Search

Your search keyword '"Service d'Urologie et Chirurgie de la Transplantation"' showing total 5 results
Start Over Author "Service d'Urologie et Chirurgie de la Transplantation" Language undetermined
5 results on '"Service d'Urologie et Chirurgie de la Transplantation"'

1. A haptic laparoscopic trainer based on affine velocity analysis: engineering and preliminary results

Author

Benjamin De Witte, Charles Barnouin, Richard Moreau, Arnaud Leleve, Xavier Martin, Christian Collet, Nady El Hoyek, Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM ), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet [Saint-Étienne] (UJM)-Université Savoie Mont Blanc (USMB [Université de Savoie] [Université de Chambéry]), Laboratoire d'InfoRmatique en Image et Systèmes d'information (LIRIS), Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-École Centrale de Lyon (ECL), Université de Lyon-Université Lumière - Lyon 2 (UL2), Ampère, Département Automatique pour l'Ingénierie des Systèmes (AIS), Ampère (AMPERE), École Centrale de Lyon (ECL), Université de Lyon-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE)-École Centrale de Lyon (ECL), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Centre National de la Recherche Scientifique (CNRS)-Institut National de Recherche pour l’Agriculture, l’Alimentation et l’Environnement (INRAE), Université de Lyon, Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot [CHU - HCL], and Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL)

Subjects
Surgeons, lcsh:Surgery, Motor skills, lcsh:RD1-811, Affine velocity, [SPI.AUTO]Engineering Sciences [physics]/Automatic, Engineering, Minimal invasive surgery, Simulator validation, Humans, Assessment metrics, Laparoscopy, Clinical Competence, Simulation Training, Research Article
Abstract

Background: General agreement exists upon the importance of acquiring laparoscopic skills outside the operation room. During the past two decades, simulation-based training and simulators have been more extensively used in surgeons’ training. Nevertheless learning through simulation-based systems is hindered by several flaws. High-fidelity simulators are cost-prohibitive which limits training opportunities. Their use also elicits a high cognitive load. Low-fidelity simulators lack in haptic, direct and summative feedback. Our goal is to develop a new low fidelity simulator integrating effective learning features as a new assessment variable while limiting the associated costs. We also aim at assessing its primary validity. Methods: We engineered a low fidelity simulator for teaching basic laparoscopic skills taking into account psychomotor skills, direct and summative feedback and engineering key features (haptic feedback and complementary assessment variables). Afterward, 77 participants with 4 different surgical skill levels (17 experts; 12 intermediates; 28 inexperienced interns and 20 novices) tested the simulator. We checked the content validity using a 10 point Likert scale. We also assessed the simulator discriminative power by comparing the 4 groups’ performance over two sessions. To do so, we used 3 variables: time, number of errors (collisions) and affine velocity. Results: The content validation mean value score was 7.57/10. The statistical analysis yielded performance discrepancies on the selected variables among the groups (pConclusion: We developed an affordable and validated simulator for testing and learning basic laparoscopic skills. The results exhibit three levels of performance on the selected variables. Experts and intermediates outperformed the inexperienced interns who in turn outperformed the novices. Results show that the embedded evaluation variables are complimentary and provide realistic results. The inclusion of a new variable and, meanwhile, haptic, direct and summative feedback is innovative regarding low-fidelity simulators. Limitations and implementation conditions of the simulator in the surgical curricula are discussed.

Published
2020
Full Text
View/download PDF

2. Anti-Donor HLA Antibody Response After Pancreatic Islet Grafting: Characteristics, Risk Factors, and Impact on Graft Function

Author

Pouliquen, Eric, Baltzinger, P., Lemle, A., Chen, Chien-Chia, Parissiadis, A., Borot, S., Frimat, L., Girerd, S., Berney, T., Lablanche, S., Benhamou, P. Y., Morelon, E., Badet, L., Dubois, V., Kessler, L., Thaunat, Olivier, Network, Gragil, Service de Transplantation, Néphrologie et Immunologie Clinique [Hôpital Edouard Herriot, HCL], Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Lymphocytes B effecteurs et à mémoire – Effector and memory B cells, Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Endocrinologie - Diabète et Maladies Métaboliques, Hôpitaux Universitaires de Strasbourg, Etablissement Français du Sang - Grand Est (EFS - alsace strasbourg), Service de Diabétologie - Endocrinologie [CHRU Besançon], Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Department of Surgery, University of Geneva [Switzerland], Service d'Endocrinologie, Pôle Digidune, CHU Grenoble, Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Etablissement français du sang- Rhône-Alpes [Lyon], Université de Lyon, Fédération de Médecine Translationnelle de Strasbourg (FMTS), Université de Strasbourg (UNISTRA), Service de diabétologie - endocrinologie, Centre Hospitalier Régional Universitaire [Besançon] (CHRU Besançon)-Hôpital Jean Minjoz, CHU Strasbourg, Geneva University Hospital (HUG), Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée [2016-2019] (LBFA [2016-2019]), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Centre Hospitalier Universitaire [Grenoble] (CHU), Service d'urologie [Centre Hospitalier Lyon Sud - HCL], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), EFS de Lyon, Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), and Université de Genève = University of Geneva (UNIGE)

