26 results on '"Broeders, N."'
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2. Complete doe-, beweeg- en beleeftuin voor woonzorgcentrum Crabbehoven
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Broeders, N. and Broeders, N.
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Voor woonzorgcentrum Crabbehoven in Dordrecht was een totaalplan ontworpen voor een doe-, beweeg- en beleeftuin in de buitenruimte, nabij de horeca en de psychogeriatrische afdeling. In het voorjaar van 2020 werd deze buitenruimte compleet opnieuw ingericht door BOERplay. Een jaar later spraken we met Mark Vosselman, directeur bedrijfsondersteuning, om erachter te komen hoe de ervaringen zijn met deze multifunctionele tuin.
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- 2023
3. Bénéfices d’un programme d’éducation thérapeutique du patient insuffisant rénal chronique en termes d’acquisition des connaissances générales et spécifiques
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Ntumba Mulunda, A., primary, Plennevaux, V., additional, Nolf, A., additional, Baudoux, T., additional, Broeders, N., additional, Simon, I., additional, Madhoun, P., additional, Hougardy, J.M., additional, Le Moine, A., additional, and Nortier, J., additional
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- 2020
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4. Cancer de la vessie et transplantation rénale
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El kaddouri, H., primary, Doerfler, A., additional, Broeders, N., additional, Nortier, J., additional, Lemoine, A., additional, Quackels, T., additional, and Roumeguère, T., additional
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- 2019
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5. Implémentation d’un programme d’éducation thérapeutique spécifique à l’IRC co-animé par des patients partenaires
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Nortier, J., primary, Ntumba Mulunda, A., additional, Plennevaux, V., additional, Néron, A., additional, Hougardy, J.M., additional, Broeders, N., additional, Simon, I., additional, Madhoun, P., additional, Le Moine, A., additional, and Godin, I., additional
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- 2019
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6. Intoxications aux aristoloches dans le monde : le point en 2018
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Nortier, J., primary, Baudoux, T., additional, Bunel, V., additional, Jadot, I., additional, Antoine, M., additional, Roumeguere, T., additional, Broeders, N., additional, and Vanherweghem, J.L., additional
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- 2018
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7. High-urgency kidney transplantation in the Eurotransplant Kidney Allocation System: success or waste of organs? The Eurotransplant 15-year all-centre survey
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Assfalg, V., Huser, N., Meel, M. van, Haller, B., Rahmel, A., Boer, J. den, Matevossian, E., Novotny, A., Knops, N., Weekers, L., Friess, H., Pratschke, J., Fugger, R., Janko, O., Rasoul-Rockenschaub, S., Bosmans, J.L., Broeders, N., Peeters, P., Mourad, M., Kuypers, D., Slavicek, J., Muehlfeld, A., Sommer, F., Viebahn, R., Pascher, A., Giet, M. van der, Zantvoort, F., Woitas, R.P., Putz, J., Grabitz, K., Kribben, A., Hauser, I., Pisarski, P., Weimer, R., Lorf, T., Fornara, P., Morath, C., Nashan, B., Lehner, F., Kliem, V., Sester, U., Grimm, M.O., Feldkamp, T., Kleinert, R., Arns, W., Monch, C., Schoenberg, M.B., Nitschke, M., Kruger, B., Thorban, S., Arbogast, H.P., Wolters, H.H., Maier, T., Lutz, J., Heller, K., Banas, B., Hakenberg, O., Kalus, M., Nadalin, S., Keller, F., Lopau, K., Bemelman, F.J., Nurmohamed, S., Sanders, J.S., Fijter, J.W. de, Christiaans, M., Hilbrands, L.B., Betjes, M., Zuilen, A. van, Heemann, U., Assfalg, V., Huser, N., Meel, M. van, Haller, B., Rahmel, A., Boer, J. den, Matevossian, E., Novotny, A., Knops, N., Weekers, L., Friess, H., Pratschke, J., Fugger, R., Janko, O., Rasoul-Rockenschaub, S., Bosmans, J.L., Broeders, N., Peeters, P., Mourad, M., Kuypers, D., Slavicek, J., Muehlfeld, A., Sommer, F., Viebahn, R., Pascher, A., Giet, M. van der, Zantvoort, F., Woitas, R.P., Putz, J., Grabitz, K., Kribben, A., Hauser, I., Pisarski, P., Weimer, R., Lorf, T., Fornara, P., Morath, C., Nashan, B., Lehner, F., Kliem, V., Sester, U., Grimm, M.O., Feldkamp, T., Kleinert, R., Arns, W., Monch, C., Schoenberg, M.B., Nitschke, M., Kruger, B., Thorban, S., Arbogast, H.P., Wolters, H.H., Maier, T., Lutz, J., Heller, K., Banas, B., Hakenberg, O., Kalus, M., Nadalin, S., Keller, F., Lopau, K., Bemelman, F.J., Nurmohamed, S., Sanders, J.S., Fijter, J.W. de, Christiaans, M., Hilbrands, L.B., Betjes, M., Zuilen, A. van, and Heemann, U.
