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Article ; Online: Characteristics, risk factors and outcome of BKV nephropathy in kidney transplant recipients: a case-control study.

Gras, Julien / Le Flécher, Arnaud / Dupont, Axelle / Vérine, Jérôme / Amara, Ali / Delaugerre, Constance / Molina, Jean Michel / Peraldi, Marie Noëlle

BMC infectious diseases

2023 Volume 23, Issue 1, Page(s) 74

Abstract: Background: Following kidney transplantation, BK virus associated nephropathy (BKVN) occurs in 1 to 10% of kidney transplant recipients (KTR) and represents a major cause of graft loss. We aim at identifying factors associated with biopsy proven BKVN ... ...

Abstract	Background: Following kidney transplantation, BK virus associated nephropathy (BKVN) occurs in 1 to 10% of kidney transplant recipients (KTR) and represents a major cause of graft loss. We aim at identifying factors associated with biopsy proven BKVN among KTR. Methods: We conducted a retrospective case-control study including all KTR with a biopsy-proven diagnosis of BKVN between 2005 and 2019. Clinical characteristics and outcome were described. For each case, one control KTR without BKV infection was identified and matched by age, transplant date, and donor status. Factors associated with BKVN diagnosis were identified using exact conditional logistic regression. Comparative survival was described using Kaplan-Meier estimator. Results: Sixty-four cases of BKVN were identified among 1737 new kidney transplantation (3.7% prevalence). Clinical characteristics did not differ between groups, except for a higher c-PRA among cases. BKVN occurred in a median time of 11 (5-14.5) months after KT, and was associated with a significantly impaired graft function at diagnosis. Following BKVN, 61 (95%) of the patients had immunosuppression reduction, which led to BKV DNAemia resolution in 49% of cases. In multivariate analysis, factors associated with BKVN diagnosis were lymphopenia < 500/mm Conclusions: BKVN remains a severe complication in KTR and is associated with an increased risk for acute rejection and return to dialysis. Lymphopenia below 500/mm
MeSH term(s)	Humans ; Kidney Transplantation/adverse effects ; Case-Control Studies ; Retrospective Studies ; Kidney Diseases/epidemiology ; Nephritis, Interstitial/etiology ; Transplant Recipients ; Risk Factors ; Lymphopenia/complications ; Polyomavirus Infections/diagnosis ; BK Virus ; Tumor Virus Infections/epidemiology ; Graft Rejection
Language	English
Publishing date	2023-02-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2041550-3
ISSN	1471-2334 ; 1471-2334
ISSN (online)	1471-2334
ISSN	1471-2334
DOI	10.1186/s12879-023-08043-z
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Use of a Belatacept-based Immunosuppression for Kidney Transplantation From Donors After Circulatory Death: A Paired Kidney Analysis.

Eid, Rita / Scemla, Anne / Giral, Magali / Arzouk, Nadia / Bertrand, Dominique / Peraldi, Marie-Noëlle / Mesnard, Laurent / Longuet, Helene / Maanaoui, Mehdi / Desbuissons, Geoffroy / Lefevre, Edouard / Snanoudj, Renaud

Transplantation direct

2024 Volume 10, Issue 5, Page(s) e1615

Abstract: Background: Efficacy and safety of belatacept have not been specifically reported for kidney transplantations from donors after circulatory death.: Methods: In this retrospective multicenter paired kidney study, we compared the outcome of kidney ... ...

Abstract	Background: Efficacy and safety of belatacept have not been specifically reported for kidney transplantations from donors after circulatory death. Methods: In this retrospective multicenter paired kidney study, we compared the outcome of kidney transplantations with a belatacept-based to a calcineurin inhibitor (CNI)-based immunosuppression. We included all kidney transplant recipients from donors after uncontrolled or controlled circulatory death performed in our center between February 2015 and October 2020 and treated with belatacept (n = 31). The control group included the recipients of the contralateral kidney that were treated with CNI in 8 other centers (tacrolimus n = 29, cyclosporine n = 2). Results: There was no difference in the rate of delayed graft function. A higher incidence of biopsy-proven rejections was noted in the belatacept group (24 versus 6 episodes). Estimated glomerular filtration rate (eGFR) was significantly higher in the belatacept group at 3-, 12-, and 36-mo posttransplant, but the slope of eGFR was similar in the 2 groups. During a mean follow-up of 4.1 y, 12 patients discontinued belatacept and 2 patients were switched from CNI to belatacept. For patients who remained on belatacept, eGFR mean value and slope were significantly higher during the whole follow-up. At 5 y, eGFR was 80.7 ± 18.5 with belatacept versus 56.3 ± 22.0 mL/min/1.73 m Conclusions: The use of belatacept for kidney transplants from either uncontrolled or controlled donors after circulatory death resulted in a better medium-term renal function for patients remaining on belatacept despite similar rates of delayed graft function and higher rates of cellular rejection.
Language	English
Publishing date	2024-04-11
Publishing country	United States
Document type	Journal Article
ISSN	2373-8731
ISSN	2373-8731
DOI	10.1097/TXD.0000000000001615
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Article: Cryptococcus neoformans meningitis in kidney transplant recipients: A diagnostic and therapeutic challenge

