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Maillard N, Chraka H, Claisse G, Dinic M, Masson I, Alamartine E, Mariat C. Le remplissage par solutés balancés améliore la balance acido-basique durant la période péri-opératoire après transplantation rénale. Nephrol Ther 2018. [DOI: 10.1016/j.nephro.2018.07.387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dinic M, Maillard N, Bouiller M, Alamartine E, Mariat C. SP079GENERIC VS BRAND NAME DRUGS FOR THE TREATMENT OF HYPERTENSION. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.sp079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Delay A, Moranne O, Maillard N, Alamartine E, Delanaye P, Mariat C. FP733CAN EARLY DECLINE IN ESTIMATED OR MEASURED GFR BE USED AS A SURROGATE FOR LONG-TERM RENAL TRANSPLANT OUTCOME? Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fp733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Dinic M, Maillard N, Claisse G, Masson I, Alamartine E, Mariat C. FO034PATTERNS OF HYPERTENSION IN RENAL TRANSPLANT PATIENTS EVALUATED WITH 24H AMBULATORY BLOOD PRESSURE MONITORING. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.fo034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Maillard N, Chraka H, Claisse G, Dinic M, Alamartine E, Mariat C. SP250RELATIVE BLOOD VOLUME MONITORING PREDICTS THE VARIATION OF MEAN ARTERIALPRESSURE DURING LONG STANDING DIALYSIS IN INTENSIVE CARE UNIT. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.sp250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Bridoux F, Carron PL, Pegourie B, Alamartine E, Augeul-Meunier K, Karras A, Joly B, Peraldi MN, Arnulf B, Vigneau C, Lamy T, Wynckel A, Kolb B, Royer B, Rabot N, Benboubker L, Combe C, Jaccard A, Moulin B, Knebelmann B, Chevret S, Fermand JP. Effect of High-Cutoff Hemodialysis vs Conventional Hemodialysis on Hemodialysis Independence Among Patients With Myeloma Cast Nephropathy: A Randomized Clinical Trial. JAMA 2017; 318:2099-2110. [PMID: 29209721 PMCID: PMC5820717 DOI: 10.1001/jama.2017.17924] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 11/06/2017] [Indexed: 11/14/2022]
Abstract
Importance Cast nephropathy is the main cause of acute kidney injury in multiple myeloma and persistent reduction in kidney function strongly affects prognosis. Strategies to rapidly remove nephrotoxic serum-free light chains combined with novel antimyeloma agents have not been evaluated prospectively. Objective To compare the hemodialysis independence rate among patients newly diagnosed with myeloma cast nephropathy treated with hemodialysis using a high-cutoff dialyzer (with very large membrane pores and high permeability to immunoglobulin light chains) or a conventional high-flux dialyzer (with small pores and lower permeability). Design, Setting, and Participants Randomized clinical trial involving 98 patients with biopsy-proven myeloma cast nephropathy requiring hemodialysis treated at 48 French centers between July 2011 and June 2016; the final date of follow-up was June 29, 2016. Interventions Intensive hemodialysis (eight 5-hour sessions over 10 days) with either a high-cutoff dialyzer (46 patients) or a conventional high-flux dialyzer (48 patients). All patients received the same chemotherapy regimen of bortezomib and dexamethasone. Main Outcomes and Measures Primary end point was hemodialysis independence at 3 months; secondary end points: hemodialysis independence rates at 6 and 12 months, hemodialysis- and chemotherapy-related adverse events, and death. Results Among 98 randomized patients, 94 (96%) (median age, 68.8 years [interquartile range, 61.2-75.3 years]; 45% women) were included in the modified intent-to-treat analysis. The hemodialysis independence rate at 3 months was 41.3% (n = 19) in the high-cutoff hemodialysis group vs 33.3% (n = 16) in the conventional hemodialysis group (between-group difference, 8.0% [95% CI, -12.0% to 27.9%], P = .42); at 6 months, the rate was 56.5% (n = 26) vs 35.4% (n = 17), respectively (between-group difference, 21.1% [95% CI, 0.9% to 41.3%], P = .04); and at 12 months, the rate was 60.9% (n = 28) vs 37.5% (n = 18) (between-group difference, 23.4% [95% CI, 3.2% to 43.5%], P = .02). The incidence of hemodialysis-related adverse events was 43% in the high-cutoff hemodialysis group vs 39% in the conventional hemodialysis group; chemotherapy-related serious adverse events, 39% vs 37%, respectively; and at 12 months, 9 patients vs 10 patients died. Conclusions and Relevance Among patients with myeloma cast nephropathy treated with a bortezomib-based chemotherapy regimen, the use of high-cutoff hemodialysis compared with conventional hemodialysis did not result in a statistically significant difference in hemodialysis independence at 3 months. However, the study may have been underpowered to identify an early clinically important difference. Trial Registration clinicaltrials.gov Identifier: NCT01208818.