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Item does not contain fulltext, BACKGROUND: In the Eurotransplant Kidney Allocation System (ETKAS), transplant candidates can be considered for high-urgency (HU) status in case of life-threatening inability to undergo renal replacement therapy. Data on the outcomes of HU transplantation are sparse and the benefit is controversial. METHODS: We systematically analysed data from 898 ET HU kidney transplant recipients from 61 transplant centres between 1996 and 2010 and investigated the 5-year patient and graft outcomes and differences between relevant subgroups. RESULTS: Kidney recipients with an HU status were younger (median 43 versus 55 years) and spent less time on the waiting list compared with non-HU recipients (34 versus 54 months). They received grafts with significantly more mismatches (mean 3.79 versus 2.42; P < 0.001) and the percentage of retransplantations was remarkably higher (37.5 versus 16.7%). Patient survival (P = 0.0053) and death with a functioning graft (DwFG; P < 0.0001) after HU transplantation were significantly worse than in non-HU recipients, whereas graft outcome was comparable (P = 0.094). Analysis according to the different HU indications revealed that recipients listed HU because of an imminent lack of access for dialysis had a significantly worse patient survival (P = 0.0053) and DwFG (P = 0.0462) compared with recipients with psychological problems and suicidality because of dialysis. In addition, retransplantation had a negative impact on patient and graft outcome. CONCLUSIONS: Facing organ shortages, increasing wait times and considerable mortality on dialysis, we question the current policy of HU allocation and propose more restrictive criteria with regard to individuals with vascular complications or repeated retransplantations in order to support patients on the non-HU waiting list with a much better long-term prognosis.
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- 2016
8. Genome-wide sequencing identifies genetic relationship between first and late-onset second cancers in aristolochic acid nephropathy patients
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Castells, X., primary, Ardin, M., additional, Rorive, S., additional, Broeders, N., additional, Heguy, A., additional, Bringuier, P.P., additional, Quackels, T., additional, Roumeguere, T., additional, Nortier, J., additional, and Zavadil, J., additional
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- 2016
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9. A New HLA Allocation Procedure of Kidneys From Deceased Donors in the Current Era of Immunosuppression
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Broeders, N., primary, Racapé, J., additional, Hamade, A., additional, Massart, A., additional, Hoang, A.D., additional, Mikhalski, D., additional, Le Moine, A., additional, and Vereerstraeten, P., additional
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- 2015
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10. Patient and graft outcome in current era of immunosuppression: a single centre pilot study
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Goubella, A., Broeders, N., Racapé, J., Hamade, A., Massart, A., Hougardy, J.-M., Hoang, A. D., Mikhalski, D., Baudoux, T., Gankam, F., Madhoun, P., Janssen, F., Moine, A. Le, Nortier, J., and Vereerstraeten, P.
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AbstractObjectives:The present single centre study aims at analyzing the impact on renal allograft outcome of the important changes which occurred in the transplant population and immunosuppressive therapy during the last two decades.Methods:From 2000 to 2013, 779 single kidney transplantations were performed on 635 patients who all received on an intent-to-treat basis steroids, a calcineurin inhibitor, mycophenolate mofetil and an induction therapy with either antithymocyte globulin or an antagonist directed to the interleukin (IL)-2 receptor. Uni- and multivariate analyses of patient and immunologic graft survival were conducted.Results:The sole factor predicting patient survival is recipient’s age: 10-year survival rates are 94·7, 81·6 and 57·9% for the <45, 45–60 and >60 years age groups, respectively (P<0·001). Peak (>50% panel reactive antibodies) anti-human leucocyte antigens (HLA) sensitization, cold ischaemia time and HLA-B and -DR mismatches (MM) influence graft outcome: at 10 years, the difference in 10-year survival rates is 5·9% between grafts from sensitized and not sensitized patients (90·9 vs 96·8%, P = 0·002), 3·8% between grafts with <18 and ≧18 hours cold ischaemia (96·6 vs 92·8%, P = 0·003), 7·3% between grafts with no MM and either B orDR MM versus those with B andDR MM (96·8 vs 89·5%, P = 0·002).Conclusion:In our single centre experience, graft survival was most strongly determined by HLA matching, offering excellent long term graft outcome to most patients.
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- 2015
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11. Long-Term Efficacy and Safety of the Long-Acting Complement C5 Inhibitor Ravulizumab for the Treatment of Atypical Hemolytic Uremic Syndrome in Adults