Gras, Julien / Tamzali, Yanis / Denis, Blandine / Gits-Muselli, Maud / Bretagne, Stéphane / Peraldi, Marie-Noëlle / Molina, Jean-Michel

Medical mycology case reports. 2021 June, v. 32

2021

Abstract: Cryptococcosis is the third most common invasive fungal infection in solid organ transplant recipients. We describe three cases of neuro-meningeal cryptococcosis occurring among kidney transplant (KT) patients, and discuss the diagnostic and therapeutic ... ...

Abstract	Cryptococcosis is the third most common invasive fungal infection in solid organ transplant recipients. We describe three cases of neuro-meningeal cryptococcosis occurring among kidney transplant (KT) patients, and discuss the diagnostic and therapeutic challenges in this context.Median time from KT to infection was 6 months [range: 3–9]. The most common clinical manifestations at diagnosis were fever (2/3), headache (2/3), and confusion (2/3); none had extra-neurological involvement. CrAg was positive in all cases at diagnosis both in serum and cerebrospinal fluid (CSF). For two patients, analysis of previous samples showed that CrAg was detected in plasma up to 4 weeks before diagnosis. All patients received induction treatment with liposomal amphotericin-B (L-AmB) and flucytosine for a median duration of 10 days [range: 7–14], followed by fluconazole maintenance therapy. Acute kidney injury secondary to L-AmB therapy was observed in only one case, but all patients had a tacrolimus overdose following initiation of maintenance therapy due to drug-drug interactions between fluconazole and tacrolimus.Among KTR, early detection of Cryptococcus meningitis using serum CrAg is possible. Close monitoring of renal function during treatment is essential due to the nephrotoxicity of L-AmB, but also drug-drug interactions between fluconazole and calcineurin inhibitors.
Keywords	Cryptococcus neoformans ; acute kidney injury ; amphotericin B ; blood serum ; cerebrospinal fluid ; cryptococcosis ; fever ; fluconazole ; flucytosine ; fungi ; headache ; kidney transplant ; meningitis ; mycology ; nephrotoxicity ; overdose ; renal function ; tacrolimus
Language	English
Dates of publication	2021-06
Size	p. 84-87.
Publishing place	Elsevier B.V.
Document type	Article
Note	NAL-AP-2-clean
ISSN	2211-7539
DOI	10.1016/j.mmcr.2021.04.005
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Immunogenicity of Anti-SARS-CoV-2 Vaccination After Kidney Transplantation in Kidney Transplant Recipients Vaccinated Before Transplantation.

Uro-Coste, Charlotte / Sberro-Soussan, Rebecca / Martinez, Frank / Amrouche, Lucile / Aubert, Olivier / Leruez-Ville, Marianne / Delage, Claire / Peraldi, Marie Noëlle / Legendre, Christophe / Lanternier, Fanny / Zuber, Julien / Anglicheau, Dany / Scemla, Anne / Chavarot, Nathalie

Transplantation

2023 Volume 107, Issue 8, Page(s) e213–e214

MeSH term(s)	Humans ; Kidney Transplantation/adverse effects ; COVID-19/prevention & control ; Transplant Recipients ; Vaccination ; Antibodies, Viral
Chemical Substances	Antibodies, Viral
Language	English
Publishing date	2023-05-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0000000000004654
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Article ; Online: BK virus genotypes and humoral response in kidney transplant recipients with BKV associated nephropathy.

Gras, Julien / Nere, Marie Laure / Peraldi, Marie Noëlle / Bonnet-Madin, Lucie / Salmona, Maud / Taupin, Jean Luc / Desgrandchamps, François / Verine, Jérôme / Brochot, Etienne / Amara, Ali / Molina, Jean Michel / Delaugerre, Constance

Transplant infectious disease : an official journal of the Transplantation Society

2023 Volume 25, Issue 2, Page(s) e14012

Abstract: Background: Among kidney transplant recipients (KTR) with BK virus associated nephropathy (BKVN), BKV genotypes' evolution and anti-BKV humoral response are not well established. We aim to analyze BKV replication and genetic evolution following ... ...

