168 results on '"Sophie Caillard"'
Search Results
2. Molecular evolution of the SARS-CoV-2 omicron BA.2 variant in kidney transplant recipients with prolonged viral shedding
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Sophie Caillard, Elodie Laugel, Ilies Benotmane, and Samira Fafi Kremer
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Microbiology (medical) ,Infectious Diseases - Published
- 2023
3. Expert Consensus on the Characteristics of Patients with Epstein–Barr Virus-Positive Post-Transplant Lymphoproliferative Disease (EBV+ PTLD) for Whom Standard-Dose Chemotherapy May be Inappropriate: A Modified Delphi Study
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Sridhar Chaganti, Arie Barlev, Sophie Caillard, Sylvain Choquet, Kate Cwynarski, Anke Friedetzky, Eva González-Barca, Natalia Sadetsky, Stefan Schneeberger, Dhanalakshmi Thirumalai, Pier L. Zinzani, and Ralf U. Trappe
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Pharmacology (medical) ,General Medicine - Published
- 2023
4. Low serum neutralization of Omicron variants a month after AZD7442 prophylaxis initiation
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Xavier de Lamballerie, Guillaume Martin-Blondel, Axelle Dupont, Jacques Izopet, France Mentré, Nassim Kamar, Brigitte Autran, Gilles Paintaud, Sophie Caillard, Amandine le Bourgeois, Christophe Richez, Lionel Couzi, Aliénor Xhaard, Zora Marjanovic, Jerome Avouac, Caroline Jacquet, Denis Anglicheau, Morgane Cheminant, Yazdan Yazdanpanah, Stéphanie N Guyen, Benjamin Terrier, Jacques Eric Gottenberg, Caroline Besson, Sophie Letrou, Sabrina Kali, Denis Angoulvant, Ventzislava Petrov Sanchez, Coralie Tardivon, Gilles Blancho, Vincent Lévy, Unité des Virus Emergents (UVE), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut Toulousain des Maladies Infectieuses et Inflammatoires (Infinity), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre d'investigation Clinique [CHU Bichat] - Épidémiologie clinique (CIC 1425), AP-HP - Hôpital Bichat - Claude Bernard [Paris], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Département d'Epidemiologie, Biostatistique et Recherche Clinique (DEBRC), Laboratoire Virologie [CHU Toulouse], Institut Fédératif de Biologie (IFB), Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)-Pôle Biologie [CHU Toulouse], Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Département de Néphrologie et Transplantation d'organes [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), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service de néphrologie et immunologie clinique [CHRU Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT), CHU Strasbourg, Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Laboratoire d'Hematologie [CHU Nantes], Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Immunology from Concept and Experiments to Translation (ImmunoConcept), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Service de Rhumatologie [CHU Pellegrin], Groupe hospitalier Pellegrin, Centre National de Référence des Maladies Auto-Immunes Systémiques Rares de l'Est et du Sud-Ouest (RESO), CHU Bordeaux [Bordeaux], Hopital Saint-Louis [AP-HP] (AP-HP), CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Cochin (IC UM3 (UMR 8104 / U1016)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Hôpital Cochin [AP-HP], Service d'Hématologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Centre de Référence Déficits Immunitaires Héréditaires (CEREDIH), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP]
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Microbiology (medical) ,Infectious Diseases ,[SDV]Life Sciences [q-bio] - Published
- 2023
5. Isolated kidney transplantation under lumasiran therapy in primary hyperoxaluria type 1: a report of five cases
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Anne-Laure Sellier-Leclerc, Elisabeth Metry, Stéphanie Clave, Peggy Perrin, Cécile Acquaviva-Bourdain, Charlène Levi, Meindert Crop, Sophie Caillard, Bruno Moulin, Jaap Groothoff, Justine Bacchetta, Paediatric Nephrology, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam Reproduction & Development (AR&D), AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, and ARD - Amsterdam Reproduction and Development
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Transplantation ,Nephrology - Published
- 2022
6. Torque teno virus DNA load as a predictive marker of antibody response to a three-dose regimen of COVID-19 mRNA-based vaccine in lung transplant recipients
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Floriane Gallais, Benjamin Renaud-Picard, Morgane Solis, Elodie Laugel, Eric Soulier, Sophie Caillard, Romain Kessler, and Samira Fafi-Kremer
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Torque teno virus ,Pulmonary and Respiratory Medicine ,Vaccines, Synthetic ,Transplantation ,COVID-19 Vaccines ,SARS-CoV-2 ,COVID-19 ,Antibodies, Viral ,Antibodies, Neutralizing ,Transplant Recipients ,Immunoglobulin G ,Antibody Formation ,DNA, Viral ,Humans ,Surgery ,RNA, Messenger ,mRNA Vaccines ,Cardiology and Cardiovascular Medicine ,Lung ,BNT162 Vaccine ,Biomarkers ,Retrospective Studies - Abstract
Previous studies have reported that lung transplant recipients (LTR) develop a poor response to two doses of COVID-19 vaccine, but data regarding the third dose are lacking. We investigated the antibody response after three doses of mRNA vaccine in LTR and its predictive factors.A total of 136 LTR, including 10 LTR previously infected and 126 COVID-19-naive LTR, were followed during and after three doses of mRNA vaccine. We retrospectively measured anti-receptor-binding domain (RBD) IgG response and neutralizing antibodies. In a posthoc analysis, we used a multivariate logistic regression model to assess the association between vaccine response and patient characteristics, including viral DNA load (VL) of the ubiquitous Torque teno virus (TTV) (optimal cut-off set by ROC curve analysis), which reflects the overall immunosuppression.After 3 doses, 47/126 (37.3%) COVID-19-naive LTR had positive anti-RBD IgG (responders) and 14/126 (11.1%) had antibody titers above 264 Binding Antibody Units/mL. None neutralized the omicron variant versus 7 of the 10 previously infected LTR. Nonresponse was associated with TTV VL ≥6.2 logCOVID-19-naive LTR respond poorly to three doses of mRNA vaccine, especially those with high TTV VL. Future studies could further evaluate this biomarker as a guide for vaccine strategies.
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- 2022
7. A gain-of-function variant in the Wiskott-Aldrich syndrome gene is associated with a MYH9-related disease-like syndrome
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David Marx, Arnaud Dupuis, Anita Eckly, Anne Molitor, Jérôme Olagne, Guy Touchard, Sihem Kaaki, Cécile Ory, Anne-Laure Faller, Bénédicte Gérard, Melanie Cotter, Lisa Westerberg, Marton Keszei, Bruno Moulin, Christian Gachet, Sophie Caillard, Seiamak Bahram, and Raphaël Carapito
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Neutropenia ,Myosin Heavy Chains ,Gain of Function Mutation ,Hearing Loss, Sensorineural ,Mutation ,Humans ,Renal Insufficiency ,Hematology ,Thrombocytopenia ,Actins ,Wiskott-Aldrich Syndrome Protein ,Wiskott-Aldrich Syndrome - Abstract
While loss-of-function variants in the WAS gene are associated with Wiskott-Aldrich syndrome and lead to microthrombocytopenia, gain-of-function variants of WAS are associated with X-linked neutropenia (XLN) and the absence of microthrombocytopenia. Only a few XLN families have been reported so far, and their platelet phenotype was not described in detail. To date, no renal involvement was described in XLN. In the present study, we report exome sequencing of individuals from 3 generations of a family with a dominant disease combining neutropenia, macrothrombocytopenia, and renal failure. We identified a heterozygous missense gain-of-function variant in the WAS gene (c.881T>C, p.I294T) that segregates with the disease and is already known to cause XLN. There was no pathogenic variant in MYH9, TUBB1, or ACTN1. This is the first report of a WAS gain-of-function variant associated with both the hematological phenotype of XLN (neutropenia, macrothrombocytopenia) and renal disease (proteinuria, renal failure) with glomerular tip lesion hyalinosis and actin condensations in effaced podocytes foot processes.
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- 2022
8. Evolution of humoral lesions on follow-up biopsy stratifies the risk for renal graft loss after antibody-mediated rejection treatment
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Antonin Bouchet, Brieuc Muller, Jerome Olagne, Thomas Barba, Mélanie Joly, Augustin Obrecht, Maud Rabeyrin, Frédérique Dijoud, Cécile Picard, Sarah Mezaache, Antoine Sicard, Alice Koenig, Anne Parissiadis, Valérie Dubois, Emmanuel Morelon, Sophie Caillard, and Olivier Thaunat
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Graft Rejection ,Transplantation ,Isoantibodies ,Nephrology ,Biopsy ,Graft Survival ,Humans ,Kidney Transplantation ,Antibodies ,Retrospective Studies ,Follow-Up Studies - Abstract
Background The standard-of-care protocol, based on plasma exchanges, high-dose intravenous immunoglobulin and optimization of maintenance immunosuppression, can slow down the evolution of antibody-mediated rejection (AMR), but with high interindividual variability. Identification of a reliable predictive tool of the response to AMR treatment is a mandatory step for personalization of the follow-up strategy and to guide second-line therapies. Methods Interrogation of the electronic databases of 2 French university hospitals (Lyon and Strasbourg) retrospectively identified 81 renal transplant recipients diagnosed with AMR without chronic lesions (cg score ≤1) at diagnosis and for whom a follow-up biopsy had been performed 3–6 months after initiation of therapy. Results The evolution of humoral lesions on follow-up biopsy (disappearance versus persistence versus progression) correlated with the risk for allograft loss (logrank test, P = .001). Patients with disappearance of humoral lesions had ∼80% graft survival at 10 years. The hazard ratio for graft loss in multivariate analysis was 3.91 (P = .04) and 5.15 (P = .02) for patients with persistence and progression of lesions, respectively. The non-invasive parameters classically used to follow the intensity of humoral alloimmune response (evolution of immunodominant DSA mean fluorescence intensity) and the decline of renal graft function (estimated glomerular filtration rate decrease and persistent proteinuria) showed little clinical value to predict the histological response to AMR therapy. Conclusion We conclude that invasive monitoring of the evolution of humoral lesions by the mean of follow-up biopsy performed 3–6 months after the initiation of therapy is an interesting tool to predict long-term outcome after AMR treatment.
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- 2022
9. Early Administration of Anti–SARS-CoV-2 Monoclonal Antibodies Prevents Severe COVID-19 in Kidney Transplant Patients
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Juliette Gueguen, Charlotte Colosio, Arnaud Del Bello, Anne Scemla, Yohan N’Guyen, Claire Rouzaud, Claudia Carvalho-Schneider, Gabriela Gautier Vargas, Pierre Tremolières, A. Jalal Eddine, Christophe Masset, Olivier Thaunat, Melchior Chabannes, Paulo Malvezzi, Pierre Pommerolle, Lionel Couzi, Nassim Kamar, Sophie Caillard, and Philippe Gatault
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Nephrology - Abstract
Kidney transplant recipients (KTRs) are prone to develop severe COVID-19 and are less well protected by vaccine than immunocompetent subjects. Thus, the use of neutralizing anti-SARS-CoV-2 monoclonal antibody (MoAb) to confer a passive immunity appears attractive in KTRs.We performed a French nationwide study to compare COVID-19-related hospitalization, 30-day admission to intensive care unit (ICU), and 30-day death between KTRs who received an early infusion of MoAb (MoAb group) and KTRs who did not (control group). Controls were identified from the COVID-SFT registry (NCT04360707) using a propensity score matching with the following covariates: age, sex, delay between transplantation and infection, induction and maintenance immunosuppressive therapy, initial symptoms, and comorbidities.A total of 80 KTRs received MoAb between February 2021 and June 2021. They were matched to 155 controls. COVID-19-related hospitalization, 30-day admission to ICU, and 30-day death were less frequently observed in the MoAb group (35.0% vs. 49.7%,The early use of MoAb in KTRs with a mild form of COVID-19 largely improved outcomes in KTRs.