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Jullien P, Laurent B, Claisse G, Masson I, Dinic M, Thibaudin D, Berthoux F, Alamartine E, Mariat C, Maillard N. Deletion Variants of CFHR1 and CFHR3 Associate with Mesangial Immune Deposits but Not with Progression of IgA Nephropathy. J Am Soc Nephrol 2017; 29:661-669. [PMID: 29114042 DOI: 10.1681/asn.2017010019] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 10/08/2017] [Indexed: 11/03/2022] Open
Abstract
Activation of complement through the alternative pathway has a key role in the pathogenesis of IgA nephropathy (IgAN). Large, international, genome-wide association studies have shown that deletion of complement factor H-related genes 1 and 3 (CFHR3,1Δ) is associated with a reduced risk of developing IgAN, although the prognostic value of these deletions in IgAN remains unknown. Here, we compared the renal outcomes of patients with IgAN according to their CFHR3,1Δ genotype. This retrospective, monocentric cohort study included 639 white patients with biopsy-proven IgAN since 1979 (mean age at diagnosis, 40.1 years; median follow-up, 132 months). We determined the number of CFHR3 and CFHR1 gene copies by quantitative PCR and collected clinical and biologic data by reviewing the patients' medical records. In all, 30.5% of the patients were heterozygous and 4% were homozygous for CFHR3,1Δ We did not detect an association between CFHR3,1Δ and age, eGFR, urinary protein excretion rate, or the presence of hypertension or hematuria at the time of diagnosis. The mean intensities of immune IgA, IgG, and C3 deposits were lower in the group with heterozygous or homozygous gene deletions than in those with no deletion. However, CFHR3,1Δ did not associate with progression to stage 3 CKD or renal death. In conclusion, the CFHR3,1Δ genotype did not associate with progression toward CKD stages 3 and 5 in our white population of patients with IgAN, although it did associate with a reduced level of glomerular immune deposits.
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Caillard S, Cellot E, Dantal J, Thaunat O, Provot F, Janbon B, Buchler M, Anglicheau D, Merville P, Lang P, Frimat L, Colosio C, Alamartine E, Kamar N, Heng AE, Durrbach A, Moal V, Rivalan J, Etienne I, Peraldi MN, Moreau A, Moulin B. A French Cohort Study of Kidney Retransplantation after Post-Transplant Lymphoproliferative Disorders. Clin J Am Soc Nephrol 2017; 12:1663-1670. [PMID: 28818847 PMCID: PMC5628715 DOI: 10.2215/cjn.03790417] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/26/2017] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVES Post-transplant lymphoproliferative disorders arising after kidney transplantation portend an increased risk of morbidity and mortality. Retransplantation of patients who had developed post-transplant lymphoproliferative disorder remains questionable owing to the potential risks of recurrence when immunosuppression is reintroduced. Here, we investigated the feasibility of kidney retransplantation after the development of post-transplant lymphoproliferative disorder. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We reviewed the data from all patients who underwent kidney retransplantation after post-transplant lymphoproliferative disorder in all adult kidney transplantation centers in France between 1998 and 2015. RESULTS We identified a total of 52 patients with kidney transplants who underwent 55 retransplantations after post-transplant lymphoproliferative disorder. The delay from post-transplant lymphoproliferative disorder to retransplantation was 100±44 months (28-224); 98% of patients were Epstein-Barr virus seropositive at the time of retransplantation. Induction therapy for retransplantation was used in 48 patients (i.e., 17 [31%] patients received thymoglobulin, and 31 [57%] patients received IL-2 receptor antagonists). Six patients were also treated with rituximab, and 53% of the patients received an antiviral drug. The association of calcineurin inhibitors, mycophenolate mofetil, and steroids was the most common maintenance immunosuppression regimen. Nine patients were switched from a calcineurin inhibitor to a mammalian target of rapamycin inhibitor. One patient developed post-transplant lymphoproliferative disorder recurrence at 24 months after retransplantation, whereas post-transplant lymphoproliferative disorder did not recur in 51 patients. CONCLUSIONS The recurrence of post-transplant lymphoproliferative disorder among patients who underwent retransplantation in France is a rare event.