Abstract	Background: Among kidney transplant recipients (KTR) with BK virus associated nephropathy (BKVN), BKV genotypes' evolution and anti-BKV humoral response are not well established. We aim to analyze BKV replication and genetic evolution following transplantation, and characterize concomitant anti-BKV-VP1 humoral response. Methods: We retrospectively analyzed 32 cases of biopsy-proven BKVN. Stored plasma and kidney biopsies were tested for BKV viral load, and VP1 sequencing performed on positive samples. BKV-VP1 genotype-specific neutralizing antibodies (NAbs) titers were determined at transplantation and BKVN. Results: At the time of BKVN diagnosis, BKV viral load was 8.2 log Conclusion: Altogether, our data suggest that among some KTR with BKVN, the BKV genotype from the donor may not be responsible for BKVN pathogenesis.
MeSH term(s)	Humans ; Kidney Transplantation/adverse effects ; BK Virus ; Viremia/complications ; Retrospective Studies ; Kidney Diseases ; Transplant Recipients ; Polyomavirus Infections ; Nephritis, Interstitial ; Tumor Virus Infections ; Genotype
Language	English
Publishing date	2023-02-07
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	1476094-0
ISSN	1399-3062 ; 1398-2273
ISSN (online)	1399-3062
ISSN	1398-2273
DOI	10.1111/tid.14012
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Article: Cryptococcus neoformans

Gras, Julien / Tamzali, Yanis / Denis, Blandine / Gits-Muselli, Maud / Bretagne, Stéphane / Peraldi, Marie-Noëlle / Molina, Jean-Michel

Medical mycology case reports

2021 Volume 32, Page(s) 84–87

Abstract	Cryptococcosis is the third most common invasive fungal infection in solid organ transplant recipients. We describe three cases of neuro-meningeal cryptococcosis occurring among kidney transplant (KT) patients, and discuss the diagnostic and therapeutic challenges in this context. Median time from KT to infection was 6 months [range: 3-9]. The most common clinical manifestations at diagnosis were fever (2/3), headache (2/3), and confusion (2/3); none had extra-neurological involvement. CrAg was positive in all cases at diagnosis both in serum and cerebrospinal fluid (CSF). For two patients, analysis of previous samples showed that CrAg was detected in plasma up to 4 weeks before diagnosis. All patients received induction treatment with liposomal amphotericin-B (L-AmB) and flucytosine for a median duration of 10 days [range: 7-14], followed by fluconazole maintenance therapy. Acute kidney injury secondary to L-AmB therapy was observed in only one case, but all patients had a tacrolimus overdose following initiation of maintenance therapy due to drug-drug interactions between fluconazole and tacrolimus. Among KTR, early detection of
Language	English
Publishing date	2021-05-04
Publishing country	Netherlands
Document type	Journal Article
ISSN	2211-7539
ISSN	2211-7539
DOI	10.1016/j.mmcr.2021.04.005
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Article ; Online: Clinical characteristics, risk factors and outcome of severe Norovirus infection in kidney transplant patients: a case-control study.

Gras, Julien / Abdel-Nabey, Moustafa / Dupont, Axelle / Le Goff, Jérôme / Molina, Jean-Michel / Peraldi, Marie Noëlle

BMC infectious diseases

2021 Volume 21, Issue 1, Page(s) 351

Abstract: Background: Human Norovirus (HuNoV) has recently been identified as a major cause of diarrhea among kidney transplant recipients (KTR). Data regarding risk factors associated with the occurrence of HuNoV infection, and its long-term impact on kidney ... ...

