16 results on '"Xavier Tillou"'
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2. Is CIS a Contraindication to Hyperthermic Intravesical Chemotherapy (HIVEC) after BCG-Failure?
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Vassili Anastay, Michael Baboudjian, Alexandra Masson-Lecomte, Cédric Lebacle, Alexandre Chamouni, Jacques Irani, Xavier Tillou, Thibaut Waeckel, Arnaud Monges, Céline Duperron, Gwenaelle Gravis, Jochen Walz, Eric Lechevallier, and Géraldine Pignot
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CIS ,Cancer Research ,recurrence ,Oncology ,BCG failure ,bladder cancer ,progression ,HIVEC ,NMIBC - Abstract
CIS of the bladder is associated with a high risk of progression. In the case of BCG failure, radical cystectomy should be performed. For patients who refuse or are ineligible, bladder-sparing alternatives are evaluated. This study aims to investigate the efficacy of Hyperthermic IntraVesical Chemotherapy (HIVEC) depending on the presence or absence of CIS. This retrospective, multicenter study was conducted between 2016 and 2021. Patients with non-muscle-invasive bladder cancer (NMIBC) with BCG failure received 6–8 adjuvant instillations of HIVEC. The co-primary endpoints were recurrence-free survival (RFS) and progression-free survival (PFS). A total of 116 consecutive patients met our inclusion criteria of whom 36 had concomitant CIS. The 2-year RFS rate was 19.9% and 43.7% in patients with and without CIS, respectively (p = 0.52). Fifteen patients (12.9%) experienced progression to muscle-invasive bladder cancer with no significant difference between patients with and without CIS (2-year PFS rate = 71.8% vs. 88.8%, p = 0.32). In multivariate analysis, CIS was not a significant prognostic factor in terms of recurrence or progression. In conclusion, CIS may not be considered a contraindication to HIVEC, as there is no significant association between CIS and the risk of progression or recurrence after treatment.
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- 2023
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3. Indications for islet or pancreatic transplantation: Statement of the TREPID working group on behalf of the Société francophone du diabète (SFD), Société francaise d’endocrinologie (SFE), Société francophone de transplantation (SFT) and Société française de néphrologie – dialyse – transplantation (SFNDT)
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Nassim Kamar, Thierry Berney, Georges Karam, Gabriella Pittau, Oriana Ciacio, F. Buron, Julien Branchereau, M. Chetboun, Karine Moreau, Bogdan Catargi, Pierre Cattan, Sophie Reffet, Kristell Le Mapihan, Michelle Elias, Jean-Pierre Duffas, Marie-Noelle Peraldi, Sandrine Lablanche, Paolo Malvezzi, Jean-Emmanuel Serre, Gianluca Donatini, Laurence Kessler, Emmanuel Cuellar, Marie Frimat, Sophie Ohlmann, Chailloux Lucy, Xavier Tillou, Jean-Pierre Riveline, Fabrizio Panaro, Marie-Christine Vantyghem, Antoine Durrbach, Tiphaine Vidal-Trecan, François Pattou, Pierre-Yves Benhamou, Mathieu Armanet, Anne Wojtusciszyn, Hélène Hanaire, Sophie Caillard, Vincent Melki, Antonio Sacunha, Emmanuel Morelon, L. Esposito, Choukroun Gabriel, Anne Lejay, Francois Gaudez, Gilles Blancho, Gaëtan Prévost, Lionel Badet, Valérie Garrigue, Rachel Tetaz, Olivier Thaunat, Axel Andres, Fabrice Muscari, Institut de Génomique Fonctionnelle (IGF), Université de Montpellier (UM)-Université Montpellier 1 (UM1)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Montpellier 2 - Sciences et Techniques (UM2)-Centre National de la Recherche Scientifique (CNRS), Hôpital Lapeyronie [Montpellier] (CHU), Centre hospitalier universitaire de Nantes (CHU Nantes), Immunotherapy in Transplantation And Autoimmunity (Team 3 - U1064 Inserm - CRTI), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Service de Néphrologie - Immunologie Clinique [Toulouse], CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse]-PRES Université de Toulouse, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Université Lille Nord de France (COMUE), Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), CHU Strasbourg, Geneva University Hospital (HUG), Université Lille Nord (France), Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée (LBFA), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), and Centre Hospitalier Universitaire [Grenoble] (CHU)
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Pediatrics ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,Islets of Langerhans Transplantation ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Pancreas transplantation ,Risk Assessment ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Risk Factors ,Diabetes mellitus ,Internal Medicine ,Humans ,Medicine ,Kidney transplantation ,ComputingMilieux_MISCELLANEOUS ,Type 1 diabetes ,business.industry ,Immunosuppression ,General Medicine ,medicine.disease ,3. Good health ,Transplantation ,Diabetes Mellitus, Type 1 ,Treatment Outcome ,Pancreatic islet transplantation ,Pancreas Transplantation ,business ,Allotransplantation - Abstract
While either pancreas or pancreatic islet transplantation can restore endogenous insulin secretion in patients with diabetes, no beta-cell replacement strategies are recommended in the literature. For this reason, the aim of this national expert panel statement is to provide information on the different kinds of beta-cell replacement, their benefit-risk ratios and indications for each type of transplantation, according to type of diabetes, its control and association with end-stage renal disease. Allotransplantation requires immunosuppression, a risk that should be weighed against the risks of poor glycaemic control, diabetic lability and severe hypoglycaemia, especially in cases of unawareness. Pancreas transplantation is associated with improvement in diabetic micro- and macro-angiopathy, but has the associated morbidity of major surgery. Islet transplantation is a minimally invasive radiological or mini-surgical procedure involving infusion of purified islets via the hepatic portal vein, but needs to be repeated two or three times to achieve insulin independence and long-term functionality. Simultaneous pancreas-kidney and pancreas after kidney transplantations should be proposed for kidney recipients with type 1 diabetes with no surgical, especially cardiovascular, contraindications. In cases of high surgical risk, islet after or simultaneously with kidney transplantation may be proposed. Pancreas, or more often islet, transplantation alone is appropriate for non-uraemic patients with labile diabetes. Various factors influencing the therapeutic strategy are also detailed in this report.
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- 2018
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4. Management of renal transplant urolithiasis: a multicentre study by the French Urology Association Transplantation Committee
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T. Culty, F. Kleinklauss, M. Gigante, Rodolphe Thuret, Julien Branchereau, Nicolas Brichart, Georges Karam, Véronique Delaporte, Lionel Badet, Thomas Bessede, Benoit Barrou, Xavier Tillou, Ricardo Codas, Yann Neuzillet, F. Sallusto, Jean-Baptiste Rigaud, Arnaud Doerfler, L. Salomon, J.M. Boutin, M.O. Timsit, Centre hospitalier universitaire de Nantes (CHU Nantes), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), and Université de Montpellier (UM)
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Male ,Nephrology ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Urinary system ,030232 urology & nephrology ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,03 medical and health sciences ,0302 clinical medicine ,Urolithiasis ,Internal medicine ,medicine ,Humans ,Percutaneous nephrolithotomy ,Retrospective Studies ,business.industry ,Incidence (epidemiology) ,Retrospective cohort study ,Middle Aged ,Kidney Transplantation ,3. Good health ,Transplantation ,Renal transplant ,030220 oncology & carcinogenesis ,Female ,business ,Watchful waiting - Abstract
International audience; PURPOSE:Urolithiasis is rare among renal transplant recipients and its management has not been clearly defined.METHODS:This multicentre retrospective study was organised by the Comité de Transplantation de l'Association Française d'Urologie (French Urology Association transplantation committee). Statistical analysis was performed with SPSS 19 software.RESULTS:Ninety-five patients were included in this study. Renal transplant urolithiasis was an incidental finding in 55% of cases, mostly on a routine follow-up ultrasound examination. One half of symptomatic stones were due to urinary tract infection and the other half were due to an episode of acute renal failure. The initial management following diagnosis of urolithiasis was double J stenting (27%), nephrostomy tube placement (21%), or watchful waiting (52%). Definitive management consisted of: watchful waiting (48%), extracorporeal lithotripsy (13%), rigid or flexible ureteroscopy (26%), percutaneous nephrolithotomy (11%) and surgical pyelotomy (2%). All transplants remained functional following treatment of the stone. The main limitation is the retrospective design.CONCLUSIONS:The incidence of lithiasis could be higher in kidney transplanted patients due to a possible anatomical or metabolical abnormalities. The therapeutic management of renal transplant urolithiasis appears to be comparable to that of native kidney urolithiasis.
