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6 results on '"Florent, Le Borgne"'

1. Lack of impact of pre-emptive deceased-donor kidney transplantation on graft outcomes: a propensity score-based study

Author

Magali Giral, Marc Ladrière, Sophie Girerd, Christophe Legendre, Laetitia Albano, Fanny Buron, Denis Glotz, Valérie Garrigue, Florent Le Borgne, Emmanuel Morelon, Carmen Lefaucheur, Yohann Foucher, Georges Mourad, Elisabeth Cassuto, MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Université de Nantes (UN)-Université de Nantes (UN), Centre hospitalier universitaire de Nantes (CHU Nantes), IDBC/A2com [Pace, France], Réseau CENTAURE, 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), Hospices Civils de Lyon (HCL), Service de Néphrologie [CHRU Nancy], Centre Hospitalier Régional Universitaire de Nancy (CHRU Nancy), Service de transplantation rénale [CHRU Nancy], Centre Hospitalier Universitaire de Nancy (CHU Nancy), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Ecotaxie, microenvironnement et développement lymphocytaire (EMily (UMR_S_1160 / U1160)), Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hopital Saint-Louis [AP-HP] (AP-HP), Hôpital Pasteur [Nice] (CHU), Centre d’Investigation Clinique de Nantes (CIC Nantes), Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Immunoregulation And Immunointervention in Transplantation and Autoimmunity (Team 4 - U1064 Inserm - CRTI), Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Le Bihan, Sylvie, Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Kidney Transplant Center [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)-Sorbonne Université (SU)-Université Paris Descartes - Paris 5 (UPD5), Department of Nephrology, Transplantation and Clinic Immunology [Hospices civils de Lyon], Hospices Civils de Lyon (HCL)-Hôpital Edouard Herriot [CHU - HCL], Service de Néphrologie, Dialyse et Transplantation (Hôpital Lapeyronie [Montpellier] CHU), Hôpital Lapeyronie [Montpellier] (CHU), Paris Translational Research Center for Organ Transplantation & Department of Nephrology and Transplantation, Université Paris Diderot - Paris 7 (UPD7)-Hopital Saint-Louis [AP-HP] (AP-HP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de néphrologie et transplantation rénale [Nice], and Université Paris Descartes - Paris 5 (UPD5)-Sorbonne Université (SU)-CHU Necker - Enfants Malades [AP-HP]

Subjects
Male, medicine.medical_specialty, Time Factors, Waiting Lists, medicine.medical_treatment, 030232 urology & nephrology, 030204 cardiovascular system & hematology, patient and graft survival, [SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, Risk Factors, Internal medicine, medicine, Humans, Renal replacement therapy, Prospective Studies, causal inference, Propensity Score, Dialysis, Kidney transplantation, Transplantation, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Graft Survival, pre-emptive kidney transplantation, Middle Aged, medicine.disease, Kidney Transplantation, [SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology, Tissue Donors, 3. Good health, Treatment Outcome, Nephrology, Cohort, Propensity score matching, Kidney Failure, Chronic, dialysis, Observational study, Female, observational study, Hemodialysis, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Follow-Up Studies
Abstract

International audience; BACKGROUND: A significant number of studies have compared graft outcomes between patients with Pre-emptive Kidney Transplantation (PreKT) and patients on Dialysis before their Kidney Transplantation (DiaKT). These studies have suffered from the limitation that the DiaKT group is composed of all the dialysed patients, including those placed on a waiting list at the time of their first dialysis session. This seriously questions the comparability of these patients with those placed on the waiting list a long time before the need for renal replacement therapy. The aim of this study was to precisely evaluate the causal effect of PreKT from deceased donors.METHODS: Data were extracted from the multicentric French DIVAT (Données Informatisées et VAlidées en Transplantation) cohort. The DiaKT group was composed of patients placed on the waiting list with an initial intention of pre-emptive transplantation. Cause-specific Cox models with propensity scores (inverse probability weighting) were used to study the patient and graft outcomes.RESULTS: Among the 1138 included patients, 554 patients were in the PreKT group. The outcomes of the PreKT group were similar compared with the DiaKT group. In particular, the life expectancy with a functioning graft was 8.51 years [95% confidence interval (CI) 8.20-8.81] for the PreKT recipients versus 8.49 years (95% CI 8.15-8.84) for the DiaKT recipients.CONCLUSIONS: Our results challenge the utility of PreKTs from deceased donors, especially with regard to the consequential increase in the waiting list.