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Thomas Barbour, Marie Scully, Gema Ariceta, Spero Cataland, Katherine Garlo, Nils Heyne, Yosu Luque, Jan Menne, Yoshitaka Miyakawa, Sung-Soo Yoon, David Kavanagh, Sunil Babu, Nilufer Broeders, Nicole Lietar, Fiona Brown, Philip Campbell, Josep M. Campistol, Paramit Chowdhury, Theo Kasimatis, Lino Cirami, Leonardo Caroti, Guilia Antognoli, Yahsou Delmas, Vladimir Dobronravov, Anja Gaeckler, Cyril Garrouste, Gregory Greenwood, Siân Griffin, Chiu-Ching Huang, I-Ru Chen, Susan Huang, Jin Seok Kim, Gaetano La Manna, Moglie Le Quintrec, Guillaume Jeantet, Iino Fumie, Eric Rondeau, Hermann Haller, Johan Morelle, Eric Goffin, Anja Muhlfeld, Shashi Nagaraj, Gowthami Arepally, Doyeun Oh, Masayoshi Okumi, Manuel Praga Terente, Francois Provot, Ulf Schönermarck, Michael Fischereder, Natalia Ramos Terrada, Barbara Seitz-Polski, Guillaume Favre, Sonia Boyer-Suavet, Maria Vinogradova, Tatiana Kirsanova, Edwin K.S. Wong, Barbour T., Scully M., Ariceta G., Cataland S., Garlo K., Heyne N., Luque Y., Menne J., Miyakawa Y., Yoon S.-S., Kavanagh D., Babu S., Broeders N., Lietar N., Brown F., Campbell P., Campistol J.M., Chowdhury P., Kasimatis T., Cirami L., Caroti L., Antognoli G., Delmas Y., Dobronravov V., Gaeckler A., Garrouste C., Greenwood G., Griffin S., Huang C.-C., Chen I.-R., Huang S., Kim J.S., La Manna G., Le Quintrec M., Jeantet G., Fumie I., Rondeau E., Haller H., Morelle J., Goffin E., Muhlfeld A., Nagaraj S., Arepally G., Oh D., Okumi M., Terente M.P., Provot F., Schonermarck U., Fischereder M., Terrada N.R., Seitz-Polski B., Favre G., Boyer-Suavet S., Vinogradova M., Kirsanova T., Wong E.K.S., Institut Català de la Salut, [Barbour T] Kidney Care, The Royal Melbourne Hospital, Melbourne, Australia. [Scully M] Department of Haematology, University College London Hospitals, London, UK. [Ariceta G] Servei de Nefrologia Pediàtrica, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Cataland S] Division of Hematology, The Ohio State University Medical Center, Columbus, Ohio, USA. [Garlo K] Clinical Development, Alexion Pharmaceuticals, Inc., Boston, Massachusetts, USA. [Heyne N] Section of Nephrology and Hypertension, Tübingen University Hospital, Tübingen, Germany, Vall d'Hebron Barcelona Hospital Campus, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, The Royal Melbourne Hospital, University College London Hospitals (UCLH), Vall d'Hebron University Hospital [Barcelona], Ohio State University [Columbus] (OSU), Universitätsklinikum Tübingen - University Hospital of Tübingen, Eberhard Karls Universität Tübingen = Eberhard Karls University of Tuebingen, Sorbonne Université - Faculté de Médecine (SU FM), Sorbonne Université (SU), Seoul National University Hospital, and Newcastle University [Newcastle]
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medicine.medical_specialty ,Thrombotic microangiopathy ,[SDV]Life Sciences [q-bio] ,Hemic and Lymphatic Diseases::Hematologic Diseases::Anemia::Anemia, Hemolytic::Hemolytic-Uremic Syndrome::Hemic and Lymphatic Diseases::Hematologic Diseases::Atypical Hemolytic Uremic Syndrome [DISEASES] ,030232 urology & nephrology ,Renal function ,Otros calificadores::Otros calificadores::/farmacoterapia [Otros calificadores] ,030204 cardiovascular system & hematology ,Other subheadings::Other subheadings::/drug therapy [Other subheadings] ,03 medical and health sciences ,0302 clinical medicine ,afecciones patológicas, signos y síntomas::procesos patológicos::atributos de la enfermedad::enfermedades raras [ENFERMEDADES] ,Clinical Research ,Internal medicine ,Atypical hemolytic uremic syndrome ,Medicine ,complement ,Adverse effect ,Complement component 5 ,business.industry ,Pathological Conditions, Signs and Symptoms::Pathologic Processes::Disease Attributes::Rare Diseases [DISEASES] ,atypical hemolytic uremic syndrome ,Acute kidney injury ,diagnóstico::pronóstico::resultado del tratamiento [TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS] ,medicine.disease ,Diagnosis::Prognosis::Treatment Outcome [ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT] ,ravulizumab ,Diseases of the genitourinary system. Urology ,3. Good health ,enfermedades hematológicas y linfáticas::enfermedades hematológicas::anemia::anemia hemolítica::síndrome hemolítico-urémico::enfermedades hematológicas y linfáticas::enfermedades hematológicas::síndrome hemolítico urémico atípico [ENFERMEDADES] ,kidney failure ,thrombotic microangiopathy ,Clinical trial ,Nephrology ,Avaluació de resultats (Assistència sanitària) ,hemolytic uremic syndrome ,RC870-923 ,Síndrome hemolíticourèmica - Tractament ,Malalties rares ,business ,Kidney disease - Abstract
Hemolytic uremic syndrome; Kidney failure; Ravulizumab Síndrome hemolítico urémico; Insuficiencia renal; Ravulizumab Síndrome hemolític urèmic; Insuficiència renal; Ravulizumab Introduction Atypical hemolytic uremic syndrome (aHUS) is a rare, complex, multisystem disease of dysregulated complement activity, characterized by progressive thrombotic microangiopathy (TMA), acute kidney injury, and multiorgan dysfunction, which often progresses to chronic kidney disease. Results from the prospective clinical trial of ravulizumab (NCT02949128) reveal rapid resolution of TMA in patients with aHUS, with sustained efficacy and safety in a 26-week initial evaluation period. Methods The aim of this analysis was to characterize the long-term efficacy and the safety profile of ravulizumab in adults with aHUS who had completed the initial evaluation period of the trial. Complete TMA response, hematologic and kidney functions, and safety were evaluated for all patients available for follow-up in the extension period (median follow-up: 76.7 weeks; range: 0.6–118.3). This trial included a total of 58 patients, 49 of whom entered the extension period. Results A total of 4 additional patients achieved complete TMA response during the follow-up period. Normalization of platelet count, serum lactate dehydrogenase (LDH), and hemoglobin observed in the 26-week initial evaluation period was sustained until the last available follow-up, as were the improvements in the estimated glomerular filtration rate (eGFR) and patient quality of life. All efficacy endpoints were correlated with the sustained inhibition of complement C5. Most adverse events (AEs) occurred early during the initial evaluation period and decreased substantially during the extension period. No patient developed a meningococcal infection or died during the extension period. Conclusion This analysis reveals that ravulizumab administered every 8 weeks is efficacious with an acceptable safety profile for the long-term treatment of adults with aHUS and provides additional clinical benefit beyond 6 months of treatment.