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- 2018
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5. Prostate cancer before renal transplantation: A multicentre study
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Christophe Iselin, Nicolas Brichart, Gregory Verhoest, L. Salomon, L. Viart, C. Pfister, C. Chahwan, F. Sallusto, Arnaud Doerfler, Xavier Tillou, S Bouyé, and T. Culty
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Male ,medicine.medical_specialty ,Urology ,medicine.medical_treatment ,Brachytherapy ,Operative Time ,Prostate-Specific Antigen/blood ,030232 urology & nephrology ,Blood Loss, Surgical ,03 medical and health sciences ,0302 clinical medicine ,Prostatic Neoplasms/therapy ,medicine ,Humans ,Kidney transplantation ,Retrospective Studies ,Prostatectomy ,ddc:617 ,business.industry ,Prostatic Neoplasms ,Retrospective cohort study ,Prostate-Specific Antigen ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Surgery ,Radiation therapy ,Transplantation ,Prostate-specific antigen ,surgical procedures, operative ,030220 oncology & carcinogenesis ,Lymphadenectomy ,Radiotherapy, Adjuvant ,business - Abstract
Summary Introduction The surgical issues of renal transplantation (RT) after localized prostate cancer (PC) treatment and oncological outcomes after transplantation in patients on the waiting list with a history of PC were unknown. We conducted a retrospective multicentre study including all patients with PC diagnosed before the kidney transplantation. Methods Fifty-two patients were included from December 1993 to December 2015. The median age at diagnosis of PC was 59.8 years old. Results The median PSA rate at diagnosis was 7 ng/mL. Twenty-seven, Twenty-four, and one PC were respectively low, intermediate and high risk according to d’Amico classification. Forty-three patients were treated by radical prostatectomy (RP): 28 retropubic, 15 laparoscopic and 3 by a perineal approach. Eighteen patients had a lymph node dissection. Four patients were treated with external radiotherapy and 2 by brachytherapy. Eight patients underwent radiotherapy after surgery. The median time between PC treatment and RT was 35.7 months. The median operating time for the renal transplantation was 180 min (IQR 150–190; min 90–max 310) with a median intraoperative bleeding of 200 mL (IQR 100–290; min 50–max 2000). A history of lymphadenectomy did not significantly lengthen operative time ( P = 0.34). No recurrence of PC was observed after a median follow of 36 months. Conclusion PC discovered before RT should be treated with RP to assess the risk of recurrence and decrease waiting for a RT. If the PC is at low risk of recurrence, it seems possible to shorten the waiting time before the RT after a multidisciplinary discussion meeting. Level of evidence 4.
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- 2017
6. A national study of kidney graft tumor treatments: Toward ablative therapy
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Lionel Badet, F. Gaudez, Ricardo Codas, G. Karam, K. Guleryuz, Julien Branchereau, Rodolphe Thuret, Benoit Barrou, M.O. Timsit, Xavier Tillou, L. Salomon, T. Culty, F. Sallusto, Gregory Verhoest, Véronique Delaporte, Eric Lechevallier, Yann Neuzillet, Grégoire Coffin, Thomas Bessede, Pascal Blanchet, Jacques Hubert, François Kleinclauss, Nicolas Terrier, M. Gigante, Arnaud Doerfler, J.M. Boutin, Service d'Urologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Normandie Université (NU), Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Imagerie Adaptative Diagnostique et Interventionnelle (IADI), Université de Lorraine (UL)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), SERVICE D'UROLOGIE, Hôpital Salvator [CHU - APHM] (Hôpitaux Sud), Institut de biologie et chimie des protéines [Lyon] (IBCP), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), CHU Pointe-à-Pitre/Abymes [Guadeloupe], Department of Civil Engineering [Lebanese American University] (CE/SOE/LAU), School of Engineering [Lebanese American University] (SOE/LAU), Lebanese American University (LAU)-Lebanese American University (LAU), Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Département d'urologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Génétique moléculaire, neurophysiologie et comportement, Centre National de la Recherche Scientifique (CNRS), Service d'urologie [Montpellier], Hôpital Lapeyronie [Montpellier] (CHU), Cancer du rein : bases moléculaires de la tumorogenèse, Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Lorraine (UL), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )-Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique )
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Ablation Techniques ,Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,030232 urology & nephrology ,030230 surgery ,Nephrectomy ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Postoperative Complications ,Ablative case ,medicine ,Humans ,Carcinoma, Renal Cell ,Dialysis ,Aged ,Retrospective Studies ,Kidney ,business.industry ,Histology ,Middle Aged ,Allografts ,Kidney Transplantation ,Kidney Neoplasms ,3. Good health ,Surgery ,Transplantation ,medicine.anatomical_structure ,Treatment Outcome ,National study ,Female ,France ,business ,Clear cell ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
International audience; BACKGROUND:Results of the conservative treatment of renal cell carcinomas arising in functional renal transplants are unknown compared to transplant nephrectomy. Only small series or case reports have been reported.METHODS:Data were collected from 32 transplantation centers nationwide on cases of de novo tumors in functional renal transplants presumed to be malignant between January 1988 and December 2013.RESULTS:Among 116 de novo transplant tumors, 62 were treated conservatively including: 48 by partial nephrectomy (PN) and 14 by thermal ablation (TA). These patients were compared to 30 other patients who were treated by transplant nephrectomy. The median age of the transplanted kidneys at the time of diagnosis was 43.5 years old as calculated from the donor's age. Tumors treated by transplant nephrectomy presented more often with symptoms (pain, fever, impaired condition, hematuria) than tumors treated conservatively (P = .019). After PN, final histology showed 27 (47.5%) papillary carcinomas, 19 (32.2%) clear cell carcinomas, 1 mixed carcinoma, and 2 oncocytomas. The median tumor size treated by PN was 24 mm with no difference in comparison to the TA group. Nine patients treated by PN had postoperative complications (21%), including 4 requiring operative intervention (Clavien IIIb). None of the patients treated by TA had complications. Specific survival was 100% at the time of last follow-up (median time after treatment 37 months) for patients treated by PN or TA.CONCLUSION:PN proved to be efficient in the treatment of small tumors of transplanted kidneys with good long-term functional and oncologic outcomes, including avoiding return to dialysis. TA seems to be an alternative therapy with good results in selected patients.
