factors and outcome of intra-abdominal fungal infections (IAFI) following simultaneous pancreas-kidney transplantation (PKT) are scarce. MATERIALS/METHODS A retrospective monocentric study was conducted on all patients who underwent simultaneous PKT from January 2007 to December 2016. Deep sites positive cultures for fungi during the first post-transplantation year were collected. Clinical, radiological, and microbiological data of proven and probable invasive fungal infections were analysed. RESULTS Among sixteen PKT patients, 15 were included. Seven patients (47%) developed an invasive fungal infection, exclusively IAFI (six proven, one probable). The proven IAFI included four peritonitis, one pancreatic necrosis with infected hematoma, and one patient with positive preservation fluid only (PF). Candida albicans (n = 4) was the most prevalent species (associated with Galactomyces candidus in one case), C glabrata, C dubliniensis, and C krusei were found in one case each. Three patients had either a positive direct examination and/or culture for renal or pancreatic PF and the culture of PF was positive for the same species that caused IAFI. IAFIs were significantly associated with pancreatic graft arterial thrombosis (5/7 vs 0/8, P = .007) and fungal contamination of PF (3/7 vs 0/8, P = .008). Among patients with IAFI, all required an early surgical revision post-transplantation [1-18 days] and six had early or delayed pancreatic graft removal. One patient died in the first post-transplant year. CONCLUSION IAFI is a common complication in PKT, associated with pancreatic graft thrombosis or fungal contamination of the graft PF, and can sometimes lead to pancreatic detransplantation.
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Affiliation(s)
- Clara Flateau
- Service de maladies infectieuses, Groupe Hospitalier Sud Ile de France, Melun, France.,Groupe de Recherche et d'Etude des Maladies Infectieuses - Paris Sud-Est (GREMLIN Paris Sud-Est), Paris, France
| | - Nawel Aït-Ammar
- Unité de Parasitologie-Mycologie, Département Prévention, Diagnostic, DMU Biologie-Pathologie, CHU Henri Mondor, Assistance Publique des Hôpitaux de Paris (APHP), Créteil, France.,Faculté de Santé, Université Paris-Est Créteil, Créteil, France
| | - Cécile Angebault
- Unité de Parasitologie-Mycologie, Département Prévention, Diagnostic, DMU Biologie-Pathologie, CHU Henri Mondor, Assistance Publique des Hôpitaux de Paris (APHP), Créteil, France.,Faculté de Santé, Université Paris-Est Créteil, Créteil, France
| | - Laurent Salomon
- Faculté de Santé, Université Paris-Est Créteil, Créteil, France.,Service d'urologie, APHP, CHU Henri Mondor, Créteil, France
| | - Marie Matignon
- Service de néphrologie, APHP, CHU Henri Mondor, Créteil, France
| | - Raphaël Lepeule
- Groupe de Recherche et d'Etude des Maladies Infectieuses - Paris Sud-Est (GREMLIN Paris Sud-Est), Paris, France.,Unité Transversale du traitement des infections, Département Prévention, Diagnostic, DMU Biologie-Pathologie, APHP, CHU Henri Mondor, Créteil, France
| | - Giovanna Melica
- Service d'immunologie clinique et maladies infectieuses, APHP, CHU Henri Mondor, Créteil, France
| | | | - Jean-Daniel Lelièvre
- Faculté de Santé, Université Paris-Est Créteil, Créteil, France.,Service d'immunologie clinique et maladies infectieuses, APHP, CHU Henri Mondor, Créteil, France
| | - Sébastien Gallien
- Groupe de Recherche et d'Etude des Maladies Infectieuses - Paris Sud-Est (GREMLIN Paris Sud-Est), Paris, France.,Faculté de Santé, Université Paris-Est Créteil, Créteil, France.,Service d'immunologie clinique et maladies infectieuses, APHP, CHU Henri Mondor, Créteil, France
| | - Françoise Botterel
- Groupe de Recherche et d'Etude des Maladies Infectieuses - Paris Sud-Est (GREMLIN Paris Sud-Est), Paris, France.,Unité de Parasitologie-Mycologie, Département Prévention, Diagnostic, DMU Biologie-Pathologie, CHU Henri Mondor, Assistance Publique des Hôpitaux de Paris (APHP), Créteil, France.,Faculté de Santé, Université Paris-Est Créteil, Créteil, France
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Abdessater M, Champy CM, da Costa JB, Courcier J, Yiou R, Hoznek A, Vordos D, Grimbert P, Matignon M, Londero T, le Corvoisier P, Salomon L, De la Taille A, Ingels A. Comparison of the iliac, vaginal and umbilical graft extraction in robot-assisted laparoscopic living donor nephrectomy. World J Urol 2020; 39:2783-2788. [PMID: 33015741 DOI: 10.1007/s00345-020-03462-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 06/30/2020] [Accepted: 09/16/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To compare different extractions routes for robot-assisted living donor nephrectomy in terms of post-operative pain and renal function recovery. METHODS Live donor kidney transplantation data from our institution were reviewed from November 2011 to March 2017. Postoperative pain was estimated using cumulative painkillers consumption. Variables were compared between the 3 groups with ANOVA for continuous data, χ2 test for categorial data. A survival analysis with Kaplan-Meier curve assessing time to transplant recipient nadir was performed to compare the renal function recovery. RESULTS Sixty-three RLDN were performed (23 iliac, 23 vaginal and 17 umbilical extractions). There was no significant difference between the three groups in terms of operative time, blood lost, warm ischemia time, cumulative painkiller consumption and renal function recovery time. Postoperative complications for Umbilical, Vaginal and Iliac were, respectively, of 0, 3 and 1. No major difference was found between the 3 groups beside a slightly longer hospital stay in the iliac group. CONCLUSION Iliac incision might impact post-operative pain with a moderate but significant longer hospital stay. Vaginal extraction is an option when cosmetic outcomes present a real demand. The three options appeared to be safe and should be discussed with the patient in regard of the surgeon experience.
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Affiliation(s)
- Maher Abdessater
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Cécile M Champy
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - José Batista da Costa
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Jean Courcier
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - René Yiou
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Andras Hoznek
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Dimitri Vordos
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Philippe Grimbert
- Department of Nephrology, APHP, Henri Mondor University Hospital, UPEC, Créteil, France
| | - Marie Matignon
- Department of Nephrology, APHP, Henri Mondor University Hospital, UPEC, Créteil, France
| | - Tiphanie Londero
- Department of Nephrology, APHP, Henri Mondor University Hospital, UPEC, Créteil, France
| | - Philippe le Corvoisier
- Department of Clinical Investigations, APHP, Henri Mondor University Hospital, UPEC, Créteil, France.,INSERM, CIC 1430, Créteil, France
| | - Laurent Salomon
- Department of Urology, Hôpital Mont-de-Marsan, Mont-de-Marsan, France
| | - Alexandre De la Taille
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France
| | - Alexandre Ingels
- Department of Urology, APHP, Henri Mondor University Hospital, UPEC, 51 Avenue du Maréchal de Lattre de Tassigny, 94010, Créteil, France.