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- 2021
12. Corrigendum to 'Rondeau E, Scully M, Ariceta G, Barbour T, Cataland S, Heyne N, Miyakawa Y, Ortiz S, Swenson E, Vallee M, Yoon S-S, Kavanagh D and Haller H; on behalf of the 311 Study Group. The long-acting C5 inhibitor, Ravulizumab, is effective and safe in adult patients with atypical hemolytic uremic syndrome naïve to complement inhibitor treatment.' Kidney Int. 2020;97:1287–1296
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Eric Rondeau, Marie Scully, Gema Ariceta, Tom Barbour, Spero Cataland, Nils Heyne, Yoshitaka Miyakawa, Stephan Ortiz, Eugene Swenson, Marc Vallee, Sung-Soo Yoon, David Kavanagh, Hermann Haller, Sunil Babu, Nilufer Broeders, Nicole Lietar, Fiona Brown, Philip Campbell, Josep M. Campistol, Miquel Blasco, Paramit Chowdhury, Theo Kasimatis, Lino Cirami, Leonardo Caroti, Guilia Antognoli, Yahsou Delmas, Vladimir Dobronravov, Anja Gaeckler, Cyril Garrouste, Gregory Greenwood, Siân Griffin, Chiu-Ching Huang, I-Ru Chen, Susan Huang, Jin Seok Kim, Gaetano La Manna, Giorgia Comai, Maria Cappuccilli, Moglie Le Quintrec, Guillaume Jeantet, Iino Fumie, Yosu Luque, Jan Menne, Johan Morelle, Eric Goffin, Anja Muhlfeld, Shashi Nagaraj, Gowthami Arepally, Doyeun Oh, Masayoshi Okumi, Manuel Praga Terente, Elena Gutierréz, Paola Rodriguez, Francois Provot, Ulf Schönermarck, Michael Fischereder, Natalia Ramos Terrada, Barbara Seitz-Polski, Guillaume Favre, Sonia Boyer-Suavet, Maria Vinogradova, Tatiana Kirsanova, Edwin K.S. Wong, Rondeau E., Scully M., Ariceta G., Barbour T., Cataland S., Heyne N., Miyakawa Y., Ortiz S., Swenson E., Vallee M., Yoon S.-S., Kavanagh D., Haller H., Babu S., Broeders N., Lietar N., Brown F., Campbell P., Campistol J.M., Blasco M., Chowdhury P., Kasimatis T., Cirami L., Caroti L., Antognoli G., Delmas Y., Dobronravov V., Gaeckler A., Garrouste C., Greenwood G., Griffin S., Huang C.-C., Chen I.-R., Huang S., Kim J.S., La Manna G., Comai G., Cappuccilli M., Le Quintrec M., Jeantet G., Fumie I., Luque Y., Menne J., Morelle J., Goffin E., Muhlfeld A., Nagaraj S., Arepally G., Oh D., Okumi M., Terente M.P., Gutierrez E., Rodriguez P., Provot F., Schonermarck U., Fischereder M., Terrada N.R., Seitz-Polski B., Favre G., Boyer-Suavet S., Vinogradova M., Kirsanova T., and Wong E.K.S.
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Kidney ,medicine.medical_specialty ,Adult patients ,business.industry ,INT ,medicine.disease ,Gastroenterology ,Complement inhibitor ,medicine.anatomical_structure ,Long acting ,Nephrology ,Internal medicine ,Atypical hemolytic uremic syndrome ,Medicine ,Ravulizumab, Thrombotic microangiopathy, Pregnancy microangiopathies, Atypical hemolytic uremic syndrome ,business - Abstract
The authors regret that 2 investigators were not included in the 311 Study Group. Members of the 311 Study Group are listed in the Appendix. The authors would like to apologize for any inconvenience caused.
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- 2021
13. Erratum to 'Rondeau E, Scully M, Ariceta G, Barbour T, Cataland S, Heyne N, Miyakawa Y, Ortiz S, Swenson E, Vallee M, Yoon S-S, Kavanagh D, Haller H; on behalf of the 311 Study Group. The long-acting C5 inhibitor, Ravulizumab, is effective and safe in adult patients with atypical hemolytic uremic syndrome naïve to complement inhibitor treatment' Kidney Int. 2020;97:1287–1296
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Eric Rondeau, Marie Scully, Gema Ariceta, Tom Barbour, Spero Cataland, Nils Heyne, Yoshitaka Miyakawa, Stephan Ortiz, Eugene Swenson, Marc Vallee, Sung-Soo Yoon, David Kavanagh, Hermann Haller, Sunil Babu, Nilufer Broeders, Nicole Lietar, Fiona Brown, Philip Campbell, Paramit Chowdhury, Theo Kasimatis, Lino Cirami, Leonardo Caroti, Guilia Antognoli, Yahsou Delmas, Vladimir Dobronravov, Anja Gaeckler, Cyril Garrouste, Gregory Greenwood, Siân Griffin, Chiu-Ching Huang, I-Ru Chen, Susan Huang, Jin Seok Kim, Gaetano La Manna, Giorgia Comai, Maria Cappuccilli, Moglie Le Quintrec, Guillaume Jeantet, Iino Fumie, Yosu Luque, Jan Menne, Johan Morelle, Eric Goffin, Anja Muhlfeld, Shashi Nagaraj, Gowthami Arepally, Doyeun Oh, Masayoshi Okumi, Manuel Praga Terente, Elena Gutierréz, Paola Rodriguez, Francois Provot, Ulf Schönermarck, Michael Fischereder, Natalia Ramos Terrada, Barbara Seitz-Polski, Guillaume Favre, Sonia Boyer-Suavet, Maria Vinogradova, Tatiana Kirsanova, Edwin K.S. Wong, Rondeau E., Scully M., Ariceta G., Barbour T., Cataland S., Heyne N., Miyakawa Y., Ortiz S., Swenson E., Vallee M., Yoon S.-S., Kavanagh D., Haller H., Babu S., Broeders N., Lietar N., Brown F., Campbell P., Chowdhury P., Kasimatis T., Cirami L., Caroti L., Antognoli G., Delmas Y., Dobronravov V., Gaeckler A., Garrouste C., Greenwood G., Griffin S., Huang C.-C., Chen I.-R., Huang S., Kim J.S., La Manna G., Comai G., Cappuccilli M., Le Quintrec M., Jeantet G., Fumie I., Luque Y., Menne J., Morelle J., Goffin E., Muhlfeld A., Nagaraj S., Arepally G., Oh D., Okumi M., Terente M.P., Gutierrez E., Rodriguez P., Provot F., Schonermarck U., Fischereder M., Terrada N.R., Seitz-Polski B., Favre G., Boyer-Suavet S., Vinogradova M., Kirsanova T., and Wong E.K.S.