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- 2022
10. Incidence of cytomegalovirus infection in seropositive kidney transplant recipients treated with everolimus: A randomized, open-label, multicenter phase 4 trial
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Hannah Kaminski, Nassim Kamar, Olivier Thaunat, Nicolas Bouvier, Sophie Caillard, Isabelle Garrigue, Dany Anglicheau, Jean-Philippe Rérolle, Yannick Le Meur, Antoine Durrbach, Thomas Bachelet, Hélène Savel, Roxane Coueron, Jonathan Visentin, Arnaud Del Bello, Isabelle Pellegrin, Julie Déchanet-Merville, Pierre Merville, Rodolphe Thiébaut, Lionel Couzi, Service de Néphrologie Transplantation, Dialyse et Aphérèse [CHU Bordeaux], CHU Bordeaux [Bordeaux], Immunology from Concept and Experiments to Translation (ImmunoConcept), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Département de Néphrologie et Transplantation d'organes [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), Centre de Physiopathologie Toulouse Purpan (CPTP), Université Toulouse III - Paul Sabatier (UT3), Université de Toulouse (UT)-Université de Toulouse (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Department of Nephrology, Transplantation and Clinic Immunology [Hospices civils de Lyon], Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Service de Néphrologie-Dialyse-Transplantation rénale [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 et Transplantation [Strasbourg], Hôpital Civil [Strasbourg], CHU Strasbourg-CHU Strasbourg, Virology Laboratory, Bordeaux University Hospital, Bordeaux, France, Service Néphrologie et transplantation rénale Adultes [CHU Necker], CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Néphrologie, Dialyse, Transplantations [CHU Limoges], CHU Limoges, Lymphocytes B, Autoimmunité et Immunothérapies (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-LabEX IGO Immunothérapie Grand Ouest, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), CHRU Brest - Service de Nephrologie (CHU - BREST - Nephrologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Hôpital Henri Mondor - Service de néphrologie et transplantation, Department of Nephrology, Transplantation and Dialysis, Bordeaux, France, Department of Nephrology, Transplantation and Dialysis, Bordeaux, Service d’information Médicale [CHU de Bordeaux] (Pôle de Santé Publique), Service d'immunologie et d'immunogénétique [Bordeaux], Université Bordeaux Segalen - Bordeaux 2-CHU Bordeaux [Bordeaux], Laboratoire d'immunologie et d'immunogénétique [CHU Bordeaux], Statistics In System biology and Translational Medicine (SISTM), Inria Bordeaux - Sud-Ouest, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)- Bordeaux population health (BPH), and Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Bordeaux (UB)-Institut de Santé Publique, d'Épidémiologie et de Développement (ISPED)-Institut National de la Santé et de la Recherche Médicale (INSERM)
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T cell biology ,Transplantation ,immunosuppressant - mechanistic target of rapamycin: everolimus ,clinical research ,nephrology ,virus diseases ,kidney transplantation ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Immunology and Allergy ,clinical trial ,Pharmacology (medical) ,infection and infectious agents - viral: Cytomegalovirus (CMV) ,practice - Abstract
International audience; Cytomegalovirus (CMV) persists as the most frequent opportunistic infection among solid organ transplant recipients. This multicenter trial aimed to test whether treatment with everolimus (EVR) could decrease the incidence of CMV DNAemia and disease. We randomized 186 CMV seropositive kidney transplant recipients in a 1:1 ratio to receive EVR or mycophenolic acid (MPA) in association with basiliximab, cyclosporin, and steroids and 87 in each group were analyzed. No universal prophylaxis was administered to either group. The composite primary endpoint was the presence of CMV DNAemia, CMV treatment, graft loss, death, and discontinuation of the study at 6 months posttransplant. In the modified intent-to-treat analysis, 42 (48.3%) and 70 (80.5%) patients in the EVR and MPA groups reached the primary endpoint (OR = 0.21, 95% CI: 0.11-0.43, p
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- 2022
11. C3 Glomerulopathy With Concurrent Thrombotic Microangiopathy: Clinical and Immunological Features
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Melchior Chabannes, Marion Rabant, Carine El Sissy, Marie-Agnès Dragon-Durey, Paula Vieira Martins, Marie Sophie Meuleman, Alexandre Karras, David Buob, Frank Bridoux, Eric Daugas, Vincent Audard, Sophie Caillard, Jérôme Olagne, Christine Kandel, Sophie Ferlicot, Carole Philipponnet, Thomas Crepin, Eric Thervet, Didier Ducloux, Véronique Frémeaux-Bacchi, and Sophie Chauvet
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Nephrology - Published
- 2023
12. Post-transplantation Burkitt lymphoma: a retrospective study of 55 patients
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Pierre Walczak, Sylvain Choquet, Jacques Dantal, David Boutboul, Felipe Suarez, Marine Baron, Veronique Morel, Thomas Cluzeau, Mohamed Touati, Michelle Elias, Emmanuel Bachy, Emmanuelle Nicolas-Virelizier, Roch Houot, Geoffroy Venton, Caroline Jacquet, Marie-Pierre Moles-Moreau, Fabrice Jardin, Eric Durot, Noureddine Balegroune, Laure Ecotiere, Romain Guieze, Nassim Kamar, Loic Ysebaert, Lionel Couzi, Hugo Gonzalez, Louise Roulin, Kevin Ou, Sophie Caillard, Heiner Zimmermann, Ralf Ulrich Trappe, and Damien Roos-Weil
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Hematology - Abstract
Not available.
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- 2023
13. Pre-exposure prophylaxis with 300 mg Evusheld elicits limited neutralizing activity against the Omicron variant
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Ilies Benotmane, Aurélie Velay, Gabriela Gautier-Vargas, Jérôme Olagne, Olivier Thaunat, Samira Fafi-Kremer, and Sophie Caillard
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Nephrology ,Humans ,HIV Infections ,Pre-Exposure Prophylaxis ,Antibodies, Viral ,Antibodies, Neutralizing - Published
- 2022
14. Use of tecovirimat for the treatment of mpox infection in a kidney transplant recipient
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Sophie Caillard, Noelle Cognard, Peggy Perrin, and Ilies Benotmane
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Transplantation ,Immunology and Allergy ,Pharmacology (medical) - Published
- 2023
15. High‐flow arteriovenous fistula and hemodynamic consequences at 1 year after kidney transplantation
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Alexandra Monnier, Nicolas Keller, Bernard Geny, Samy Talha, Noëlle Cognard, Bruno Moulin, and Sophie Caillard
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medicine.medical_specialty ,Cardiac output ,business.industry ,Fistula ,Hemodynamics ,Arteriovenous fistula ,medicine.disease ,Kidney Transplantation ,Cohort Studies ,Arteriovenous Shunt, Surgical ,Renal Dialysis ,Nephrology ,Internal medicine ,Arteriovenous Fistula ,medicine ,Cardiology ,Humans ,Prospective Studies ,business ,High flow ,Pathological ,Kidney transplantation ,Cohort study - Abstract
INTRODUCTION There are only scarce data regarding the cardiovascular impact of arteriovenous fistula after kidney transplantation depending on fistula flow. METHODS We performed a single-center, prospective, cohort study including 49 patients with a functional fistula at 1 year from kidney transplantation. Patients were convened for a clinical work-up, a biological analysis, a fistula's Doppler ultrasonography and an echocardiography. Main judgment criterion was comparison of echocardiography parameters between patients with relative (fistula flow >1 L/min and a fistula flow/cardiac output ratio >20%), absolute high-flow fistula (fistula flow >2 L/min) and normal-flow fistula. RESULTS High-flow fistula frequency was 69%. Significantly higher left ventricular end-diastolic and systolic diameters were observed in this group compared with the normal-flow fistula group (53 ± 6 vs. 48 ± 7 mm; p = 0.04 and 33 ± 6 vs. 28 ± 8 mm; p = 0.02) and between the absolute and relative high-flow fistula subgroups (56 ± 6 vs. 51 ± 6 mm; p = 0.009 and 35 ± 6 vs. 31 ± 5 mm; p = 0.01). The study showed no other significant differences. CONCLUSIONS This study showed a significantly higher but not pathological left ventricular end-diastolic and systolic diameters values in patients with high-flow fistula compared with patients with normal-flow fistula and between patients with respectively absolute and relative high-flow fistula.
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- 2021
16. SARS-Cov-2 Seroprevalence in a French Kidney Transplant Center Located Within a 'High-risk' Zone
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Gabriela Gautier Vargas, Vanessa Jegou, Karima Kedjam, Jonas Martzloff, Bruno Moulin, Ilies Benotmane, Céline Meidinger, Audrey Desmarquets, Laura Braun, Lucille Steinmetz, Sophie Caillard, Sandra Ludwiller, Francoise Heibel, Noëlle Cognard, Murielle Morvan, Xavier Bassand, Dominique Schmitt, Danielle Roy, Amandine Bigot, Peggy Perrin, Anne Rihon, Jérôme Olagne, David Marx, and Samira Fafi Kremer
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Transplantation ,medicine.medical_specialty ,SARS-CoV-2 ,Transmission (medicine) ,business.industry ,COVID-19 ,Outbreak ,Seroepidemiologic Studies ,Antibodies, Viral ,medicine.disease ,Kidney Transplantation ,Asymptomatic ,Covid ,Serology ,Internal medicine ,Cohort ,ComputingMethodologies_DOCUMENTANDTEXTPROCESSING ,medicine ,Humans ,Seroprevalence ,France ,medicine.symptom ,business ,Kidney transplantation - Abstract
Supplemental Digital Content is available in the text., Background. Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in kidney transplant recipients (KTRs) remain rare. We sought to shed further light on this issue by conducting a single-center study in a kidney transplant center located in one of the France’s highest risk zone (Grand Est) for coronavirus disease 2019 (Covid-19) during the initial disease outbreak. Methods. To this aim, we used a survey approach coupled with systematic investigation of SARS-CoV-2 serology in a cohort of 1390 KTRs. Results. SARS-CoV-2 serologies were available for 780 survey respondents, among whom 48 had anti-SARS-CoV-2 antibodies (total seroprevalence: 6.2%). Thirty-five of the 48 seropositive KTRs had previously received a diagnosis of Covid-19, whereas the remaining 13 patients were not known to be infected (8 asymptomatic cases). Specifically, 18.7% of seropositive KTRs and 1.1% of the entire cohort were asymptomatic. Household exposure was found to markedly increase the risk of SARS-CoV-2 transmission. Conclusions. Our findings demonstrate that the overall SARS-CoV-2 seroprevalence in KTRs living in one of the France’s highest risk zone for Covid-19 during the first French lockdown was as low as 6.3%. Rapid and strict implementation of protective measures could have significantly mitigated virus spread even in an area of high virus circulation.
