Browsing by Author "Guilbeau-Frugier, Céline"

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Long-Term Outcome of Reusing a Kidney Allograft Retrieved From a Living Recipient and Retransplanted Into a Second Recipient
(Başkent Üniversitesi, 2013-04) Bellière, Julie; Rostaing, Lionel; Kamar, Nassim; Guilbeau-Frugier, Céline; Sallusto, Federico
This case report shows that the 5-year outcome of a reused kidney from live-kidney allograft recipients because of intractable recurrence of thrombotic microangiopathy was excellent.
Long-term Results of Conversion From Calcineurin Inhibitors to Sirolimus in 150 Maintenance Kidney Transplant Patients
(Başkent Üniversitesi, 2012-04) Garrouste, Cyril; Lavayssière, Laurence; Rostaing, Lionel; Ribes, David; Cointault, Olivier; Nogier, Marie-Béatrice; Esposito, Laure; Guitard, Joëlle; Guilbeau-Frugier, Céline; Kamar, Nassim
Objectives: This retrospective single-center study evaluated long-term renal function after conversion from calcineurin inhibitors to sirolimus-based immunosuppression in kidney transplant recipients. Materials and Methods: From 2001 to 2009, one hundred fifty kidney transplant recipients were converted from calcineurin inhibitors to sirolimus at least 3 months after transplant. Results: After a mean follow-up of 171 weeks, 56.7% of converted patients remained on sirolimus. The 5-year survival rate of the patients (including intent-to-treat) and grafts was 85.5% and 83.6%. Patients on sirolimus showed significant improvement in renal function with a creatinine clearance of 50.9 ± 20.7 and 52.9 ± 20.8 mL/minute at month 0 and month 24. Independent predictive factors associated with a stable estimated glomerular filtration rate at the last follow-up of sirolimus patients were (1) having a living donor, (2) absence of anti-HLA alloantibodies at month 0, and (3) cyclosporine versus tacrolimus used before conversion. Adverse effects were reported in 134 patients (89.3%). They included (1) hospitalization for infection (n=52), (2) de novo proteinuria (n=40), and (3) eight patients with biopsy-proven acute rejection. Sirolimus was stopped and replaced by calcineurin inhibitors in 37 patients after a mean of 16 months treatment. After stopping sirolimus, renal-allograft function remained stable at 2 years. Conclusions: Conversion of calcineurin inhibitors to sirolimus in kidney transplant recipients was associated with improved renal function. The reintroduction of calcineurin inhibitors was safe in patients who were withdrawn from sirolimus owing to adverse effects.
Unusual Presentation of Cytomegalovirus Infection in Patients After Organ Transplant
(Başkent Üniversitesi, 2009-03) Guilbeau-Frugier, Céline; Rostaing, Lionel; Tiple, Aurélien; Kamar, Nassim; Esposito, Laure; Mengelle, Catherine; Combelles, Sophie; Otal, Philippe
Objectives: Cytomegalovirus (CMV) infection has an enormous impact in solid-organ transplant patients. In immunocompromised patients, CMV is associated with well-known direct effects. We herein describe 3 unusual patterns occurring in the setting of tissue-invasive CMV associated with high viral load. Materials and Methods: Of our 3 cases, the first patient after kidney transplant presented with cholestasis related to radiological cholangitis; the second patient after heart transplant presented with erythema nodosum with CMV infection as the sole cause; and the third patient after kidney transplant presented with acute renal failure related to mild interstitial nephritis with acute tubular necrosis and tubulitis. Results: The first patient’s cholestasis resolved with antiviral therapy, as did the erythema nodosum and CMV infection of the heart transplant patient. The third patient’s acute renal failure resolved by increased steroid dosage, plasma exchanges, and ganciclovir therapy. Conclusions: These 3 unusual presentations of tissue-invasive CMV had favorable outcomes with antiviral therapy.