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Acquier M, Taton B, Alain S, Garrigue I, Mary J, Pfirmann P, Visentin J, Hantz S, Merville P, Kaminski H, Couzi L. Cytomegalovirus DNAemia Requiring (Val)Ganciclovir Treatment for More Than 8 Weeks Is a Key Factor in the Development of Antiviral Drug Resistance. Open Forum Infect Dis 2023; 10:ofad018. [PMID: 36817745 PMCID: PMC9933945 DOI: 10.1093/ofid/ofad018] [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: 11/10/2022] [Accepted: 01/19/2023] [Indexed: 01/25/2023] Open
Abstract
Background Prolonged (val)ganciclovir [(V)GCV] exposure for ≥6 weeks is a known predisposing factor for cytomegalovirus (CMV) drug resistance. However, the selection of this threshold was based on limited data. In this study, we sought to reappraise the risk factors for the development of (V)GCV resistance through a specific focus on kidney transplant recipients (KTRs). Methods This single-center retrospective study included 313 consecutive KTRs treated for a first CMV episode. Adjusted Cox multivariate regression analysis was used for identifying independent risk factors. Results Antiviral drug resistance was identified in 20 (6%) KTRs. A cumulative (V)GCV exposure for more than 6 weeks (regardless of the viral load) was not associated with antiviral drug resistance (hazard ratio [HR] = 2.45, 95% confidence interval [CI] = 0.33-18.30, P = .38). In contrast, persistent CMV DNAemia requiring (V)GCV treatment for more than 8 weeks was the main independent risk factor for antiviral drug resistance (HR = 11.68, 95% CI = 2.62-52.01, P = .001). The (V)GCV treatment for more than 8 weeks was given to 9% and 18% of patients who had persistent or recurrent CMV DNAemia, respectively. These scenarios were associated with the occurrence of drug resistance in 39% and 12% of cases, respectively. Conclusions Cumulative (V)GCV exposure ≥6 weeks regardless of the viral load is not associated with antiviral drug resistance. In contrast, prolonged exposure to (V)GCV during CMV replication (with a cutoff ³8 weeks) seems to be a key factor.
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Affiliation(s)
- M Acquier
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - B Taton
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - S Alain
- National Reference Center for Herpes Viruses, Virology Department, Limoges University Hospital, LimogesFrance.,UMR INSERM U1092, RESINFIT, Limoges University, LimogesFrance
| | - I Garrigue
- Laboratory of Virology, Bordeaux University Hospital, Bordeaux, France
| | - J Mary
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - P Pfirmann
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France
| | - J Visentin
- CNRS-UMR 5164 ImmunoConcEpT, Bordeaux University, Bordeaux, France.,Laboratory of Immunology and Immunogenetics, Bordeaux University Hospital, Bordeaux, France
| | - S Hantz
- National Reference Center for Herpes Viruses, Virology Department, Limoges University Hospital, LimogesFrance.,UMR INSERM U1092, RESINFIT, Limoges University, LimogesFrance
| | - P Merville
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France.,CNRS-UMR 5164 ImmunoConcEpT, Bordeaux University, Bordeaux, France
| | - H Kaminski
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France.,CNRS-UMR 5164 ImmunoConcEpT, Bordeaux University, Bordeaux, France
| | - L Couzi
- Department of Nephrology, Transplantation, Dialysis and Apheresis, Bordeaux University Hospital, Bordeaux, France.,CNRS-UMR 5164 ImmunoConcEpT, Bordeaux University, Bordeaux, France
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Chauveau B, Merville P, Soulabaille B, Taton B, Kaminski H, Visentin J, Vermorel A, Bouzgarrou M, Couzi L, Grenier N. L’élastographie par résonance magnétique dans l’évaluation de la fibrose interstitielle en transplantation rénale : résultats d’une étude prospective. Nephrol Ther 2022. [DOI: 10.1016/j.nephro.2022.07.272] [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: 10/14/2022]
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3
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Charmetant X, Rigault G, Kaminski H, Visentin J, Marseres G, Merville P, Déchanet-Merville J, Dubois V, Couzi L, Thaunat O. Les lymphocytes T γ/δ ne sont pas impliqués dans la production d’anticorps spécifiques du donneur après transplantation rénale. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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4
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Taton B, Pfirmann P, Couzi L, Merville P, Kaminski H. Réévaluation de l’épidémiologie et des facteurs de risque des infections opportunistes en transplantation rénale. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.077] [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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Moreau K, Monsaingeon-Henry M, Pupier E, Jambon F, Merville P, Couzi L, Kaminski H, Gatta-Cherifi B. Chirurgie bariatrique après transplantation rénale : risque accru de survenue d’insuffisance rénale fonctionnelle. Nephrol Ther 2021. [DOI: 10.1016/j.nephro.2021.07.120] [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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Orieux A, Picard F, Vermorel A, Kaminski H, Couzi L, Merville P, Rubin S. Le syndrome cardio-rénal post transplantation est une cause fréquente de retard de reprise de fonction : une étude de cohorte. Nephrol Ther 2020. [DOI: 10.1016/j.nephro.2020.07.110] [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: 10/23/2022]
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Préterre J, Visentin J, Saint Cricq M, Kaminski H, Merville P, Kamar N, Couzi L. Prévention des récidives de cancers cutanés après transplantation rénale : comparaison rétrospective de deux stratégies d’immunosuppresseurs basées sur les inhibiteurs de mTOR. Nephrol Ther 2019. [DOI: 10.1016/j.nephro.2019.07.311] [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: 10/26/2022]
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Roucoules M, Couzi L, Merville P, Richez C, Lazaro E, Blanco P, Gensous N, Duffau P. Protéinurie et autres facteurs pronostiques d’insuffisance rénale chronique dans la néphropathie lupique de classe III/IV : étude rétrospective monocentrique sur 118 patients. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.03.028] [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: 10/26/2022]
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Guidicelli G, Visentin J, Franchini N, Borg C, Merville P, Couzi L, Taupin JL. Prevalence, distribution and amplitude of the complement interference phenomenon in single antigen flow beads assays. HLA 2018; 91:507-513. [DOI: 10.1111/tan.13263] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 03/27/2018] [Indexed: 11/30/2022]
Affiliation(s)
- G. Guidicelli
- CHU de Bordeaux, Laboratoire d'Immunologie et Immunogénétique; Hôpital Pellegrin; Bordeaux France
| | - J. Visentin
- CHU de Bordeaux, Laboratoire d'Immunologie et Immunogénétique; Hôpital Pellegrin; Bordeaux France
- Université de Bordeaux; Bordeaux France
- Immuno ConcEpT, UMR CNRS 5164; Bordeaux France
| | - N. Franchini
- CHU de Bordeaux, Laboratoire d'Immunologie et Immunogénétique; Hôpital Pellegrin; Bordeaux France
| | - C. Borg
- CHU de Bordeaux, Laboratoire d'Immunologie et Immunogénétique; Hôpital Pellegrin; Bordeaux France
| | - P. Merville
- Université de Bordeaux; Bordeaux France
- Immuno ConcEpT, UMR CNRS 5164; Bordeaux France
- CHU de Bordeaux, Service de Néphrologie, Transplantation, Dialyse et Aphérèses; Bordeaux France
| | - L. Couzi
- Université de Bordeaux; Bordeaux France
- Immuno ConcEpT, UMR CNRS 5164; Bordeaux France