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- 2021
17. Rituximab for recurrence of primary focal segmental glomerulosclerosis after kidney transplantation: Results of a nationwide study
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Paolo Malvezzi, Dany Anglicheau, Sophie Caillard, Julien Aniort, Betoul Schvartz, Antoine Thierry, Nicolas Bouvier, Christophe Legendre, Vincent Pernin, Clarisse Greze, Coralie Poulain, Nicolas Maillard, Jean Philippe Rerolle, Camille Lanaret, Nassim Kamar, Didier Ducloux, Arnaud Del Bello, Charlotte Uro‐Coste, Cyril Garrouste, Franck Martinez, Julie Oniszczuk, Dominique Bertrand, Lionel Couzi, Anne Elisabeth Heng, Laurent Mesnard, Céline Lambert, Johnny Sayegh, Vincent Audard, Marie-Pascale Morin, and Mathias Büchler
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Adult ,medicine.medical_specialty ,medicine.medical_treatment ,030230 surgery ,Gastroenterology ,Hypogammaglobulinemia ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,Internal medicine ,medicine ,Humans ,Immunology and Allergy ,Pharmacology (medical) ,Kidney transplantation ,Retrospective Studies ,Transplantation ,Glomerulosclerosis, Focal Segmental ,Primary Focal Segmental Glomerulosclerosis ,business.industry ,medicine.disease ,Kidney Transplantation ,Calcineurin ,Treatment Outcome ,Plasmapheresis ,Rituximab ,Complication ,business ,Kidney disease ,medicine.drug - Abstract
Rituximab (RTX) therapy for primary focal segmental glomerulosclerosis recurrence after kidney transplantation (KT) has been extensively debated. We aimed to assess the benefit of adding RTX to plasmapheresis (PP), corticosteroids, and calcineurin inhibitors (standard of care, SOC). We identified 148 adult patients who received KT in 12/2004-12/2018 at 21 French centers: 109 received SOC (Group 1, G1), and 39 received immediate RTX along with SOC (Group 2, G2). In G1, RTX was introduced after 28 days of SOC in the event of failure (G1a, n = 19) or PP withdrawal (G1b, n = 12). Complete remission (CR) was achieved in 46.6% of patients, and partial remission (PR) was achieved in 33.1%. The 10-year graft survival rates were 64.7% and 17.9% in responders and nonresponders, respectively. Propensity score analysis showed no difference in CR+PR rates between G1 (82.6%) and G2 (71.8%) (p = .08). Following the addition of RTX (G1a), 26.3% of patients had CR, and 31.6% had PR. The incidence of severe infections was similar between patients treated with and without RTX. In multivariable analysis, infection episodes were associated with hypogammaglobulinemia
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- 2021
18. Impact of Covid-19 on kidney transplant and waiting list patients: Lessons from the first wave of the pandemic
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Benoit Barrou, Yannick Le Meur, L. Sebbag, Lionel Couzi, Lisa M. McElroy, Sophie Caillard, Yuval A. Patel, Scott Sanoff, Olivier Thaunat, Mathias Büchler, Gilles Blancho, Jérôme Dumortier, Marc Hazzan, Brian I. Shaw, Dany Anglicheau, Mariya L. Samoylova, Miriam Manook, Eric Epailly, Sacha Mussot, CHU Bordeaux [Bordeaux], Immunology from Concept and Experiments to Translation (ImmunoConcept), Université de Bordeaux (UB)-Centre National de la Recherche Scientifique (CNRS), Université de Bordeaux (UB), Duke University [Durham], CHU Strasbourg, Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques ( IRTOMIT), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Département de Néphrologie [CHU Necker], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Hypertension arterielle pulmonaire physiopathologie et innovation thérapeutique, Centre Chirurgical Marie Lannelongue (CCML)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hôpital Louis Pradel [CHU - HCL], 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), Centre hospitalier universitaire de Nantes (CHU Nantes), Université de Nantes (UN), CHRU Brest - Service de Nephrologie (CHU - BREST - Nephrologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Service de Néphrologie et Transplantation rénale [CHRU-lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), CarMeN, laboratoire, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre chirurgical Marie Lannelongue-Institut National de la Santé et de la Recherche Médicale (INSERM), and Centre National de la Recherche Scientifique (CNRS)-Université de Bordeaux (UB)
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Male ,medicine.medical_specialty ,Waiting Lists ,Patients ,Coronavirus disease 2019 (COVID-19) ,[SDV]Life Sciences [q-bio] ,030232 urology & nephrology ,Kidney ,Kidney transplant ,Article ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Health care ,Pandemic ,Candidates ,medicine ,Humans ,Pandemics ,Kidney transplantation ,Transplantation ,business.industry ,Communication ,Patient Preference ,Middle Aged ,medicine.disease ,Kidney Transplantation ,3. Good health ,[SDV] Life Sciences [q-bio] ,Nephrology ,Waiting list ,Communicable Disease Control ,Emergency medicine ,Female ,France ,Covid-19 ,business ,Attitude to Health - Abstract
International audience; BACKGROUND: The first wave of the Covid-19 pandemic resulted in a drastic reduction in kidney transplantation and a profound change in transplant care in France. It is critical for kidney transplant centers to understand the behaviors, concerns and wishes of transplant recipients and waiting list candidates. METHODS: French kidney patients were contacted to answer an online electronic survey at the end of the lockdown. RESULTS: At the end of the first wave of the pandemic in France (11 May 2020), 2112 kidney transplant recipients and 487 candidates answered the survey. More candidates than recipients left their home during the lockdown, mainly for health care (80.1% vs. 69.4%; P\textless0.001). More candidates than recipients reported being exposed to Covid-19 patients (2.7% vs. 1.2%; P=0.006). Many recipients and even more candidates felt inadequately informed by their transplant center during the pandemic (19.6% vs. 54%; P\textless0.001). Among candidates, 71.1% preferred to undergo transplant as soon as possible, 19.5% preferred to wait until Covid-19 had left their community, and 9.4% were not sure what to do. CONCLUSIONS: During the Covid-19 pandemic in France, the majority of candidates wished to receive a transplant as soon as possible without waiting until Covid-19 had left their community. Communication between kidney transplant centers and patients must be improved to better understand and serve patients' needs.
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- 2021
19. Covid-19 en transplantation rénale, leçons du registre français
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Sophie Caillard, Olivier Thaunat, and Marc Hazzan
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Male ,medicine.medical_specialty ,Waiting Lists ,Coronavirus disease 2019 (COVID-19) ,030232 urology & nephrology ,Mortalité ,Article ,03 medical and health sciences ,0302 clinical medicine ,Facteurs de risqué ,Pronostic ,Humans ,Medicine ,Registries ,Mortality ,Kidney transplantation ,Aged ,Gynecology ,business.industry ,Renal transplantation ,Middle Aged ,Prognosis ,medicine.disease ,Kidney Transplantation ,Transplant Recipients ,Hospitalization ,Risk factors ,Nephrology ,Creatinine ,Transplantation rénale ,Female ,France ,Covid-19 ,business - Abstract
Résumé La pandémie Covid-19 frappe la population de transplantés français dès le 3 mars 2020. Très rapidement, un registre français s’est mis en place sous l’égide de la Société francophone de transplantation permettant de colliger les cas de Covid-19 confirmés survenant chez des patients transplantés de rein dans la quasi-totalité des centres français. L’analyse de ce registre conjointement à celle des données du registre Cristal de l’Agence de la Biomédecine a permis d’aboutir à des premiers résultats instructifs. Nous avons d’abord montré que l’incidence des formes sévères au sein des patients transplantés hospitalisés pour Covid-19 était de 46 % et que leur mortalité était de 22,8 %. Les facteurs de risque de formes sévères et de mortalité sont décrits. Nous avons ensuite montré, en comparant les transplantés à des patients immunocompétents appariés pour les principaux facteurs de gravité de cette maladie, que la mortalité des patients transplantés était plus élevée parmi des transplantés (17,9 % vs 11,4 % ; p
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- 2021
20. Isolated kidney transplantation under lumasiran therapy in primary hyperoxaluria type 1: a report of 5 cases
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Anne-Laure, Sellier-Leclerc, Ella, Metry, Stéphanie, Clave, Peggy, Perrin, Cécile, Acquaviva-Bourdain, Charlène, Levi, Meindert, Crop, Sophie, Caillard, Bruno, Moulin, Jaap, Groothoff, and Justine, Bacchetta
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- 2022
21. Tixagevimab-cilgavimab as an early treatment for COVID-19 in kidney transplant recipients
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Ilies Benotmane, Jérôme Olagne, Gabriela Gautier Vargas, Noëlle Cognard, Francoise Heibel, Laura Braun-Parvez, Nicolas Keller, Jonas Martzloff, Peggy Perrin, Romain Pszczolinski, Bruno Moulin, Samira Fafi-Kremer, and Sophie Caillard
- Abstract
ObjectiveThis single-center retrospective study evaluated the use of tixagevimab-cilgavimab as an early treatment for COVID-19 in kidney transplant recipients (KTRs) during the omicron wave.MethodsKTRs were deemed at high risk for moderate-to-severe COVID-19 in presence of at least one comorbidity (age >60 years, diabetes, obesity, or cardiovascular disease) associated with a weak humoral response (ResultsOf the 61 KTRs at high risk, 26 received tixagevimab-cilgavimab. COVID-19-related hospitalizations (3.8% versus 34%, p=0.006) and oxygen need (3.8% versus 23%, p=0.04) were significantly less frequent in patients who received tixagevimab-cilgavimab. In addition, non-significant trends towards a lower number of ICU admissions (3.8% versus 14.3% p=0.17) and deaths (0 versus 3, p=0.13) were observed after administration of tixagevimab-cilgavimab. Ten of the 73 low-risk KTRs received tixagevimab-cilgavimab, and no significant clinical benefit was observed in this subgroup.ConclusionEarly administration of tixagevimab-cilgavimab may be clinically useful in high-risk KTRs with COVID-19; however, no major benefit was observed for low-risk patients.