Published
2019
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2. Is pre-transplant sensitization against angiotensin II type 1 receptor still a risk factor of graft and patient outcome in kidney transplantation in the anti-HLA Luminex era? A retrospective study

Author

Florent Le Borgne, Magali Giral, Yohann Foucher, Marie Rimbert, Daniel Anglicheau, Clement Deltombe, Emmanuel Morelon, Florence Gillaizeau, Pierrick Guerif, Stéphanie Malard-Castagnet, Katy Trébern-Launay, Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), 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), MethodS in Patients-centered outcomes and HEalth ResEarch (SPHERE), Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, Biostatistique, Recherche Clinique et Mesures Subjectives en Santé, Université de Nantes (UN), LabEx TRANSPLANTEX [CHU de Nantes], Thematic Research and Care Network RTRS 'Centaure' [Strasbourg], Université de Strasbourg (UNISTRA), Département de transplantation rénale [Hôpital 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), Département de transplantation et d'immunologie clinique [Hôpital Edouard Herriot, HCL], Hôpital Edouard Herriot [CHU - HCL], Hospices Civils de Lyon (HCL)-Hospices Civils de Lyon (HCL), Centre d'Immuno-Monitorage Nantes Atlantique [CHU Nantes] (Plate-forme CIMNA - SFR Santé), Centre hospitalier universitaire de Nantes (CHU Nantes), CIC biothérapies CBT 0503 [Nantes], Hôtel-Dieu de Nantes-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre hospitalier universitaire de Nantes (CHU Nantes), Etablissement Français du Sang [Nantes], One lambda., Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR des Sciences Pharmaceutiques et Biologiques, and Le Bihan, Sylvie

Subjects
Adult, Graft Rejection, Male, medicine.medical_specialty, 030232 urology & nephrology, 030230 surgery, Gastroenterology, acute rejection, Receptor, Angiotensin, Type 1, Angiotensin type 1 receptor antibodies, 03 medical and health sciences, 0302 clinical medicine, HLA Antigens, Internal medicine, medicine, Humans, Risk factor, graft outcome, Kidney transplantation, Aged, Retrospective Studies, Transplantation, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, business.industry, Proportional hazards model, Retrospective cohort study, Middle Aged, medicine.disease, Kidney Transplantation, Angiotensin II, Tacrolimus, 3. Good health, Surgery, Cohort, Female, Kidney Diseases, business, pretransplant, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; We aimed to assess the correlation of anti-angiotensin II type 1 receptor antibodies (anti-AT1R-Abs) before transplantation on a multicentric cohort of kidney transplant recipients (2008-2012), under tacrolimus and mycophenolate mofetil (MMF), screened by Luminex technology for anti-HLA immunization. Anti-AT1R antibody levels were measured by ELISA in pretransplantation sera of 940 kidney recipients from three French centers of the DIVAT cohort. Multivariable Cox models estimated the association between pretransplant anti-angiotensin II type 1 receptor antibodies and time to acute rejection episodes (ARE) or time to graft failure. Within our cohort, 387 patients (41.2%) had pretransplant AT1R-Abs higher than 10 U/ml and only 8% (72/970) greater than 17 U/ml. The cumulative probability of clinically relevant (cr)-ARE was 22.5% at 1 year post-trans-plantation [95% CI (19.9-25.4%)]. The cumulative probability of graft failure and patient death were 10.6% [95% CI (8.4-13.3%)] and 5.7% [95% CI (4.0-8.1%)] at 3 years post-transplantation, respectively. Multivariate Cox models indicated that pretransplant anti-AT1R antibody levels higher than 10 U/ml were not significantly independently associated with higher risks of acute rejection episodes [HR = 1.04, 95% CI (0.80-1.35)] nor with risk of graft failure [HR = 0.86, 95% CI (0.56-1.33)]. Our study did not confirm an association between pretransplant anti-AT1R antibody levels and kidney transplant outcomes.