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- 2016
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7. Recombinant human C1-inhibitor prevents acute antibody-mediated rejection in alloimmunized baboons
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Xavier Tillou, Nicolas Poirier, Stéphanie Le Bas-Bernardet, Georges Karam, Gilles Blancho, Jean-Paul Soulillou, Fabio Vistoli, Jeremy Hervouet, David Minault, Mohamed R. Daha, and Karine Renaudin
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Graft Rejection ,complement regulation ,KIDNEY-TRANSPLANTATION ,Context (language use) ,nonhuman primate ,kidney allograft ,COMPLEMENT INHIBITION ,Antibodies ,CLASSIFICATION ,C1-inhibitor ,Classical complement pathway ,Medicine ,Animals ,C1 INHIBITOR ,Kidney transplantation ,PIG ,biology ,business.industry ,medicine.disease ,alloantibodies ,Kidney Transplantation ,Recombinant Proteins ,Complement system ,Blockade ,Transplantation ,Disease Models, Animal ,Complement Inactivating Agents ,Nephrology ,HUMORAL REJECTION ,Immunology ,Acute Disease ,biology.protein ,antibody-mediated rejection ,SURVIVAL ,Immunization ,Antibody ,business ,Complement C1 Inhibitor Protein ,HYPERACUTE REJECTION ,Papio - Abstract
Acute antibody-mediated rejection is an unsolved issue in transplantation, especially in the context of pretransplant immunization. The deleterious effect of preformed cytotoxic anti-HLA antibodies through complement activation is well proven, but very little is known concerning complement blockade to prevent/cure this rejection. Here, we used a baboon model of preimmunization to explore the prevention of acute antibody-mediated rejection by an early inhibition of the classical complement pathway using human recombinant C1-inhibitor. Baboons were immunized against peripheral blood mononuclear cells from allogeneic donors and, once a specific and stable immunization had been established, they received a kidney from the same donor. Rejection occurred at day 2 posttransplant in untreated presensitized recipients, with characteristic histological lesions and complement deposition. As recombinant human C1-inhibitor blocks in vitro cytotoxicity induced by donor-specific antibodies, other alloimmunized baboons received the drug thrice daily intravenously during the first 5 days after transplant. Rejection was prevented during this treatment but occurred after discontinuation of treatment. We show here that early blockade of complement activation by recombinant human C1-inhibitor can prevent acute antibody-mediated rejection in presensitized recipients. This treatment could also be useful in other forms of acute antibody-mediated rejection caused by induced antibodies. Kidney International (2010) 78, 152-159; doi:10.1038/ki.2010.75; published online 24 March 2010
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- 2010
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8. The subclassification of papillary renal cell carcinoma does not affect oncological outcomes after nephron sparing surgery
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C. Lenormand, İlker Gökçe, Nam Son Vuong, N. Koutlidis, Jean Jacques Patard, Jérôme Rigaud, Yvonne Chowaniec, Abdel Rahmene Azzouzi, Alexandre Ingels, Jean Baptiste Beauval, Toru Matsugasumi, Pierre Bigot, Guillaume Ploussard, Masatoshi Eto, Morgan Rouprêt, Eduard Baco, Arnaud Mejean, Jean François Hetet, A. Schneider, B. Reix, Philippe Sebe, Michel Soulié, Jean-Christophe Bernhard, Arnaud Doerfler, Stéphane Larré, Adnan El Bakri, Gregory Verhoest, Inderbir S. Gill, Karim Bensalah, Evren Süer, Christian Pfister, Xavier Tillou, Vincent Flamand, Priscilla Léon, Aurélien Descazeaud, François Xavier Nouhaud, Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM), Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes (IGDR), Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Service d'urologie, Centre hospitalier universitaire de Nantes (CHU Nantes), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Universitaire de Cancérologie [Paris] (IUC), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service d'Urologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de Néphrologie, Dialyse, Transplantations [CHU Limoges], CHU Limoges, Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), CHU Pontchaillou [Rennes], Laboratoire Traitement du Signal et de l'Image (LTSI), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM), AP-HP Hôpital Bicêtre (Le Kremlin-Bicêtre), Cancer Center Amsterdam, Amsterdam Public Health, Urology, Université d'Angers ( UA ) -CHU Angers, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Institut de Génétique et Développement de Rennes ( IGDR ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Centre National de la Recherche Scientifique ( CNRS ) -Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Centre hospitalier universitaire de Nantes ( CHU Nantes ), Centre de Recherche en Cancérologie / Nantes - Angers ( CRCNA ), CHU Angers-Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Hôpital Laennec-Centre National de la Recherche Scientifique ( CNRS ) -Faculté de Médecine d'Angers-Centre hospitalier universitaire de Nantes ( CHU Nantes ), Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Institut Universitaire de Cancérologie, Université Pierre et Marie Curie - Paris 6 ( UPMC ), Service d'Urologie [Caen], Université de Caen Normandie ( UNICAEN ), Normandie Université ( NU ) -Normandie Université ( NU ) -CHU Caen, Hôpital Européen Georges Pompidou [APHP] ( HEGP ), Laboratoire Traitement du Signal et de l'Image ( LTSI ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Institut National de la Santé et de la Recherche Médicale ( INSERM ), Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Universitaire de Cancérologie [Sorbonne Université] (IUC), Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), and Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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Male ,Oncology ,Prognostic factor ,medicine.medical_specialty ,medicine.medical_treatment ,Urology ,030232 urology & nephrology ,Medical Oncology ,urologic and male genital diseases ,Affect (psychology) ,Nephrectomy ,Oncologic outcomes ,Papillary renal cell carcinoma ,Disease-Free Survival ,Article ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Humans ,Medicine ,[ SDV.IB ] Life Sciences [q-bio]/Bioengineering ,Carcinoma, Renal Cell ,Neoplasm Staging ,Retrospective Studies ,Papillary renal cell carcinomas ,business.industry ,Nephrons ,Middle Aged ,Prognosis ,United States ,Kidney Neoplasms ,3. Good health ,Survival Rate ,Nephrology ,030220 oncology & carcinogenesis ,Nephron sparing surgery ,Disease Progression ,Female ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,France ,business - Abstract
International audience; Objectives To evaluate the oncological outcomes of papillary renal cell carcinoma (pRCC) following nephron sparing surgery (NSS) and to determine whether the subclassification type of pRCC could be a prognostic factor for recurrence, progression, and specific death. Materials and methods An international multicentre retrospective study involving 19 institutions and the French network for research on kidney cancer was conducted after IRB approval. We analyzed data of all patients with pRCC who were treated by NSS between 2004 and 2014. Results We included 486 patients. Tumors were type 1 pRCC in 369 (76 %) cases and type 2 pRCC in 117 (24 %) cases. After a mean follow-up of 35 (1–120) months, 8 (1.6 %) patients experienced a local recurrence, 12 (1.5 %) had a metastatic progression, 24 (4.9 %) died, and 7 (1.4 %) died from cancer. Patients with type I pRCC had more grade II (66.3 vs. 46.1 %; p \textless 0.001) and less grade III (20 vs. 41 %; p \textless 0.001) tumors. Three-year estimated cancer-free survival (CFS) rate for type 1 pRCC was 96.5 % and for type 2 pRCC was 95.1 % (p = 0.894), respectively. Three-year estimated cancer-specific survival rate for type 1 pRCC was 98.4 % and for type 2 pRCC was 97.3 % (p = 0.947), respectively. Tumor stage superior to pT1 was the only prognostic factor for CFS (HR 3.5; p = 0.03). Conclusion Histological subtyping of pRCC has no impact on oncologic outcomes after nephron sparing surgery. In this selected population of pRCC tumors, we found that tumor stage is the only prognostic factor for cancer-free survival
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- 2016
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9. Étude multicentrique sur les traitements conservateurs des tumeurs du greffon : vers les traitements ablatifs ?