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Jullien P, Seitz Polski B, Maillard N, Thibaudin D, Laurent B, Ollier E, Alamartine E, Lambeau G, Mariat C. Anti-phospholipase A2 receptor antibody levels at diagnosis predicts spontaneous remission of idiopathic membranous nephropathy. Clin Kidney J 2017; 10:209-214. [PMID: 28396737 PMCID: PMC5381233 DOI: 10.1093/ckj/sfw121] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Accepted: 09/19/2016] [Indexed: 11/27/2022] Open
Abstract
Background: The diagnostic role of circulating anti-phospholipase A2 receptor antibodies (anti-PLA2R Abs) is now well recognized in idiopathic membranous nephropathy (iMN). These Abs could also be interesting as predictors of clinical outcome. In this study, we explored the prognostic value of anti-PLA2R Abs measured in a cohort of iMN patients, with a special focus on their ability to detect patients achieving spontaneous remission. Methods: All adult patients with biopsy-proven iMN diagnosed between 1978 and 2007 were retrospectively screened in our centre. Using a validated enzyme-linked immunosorbent assay, levels of anti-PLA2R Abs were measured from serum samples obtained at the time of renal biopsy and stored at −80°C until processing. Clinical data on disease activity, treatments and outcomes were collected by reviewing patients’ medical records. The association between anti-PLA2R Ab titres and clinical activity/outcome was assessed by Cox proportional hazard and Kaplan–Meier methods. Results: In this retrospective study, 68 patients were included in the final analysis (median follow-up of 81 months). No significant association was found between anti-PLA2R Ab titres at diagnosis with baseline proteinuria, baseline estimated glomerular filtration rate or chronic kidney disease progression. Spontaneous remission was observed in 22% of patients. Ab titres were significantly and gradually correlated in a dose–response manner with the likelihood of spontaneous remission. Conclusions: While Ab titres measured at diagnosis were not found to predict the activity of iMN, evaluation of anti-PLA2R Ab titres might prove useful in the early identification of patients likely to achieve spontaneous remission.
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Claisse G, Absi L, Cognasse F, Alamartine E, Mariat C, Maillard N. Relationship between Mean Fluorescence Intensity and C1q/C3d-fixing capacities of anti-HLA antibodies. Hum Immunol 2017; 78:336-341. [PMID: 28189573 DOI: 10.1016/j.humimm.2017.02.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 02/05/2017] [Accepted: 02/07/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND Complement-binding assays are proposed to better stratify the risk of antibody-mediated rejection associated-graft failure. Despite promising clinical results, some have suggested that the MFI of anti-HLA antibodies may influence these tests. METHODS We investigated the impact of Abs MFI reduction, induced by plasmapheresis, on C1q- and C3d-binding assays. Sera provided from 7 sensitized kidney transplant patients were analyzed. RESULTS Four hundreds and thirty-three SABs were analyzed. Before plasmapheresis, when compared to C1q- SABs, C1q+ SABs had a higher median MFI [17397 (IQR: 14851-18794) vs. 2745 (IQR: 1125-6476), p<0.01]. SABs that remained C1q+ after plasmapheresis had a higher median MFI. Regarding the C3d assay, results were strictly comparable. MFI value was a powerful predictor of both C1q and C3d positivity [AUC 0.97 (CI95% 0.95-0.99) and 0.96, (CI95% 0.93-0.98), respectively]. CONCLUSION Our data suggest that both C1q- and C3d-binding assays are intimately linked to the MFI of anti-HLA Abs.