- CHU de Bordeaux, Service de Néphrologie, Transplantation, Dialyse et Aphérèses; Bordeaux France
| | - J.-L. Taupin
- CHU de Bordeaux, Laboratoire d'Immunologie et Immunogénétique; Hôpital Pellegrin; Bordeaux France
- Université de Bordeaux; Bordeaux France
- Immuno ConcEpT, UMR CNRS 5164; Bordeaux France
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Woillard J, Picard N, Essig M, Merville P, Monchaud C, Marquet P. Effect of CYP3A4*22, CYP3A5*3, POR*28 , and PPARA RS4253728 on Tacrolimus Exposure and Neurotoxicity in Kidney Transplant Recipients. Clin Ther 2017. [DOI: 10.1016/j.clinthera.2017.05.045] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Saunier A, Durgahee K, Badry V, Barthod L, Ngo Bell E, Viallard J, Merville P, Seneschal J, Vandenhende M, Bonnet F. Patients traités par rituximab pour une maladie immuno-inflammatoire : peut-on prévoir ceux qui présenteront des complications infectieuses ? Med Mal Infect 2017. [DOI: 10.1016/j.medmal.2017.03.194] [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: 10/19/2022]
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12
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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] [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: 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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Affiliation(s)
- L. Ghisdal
- Department of Nephrology, Dialysis, and TransplantationHôpital Erasme (Université Libre de Bruxelles)BrusselsBelgium,Present address: Department of NephrologyCentre Hospitalier EpiCURABaudourBelgium
| | - C. Baron
- Department of NephrologyCentre Hospitalier Régional Universitaire de ToursToursFrance
| | - Y. Lebranchu
- Department of NephrologyCentre Hospitalier Régional Universitaire de ToursToursFrance
| | - O. Viklický
- Department of NephrologyTransplant CentreInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - A. Konarikova
- Department of NephrologyTransplant CentreInstitute for Clinical and Experimental MedicinePragueCzech Republic
| | - M. Naesens
- Department of Microbiology and ImmunologyKU LeuvenUniversity of LeuvenLeuvenBelgium,Department of NephrologyUniversity Hospitals LeuvenLeuvenBelgium
| | - D. Kuypers
- Department of Microbiology and ImmunologyKU LeuvenUniversity of LeuvenLeuvenBelgium,Department of NephrologyUniversity Hospitals LeuvenLeuvenBelgium
| | - M. Dinic
- Department of NephrologyCentre Hospitalier Universitaire de Saint‐EtienneSaint‐EtienneFrance
| | - E. Alamartine
- Department of NephrologyCentre Hospitalier Universitaire de Saint‐EtienneSaint‐EtienneFrance
| | - G. Touchard
- Department of NephrologyCentre Hospitalier Universitaire de PoitiersPoitiersFrance
| | - T. Antoine
- Department of NephrologyCentre Hospitalier Universitaire de PoitiersPoitiersFrance
| | - M. Essig
- Department of Nephrology, Dialysis, TransplantationCentre Hospitalier Universitaire de Limoges and INSERM UMR 850 (Université de Limoges)LimogesFrance
| | - J. P. Rerolle
- Department of Nephrology, Dialysis, TransplantationCentre Hospitalier Universitaire de Limoges and INSERM UMR 850 (Université de Limoges)LimogesFrance
| | - P. Merville
- Department of NephrologyCentre Hospitalier Universitaire de BordeauxBordeauxFrance
| | - J. L. Taupin
- Department of Immunology and HistocompatibilityHôpital Saint‐LouisParisFrance
| | - Y. Le Meur
- Department of NephrologyCentre Hospitalier Universitaire la Cavale blancheBrestFrance
| | - A. Grall‐Jezequel
- Department of NephrologyCentre Hospitalier Universitaire la Cavale blancheBrestFrance
| | - F. Glowacki
- Department of NephrologyCentre Régional Hospitalier Universitaire de LilleLilleFrance
| | - C. Noël
- Department of NephrologyCentre Régional Hospitalier Universitaire de LilleLilleFrance
| | - C. Legendre
- Department of Renal TransplantationUniversité Paris Descartes and Hôpital NeckerAssistance Publique‐Hôpitaux de ParisParisFrance
| | - D. Anglicheau
- Department of Renal TransplantationUniversité Paris Descartes and Hôpital NeckerAssistance Publique‐Hôpitaux de ParisParisFrance
| | - N. Broeders
- Department of Nephrology, Dialysis, and TransplantationHôpital Erasme (Université Libre de Bruxelles)BrusselsBelgium
| | - W. Coppieters
- Unit of Animal GenomicsGroupe Interdisciplinaire de Génoprotéomique Appliquée‐Research (GIGA‐R)University of LiègeLiègeBelgium
| | - E. Docampo
- Unit of Animal GenomicsGroupe Interdisciplinaire de Génoprotéomique Appliquée‐Research (GIGA‐R)University of LiègeLiègeBelgium
| | - M. Georges
- Unit of Animal GenomicsGroupe Interdisciplinaire de Génoprotéomique Appliquée‐Research (GIGA‐R)University of LiègeLiègeBelgium
| | - Z. Ajarchouh
- Institute of Interdisciplinary Research in Molecular and Human biology (IRIBHM)Université Libre de BruxellesBrusselsBelgium
| | - A. Massart
- Department of Nephrology, Dialysis, and TransplantationHôpital Erasme (Université Libre de Bruxelles)BrusselsBelgium,Institute of Interdisciplinary Research in Molecular and Human biology (IRIBHM)Université Libre de BruxellesBrusselsBelgium
| | - J. Racapé
- Centre of EpidemiologyBiostatistic and Clinical ResearchSchool of Public Health (Université Libre de Bruxelles)BrusselsBelgium
| | - D. Abramowicz
- Department of Nephrology, Dialysis, and TransplantationHôpital Erasme (Université Libre de Bruxelles)BrusselsBelgium,Department of NephrologyAntwerp University HospitalAntwerpenBelgium
| | - M. Abramowicz
- Institute of Interdisciplinary Research in Molecular and Human biology (IRIBHM)Université Libre de BruxellesBrusselsBelgium,Medical Genetics DepartmentHôpital Erasme (Université Libre de Bruxelles)BrusselsBelgium
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13
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Kaminski H, Couzi L, Garrigue I, Moreau JF, Déchanet-Merville J, Merville P. Easier Control of Late-Onset Cytomegalovirus Disease Following Universal Prophylaxis Through an Early Antiviral Immune Response in Donor-Positive, Recipient-Negative Kidney Transplants. Am J Transplant 2016; 16:2384-94. [PMID: 26953216 DOI: 10.1111/ajt.13781] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [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: 01/03/2016] [Revised: 02/07/2016] [Accepted: 02/25/2016] [Indexed: 01/25/2023]
Abstract
Universal prophylaxis for cytomegalovirus (CMV) prevention is viable but, compared with a preemptive strategy, leads to higher incidence of late-onset disease (LOD) associated with poor patient and graft survival. The purpose of this study was to compare LOD with early onset disease (EOD), with a focus on the highest risk kidney transplant recipients (KTRs): CMV seronegative recipients transplanted from seropositive donors (D+R-). Since CMV control depends on both antiviral treatment and specific immune response, we also compared Vδ2-negative (Vδ2(neg) ) γδ T cell expansion involved in CMV infection resolution. EOD was defined as occurring <3 mo and LOD as occurring >3 mo after transplantation. Depending on the period, universal prophylaxis or preemptive treatment was used. Overall, 168 D+R- KTRs were included between 2003 and 2011. LOD was associated with a lower peak DNAemia (p = 0.04), fewer recurrences (odds ratio 0.16; 95% confidence interval 0.05-0.55; p = 0.01) and shorter anti-CMV curative treatment (40 vs. 60 days, p < 0.0001). As a corollary, we found that Vδ2(neg) γδ T cell expansion was faster in LOD than in EOD (31 vs. 168 days after the beginning of CMV disease, p < 0.0001). In D+R- KTRs, universal prophylaxis is associated with more LOD, which had better infection management and a faster immune response. These results support the use of universal prophylaxis over a preemptive strategy and reappraise outcomes of LOD.