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Rodolphe Thuret, M.O. Timsit, M. Devonec, Georges Karam, R. Codas, Nicolas Terrier, J.M. Boutin, Jacques Hubert, K. Guleryuz, F. Sallusto, E. Lechevallier, C. Sénéchal, Henri Bensadoun, Gregory Verhoest, Arnaud Doerfler, A. Erauso, Damien Chambade, G. Coffin, L. Salomon, L. Viart, Xavier Tillou, S Bouyé, Service d'Urologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), CHU Bordeaux [Bordeaux], Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'Urologie [CHU Saint-Louis], Université Paris Diderot - Paris 7 (UPD7)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Marseille, CHI Créteil, CHU Pointe-à-Pitre/Abymes [Guadeloupe], CHU Toulouse [Toulouse], Centre Hospitalier Universitaire [Grenoble] (CHU), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), CHU Pontchaillou [Rennes], CHU Amiens-Picardie, Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-Université Paris Diderot - Paris 7 (UPD7)-Groupe Hospitalier Saint Louis - Lariboisière - Fernand Widal [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), CHU Pitié-Salpêtrière [APHP], Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO)-Assistance publique - Hôpitaux de Paris (AP-HP) (APHP), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)
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Gynecology ,03 medical and health sciences ,medicine.medical_specialty ,0302 clinical medicine ,business.industry ,030220 oncology & carcinogenesis ,Urology ,030232 urology & nephrology ,medicine ,business ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,ComputingMilieux_MISCELLANEOUS ,3. Good health - Abstract
Objectifs Decrire l’experience francaise des traitements conservateurs (nephrectomie partielle, radiofrequence et cryoablation) des tumeurs du greffon renal. Methodes Etude retrospective, nationale, multicentrique basee sur les donnees recueillies dans 32 centres de transplantation en France. De janvier 1988 a decembre 2013, les patients traites par traitements conservateurs pour tumeur d’un greffon fonctionnel ont ete inclus. Cent seize tumeurs du greffon ont ete diagnostiquees. Resultats Quarante-huit patients ont eu un traitement par nephrectomie partielle, 11 par radiofrequence et 3 par cryoablation. Les tumeurs traitees par nephrectomie elargie etaient plus souvent symptomatiques par rapport aux autres traitements ( p = 0,019). L’analyse anatomopathologique apres nephrectomie partielle retrouvait 27 carcinomes papillaires, 19 carcinomes a cellules claires, 1 tumeur mixte et 2 oncocytomes sans difference significative par rapport aux traitements ablatifs. La taille moyenne tumorale etait de 24,9 mm sans difference par rapport aux traitements ablatifs ( p = 0,3). Neuf patients ont eu des complications postoperatoires (20,9 %), quatre necessitant une reprise chirurgicale (Clavien IIIb). Aucun des patients traites par radiotherapie ou cryoablation n’ont eu de complications. La duree moyenne de suivi etait de 44,9 mois. Cinquante-neuf (95,1 %) patients avaient un greffon fonctionnel au long terme. La survie specifique etait de 100 %. Conclusion La nephrectomie partielle a prouve son efficacite dans le traitement des petites tumeurs de-novo du greffon renal avec des resultats oncologiques et fonctionnels a long terme satisfaisants. Chez des patients selectionnes, la cryoablation et la radiofrequence peuvent etre des alternatives therapeutiques avec egalement de bons resultats.
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- 2015
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10. FR104, an Antagonist Anti-CD28 Monovalent Fab' Antibody, Prevents Alloimmunization and Allows Calcineurin Inhibitor Minimization in Nonhuman Primate Renal Allograft
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S. Le Bas-Bernardet, Jeremy Hervouet, David Minault, Karine Renaudin, Nicolas Poirier, Julien Branchereau, Vianney Charpy, Véronique Nerrière-Daguin, Flora Coulon, Caroline Mary, Sabrina Pengam, Bernard Vanhove, Simon Ville, Nahzli Dilek, Gilles Blancho, Xavier Tillou, Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Effimune SAS [Nantes], Département d'Urologie [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Département d'Urologie [CHU Caen], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Fondation de la Recherche Médicale, the Progreffe, Centaure foundations (France), the IHU-Cesti project, Nantes Metropole and the Pays de la Loire Region., ANR-09-BIOT-0013,TOLESTIM,Antagoniste de CD28 à action prolongée stimulateur de la tolérance en transplantation(2009), European Project, Le Bihan, Sylvie, Biotech : Biotechnologies - Antagoniste de CD28 à action prolongée stimulateur de la tolérance en transplantation - - TOLESTIM2009 - ANR-09-BIOT-0013 - Biotech - VALID, and TRIAD (EU-FP7-Health program EC-GA N8281493) - INCOMING
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Graft Rejection ,Nephrology ,medicine.medical_specialty ,Regulatory T cell ,medicine.medical_treatment ,Blotting, Western ,Calcineurin Inhibitors ,Enzyme-Linked Immunosorbent Assay ,chemical and pharmacologic phenomena ,Real-Time Polymerase Chain Reaction ,T-Lymphocytes, Regulatory ,Immune tolerance ,Immunoenzyme Techniques ,Immunoglobulin Fab Fragments ,CD28 Antigens ,Internal medicine ,Animals ,Transplantation, Homologous ,Immunology and Allergy ,Medicine ,Pharmacology (medical) ,RNA, Messenger ,Cells, Cultured ,Immunosuppression Therapy ,Transplantation ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,biology ,Reverse Transcriptase Polymerase Chain Reaction ,business.industry ,Graft Survival ,CD28 ,Immunosuppression ,hemic and immune systems ,Flow Cytometry ,Kidney Transplantation ,Tacrolimus ,3. Good health ,Calcineurin ,medicine.anatomical_structure ,Immunology ,biology.protein ,Immunization ,Kidney Diseases ,Antibody ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Papio - Abstract
International audience; Selective targeting of CD28 might represent an effective immunomodulation strategy by preventing T cell costimulation, while favoring coinhibition since inhib-itory signals transmitted through CTLA-4; PD-L1 and B7 would not be affected. We previously showed in vitro and in vivo that anti-CD28 antagonists suppress effector T cells while enhancing regulatory T cell (Treg) suppression and immune tolerance. Here, we evaluate FR104, a novel antagonist pegylated anti-CD28 Fab' antibody fragment, in nonhuman primate renal allo-transplantation. FR104, in association with low doses of tacrolimus or with rapamycin in a steroid-free therapy, prevents acute rejection and alloantibody development and prolongs allograft survival. However , when FR104 was associated with mycophenolate mofetil and steroids, half of the recipients rejected their grafts prematurely. Finally, we observed an accumulation of Helios-negative Tregs in the blood and within the graft after FR104 therapy, confirmed by Treg-specific demethylated region DNA analysis. In conclusion , FR104 reinforces immunosuppression in calci-neurin inhibitor (CNI)-low or CNI-free protocols, without the need of steroids. Accumulation of intra-graft Tregs suggested the promotion of immunoregu-latory mechanisms. Selective CD28 antagonists might become an alternative CNI-sparing strategy to B7 antagonists for kidney transplant recipients.