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Ghisdal L, Baron C, Lebranchu Y, Viklický O, Konarikova A, Naesens M, Kuypers D, Dinic M, Alamartine E, Touchard G, Antoine T, Essig M, Rerolle JP, Merville P, Taupin JL, Le Meur Y, Grall‐Jezequel A, Glowacki F, Noël C, Legendre C, Anglicheau D, Broeders N, Coppieters W, Docampo E, Georges M, Ajarchouh Z, Massart A, Racapé J, Abramowicz D, Abramowicz M. Genome-Wide Association Study of Acute Renal Graft Rejection. Am J Transplant 2017; 17:201-209. [PMID: 27272414 PMCID: PMC5215306 DOI: 10.1111/ajt.13912] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 04/29/2016] [Accepted: 05/23/2016] [Indexed: 01/25/2023]
Abstract
Acute renal rejection is a major risk factor for chronic allograft dysfunction and long-term graft loss. We performed a genome-wide association study to detect loci associated with biopsy-proven acute T cell-mediated rejection occurring in the first year after renal transplantation. In a discovery cohort of 4127 European renal allograft recipients transplanted in eight European centers, we used a DNA pooling approach to compare 275 cases and 503 controls. In an independent replication cohort of 2765 patients transplanted in two European countries, we identified 313 cases and 531 controls, in whom we genotyped individually the most significant single nucleotide polymorphisms (SNPs) from the discovery cohort. In the discovery cohort, we found five candidate loci tagged by a number of contiguous SNPs (more than five) that was never reached in iterative in silico permutations of our experimental data. In the replication cohort, two loci remained significantly associated with acute rejection in both univariate and multivariate analysis. One locus encompasses PTPRO, coding for a receptor-type tyrosine kinase essential for B cell receptor signaling. The other locus involves ciliary gene CCDC67, in line with the emerging concept of a shared building design between the immune synapse and the primary cilium.
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Jullien P, Laurent B, Sauron C, Mariat C, Alamartine E, Maillard N. L’évolution du score d’Oxford par biopsies rénales itératives est un marqueur pronostique indépendant au cours de la néphropathie à IgA primitive. Nephrol Ther 2016. [DOI: 10.1016/j.nephro.2016.07.324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Jullien P, Alamartine E, Mariat C, Berthoux F, Laurent B, Maillard N. SP130REPEAT RENAL BIOPSY IMPROVES OXFORD CLASSIFICATION BASED PREDICTION OF IGA NEPHROPATHY OUTCOME. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw160.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Claisse G, Absi L, Alamartine E, Maillard N, Mariat C. SO003RELATIONSHIP BETWEEN MEAN FLUORESCENCE INTENSITY AND C1Q/C3D-FIXING CAPACITIES OF ANTI-HLA ANTIBODIES. Nephrol Dial Transplant 2016. [DOI: 10.1093/ndt/gfw117.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Verhoeven PO, Gagnaire J, Haddar CH, Grattard F, Thibaudin D, Afiani A, Cazorla C, Carricajo A, Mariat C, Alamartine E, Lucht F, Garraud O, Pozzetto B, Botelho-Nevers E, Berthelot P. Identifying Hemodialysis Patients With the Highest Risk of Staphylococcus aureus Endogenous Infection Through a Simple Nasal Sampling Algorithm. Medicine (Baltimore) 2016; 95:e3231. [PMID: 27057858 PMCID: PMC4998774 DOI: 10.1097/md.0000000000003231] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
In contrast to Staphylococcus aureus intermittent nasal carriers, persistent ones have the highest risk of infection. This study reports the usefulness of a simple nasal sampling algorithm to identify the S. aureus nasal carriage state of hemodialysis patients (HPs) and their subsequent risk of infection.From a cohort of 85 HPs, 76 were screened for S. aureus nasal carriage once a week during a 10-week period. The S. aureus nasal load was quantified by using either culture on chromogenic medium or fully automated real-time polymerase chain reaction assay. Molecular typing was used to compare strains from carriage and infection.The algorithm based on quantitative cultures was able to determine the status of S. aureus nasal carriage with a sensitivity of 95.8%, a specificity of 94.2%, a positive predictive value of 88.5%, and a negative predictive value of 98.0%. Of note, the determination of the S. aureus carriage state was obtained on the first nasal sample for all the 76 HPs, but 1 (98.7%). The algorithm based on quantitative polymerase chain reaction assay directly from the specimen yielded similar performances. During the 1-year follow-up after the last sampling episode, HPs classified as persistent nasal carriers with the algorithm were found to have a higher risk of S. aureus infection than those classified as nonpersistent carriers (P < 0.05), especially for infections of endogenous origin (P < 0.001).This simple algorithm is reliable for determining the S. aureus nasal carriage status in clinical practice and could contribute to characterize at an early stage of take-up patients with the highest risk of S. aureus infection.