Abstract	Background: Human Norovirus (HuNoV) has recently been identified as a major cause of diarrhea among kidney transplant recipients (KTR). Data regarding risk factors associated with the occurrence of HuNoV infection, and its long-term impact on kidney function are lacking. Methods: We conducted a retrospective case-control study including all KTR with a diagnosis of HuNoV diarrhea. Each case was matched to a single control according to age and date of transplantation, randomly selected among our KTR cohort and who did not develop HuNoV infection. Risk factors associated with HuNoV infection were identified using conditional logistic regression, and survival was estimated using Kaplan-Meier estimator. Results: From January 2012 to April 2018, 72 cases of NoV diarrhea were identified among 985 new KT, leading to a prevalence of HuNoV infection of 7.3%. Median time between kidney transplantation and diagnosis was 46.5 months (Inter Quartile Range [IQR]:17.8-81.5), and the median duration of symptoms 40 days (IQR: 15-66.2). Following diagnosis, 93% of the cases had a reduction of immunosuppression. During follow-up, de novo Donor Specific Antibody (DSA) were observed in 8 (9%) cases but none of the controls (p = 0.01). Acute rejection episodes were significantly more frequent among cases (13.8% versus 4.2% in controls; p = 0,03), but there was no difference in serum creatinine level at last follow-up between the two groups (p = 0.08). Pre-transplant diabetes and lymphopenia below 1000/mm Conclusion: HuNoV infection is a late-onset and prolonged infection among KTR. The current management, based on the reduction of immunosuppressive treatment, is responsible for the appearance of de novo DSA and an increase in acute rejection episodes.
MeSH term(s)	Adult ; Caliciviridae Infections/diagnosis ; Caliciviridae Infections/etiology ; Caliciviridae Infections/pathology ; Case-Control Studies ; Diabetes Complications/pathology ; Diarrhea/diagnosis ; Diarrhea/virology ; Female ; Graft Rejection/etiology ; Graft Rejection/mortality ; Graft Rejection/prevention & control ; Humans ; Immunosuppressive Agents/therapeutic use ; Kaplan-Meier Estimate ; Kidney Transplantation/adverse effects ; Logistic Models ; Lymphopenia/complications ; Lymphopenia/pathology ; Male ; Middle Aged ; Norovirus/isolation & purification ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Severity of Illness Index
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2021-04-15
Publishing country	England
Document type	Journal Article
ISSN	1471-2334
ISSN (online)	1471-2334
DOI	10.1186/s12879-021-06062-2
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Article ; Online: Conversion to belatacept after lung transplantation: Report of 10 cases.

Brugière, Olivier / Vallée, Alexandre / Raimbourg, Quentin / Peraldi, Marie-Noelle / de Verdière, Sylvie Colin / Beaumont, Laurence / Hamid, Abdulmonem / Zrounba, Mathilde / Roux, Antoine / Picard, Clément / Parquin, François / Glorion, Matthieu / Oniszczuk, Julie / Hertig, Alexandre / Mal, Hervé / Bunel, Vincent

PloS one

2023 Volume 18, Issue 3, Page(s) e0281492

Abstract: Background: Calcineurin inhibitors (CNIs) remain the cornerstone of maintenance immunosuppression (IS) after lung transplantation (LTx), although CNI-related life-threatening toxic effects may occur. Belatacept, a novel immunosuppressant that blocks a T- ...

Abstract	Background: Calcineurin inhibitors (CNIs) remain the cornerstone of maintenance immunosuppression (IS) after lung transplantation (LTx), although CNI-related life-threatening toxic effects may occur. Belatacept, a novel immunosuppressant that blocks a T-cell co-stimulation pathway, is a non-nephrotoxic drug indicated as an alternative to CNIs in kidney Tx. In LTx, there are only a few reports of belatacept conversion as a CNI-free or CNI-sparing IS treatment. Methods: We reviewed a series of 10 LTx recipients with conversion to a CNI-free belatacept IS regimen within the first year post-LTx (n = 7) or a belatacept/low-dose CNI combination after the first year (n = 3). Results: Use of belatacept was triggered by severe renal failure in 9 patients and under-IS with previous other IS-related toxicities in 1 patient. Mean estimated glomerular filtration rate after starting belatacept significantly improved at 6 months after initiation and at the last-follow-up (p = 0.006, and p = 0.002 respectively). The incidence of recurrent and/or severe acute cellular rejection (ACR) episodes was high in patients with CNI-free belatacept-based IS (n = 4/7). Chronic graft allograft dysfunction developed in 2 of 9 recipients under belatacept IS. Belatacept was stopped in 6 patients because of recurrent/severe ACR (n = 3), recurrent opportunistic infections (n = 1), center modified policy (n = 1), or other cause (n = 1). Conclusion: Early conversion to CNI-free belatacept-based IS improved renal function in this series but was counterbalanced by a high incidence of recurrent ACR, including life-threatening episodes. Other studies are needed to better determine the indications for its use after LTx, possibly with lower immunological risk IS regimens, such as CNI-sparing belatacept.
MeSH term(s)	Humans ; Abatacept/therapeutic use ; Abatacept/pharmacology ; Calcineurin Inhibitors/adverse effects ; Graft Rejection/drug therapy ; Graft Rejection/prevention & control ; Graft Survival ; Immunosuppressive Agents/adverse effects ; Kidney Transplantation/adverse effects ; Lung Transplantation/adverse effects
Chemical Substances	Abatacept (7D0YB67S97) ; Calcineurin Inhibitors ; Immunosuppressive Agents
Language	English
Publishing date	2023-03-15
Publishing country	United States
Document type	Journal Article
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0281492
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Article ; Online: Estimating Extracellular Fluid Volume in Healthy Individuals: Evaluation of Existing Formulae and Development of a New Equation.