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Affiliation(s)
- H Kaminski
- Department of Nephrology, Transplantation and Dialysis, Bordeaux, France
| | - L Couzi
- Department of Nephrology, Transplantation and Dialysis, Bordeaux, France.,National Center of Scientific Research (CNRS), Research Unit 5234, Bordeaux, France
| | - I Garrigue
- Virology Laboratory, Bordeaux, France.,National Center of Scientific Research, Mix Unit of Research 5164, Bordeaux, France
| | - J-F Moreau
- National Center of Scientific Research (CNRS), Research Unit 5234, Bordeaux, France.,Immunology Laboratory, Pellegrin Hospital, Bordeaux, France
| | - J Déchanet-Merville
- National Center of Scientific Research (CNRS), Research Unit 5234, Bordeaux, France
| | - P Merville
- Department of Nephrology, Transplantation and Dialysis, Bordeaux, France.,National Center of Scientific Research (CNRS), Research Unit 5234, Bordeaux, France
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Cornelis F, Petitpierre F, Le Bras Y, Lasserre A, Couzi L, Combes C, Merville P, Ferrière J, Grenier N. Embolization of renal arteries before transplantation in patients with polycystic kidney disease: a single institution long-term experience. J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.279] [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: 10/22/2022] Open
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Bachelet T, Merville P, Dechanet-Merville J, Couzi L. Cytomegalovirus-Induced γδ T Cells During Rejection: An Ambivalent T Cell. Am J Transplant 2016; 16:368-9. [PMID: 26781911 DOI: 10.1111/ajt.13568] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Revised: 08/14/2015] [Accepted: 08/29/2015] [Indexed: 01/25/2023]
Affiliation(s)
- T Bachelet
- Clinique Saint-Augustin-CTMR, Bordeaux, France.,Department of Nephrology, Transplantation, and Dialysis, Bordeaux University Hospital, Bordeaux, France
| | - P Merville
- Department of Nephrology, Transplantation, and Dialysis, Bordeaux University Hospital, Bordeaux, France.,National Center of Scientific Research, Mix Unit of Research 5164, University of Bordeaux, Bordeaux, France
| | - J Dechanet-Merville
- National Center of Scientific Research, Mix Unit of Research 5164, University of Bordeaux, Bordeaux, France
| | - L Couzi
- Department of Nephrology, Transplantation, and Dialysis, Bordeaux University Hospital, Bordeaux, France.,National Center of Scientific Research, Mix Unit of Research 5164, University of Bordeaux, Bordeaux, France
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Queruel V, Kabore R, Guillaume A, Moreau K, Leffondre K, Couzi L, Quinart A, Rogier J, Tauzin-fin P, Merville P, Robert G, Pasticier G, Bensadoun H, Ferrière J, Bernhard J. Quelle valeur accorder à l’IMC dans l’évaluation de la morbidité périopératoire de la transplantation rénale ? Prog Urol 2015; 25:764-5. [DOI: 10.1016/j.purol.2015.08.101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Viot B, Garrigue I, Taton B, Bachelet T, Moreau JF, Dechanet-Merville J, Merville P, Couzi L. Two-year post-transplantation cytomegalovirus DNAemia in asymptomatic kidney transplant recipients: incidence, risk factors, and outcome. Transpl Infect Dis 2015; 17:497-509. [DOI: 10.1111/tid.12408] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2014] [Revised: 04/06/2015] [Accepted: 05/14/2015] [Indexed: 12/15/2022]
Affiliation(s)
- B. Viot
- Service de Néphrologie-Transplantation-Dialyse; Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin; Bordeaux France
- Université de Bordeaux; Bordeaux France
| | - I. Garrigue
- Université de Bordeaux; Bordeaux France
- Laboratoire de Virologie; Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin; Bordeaux France
- Microbiologie Fondamentale et Pathogénicité; Unité Mixte de Recherche (UMR) 5234; Bordeaux France
| | - B. Taton
- Service de Néphrologie-Transplantation-Dialyse; Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin; Bordeaux France
- Université de Bordeaux; Bordeaux France
| | - T. Bachelet
- Service de Néphrologie-Transplantation-Dialyse; Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin; Bordeaux France
- Université de Bordeaux; Bordeaux France
- Centre National de la Recherche Scientifique (CNRS)- Unité Mixte de Recherche (UMR) 5164, CIRID; Bordeaux France
| | - J.-F. Moreau
- Université de Bordeaux; Bordeaux France
- Centre National de la Recherche Scientifique (CNRS)- Unité Mixte de Recherche (UMR) 5164, CIRID; Bordeaux France
| | - J. Dechanet-Merville
- Université de Bordeaux; Bordeaux France
- Centre National de la Recherche Scientifique (CNRS)- Unité Mixte de Recherche (UMR) 5164, CIRID; Bordeaux France
| | - P. Merville
- Service de Néphrologie-Transplantation-Dialyse; Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin; Bordeaux France
- Université de Bordeaux; Bordeaux France
- Centre National de la Recherche Scientifique (CNRS)- Unité Mixte de Recherche (UMR) 5164, CIRID; Bordeaux France
| | - L. Couzi
- Service de Néphrologie-Transplantation-Dialyse; Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin; Bordeaux France
- Université de Bordeaux; Bordeaux France
- Centre National de la Recherche Scientifique (CNRS)- Unité Mixte de Recherche (UMR) 5164, CIRID; Bordeaux France
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Hellemans R, Hazzan M, Durand D, Mourad G, Lang P, Kessler M, Charpentier B, Touchard G, Berthoux F, Merville P, Ouali N, Squifflet JP, Bayle F, Wissing KM, Noël C, Abramowicz D. Daclizumab Versus Rabbit Antithymocyte Globulin in High-Risk Renal Transplants: Five-Year Follow-up of a Randomized Study. Am J Transplant 2015; 15:1923-32. [PMID: 25707875 DOI: 10.1111/ajt.13191] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [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: 07/07/2014] [Revised: 12/07/2014] [Accepted: 12/24/2014] [Indexed: 01/25/2023]
Abstract
We previously reported a randomized controlled trial in which 227 de novo deceased-donor kidney transplant recipients were randomized to rabbit antithymocyte (rATG, Thymoglobulin) or daclizumab if they were considered to be at high immunological risk, defined as high panel reactive antibodies (PRA), loss of a first kidney graft through rejection within 2 years of transplantation, or third or fourth transplantation. Patients treated with rATG had lower incidences of biopsy-proven acute rejection (BPAR) and steroid-resistant rejection at 1 year. Patients were followed to 5 years posttransplant in an observational study; findings are described here. Treatment with rATG was associated with a lower rate of BPAR at 5 years (14.2% vs. 26.0% with daclizumab; p = 0.035). Only one rATG-treated patient (0.9%) and one daclizumab-treated patient (1.0%) developed BPAR after 1 year. Five-year graft and patient survival rates, and renal function, were similar between the two groups. Overall graft survival at 5 years was significantly higher in patients without BPAR (81.0% vs. 54.8%; p < 0.001). In conclusion, rATG is superior to daclizumab for the prevention of BPAR among high-immunological-risk renal transplant recipients. Overall graft survival at 5 years was approximately 70% with either induction therapy, which compares favorably to low-risk cohorts.