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36
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Charles P, Dechartres A, Terrier B, Cohen P, Faguer S, Huart A, Hamidou M, Agard C, Bonnotte B, Samson M, Karras A, Jourde-Chiche N, Lifermann F, Gobert P, Hanrotel-Saliou C, Godmer P, Martin-Silva N, Pugnet G, Matignon M, Aumaitre O, Viallard JF, Maurier F, Meaux-Ruault N, Rivière S, Sibilia J, Puéchal X, Mouthon L, Guillevin L. Corrigendum to: Reducing the initial number of rituximab maintenance-therapy infusions for ANCA-associated vasculitides: randomized-trial post-hoc analysis. Rheumatology (Oxford) 2020; 59:3119. [DOI: 10.1093/rheumatology/keaa222] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Pierre Charles
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
- Département de Médecine Interne, Institut Mutualiste Montsouris, Paris, France. *See Acknowledgements section for a list of the French Vasculitis Study Group
| | - Agnès Dechartres
- Sorbonne Universitù, Institut National de la Santù et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP. Sorbonne Université, Hôpital Pitié Salpêtriére, Département de Santé Publique, Paris
| | - Benjamin Terrier
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
| | - Pascal Cohen
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
| | - Stanislas Faguer
- Département de Néphrologie et Transplantation d’Organes, Centre Hospitalier Universitaire (CHU) de Toulouse, Toulouse
| | - Antoine Huart
- Département de Néphrologie et Transplantation d’Organes, Centre Hospitalier Universitaire (CHU) de Toulouse, Toulouse
| | | | | | - Bernard Bonnotte
- Service de Médecine Interne et Immunologie Clinique, CHU de Dijon, INSERM, UMR 1098, Université de Bourgogne Franche-Comté, FHU INCREASE, Dijon
| | - Maxime Samson
- Service de Médecine Interne et Immunologie Clinique, CHU de Dijon, INSERM, UMR 1098, Université de Bourgogne Franche-Comté, FHU INCREASE, Dijon
| | - Alexandre Karras
- Centre de Néphrologie et de Transplantation Rénale, Unité de Néphrologie, APHP, Hôpital Européen Georges-Pompidou, Université Paris Descartes, Paris
| | - Noémie Jourde-Chiche
- Aix–Marseille Université, Centre de Néphrologie et de Transplantation Rénale, AP–HM, Hôpital de la Conception, Marseille
| | | | | | - Catherine Hanrotel-Saliou
- Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital la Cavale Blanche, CH Régionale Universitaire Brest, Brest
| | - Pascal Godmer
- Département de Médecine Interne, CH Bretagne Atlantique de Vannes, Vannes
| | | | | | | | - Olivier Aumaitre
- Service de Médecine Interne, CHU, Hôpital Gabriel-Montpied, Clermont-Ferrand
| | | | | | | | - Sophie Rivière
- Service de Médecine Interne, CHU de Montpellier, Montpellier
| | - Jean Sibilia
- Service de Rhumatologie, Hôpital de Hautepierre, CHU de Strasbourg, Strasbourg, France
| | - Xavier Puéchal
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
| | - Luc Mouthon
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
| | - Loïc Guillevin
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
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Lebeaux D, Coussement J, Chauvet C, Matignon M, Scemla A, Bouvier N, Dantal J, Vollaard AM, Wunderink HF, Van Wijngaerden E, Naesens M, Kamar N, De Greef J, Guillemain R, Borie R, Candon S. Autoantibodies against granulocyte macrophage colony-stimulating factor and Nocardia infection in solid organ transplant recipients. Transpl Int 2020; 33:1827-1829. [PMID: 32881092 DOI: 10.1111/tri.13727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- David Lebeaux
- Université de Paris, Paris, France.,Unité Mobile d'Infectiologie, Service de Microbiologie, APHP, Hôpital Européen Georges Pompidou, Paris, France.,Centre d'Infectiologie Necker-Pasteur and Institut Imagine, Sorbonne Paris Cité, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants Malades, Université de Paris, Paris, France
| | - Julien Coussement
- Department of Infectious Diseases, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Cécile Chauvet
- Service de Transplantation Rénale, Hôpital Edouard HERRIOT, Lyon, France
| | - Marie Matignon
- Groupe Henri Mondor-Albert Chenevier, Nephrology and Transplantation Department, Assistance Publique-Hôpitaux de Paris, Centre d'Investigation Clinique-BioThérapies 504, Créteil, France.,Institut National de la Santé et de la Recherche Médicale U955, Paris Est University, Créteil, France
| | - Anne Scemla
- Kidney Transplantation Unit, Assistance Publique-Hôpitaux de Paris, RTRS Centaure, Labex Transplantex, Hôpital Necker Enfants Malades, Université Paris Descartes Sorbonne Paris Cité, Paris, France
| | - Nicolas Bouvier
- Service de Néphrologie, Université de Caen - Normandie, Caen, France
| | - Jacques Dantal
- ITUN (Institut de Transplantation, d'Urologie et de Néphrologie), CHU Nantes, Nantes, France
| | - Albert M Vollaard
- Department of Infectious Diseases, Leiden University Medical Center, Leiden, The Netherlands
| | - Herman F Wunderink
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Eric Van Wijngaerden
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Maarten Naesens
- Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Nassim Kamar
- Department of Nephrology and Organ Transplantation, CHU Rangueil, Toulouse, France.,INSERM U1043, IFR-BMT, CHU Purpan, Université Paul Sabatier, Toulouse, France
| | - Julien De Greef
- Service de Médecine interne et Maladies infectieuses, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Romain Guillemain
- Service d'Anesthésie-Réanimation, Hôpital Européen Georges Pompidou, Paris, France
| | - Raphael Borie
- Service de Pneumologie A, APHP, Hôpital Bichat, Paris, France.,INSERM U1152, Paris, France
| | - Sophie Candon
- Université de Paris, Paris, France.,Immunologie Biologique, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants Malades, Paris, France