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- 2022
22. Persistence of SARS-CoV-2 antibodies in kidney transplant recipients
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Peggy Perrin, Sophie Caillard, Ilies Benotmane, Samira Fafi-Kremer, Marie-José Wendling, Aurélie Velay, and Gabriela Gautier Vargas
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Transplantation ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,biology ,SARS-CoV-2 ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,COVID-19 ,Kidney Transplantation ,Kidney transplant ,Virology ,Transplant Recipients ,Infectious disease (medical specialty) ,biology.protein ,Humans ,Immunology and Allergy ,Medicine ,Pharmacology (medical) ,Antibody ,business ,Immunosuppressive Agents - Published
- 2021
23. Association Between Maintenance Immunosuppressive Regimens and COVID-19 Mortality in Kidney Transplant Recipients
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Alexandre O, Gérard, Susana, Barbosa, Dany, Anglicheau, Lionel, Couzi, Marc, Hazzan, Olivier, Thaunat, Gilles, Blancho, Sophie, Caillard, Antoine, Sicard, and Faouzi, Saliba
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Male ,Transplantation ,Antimetabolites ,TOR Serine-Threonine Kinases ,Calcineurin Inhibitors ,COVID-19 ,Middle Aged ,Mycophenolic Acid ,Kidney Transplantation ,Transplant Recipients ,Abatacept ,Cohort Studies ,Creatinine ,Humans ,Female ,Immunosuppressive Agents - Abstract
Solid organ transplant recipients are at high risk for fatal forms of coronavirus disease 2019 (COVID-19). We conducted a cohort study among kidney transplant (KT) recipients from the French Solid Organ Transplant COVID-19 Registry to investigate the association between maintenance immunosuppressive drugs and 60-d mortality.Data from all KT recipients with COVID-19 included in the French Solid Organ Transplant COVID-19 Registry between February 28, 2020, and December 30, 2020, were retrieved. We evaluated associations between immunosuppressive drugs and death within 60 d using logistic regression, with all baseline characteristics considered to influence outcome or immunosuppressive regimen. The Benjamini-Hochberg correction was used for controlling false positive rate; 40 multiple imputations were performed. Adjusted P value0.05 was considered statistically significant.There were 1451 KT recipients included. Median age was 58 y, and 66.4% were men. Most frequent comorbidities were hypertension (81.9%), diabetes (34.5%), and cardiovascular disease (29.5%). Median time since transplant was 71 mo. Maintenance immunosuppression regimens included calcineurin inhibitors (1295, 89.2%), antimetabolites (1205, 83%), corticosteroids (1094, 75.4%), mammalian target of rapamycin inhibitors (144, 9.9%), and belatacept (58, 4.0%). Among 1451 transplant recipients, 201 (13.9%) died within 60 d. Older age and higher baseline serum creatinine were associated with mortality (odds ratios, 1.09 [1.07-1.11] and 1.01 [1.005-1.009], P0.001). Corticosteroid-free regimens were associated with a significantly lower risk of death (odds ratio, 0.48 [0.31-0.76]; P = 0.011).Corticosteroid-free regimens were associated with a lower risk of death in KT recipients with COVID-19. Long-term exposure to corticosteroids impairs immune functions and may predispose solid organ transplant recipients to severe forms of COVID-19.
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- 2022
24. Aetiology, clinical features, diagnostic studies, and outcomes of community-acquired pneumonia in kidney transplant recipients admitted to hospital: a multicenter retrospective French cohort study
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Benoît Schwartz, Vincent Dupont, Sandra Dury, Aline Carsin-Vu, null Thomas Guillard, Sophie Caillard, Luc Frimat, Stephane Sanchez, Betoul Schvartz, Firouzé Bani-Sadr, null Damien Jolly, null Philippe Rieu, and null Antoine Goury
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Microbiology (medical) ,Infectious Diseases ,General Medicine - Abstract
To assess the aetiology, clinical features, diagnostic studies and outcomes of community-acquired pneumonia (CAP) in a French cohort of hospitalized kidney transplant recipients kidney transplant recipients.We performed a retrospective, multicenter study in kidney transplant recipients admitted to 10 French centers for CAP from January 2016 to December 2018. CAP discharge diagnoses were clinically and radiologically validated. We assessed a descriptive analysis of all confirmed CAP including medical ward and intensive care unit (ICU) admissions.165 CAP episodes in 132 patients were included. Median time from transplantation to admission was 6.4 [IQR, 1.6-12.3] years, with corticosteroid exposure in 112/165 (67.9%) cases. Sputum culture was performed in 47/165 (28.5%) cases including 7/47 (14.9%) positive samples. Bronchoscopy was performed in 87/165 (52.7%) cases with pathogens identified in 39/87 (44.8%) cases. Microbiological studies led to identify a respiratory pathogen in 64/165 (38.8%) CAP episodes including 11/64 (17.2%) polymicrobial cases. Among these 64 episodes, 75 micro-organisms were identified; 46/75 (61.3%) core respiratory pathogens and 29/75 (38.7%) opportunistic or drug-resistant organisms including Pneumocystis jirovecii 9/75 (12%), Pseudomonas aeruginosa 5/75 (6.7%), multidrug-resistant Enterobacteriaceae 4/75 (5.3%) and Aspergillus 4/75 (5.3%). Patients required ICU admission in 26/165 (15.8%) episodes, invasive ventilation in 20/165 (12.1%) cases and 22/165 (13.3%) needed in-hospital dialysis.CAP episodes occurred in KTR with a long history of immunosuppressive drug exposure. Diagnostic studies identified a micro-organism in more than one third of CAP episodes, including drug-resistant and opportunistic pathogens.
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- 2022
25. A rapid decline in the anti-receptor-binding domain of the SARS-CoV-2 spike protein IgG titer in kidney transplant recipients after tixagevimab-cilgavimab administration
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Ilies Benotmane, Aurélie Velay, Gabriela-Gautier Vargas, Jérôme Olagne, Noëlle Cognard, Françoise Heibel, Laura Braun-Parvez, Jonas Martzloff, Peggy Perrin, Romain Pszczolinski, Bruno Moulin, Samira Fafi-Kremer, and Sophie Caillard
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Nephrology ,SARS-CoV-2 ,Immunoglobulin G ,Spike Glycoprotein, Coronavirus ,Humans ,COVID-19 ,Kidney Transplantation - Published
- 2022
26. Breakthrough COVID-19 cases despite prophylaxis with 150 mg of tixagevimab and 150 mg of cilgavimab in kidney transplant recipients
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Ilies Benotmane, Aurélie Velay, Gabriela Gautier-Vargas, Jérôme Olagne, Augustin Obrecht, Noëlle Cognard, Françoise Heibel, Laura Braun-Parvez, Nicolas Keller, Jonas Martzloff, Peggy Perrin, Romain Pszczolinski, Bruno Moulin, Samira Fafi-Kremer, Olivier Thaunat, and Sophie Caillard
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Transplantation ,SARS-CoV-2 ,Immunology and Allergy ,Humans ,COVID-19 ,Pharmacology (medical) ,Sciences du Vivant [q-bio]/Médecine humaine et pathologie ,Antibodies, Viral ,Kidney Transplantation ,Antibodies, Neutralizing - Abstract
The cilgavimab-tixagevimab combination retains a partial in vitro neutralizing activity against the current SARS-CoV-2 variants of concern (omicron BA.1, BA.1.1, and BA.2). Here, we examined whether preexposure prophylaxis with cilgavimab-tixagevimab can effectively protect kidney transplant recipients (KTRs) against the omicron variant. Of the 416 KTRs who received intramuscular prophylactic injections of 150 mg tixagevimab and 150 mg cilgavimab, 39 (9.4%) developed COVID-19. With the exception of one case, all patients were symptomatic. Hospitalization and admission to an intensive care unit were required for 14 (35.9%) and three patients (7.7%), respectively. Two KTRs died of COVID-19-related acute respiratory distress syndrome. SARS-CoV-2 sequencing was carried out in 15 cases (BA.1, n = 5; BA.1.1, n = 9; BA.2, n = 1). Viral neutralizing activity of the serum against the BA.1 variant was negative in the 12 tested patients, suggesting that this prophylactic strategy does not provide sufficient protection against this variant of concern. In summary, preexposure prophylaxis with cilgavimab-tixagevimab at the dose of 150 mg of each antibody does not adequately protect KTRs against omicron. Further clarification of the optimal dosing can assist in our understanding of how best to harness its protective potential.
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- 2022
27. Development and Validation of Multivariable Prediction Models of Serological Response to SARS-CoV-2 Vaccination in Kidney Transplant Recipients
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Bilgin Osmanodja, Johannes Stegbauer, Marta Kantauskaite, Lars Christian Rump, Andreas Heinzel, Roman Reindl-Schwaighofer, Rainer Oberbauer, Ilies Benotmane, Sophie Caillard, Christophe Masset, Clarisse Kerleau, Gilles Blancho, Klemens Budde, Fritz Grunow, Michael Mikhailov, Eva Schrezenmeier, Simon Ronicke, Freie Universität Berlin, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Heinrich Heine Universität Düsseldorf = Heinrich Heine University [Düsseldorf], University Hospital Düsseldorf, Medizinische Universität Wien = Medical University of Vienna, CHU Strasbourg, Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Team 4 : Deciphering organ immune regulation in inflammation and transplantation (DORI-t) (U1064 Inserm - CR2TI), Centre de Recherche en Transplantation et Immunologie - Center for Research in Transplantation and Translational Immunology (U1064 Inserm - CR2TI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Nantes Université - pôle Santé, Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Nantes Université - UFR de Médecine et des Techniques Médicales (Nantes Univ - UFR MEDECINE), Nantes Université (Nantes Univ)-Nantes Université (Nantes Univ), Centre hospitalier universitaire de Nantes (CHU Nantes), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Team 3 : Integrative transplantation, HLA, Immunology and genomics of kidney injury (U1064 Inserm - CR2TI), Berlin Institute of Health (BIH), and KERANDEL-DION, Céline
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clinical decision support ,[SDV] Life Sciences [q-bio] ,immunosuppression therapy ,COVID-19 Vaccines ,SARS-CoV-2 ,[SDV]Life Sciences [q-bio] ,Immunology ,Vaccination ,Immunology and Allergy ,Humans ,COVID-19 ,Kidney Transplantation - Abstract
BackgroundRepeated vaccination against SARS-CoV-2 increases serological response in kidney transplant recipients (KTR) with high interindividual variability. No decision support tool exists to predict SARS-CoV-2 vaccination response in KTR.MethodsWe developed, internally and externally validated five different multivariable prediction models of serological response after the third and fourth vaccine dose against SARS-CoV-2 in KTR. Using 27 candidate predictor variables, we applied statistical and machine learning approaches including logistic regression (LR), LASSO-regularized LR, random forest, and gradient boosted regression trees. For development and internal validation, data from 585 vaccinations were used. External validation was performed in four independent, international validation datasets comprising 191, 184, 254, and 323 vaccinations, respectively.FindingsLASSO-regularized LR performed on the whole development dataset yielded a 23- and 11- variable model, respectively. External validation showed AUC-ROC of 0.855, 0.749, 0.828, and 0.787 for the sparser 11-variable model, yielding an overall performance 0.819.InterpretationAn 11-variable LASSO-regularized LR model predicts vaccination response in KTR with good overall accuracy. Implemented as an online tool, it can guide decisions when choosing between different immunization strategies to improve protection against COVID-19 in KTR.