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Affiliation(s)
- R Hellemans
- Dienst Néphrologie, Universitair Ziekenhuis Antwerpen, Edegem, Belgium
| | - M Hazzan
- Service de N, é, phrologie, Hôpital, Lille, France
| | - D Durand
- Service de Néphrologie-HTA-Dialyse-Transplantation, CHU-Toulouse Rangueil, Toulouse, France
| | - G Mourad
- Département de Néphrologie et Transplantation, CHRU-Hôpital Lapeyronie, Montpellier, France
| | - P Lang
- Service de Néphrologie, Hôpital Henri Mondor, Créteil, France
| | - M Kessler
- Département de Néphrologie, Hôpital Universitaire de Nancy, Nancy, France
| | - B Charpentier
- Service de Néphrologie, CHRU de Bicêtre, Bicêtre, France
| | - G Touchard
- Service de Néphrologie-Transplantation, CHU de Poitiers, Hôpital Jean-Bernard, Poitiers, France
| | - F Berthoux
- Service de Néphrologie, CHRU-Hôpital Nord, Saint-Etienne, France
| | - P Merville
- Service de Néphrologie, Hôpital Pellegrin, Bordeaux, France
| | - N Ouali
- Service de Néphrologie A, Hôpital Tenon, Paris, France
| | - J-P Squifflet
- Cliniques Universitaires St Luc, Brussels, and Department of Abdominal Transplantation, CHU Sart Tilman, Liege, Belgium
| | - F Bayle
- Service de Néphrologie, CHU de Grenoble, Grenoble, France
| | - K M Wissing
- Dienst Nefrologie, Universitair Ziekenhuis Brussel, Brussels, Belgium
| | - C Noël
- Service de N, é, phrologie, Hôpital, Lille, France
| | - D Abramowicz
- Dienst Néphrologie, Universitair Ziekenhuis Antwerpen, Edegem, Belgium
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Petitpierre F, Cornelis F, Couzi L, Lasserre AS, Tricaud E, Le Bras Y, Merville P, Combe C, Ferriere JM, Grenier N. Embolization of renal arteries before transplantation in patients with polycystic kidney disease: a single institution long-term experience. Eur Radiol 2015; 25:3263-71. [PMID: 25981217 DOI: 10.1007/s00330-015-3730-3] [Citation(s) in RCA: 15] [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: 11/07/2014] [Revised: 01/17/2015] [Accepted: 03/20/2015] [Indexed: 01/23/2023]
Abstract
PURPOSE We aimed to retrospectively assess the long-term safety and efficacy of embolization of renal arteries (ERA) in patients with polycystic kidney disease (PKD) before renal transplantation. MATERIAL AND METHODS Between January 2008 and November 2013, 82 ERA procedures were performed on 76 kidneys in 73 patients (mean age 53 years, range: 34-72). All patients had terminal-stage PKD and were under dialysis and on the renal transplant waiting list with a temporary contraindication due to excessive renal volume. RESULTS ERA was considered successful in 89.5% (68/76) of embolized kidneys, meaning that the temporary contraindication for transplantation could be withdrawn for 65 patients (on average 5.6 months, range: 2.8-24.3, after ERA). Mean volume reduction was 40 (range: 2-69) at 3 months and 59% (35-86) thereafter (both p < 0.001). Post-embolization syndrome occurred after 15 of 82 procedures (18.3%). The severe complication rate was 4.9%. Forty-three (67.7%) transplantations were successfully conducted after ERA, with a mean follow-up of 26.2 months (range: 1.8-59.5), and the estimated 5-year graft survival rate was 95.3% [95% CI: 82.7-98.8]. CONCLUSIONS ERA is a safe and effective alternative to nephrectomy before renal transplantation in patients with PKD. KEY POINTS • Embolization of non-functioning polycystic kidneys allowed transplantation in 89.5% of cases. • Technical failure rate was 7.9% after embolization, irrespective of the technique used. • Post-embolization syndrome occurred after 18.3% of the procedures. • A low rate of severe complications (4.9%) was observed after renal embolization.
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Affiliation(s)
- F Petitpierre
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - F Cornelis
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France.
| | - L Couzi
- Department of Nephrology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - A S Lasserre
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - E Tricaud
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - Y Le Bras
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - P Merville
- Department of Nephrology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - C Combe
- Department of Urology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - J M Ferriere
- Department of Urology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
| | - N Grenier
- Department of Radiology, Pellegrin Hospital, Place Amélie Raba Léon, 33076, Bordeaux, France
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Rostaing L, Hertig A, Albano L, Anglicheau D, Durrbach A, Vuiblet V, Moulin B, Merville P, Hazzan M, Lang P, Touchard G, Hurault deLigny B, Quéré S, Di Giambattista F, Dubois YC, Rondeau E. Fibrosis progression according to epithelial-mesenchymal transition profile: a randomized trial of everolimus versus CsA. Am J Transplant 2015; 15:1303-12. [PMID: 25808994 DOI: 10.1111/ajt.13132] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 11/12/2014] [Accepted: 11/30/2014] [Indexed: 01/25/2023]
Abstract
Markers of epithelial-mesenchymal transition (EMT) may identify patients at high risk of graft fibrogenesis who could benefit from early calcineurin inhibitor (CNI) withdrawal. In a randomized, open-label, 12-month trial, de novo kidney transplant patients received cyclosporine, enteric-coated mycophenolate sodium (EC-MPS) and steroids to month 3. Patients were stratified as EMT+ or EMT- based on month 3 biopsy, then randomized to start everolimus with half-dose EC-MPS (720 mg/day) and cyclosporine withdrawal (CNI-free) or continue cyclosporine with standard EC-MPS (CNI). The primary endpoint was progression of graft fibrosis (interstitial fibrosis/tubular atrophy [IF/TA] grade increase ≥1 between months 3-12) in EMT+ patients. 194 patients were randomized (96 CNI-free, 98 CNI); 153 (69 CNI-free, 84 CNI) were included in histological analyses. Fibrosis progression occurred in 46.2% (12/26) CNI-free EMT+ patients versus 51.6% (16/31) CNI EMT+ patients (p = 0.68). Biopsy-proven acute rejection (BPAR, including subclinical events) occurred in 25.0% and 5.1% of CNI-free and CNI patients, respectively (p < 0.001). In conclusion, early CNI withdrawal with everolimus initiation does not prevent interstitial fibrosis. Using this CNI-free protocol, in which everolimus exposure was relatively low and administered with half-dose EC-MPS, CNI-free patients were overwhelmingly under-immunosuppressed and experienced an increased risk of BPAR.