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Runyo F, Matignon M, Audureau E, Gomart C, Boueilh A, Vindrios W, Grimbert P, Gallien S, Melica G. 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. Med Mal Infect 2020. [DOI: 10.1016/j.medmal.2020.06.039] [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: 11/15/2022]
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Gressens S, Melica G, Vindrios W, Stehle T, Andureau E, Gallien S, Grimbert P, Matignon M, Joher N. Sévérité de l’infection COVID-19 chez les patients transplantés rénaux d’un centre francilien. Med Mal Infect 2020. [PMCID: PMC7442053 DOI: 10.1016/j.medmal.2020.06.166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction Le phénotype du COVID-19 est très variable. Identifier et caractériser les populations à risque d’évolution défavorable est cruciale. L’objectif de cette étude est de décrire l’infection COVID-19 dans une population de transplantés rénaux (TR). Matériels et méthodes Il s’agit d’une étude rétrospective monocentrique des TR atteints de COVID-19 de février à mai 2020. Les cas confirmés par PCR et les cas possibles (clinique et lésions pulmonaires scanographiques compatibles) ont été inclus. La mortalité a été comparée avec celle de la population générale non transplantée dans le même centre. Résultats Parmi 1004 TR, 34 dont 26 hommes ont été atteints de COVID-19, avec un délai médian de 6 ans [2,2–10,3] après la transplantation. Deux patients avaient été transplantés dans les 6 mois précédents. L’âge moyen était de 61 ans [23–81]. Les principales comorbidités étaient une hypertension artérielle (31 cas, 94 %), une cardiopathie (16 cas, 47 %) et un diabète (14 cas, 41 %). Le traitement de maintenance associait les inhibiteurs de la calcineurine, les anti-métabolites et les corticoïdes chez 22 patients (65 %). Le débit de filtration glomérulaire estimé était de 40 mL/min/1,73 m2 [32–52]. Neuf patients (26,5 %) avaient déjà présenté des complications infectieuses pulmonaires après la greffe. Trente patients (88 %) ont été hospitalisés avec un délai médian de 7,7 jours [3–9,5] après le début des symptômes. Les signes cliniques initiaux principaux étaient une fièvre (n = 28,82 %), une toux (n = 23, 68 %), une dyspnée (n = 16, 47 %) et une diarrhée (n = 12, 35 %). À l’admission on observait une lymphopénie chez 18 patients (53 %), une CRP médiane à 84 mg/L [31,2–99,8] et une PCT médiane à 0,25 μg/L [0,19–0,4]. Sept patients sur 18 (39 %) présentaient une atteinte parenchymateuse pulmonaire sévère (plus de 50 %) au scanner. Les traitements spécifiques comprenaient l’hydroxychloroquine (n = 6, 18 %), l’association lopinavir/ritonavir (n = 1, 3 %), les anti-IL6 (n = 2, 6 %). L’arrêt d’un des immunosuppresseurs a été effectué chez 20 patients. Une forme clinique sévère (admission en réanimation ou oxygénothérapie ≥ 9 L/min) est survenue chez 20 patients (61 %). Le délai d’admission en réanimation était de 2,5 jours [0–6,5] depuis l’hospitalisation. Vingt patients (61 %) ont présenté une insuffisance rénale aiguë dont 6 nécessitant de l’hémodialyse. Quinze patients (44 %) sont décédés dans un délai de 11 jours [7–16] après l’hospitalisation. Le taux de décès chez les patients hospitalisés pour COVID-19 non TR était de 15,4 %. Conclusion Les patients transplantés rénaux sont une population à haut risque de forme sévère de COVID-19 avec un taux de mortalité approchant 50 % dans cette étude. Le renforcement des stratégies préventives et de dépistage semble primordial chez ces patients immunodéprimés et à fort risque cardiovasculaire.
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Živná M, Kidd K, Zaidan M, Vyleťal P, Barešová V, Hodaňová K, Sovová J, Hartmannová H, Votruba M, Trešlová H, Jedličková I, Sikora J, Hůlková H, Robins V, Hnízda A, Živný J, Papagregoriou G, Mesnard L, Beck BB, Wenzel A, Tory K, Häeffner K, Wolf MTF, Bleyer ME, Sayer JA, Ong ACM, Balogh L, Jakubowska A, Łaszkiewicz A, Clissold R, Shaw-Smith C, Munshi R, Haws RM, Izzi C, Capelli I, Santostefano M, Graziano C, Scolari F, Sussman A, Trachtman H, Decramer S, Matignon M, Grimbert P, Shoemaker LR, Stavrou C, Abdelwahed M, Belghith N, Sinclair M, Claes K, Kopel T, Moe S, Deltas C, Knebelmann B, Rampoldi L, Kmoch S, Bleyer AJ. An international cohort study of autosomal dominant tubulointerstitial kidney disease due to REN mutations identifies distinct clinical subtypes. Kidney Int 2020; 98:1589-1604. [PMID: 32750457 DOI: 10.1016/j.kint.2020.06.041] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 01/05/2023]
Abstract
There have been few clinical or scientific reports of autosomal dominant tubulointerstitial kidney disease due to REN mutations (ADTKD-REN), limiting characterization. To further study this, we formed an international cohort characterizing 111 individuals from 30 families with both clinical and laboratory findings. Sixty-nine individuals had a REN mutation in the signal peptide region (signal group), 27 in the prosegment (prosegment group), and 15 in the mature renin peptide (mature group). Signal group patients were most severely affected, presenting at a mean age of 19.7 years, with the prosegment group presenting at 22.4 years, and the mature group at 37 years. Anemia was present in childhood in 91% in the signal group, 69% prosegment, and none of the mature group. REN signal peptide mutations reduced hydrophobicity of the signal peptide, which is necessary for recognition and translocation across the endoplasmic reticulum, leading to aberrant delivery of preprorenin into the cytoplasm. REN mutations in the prosegment led to deposition of prorenin and renin in the endoplasmic reticulum-Golgi intermediate compartment and decreased prorenin secretion. Mutations in mature renin led to deposition of the mutant prorenin in the endoplasmic reticulum, similar to patients with ADTKD-UMOD, with a rate of progression to end stage kidney disease (63.6 years) that was significantly slower vs. the signal (53.1 years) and prosegment groups (50.8 years) (significant hazard ratio 0.367). Thus, clinical and laboratory studies revealed subtypes of ADTKD-REN that are pathophysiologically, diagnostically, and clinically distinct.