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- 2022
28. Prediction of Vaccine Response and Development of a Personalized Anti-SARS-CoV-2 Vaccination Strategy in Kidney Transplant Recipients: Results from a Large Single-Center Study
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Ilies Benotmane, Gabriela Gautier-Vargas, Noëlle Cognard, Jérôme Olagne, Françoise Heibel, Laura Braun-Parvez, Jonas Martzloff, Peggy Perrin, Romain Pszczolinski, Bruno Moulin, Samira Fafi-Kremer, and Sophie Caillard
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kidney transplant recipients ,COVID-19 ,anti-SARS-CoV-2 mRNA vaccine ,serological response ,prediction ,Medicine (miscellaneous) - Abstract
Kidney transplant recipients (KTRs) displays marked inter-individual variations in magnitude of immune responses to anti-SARS-CoV-2 vaccination. The aim of this large single-center study was to identify the predictive factors for serological response to the mRNA-1273 vaccine in KTRs. We also devised a score to optimize prediction with the goal of implementing a personalized vaccination strategy. The study population consisted of 564 KTRs who received at least two doses of the mRNA-1273 vaccine. Anti-RBD IgG titers were quantified one month after each vaccine dose and until six months thereafter. A third dose vaccine was given when the antibody titer after the second dose was
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- 2022
29. Chronic Hepatitis C Virus Infection After Kidney Transplantation With or Without Direct-Acting Antivirals in a Real-Life Setting: A French Multicenter Experience
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Nicolas Bouvier, Yannick Le Meur, Cyril Garrouste, Dominique Bertrand, Johnny Sayegh, Eloi Chevallier, Matthias Büchler, Sophie Caillard, Joseph Rivalan, Antoine Thierry, Lionel Rostaing, Philippe Gatault, Charlotte Colosio, Jean-Philippe Rerolle, Service de néphrologie, dialyse, aphérèses et transplantation, CHU Grenoble-Université Joseph Fourier - Grenoble 1 (UJF), Centre Hospitalier Universitaire [Grenoble] (CHU), Laboratory of Immunology, CHRU de Tours, Tours, France, Service de néphrologie et hémodialyse [CHU de Strasbourg], CHU Strasbourg, Service de Néphrologie-Dialyse-Transplantation rénale [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), Department of Nephrology, Reims University Hospital, Reims, France, Centre Hospitalier Universitaire de Rennes (CHU Rennes), Département de Néphrologie-Dialyse-Transplantation [CHU Angers], Centre Hospitalier Universitaire d'Angers (CHU Angers), PRES Université Nantes Angers Le Mans (UNAM)-PRES Université Nantes Angers Le Mans (UNAM), Service de Néphrologie [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU)-Université de Rouen Normandie (UNIROUEN), Normandie Université (NU), CHRU Brest - Service de Nephrologie (CHU - BREST - Nephrologie), Centre Hospitalier Régional Universitaire de Brest (CHRU Brest), Lymphocyte B et Auto-immunité (LBAI), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO), Département de Néphrologie [CHU Poitiers], Centre hospitalier universitaire de Poitiers (CHU Poitiers), Service de Néphrologie [Clermont-Ferrand], CHU Clermont-Ferrand-Université d'Auvergne - Clermont-Ferrand I (UdA), Service de néphrologie et immunologie clinique [CHRU Tours] (EA4245 UT), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours, Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service de néphrologie et immunologie clinique [CHRU Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT), and Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble
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Adult ,Male ,Ledipasvir ,medicine.medical_specialty ,Pyrrolidines ,Daclatasvir ,Sustained Virologic Response ,Sofosbuvir ,030232 urology & nephrology ,Antiviral Agents ,Gastroenterology ,Group A ,Virus ,Group B ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Internal medicine ,Humans ,Medicine ,Kidney transplantation ,Retrospective Studies ,Fluorenes ,Transplantation ,business.industry ,Imidazoles ,virus diseases ,Valine ,Hepatitis C, Chronic ,Middle Aged ,medicine.disease ,Kidney Transplantation ,3. Good health ,Treatment Outcome ,chemistry ,[SDV.IMM]Life Sciences [q-bio]/Immunology ,Benzimidazoles ,Female ,030211 gastroenterology & hepatology ,Surgery ,Carbamates ,France ,business ,Viral hepatitis ,medicine.drug - Abstract
Kidney transplant recipients (KTRs) are frequently infected with chronic hepatitis C virus (HCV), which can increase the risk of graft loss. Active HCV infections among KTRs are associated with shorter survival times. The emergence of very efficient interferon-free treatments (direct-acting antivirals [DAAs]) has revolutionized prognoses for chronic viral hepatitis. We performed a multicenter study where HCV (+)/RNA (+) KTRs were followed up and either received DAAs (group A) or not (group B) according to the transplant center. The aim was to assess, in a real-life setting, the impact of DAA therapy and to compare these results with those from HCV RNA (+) KTRs where HCV infection was not treated during the same period.This study included 66 patients from 11 centers: 44 patients (66.7%; group A) received DAAs, whereas 22 patients did not (group B); the 2 groups were comparable according to baseline data. Most patients (88.6%) received sofosbuvir, 50% received ledipasvir, and 34.7% received daclatasvir. The duration of treatments ranged from 8 to 24 weeks.HCV RNA clearance (ie, a sustained virologic response) was observed in 95.4% of treated patients. Eradication of HCV led to a significant decrease in liver enzymes (50% reduction for alanine aminotransferase [P ≤ .001] and 41% for gamma glutamyl transpeptidase [P .001]). Conversely, liver enzymes did not decrease in group B. Death occurred significantly more frequently in nontreated than treated patients (3 in group B vs none in group A, P = .003). Of the 10 treated patients with severe renal impairment before DAA therapy, 6 experienced graft loss.DAAs are very effective at treating chronic HCV and have an excellent tolerance profile.
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- 2020
30. Pre-exposure prophylaxis with Evusheld™ elicits limited neutralizing activity against the omicron variant in kidney transplant patients
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Ilies Benotmane, Aurélie Velay, Olivier Thaunat, Gabriela Gautier Vargas, Jérôme Olagne, Samira Fafi-Kremer, and Sophie Caillard
- Abstract
The combination of cilgavimab-tixagevimab (Evusheld™, Astra Zeneca) became the mainstay for protecting transplant recipients with poor response to vaccination against the omicron variant. Serum neutralizing capacity against SARS-CoV-2 is positively associated with protection against severe forms of Covid-19.Both anti-RBD IgG titers and neutralizing antibody titers against the omicron BA.1 variant were measured in serum samples collected from 63 adult kidney transplant recipients who received prophylactic injections of Evusheld™. Patients who received prophylactic Ronapreve™ (casirivimab-imdevimab, n = 39) and those who were infected with SARS-CoV-2 during the fifth wave of the pandemic (n = 14) served as negative and positive controls, respectively.After a median interval from injection of 29 days (interquartile range 29-33 days), only 9.5% of patients who received Evusheld™ were able to neutralize the omicron variant compared to 71% of patients who were infected with SARS-CoV-2 and 2.6% of those who received Ronapreve™. Interestingly, convalescent patients displayed higher levels of neutralizing antibodies than those who received EvusheldTM (median: 2.3 log IC50, IQR: 1.5-2.7 versus 0.00 log IC50, IQR: 0&[ndash] 0.05; pThese findings suggest that Evusheld™ given at a dose of 300 mg is not sufficient to elicit an anti-RDB titer that confers in vivo neutralizing activity and support recent FDA recommendations, derived from in vitro models, regarding the need to increase the dose of Evusheld™
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- 2022
31. Breakthrough Covid-19 cases despite tixagevimab and cilgavimab (Evusheld™) prophylaxis in kidney transplant recipients
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Ilies Benotmane, Aurélie Velay, Gabriela Gautier Vargas, Jérôme Olagne, Samira Fafi-Kremer, Olivier Thaunat, and Sophie Caillard
- Abstract
While the combination of casirivimab-imdevimab (Ronapreve™ Roche Regeneron) has been shown to confer satisfactory protection against the delta variant kidney transplant recipients (KTRs) with COVID-19, it has limited neutralizing activity against the current variants of concern (Omicron BA.1, BA.1.1 and BA.2). In contrast, cilgavimab-tixagevimab combination (Evusheld™, Astra Zeneca) retains a partial neutralizing activity against omicron in vitro. We examined whether preexposure prophylaxis with Evusheld™ can effectively protect kidney transplant recipients (KTRs) against the Omicron variant.Of the 416 KTRs who received intramuscular prophylactic injections of Evusheld™ (150 mg tixagevimab and 150 mg cilgavimab), 39 (9.4%) developed COVID-19. With the exception of one patient, all KTRs were symptomatic. Hospitalization and admission to an intensive care unit were required for 14 (35.9%) and three patients, respectively. Two KTRs died of COVID-19-related acute respiratory distress syndrome. SARS-CoV-2 sequencing was carried out in 15 cases (BA.1, n = 5; BA.1.1, n = 9; BA.2, n=1). Viral neutralizing activity of the serum against BA.1 variant was negative in the 12 tested patients, suggesting that this prophylaxis strategy provides insufficient protection against this variant of concern.Preexposure prophylaxis with Evusheld™ does not adequately protect KTRs against Omicron. Further clarification of the optimal dosing can assist in our understanding of how best to harness its protective potential.
- Published
- 2022
32. Infection or a third dose of mRNA vaccine elicits neutralizing antibody responses against SARS-CoV-2 in kidney transplant recipients
- Author
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Xavier Charmetant, Maxime Espi, Ilies Benotmane, Véronique Barateau, Francoise Heibel, Fanny Buron, Gabriela Gautier-Vargas, Marion Delafosse, Peggy Perrin, Alice Koenig, Noëlle Cognard, Charlène Levi, Floriane Gallais, Louis Manière, Paola Rossolillo, Eric Soulier, Florian Pierre, Anne Ovize, Emmanuel Morelon, Thierry Defrance, Samira Fafi-Kremer, Sophie Caillard, and Olivier Thaunat
- Subjects
Vaccines, Synthetic ,COVID-19 Vaccines ,SARS-CoV-2 ,COVID-19 ,Humans ,Prospective Studies ,mRNA Vaccines ,General Medicine ,Antibodies, Viral ,Antibodies, Neutralizing ,Kidney Transplantation ,BNT162 Vaccine ,Transplant Recipients - Abstract
Transplant recipients, who receive therapeutic immunosuppression to prevent graft rejection, are characterized by high coronavirus disease 2019 (COVID-19)–related mortality and defective response to vaccines. We observed that previous infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but not the standard two-dose regimen of vaccination, provided protection against symptomatic COVID-19 in kidney transplant recipients. We therefore compared the cellular and humoral immune responses of these two groups of patients. Neutralizing anti–receptor-binding domain (RBD) immunoglobulin G (IgG) antibodies were identified as the primary correlate of protection for transplant recipients. Analysis of virus-specific B and T cell responses suggested that the generation of neutralizing anti-RBD IgG may have depended on cognate T-B cell interactions that took place in germinal center, potentially acting as a limiting checkpoint. High-dose mycophenolate mofetil, an immunosuppressive drug, was associated with fewer antigen-specific B and T follicular helper (TFH) cells after vaccination; this was not observed in patients recently infected with SARS-CoV-2. Last, we observed that, in two independent prospective cohorts, administration of a third dose of SARS-CoV-2 mRNA vaccine restored neutralizing titers of anti-RBD IgG in about 40% of individuals who had not previously responded to two doses of vaccine. Together, these findings suggest that a third dose of SARS-CoV-2 mRNA vaccine improves the RBD-specific responses of transplant patients treated with immunosuppressive drugs.