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Affiliation(s)
- L Rostaing
- Department of Nephrology, Dialysis and Transplantation, Hôpital de Rangueil, Toulouse, France
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Moreau K, Desseix A, Merville P, Couzi L, Germain C, Thiebaut R, Chauveau P. P268: Évolution de la masse cellulaire active avant et après greffe rénale : impact de l’activité physique. NUTR CLIN METAB 2014. [DOI: 10.1016/s0985-0562(14)70910-0] [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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Taton B, Moreau K, Leffondre K, Combe C, Merville P, Couzi L. Valeur pronostique à 5ans du DFGe et de sa pente à l’issue de la première année après transplantation rénale. Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Faguer S, Esposito L, Casemayou A, Pirson Y, Decramer S, Cartery C, Hazan M, Mourad G, Roussey G, Merville P, Chauveau D, Rostaing L. L’expression d’HNF-1β est dépendante de la calcineurine (phosphatase 2B) épithéliale : implications chez les patients avec mutation d’HNF1B bénéficiant d’une transplantation. Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Le Meur Y, Büchler M, Mousson C, Albano L, Merville P, Caillard S, Etienne I, Hazzan M, Anglicheau D, Rerolle J, Heng A, Kamar N. Éude randomisée multicentrique de l’utilisation de l’évérolimus dans la transplantation rénale de type « ld for old » (Everold). Nephrol Ther 2014. [DOI: 10.1016/j.nephro.2014.07.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Lebranchu Y, Legendre C, Merville P, Durrbach A, Rostaing L, Thibault G, Paintaud G, Quere S, Di Giambattista F, Buchler M. Comparison of Interleukin-2 (Il-2) Blockade in Kidney Transplant Patients Randomized to 40mg or 80mg Basiliximab (BSX) With Cyclosporine (CsA) or 80mg BSX With Everolimus (EVR). Transplantation 2014. [DOI: 10.1097/00007890-201407151-01958] [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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Blancho G, Budde K, Merville P, Moal M, Rostaing L, Harler M, Grinyo J. Outcomes at 3 Years in EBV+ European Subpopulations From BENEFIT and BENEFIT-EXT. Transplantation 2014. [DOI: 10.1097/00007890-201407151-01515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Labat V, Chaslot M, Morel D, Gerbouin O, Grellet J, Merville P. D-04: Traitement par fumagilline de la microsporidiose à Enterocytozoon bieneusi chez les transplantés rénaux : 2 cas rapportés. Med Mal Infect 2014. [DOI: 10.1016/s0399-077x(14)70138-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Schachtner T, Reinke P, Dorje C, Mjoen G, Midtvedt K, Strom EH, Oyen O, Jenssen T, Reisaeter AV, Smedbraaten YV, Sagedal S, Mjoen G, Fagerland MW, Hartmann A, Thiel S, Zulkarnaev A, Vatazin A, Vincenti F, Harel E, Kantor A, Thurison T, Hoyer-Hansen G, Craik C, Kute VB, Shah PS, Vanikar AV, Modi PR, Shah PR, Gumber MR, Patel HV, Engineer DP, Shah VR, Rizvi J, Trivedi HL, Malheiro J, Dias L, Martins LS, Fonseca I, Pedroso S, Almeida M, Castro-Henriques A, Cabrita A, Costa C, Ritta M, Sinesi F, Sidoti F, Mantovani S, Di Nauta A, Messina M, Cavallo R, Verflova A, Svobodova E, Slatinska J, Slavcev A, Pokorna E, Viklicky O, Yagan J, Chandraker A, Messina M, Diena D, Tognarelli G, Ranghino A, Bussolino S, Fop F, Segoloni GP, Biancone L, Leone F, Mauro MV, Gigliotti P, Lofaro D, Greco F, Perugini D, Papalia T, Perri A, Vizza D, Giraldi C, Bonofilgio R, Luis-Lima S, Marrero D, Gonzalez-Rinne A, Torres A, Salido E, Jimenez-Sosa A, Aldea-Perona A, Gonzalez-Posada JM, Perez-Tamajon L, Rodriguez-Hernandez A, Negrin-Mena N, Porrini E, Mjoen G, Pihlstrom H, Dahle DO, Holdaas H, Von Der Lippe N, Waldum B, Brekke F, Amro A, Reisaeter AV, Os I, Klin P, Sanabria H, Bridoux P, De Francesco J, Fortunato RM, Raffaele P, Kong J, Son SH, Kwon HY, Whang EJ, Choi WY, Yoon CS, Thanaraj V, Theakstone A, Stopper K, Ferraro A, Bhattacharjya S, Devonald M, Williams A, Mella A, Messina M, Gallo E, Fop F, Di Vico MC, Diena D, Pagani F, Gai M, Ranghino A, Segoloni GP, Biancone L, Cho HJ, Nho KW, Park SK, Kim SB, Yoshida K, Ishii D, Ohyama T, Kohguchi D, Takeuchi Y, Varga A, Sandor B, Kalmar-Nagy K, Toth A, Toth K, Szakaly P, Zulkarnaev A, Vatazin A, Kildushevsky A, Fedulkina V, Kantaria R, Staeck O, Halleck F, Rissling O, Naik M, Neumayer HH, Budde K, Khadzhynov D, Bhadauria D, Kaul A, Prasad N, Sharma RK, Sezer S, Bal Z, Erkmen Uyar M, Guliyev O, Erdemir B, Colak T, Ozdemir N, Haberal M, Caliskan Y, Yazici H, Artan AS, Oto OA, Aysuna N, Bozfakioglu S, Turkmen A, Yildiz A, Sever MS, Yagisawa T, Nukui A, Kimura T, Nannmoku K, Kurosawa A, Sakuma Y, Miki A, Damiano F, Ligabue G, De Biasi S, Granito M, Cossarizza A, Cappelli G, Martins LS, Fonseca I, Malheiro J, Henriques AC, Pedroso S, Almeida M, Dias L, Davide J, Cabrita A, Von During ME, Jenssen TG, Bollerslev J, Godang K, Asberg A, Hartmann A, Bachelet T, Martinez C, Bello A, Kejji S, Couzi L, Guidicelli G, Lepreux S, Visentin J, Congy-Jolivet N, Rostaing L, Taupin JL, Kamar N, Merville P, Sezer S, Bal Z, Erkmen Uyar M, Ozdemir H, Guliyev O, Yildirim S, Tutal E, Ozdemir N, Haberal M, Sezer S, Erkmen Uyar M, Bal Z, Guliyev O, Sayin B, Colak T, Ozdemir Acar N, Haberal M, Banasik M, Boratynska M, Koscielska-Kasprzak K, Kaminska D, Bartoszek D, Mazanowska O, Krajewska M, Zmonarski S, Chudoba P, Dawiskiba T, Protasiewicz M, Halon A, Sas A, Kaminska M, Klinger M, Stefanovic N, Cvetkovic T, Velickovic - Radovanovic R, Jevtovic - Stoimenov T, Vlahovic P, Rungta R, Das P, Ray DS, Gupta S, Kolonko A, Szotowska M, Kuczera P, Chudek J, Wiecek A, Sikora-Grabka E, Adamczak M, Szotowska M, Kuczera P, Madej P, Wiecek A, Amanova A, Kendi Celebi Z, Bakar F, Caglayan