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Affiliation(s)
- Martina Živná
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kendrah Kidd
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic; Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mohamad Zaidan
- Service de Néphrologie‒Transplantation, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Petr Vyleťal
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Veronika Barešová
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Kateřina Hodaňová
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jana Sovová
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Hana Hartmannová
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Miroslav Votruba
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Helena Trešlová
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ivana Jedličková
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jakub Sikora
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Helena Hůlková
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Victoria Robins
- Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Aleš Hnízda
- Department of Biochemistry, University of Cambridge, Cambridge, UK
| | - Jan Živný
- Institute of Pathophysiology, First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Gregory Papagregoriou
- Center of Excellence in Biobanking and Biomedical Research, Molecular Medicine Research Center, University of Cyprus, Nicosia, Cyprus
| | - Laurent Mesnard
- Sorbonne Université, Urgences Néphrologiques et Transplantation Rénale, Assistance Publique-Hôpitaux de Paris (APHP), Hôpital Tenon, Paris, France
| | - Bodo B Beck
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Human Genetics, Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC) and Center for Rare Diseases Cologneies(ZSEK), Cologne, Germany
| | - Andrea Wenzel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Institute of Human Genetics, Cologne, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne (CMMC) and Center for Rare Diseases Cologneies(ZSEK), Cologne, Germany
| | - Kálmán Tory
- MTA-SE Lendület Nephrogenetic Laboratory, Semmelweis University, Budapest, Hungary; First Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Karsten Häeffner
- Department of General Pediatrics, Adolescent Medicine and Neonatology, Medical Center, Faculty of Medicine, Universitätsklinikum Freiburg, Freiburg, Germany
| | - Matthias T F Wolf
- Pediatric Nephrology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Michael E Bleyer
- Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - John A Sayer
- Renal Services, The Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK; Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK; NIHR Newcastle Biomedical Research Centre, Newcastle University, Newcastle upon Tyne, UK
| | - Albert C M Ong
- Kidney Genetics Group, Academic Nephrology Unit, Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, Sheffield, UK
| | - Lídia Balogh
- First Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Anna Jakubowska
- Department of Pediatric Nephrology Medical University Wrocław, Poland
| | - Agnieszka Łaszkiewicz
- Laboratory of Molecular and Cellular Immunology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Wrocław, Poland
| | - Rhian Clissold
- Exeter Kidney Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK
| | - Charles Shaw-Smith
- Exeter Kidney Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter, Devon, UK
| | - Raj Munshi
- Division of Nephrology, Department of Pediatrics, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Robert M Haws
- Pediatrics-Nephrology, Marshfield Medical Center, Marshfield, Wisconsin, USA
| | - Claudia Izzi
- Division of Nephrology and Dialysis, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia and Montichiari Hospital, Brescia, Italy
| | - Irene Capelli
- Department of Experimental Diagnostic and Specialty Medicine, Nephrology, Dialysis and Renal Transplant Unit, S. Orsola Hospital, University of Bologna, Bologna, Italy
| | | | - Claudio Graziano
- Medical Genetics Unit, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Francesco Scolari
- Division of Nephrology and Dialysis, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia and Montichiari Hospital, Brescia, Italy
| | - Amy Sussman
- Department of Medicine, Division of Nephrology, University of Arizona Health Sciences Center, Tucson, Arizona, USA
| | - Howard Trachtman
- Division of Nephrology, Department of Pediatrics, New York University School of Medicine, New York, New York, USA
| | - Stephane Decramer
- Pediatric Nephrology, Centre Hospitalier Universitaire de Toulouse (CHU de Toulouse), Toulouse, France; France Rare Renal Disease Reference Centre (SORARE), Toulouse, France; Centre Hospitalier Universitaire de Toulouse (CHU de Toulouse), Toulouse, France
| | - Marie Matignon
- AP-HP (Assistance Publique-Hôpitaux de Paris), Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France; Université Paris-Est-Créteil, (UPEC), DHU (Département Hospitalo-Universitaire) VIC (Virus-Immunité-Cancer), IMRB (Institut Mondor de Recherche Biomédicale), Equipe 21, INSERM U 955, Créteil, France
| | - Philippe Grimbert
- AP-HP (Assistance Publique-Hôpitaux de Paris), Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France; Université Paris-Est-Créteil, (UPEC), DHU (Département Hospitalo-Universitaire) VIC (Virus-Immunité-Cancer), IMRB (Institut Mondor de Recherche Biomédicale), Equipe 21, INSERM U 955, Créteil, France; AP-HP (Assistance Publique-Hôpitaux de Paris), CIC-BT 504, Créteil, France
| | - Lawrence R Shoemaker
- Division of Nephrology, Department of Pediatrics, University of Florida, Gainesville, Florida, USA
| | | | - Mayssa Abdelwahed
- Laboratory of Human Molecular Genetics, Faculty of Medicine, University of Sfax, Sfax, Tunisia
| | - Neila Belghith
- Laboratory of Human Molecular Genetics, Faculty of Medicine, University of Sfax, Sfax, Tunisia; Medical Genetics Department of Hedi Chaker Hospital, Sfax, Tunisia
| | - Matthew Sinclair
- Division of Nephrology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA
| | - Kathleen Claes
- Department of Nephrology and Renal Transplantation, University Hospitals Leuven, Leuven, Belgium; Laboratory of Nephrology, Department of Microbiology and Immunology, Katholieke Universiteit (KU) Leuven, Leuven, Belgium
| | - Tal Kopel
- Nephrology Division, University of Montreal Hospital Centre, Hopital Saint-Luc, Montréal, Québec, Canada
| | - Sharon Moe
- Division of Nephrology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Constantinos Deltas
- Center of Excellence in Biobanking and Biomedical Research, Molecular Medicine Research Center, University of Cyprus, Nicosia, Cyprus
| | - Bertrand Knebelmann
- Department of Nephrology‒Transplantation, Necker Hospital, APHP, Paris, France; Paris Descartes University, Sorbonne Paris Cité, Paris, France; Département Biologie cellulaire, INSERM U1151, Institut Necker Enfants Malades, Paris, France
| | - Luca Rampoldi
- Molecular Genetics of Renal Disorders, Division of Genetics and Cell Biology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Stanislav Kmoch
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic; Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Anthony J Bleyer
- Research Unit of Rare Diseases, Department of Pediatric and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University, Prague, Czech Republic; Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
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Snanoudj R, Siemowski J, Amankwa E, Kheav VD, Arzouk N, Galichon P, Matignon M, Legendre C, Delahousse M, Caillat-Zucman S, Taupin JL. Predictive value of mixed antigen screen beads in pre-transplant assessment of HLA immunization in solid organ transplant recipients. Clin Transplant 2020; 34:e14002. [PMID: 32510715 DOI: 10.1111/ctr.14002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 02/06/2020] [Revised: 05/02/2020] [Accepted: 05/29/2020] [Indexed: 11/29/2022]
Abstract
Pre-transplant serum screening of anti-HLA antibodies is recommended for solid organ transplantations. Many laboratories use the less expensive bead-based screening assay as the main technique and, if positive, turn to single-antigen beads (SAB). We studied the correlations between these two immunoassays. We re-analyzed the raw data of the two assays in 3030 first organ transplant recipients, explored with the two tests. We performed a ROC curve analysis of the screening ratio to predict a positive SAB assay. The AUC were 0.72 and 0.64 for class I and class II. The optimal thresholds of screening ratios were 3.28 (class I) and 2.11 (class II). Whatever the class, the negative predictive value was low, around 40%, with 36% of discordant sera, as defined by negative screening and positive SAB. Testing class I discordant sera on acid-treated SAB showed that 54% of antibodies reacted against denatured HLA molecules. However, these screening-negative sera may contain donor-specific antibodies in 13.9% and 28.7% of cases for class I and class II, respectively, involved in antibody-mediated rejection with the same frequency as non-discordant sera. Given the low predictive value of screening, both assays should be performed at least once on the same serum before transplantation.