Subjects
Graft Rejection, Male, antibody-mediated (ABMR) [rejection], [SDV]Life Sciences [q-bio], medicine.medical_treatment, Islets of Langerhans Transplantation, 030232 urology & nephrology, 030230 surgery, Postoperative Complications, 0302 clinical medicine, HLA Antigens, Risk Factors, Isoantibodies, Immunology and Allergy, Pharmacology (medical), Longitudinal Studies, ComputingMilieux_MISCELLANEOUS, Sensitization, geography.geographical_feature_category, ddc:617, biology, Graft Survival, Middle Aged, Prognosis, Islet, Tissue Donors, 3. Good health, medicine.anatomical_structure, Immunosuppressive drug, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, [SDV.IMM]Life Sciences [q-bio]/Immunology, Female, Antibody, Type 1, Adult, Human leukocyte antigen, clinical research/practice, 03 medical and health sciences, Diabetes mellitus, Diabetes Mellitus, alloantibody, medicine, Humans, Retrospective Studies, Transplantation, geography, business.industry, islet transplantation, Insulin, medicine.disease, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Transplant Recipients, body regions, rejection: antibody-mediated (ABMR), Immunology, biology.protein, business, Follow-Up Studies
Abstract

International audience; Pancreatic islet grafting restores endogenous insulin production in type 1 diabetic patients, but long-term outcomes remain disappointing as a result of immunological destruction of allogeneic islets. In solid organ transplantation, donor-specific anti-HLA antibodies (DSA) are the first cause of organ failure. This retrospective multicentric study aimed at providing in-depth characterization of DSA response after pancreatic islet grafting, identifying the risk factor for DSA generation and determining the impact of DSA on graft function. Forty-two pancreatic islet graft recipients from the Groupe Rhin-Rhône-Alpes-Genève pour la Greffe d'Ilots de Langerhans consortium were enrolled. Pre- and postgrafting sera were screened for the presence of DSA and their ability to activate complement. Prevalence of DSA was 25% at 3 years postgrafting. The risk of sensitization increased steeply after immunosuppressive drug withdrawal. DSA repertoire diversity correlated with the number of HLA and eplet mismatches. DSA titer was significantly lower from that observed in solid organ transplantation. No detected DSA bound the complement fraction C3d. Finally, in contrast with solid organ transplantation, DSA did not seem to negatively affect pancreatic islet graft survival. This might be due to the low DSA titers, specific features of IgG limiting their ability to activate the complement and/or the lack of allogenic endothelial targets in pancreatic islet grafts.

Published
2017
Full Text
View/download PDF

3. Chronic Rejection in Human Vascularized Composite Allotransplantation (Hand and Face Recipients)

Author

Olivier Thaunat, Sylvie Testelin, Lionel Badet, J. Kanitakis, Jean-Michel Dubernard, Bernard Devauchelle, Emmanuel Morelon, Aram Gazarian, Palmina Petruzzo, Clinique Dermatologique, Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Department of Medical Sciences, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS), Clinique du Parc, Lymphocytes B effecteurs et à mémoire – Effector and memory B cells, Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Transplantation, Néphrologie et Immunologie Clinique [Hôpital Edouard Herriot, HCL], CHU Amiens-Picardie, CHirurgie, IMagerie et REgénération tissulaire de l’extrémité céphalique - Caractérisation morphologique et fonctionnelle - UR UPJV 7516 (CHIMERE), Université de Picardie Jules Verne (UPJV), and Département de chirurgie maxillofaciale et stomatologie [CHU d'Amiens-Picardie]

Subjects
Graft Rejection, Vascularized Composite Allotransplantation, Transplantation, medicine.medical_specialty, Graft acceptance, business.industry, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Immunosuppression, 030230 surgery, medicine.disease, Surgery, 03 medical and health sciences, 0302 clinical medicine, Vascular narrowing, Atrophy, Deep tissue, Chronic Disease, medicine, Humans, 030211 gastroenterology & hepatology, Composite tissue, business, Immune mechanisms
Abstract