Published
2017
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3. Standardized and weighted time-dependent receiver operating characteristic curves to evaluate the intrinsic prognostic capacities of a marker by taking into account confounding factors

Author

Florence Gillaizeau, Christophe Combescure, Magali Giral, Marion Chapal, Yohann Foucher, Florent Le Borgne, Bruno Giraudeau, Le Bihan, Sylvie, 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), and Université de Nantes (UN)-Université de Nantes (UN)

Subjects
Statistics and Probability, Epidemiology, Computer science, 01 natural sciences, 010104 statistics & probability, 03 medical and health sciences, 0302 clinical medicine, Health Information Management, Statistics, 030212 general & internal medicine, confounding factors, receiver operating characteristic curve, 0101 mathematics, propensity score, Event (probability theory), [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Receiver operating characteristic, business.industry, Inverse probability weighting, Confounding, Pattern recognition, Confounding Factors, Epidemiologic, Prognosis, Kidney Transplantation, ROC Curve, Creatinine, Prognostic capacities, Propensity score matching, Artificial intelligence, Primary Graft Dysfunction, time-to-event data, business, Algorithms, Biomarkers, inverse probability weighting, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Time-dependent receiver operating characteristic curves allow to evaluate the capacity of a marker to discriminate between subjects who experience the event up to a given prognostic time from those who are free of this event. In this article, we propose an inverse probability weighting estimator of a standardized and weighted time-dependent receiver operating characteristic curve. This estimator provides a measure of the prognostic capacities by taking into account potential confounding factors. We illustrate the robustness of the estimator by a simulation-based study and its usefulness by two applications in kidney transplantation.

Published
2017
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4. Comparisons of the performance of different statistical tests for time-to-event analysis with confounding factors: practical illustrations in kidney transplantation

Author

Anne Héléne Querard, Bruno Giraudeau, Yohann Foucher, Magali Giral, Florent Le Borgne, Le Bihan, Sylvie, 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), Biostatistique, Pharmacoépidémiologie et Mesures Subjectives en Santé, PRES Université Nantes Angers Le Mans (UNAM), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), IDBC/A2com [Pace, France], Centre de Recherche Épidémiologie et Statistique Sorbonne Paris Cité (CRESS (U1153 / UMR_A_1125 / UMR_S_1153)), Institut National de la Recherche Agronomique (INRA)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), Université Francois Rabelais [Tours], PRES Centre-Val de Loire Université, Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Service de Néphrologie, dialyse, transplantation [CHD Vendée] (Site de La Roche sur Yon), Centre Hospitalier Départemental - Hôpital de La Roche-sur-Yon (CHD Vendée), Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Université Paris Descartes - Paris 5 (UPD5)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA), Centre Hospitalier Départemental Vendée, Université Paris Diderot - Paris 7 (UPD7)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National de la Recherche Agronomique (INRA)-Université Paris Descartes - Paris 5 (UPD5)-Université Sorbonne Paris Cité (USPC), CIC Tours, Hôpital Bretonneau-Université de Tours-Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours-Institut National de la Santé et de la Recherche Médicale (INSERM)

Subjects
Statistics and Probability, Time Factors, Epidemiology, adjusted Kaplan-Meier estimator, Biostatistics, Wald test, 01 natural sciences, 010104 statistics & probability, 03 medical and health sciences, 0302 clinical medicine, Statistics, Econometrics, Humans, Medicine, Computer Simulation, 030212 general & internal medicine, 0101 mathematics, propensity score, Proportional Hazards Models, Statistical hypothesis testing, Models, Statistical, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Proportional hazards model, business.industry, Inverse probability weighting, Confounding, Confounding Factors, Epidemiologic, Kidney Transplantation, simulation study, Tissue Donors, survival data, Propensity score matching, adjusted log-rank test, Observational study, business, inverse probability weighting, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology, Type I and type II errors
Abstract

International audience; Confounding factors are commonly encountered in observational studies. Several confounder-adjusted tests to compare survival between differently exposed subjects were proposed. However, only few studies have compared their performances regarding type I error rates, and no study exists evaluating their type II error rates. In this paper, we performed a comparative simulation study based on two different applications in kidney transplantation research. Our results showed that the propensity score-based inverse probability weighting (IPW) log-rank test proposed by Xie and Liu (2005) can be recommended as a first descriptive approach as it provides adjusted survival curves and has acceptable type I and II error rates. Even better performance was observed for the Wald test of the parameter corresponding to the exposure variable in a multivariable-adjusted Cox model. This last result is of primary interest regarding the exponentially increasing use of propensity score-based methods in the literature.