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Affiliation(s)
- Renaud Snanoudj
- Transplantation and Nephrology Department, Hôpital Foch, Suresnes, France
| | - Jérémy Siemowski
- Laboratory of Immunology and Histocompatibility, Hôpital Saint-Louis, Paris, France
| | - Elizabeth Amankwa
- Laboratory of Immunology and Histocompatibility, Hôpital Saint-Louis, Paris, France
| | - Vissal-David Kheav
- Laboratory of Immunology and Histocompatibility, Hôpital Saint-Louis, Paris, France
| | - Nadia Arzouk
- Transplantation and Nephrology Department, Hôpital Pitié-Salpétrière, Paris, France
| | - Pierre Galichon
- Transplantation and Nephrology Department, Hôpital Pitié-Salpétrière, Paris, France
| | - Marie Matignon
- Transplantation and Nephrology Department, Hôpital Henri-Mondor, Créteil, France
| | | | - Michel Delahousse
- Transplantation and Nephrology Department, Hôpital Foch, Suresnes, France
| | - Sophie Caillat-Zucman
- Laboratory of Immunology and Histocompatibility, Hôpital Saint-Louis, Paris, France.,INSERM UMRS 976, Institut Universitaire d'Hématologie, University Paris Diderot, Hôpital Saint-Louis, Paris, France
| | - Jean-Luc Taupin
- Laboratory of Immunology and Histocompatibility, Hôpital Saint-Louis, Paris, France
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Mauhin W, Benveniste O, Amelin D, Montagner C, Lamari F, Caillaud C, Douillard C, Dussol B, Leguy-Seguin V, D'Halluin P, Noel E, Zenone T, Matignon M, Maillot F, Ly KH, Besson G, Willems M, Labombarda F, Masseau A, Lavigne C, Lacombe D, Maillard H, Lidove O. Cornea verticillata and acroparesthesia efficiently discriminate clusters of severity in Fabry disease. PLoS One 2020; 15:e0233460. [PMID: 32442237 PMCID: PMC7244174 DOI: 10.1371/journal.pone.0233460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 05/05/2020] [Indexed: 12/25/2022] Open
Abstract
BACKGROUD Fabry disease (OMIM #301 500), the most prevalent lysosomal storage disease, is caused by enzymatic defects in alpha-galactosidase A (GLA gene; Xq22.1). Fabry disease has historically been characterized by progressive renal failure, early stroke and hypertrophic cardiomyopathy, with a diminished life expectancy. A nonclassical phenotype has been described with an almost exclusive cardiac involvement. Specific therapies with enzyme substitution or chaperone molecules are now available depending on the mutation carried. Numerous clinical and fundamental studies have been conducted without stratifying patients by phenotype or severity, despite different prognoses and possible different pathophysiologies. We aimed to identify a simple and clinically relevant way to classify and stratify patients according to their disease severity. METHODS Based on data from the French Fabry Biobank and Registry (FFABRY; n = 104; 54 males), we applied unsupervised multivariate statistics to determine clusters of patients and identify clinical criteria that would allow an effective classification of adult patients. Thanks to these criteria and empirical clinical considerations we secondly elaborate a new score that allow the severity stratification of patients. RESULTS We observed that the absence of acroparesthesia or cornea verticillata is sufficient to classify males as having the nonclassical phenotype. We did not identify criteria that significantly cluster female patients. The classical phenotype was associated with a higher risk of severe renal (HR = 35.1; p <10-3) and cardiac events (HR = 4.8; p = 0.008) and a trend toward a higher risk of severe neurological events (HR = 7.7; p = 0.08) compared to nonclassical males. Our simple, rapid and clinically-relevant FFABRY score gave concordant results with the validated MSSI. CONCLUSION Acroparesthesia and cornea verticillata are simple clinical criteria that efficiently stratify Fabry patients, defining 3 different groups: females and males with nonclassical and classical phenotypes of significantly different severity. The FFABRY score allows severity stratification of Fabry patients.
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Affiliation(s)
- Wladimir Mauhin
- Internal Medicine Department, Reference Center for Lysosomal Storage Disorders, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
- UMRS 974, INSERM, Sorbonne Université, Paris, France
| | - Olivier Benveniste
- UMRS 974, INSERM, Sorbonne Université, Paris, France
- Internal Medicine Department, Pitié Salpêtrière University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
| | - Damien Amelin
- UMRS 974, INSERM, Sorbonne Université, Paris, France
| | - Clémence Montagner
- Internal Medicine Department, Reference Center for Lysosomal Storage Disorders, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
| | - Foudil Lamari
- Metabolic Biochemistry Department, Pitié Salpêtrière University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
- Groupe de Recherche Clinique 13 Neurométabolisme, Sorbonne Université, Paris, France
| | - Catherine Caillaud
- Biochemistry, Metabolomic and Proteomic Department, Necker Enfants Malades University Hospital, Assistance Publique Hôpitaux de Paris, Paris, France
- UMRS 1151, INSERM, Institute Necker Enfants Malades, Paris Descartes University, Paris, France
| | - Claire Douillard
- Reference Center for Inborn Metabolic Diseases, Jeanne de Flandres Hospital, Lille, France
| | - Bertrand Dussol
- Nephrology Department, Assistance Publique Hôpitaux de Marseille, Marseille, France
- Centre d’Investigation Clinique 1409, INSERM, Aix Marseille Université, Marseille, France
| | - Vanessa Leguy-Seguin
- Internal Medicine and Clinical Immunology Department, Francois Mitterrand Hospital, Dijon, France
| | - Pauline D'Halluin
- Nephrology and Haemodialysis Department, Centre Hospitalier Côte Basque, Bayonne, France
| | - Esther Noel
- Internal Medicine Department, Strasbourg University Hospital, Strasbourg, France
| | - Thierry Zenone
- Internal Medicine Department, Valence Hospital, Valence, France
| | - Marie Matignon
- Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Henri-Mondor/Albert-Chenevier University Hospital, Assistance Publique Hôpitaux de Paris, Créteil, France
- UMRS 955, Institut Mondor de Recherche Biomédicale, INSERM, University of Paris-Est-Créteil, Créteil, France
| | - François Maillot
- Internal Medicine Department, Tours University Hospital, Tours, France
- UMRS 1253, University of Tours, Tours, France
| | - Kim-Heang Ly
- Internal Medicine Department, Dupuytren University Hospital, Limoges, France
| | - Gérard Besson
- Neurology Department, Grenoble University Hospital, Grenoble, France
| | - Marjolaine Willems
- Medical Genetics and Rare Diseases Department, Montpellier University Hospital, Montpellier, France
| | | | - Agathe Masseau
- Internal Medicine Department, Hôtel-Dieu University Hospital, Nantes, France
| | - Christian Lavigne
- Internal Medicine and Vascular Diseases Department, Angers University Hospital, Angers, France
| | - Didier Lacombe
- Medical Genetics Department, Bordeaux University Hospital, Bordeaux, France
- INSERM U1211, Bordeaux University, Bordeaux, France
| | - Hélène Maillard
- Internal Medicine Department, Huriez Hospital, University of Lille, Lille, France
| | - Olivier Lidove
- Internal Medicine Department, Reference Center for Lysosomal Storage Disorders, Groupe Hospitalier Diaconesses Croix Saint-Simon, Paris, France
- UMRS 974, INSERM, Sorbonne Université, Paris, France
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Mahévas M, Tran VT, Roumier M, Chabrol A, Paule R, Guillaud C, Fois E, Lepeule R, Szwebel TA, Lescure FX, Schlemmer F, Matignon M, Khellaf M, Crickx E, Terrier B, Morbieu C, Legendre P, Dang J, Schoindre Y, Pawlotsky JM, Michel M, Perrodeau E, Carlier N, Roche N, de Lastours V, Ourghanlian C, Kerneis S, Ménager P, Mouthon L, Audureau E, Ravaud P, Godeau B, Gallien S, Costedoat-Chalumeau N. Clinical efficacy of hydroxychloroquine in patients with covid-19 pneumonia who require oxygen: observational comparative study using routine care data. BMJ 2020; 369:m1844. [PMID: 32409486 PMCID: PMC7221472 DOI: 10.1136/bmj.m1844] [Citation(s) in RCA: 268] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/05/2020] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To assess the effectiveness of hydroxychloroquine in patients admitted to hospital with coronavirus disease 2019 (covid-19) pneumonia who require oxygen. DESIGN Comparative observational study using data collected from routine care. SETTING Four French tertiary care centres providing care to patients with covid-19 pneumonia between 12 March and 31 March 2020. PARTICIPANTS 181 patients aged 18-80 years with documented severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pneumonia who required oxygen but not intensive care. INTERVENTIONS Hydroxychloroquine at a dose of 600 mg/day within 48 hours of admission to hospital (treatment group) versus standard care without hydroxychloroquine (control group). MAIN OUTCOME MEASURES The primary outcome was survival without transfer to the intensive care unit at day 21. Secondary outcomes were overall survival, survival without acute respiratory distress syndrome, weaning from oxygen, and discharge from hospital to home or rehabilitation (all at day 21). Analyses were adjusted for confounding factors by inverse probability of treatment weighting. RESULTS In the main analysis, 84 patients who received hydroxychloroquine within 48 hours of admission to hospital (treatment group) were compared with 89 patients who did not receive hydroxychloroquine (control group). Eight additional patients received hydroxychloroquine more than 48 hours after admission. In the weighted analyses, the survival rate without transfer to the intensive care unit at day 21 was 76% in the treatment group and 75% in the control group (weighted hazard ratio 0.9, 95% confidence interval 0.4 to 2.1). Overall survival at day 21 was 89% in the treatment group and 91% in the control group (1.2, 0.4 to 3.3). Survival without acute respiratory distress syndrome at day 21 was 69% in the treatment group compared with 74% in the control group (1.3, 0.7 to 2.6). At day 21, 82% of patients in the treatment group had been weaned from oxygen compared with 76% in the control group (weighted risk ratio 1.1, 95% confidence interval 0.9 to 1.3). Eight patients in the treatment group (10%) experienced electrocardiographic modifications that required discontinuation of treatment. CONCLUSIONS Hydroxychloroquine has received worldwide attention as a potential treatment for covid-19 because of positive results from small studies. However, the results of this study do not support its use in patients admitted to hospital with covid-19 who require oxygen.