International audience; Vascularized composite tissue allografts (VCA) have become a viable option to restore severely damaged parts of the body that cannot be repaired with conventional surgical techniques. Acute rejection develops frequently in the early postgraft period both in human and experimental VCA, but the possibility of human VCA to undergo chronic rejection (CR) remained initially unknown. The experience gained over the years shows that, similar to solid organ transplants (SOT), human VCA can also develop CR. Chronic rejection is clinically mostly apparent on the skin and targets preferentially skin and deep vessels, leading, as in SOT, to graft vasculopathy and often to graft loss. Dermal sclerosis and adnexal atrophy are additional features of CR. The pathogenetic immune mechanisms involved (cell-mediated versus humoral) remain incompletely known. The changes of CR can be detected with skin and deep tissue biopsies. Modern in vivo imaging tools can detect vascular narrowing and have the advantage of being noninvasive. However, the diagnosis and treatment of CR remain challenging, as several important questions remain to be answered: a more accurate definition of CR in VCA is needed to establish criteria allowing an accurate and early diagnosis. The pathogenetic mechanisms of CR need to be better understood to allow more efficacious treatment. Favoring/triggering factors of CR need to be better known so that they can be avoided. As in SOT, there is a need for efficient tolerance-inducing protocols that will favor graft acceptance and (ideally) circumvent the necessity of lifelong immunosuppression.

Published
2016
Full Text
View/download PDF

4. Vascularized composite allotransplantation still remains an emerging field after 17 years

Author

Emmanuel Morelon, Palmina Petruzzo, Lymphocytes B effecteurs et à mémoire – Effector and memory B cells, Centre International de Recherche en Infectiologie - UMR (CIRI), École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), and Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)

Subjects
Transplantation, medicine.medical_specialty, Field (physics), business.industry, 030230 surgery, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, Vascularized Composite Allotransplantation, Surgery, 03 medical and health sciences, 0302 clinical medicine, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Immunology and Allergy, Medicine, [SDV.IMM]Life Sciences [q-bio]/Immunology, 030211 gastroenterology & hepatology, business, ComputingMilieux_MISCELLANEOUS
Abstract

International audience

Published
2015
Full Text
View/download PDF

5. Immunopathology of rejection: do the rules of solid organ apply to vascularized composite allotransplantation?

Author

Lionel Badet, Palmina Petruzzo, Valérie Dubois, Jean Kanitakis, Emmanuel Morelon, Olivier Thaunat, Lymphocytes B effecteurs et à mémoire – Effector and memory B cells, Centre International de Recherche en Infectiologie (CIRI), École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-École normale supérieure de Lyon (ENS de Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Université Jean Monnet - Saint-Étienne (UJM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Service de Transplantation, Néphrologie et Immunologie Clinique [Hôpital Edouard Herriot, HCL], Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Service d'Urologie et Chirurgie de la Transplantation, Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Etablissement français du sang- Rhône-Alpes [Lyon], Département de Dermatologie [CH Lyon-Sud, Pierre-Bénite], Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Department of Medical Sciences, Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome] (UNIROMA), Centre International de Recherche en Infectiologie - UMR (CIRI), Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-École normale supérieure - Lyon (ENS Lyon)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Centre National de la Recherche Scientifique (CNRS), and Università degli Studi di Roma 'La Sapienza' = Sapienza University [Rome]

Subjects
Graft Rejection, medicine.medical_specialty, Allosensitization, T cell, medicine.medical_treatment, T-Lymphocytes, Vascularized Composite Allotransplantation, Organ transplantation, Antibodies, Bone Marrow, Immunopathology, otorhinolaryngologic diseases, medicine, Immunology and Allergy, Animals, Humans, Transplantation, business.industry, Immunosuppression, Organ Transplantation, [SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology, 3. Good health, stomatognathic diseases, medicine.anatomical_structure, [SDV.MP.VIR]Life Sciences [q-bio]/Microbiology and Parasitology/Virology, Immunology, [SDV.IMM]Life Sciences [q-bio]/Immunology, Bone marrow, Solid organ, business
Abstract

International audience; PURPOSE OF REVIEW: As both the number of vascularized composite allotransplants (VCAs) recipients and the duration of their follow-up are limited, immunopathology of VCA rejection remains incompletely understood. VCAs have several immunological peculiarities, which make inaccurate a direct extrapolation of all rules established for solid organs. RECENT FINDINGS: Despite their bone marrow content, VCA do not induce chimerism in recipient and are therefore not spontaneously tolerated. Skin compartment of VCA contains a high density of antigen-presenting cells (APCs), some with self-renewal capacity. Donor APCs are responsible for continuous direct allosensitization of recipient's T cells that explains the high incidence of skin T-cell-mediated rejection and their occurrence beyond 1 year.Regenerative capability of the skin prevents the development of chronic rejection of this compartment as long as immunosuppression is maintained. In contrast, VCA can develop graft arteriosclerosis, which could be because of T cell and/or chronic antibody-mediated rejection (AMR). VCA recipients can indeed develop donor-specific antibodies (DSA). Whether DSA can also trigger acute AMR of VCA remains to be clarified. SUMMARY: A better understanding of the specificities of the immunopathology of VCA rejection should pave the way for the rationalization of immunosuppressive strategies aiming at optimizing long-term outcome.

Published
2015
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results