Published
2016
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5. A useful scoring system for the prediction and management of delayed graft function following kidney transplantation from cadaveric donors

Author

Georges Mourad, Fanny Buron, Lionel Rostaing, Florent Le Borgne, Michèle Kessler, Magali Giral, Valérie Garrigue, Christophe Legendre, Emmanuel Morelon, Pascal Daguin, Katy Launay, Jean-Paul Soulillou, Henri Kreis, Marion Chapal, Yohann Foucher, Lucile Offredo, Marc Ladrière, Nassim Kamar, 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), Réseau CENTAURE [Nantes], Université de Nantes (UN)-Institut de Transplantation et de Recherche en Transplantation (ITUN - Institut Transplantation Urologie Néphroplogie*)-Centre hospitalier universitaire de Nantes (CHU Nantes), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), LabEx TRANSPLANTEX [CHU de Nantes], Biostatistique, Pharmacoépidémiologie et Mesures Subjectives en Santé, PRES Université Nantes Angers Le Mans (UNAM), 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), Université Paris Descartes - Paris 5 (UPD5), Université Sorbonne Paris Cité (USPC), Service de Néphrologie, Dialyse et Transplantation (Hôpital Lapeyronie [Montpellier] CHU), Hôpital Lapeyronie [Montpellier] (CHU), Service de Néphrologie [Lyon], Hospices Civils de Lyon (HCL)-Centre Hospitalier Lyon Sud [CHU - HCL] (CHLS), Hospices Civils de Lyon (HCL), Département de Néphrologie et Transplantation d'organes, Hôpital de Rangueil, CHU Toulouse [Toulouse]-CHU Toulouse [Toulouse], Université Toulouse III - Paul Sabatier (UT3), Université Fédérale Toulouse Midi-Pyrénées, Service de transplantation rénale [CHRU Nancy], Centre Hospitalier Universitaire de Nancy (CHU Nancy), Roche Laboratory., ANR-11-JSV1-0008,CSM (Composite Surrogate Marker),Construction d'un marqueur composite de substitution de la survie à long terme : application à la transplantation rénale(2011), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes)-Institut de Transplantation et de Recherche en Transplantation (ITUN - Institut Transplantation Urologie Néphroplogie*), 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), Le Bihan, Sylvie, and Jeunes Chercheuses et Jeunes Chercheurs - Construction d'un marqueur composite de substitution de la survie à long terme : application à la transplantation rénale - - CSM (Composite Surrogate Marker)2011 - ANR-11-JSV1-0008 - JCJC - VALID

Subjects
Male, 030232 urology & nephrology, 030230 surgery, Body Mass Index, Cohort Studies, chemistry.chemical_compound, 0302 clinical medicine, risk factors, Prospective Studies, Young adult, Child, Prospective cohort study, Kidney transplantation, Aged, 80 and over, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Cold Ischemia, Age Factors, Induction Chemotherapy, Middle Aged, Mobile Applications, Tissue Donors, 3. Good health, Nephrology, statistics, Area Under Curve, Child, Preschool, Creatinine, Predictive value of tests, Female, Smartphone, Immunosuppressive Agents, Cohort study, Adult, medicine.medical_specialty, Adolescent, kidney transplantation, Decision Support Techniques, Young Adult, 03 medical and health sciences, delayed graft function, Predictive Value of Tests, Cadaver, medicine, Humans, Aged, Antilymphocyte Serum, business.industry, transplant outcomes, Infant, medicine.disease, Surgery, Transplantation, ROC Curve, chemistry, business, Complication, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Delayed graft function (DGF) is a common complication in kidney transplantation and is known to be correlated with short-and long-term graft outcomes. Here we explored the possibility of developing a simple tool that could predict with good confidence the occurrence of DGF and could be helpful in current clinical practice. We built a score, tentatively called DGFS, from a French multicenter and prospective cohort of 1844 adult recipients of deceased donor kidneys collected since 2007, and computerized in the Données Informatisées et VAlidées en Transplantation databank. Only five explicative variables (cold ischemia time, donor age, donor serum creatinine, recipient body mass index, and induction therapy) contributed significantly to the DGF prediction. These were associated with a good predictive capacity (area under the ROC curve at 0.73). The DGFS calculation is facilitated by an application available on smartphones, tablets, or computers at www.divat.fr/en/online-calculators/ dgfs. The DGFS should allow the simple classification of patients according to their DGF risk at the time of transplantation, and thus allow tailored-specific management or therapeutic strategies.