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Affiliation(s)
- Matthieu Mahévas
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Viet-Thi Tran
- Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France
| | - Mathilde Roumier
- Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Amélie Chabrol
- Department of Infectious Diseases, Sud Francilien Hospital, Corbeil-Essonnes, France
| | - Romain Paule
- Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Constance Guillaud
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Elena Fois
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Raphael Lepeule
- Transversal Infections Treatment Unit, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | - Tali-Anne Szwebel
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | | | - Frédéric Schlemmer
- Pulmonology Unit, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | - Marie Matignon
- Department of Nephrology, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | - Mehdi Khellaf
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Etienne Crickx
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Benjamin Terrier
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Caroline Morbieu
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Paul Legendre
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Julien Dang
- Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France
| | - Yoland Schoindre
- Department of Internal Medicine, Foch Hospital, Suresnes, France
| | - Jean-Michel Pawlotsky
- Department of Virology, Bacteriology-Hygiene, and Mycology-Parasitology Centre, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Marc Michel
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Elodie Perrodeau
- Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France
| | - Nicolas Carlier
- Department of Pulmonology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Nicolas Roche
- Department of Pulmonology, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Victoire de Lastours
- Department of Internal Medicine, Beaujon Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Clément Ourghanlian
- Pharmacy, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | - Solen Kerneis
- Mobile Infectious Disease Team, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Philippe Ménager
- Pulmonology Unit, Sud Francilien Hospital, Corbeil-Essonnes, France
| | - Luc Mouthon
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
| | - Etienne Audureau
- Clinical Epidemiology and Aging Team, Mondor Institute for Biomedical Research (INSERM U955), Public Health Services, Henri-Mondor Hosptial, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, Créteil, France
| | - Philippe Ravaud
- Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France
| | - Bertrand Godeau
- Department of Internal Medicine, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Paris, Paris-Est Créteil University, 51 avenue du Maréchal de Lattre de Tassigny, 94000 Créteil, France
| | - Sébastien Gallien
- Department of Infectious Diseases, Henri-Mondor Hospital, Assistance Publique-Hôpitaux de Pari, Paris-Est Créteil University, Créteil, France
| | - Nathalie Costedoat-Chalumeau
- Centre for Clinical Epidemiology, Hôtel-Dieu Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Centre of Research in Epidemiology and Statistics, Paris, France
- Department of Internal Medicine, Cochin Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Paris, France
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Charles P, Dechartres A, Terrier B, Cohen P, Faguer S, Huart A, Hamidou M, Agard C, Bonnotte B, Samson M, Karras A, Jourde-Chiche N, Lifermann F, Gobert P, Hanrotel-Saliou C, Godmer P, Martin-Silva N, Pugnet G, Matignon M, Aumaitre O, Viallard JF, Maurier F, Meaux-Ruault N, Rivière S, Sibilia J, Puéchal X, Mouthon L, Guillevin L. Reducing the initial number of rituximab maintenance-therapy infusions for ANCA-associated vasculitides: randomized-trial post-hoc analysis. Rheumatology (Oxford) 2020; 59:2970-2975. [DOI: 10.1093/rheumatology/kez621] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/02/2019] [Indexed: 11/13/2022] Open
Abstract
AbstractObjectiveThe randomized, controlled MAINRITSAN2 trial was designed to compare the capacity of an individually tailored therapy [randomization day 0 (D0)], with reinfusion only when CD19+ lymphocytes or ANCA had reappeared, or if the latter’s titre rose markedly, with that of five fixed-schedule 500-mg rituximab infusions [D0 + D14, then months (M) 6, 12 and 18] to maintain ANCA-associated vasculitis (AAV) remissions. Relapse rates did not differ at M28. This ancillary study was undertaken to evaluate the effect of omitting the D14 rituximab infusion on AAV relapse rates at M12.MethodsMAINRITSAN2 trial data were subjected to post-hoc analyses of M3, M6, M9 and M12 relapse-free survival rates in each arm as primary end points. Exploratory subgroup analyses were run according to CYC or rituximab induction and newly diagnosed or relapsing AAV.ResultsAt M3, M6, M9 and M12, respectively, among the 161 patients included, 79/80 (98.8%), 76/80 (95%), 74/80 (92.5%) and 73/80 (91.3%) from D0, and 80/81 (98.8%), 78/81 (96.3%), 76/81 (93.8%) and 76/81 (93.8%) from D0+D14 groups were alive and relapse-free. No between-group differences were observed. Results were not affected by CYC or rituximab induction, or newly diagnosed or relapsing AAV.ConclusionsWe were not able to detect a difference between the relapse-free survival rates for up to M12 for the D0 and D0+D14 rituximab-infusion groups, which could suggest that omitting the D14 rituximab remission-maintenance dose did not modify the short-term relapse-free rate. Nevertheless, results at M12 may also have been influenced by the rituximab-infusion strategies for both groups.