MG, Keven K, Massimetti C, Imperato G, Zampi G, De Vincenzi A, Fabbri GDD, Brescia F, Feriozzi S, Filipov JJ, Zlatkov BK, Dimitrov EP, Svinarov DA, Poesen R, De Vusser K, Evenepoel P, Kuypers D, Naesens M, Meijers B, Kocak H, Yilmaz VT, Yilmaz F, Uslu HB, Aliosmanoglu I, Ermis H, Dinckan A, Cetinkaya R, Ersoy FF, Suleymanlar G, Fonseca I, Oliveira JC, Santos J, Martins LS, Almeida M, Dias L, Pedroso S, Lobato L, Castro-Henriques A, Mendonca D, Watarai Y, Yamamoto T, Tsujita M, Hiramitsu T, Goto N, Narumi S, Kobayashi T, Dahle DO, Holdaas H, Reisaeter AV, Dorje C, Mjoen G, Line PD, Hartmann A, Housawi A, House A, Ng C, Denesyk K, Rehman F, Moist L, Musetti C, Battista M, Izzo C, Guglielmetti G, Airoldi A, Stratta P, Musetti C, Cena T, Quaglia M, Fenoglio R, Cagna D, Airoldi A, Amoroso A, Stratta P, Palmisano A, Degli Antoni AM, Vaglio A, Piotti G, Cremaschi E, Buzio C, Maggiore U, Lee MC, Hsu BG, Zalamea Jarrin F, Sanchez Sobrino B, Lafuente Covarrubias O, Karsten Alvarez S, Dominguez Apinaniz P, Llopez Carratala R, Portoles Perez J, Yildirim T, Yilmaz R, Turkmen E, Altindal M, Arici M, Altun B, Erdem Y, Dounousi E, Mitsis M, Naka K, Pappas H, Lakkas L, Harisis H, Pappas K, Koutlas V, Tzalavra I, Spanos G, Michalis L, Siamopoulos K, Iwabuchi T, Yagisawa T, Kimura T, Nanmoku K, Kurosawa A, Yasunaru S, Lee MC, Hsu BG, Yoshikawa M, Kitamura K, Fuji H, Fujisawa M, Nishi S, Carta P, Zanazzi M, Buti E, Larti A, Caroti L, Di Maria L, Minetti EE, Shi Y, Luo L, Cai B, Wang T, Zou Y, Wang L, Kim Y, Kim HS, Choi BS, Park CW, Yang CW, Kim YS, Chung BH, Baek CH, Kim M, Kim JS, Yang WS, Han DJ, Park SK, Mikolasevic I, Racki S, Lukenda V, Persic MP, Colic M, Devcic B, Orlic L, Sezer S, Gurlek Demirci B, Guliyev O, Colak T, Say N CB, Ozdemir Acar FN, Haberal M, Vali S, Ismal K, Sahay M, Civiletti F, Cantaluppi V, Medica D, Mazzeo AT, Assenzio B, Mastromauro I, Deambrosis I, Giaretta F, Fanelli V, Mascia L, Musetti C, Airoldi A, Quaglia M, Guglielmetti G, Battista M, Izzo C, Stratta P, Lakkas L, Naka K, Dounousi E, Koutlas V, Gkirdis I, Bechlioulis A, Evangelou D, Zarzoulas F, Kotsia A, Balafa O, Tzeltzes G, Nakas G, Pappas K, Kalaitzidis R, Katsouras C, Michalis L, Siamopoulos K, Tutal E, Erkmen Uyar M, Uyanik S, Bal Z, Guliyev O, Toprak SK, Ilhan O, Sezer S, Bal Z, Ekmen Uyar M, Guliyev O, Sayin B, Colak T, Sezer S, Haberal M, Hernandez Vargas H, Artamendi Larranaga M, Ramalle Gomara E, Gil Catalinas F, Bello Ovalle A, Pimentel Guzman G, Coloma Lopez A, Sierra Carpio M, Gil Paraiso A, Dall Anesse C, Beired Val I, Huarte Loza E, Choy BY, Kwan L, Mok M, Chan TM, Yamakawa T, Kobayashi A, Yamamoto I, Mafune A, Nakada Y, Tannno Y, Tsuboi N, Yamamoto H, Yokoyama K, Ohkido I, Yokoo T, Luque Y, Anglicheau D, Rabant M, Clement R, Kreis H, Sartorius A, Noel LH, Timsit MO, Legendre C, Rancic N, Vavic N, Dragojevic-Simic V, Katic J, Jacimovic N, Kovacevic A, Mikov M, Veldhuijzen NMH, Rookmaaker MB, Van Zuilen AD, Nquyen TQ, Boer WH, Mjoen G, Pihlstrom H, Dahle DO, Holdaas H, Sahtout W, Ghezaiel H, Azzebi A, Ben Abdelkrim S, Guedri Y, Mrabet S, Nouira S, Ferdaws S, Amor S, Belarbia A, Zellama D, Mokni M, Achour A, Viklicky O, Parikova A, Slatinska J, Hanzal V, Fronek J, Orandi BJ, James NT, Montgomery RA, Desai NM, Segev DL, Fontana F, Ballestri M, Magistroni R, Damiano F, Cappelli G. TRANSPLANTATION CLINICAL 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu160] [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: 11/13/2022] Open
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Berthelot L, Robert T, Tabary T, Vuiblet V, Drame M, Toupance O, Rieu P, Monteiro RC, Toure F, Ferrario S, Cantaluppi V, De Lena M, Dellepiane S, Beltramo S, Rossetti M, Manzione AM, Messina M, Gai M, Dolla C, Biancone L, Camussi G, Pontrelli P, Oranger AR, Accetturo M, Rascio F, Gigante M, Castellano G, Schena A, Fiorentino M, Zito A, Zaza G, Stallone G, Gesualdo L, Grandaliano G, Pattonieri EF, Gregorini M, Corradetti V, Rocca C, Milanesi S, Peloso A, Ferrario J, Cannone M, Bosio F, Maggi N, Avanzini MA, Minutillo P, Paulli M, Maestri M, Rampino T, Dal Canton A, Wu KST, Coxall O, Luque Y, Candon S, Rabant M, Noel LH, Thervet E, Chatenoud L, Snanoudj R, Anglicheau D, Legendre C, Zuber J, Hruba P, Brabcova I, Krepsova E, Slatinska J, Sekerkova A, Striz I, Zachoval R, Viklicky O, Scholbach TM, Wang HK, Loong CC, Yang AH, Wu TH, Hruba P, Brabcova I, Krepsova E, Slatinska J, Sekerkova A, Striz I, Zachoval R, Viklicky O, Guberina H, Rebmann V, Dziallas P, Dolff S, Wohlschlaeger J, Heinemann FM, Witzke O, Zoet YM, Claas FHJ, Horn PA, Kribben A, Doxiadis IIN, Prasad N, Yadav B, Agarwal V, Jaiswal A, Rai M, Hope CM, Coates PT, Heeger PS, Carroll R, Zaza G, Masola V, Secchi MF, Onisto M, Gambaro G, Lupo A, Matsuyama M, Kobayashi T, Yoneda Y, Chargui J, Touraine JL, Yoshimura R, Vizza D, Perri A, Lupinacci S, Toteda G, Lofaro D, Leone F, Gigliotti P, La Russa A, Papalia T, Bonofilgio R, Sentis Fuster A, Kers J, Yapici U, Claessen N, Bemelman FJ, Ten Berge IJM, Florquin S, Glotz D, Rostaing L, Squifflet JP, Merville P, Belmokhtar C, Le Ny G, Lebranchu Y, Papazova DA, Friederich-Persson M, Koeners MP, Joles JA, Verhaar MC, Trivedi HL, Vanikar AV, Dave SD, Suarez Alvarez B, Garcia Melendreras S, Carvajal Palao R, Diaz Corte C, Ruiz Ortega M, Lopez-Larrea C, Yadav AK, Bansal D, Kumar V, Kumar V, Minz M, Jha V, Kaminska D, Koscielska-Kasprzak K, Chudoba P, Mazanowska O, Banasik M, Zabinska M, Boratynska M, Lepiesza A, Korta K, Klinger M, Csohany R, Prokai A, Pap D, Balicza-Himer N, Vannay A, Fekete A, Kis-Petik K, Peti-Peterdi J, Szabo A, Masajtis-Zagajewska A, Muras K, Niewodniczy M, Nowicki M, Pascual J, Srinivas TR, Chadban