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Duprey A, Chavent B, Maillard N, Mariat C, Alamartine E, Albertini JN, Favre JP, Barral X. Common hepatic artery as inflow in kidney transplantation. Am J Transplant 2015; 15:2991-4. [PMID: 26095663 DOI: 10.1111/ajt.13340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 03/13/2015] [Accepted: 03/31/2015] [Indexed: 01/25/2023]
Abstract
Kidney transplantation originating from the hepatic artery has not previously been reported. Herein, we report a third kidney transplantation with the common hepatic artery as inflow. A 62-year-old male with chronic renal failure due to polycystic kidney disease was proposed to a third kidney transplantation. CT-scan showed diffuse calcification of the aorto-iliac axis and the splenic artery. The common hepatic artery was the only artery suitable for anastomosis and as such was chosen as the inflow for retransplantation. The operation was performed through a right subcostal laparotomy. A saphenous bypass was interposed between the common hepatic artery and the graft, then the renal vein was anastomosed to the suprarenal inferior vena cava. Duration of warm ischemia was 27 min. Postoperative course was complicated with delayed graft function of 17 days and pulmonary infection. Patient was discharged at day 30. With a follow-up of 40 months, serum creatinine level and eGFR are, respectively, 191 µmol/L and 32 mL/min. Hepato-renal bypass technique can be used in kidney retransplantation when patient anatomy is not compatible with other classical options.
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Guinier C, Benamara A, Maillard N, Alamartine E, Mariat C, Oriol P, Camdessanche P, Legrand D, Cognasse F, Garraud O. « Échange plasmatique : 10ans de pratique au CHU de Saint-Étienne ; évaluation du plasma inactivé par l’Amotosalen ». Transfus Clin Biol 2015. [DOI: 10.1016/j.tracli.2015.06.260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Julien P, Laurent B, Sauron C, Mariat C, Alamartine E. Classification d’Oxford pour les biopsies itératives de néphropathie à IgA. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Claisse G, Hougardy J, Alamartine E, Delanaye P, Maillard N, Morel J, Mariat C. Évaluation d’un nouvel estimateur du débit de filtration glomérulaire cinétique (KeGFR) pour prédire la survenue d’une insuffisance rénale aiguë après chirurgie cardiaque : étude AKInetic. Nephrol Ther 2015. [DOI: 10.1016/j.nephro.2015.07.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Maillard N, Absi L, Claisse G, Masson I, Alamartine E, Mariat C. Protein A-Based Immunoadsorption Is More Efficient Than Conventional Plasma Exchange to Remove Circulating Anti-HLA Antibodies. Blood Purif 2015; 40:167-72. [DOI: 10.1159/000437041] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2015] [Accepted: 06/17/2015] [Indexed: 11/19/2022]
Abstract
We retrospectively evaluated the ability of protein-A immunoadsorption (IA) as compared to that of conventional plasma exchanges (PE) in reducing the mean fluorescence intensity (MFI) of anti-HLA antibodies assessed by the single antigen assay in sensitized renal transplant recipients. Change in MFI of 441 anti-HLA antibodies was measured after 1 single session of IA or after 3 consecutive daily PE sessions. While both strategies were able to significantly lower the amount of anti-HLA antibodies, the relative reduction in MFI was higher after IA as compared to PE (-69 vs. -58%, respectively, p = 0.003). This better efficacy of IA was observed despite a lower total volume of treated plasma (105 ± 6 vs. 160 ± 16 ml/kg after IA and after PE, respectively). Our data suggest a higher efficiency of IA over conventional PE sessions to remove anti-HLA antibodies and call for a larger evaluation of IA to confirm its potential added value in desensitization protocols.
