Extracorporeal photopheresis for the treatment of graft rejection in 33 adult kidney transplant recipients
| Autor: | Carole Philipponnet, Aurélien Tiple, Cyril Garrouste, Bruno Pereira, Philippe Grimbert, Etienne Merlin, Mathilde Tamain, George Kosmadakis, Mathias Büchler, Arnaud Lionet, Jean-François Augusto, Johnny Sayegh, Marc Hazzan, Anne-Elisabeth Heng |
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| Přispěvatelé: | Service de Néphrologie - Hémodialyses [CHU Clermont-Ferrand], Pôle RHEUNNIRS [CHU Clermont-Ferrand], CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand-CHU Gabriel Montpied [Clermont-Ferrand], CHU Clermont-Ferrand-CHU Clermont-Ferrand, Université d'Angers (UA), Service de Néphrologie et Transplantation rénale [CHRU-lille], Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Service de néphrologie, dialyse, aphérèses et transplantation, CHU Grenoble-Université Grenoble Alpes [2016-2019] (UGA [2016-2019]), Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Université de Lille, Université de Tours (UT), Service de Pédiatrie Générale [CHU Clermont-Ferrand], CHU Estaing [Clermont-Ferrand], CH Vichy, Unité de Biostatistiques [CHU Clermont-Ferrand], Direction de la recherche clinique et de l’innovation [CHU Clermont-Ferrand] (DRCI), CCSD, Accord Elsevier, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble, Université Francois Rabelais [Tours] |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Graft Rejection Male medicine.medical_specialty Adolescent medicine.medical_treatment [SDV]Life Sciences [q-bio] education Urology Renal function 030204 cardiovascular system & hematology Kidney Kidney transplant 03 medical and health sciences fluids and secretions 0302 clinical medicine Extracorporeal Photopheresis medicine Humans Risk factor ComputingMilieux_MISCELLANEOUS Kidney transplantation Aged Retrospective Studies Heart transplantation business.industry Retrospective cohort study Hematology Middle Aged medicine.disease Kidney Transplantation 3. Good health [SDV] Life Sciences [q-bio] Concomitant Photopheresis Female business 030215 immunology |
| Zdroj: | Transfusion and Apheresis Science Transfusion and Apheresis Science, 2019, 58, pp.515-524. ⟨10.1016/j.transci.2019.06.031⟩ Transfusion and Apheresis Science, Elsevier, 2019, 58, pp.515-524. ⟨10.1016/j.transci.2019.06.031⟩ |
| ISSN: | 1473-0502 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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