S, Citterio F, Henry M, Legendre C, Oppenheimer F, Lee PC, Tedesco-Silva H, Zeier M, Watarai Y, Dong G, Hexham M, Bernhardt P, Vincenti F, Rocchetti MT, Pontrelli P, Rascio F, Fiorentino M, Zito A, Stallone G, Gesualdo L, Grandaliano G, Su owicz J, Wojas-Pelc A, Ignacak E, Janda K, Krzanowski M, Su owicz W, Dellepiane S, Cantaluppi V, Mitsuhashi M, Murakami T, Benso A, Biancone L, Camussi G, Scholbach TM, Wang HK, Loong CC, Wu TH, Leuning D, Reinders M, Lievers E, Duijs J, Van Zonneveld AJ, Van Kooten C, Engelse M, Rabelink T, Assounga A, Omarjee S, Ngema Z, Ersoy A, Gultepe A, Isiktas Sayilar E, Akalin H, Coskun F, Oner Torlak M, Ayar Y, Riegersperger M, Plischke M, Steinhauser C, Jallitsch-Halper A, Sengoelge G, Winkelmayer WC, Sunder-Plassmann G, Foedinger M, Kaziuk M, Kuz'Niewski M, Ignacak E, B Tkowska- Prokop A, Pa Ka K, Dumnicka P, Kolber W, Su Owicz W. TRANSPLANTATION BASIC SCIENCE, ALLOGENIC AND XENOGENIC TOLERANCE. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu179] [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: 11/14/2022] Open
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Moreau K, Geneviève M, Sartorius A, Giral M, Janbon B, Kreis H, Legendre C, Merville P, Combe C. O20 Impact de l’anorexie mentale sur les résultats à 5 ans en transplantation rénale. NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70292-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Chauvet C, Chauveau P, Hourmant M, Hurault de Ligny B, Kolko A, Lefrançois G, Merville P, Moulin B, Mourad G, Rostaing L, Zins B, Kessler M, Peraldi MN. [20% of living donor kidney transplantation in France? Yes, it's possible!]. Nephrol Ther 2013; 9:459-60. [PMID: 24176652 DOI: 10.1016/j.nephro.2013.08.001] [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: 07/06/2013] [Accepted: 07/06/2013] [Indexed: 11/15/2022]
Affiliation(s)
- C Chauvet
- Service de néphrologie, hôpital Saint-Louis, 1, avenue Claude-Vellefaux, 75010 Paris, France
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Bachelet T, Couzi L, Lepreux S, Legeret M, Pariscoat G, Guidicelli G, Merville P, Taupin JL. Kidney intragraft donor-specific antibodies as determinant of antibody-mediated lesions and poor graft outcome. Am J Transplant 2013; 13:2855-64. [PMID: 24102857 DOI: 10.1111/ajt.12438] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [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: 01/07/2013] [Revised: 05/17/2013] [Accepted: 06/03/2013] [Indexed: 01/25/2023]
Abstract
Allograft pathology, antibody-tissue interaction as demonstrated by C4d deposition and serological evidence of donor-specific antibodies (DSA) are the cardinal diagnostic features of antibody-mediated lesions (AML) in kidney transplantation. However, discrepancy between histological and serological findings is common, and more reliable diagnostic tools are called for. Here, we asked whether the in situ detection of DSA could serve as marker for AML. To that end, we applied the anti-HLA single antigen flow bead assay to eluates from 51 needle core graft biopsies performed for cause. Intragraft antibody profiles were correlated to serum DSA (sDSA), histological data and transplant outcome. The prevalence and the mean number of intragraft DSA (gDSA) were lower than that of sDSA (15/51 gDSA+ vs. 37/51 sDSA+ patients; 1.64 gDSA vs. 2.24 sDSA per patient). DSA were detected in all anti-HLA antibody-positive biopsies (15/15). The presence of gDSA was significantly associated with (1) microcirculation lesions taken individually (g, cg) and analyzed in functional clusters (ptc + g + cg > 0, cg + mm > 0), (2) C4d positivity and (3) a worse short-term transplant outcome (p = 0.05). These associations were not found for patients presenting only sDSA. Taken together, these results indicate that gDSA is a severity marker of antibody-mediated pathogenic process.
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Affiliation(s)
- T Bachelet
- Department of Nephrology, Dialysis and Transplantation, CHU Bordeaux, Bordeaux, France; Laboratory of Immunology and Immunogenetics, CHU Bordeaux, Bordeaux, France; UMR 5164, CNRS and University Bordeaux Segalen, Bordeaux, France
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Taton B, Moreau K, Lepreux S, Bachelet T, Trimoulet P, De Ledinghen V, Pommereau A, Ronco P, Kamar N, Merville P, Couzi L. Hepatitis E virus infection as a new probable cause of de novo membranous nephropathy after kidney transplantation. Transpl Infect Dis 2013; 15:E211-5. [PMID: 24103101 DOI: 10.1111/tid.12143] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [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: 05/17/2013] [Revised: 06/23/2013] [Accepted: 06/27/2013] [Indexed: 12/21/2022]
Abstract
Hepatitis E virus (HEV) has been identified as a cause of chronic viral hepatitis in immunocompromised patients. Some glomerular diseases were found to be associated with this infection. We report the first case, to our knowledge, of a kidney transplant recipient who developed an HEV infection and de novo membranous nephropathy (MN) concomitantly. The patient displayed a hepatic cytolysis first and a nephrotic syndrome occurred 3 months later. HEV infection was diagnosed upon positive polymerase chain reaction on plasma and stool samples, and renal allograft biopsy revealed de novo MN. Typical causes of MN were definitively excluded. A 3-month course of ribavirin monotherapy allowed the patient to mount a sustained viral response that was rapidly followed by complete remission of the nephrotic syndrome. The chronology of the onset and remission of both diseases is highly suggestive of a causal relationship between hepatitis E and MN.