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Masson I, Maillard N, Cavalier E, Alamartine E, Mariat C, Delanaye P. KDIGO Guidelines and Kidney Transplantation: Is the Cystatin-C Based Recommendation Relevant? Am J Transplant 2015; 15:2211-4. [PMID: 25808194 DOI: 10.1111/ajt.13258] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 01/11/2015] [Accepted: 01/29/2015] [Indexed: 01/25/2023]
Abstract
The KDIGO guidelines propose a new approach to diagnose chronic kidney disease (CKD) based on estimated glomerular filtration rate (GFR). In patients with a GFR value comprised between 45 and 59 mL/min/1.73 m(2) as estimated by the CKD-EPI creatinine equation (eGFRcreat ), it is suggested to confirm the diagnosis with a second estimation using the CKD-EPI cystatin C-based equations (eGFRcys /eGFRcreat-cys) . We sought to determine whether this new diagnostic strategy might extend to kidney transplant recipients (KTR) and help to identify those with decreased GFR. In 670 KTR for whom a measured GFR was available, we simulated the detection of CKD using the two-steps approach recommended by the guidelines in comparison to the conventional approach relying on creatinine equation. One hundred forty-five patients with no albuminuria had eGFRcreat between 45 and 59 mL/min/1.73 m(2) . Among them, 23% had inulin clearance over 60 mL/min/1.73 m(2) and were thus incorrectly classified as CKD patients. When applying the Kidney Disease: Improving Global Outcomes (KDIGO) strategy, 138 patients were confirmed as having a GFR below 60 mL/min with eGFRcreat-cys . However, 21% of them were misclassified in reference to measured GFR. Our data do no not support the use of cystatin C as a confirmatory test of stage 3 A CKD in KTR.
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Jullien P, Seitz-Polski B, Maillard N, Thibaudin D, Laurent B, Claisse G, Alamartine E, Lambeau G, Mariat C. FP138ANTI-PLA2R ANTIBODIES LEVEL AT DIAGNOSIS PREDICTS SPONTANEOUS REMISSION OF MEMBRANOUS NEPHROPATHY. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv171.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Claisse G, Hougardy JM, Morel J, Alamartine E, Maillard N, Mariat C. SP242EVALUATION OF A NEW KINETIC ESTIMATED GLOMERULAR FILTRATION RATE (KEGFR) FOR THE PREDICTION OF POST-CARDIAC SURGERY ACUTE KIDNEY INJURY: THE AKINETIC STUDY. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv190.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ghisdal L, Baron C, Lebranchu Y, Viklický O, Konarikova A, Naesen M, Dinic M, Alamartine E, Touchard G, Thierry A, Essig M, Rerolle JP, Merville P, Taupin JL, Le Meur Y, Glowacki F, Noël C, Legendre C, Coppieter W, Do Campo E, Georges M, Massart A, Racapé J, Abramowicz D, Abramowicz M. SP007GENOME-WIDE ASSOCIATION STUDY IDENTIFIES NEW LOCI ASSOCIATED WITH ACUTE RENAL GRAFT REJECTION. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv187.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Claisse G, Thibaudin D, Maillard N, Alamartine E, Mariat C. FP519ADEQUACY OF CONVECTIVE VOLUME DELIVERED BY CONTROL SYSTEM “AUTOSUB” (FRESENIUS) AND ULTRACONTROL (HOSPAL) WITH THE VOLUME OF 23,7 LITRES SUGGESTED BY THE ESHOL STUDY. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv179.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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