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- 2015
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11. Bortezomib, C1-inhibitor and plasma exchange do not prolong the survival of multi-transgenic GalT-KO pig kidney xenografts in baboons
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Andrea Perota, Simon C. Robson, David H. Sachs, Cesare Galli, Gilles Blancho, Mark B. Nottle, Emanuele Cozzi, Paolo Simioni, Béatrice Charreau, S. Le Bas-Bernardet, N. Klar, Giovanna Lazzari, Nahzli Dilek, Anthony J. F. D'apice, Evelyn J Salvaris, Irina Lagutina, Nicolas Poirier, Kazuhiko Yamada, Jeremy Hervouet, J. P. Soulillou, Julien Branchereau, Linda Scobie, Claire Crossan, Xavier Tillou, Karine Renaudin, Michael E. Breimer, Bernard Vanhove, M. Châtelais, Y Takeuchi, Peter J. Cowan, M. Diswall, Roberto Duchi, David Minault, Mohamed R. Daha, Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Transplant Immunology Unit [Padua, Italy], Padua General Hospital [Padua, Italy], Consorzio per la Ricerca sul Trapianto d'Organ = Consortium for Research in Organ Transplantation (CORIT), Effimune SAS [Nantes], Département de Pathologie [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), Department of Biological & Biomedical Sciences [Glasgow, UK], Glasgow Caledonian University (GCU), University College of London [London] (UCL), Department of Surgery [Gothenburg, Sweden] (Institute of Clinical Sciences), Sahlgrenska Academy at University of Gothenburg [Göteborg], Department of Nephrology [Leiden, The Netherlands], Leiden University Medical Center (LUMC), Department of Cardiologic, Thoracic and Vascular Sciences [Padua, Italy], Università degli Studi di Padova = University of Padua (Unipd), Department of Medicine [Boston, MA, USA], Beth Israel Deaconess Medical Center [Boston] (BIDMC), Harvard Medical School [Boston] (HMS)-Harvard Medical School [Boston] (HMS), School of Paediatrics and Reproductive Health [Adelaide, Australia], University of Adelaide-Robinson Research Institute, University of Adelaide, Immunology Research Centre [Melbourne, VIC, Australia], St Vincent's Hospital Melbourne [Australia], Transplantation Biology Research Center [Boston, MA, USA], Harvard Medical School [Boston] (HMS)-Massachusetts General Hospital [Boston], Avantea [Cremona, Italy], Department of Veterinary Medical Science [Ozzano Emilia, Italy], University of Bologna/Università di Bologna, This work was supported by the European Commission’s Sixth Framework Programme, under the priority thematic area Life Sciences, Genomics and Biotechnology for Health, contract N°. LSHB-CT- 2006- 037377, XENOME and by NIH Grant #5P01AI45897., Le Bihan, Sylvie, Consortium for Research in Organ Transplantation [Padua, Italy] (CORIT), University of Padua [Italy], University of Bologna, Le Bas-Bernardet, S., Tillou, X., Branchereau, J., Dilek, N., Poirier, N., Chatelais, M., Charreau, B., Minault, D., Hervouet, J., Renaudin, K., Crossan, C., Scobie, L., Takeuchi, Y., Diswall, M., Breimer, M.E., Klar, N., Daha, M.R., Simioni, P., Robson, S.C., Nottle, M.B., Salvaris, E.J., Cowan, P.J., D'Apice, A.J.F., Sachs, D.H., Yamada, K., Lagutina, I., Duchi, R., Perota, A., Lazzari, G., Galli, C., Cozzi, E., Soulillou, J.-P., Vanhove, B., and Blancho, G.
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basic (laboratory) research/science ,translational research/science ,medicine.medical_treatment ,Sus scrofa ,Cytomegalovirus ,kidney transplantation/nephrology ,immunosuppression/immune modulation ,030230 surgery ,Pharmacology ,Kidney ,Virus Replication ,xenoantibody ,Animals, Genetically Modified ,Bortezomib ,Gene Knockout Techniques ,0302 clinical medicine ,Models ,xenotransplantation ,Innate ,Immunology and Allergy ,genetics ,Pharmacology (medical) ,0303 health sciences ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,biology ,Plasma Exchange ,Medicine (all) ,Graft Survival ,Immunosuppression ,Galactosyltransferases ,Boronic Acids ,Papio anubis ,3. Good health ,Pyrazines ,Models, Animal ,Heterografts ,Complement C1 Inhibitor Protein ,Immunosuppressive Agents ,medicine.drug ,plasmapheresis/plasma exchange ,Xenotransplantation ,Genetically Modified ,Animal models: nonhuman primate ,immunosuppressive regimens ,Animals ,Autoimmune Diseases ,Immunity, Innate ,Kidney Transplantation ,Transplantation ,Article ,03 medical and health sciences ,Classical complement pathway ,biology.animal ,medicine ,030304 developmental biology ,business.industry ,Animal ,Immunity ,Complement system ,immunosuppressive regimen ,Immunology ,Alternative complement pathway ,genetic ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Baboon - Abstract
Galactosyl-transferase KO (GalT-KO) pigs represent a potential solution to xenograft rejection, particularly in the context of additional genetic modifications. We have performed life supporting kidney xenotransplantation into baboons utilizing GalT-KO pigs transgenic for human CD55/CD59/CD39/HT. Baboons received tacrolimus, mycophenolate mofetil, corticosteroids and recombinant human C1 inhibitor combined with cyclophosphamide or bortezomib with or without 2-3 plasma exchanges. One baboon received a control GalT-KO xenograft with the latter immunosuppression. All immunosuppressed baboons rejected the xenografts between days 9 and 15 with signs of acute humoral rejection, in contrast to untreated controls (n = 2) that lost their grafts on days 3 and 4. Immunofluorescence analyses showed deposition of IgM, C3, C5b-9 in rejected grafts, without C4d staining, indicating classical complement pathway blockade but alternate pathway activation. Moreover, rejected organs exhibited predominantly monocyte/macrophage infiltration with minimal lymphocyte representation. None of the recipients showed any signs of porcine endogenous retrovirus transmission but some showed evidence of porcine cytomegalovirus (PCMV) replication within the xenografts. Our work indicates that the addition of bortezomib and plasma exchange to the immunosuppressive regimen did not significantly prolong the survival of multi-transgenic GalT-KO renal xenografts. Non-Gal antibodies, the alternative complement pathway, innate mechanisms with monocyte activation and PCMV replication may have contributed to rejection.