Published
2014
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6. Increased soluble Flt-1 correlates with delayed graft function and early loss of peritubular capillaries in the kidney graft

Author

Anne Moreau, Fadi Fakhouri, Maryvonne Hourmant, Emanuelle Meffray, Florent Le Borgne, Yohann Foucher, Marion Chapal, Mélanie Néel, Odette Carceles, Magalie Giral, Centre de Recherche en Transplantation et Immunologie (U1064 Inserm - CRTI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Nantes - UFR de Médecine et des Techniques Médicales (UFR MEDECINE), Université de Nantes (UN)-Université de Nantes (UN), Institut de transplantation urologie-néphrologie (ITUN), Université de Nantes (UN)-Centre hospitalier universitaire de Nantes (CHU Nantes), Biostatistique, Recherche Clinique et Mesures Subjectives en Santé, Université de Nantes (UN), Département de Pathologie [CHU Nantes], Centre hospitalier universitaire de Nantes (CHU Nantes), An ATIP-AVENIR funding from INSERM., and Le Bihan, Sylvie

Subjects
Adult, Male, medicine.medical_specialty, Vascular repair, 030232 urology & nephrology, Urology, Endothelial repair, Delayed Graft Function, Peritubular capillaries, Monocytes, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, Risk Factors, medicine, Living Donors, Humans, Prospective Studies, Risk factor, Tyrosine, 030304 developmental biology, Aged, 0303 health sciences, Transplantation, Kidney, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Vascular Endothelial Growth Factor Receptor-1, business.industry, Ischemia-reperfusion, Plasma levels, Anatomy, Middle Aged, VEGF, Kidney Transplantation, Capillaries, medicine.anatomical_structure, Kidney Tubules, Solubility, Reperfusion Injury, embryonic structures, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

International audience; Background. Ischemia-reperfusion induces tubular and endothelial damage in the renal graft and leads to delayed graft function (DGF) and to an early loss of peritubular capillaries (PTC). Few, if any, clinical studies have assessed the impact of proangiogenic and antiangiogenic factors on endothelial repair during renal transplantation (RT)Yrelated ischemia-reperfusion. Methods. We prospectively assessed the kinetics of the antiangiogenic factor soluble Fms-like tyrosine kinase-1 (sFlt-1) in 136 consecutive RT patients and analyzed sFlt-1 impact on DGF and PTC loss.Results. sFlt-1 plasma levels increased by twofold to threefold throughout the first week after RT. This increase was more marked in recipients of grafts from deceased donors compared with living donors. Patients with DGF had higher sFlt-1 levels at all time points during the first 7 days after RT and a higher peak sFlt-1 compared with those without DGF. In multivariate analysis, a peak plasma sFlt-1 of 250 pg/mL or higher was associated with 2.5-fold increase in the risk of DGF (P=0.04). Similarly, patients with a peak plasma sFlt-1 of 250 pg/mL or higher had a more pronounced early decrease in PTC compared with those with a peak sFlt-1 less than 250 pg/mL.Conclusions. sFlt-1 is a new nonimmunologic independent risk factor for DGF and PTC loss. Its inhibition may help improve the outcome of RT.

Published
2013
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