- Published
- 2022
33. Urinary collagen-derived peptides as sensitive markers for bone resorption and bisphosphonate treatment in kidney transplant patients
- Author
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David Marx, Dany Anglicheau, Sophie Caillard, Bruno Moulin, Audrey Kochman, Harald Mischak, Martin Pejchinowski, Agnieszka Latosinska, Frank Bienaimé, Dominique Prié, Pierre Marquet, Peggy Perrin, Wilfried Gwinner, and Jochen Metzger
- Abstract
Kidney transplant recipients (KTR) are at increased risk of fractures. Total urinary hydroxyproline excretion used to be a marker for bone resorption (BR) but faded into the background when more specific markers like Beta-CrossLaps (CTX) became available. Proteomic studies identified numerous hydroxyproline-containing urinary collagen peptides but their origin remains unknown. We followed the hypothesis that some of the urinary collagen peptides are associated with BR and are markers for pathophysiological changes in bone metabolism of KTR. Clinical and laboratory data including serum levels of CTX in 96 KTR from two French centers (Strasbourg, n=38; Paris-Necker, n=58) were correlated with the signal intensity of urinary peptides identified by capillary electrophoresis (CE) coupled to mass spectrometry (MS) and tandem-MS. The effect of oral bisphosphonates on urinary peptides was studied in an independent group of 11 KTR. Eighty-two urinary peptides were identified to be significantly correlated with serum CTX levels in both cohorts. Statistical association with parameters other than BR markers were not significant. Collagen α-1(I) chain (COL1A1) was the most frequently identified peptide source. COL1A1 peptides associated with BR were significantly more hydroxylated than those showing no association (55.9% versus 45,2%, p2-test). From the 82 urinary peptides correlated to CTX, 17 were significantly associated with bisphosphonate treatment. All of these 17 peptides showed a marked reduction in their excretion levels after 410 ± 344 days of bisphosphonate treatment compared to baseline levels. We studied the cleavage sites of these COL1A1 peptides and observed a signature of Cathepsin K and Matrix Metallopeptidase 9. This study provides strong evidence for the occurrence of collagen peptides in the urine of KTR that are associated with BR and that are sensitive to bisphosphonate treatment. Their assessment might become a valuable tool to monitor bone status in KTR.
- Published
- 2022
34. Low immunization rates among kidney transplant recipients who received 2 doses of the mRNA-1273 SARS-CoV-2 vaccine
- Author
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Ilies Benotmane, Gabriela Gautier-Vargas, Samira Fafi-Kremer, Noëlle Cognard, Jérôme Olagne, Laura Braun-Parvez, Jonas Martzloff, Peggy Perrin, Francoise Heibel, Bruno Moulin, and Sophie Caillard
- Subjects
Immunity, Cellular ,Vaccines ,Messenger RNA ,business.industry ,medicine.medical_treatment ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,medicine.disease ,Kidney Transplantation ,Kidney transplant ,Vaccination ,Immunization ,Nephrology ,Immunity ,Antibody Formation ,Immunology ,medicine ,RNA, Messenger ,Renal replacement therapy ,business ,Letter to the Editor ,Kidney transplantation - Published
- 2021
35. Opportunistic infections after conversion to belatacept in kidney transplantation
- Author
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Isabelle Etienne, Rebecca Sberro, Cyril Garrouste, Ludivine Lebourg, Charlotte Colosio, Mathilde Lemoine, Antoine Thierry, Nicolas Bouvier, Dominique Bertrand, Philippe Gatault, Leonard Golbin, Sophie Caillard, Nathalie Chavarot, Maïté Jauréguy, Anne Grall-Jezequel, Johnny Sayegh, Dominique Guerrot, and Jean-Philippe Rerolle
- Subjects
Graft Rejection ,Male ,medicine.medical_specialty ,030232 urology & nephrology ,Renal function ,Opportunistic Infections ,030230 surgery ,Pneumocystis pneumonia ,Belatacept ,Gastroenterology ,Abatacept ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Humans ,Kidney transplantation ,Retrospective Studies ,Transplantation ,business.industry ,Incidence ,Incidence (epidemiology) ,Graft Survival ,Middle Aged ,medicine.disease ,Kidney Transplantation ,Lymphoproliferative Disorders ,Calcineurin ,Nephrology ,Cohort ,Female ,France ,business ,Immunosuppressive Agents ,Glomerular Filtration Rate ,medicine.drug - Abstract
Background Belatacept (bela) rescue therapy seems to be a valuable option for calcineurin inhibitor chronic toxicity in kidney transplantation. Nevertheless, the risk of infection associated with bela is not well reported. Methods We report the rate of opportunistic infections (OPI) after a switch to bela in a multicentric cohort of 280 kidney transplant patients. Results Forty-two OPI occurred in 34 patients (12.1%), on average 10.8 ± 11.3 months after the switch. With a cumulative exposure of 5128 months of bela treatment, we found an incidence of 0.008 OPI/month of exposure, and 9.8 OPI/100 person-years. The most common OPI was cytomegalovirus (CMV) disease in 18/42 OPI (42.9%) and pneumocystis pneumonia in 12/42 OPI (28.6%). Two patients presented a progressive multifocal leucoencephalopathy and two patients developed a cerebral Epstein–Barr virus-induced post-transplant lymphoproliferative disease. OPI led to death in 9/34 patients (26.5%) and graft failure in 4/34 patients (11.8%). In multivariate analysis, estimated glomerular filtration rate Conclusions The risk of OPI is significant post-conversion to bela and may require additional monitoring and prophylactic therapy, particularly regarding pneumocystis pneumonia and CMV disease. These data need to be confirmed in a larger case–control study.
- Published
- 2020
36. Arterial Embolization of Polycystic Kidneys for Heterotopic Transplantation
- Author
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Benjamin Del Tatto, Ioan Gogeneata, Mickael Ohana, Fabien Thaveau, Sophie Caillard, Nabil Chakfe, Anne Lejay, Yannick Georg, Mitochondrie, stress oxydant et protection musculaire (MSP), Université de Strasbourg (UNISTRA), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Immuno-Rhumatologie Moléculaire, and Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)
- Subjects
Male ,Polycystic Kidney Diseases ,Transplantation, Heterotopic ,Middle Aged ,Polycystic Kidney, Autosomal Dominant ,Nephrectomy ,Embolization, Therapeutic ,Treatment Outcome ,[INFO.INFO-TI]Computer Science [cs]/Image Processing [eess.IV] ,Humans ,Radiology, Nuclear Medicine and imaging ,Surgery ,Female ,Cardiology and Cardiovascular Medicine ,Retrospective Studies - Abstract
Introduction: The purpose of this study was to evaluate the efficacy of polycystic kidney embolization, performed to reduce kidney volume before heterotopic kidney transplantation, as this technique could be an alternative to pretransplant nephrectomy. Materials and Methods: All patients who underwent pretransplant embolization of polycystic kidneys were included in a prospective register from June 2014 to February 2020. All patients underwent computed tomography (CT) scan with volumetric reconstruction (OsiriX, Bernex, Switzerland) before embolization and were then followed up at 3 and 6 months after embolization. Primary outcome was percentage of kidney volume reduction. Secondary outcomes were 30 day mortality and morbidity. Results: Thirty-one embolizations performed on 29 patients (medium age = 55.6; 62.1% male) were included between June 2014 and February 2020. All patients were under dialysis before embolization (9 peritoneal dialysis and 20 hemodialysis). Technical success was observed in 96.8% of cases. Mean procedural time was 65 minutes (range = 35–106 minutes) and mean length of in-hospital stay was 3.8 days (range = 3–6 days). A volume reduction allowing a kidney transplant was obtained for 28 patients (96.5%). The mean volume reduction was 39.9% (range = 6.01–68.2). The main observed complication was postembolization pain in 10 cases (32.2%). One patient needed complementary nephrectomy due to insufficient volume reduction. Twenty-three patients (79.3%) received renal transplant during follow-up with a mean delay of 19.5 month (range = 4–54). Conclusion: Polycystic kidney embolization is an effective and safe minimally invasive technique. It can be proposed as the first-choice technique for kidney transplant recipients as an alternative to pretransplantation nephrectomy.
- Published
- 2022
37. Antibody Response to a Fourth Messenger RNA COVID-19 Vaccine Dose in Kidney Transplant Recipients: A Case Series
- Author
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Sophie Caillard, Olivier Thaunat, Ilies Benotmane, Christophe Masset, and Gilles Blancho
- Subjects
COVID-19 Vaccines ,Observations: Case Reports ,Antibody Formation ,Internal Medicine ,COVID-19 ,Humans ,General Medicine ,RNA, Messenger ,Letters ,Antibodies, Viral ,Kidney Transplantation - Published
- 2022
38. Protocol Biopsies in Patients With Subclinical De Novo Donor-specific Antibodies After Kidney Transplantation: A Multicentric Study
- Author
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Philippe Gatault, Dominique Bertrand, Luca Lanfranco, Arnaud François, Cyril Garrouste, Fabienne Farce, Sophie Caillard, Nicolas Bouvier, Charlotte Laurent, Aliénor Galinier, Dominique Guerrot, Isabelle Etienne, Johnny Sayegh, and Maïté Jauréguy
- Subjects
Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,Biopsy ,030232 urology & nephrology ,Urology ,Renal function ,030230 surgery ,Kidney ,03 medical and health sciences ,0302 clinical medicine ,Clinical Protocols ,HLA Antigens ,Isoantibodies ,Humans ,Transplantation, Homologous ,Medicine ,Kidney transplantation ,Retrospective Studies ,Subclinical infection ,Transplantation ,medicine.diagnostic_test ,business.industry ,Histocompatibility Testing ,Standard treatment ,Graft Survival ,Retrospective cohort study ,Middle Aged ,Allografts ,medicine.disease ,Kidney Transplantation ,3. Good health ,Treatment Outcome ,medicine.anatomical_structure ,Kidney Failure, Chronic ,Female ,business ,Immunosuppressive Agents ,Follow-Up Studies - Abstract
De novo donor-specific antibodies (DSAs) are associated with antibody-mediated rejection (AMR) and allograft loss. Whether monitoring of de novo DSA (dnDSA) paired with systematic kidney biopsy should become routine remains to be established.A retrospective multicentric study (9 French kidney transplant units of the Spiesser group) included patients without graft dysfunction biopsied because of the presence of dnDSA (One Lambda, mean fluorescence intensity [MFI],1000).One hundred twenty-three patients (85 male/38 female; mean age, 49.5 ± 13.1 y old) were biopsied after the detection of a dnDSA, 65.3 months (median) after kidney transplantation. Graft function was stable within 3 months before biopsy (estimated glomerular filtration rate, 55.3 ± 18.9 mL/min/1.73 m). Fifty-one subclinical AMRs (sAMRs) (41.4%) were diagnosed, of which 32 (26%) active and 19 (15.5%) chronic active sAMR. Seventy-two biopsies revealed no AMR (58.5%). Predictive factors associated with the diagnosis of active sAMR were MFI of immunodominant DSA4000, MFI of the sum of DSA6300, age of the recipient45 years old, and the absence of steroids at biopsy. The presence of proteinuria200 mg/g was predictive of chronic active sAMR. The decrease of estimated glomerular filtration rate at 5 years post-biopsy was significantly higher in patients with acute sAMR (-25.2 ± 28.3 mL/min/1.73 m) and graft survival significantly lower.Performing a kidney graft biopsy for the occurrence of dnDSA without renal dysfunction leads to the diagnosis of a sAMR in over 40% of cases. Nevertheless, we did not observe any effect of standard treatment in acute sAMR.