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Affiliation(s)
- Pierre Charles
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
- Département de Médecine Interne, Institut Mutualiste Montsouris, Paris, France. *See Acknowledgements section for a list of the French Vasculitis Study Group
| | - Agnès Dechartres
- Sorbonne Universitù, Institut National de la Santù et de la Recherche Médicale (INSERM), Institut Pierre Louis d'Epidémiologie et de Santé Publique, AP-HP. Sorbonne Université, Hôpital Pitié Salpêtriére, Département de SantÕ Publique, Paris
| | - Benjamin Terrier
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
| | - Pascal Cohen
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
| | - Stanislas Faguer
- Département de Néphrologie et Transplantation d’Organes, Centre Hospitalier Universitaire (CHU) de Toulouse, Toulouse
| | - Antoine Huart
- Département de Néphrologie et Transplantation d’Organes, Centre Hospitalier Universitaire (CHU) de Toulouse, Toulouse
| | | | | | - Bernard Bonnotte
- Service de Médecine Interne et Immunologie Clinique, CHU de Dijon, INSERM, UMR 1098, Université de Bourgogne Franche-Comté, FHU INCREASE, Dijon
| | - Maxime Samson
- Service de Médecine Interne et Immunologie Clinique, CHU de Dijon, INSERM, UMR 1098, Université de Bourgogne Franche-Comté, FHU INCREASE, Dijon
| | - Alexandre Karras
- Centre de Néphrologie et de Transplantation Rénale, Unité de Néphrologie, APHP, Hôpital Européen Georges-Pompidou, Université Paris Descartes, Paris
| | - Noémie Jourde-Chiche
- Aix–Marseille Université, Centre de Néphrologie et de Transplantation Rénale, AP–HM, Hôpital de la Conception, Marseille
| | | | | | - Catherine Hanrotel-Saliou
- Service de Néphrologie, Dialyse et Transplantation Rénale, Hôpital la Cavale Blanche, CH Régionale Universitaire Brest, Brest
| | - Pascal Godmer
- Département de Médecine Interne, CH Bretagne Atlantique de Vannes, Vannes
| | | | | | | | - Olivier Aumaitre
- Service de Médecine Interne, CHU, Hôpital Gabriel-Montpied, Clermont-Ferrand
| | | | | | | | - Sophie Rivière
- Service de Médecine Interne, CHU de Montpellier, Montpellier
| | - Jean Sibilia
- Service de Rhumatologie, Hôpital de Hautepierre, CHU de Strasbourg, Strasbourg, France
| | - Xavier Puéchal
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
| | - Luc Mouthon
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
| | - Loïc Guillevin
- Centre de Référence Maladies Systémiques et Auto-Immunes Rares, Université Paris Descartes, APHP, Hôpital Cochin, Paris
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Pilon C, Bigot J, Grondin C, Thiolat A, Lang P, Cohen JL, Grimbert P, Matignon M. Phenotypic and Transcriptomic Lymphocytes Changes in Allograft Recipients After Intravenous Immunoglobulin Therapy in Kidney Transplant Recipients. Front Immunol 2020; 11:34. [PMID: 32038663 PMCID: PMC6993066 DOI: 10.3389/fimmu.2020.00034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 01/08/2020] [Indexed: 11/18/2022] Open
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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Affiliation(s)
- Caroline Pilon
- APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Centre d'Investigation Clinique Biothérapie, Créteil, France.,Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France
| | - Jeremy Bigot
- Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France
| | - Cynthia Grondin
- APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Centre d'Investigation Clinique Biothérapie, Créteil, France
| | - Allan Thiolat
- Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France
| | - Philippe Lang
- Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France.,APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Nephrology and Transplantation Department, Créteil, France
| | - José L Cohen
- APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Centre d'Investigation Clinique Biothérapie, Créteil, France.,Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France
| | - Philippe Grimbert
- APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Centre d'Investigation Clinique Biothérapie, Créteil, France.,Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France.,APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Nephrology and Transplantation Department, Créteil, France
| | - Marie Matignon
- APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Centre d'Investigation Clinique Biothérapie, Créteil, France.,Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France.,APHP (Assistance Publique-Hôpitaux de Paris), Hôpital H. Mondor-A. Chenevier, Nephrology and Transplantation Department, Créteil, France
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Pilon C, Stehlé T, Beldi-Ferchiou A, Matignon M, Thiolat A, Burlion A, Grondin C, Birebent B, Pirenne F, Rouard H, Lang P, Marodon G, Grimbert P, Cohen JL. Human Apoptotic Cells, Generated by Extracorporeal Photopheresis, Modulate Allogeneic Immune Response. Front Immunol 2019; 10:2908. [PMID: 31921167 PMCID: PMC6930166 DOI: 10.3389/fimmu.2019.02908] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 11/26/2019] [Indexed: 01/05/2023] Open
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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Affiliation(s)
- Caroline Pilon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalo-Universitaire Chenevier Mondor, Centre d'Investigation Clinique Biothérapie, Créteil, France.,Institut Mondor de recherche biomédicale, Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France
| | - Thomas Stehlé
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalo-Universitaire Chenevier Mondor, Centre d'Investigation Clinique Biothérapie, Créteil, France.,Institut Mondor de recherche biomédicale, Université Paris-Est, UMR_S955, UPEC, Créteil, France.,AP-HP, Groupe Hospitalo-Universitaire Chenevier Mondor, Service de Néphrologie-Transplantation, Créteil, France
| | - Asma Beldi-Ferchiou
- Institut Mondor de recherche biomédicale, Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France
| | - Marie Matignon
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalo-Universitaire Chenevier Mondor, Centre d'Investigation Clinique Biothérapie, Créteil, France.,Institut Mondor de recherche biomédicale, Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France.,AP-HP, Groupe Hospitalo-Universitaire Chenevier Mondor, Service de Néphrologie-Transplantation, Créteil, France
| | - Allan Thiolat
- Institut Mondor de recherche biomédicale, Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France
| | - Aude Burlion
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Cynthia Grondin
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalo-Universitaire Chenevier Mondor, Centre d'Investigation Clinique Biothérapie, Créteil, France.,Institut Mondor de recherche biomédicale, Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France
| | - Brigitte Birebent
- Etablissement Français du Sang (EFS) - Ile de France, Créteil, France
| | - France Pirenne
- Etablissement Français du Sang (EFS) - Ile de France, Créteil, France.,Inserm, U955, Equipe 2, Créteil, France
| | - Hélène Rouard
- Etablissement Français du Sang (EFS) - Ile de France, Créteil, France
| | - Philippe Lang
- Institut Mondor de recherche biomédicale, Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France.,AP-HP, Groupe Hospitalo-Universitaire Chenevier Mondor, Service de Néphrologie-Transplantation, Créteil, France
| | - Gilles Marodon