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- 2015
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12. Ischemic pre- and post-conditioning : current clinical applications
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N. Chatauret, T. Saint Yves, C. Billault, Xavier Tillou, R. Thuillier, Benoit Barrou, Rodolphe Thuret, Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques ( IRTOMIT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Poitiers, Service d'Urologie [Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service d'Urologie [CHU Caen], Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Service de Biochimie [Poitiers], Service d'urologie, néphrologie et transplantation [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (APHP)-CHU Pitié-Salpêtrière [APHP], Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), and Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM)
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medicine.medical_specialty ,Urology ,030232 urology & nephrology ,030204 cardiovascular system & hematology ,Kidney ,Kidney transplantation ,03 medical and health sciences ,0302 clinical medicine ,Conditionnement ischémique ,Internal medicine ,Ischemic conditioning ,medicine ,Animals ,Humans ,Ischemia-reperfusion injuries ,Ischemic Postconditioning ,Ischemic Preconditioning ,Pre and post ,Lésions d’ischémie reperfusion ,business.industry ,medicine.disease ,Warm ischemia ,3. Good health ,Cardiac surgery ,Transplantation ,Anesthesia ,Cardiology ,Conditioning ,Transplantation rénale ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Large animal - Abstract
International audience; Ischemic conditioning is a phenomenon through which short sequences of ischemiareperfusion applied to an organ confer some degree of protection towards future ischemic insults. This phenomenon was first observed in the mid-1980s in cardiac surgery, and has been since widely studied in different settings. Different sort of ischemic conditioning exist: local vs remote, direct or pharmacological, and with different timeframes of protection. Ischemic conditioning seems especially suited to applications in transplantation since schedules of both cold and warm ischemia, as well as reperfusion, are carefully and easily controlled, and the benefits of protecting fragile organs against ischemia-reperfusion injuries might help widen the pool of possible grafts and ensure better graft function and survival. The pathways through which ischemic conditioning work are many, offering both preservation of cell energy, protection against oxidative stress, better blood flow to organs and protection against apoptosis. In the field of pharmacological conditioning, which tries to mimic the protective effects of traditional ischemic conditioning without the potential side-effects associated with vessel clamping, many common-use drugs including anesthetics have been shown to be effective. Significant results have been obtained in small animal models, but while ischemic conditioning is successfully used in cardiac surgery, studies in large animal models and human applications in liver and kidney transplantation are still inconclusive.; Le conditionnement ischémique est un procédé par lequel de courtes séquences d’ischémie-reperfusion appliquées à un organe confèrent un certain degré de protection envers les futures lésions ischémiques. Ce phénomène a été observé pour la première fois dans le milieu des années 1980 en chirurgie cardiaque, et a été depuis largement étudié dans différents contextes. D’autre types de conditionnement ischémique existent: locale ou à distance, directe ou pharmacologique. Le conditionnement ischémique semble particulièrement adapté à une application en transplantation avec des périodes d’ischémie chaude et froide, une reperfusion soigneusement et facilement contrôlé. Les avantages de la protection des organes fragiles contre les blessures d’ischémiereperfusion pourraient contribuer à élargir le pool de greffons disponibles et à assurer une meilleure fonction et survie du greffon. Les mécanismes d’action du conditionnement ischémique sont nombreux: préservation de l’énergie de la cellule, protection contre le stress oxydatif, meilleure circulation sanguine vers les organes et protection contre l’apoptose. Dans le domaine du conditionnement pharmacologique, qui tente d’imiter les effets protecteurs de conditionnement ischémique traditionnel sans les effets secondaires potentiels associés au clampage vasculaire, de nombreux médicaments d’usage courant, y compris les anesthésiques ont démontré leur efficacité. Des résultats significatifs ont ainsi été obtenus dans des modèles animaux de petite taille. Cependant même si le conditionnement ischémique est utilisé avec succès en chirurgie cardiaque, les études sur des modèles expérimentaux de gros animaux et des applications humaines dans la transplantation hépatique ou rénale ne sont toujours pas concluantes.
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- 2014
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13. Evaluation of FR104, a Treg sparing antagonist anti-CD28 monovalent Fab’ antibody in kidney transplantation in non-human primates
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Nahzli Dilek, Xavier Tillou, David Minault, Nicolas Poirier, Caroline Mary, Gilles Blancho, Stéphanie Le Bas-Bernardet, Jeremy Hervouet, Julien Branchereau, Bernard Vanhove, Effimune, Faculté de Médecine de Nantes, Immunointervention dans les allo et xénotransplantations, Université de Nantes (UN)-IFR26-Institut National de la Santé et de la Recherche Médicale (INSERM)-ITUN, and BMC, Ed.
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Pathology ,medicine.medical_specialty ,lcsh:Medicine ,Pharmacology ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,General Biochemistry, Genetics and Molecular Biology ,biology.animal ,Medicine ,ComputingMilieux_MISCELLANEOUS ,Kidney transplantation ,Medicine(all) ,Kidney ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,biology ,Biochemistry, Genetics and Molecular Biology(all) ,business.industry ,lcsh:R ,Antagonist ,CD28 ,Histology ,General Medicine ,medicine.disease ,[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,Tacrolimus ,medicine.anatomical_structure ,Poster Presentation ,biology.protein ,Antibody ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Baboon - Abstract
Methods and results Here we evaluated in a non-human primates this “Treg sparing strategy” with FR104, a novel monovalent humanized and pegylated Fab’ anti-CD28 antibody fragment. PK/PD studies in monkeys revealed that FR104 presented an elimination half-life of 8 days and 100% target saturation over at least a month after a single iv injection of 5 mg/kg. FR104 was next evaluated in a baboon kidney allograft model at the dose of 5 mg/kg at day 0, 4, 14 and then every two-week until 3 months. Monotherapy modestly but significantly prolonged allograft survival (MST: 18.5 days for monotherapy vs 6 days for untreated recipients). FR104 synergized with low doses tacrolimus (lowTac, trough: 5-10 ng/ml; MST >100 days for FR104/ lowTac vs. 15 days for lowTac alone) as well as with calcineurin-free regimens: therapeutic doses of MMF or rapamycin (day 0-90) with 1 mg/kg of corticosteroids from day 0-14 (MST >100 days for FR104 + MMF/Rapa vs. 18/15 days for MMF/Rapa alone). Flow cytometry analyses indicated that blood Treg cells of the natural and inducible types were preserved in FR104/MMF or FR104/lowTAC bitherapies and accumulated in FR104 monotherapy and in FR104/Rapa bitherapy, whereas Treg cells were lowered by MMF and lowTac monotherapies. Histology also revealed that CTLA4+ and Foxp3+ T lymphocytes were accumulated into the graft of FR104 treated recipients.
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- 2012
14. Gene transfer of human CD40Ig does not prevent rejection in a non-human primate kidney allotransplantation model
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Antoine Blancher, Nahzli Dilek, Jeremy Hervouet, Yan Cherel, Jack-Yves Deschamps, Alice Toromanoff, Bernard Vanhove, Caroline Le Guiner, Gilles Blancho, David Minault, Xavier Tillou, Brigitte Le Mauff, Karine Renaudin, Nicolas Poirier, Ignacio Anegon, Mathieu Angin, ProdInra, Migration, Institut National de la Santé et de la Recherche Médicale (INSERM), UMR1089, Laboratoire d'Immunogénétique Moléculaire (LIMT), Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées-Université Fédérale Toulouse Midi-Pyrénées, Physiopathologie Animale et bioThérapie du muscle et du système nerveux (PAnTher), Institut National de la Recherche Agronomique (INRA)-École nationale vétérinaire, agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), Service d'Anatomie Pathologique, Centre Hospitalier Universitaire G. R. Laennec (HGRL Saint-Herblain)-Centre hospitalier universitaire de Nantes (CHU Nantes), CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Institut National de la Recherche Agronomique (INRA)-Ecole Nationale Vétérinaire, Agroalimentaire et de l'alimentation Nantes-Atlantique (ONIRIS), and Centre hospitalier universitaire de Nantes (CHU Nantes)-Centre Hospitalier Universitaire G. R. Laennec (HGRL Saint-Herblain)
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Graft Rejection ,Male ,medicine.medical_treatment ,primate ,0302 clinical medicine ,Immunology and Allergy ,0303 health sciences ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,biology ,Graft Survival ,Gene Transfer Techniques ,CD28 ,hemic and immune systems ,Dependovirus ,Mixed lymphocyte reaction ,3. Good health ,Models, Animal ,Veterinary medicine and animal Health ,Antibody ,Recombinant Fusion Proteins ,Immunology ,CD40 Ligand ,Genetic Vectors ,Médecine humaine et pathologie ,Immunoglobulins ,03 medical and health sciences ,Immune system ,Transplantation Immunology ,medicine ,Animals ,Humans ,Transplantation, Homologous ,CD40 Antigens ,030304 developmental biology ,Transplantation ,[SDV.BA.MVSA]Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health ,tolérance ,[SDV.BA.MVSA] Life Sciences [q-bio]/Animal biology/Veterinary medicine and animal Health ,Fusion protein ,Kidney Transplantation ,Blockade ,Immunity, Humoral ,Macaca fascicularis ,Médecine vétérinaire et santé animal ,biology.protein ,Human health and pathology ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,030215 immunology ,Allotransplantation - Abstract
Background Blockade of costimulation signaling required for immune response, such as CD40/CD40L and CD28/B7, is a reasonable strategy to prevent rejection and in defined combinations may allow donor specific tolerance. Indeed, in rodents, costimulation blockade with CD28/B7 antagonists or with CD40Ig was able to induce regulatory T cells and transplant tolerance whereas in primates, anti-CD40 antibodies, anti-CD40L antibodies or CTLA4Ig, used as monotherapy, significantly delayed graft rejection. Methods Using an adeno-associated virus (AAV) vector mediated gene transfer of a human CD40Ig fusion protein (hCD40Ig) in primates, we evaluated the capacity of this costimulation blockade molecule interfering with CD40/CD40L signaling in prolonging kidney transplants in cynomolgus monkeys. Results This gene transfer strategy allowed for maintaining a plateau of hCD40Ig production within two months and avoided a high-scale production phase of this molecule. Although the hCD40Ig was able to bind efficiently to human and macaque CD40L and high (> 200 μg/ml) transgene expression was obtained, no effect on graft survival was observed. In addition, there was no inhibition of humoral response to vaccination. In vitro , hCD40Ig strongly increased mixed lymphocyte reaction, and when compared to the anti-CD40L antibody h5C8, was not as potent to induce complement-dependent cytotoxicity. Conclusion These data suggest that CD40/CD40L blockade using a non-depleting CD40Ig fusion protein, a therapeutic strategy that showed efficacy in rodents, is not able to modulate the immune response in primates. These data highlight important biological differences between rodent and primate models to evaluate therapeutic strategies at the preclinical level.