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N.A ,Nephrology - Abstract
The publisher regrets that the members of the 311 Study Group were not included as collaborative authors. Members of the 311 Study Group are listed in the Appendix. The publisher would like to apologize for any inconvenience caused.
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- 2020
14. 209 - Genome-wide sequencing identifies genetic relationship between first and late-onset second cancers in aristolochic acid nephropathy patients.
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Castells, X., Ardin, M., Rorive, S., Broeders, N., Heguy, A., Bringuier, P.P., Quackels, T., Roumeguere, T., Nortier, J., and Zavadil, J.
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- 2016
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15. 5-Year outcomes of the prospective and randomized CISTCERT study comparing steroid withdrawal to replacement of cyclosporine with everolimus in de novo kidney transplant patients.
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Pipeleers L, Abramowicz D, Broeders N, Lemoine A, Peeters P, Van Laecke S, Weekers LE, Sennesael J, Wissing KM, Geers C, and Bosmans JL
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- Cyclosporine, Graft Rejection prevention & control, Graft Survival, Humans, Immunosuppressive Agents, Mycophenolic Acid, Prospective Studies, Steroids, Everolimus, Kidney Transplantation
- Abstract
Withdrawal of either steroids or calcineurin inhibitors are two strategies to reduce treatment-related side effects and improve long-term outcomes of kidney transplantation. The CISTCERT study compared the efficacy and safety of these two strategies. In this multicenter, randomized controlled trial, 151 incident kidney transplant recipients received cyclosporine (CsA), mycophenolic acid (MPA), and steroids during three months, followed by either steroid withdrawal (CsA/MPA) or replacement of cyclosporine with everolimus (EVL) (EVL/MPA/steroids). 5-year patient survival (89% vs. 86%; P = NS) and death-censored graft survival (95% vs. 96%; P = NS) were comparable in the CsA/MPA and EVL/MPA/steroids arm, respectively.
51 CrEDTA clearance was comparable in the intention-to-treat analysis, but in the on-treatment population, the EVL/MPA/steroids arm exhibited a superior51 CrEDTA clearance at 1 and 5 years after transplantation (61.6 vs. 52.4, P = 0.05 and 59.1 vs. 46.2ml/min/1.73 m2 , P = 0.042). Numerically more and more severe rejections were observed in the EVL/MPA/steroids arm, which also experienced a higher incidence of posttransplant diabetes (26% vs. 6%, P = 0.0016) and infections. No significant differences were observed in cardiovascular outcomes and malignancy. Both regimens provide an excellent long-term patient survival and graft survival. Regarding graft function, EVL/MPA/steroids is an attractive strategy for patients with good tolerability who remain free of rejection. (ClinicalTrials.gov number: NCT00903188; EudraCT Number 2007-005844-26)., (© 2020 Steunstichting ESOT. Published by John Wiley & Sons Ltd.)- Published
- 2021
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16. Sirolimus for Secondary Prevention of Skin Cancer in Kidney Transplant Recipients: 5-Year Results.
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Dantal J, Morelon E, Rostaing L, Goffin E, Brocard A, Tromme I, Broeders N, Del Marmol V, Chatelet V, Dompmartin A, Kessler M, Serra A, Hofbauer GFL, Kamar N, Pouteil-Noble C, Kanitakis J, Roux A, Decullier E, and Euvrard S
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- Calcineurin Inhibitors adverse effects, Carcinoma, Squamous Cell prevention & control, Humans, Kidney Transplantation, Secondary Prevention methods, Skin Neoplasms prevention & control, Transplant Recipients, Carcinoma, Squamous Cell immunology, Immunocompromised Host drug effects, Immunosuppressive Agents therapeutic use, Sirolimus therapeutic use, Skin Neoplasms immunology
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Purpose Transplant recipients who develop cutaneous squamous cell carcinomas are at high risk for multiple subsequent skin cancers. Sirolimus has been shown to reduce the occurrence of secondary skin cancers, but no study included a follow-up exceeding 2 years. We extended at 5 years the TUMORAPA randomized trial of sirolimus-based immunosuppressive regimen versus calcineurin inhibitor-based immunosuppression. Methods Kidney transplant recipients receiving calcineurin inhibitors who had at least one cutaneous squamous cell carcinoma were randomly assigned to receive sirolimus as a substitute for calcineurin inhibitors (n = 64) or to maintain their initial treatment (n = 56). The primary end point was survival free of squamous cell carcinoma at 5 years. Secondary end points included the occurrence of other skin cancers, renal function, patient and graft survival, and treatment tolerance. Results Survival free of cutaneous squamous cell carcinoma was significantly longer in the sirolimus group than in the calcineurin inhibitor group ( P = .007). In the sirolimus group, the number of patients with new skin cancers was significantly lower compared with the calcineurin inhibitor group: 22% versus 59% for squamous cell carcinomas ( P < .001), 34% versus 66% for other skin cancers ( P < .001), and 20% versus 37.5% for basal cell carcinomas ( P < .05). Kidney graft function, patients, and graft survival were similar in both groups. In the sirolimus group, the mean number of serious adverse effects per patient decreased from 1.16 during the first 2 years, to 0.83 between years 2 and 5. Conclusion In kidney transplant recipients with previous cutaneous squamous cell carcinomas, the antitumoral effect of conversion from calcineurin inhibitors to sirolimus was maintained at 5 years, and sirolimus tolerance was satisfactory.