- Published
- 2019
39. Unilateral nephrectomy versus renal arterial embolization and technique survival in peritoneal dialysis patients with autosomal dominant polycystic kidney disease
- Author
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Malick Touam, A. Duval-Sabatier, Fatouma Touré, Celia Lessore de Sainte Foy, Lukshe Kanagaratnam, Mikael Sigogne, Sophie Caillard, Antoine Braconnier, Pascale Halin, Belkacem Issad, Malika Pierre, Karine Moreau, Andréea Petrache, François Vrtovsnik, Clémence Béchade, Luc Frimat, Thierry Lobbedez, François Petitpierre, and Christian Verger
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Autosomal dominant polycystic kidney disease ,Urology ,Nephrectomy ,Peritoneal dialysis ,Renal Artery ,medicine ,Humans ,Embolization ,Retrospective Studies ,Transplantation ,Kidney ,Dialysis adequacy ,business.industry ,Arterial Embolization ,Middle Aged ,Polycystic Kidney, Autosomal Dominant ,Prognosis ,medicine.disease ,Embolization, Therapeutic ,Survival Rate ,medicine.anatomical_structure ,Nephrology ,Female ,business ,Peritoneal Dialysis - Abstract
Background Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic disorder associated with progressive enlargement of the kidneys and liver. ADPKD patients may require renal volume reduction, especially before renal transplantation. The standard treatment is unilateral nephrectomy. However, surgery incurs a risk of blood transfusion and alloimmunization. Furthermore, when patients are treated with peritoneal dialysis (PD), surgery is associated with an increased risk of temporary or definitive switch to haemodialysis (HD). Unilateral renal arterial embolization can be used as an alternative approach to nephrectomy. Methods We performed a multicentre retrospective study to compare the technique of survival of PD after transcatheter renal artery embolization with that of nephrectomy in an ADPKD population. We included ADPKD patients treated with PD submitted to renal volume reduction by either surgery or arterial embolization. Secondary objectives were to compare the frequency and duration of a temporary switch to HD in both groups and the impact of the procedure on PD adequacy parameters. Results More than 700 patient files from 12 centres were screened. Only 37 patients met the inclusion criteria (i.e. treated with PD at the time of renal volume reduction) and were included in the study (21 embolized and 16 nephrectomized). Permanent switch to HD was observed in 6 embolized patients (28.6%) versus 11 nephrectomized patients (68.8%) (P = 0.0001). Renal artery embolization was associated with better technique survival: subdistribution hazard ratio (SHR) 0.29 [95% confidence interval (CI) 0.12–0.75; P = 0.01]. By multivariate analysis, renal volume reduction by embolization and male gender were associated with a decreased risk of switching to HD. After embolization, a decrease in PD adequacy parameters was observed but no embolized patients required temporary HD; the duration of hospitalization was significantly lower [5 days [interquartile range (IQR) 4.0–6.0] in the embolization group versus 8.5 days (IQR 6.0–11.0) in the surgery group. Conclusions Transcatheter renal artery embolization yields better technique survival of PD in ADPKD patients requiring renal volume reduction.
- Published
- 2019
40. Changing of therapeutic trends between the 1st and 2nd wave did not reduce COVID-19 related mortality of renal transplant recipients: a national registry study
- Author
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Valentin Goutaudier, Philippe Gatault, Marc Hazzan, Bastien Berger, Sophie Caillard, and Nassim Kamar
- Abstract
SARS-CoV-2 pandemic evolved in two consecutive waves over 2020 (for France: 1st wave from March 1 to July 31; and 2nd wave from August 1 to December 31). Improvements in the management of COVID-19 led to a reduction of mortality rates in hospitalized patients during the second wave. Whether this progress also benefited to kidney transplant recipients (KTR), a population particularly vulnerable to severe COVID-19, remained unclear.In France, 957 KTR were hospitalized for COVID-19 in 2020 and their data were prospectively collected in the French SOT COVID registry. The presentation, management, and outcomes of the 359 KTR diagnosed during the 1st wave were compared to those of the 598 of the 2nd wave. Baseline comorbidities were largely similar between KTR of the 2 waves. Maintenance immunosuppression was reduced in most patients but withdrawal of antimetabolite (73.7% vs 58.4%, pWe conclude that changing of therapeutic trends during 2020 did not reduce COVID-19 related mortality in KTR. Our data indirectly support the importance of vaccination and monoclonal neutralizing anti-SARS-CoV-2 antibodies to protect KTR from severe COVID-19.
- Published
- 2021
41. COVID-19 and kidney transplantation
- Author
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Sophie Caillard
- Subjects
General Medicine - Abstract
The COVID-19 pandemic affects the transplant recipients since March 2020. Transplant centers quickly organized themselves to optimize the management of the immunocompromised patients and to progress in the knowledge of this new disease. To this end, a French Registry was created, which includes all solid organ transplant patients who have developed a SARS Cov2 infection. Numerous studies have been carried out using these data to describe this new disease in transplant patients, to characterize its clinical and biological risk factors and to define its prognosis. The 60 days-mortality of transplant patients hospitalized for COVID-19 was evaluated at 23% and renal failure plays a major role in the poor prognosis in addition to the classical risk factors described in the general population. The advent of vaccination has been a great relief but transplanted patients have shown a poor vaccine response keeping them at risk of severe disease even after an adapted vaccination scheme. Specific strategies was proposed in this particularly fragile population like increasing vaccine doses or using anti SARS Cov-2 monoclonal antibodies.
- Published
- 2022
42. Combining predictive markers for severe COVID-19: Torquetenovirus DNA load and SARS-CoV-2 RNAemia
- Author
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Morgane Solis, Floriane Gallais, Sabrina Garnier-Kepka, Nicolas Lefebvre, Ilies Benotmane, Pierre-Olivier Ludes, Vincent Castelain, Ferhat Meziani, Sophie Caillard, Olivier Collange, and Samira Fafi-Kremer
- Subjects
Infectious Diseases ,COVID-19 Testing ,SARS-CoV-2 ,Virology ,COVID-19 ,Humans ,RNA, Viral ,DNA ,Antibodies, Viral - Abstract
SARS-CoV-2 is the cause of worldwide COVID-19, which severity has been linked to the immune and inflammatory response. Here, we investigate Torquetenovirus (TTV) DNA load - a marker reflecting the intensity of the overall immune response - as well as SARS-CoV-2 RNAemia and IgM/IgG antibodies in COVID-19-positive patients.Two hundred and fifteen COVID-19-positive patients were enrolled, including 87 severe cases and 128 mild-moderate cases. SARS-CoV-2 RNAemia and IgM/IgG antibodies, as well as TTV DNA loads, were measured on longitudinal plasma samples.The rate of severe cases was higher in patients with low TTV DNA load in plasma considering a threshold of 700 copies/mL. In severe patients, SARS-CoV-2 RNAemia positivity rates were higher than those in mild-moderate cases at any timepoint. When combined, TTV DNA load and SARS-CoV-2 RNAemia allowed to predict the outcome of COVID-19 infection, with a higher risk (HR=12.4) of ICU admission in patients with low TTV DNA load and positive SARS-CoV-2 RNAemia.TTV DNA load and SARS-CoV-2 RNAemia may be effective, non-invasive markers reflecting disease severity and poor outcome that could be conveniently measured in a clinical laboratory setting, as soon as COVID-19 diagnosis is made.
- Published
- 2021
43. Antibody response to a fourth mRNA Covid-19 vaccine boost in weak responder kidney transplant recipients
- Author
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Ilies Benotmane, Sophie Caillard, Olivier Thaunat, Gilles Blancho, and christophe masset
- Subjects
Regimen ,Messenger RNA ,2019-20 coronavirus outbreak ,Antibody response ,Multicenter study ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Immunology ,Medicine ,Solid organ transplantation ,business ,Kidney transplant - Abstract
The US FDA has recently authorized immunocompromised people to receive a third dose of mRNA Covid-19 vaccine following the two-doses regimen to further boost protection. Unfortunately, a non-negligible proportion of people treated with immunosuppressive drugs either do not respond or show only a weak response after a third boost and should, therefore, still be considered at risk of severe Covid-19. As of June 2021, we were granted the opportunity to offer a fourth vaccine dose to French solid organ transplant recipients who still showed a weak antibody response after the third dose. In this multicenter study, we demonstrate that that the protection conferred by a fourth dose is adequate for the majority of kidney transplant recipients.
- Published
- 2021
44. High Predictive Value of the Soluble ZEBRA Antigen (Epstein-Barr Virus Trans-Activator Zta) in Transplant Patients with PTLD
- Author
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Julien Lupo, Anne-Sophie Wielandts, Marlyse Buisson, CRYOSTEM Consortium, Mohammed Habib, Marwan Hamoudi, Patrice Morand, Frans Verduyn-Lunel, Sophie Caillard, and Emmanuel Drouet
- Subjects
Microbiology (medical) ,Epstein-Barr Virus ,ZEBRA protein ,BZLF1 ,PTLD ,post-transplant lymphoproliferative disease ,predictive biomarker ,Infectious Diseases ,General Immunology and Microbiology ,Immunology and Allergy ,Molecular Biology - Abstract
The ZEBRA (Z EBV replication activator) protein is the major transcription factor of EBV, expressed upon EBV lytic cycle activation. An increasing body of studies have highlighted the critical role of EBV lytic infection as a risk factor for lymphoproliferative disorders, such as post-transplant lymphoproliferative disease (PTLD). We studied 108 transplanted patients (17 PTLD and 91 controls), retrospectively selected from different hospitals in France and in the Netherlands. The majority of PTLD were EBV-positive diffuse large B-cell lymphomas, five patients experienced atypical PTLD forms (EBV-negative lymphomas, Hodgkin’s lymphomas, and T-cell lymphomas). Fourteen patients among the seventeen who developed a pathologically confirmed PTLD were sZEBRA positive (soluble ZEBRA, plasma level above 20 ng/mL, measured by an ELISA test). The specificity and positive predictive value (PPV) of the sZEBRA detection in plasma were 98% and 85%, respectively. Considering a positivity threshold of 20 ng/mL, the sensitivity of the sZEBRA was 82.35% and the specificity was 94.51%. The mean of the sZEBRA values in the PTLD cases were significantly higher than in the controls (p < 0.0001). The relevance of the lytic cycle and, particularly, the role of ZEBRA in lymphomagenesis is a new paradigm pertaining to the prevention and treatment strategies for PTLD. Given the high-specificity and the predictive values of this test, it now appears relevant to investigate the lytic EBV infection in transplanted patients as a prognostic biomarker.
- Published
- 2022
45. A fourth SARS-CoV-2 mRNA vaccine in strictly seronegative kidney transplant recipients
- Author
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Christophe Masset, Ilies Benotmane, Jacques Dantal, Claire Garandeau, Gabriella Gauthier-Vargas, Diego Cantarovich, Aurélie Meurette, Magali Giral, Sophie Caillard, and Gilles Blancho
- Subjects
Vaccines, Synthetic ,COVID-19 Vaccines ,SARS-CoV-2 ,Nephrology ,COVID-19 ,Humans ,mRNA Vaccines ,Kidney Transplantation ,Transplant Recipients - Published
- 2022
46. Antibody Response After a Third Dose of the mRNA-1273 SARS-CoV-2 Vaccine in Kidney Transplant Recipients With Minimal Serologic Response to 2 Doses
- Author
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Jérôme Olagne, Ilies Benotmane, Samira Fafi-Kremer, Noëlle Cognard, Gabriela Gautier, Peggy Perrin, and Sophie Caillard
- Subjects
Messenger RNA ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,General Medicine ,Virology ,Kidney transplant ,Serology ,Antibody response ,Research Letter ,Medicine ,business ,Antibody formation - Abstract
This study examines the antibody responses to a third dose (100 μg) of the mRNA-1273 SARS-CoV-2 vaccine among kidney transplant recipients in France who had not responded to 2 doses of the vaccine.