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- 2012
15. Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population
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Laurent Salomon, Lionel Badet, Georges Karam, Jacques Tostain, Pierre Bigot, Nathalie Rioux-Leclercq, Sébastien Barbet, Jean-Etienne Terrier, Bernard Escudier, Michel Soulié, Hicham Elkentaoui, Abdel-Rahmène Azzouzi, Fabrice Dugardin, Yann Neuzillet, Jean-Christophe Bernhard, Jacques Hubert, Aurélien Descazeaux, Karim Fehri, Nicolas Brichart, Philippe Paparel, J.M. Boutin, Laurent Guy, Baptiste Tisserand, Arnaud Mejean, Ismaël Galliot, Marc-Olivier Timsit, Laurence Bastien, Jérôme Rigaud, Antoine Valeri, Jacques Petit, Laurent Zini, Benoit Barrou, Christian Pfister, Xavier Tillou, Franck Bruyère, Fabien Saint, Herve Lang, Jean-Jacques Patard, Marie-Dominique Azemar, Denis Chautard, Julien Branchereau, Hervé Wallerand, Pascal Rischmann, Laura Poissonnier, Charles Deruelle, Lucille Martin, Laurence Albiges, Jacques Irani, Arnauld Villers, Thierry Lebret, Hervé Baumert, François Kleinclauss, Nicolas Terrier, Jean-Alexandre Long, Pierre-Etienne Theveniaud, M. Gigante, Frédéric Staerman, Jean-Marie Ferriere, Romain Mathieu, Morgan Rouprêt, F. Sallusto, Benoit Feuillu, Service d'urologie, Hôpital Foch [Suresnes], CHU Amiens-Picardie, Université de Rennes 1 ( UR1 ), Université de Rennes ( UNIV-RENNES ) -Université de Rennes ( UNIV-RENNES ) -Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Grenoble-Hôpital Michallon, Service d'urologie-andrologie, CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] ( UJM ) -Hôpital nord, Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] ( CHLS ), Hospices Civils de Lyon ( HCL ) -Hospices Civils de Lyon ( HCL ), Hôpital Saint-Joseph, Département de médecine oncologique [Gustave Roussy], Institut Gustave Roussy ( IGR ), CHU Strasbourg, Service d'anatomie et cytologie pathologiques [Rennes], Université d'Angers ( UA ) -CHU Angers, Service d'urologie, andrologie et transplantation rénale, Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux]-Groupe hospitalier Pellegrin, Institut Mondor de recherche biomédicale ( IMRB ), Institut National de la Santé et de la Recherche Médicale ( INSERM ) -Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Service d'urologie [Tours], Hôpital Bretonneau-CHRU Tours, Hôtel-Dieu, Service d'Urologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy ( CHRU Nancy ), Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] ( CHRU Lille ), Service de Chirurgie urologique et andrologie [CHU Limoges], CHU Limoges, Service d'urologie et transplantation rénales [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP)-CHU Pitié-Salpêtrière [APHP], Service de Néphrologie et Urologie, Centre Hospitalier Régional Universitaire [Besançon] ( CHRU Besançon ) -Hôpital Saint-Jacques, Service d'urologie [Rouen], CHU Rouen-Université de Rouen Normandie ( UNIROUEN ), Normandie Université ( NU ) -Normandie Université ( NU ), Université de Reims Champagne-Ardenne ( URCA ), Centre hospitalier universitaire de Poitiers ( CHU Poitiers ) -Hôpital La Milétrie, Assistance publique - Hôpitaux de Paris (AP-HP)-Université Paris Descartes - Paris 5 ( UPD5 ) -CHU Necker - Enfants Malades [AP-HP], Service d'Urologie - Transplantation Rénale - Andrologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], CHU Clermont-Ferrand-Hôpital Gabriel Montpied, Université de Brest ( UBO ) -Centre Hospitalier Régional Universitaire de Brest ( CHRU Brest ), Service d'urologie [Mondor], Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 ( UPEC UP12 ), Université Paris-Sud - Paris 11 ( UP11 ) -Assistance publique - Hôpitaux de Paris (AP-HP)-Hôpital Bicêtre, members of the Comité de Transplantation de l'Association Française d'Urologie, the Comité de Cancérologie de l'Association Française d'Urologie, Service d'urologie [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-CHU Pontchaillou [Rennes], CHU Saint-Etienne-Université Jean Monnet [Saint-Étienne] (UJM)-Hôpital nord, Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Institut Gustave Roussy (IGR), Université d'Angers (UA)-Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Institut Mondor de recherche biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bretonneau-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service d'urologie et transplantation rénales [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Saint-Jacques, CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), Université de Reims Champagne-Ardenne (URCA), Centre hospitalier universitaire de Poitiers (CHU Poitiers)-Hôpital La Milétrie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Descartes - Paris 5 (UPD5)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université de Brest (UBO)-Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Hôpital Bicêtre-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris-Sud - Paris 11 (UP11), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Service d'anatomie et cytologie pathologiques [Rennes] = Anatomy and Cytopathology [Rennes], CHU Pontchaillou [Rennes], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau, Service d'Urologie [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand, Université Paris-Sud - Paris 11 (UP11)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Bicêtre, De Villemeur, Hervé, CHU Saint-Etienne-Université Jean Monnet - Saint-Étienne (UJM)-Hôpital nord, Département d'Urologie-Andrologie et Transplantation Rénale [CHU Toulouse], Pôle Urologie - Néphrologie - Dialyse - Transplantations - Brûlés - Chirurgie plastique - Explorations fonctionnelles et physiologiques [CHU Toulouse], and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
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Male ,[ SDV.MHEP.UN ] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,MESH: Chi-Square Distribution ,Time Factors ,MESH : Retrospective Studies ,030232 urology & nephrology ,MESH : Aged ,Kaplan-Meier Estimate ,MESH: Risk Assessment ,urologic and male genital diseases ,Gastroenterology ,[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,[ SDV.CAN ] Life Sciences [q-bio]/Cancer ,MESH: Proportional Hazards Models ,MESH : Carcinoma, Renal Cell ,0302 clinical medicine ,Renal cell carcinoma ,MESH: Risk Factors ,Risk Factors ,MESH : Female ,MESH : Neoplasm Staging ,MESH : Risk Assessment ,MESH: Treatment Outcome ,MESH: Aged ,education.field_of_study ,Univariate analysis ,MESH: Middle Aged ,MESH: Carcinoma, Renal Cell ,MESH: Neoplasm Staging ,Middle Aged ,MESH : Adult ,MESH : Survival Rate ,MESH : Risk Factors ,Kidney Neoplasms ,3. Good health ,Survival Rate ,Treatment Outcome ,MESH: Kidney Failure, Chronic ,030220 oncology & carcinogenesis ,Female ,France ,MESH : Time Factors ,Adult ,medicine.medical_specialty ,MESH: Survival Rate ,Urology ,MESH : Male ,Population ,[SDV.CAN]Life Sciences [q-bio]/Cancer ,MESH : Treatment Outcome ,Risk Assessment ,MESH : Kidney Failure, Chronic ,End stage renal disease ,MESH : Kaplan-Meier Estimate ,03 medical and health sciences ,[SDV.CAN] Life Sciences [q-bio]/Cancer ,Internal medicine ,medicine ,Humans ,MESH : Middle Aged ,education ,MESH : France ,Survival rate ,Carcinoma, Renal Cell ,MESH: Kaplan-Meier Estimate ,Aged ,Neoplasm Staging ,Proportional Hazards Models ,Retrospective Studies ,MESH: Humans ,Chi-Square Distribution ,MESH : Chi-Square Distribution ,business.industry ,MESH: Time Factors ,MESH : Humans ,MESH: Adult ,MESH: Retrospective Studies ,medicine.disease ,MESH : Proportional Hazards Models ,[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology ,MESH: Male ,MESH : Kidney Neoplasms ,Surgery ,Transplantation ,MESH: France ,Kidney Failure, Chronic ,MESH: Kidney Neoplasms ,business ,Kidney cancer ,MESH: Female ,Kidney disease - Abstract
