Extracorporeal photopheresis for the ...
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Article dans une revue scientifique: Article original
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Title :
Extracorporeal photopheresis for the treatment of graft rejection in 33 adult kidney transplant recipients
Author(s) :
Tamain, Mathilde [Auteur]
Université Clermont Auvergne [UCA]
Sayegh, Johnny [Auteur]
Centre Hospitalier Universitaire d'Angers [CHU Angers]
Lionet, Arnaud [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Grimbert, Philippe [Auteur]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Philipponnet, Carole [Auteur]
CHU Clermont-Ferrand
Hazzan, Marc [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Augusto, Jean-Francois [Auteur]
Université d'Angers [UA]
Buchler, Mathias [Auteur]
Merlin, Etienne [Auteur]
CHU Clermont-Ferrand
Kosmadakis, George [Auteur]
Tiple, Aurelien [Auteur]
CHU Clermont-Ferrand
Pereira, Bruno [Auteur]
CHU Clermont-Ferrand
Garrouste, Cyril [Auteur]
CHU Clermont-Ferrand
Heng, Anne-Elisabeth [Auteur]
Université Clermont Auvergne [UCA]
Université Clermont Auvergne [UCA]
Sayegh, Johnny [Auteur]
Centre Hospitalier Universitaire d'Angers [CHU Angers]
Lionet, Arnaud [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Grimbert, Philippe [Auteur]
Université Paris-Est Créteil Val-de-Marne - Paris 12 [UPEC UP12]
Philipponnet, Carole [Auteur]
CHU Clermont-Ferrand
Hazzan, Marc [Auteur]
Lille Inflammation Research International Center - U 995 [LIRIC]
Augusto, Jean-Francois [Auteur]
Université d'Angers [UA]
Buchler, Mathias [Auteur]
Merlin, Etienne [Auteur]
CHU Clermont-Ferrand
Kosmadakis, George [Auteur]
Tiple, Aurelien [Auteur]
CHU Clermont-Ferrand
Pereira, Bruno [Auteur]
CHU Clermont-Ferrand
Garrouste, Cyril [Auteur]
CHU Clermont-Ferrand
Heng, Anne-Elisabeth [Auteur]
Université Clermont Auvergne [UCA]
Journal title :
Transfusion and Apheresis Science
Abbreviated title :
Transfus. Apher. Sci.
Volume number :
58
Pages :
515-524
Publication date :
2019-08
ISSN :
1473-0502
English keyword(s) :
Allograft rejection
Extracorporeal photopheresis
Kidney transplantation
Extracorporeal photopheresis
Kidney transplantation
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
Background - Extracorporeal photopheresis (ECP) has shown encouraging results in the prevention of allograft rejection in heart transplantation. However, the role of ECP in kidney transplant (KT) rejection needs to be ...
Show more >Background - Extracorporeal photopheresis (ECP) has shown encouraging results in the prevention of allograft rejection in heart transplantation. However, the role of ECP in kidney transplant (KT) rejection needs to be determined. Methods - This multicentre retrospective study included 33 KT recipients who were treated with ECP for allograft rejection (23 acute antibody-mediated rejections (AMRs), 2 chronic AMRs and 8 acute cellular rejections (ACRs)). The ECP indications were KT rejection in patients who were resistant to standard therapies (n = 18) or in patients for whom standard therapies were contraindicated because of concomitant infections or cancers (n = 15). Results - At 12 months (M12) post-ECP, 11 patients (33%) had a stabilization of kidney function with a graft survival rate of 61%. The Banff AMR score (g + ptc + v) was a risk factor for graft loss at M12 (HR 1.44 [1.01-2.05], p < 0.05). The factorial mixed data analysis identified 2 clusters. Patients with a functional graft at M12 tended to have cellular and/or chronic rejections. Patients with graft loss at M12 tended to have acute rejections and/or AMR; higher serum creatinine levels; DSA levels and histologic scores of AMR; and a longer delay between the rejection and ECP start than those of patients with functional grafts. Conclusions - ECP may be helpful to control ACR or moderate AMR in KT recipients presenting concomitant opportunistic infections or malignancies when it is initiated early.Show less >
Show more >Background - Extracorporeal photopheresis (ECP) has shown encouraging results in the prevention of allograft rejection in heart transplantation. However, the role of ECP in kidney transplant (KT) rejection needs to be determined. Methods - This multicentre retrospective study included 33 KT recipients who were treated with ECP for allograft rejection (23 acute antibody-mediated rejections (AMRs), 2 chronic AMRs and 8 acute cellular rejections (ACRs)). The ECP indications were KT rejection in patients who were resistant to standard therapies (n = 18) or in patients for whom standard therapies were contraindicated because of concomitant infections or cancers (n = 15). Results - At 12 months (M12) post-ECP, 11 patients (33%) had a stabilization of kidney function with a graft survival rate of 61%. The Banff AMR score (g + ptc + v) was a risk factor for graft loss at M12 (HR 1.44 [1.01-2.05], p < 0.05). The factorial mixed data analysis identified 2 clusters. Patients with a functional graft at M12 tended to have cellular and/or chronic rejections. Patients with graft loss at M12 tended to have acute rejections and/or AMR; higher serum creatinine levels; DSA levels and histologic scores of AMR; and a longer delay between the rejection and ECP start than those of patients with functional grafts. Conclusions - ECP may be helpful to control ACR or moderate AMR in KT recipients presenting concomitant opportunistic infections or malignancies when it is initiated early.Show less >
Language :
Anglais
Audience :
Internationale
Popular science :
Non
Administrative institution(s) :
CHU Lille
Inserm
Université de Lille
Inserm
Université de Lille
Submission date :
2024-01-30T10:27:56Z
2024-04-03T17:19:26Z
2024-04-03T17:19:26Z
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