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Affiliation(s)
- B Taton
- Nephrology-Transplantation, CHU de Bordeaux, Bordeaux, France
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Hruba P, Brabcova I, Krejcik Z, Stranecky V, Honsova E, Viklicky O, Rocchetti MT, Pontrelli P, Rascio F, Fiorentino M, Stallone G, Gesualdo L, Grandaliano G, Lemy A, Lionet A, Noel C, Couzi L, Taupin JL, Merville P, Hiesse C, Suberbielle-Boissel C, De Meyer M, Latinne D, Racape J, Wissing KM, Claas FHJ, Toungouz M, Abramowicz D, Caballero A, Ruiz-Esteban P, Leon M, Palma-Merida E, Burgos D, Cabello M, Gonzalez-Molina M, Torres A, Hernandez D, Janssen EHCC, Ledeganck KJ, Hoenderop JGJ, Verpooten GAL, De Winter BY. Transplantation - basic. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Saunier A, Lazaro E, Moreau K, Couzi L, Bachelet T, Morel D, Merville P, Lortholary O. Dix-huit mois plus tard, 14 kilos en moins une diagnostique de cryptococcose neuroméningée persistante chez un greffé renal. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Couzi L, Helou S, Bachelet T, Martin S, Moreau K, Morel D, Lafon M, Garrigue I, Merville P. Preemptive Therapy Versus Valgancyclovir Prophylaxis in Cytomegalovirus-positive Kidney Transplant Recipients Receiving Antithymocyte Globulin Induction. Transplant Proc 2012; 44:2809-13. [DOI: 10.1016/j.transproceed.2012.09.029] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Moreau K, Desseix A, Bachelet T, Merville P, Couzi L, Savel H, Thiebaut R, Chauveau P. L’évolution de la composition corporelle à court et long terme après transplantation rénale est influencée par les caractéristiques nutritionnelles pré greffe : résultats de l’étude CORPOS. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2012.07.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Kaminski H, Couzi L, Helou S, Bachelet T, Guarrigue I, Déchanet-Merville J, Merville P. Profil des sous-populations de lymphocytes T conventionnels et non conventionnels au cours de l’infection à CMV résistante aux antiviraux. Nephrol Ther 2012. [DOI: 10.1016/j.nephro.2012.07.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Couzi L, Helou S, Bachelet T, Moreau K, Martin S, Morel D, Lafon ME, Boyer B, Alain S, Garrigue I, Merville P. High incidence of anticytomegalovirus drug resistance among D+R- kidney transplant recipients receiving preemptive therapy. Am J Transplant 2012; 12:202-9. [PMID: 21967659 DOI: 10.1111/j.1600-6143.2011.03766.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Anti-cytomegalovirus (CMV) prophylaxis is recommended in D+R- kidney transplant recipients (KTR), but is associated with a theoretical increased risk of developing anti-CMV drug resistance. This hypothesis was retested in this study by comparing 32 D+R- KTR who received 3 months prophylaxis (valganciclovir) with 80 D+R- KTR who received preemptive treatment. The incidence of CMV infections was higher in the preemptive group than in the prophylactic group (60% vs. 34%, respectively; p = 0.02). Treatment failure (i.e. a positive DNAemia 8 weeks after the initiation of anti-CMV treatment) was more frequent in the preemptive group (31% vs. 3% in the prophylactic group; p = 0.001). Similarly, anti-CMV drug resistance (UL97 or UL54 mutations) was also more frequent in the preemptive group (16% vs. 3% in the prophylactic group; p = 0.05). Antiviral treatment failures were associated with anti-CMV drug resistance (p = 0.0001). Patients with a CMV load over 5.25 log(10) copies/mL displayed the highest risk of developing anti-CMV drug resistance (OR = 16.91, p = 0.0008). Finally, the 1-year estimated glomerular filtration rate was reduced in patients with anti-CMV drug resistance (p = 0.02). In summary, preemptive therapy in D+R- KTR with high CMV loads and antiviral treatment failure was associated with a high incidence of anti-CMV drug resistance.
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Affiliation(s)
- L Couzi
- Centre Hospitalier Universitaire de Bordeaux, Hôpital Pellegrin, 33076 Bordeaux, France.
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Carrié C, Quinart A, Gille O, Merville P, Sztark F. [Postoperative diaphragmatic paralysis after kidney transplantation]. Ann Fr Anesth Reanim 2011; 30:939-941. [PMID: 22040864 DOI: 10.1016/j.annfar.2011.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
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Le Bras Y, Couzi L, Lafourcade JP, Cornelis F, Rigou G, Merville P, Combe C, Grenier N. Embolisation des reins polykystiques en préparation d’une greffe rénale : comparaison et résultats de deux différentes techniques. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Godron A, Harambat J, Mensire A, May A, Merville P, Godin M, Chauveau D, Cochat P, Bouissou F, Guest G, Blanchard A, Vargas-Poussou R. Syndrome d’hypomagnésémie, hypercalciurie, néphrocalcinose familiale (FHHNC) : histoire naturelle et corrélation phénotype génotype chez 29 patients porteurs de mutations des gènes CLDN16 ou CLDN19. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.062] [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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Moreau K, Desseix A, Germain C, Morel D, Couzi L, Merville P, Thiebaut R, Chauveau P. Composition corporelle et statut nutritionnel chez 98 patients en attente de greffe rénale : résultats préliminaires de l’étude CORPOS. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.273] [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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Bachelet T, Couzi L, Pitard V, Sicard X, Lepreux S, Taupin JL, Merville P, Dechanet-Merville J. Un nouvel effecteur cellulaire dans les lésions de la microcirculation à médiation humorale. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bachelet T, Legeret M, Couzi L, Lepreux S, Taupin JL, Merville P. Caractérisation en identification Single Antigen Bead LUMINEX* de 51 éluats de biopsies de greffon rénal : incidence et impact des anticorps dirigés contre le donneur présents dans les greffons ou « DSA intragraft ». Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Bachelet T, Couzi L, Moreau K, Morel D, Merville P. Impact à long terme des infections bactériennes post-transplantation chez 635 patients transplantés rénaux. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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47
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Couzi L, Moulin B, Morin M, Albano L, Godin M, Barrou B, Alamartine E, Morelon E, Girardot-Seguin S, Misdrahi D, Cassuto E, Merville P. Facteurs prédictifs de l’observance en transplantation rénale : étude observationnelle française. Nephrol Ther 2011. [DOI: 10.1016/j.nephro.2011.07.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Bachelet T, Couzi L, Guidicelli G, Moreau K, Morel D, Merville P, Taupin JL. Anti-Cw donor-specific alloantibodies can lead to positive flow cytometry crossmatch and irreversible acute antibody-mediated rejection. Am J Transplant 2011; 11:1543-4. [PMID: 21668642 DOI: 10.1111/j.1600-6143.2011.03584.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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Cornelis F, Couzi L, Le Bras Y, Hubrecht R, Dodré E, Geneviève M, Pérot V, Wallerand H, Ferrière JM, Merville P, Grenier N. Embolization of polycystic kidneys as an alternative to nephrectomy before renal transplantation: a pilot study. Am J Transplant 2010; 10:2363-9. [PMID: 21143393 DOI: 10.1111/j.1600-6143.2010.03251.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In autosomal polycystic kidney disease, nephrectomy is required before transplantation if kidney volume is excessive. We evaluated the effectiveness of transcatheter arterial embolization (TAE) to obtain sufficient volume reduction for graft implantation. From March 2007 to December 2009, 25 patients with kidneys descending below the iliac crest had unilateral renal TAE associated with a postembolization syndrome protocol. Volume reduction was evaluated by CT before, 3, and 6 months after embolization. The strategy was considered a success if the temporary contraindication for renal transplantation could be withdrawn within 6 months after TAE. TAE was well tolerated and the objective was reached in 21 patients. The temporary contraindication for transplantation was withdrawn within 3 months after TAE in 9 patients and within 6 months in 12 additional patients. The mean reduction in volume was 42% at 3 months (p = 0.01) and 54% at 6 months (p = 0.001). One patient required a cyst sclerosis to reach the objective. The absence of sufficient volume reduction was due to an excessive basal renal volume, a missed accessory artery and/or renal artery revascularization. Embolization of enlarged polycystic kidneys appears to be an advantageous alternative to nephrectomy before renal transplantation.
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Affiliation(s)
- F Cornelis
- Department of Adult Diagnostic and Interventional Imaging, Bordeaux University Hospital, Place Amélie Raba Léon, Bordeaux, France
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Raffray L, Couzi L, Viallard JF, Pellegrin JL, Augis V, Vernant JP, Merville P. Mycophenolate mofetil: a possible cause of hemophagocytic syndrome following renal transplantation? Am J Transplant 2010; 10:2378-9. [PMID: 20840482 DOI: 10.1111/j.1600-6143.2010.03254.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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