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- 2018
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17. Prospective randomized study of conversion from tacrolimus to cyclosporine A to improve glucose metabolism in patients with posttransplant diabetes mellitus after renal transplantation.
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Wissing KM, Abramowicz D, Weekers L, Budde K, Rath T, Witzke O, Broeders N, Kianda M, and Kuypers DRJ
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- Diabetes Mellitus etiology, Diabetes Mellitus pathology, Female, Follow-Up Studies, Glomerular Filtration Rate, Graft Rejection etiology, Graft Rejection pathology, Graft Survival, Humans, Immunosuppressive Agents therapeutic use, Kidney Function Tests, Male, Middle Aged, Postoperative Complications, Prognosis, Prospective Studies, Risk Factors, Cyclosporine therapeutic use, Diabetes Mellitus drug therapy, Glucose metabolism, Graft Rejection drug therapy, Kidney Failure, Chronic surgery, Kidney Transplantation adverse effects, Tacrolimus therapeutic use
- Abstract
Tacrolimus (TAC) increases the risk of posttransplant diabetes (PTDM) compared with cyclosporine A (CYC). The present 12-month, multicenter, investigator-driven, prospective, randomized study was designed to assess whether conversion from tacrolimus to CYC can reverse PTDM after renal transplantation. Predominantly white patients with PTDM according to the 2005 American Diabetes Association criteria were randomized to either replacement of TAC with CYC or continuation of their TAC-based regimen after stratification for type of glucose-lowering therapy, steroid therapy, and hepatitis C status. At 12 months, 14 of 41 patients with complete data in the CYC arm (34%; 95%CI 19%-49%) were free of diabetes, whereas this was the case in only 4 of 39 patients (10%; 95%CI 3%-20%) in the TAC arm (P = .01). At 12 months, 39% of patients in the CYC arm were off glucose-lowering medication vs 13% of patients in the TAC arm (P = .01). The CYC group decreased glycated hemoglobin level during the 12-month follow-up, resulting in significantly lower levels compared with the TAC group (6.0 ± 0.9% vs 7.1 ± 1.7% at 12 months; P = .002). In conclusion, replacement of TAC with CYC significantly improves glucose metabolism and has the potential to reverse diabetes during the first year after conversion. (EU Clinical Trials Register No. 2006-001765-42)., (© 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.)
- Published
- 2018
- Full Text
- View/download PDF
18. Belgian consensus statement on the diagnosis and management of patients with atypical hemolytic uremic syndrome.
- Author
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Claes KJ, Massart A, Collard L, Weekers L, Goffin E, Pochet JM, Dahan K, Morelle J, Adams B, Broeders N, Stordeur P, Abramowicz D, Bosmans JL, Van Hoeck K, Janssens P, Pipeleers L, Peeters P, Van Laecke S, Levtchenko E, Sprangers B, van den Heuvel L, Godefroid N, and Van de Walle J
- Subjects
- Adult, Antibodies, Monoclonal, Humanized therapeutic use, Belgium, Child, Consensus, Humans, Kidney Transplantation, Nephrology organization & administration, Practice Guidelines as Topic, Atypical Hemolytic Uremic Syndrome diagnosis, Atypical Hemolytic Uremic Syndrome therapy
- Published
- 2018
- Full Text
- View/download PDF
19. Severe myoglobinuric acute kidney injury in a kidney recipient: rapid recovery after hemodialysis with the super high-flux membrane Theralite® .
- Author
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Goubella A, Gankam-Kengne F, Baudoux T, Fagnoul D, Husson C, Delforge ML, Broeders N, and Nortier JL
- Subjects
- Acute Kidney Injury therapy, Humans, Interleukin-6 blood, Male, Middle Aged, Myoglobinuria therapy, Rhabdomyolysis therapy, Acute Kidney Injury etiology, Kidney Transplantation adverse effects, Myoglobinuria etiology, Renal Dialysis methods
- Abstract
Myoglobinuric acute kidney injury (AKI) is a severe condition requiring early therapeutic strategies. Early recognition and treatment are crucial to reduce morbidity and mortality rate. Here, we report a kidney recipient with severe rhabdomyolysis and AKI secondary to parvovirus B19 infection. Initiation of hemodialysis with the super high-flux filter Theralite
® (Gambro, cut-off 45 kDa, 2.1 m2 ) resulted in the clearance of myoglobin from 61 to 71% after 3 hours. Elimination rates of IL-6 and β2-microglobulin were ~ 30 - 64% and 55 - 71% after 3 hours, respectively. Renal graft function rapidly recovered. The place of this effective but expensive procedure still needs to be defined and validated in high-risk patients. .- Published
- 2017
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- View/download PDF
20. Donor Cancer Transmission in Kidney Transplantation.
- Author
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Baudoux TER, Gastaldello K, Rorive S, Hamade A, Broeders N, and Nortier JL
- Published
- 2016
- Full Text
- View/download PDF
21. High-urgency kidney transplantation in the Eurotransplant Kidney Allocation System: success or waste of organs? The Eurotransplant 15-year all-centre survey.