- Published
- 2021
47. Strong antibody response after a first dose of a SARS-CoV-2 mRNA-based vaccine in kidney transplant recipients with a previous history of COVID-19
- Author
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Aurélie Velay, Noëlle Cognard, Gabriela Gautier-Vargas, Pierre Gantner, Peggy Perrin, Floriane Gallais, Ilies Benotmane, Sophie Caillard, Francoise Heibel, Samira Fafi-Kremer, Jonas Martzloff, Laura Braun-Parvez, Jérôme Olagne, Bruno Moulin, univOAK, Archive ouverte, Immuno-Rhumatologie Moléculaire, Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), CHU Strasbourg, LabEx Transplantex [Strasbourg], Université de Strasbourg (UNISTRA), and Fédération de Médecine Translationnelle de Strasbourg (FMTS)
- Subjects
2019-20 coronavirus outbreak ,COVID-19 Vaccines ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Kidney transplant ,Letter to the Editors ,Immunology and Allergy ,Medicine ,Humans ,Pharmacology (medical) ,RNA, Messenger ,Letter to the Editor ,Transplantation ,Messenger RNA ,[SDV.MHEP] Life Sciences [q-bio]/Human health and pathology ,business.industry ,SARS-CoV-2 ,COVID-19 ,Kidney Transplantation ,Transplant Recipients ,Past history ,Antibody response ,Immunization ,Immunology ,Antibody Formation ,business ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology - Abstract
A recent study demonstrated that a single dose of a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA-based vaccine is sufficient to mount a robust immunological response in immunocompetent subjects with a previous history of coronavirus disease 2019 (COVID-19).1,2 While research has suggested that immunocompromised kidney transplant recipients (KTRs) who received mRNA-based vaccines show low immunization rates,3-5 the question as to whether this also applies to KTRs with a past history of COVID-19 remains unanswered. The aim of this study was to describe the results of immunization after one dose of the mRNA-1273 SARS-CoV-2 vaccine in KTRs who were already seropositive at baseline because of previous exposure to SARS-CoV-2.
- Published
- 2021
48. The MHC class I MICA gene is a histocompatibility antigen in kidney transplantation
- Author
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Raphael Carapito, Ismail Aouadi, Martin Verniquet, Meiggie Untrau, Angélique Pichot, Thomas Beaudrey, Xavier Bassand, Sébastien Meyer, Loic Faucher, Juliane Posson, Aurore Morlon, Irina Kotova, Florent Delbos, Alexandre Walencik, Alice Aarnink, Anne Kennel, Caroline Suberbielle, Jean-Luc Taupin, Benedict M. Matern, Eric Spierings, Nicolas Congy-Jolivet, Arnaud Essaydi, Peggy Perrin, Antoine Blancher, Dominique Charron, Nezih Cereb, Myriam Maumy-Bertrand, Frédéric Bertrand, Valérie Garrigue, Vincent Pernin, Laurent Weekers, Maarten Naesens, Nassim Kamar, Christophe Legendre, Denis Glotz, Sophie Caillard, Marc Ladrière, Magali Giral, Dany Anglicheau, Caner Süsal, Seiamak Bahram, Süsal, Caner, Carapito, Raphael, Aouadi, Ismail, Verniquet, Martin, Untrau, Meiggie, Pichot, Angelique, Beaudrey, Thomas, Bassand, Xavier, Meyer, Sebastien, Faucher, Loic, Posson, Juliane, Morlon, Aurore, Kotova, Irina, Delbos, Florent, Walencik, Alexandre, Aarnink, Alice, Kennel, Anne, Suberbielle, Caroline, Taupin, Jean-Luc, Matern, Benedict M., Spierings, Eric, Congy-Jolivet, Nicolas, Essaydi, Arnaud, Perrin, Peggy, Blancher, Antoine, Charron, Dominique, Cereb, Nezih, Maumy-Bertrand, Myriam, Bertrand, Frederic, Garrigue, Valerie, Pernin, Vincent, Weekers, Laurent, Naesens, Maarten, Kamar, Nassim, Legendre, Christophe, Glotz, Denis, Caillard, Sophie, Ladriere, Marc, Giral, Magali, Anglicheau, Dany, Bahram, Seiamak, and School of Medicine
- Subjects
Graft Rejection ,Biochemistry & Molecular Biology ,Science & Technology ,HLA ANTIBODIES ,Biochemistry and molecular biology ,Cell biology ,Medicine ,Graft Survival ,Histocompatibility Antigens Class I ,Cell Biology ,General Medicine ,Research & Experimental Medicine ,Kidney Transplantation ,General Biochemistry, Genetics and Molecular Biology ,Antibodies ,Kidney transplantation ,Alloantibody ,Medicine, Research & Experimental ,REJECTION ,Humans ,Life Sciences & Biomedicine - Abstract
The identity of histocompatibility loci, besides human leukocyte antigen (HLA), remains elusive. The major histocompatibility complex (MHC) class I MICA gene is a candidate histocompatibility locus. Here, we investigate its role in a French multicenter cohort of 1,356 kidney transplants. MICA mismatches were associated with decreased graft survival (hazard ratio (HR), 2.12; 95% confidence interval (CI): 1.45-3.11; P < 0.001). Both before and after transplantation anti-MICA donor-specific antibodies (DSA) were strongly associated with increased antibody-mediated rejection (ABMR) (HR, 3.79; 95% CI: 1.94-7.39; P < 0.001; HR, 9.92; 95% CI: 7.43-13.20; P < 0.001, respectively). This effect was synergetic with that of anti-HLA DSA before and after transplantation (HR, 25.68; 95% CI: 3.31-199.41; P = 0.002; HR, 82.67; 95% CI: 33.67-202.97; P < 0.001, respectively). De novo-developed anti-MICA DSA were the most harmful because they were also associated with reduced graft survival (HR, 1.29; 95% CI: 1.05-1.58; P = 0.014). Finally, the damaging effect of anti-MICA DSA on graft survival was confirmed in an independent cohort of 168 patients with ABMR (HR, 1.71; 95% CI: 1.02-2.86; P = 0.041). In conclusion, assessment of MICA matching and immunization for the identification of patients at high risk for transplant rejection and loss is warranted., ‘Laboratoire d’Excellence’ (LabEx) TRANSPLANTEX; IdEx Unistra; SFRI-STRAT’US; INSERM; European Union (EU); European Regional Development Fund; INTERREG V Program; France’s National Research Agency (Agence Nationale de Recherche; ANR); Investment for the Future Program (Programme des Investissements d’Avenir; PIA); Strasbourg’s Interdisciplinary Thematic Institute (ITI) for Precision Medicine; TRANSPLANTEX NG; ITI 2021–2028 Program of the University of Strasbourg; CNRS; Institut Universitaire de France (IUF); Fédération Hospitalo-Universitaire (FHU) OMICARE; MSD Avenir ‘Autogen’
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- 2021
49. COVID-19 in a kidney transplant recipient treated with eculizumab for atypical hemolytic uremic syndrome: a case report
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Gabriela Gautier-Vargas, Noëlle Cognard, Ilies Benotmane, Sophie Caillard, and Peggy Perrin
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,SARS-CoV-2 ,business.industry ,COVID-19 ,Eculizumab ,Antibodies, Monoclonal, Humanized ,medicine.disease ,Gastroenterology ,Kidney transplantation ,Kidney transplant recipient ,Nephrology ,Internal medicine ,Case report ,Atypical hemolytic uremic syndrome ,Lessons for the Clinical Nephrologist ,medicine ,Humans ,business ,Atypical Hemolytic Uremic Syndrome ,medicine.drug - Published
- 2021
50. FC 126IMPACT OF POLYCLONAL ANTI-T-LYMPHOCYTE IMMUNOGLOBULINS ON THE RECURRENCE OF IGA NEPHROPATHY AFTER KIDNEY TRANSPLANTATION: THE PIRAT STUDY
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Matthias Büchler, Benoit Barrou, Nicolas Maillard, Christophe Mariat, Moglie Le Quintrec, Pierre Merville, Sophie Caillard, Maryvonne Hourmant, Nassim Kamar, Didier Ducloux, Emmanuel Morelon, Claire Pouteil-Noble, Luc Frimat, and Laetitia Albano
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Transplantation ,biology ,business.industry ,T lymphocyte ,medicine.disease ,Mycophenolic acid ,Tacrolimus ,Nephropathy ,Nephrology ,Polyclonal antibodies ,Immunology ,medicine ,biology.protein ,Antibody ,business ,Kidney transplantation ,medicine.drug - Abstract
Background and Aims IgA Nephropathy (IgAN) often recurs on kidney transplants, accounting for a significant specific kidney failure occurrence after ten years of transplantation vintage. Polyclonal anti-T-lymphocyte antibodies (PATLA) immunosuppressive induction has been shown to be associated with a lower rate of IgAN recurrence compared to basiliximab and no induction in a retrospective study. The aim of the PIRAT study was to compare an induction by PATLA versus basiliximab by the mean of a randomized controlled trial. Method Adults with biopsy-proven primary IgAN as primary cause of end stage of renal disease, first transplantation, panel reactive antibody 300mg/d during 5 years post-transplantation. Protocol biopsy at 5 years was highly recommended. Results A total of 117 patients were finally included in 13 French transplant centers, with 60 patients in the PATLA group and 57 in the basiliximab control group. Both groups were similar (median, PATLA vs. basiliximab, p>0.05 wilcoxon test) in term of sex ratio (4.45 vs 4.57), recipient age (47.9 vs. 47.7 years old), dialysis vintage (26.2 vs. 24.6 months), age at IgAN diagnosis (35.0 vs. 42.2 years old), cold ischemia (780 min vs 682 min), warm ischemia (34 vs. 36.1min), proportion of living donors (33% vs. 25%). The 5-year protocol biopsy was performed on 48% vs. 45% of patients, with overall proportion of patients evaluated by at least one biopsy of 63% vs. 66%. A trend in favor to the protection by PATLA from the occurrence of a clinico-histological recurrence was found (hazard ratio, univariate Cox model 0,35 [0.11-1.1], p=0.082). Biopsy proven histological recurrence was significantly lower after PATLA induction (HR 0.34 [0.16-0.76], p=0.0079). PATLA group experienced more infections (40 vs. 28 p=0.06), a lower number of graft losses (3 vs 9, p=0.07), a lower number of biopsy-proven acute rejections (5 vs 10, p=0.17). Similar rates of cytomegalovirus and BK virus infections were found. Conclusion PATLA for immunosuppressive induction was found protective from the recurrence of IgA deposition during the first 5 years after transplantation, compared to basiliximab. A similar trend, although not significant, was found about the clinico-histological recurrence which was the predefined primary outcome.
- Published
- 2021
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