Faucon, Anne-Laure / Flamant, Martin / Delanaye, Pierre / Lambert, Oriane / Essig, Marie / Peraldi, Marie-Noëlle / Tabibzadeh, Nahid / Haymann, Jean-Philippe / Stengel, Bénédicte / Geri, Guillaume / Vidal-Petiot, Emmanuelle

Kidney international reports

2022 Volume 7, Issue 4, Page(s) 810–822

Abstract: Introduction: Several clinical settings require an accurate estimation of the physiologically expected extracellular fluid volume (ECFV). We aimed to analyze the performances of existing ECFV-estimating equations and to develop a new equation.: ... ...

Abstract	Introduction: Several clinical settings require an accurate estimation of the physiologically expected extracellular fluid volume (ECFV). We aimed to analyze the performances of existing ECFV-estimating equations and to develop a new equation. Methods: The performances of 11 ECFV-estimating equations were analyzed in 228 healthy kidney donor candidates (Bichat Hospital, Paris, France) who underwent ECFV measurement using the distribution volume of Results: Participants from Bichat (mean age 45.2 ± 12.0 years, 43.0% men) and Tenon (47.8 ± 10.3 years, 29.6% men) hospitals had a mean measured ECFV of 15.4 ± 2.8 l and 15.1 ± 2.1 l, respectively. Available ECFV-estimating formulae have highly variable precision and accuracy. The new equation incorporating body weight, height, sex, and age had better precision and accuracy than all other equations in the external validation cohort, with a median bias of -0.20 (95% CI: -0.35 to -0.05) l versus -2.63 (-2.87 to -2.42) l to -0.57 (- 0.83 to -0.40) l and 0.21 (0.12 to 0.43) l to 2.89 (2.65 to 3.11) l, for underestimating and overestimating equations, respectively, an interquartile range for the bias of 0.88 (0.70 to 1.08) l versus 0.91 (0.71 to 1.20) l to 1.93 (1.67 to 2.25) l, and an accuracy within 10% of 90.9% (83.8 to 94.4) versus 88.0% (81.0 to 92.3) to 8.5% (4.2 to 13.4). These results were consistent across subgroups defined by sex, body mass index (BMI), body surface area (BSA), age, and ethnicity. Conclusion: We developed and validated a new equation to estimate the individual reference value of ECFV, which is easily usable in clinical practice. Further validation in cohorts including individuals of extreme age and corpulence remains needed.
Language	English
Publishing date	2022-01-26
Publishing country	United States
Document type	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2022.01.1057
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Article: TRANSPLANTATION RÉNALE ABO INCOMPATIBLE.

Abboud, Imad / Peraldi, Marie-noelle / Glotz, Denis

Le Journal medical libanais. The Lebanese medical journal

2015 Volume 63, Issue 3, Page(s) 159–163

Abstract: ABC-incompatible (ABOi) living donor renal transplantation is being developed since the 80s, and may provide a significant source of organs. Blood group A and B antigens are expressed not only on red blood cells but also on renal vascular endothelial and ...

Title translation	Renal transplantation from ABO incompatible donors.
Abstract	ABC-incompatible (ABOi) living donor renal transplantation is being developed since the 80s, and may provide a significant source of organs. Blood group A and B antigens are expressed not only on red blood cells but also on renal vascular endothelial and renal epithelial membranes. Each individual has preformed natural antibodies against his/ her absent A and/or B antigens. These antibodies may directly damage the ABOi allograft and cause its diffuse thrombosis and primary non-function. ABOi allogratf recipients are conditioned with one dose of rituximab (as a "pharmacological splenectomy") and oral immunosuppressive treatment is introduced several days pre-operatively. Anti A/B titers are lowered by plasmapheresis or specific immunoadsorption. Close follow-up is mandatory in the first two weeks after transplantation, due to higher acute humoral rejection risk, until reaching an "accommodation" state. Thereafter, graft and patient survivals are the same as those of ABO compatible renal transplantations.
MeSH term(s)	ABO Blood-Group System/immunology ; Blood Group Incompatibility/immunology ; Clinical Protocols ; Humans ; Immunosuppression ; Kidney Transplantation ; Tissue Donors ; Transplantation Immunology
Chemical Substances	ABO Blood-Group System
Language	French
Publishing date	2015-07
Publishing country	Lebanon
Document type	English Abstract ; Journal Article
ZDB-ID	412536-8
ISSN	0023-9852
ISSN	0023-9852
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