- Author
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Assfalg V, Hüser N, van Meel M, Haller B, Rahmel A, de Boer J, Matevossian E, Novotny A, Knops N, Weekers L, Friess H, Pratschke J, Függer R, Janko O, Rasoul-Rockenschaub S, Bosmans JL, Broeders N, Peeters P, Mourad M, Kuypers D, Slaviček J, Muehlfeld A, Sommer F, Viebahn R, Pascher A, van der Giet M, Zantvoort F, Woitas RP, Putz J, Grabitz K, Kribben A, Hauser I, Pisarski P, Weimer R, Lorf T, Fornara P, Morath C, Nashan B, Lehner F, Kliem V, Sester U, Grimm MO, Feldkamp T, Kleinert R, Arns W, Mönch C, Schoenberg MB, Nitschke M, Krüger B, Thorban S, Arbogast HP, Wolters HH, Maier T, Lutz J, Heller K, Banas B, Hakenberg O, Kalus M, Nadalin S, Keller F, Lopau K, Bemelman FJ, Nurmohamed S, Sanders JS, de Fijter JW, Christiaans M, Hilbrands L, Betjes M, van Zuilen A, and Heemann U
- Subjects
- Adolescent, Adult, Aged, Child, Child, Preschool, Europe epidemiology, Female, Graft Rejection mortality, Graft Survival, Humans, Infant, Infant, Newborn, Male, Middle Aged, Prognosis, Reoperation, Surveys and Questionnaires, Waiting Lists, Young Adult, Donor Selection standards, Graft Rejection epidemiology, Kidney Transplantation mortality, Resource Allocation standards, Tissue and Organ Procurement standards
- Abstract
Background: In the Eurotransplant Kidney Allocation System (ETKAS), transplant candidates can be considered for high-urgency (HU) status in case of life-threatening inability to undergo renal replacement therapy. Data on the outcomes of HU transplantation are sparse and the benefit is controversial., Methods: We systematically analysed data from 898 ET HU kidney transplant recipients from 61 transplant centres between 1996 and 2010 and investigated the 5-year patient and graft outcomes and differences between relevant subgroups., Results: Kidney recipients with an HU status were younger (median 43 versus 55 years) and spent less time on the waiting list compared with non-HU recipients (34 versus 54 months). They received grafts with significantly more mismatches (mean 3.79 versus 2.42; P < 0.001) and the percentage of retransplantations was remarkably higher (37.5 versus 16.7%). Patient survival (P = 0.0053) and death with a functioning graft (DwFG; P < 0.0001) after HU transplantation were significantly worse than in non-HU recipients, whereas graft outcome was comparable (P = 0.094). Analysis according to the different HU indications revealed that recipients listed HU because of an imminent lack of access for dialysis had a significantly worse patient survival (P = 0.0053) and DwFG (P = 0.0462) compared with recipients with psychological problems and suicidality because of dialysis. In addition, retransplantation had a negative impact on patient and graft outcome., Conclusions: Facing organ shortages, increasing wait times and considerable mortality on dialysis, we question the current policy of HU allocation and propose more restrictive criteria with regard to individuals with vascular complications or repeated retransplantations in order to support patients on the non-HU waiting list with a much better long-term prognosis., (© The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)
- Published
- 2016
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22. Therapeutic drug monitoring of enteric-coated mycophenolate sodium by limited sampling strategies is associated with a high rate of failure.
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Hougardy JM, Maufort L, Cotton F, Coussement J, Mikhalski D, Wissing KM, Le Moine A, Broeders N, and Abramowicz D
- Abstract
Background: Therapeutic drug monitoring of mycophenolic acid (MPA) is usually performed with a limited sampling strategy (LSS), which relies on a limited number of blood samples and subsequent extrapolation of the global exposure to MPA. LSS is usually performed successfully with mycophenolate mofetil (MMF), but data on enteric-coated mycophenolate sodium (EC-MPS) are scarce. Here, we evaluated the feasibility of 6-h LSS therapeutic drug monitoring with EC-MPS compared with MMF monitoring among kidney transplant recipients., Methods: Sixty-two patients who received EC-MPS during the first 6 months of transplantation were compared with a matched group of 64 MMF-treated kidney transplant recipients. The area under the curve (AUC) was computed by LSS using multiple concentration time points (0, 1, 2, 3 and 6 h post-dose) and a trapezoidal rule. Patients had MPA therapeutic drug monitoring performed on two occasions, one within 2 weeks and the second after 3-4 months of transplantation., Results: EC-MPS monitoring and MMF therapeutic drug monitoring were not interpretable in 34.5% (n = 40/116) and 1.8% (n = 2/112) of patients, respectively {relative risk [RR] 19.3 [95% confidence interval (CI) 4.8-78.0]; P < 0.0001}. The main cause of abnormal EC-MPS therapeutic drug monitoring was delayed absorption of both the previous evening and the morning dose, resulting in MPA plasma levels before the next morning dose being higher than MPA plasma levels measured at 1, 2 and 3 h after taking EC-MPS. Cyclosporin in association with MMF significantly increased the risk of low AUC values (<30 mg h/L) in comparison with tacrolimus [55% (n = 11/20) and 10% (n = 9/88), respectively; RR 5.4 (95% CI 2.6-11.2); P < 0.0001]., Conclusions: The risk of therapeutic drug monitoring failure with EC-MPS is >30% during the first 6 months of renal transplantation. Delayed pharmacokinetics was the main reason. In contrast, the risk of therapeutic drug monitoring failure was substantially lower with MMF.
- Published
- 2016
- Full Text
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23. Encapsulating Peritoneal Sclerosis In a Kidney Graft Recipient Unmasked by Everolimus Switch.
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Pozdzik AA, Fernandez V, Demetter P, Tooulou M, Matos C, Gammar N, Broeders N, Dratwa M, and Nortier J
- Subjects
- Female, Humans, Peritoneal Fibrosis therapy, Young Adult, Everolimus adverse effects, Glomerulonephritis, Membranoproliferative surgery, Immunosuppressive Agents adverse effects, Kidney Transplantation adverse effects, Peritoneal Fibrosis diagnosis, Peritoneal Fibrosis etiology
- Published
- 2015
- Full Text
- View/download PDF
24. [Anti-NEP and anti-PLA2R antibodies in membranous nephropathy: an update].