International audience; BACKGROUND: Patients with end-stage renal disease (ESRD) are at risk of developing renal tumours. OBJECTIVE: Compare clinical, pathologic, and outcome features of renal cell carcinomas (RCCs) in ESRD patients and in patients from the general population. DESIGN, SETTING, AND PARTICIPANTS: Twenty-four French university departments of urology participated in this retrospective study. INTERVENTION: All patients were treated according to current European Association of Urology guidelines. MEASUREMENTS: Age, sex, symptoms, tumour staging and grading, histologic subtype, and outcome were recorded in a unique database. Categoric and continuous variables were compared by using chi-square and student statistical analyses. Cancer-specific survival (CSS) was assessed by Kaplan-Meier and Cox methods. RESULTS AND LIMITATIONS: The study included 1250 RCC patients: 303 with ESRD and 947 from the general population. In the ESRD patients, age at diagnosis was younger (55 ± 12 yr vs 62 ± 12 yr); mean tumour size was smaller (3.7 ± 2.6 cm vs 7.3 ± 3.8 cm); asymptomatic (87% vs 44%), low-grade (68% vs 42%), and papillary tumours were more frequent (37% vs 7%); and poor performance status (PS; 24% vs 37%) and advanced T categories (≥ 3) were more rare (10% vs 42%). Consistently, nodal invasion (3% vs 12%) and distant metastases (2% vs 15%) occurred less frequently in ESRD patients. After a median follow-up of 33 mo (range: 1-299 mo), 13 ESRD patients (4.3%), and 261 general population patients (27.6%) had died from cancer. In univariate analysis, histologic subtype, symptoms at diagnosis, poor PS, advanced TNM stage, high Fuhrman grade, large tumour size, and non-ESRD diagnosis context were adverse predictors for survival. However, only PS, TNM stage, and Fuhrman grade remained independent CSS predictors in multivariate analysis. The limitation of this study is related to the retrospective design. CONCLUSIONS: RCC arising in native kidneys of ESRD patients seems to exhibit many favourable clinical, pathologic, and outcome features compared with those diagnosed in patients from the general population.
- Published
- 2011
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16. Morbidity of retropubic radical prostatectomy for prostate cancer in renal transplant recipients: multicenter study from Renal Transplantation Committee of French Urological Association
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Jacques Petit, François Kleinclauss, Nicolas Terrier, G. Guichard, Yann Neuzillet, Eric Lechevallier, Xavier Tillou, Comité de transplantation rénale, Association Française d'Urologie, Service d'urologie, andrologie et transplantation rénale, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Hôpital Saint-Jacques, Interactions hôte-greffon-tumeur, ingénierie cellulaire et génique - UFC (UMR INSERM 1098) (RIGHT), Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS BFC)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Service d'urologie et de transplantation rénale, Université de la Méditerranée - Aix-Marseille 2-Assistance Publique - Hôpitaux de Marseille (APHM), Service d'urologie, CHU Amiens-Picardie, Département Urologie, CHU Grenoble, Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])-Université de Franche-Comté (UFC), Saas, Philippe, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Franche-Comté (UFC), and Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC)-Etablissement français du sang [Bourgogne-Franche-Comté] (EFS [Bourgogne-Franche-Comté])
- Subjects
Male ,Nephrology ,medicine.medical_treatment ,030232 urology & nephrology ,MESH: Kidney Transplantation ,0302 clinical medicine ,MESH: Treatment Outcome ,MESH: Urologic Surgical Procedures ,MESH: Aged ,education.field_of_study ,MESH: Middle Aged ,Prostatectomy ,Middle Aged ,3. Good health ,Treatment Outcome ,030220 oncology & carcinogenesis ,Urologic Surgical Procedures ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Kidney Diseases ,France ,medicine.medical_specialty ,[SDV.IMM] Life Sciences [q-bio]/Immunology ,Urology ,Urinary system ,Population ,03 medical and health sciences ,MESH: Prostatectomy ,Internal medicine ,medicine ,Humans ,education ,Aged ,Retrospective Studies ,MESH: Kidney Diseases ,MESH: Humans ,business.industry ,Prostatic Neoplasms ,Retrospective cohort study ,MESH: Retrospective Studies ,medicine.disease ,Kidney Transplantation ,MESH: Urology ,MESH: Male ,Surgery ,Transplantation ,MESH: France ,MESH: Prostatic Neoplasms ,business ,Kidney cancer ,Kidney disease - Abstract
International audience; OBJECTIVES: To evaluate the morbidity and surgical complications of retropubic radical prostatectomy (RRP) in renal transplant recipients (RTRs) and compare these results with the observed morbidity in a control group of nontransplanted patients. METHODS: We conducted a multicenter retrospective study and reviewed the charts and records of 20 RTRs who had undergone RRP for localized prostate cancer at four French renal transplant centers belonging to the Renal Transplantation Committee of the French Urological Association from April 1996 to April 2007. A total of 40 patients who had undergone RRP at the same centers, by the same surgeons, were analyzed as the case-control population. RESULTS: The mean operating time (163 +/- 41 vs 160 +/- 66 minutes), blood loss (516 +/- 279 vs 566 +/- 449 mL), transfusion rate (20% vs 22.5%), and hospital stay (11.9 +/- 5.44 vs 9.45 +/- 2.8 days) were similar in the RTR and case-control populations. No graft loss or graft injury was reported in the RTRs, except for two ureteral injuries that were immediately repaired during RRP. No decrease in the kidney graft function was observed after RRP. The rate of medical complication (deep venous thrombosis, pulmonary embolism, urinary tract infection) was similar in both groups, except for the rate of bacterial systemic infection, which was significantly greater in the RTRs than in the controls (15% vs 2.5%, P = .01). CONCLUSIONS: In our study, RRP was a safe procedure to treat localized prostate cancer in RTRs. RRP resulted in the same morbidity in RTRs as in the case-control population.
- Published
- 2008
- Full Text
- View/download PDF
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