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, Centre d'Immunologie et des Maladies Infectieuses (CIMI-Paris), Paris, France
| | - Philippe Grimbert
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalo-Universitaire Chenevier Mondor, Centre d'Investigation Clinique Biothérapie, Créteil, France.,Institut Mondor de recherche biomédicale, Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France.,AP-HP, Groupe Hospitalo-Universitaire Chenevier Mondor, Service de Néphrologie-Transplantation, Créteil, France
| | - José L Cohen
- Assistance Publique-Hôpitaux de Paris (AP-HP), Groupe Hospitalo-Universitaire Chenevier Mondor, Centre d'Investigation Clinique Biothérapie, Créteil, France.,Institut Mondor de recherche biomédicale, Université Paris-Est, UMR_S955, UPEC, Créteil, France.,Inserm, U955, Equipe 21, Créteil, France
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Charles P, Dechartres A, Terrier B, Cohen P, Faguer S, Huart A, Hamidou M, Agard C, Bonnotte B, Samson M, Karras A, Jourde-Chiche N, Lifermann F, Gobert P, Hanrotel-Saliou C, Godmer P, Martin-Silva N, Pugnet G, Matignon M, Guillevin L. Réduction du nombre de perfusions de rituximab au début du traitement d’entretien des vascularites associées aux ANCA. Résultats d’une analyse post-hoc de l’essai contrôlé randomisé MAINRITSAN2. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.059] [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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Pelegrin T, Champy C, Ingels A, Matignon M, Grimbert P, Salomon L, De la Taille A. Retour d’expérience sur 100 prélèvements de rein de donneur vivant par cœlioscopie robot-assistée : mise à jour d’une série monocentrique. Prog Urol 2019. [DOI: 10.1016/j.purol.2019.08.199] [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]
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Tamzali Y, Scemla A, Taupin P, Randhawa S, Moal V, Garandeau C, Levi C, Matignon M, Fihman V, Le Quintrec M, Luque Y, Retbi A, Bertrand D, Thervet E, Cherrak I, Chemouny JM, Barrou B, Tourret-Arnaud J. 2658. Meningitis in Kidney Transplant Recipients: TransMéninges, a French Multicentric Retrospective Cohort Study. Open Forum Infect Dis 2019. [PMCID: PMC6810541 DOI: 10.1093/ofid/ofz360.2336] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background The management of meningitis requires the prompt introduction of high-dose probabilistic anti-infectious therapy. The literature reporting on meningitis in kidney transplant recipients (KTR) is scarce and no recommendation exists for this specific population. Methods We retrospectively included all adult KTRs diagnosed with meningitis (cerebro-spinal fluid (CSF) cell count >10/mm3 or positive fungal antigen or direct examination) between 2007 and 2018 in 16 French hospitals. Clinical, biological, and therapeutic data, and 1-year kidney and patient survival were collected. Results Meningitis occurred in 134 KTRs (mean age 57+/11.8 years, 56% male), after a median time of 27 months (IQR 8–65); 25% of patients received an immunosuppressive treatment before kidney transplantation, induction treatment included lymphocyte-depleting antibodies in 63%, and 53% presented diabetes (34% before and 19% after the transplantation). The etiologies included Cryptococcus neoformans (30%), Herpesviridae (22%, including Varicella-Zoster Virus 15%), idiopathic forms (11%), Gram-negative bacilli (8% of which 20% produced an extended spectrum β-lactamase), %), infusion of intravenous immunoglobulins (6%), post-transplant lymphoproliferative disorders (5%), Aspergillus fumigatus (4%), Listeria monocytogenes (4%), Enterovirus (4%), and Mycobacterium tuberculosis (3%). The most common symptoms were fever (82.5%), headaches (75%), encephalitis (55%), and convulsion (22.5%). CSF hypercellularity (found in 92% of the cases) was lymphocytic in 65% of the cases and neutrophilic in 35%. Initial anti-infectious therapy was inappropriate in 27% of the cases. One-year patient, graft, and death-censored graft survival rates were 84%, 76%, and 89%, respectively. Conclusion Meningitis after kidney transplantation encompasses a wide range of causes, with C. neoformans and VZV explaining more than 50% of the cases. Gram-negative bacilli are the most represented bacteria with a high rate of antimicrobial resistance. Treatment guidelines should be reconsidered in the specific population of KTRs as the etiology greatly differs from what is observed in the general population. Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Yanis Tamzali
- APHP, Pitié-Salpétrière Hospital, Paris, Ile-de-France, France
| | - Anne Scemla
- APHP, Necker Hospital, Paris, Ile-de-France, France
| | | | - Sunny Randhawa
- APHM, Marseille Hospitals, Marseille, Provence-Alpes-Cote d’Azur, France
| | - Valérie Moal
- APHM, Marseille Hospitals, Marseille, Provence-Alpes-Cote d’Azur, France
| | | | - Charlène Levi
- Hospices civils de Lyon, Lyon Hospitals, Lyon, Rhone-Alpes, France
| | - Marie Matignon
- APHP, Hôpital Henri Mondor, Créteil, Ile-de-France, France
| | - Vincent Fihman
- APHP, Hôpital Henri Mondor, Créteil, Ile-de-France, France
| | | | - Yosu Luque
- APHP,Tenon Hospital, Paris, Ile-de-France, France
| | - Aurelia Retbi
- APHP, Saint-Antoine Hospital, Paris, Ile-de-France, France
| | | | - Eric Thervet
- APHP, Georges Pompidou Hospital, Paris, Ile-de-France, France
| | - Ilham Cherrak
- APHP, Georges Pompidou Hospital, Paris, Ile-de-France, France
| | | | - Benoît Barrou
- APHP, Pitié-Salpétrière Hospital, Paris, Ile-de-France, France
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Moktefi A, Kofman T, Sakhi H, Matignon M, Grimbert P. Simultaneous cytomegalovirus glomerulitis and BK virus nephropathy leading to kidney allograft loss. Pathology 2019; 51:641-644. [PMID: 31470994 DOI: 10.1016/j.pathol.2019.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 04/24/2019] [Accepted: 05/10/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Anissa Moktefi
- APHP (Assistance Publique-Hôpitaux de Paris), Pathology Department, Groupe Hospitalier Henri-Mondor/Albert Chenevier, Créteil, France; Université Paris-Est-Créteil, (UPEC), DHU (Département Hospitalo-Universitaire), VIC (Virus-Immunité-Cancer), IMRB (Institut Mondor de Recherche Biomédicale), Equipe 21, INSERM U 955, Créteil, France.
| | - Tomek Kofman
- AP-HP (Assistance Publique-Hôpitaux de Paris), Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
| | - Hamza Sakhi
- Université Paris-Est-Créteil, (UPEC), DHU (Département Hospitalo-Universitaire), VIC (Virus-Immunité-Cancer), IMRB (Institut Mondor de Recherche Biomédicale), Equipe 21, INSERM U 955, Créteil, France; AP-HP (Assistance Publique-Hôpitaux de Paris), Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
| | - Marie Matignon
- Université Paris-Est-Créteil, (UPEC), DHU (Département Hospitalo-Universitaire), VIC (Virus-Immunité-Cancer), IMRB (Institut Mondor de Recherche Biomédicale), Equipe 21, INSERM U 955, Créteil, France; AP-HP (Assistance Publique-Hôpitaux de Paris), Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
| | - Philippe Grimbert
- Université Paris-Est-Créteil, (UPEC), DHU (Département Hospitalo-Universitaire), VIC (Virus-Immunité-Cancer), IMRB (Institut Mondor de Recherche Biomédicale), Equipe 21, INSERM U 955, Créteil, France; AP-HP (Assistance Publique-Hôpitaux de Paris), Nephrology and Renal Transplantation Department, Institut Francilien de Recherche en Néphrologie et Transplantation (IFRNT), Groupe Hospitalier Henri-Mondor/Albert-Chenevier, Créteil, France
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