- Author
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Pozdzik AA, Debiec H, I Brochériou, Husson C, Rorive S, Broeders N, Le Moine A, Ronco P, and Nortier J
- Subjects
- Adult, Disease Progression, Genetic Predisposition to Disease, Glomerulonephritis, Membranous classification, Glomerulonephritis, Membranous genetics, HLA-DQ alpha-Chains genetics, Humans, Kidney Failure, Chronic etiology, Kidney Failure, Chronic pathology, Autoantibodies adverse effects, Glomerulonephritis, Membranous immunology, Neprilysin immunology, Receptors, Phospholipase A2 immunology
- Abstract
Membranous nephropathy (MN) is the most common cause for nephrotic syndrome in adults and occurs as an idiopathic (primary) or secondary disease. Since the early 2000's, substantial advances have been made in the understanding of the molecular bases of MN. The neutral endopeptidase (NEP) and the receptor for secretory phospholipase A2 (PLA2R) have been identified as target antigens for circulating and deposited antibodies in allo-immune neonatal and adult " idiopathic " MN, respectively. These antibodies recognize specific antigens of podocytes, precipitate as subepithelial immune complexes and activate complement leading to proteinuria. Anti-PLA2R antibodies are of particular clinical importance. Indeed, they are detected in approximately 70% of primary MN in adults, demonstrating that MN actually is an autoimmune condition specific to the kidney. In Europeans, genome-wide studies have shown an association between alleles of PLA2R1 and HLA DQA1 (class II genes of tissue histocompatibility complex) genes and idiopathic MN. Newly developed diagnostic tests detecting circulating anti-PLA2R antibody and PLA2R antigen in glomerular deposits have induced a change in paradigm in the diagnostic approach of idiopathic MN. Measurement of circulating anti-PLA2R antibody is also very useful for the monitoring of MN activity. However, the mechanisms responsible for the formation of anti-PLA2R antibodies as well as those involved in the progression of MN to end-stage renal disease remain to be defined.
- Published
- 2015
25. Bacillus Calmette-Guerin therapy in non-muscle-invasive bladder carcinoma after renal transplantation for end-stage aristolochic acid nephropathy.
- Author
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Roumeguère T, Broeders N, Jayaswal A, Rorive S, Quackels T, Pozdzik A, Arlt VM, Schmeiser HH, and Nortier JL
- Subjects
- Administration, Intravesical, Adult, Aged, Female, Follow-Up Studies, Humans, Kidney Failure, Chronic chemically induced, Middle Aged, Neoplasm Invasiveness, Urinary Bladder Neoplasms pathology, Aristolochic Acids toxicity, BCG Vaccine therapeutic use, Kidney Failure, Chronic surgery, Kidney Transplantation, Urinary Bladder Neoplasms drug therapy
- Abstract
Intravesical instillation of bacillus Calmette-Guerin (BCG) is the treatment of choice for non-muscle-invasive bladder cancer (NMIBC) of high grade and/or carcinoma in situ. This study evaluated the feasibility, efficacy, and tolerance of BCG instillations in eight kidney recipients for end-stage aristolochic acid nephropathy (AAN), a condition at high risk of urothelial carcinoma, and diagnosed for NMIBC. Five of them had relapsed after mitomycin C treatment. Tolerance to BCG was evaluated clinically and regular follow-up with fluorescence cystoscopy was performed along with renal graft function monitoring. Immunosuppression doses were adjusted and prophylactic anti-tuberculous treatment given to reduce risks of graft rejection and infection. After a mean follow-up period of 50 months, seven of the eight patients are free of relapse and kidney graft function remained unchanged. Tolerance was good, except for one episode of fever and one early discontinuation because of subjective discomfort. No systemic tuberculous infection was observed. This is the first clinical observation of successful BCG therapy for NMIBC in patients given transplant for end-stage AAN. Under standardized conditions, immunotherapy based on intravesical BCG is feasible, effective, and well tolerated in renal transplantation., (© 2014 Steunstichting ESOT.)
- Published
- 2015
- Full Text
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26. Delayed Graft Function in Kidney Transplants: Time Evolution, Role of Acute Rejection, Risk Factors, and Impact on Patient and Graft Outcome.
- Author
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Chaumont M, Racapé J, Broeders N, El Mountahi F, Massart A, Baudoux T, Hougardy JM, Mikhalsky D, Hamade A, Le Moine A, Abramowicz D, and Vereerstraeten P
- Abstract
Background. Although numerous risk factors for delayed graft function (DGF) have been identified, the role of ischemia-reperfusion injury and acute rejection episodes (ARE) occurring during the DGF period is ill-defined and DGF impact on patient and graft outcome remains controversial. Methods. From 1983 to 2014, 1784 kidney-only transplantations from deceased donors were studied. Classical risk factors for DGF along with two novel ones, recipient's perioperative saline loading and residual diuresis, were analyzed by logistic regression and receiver operating characteristic (ROC) curves. Results. Along with other risk factors, absence of perioperative saline loading increases acute rejection incidence (OR = 1.9 [1.2-2.9]). Moreover, we observed two novel risk factors for DGF: patient's residual diuresis ≤500 mL/d (OR = 2.3 [1.6-3.5]) and absence of perioperative saline loading (OR = 3.3 [2.0-5.4]). Area under the curve of the ROC curve (0.77 [0.74-0.81]) shows an excellent discriminant power of our model, irrespective of rejection. DGF does not influence patient survival (P = 0.54). However, graft survival is decreased only when rejection was associated with DGF (P < 0.001). Conclusions. Perioperative saline loading efficiently prevents ischemia-reperfusion injury, which is the predominant factor inducing DGF. DGF per se has no influence on patient and graft outcome. Its incidence is currently close to 5% in our centre.
- Published
- 2015
- Full Text
- View/download PDF
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