Publications by authors named "Bunel V"

Article Synopsis
  • Long-term oxygen therapy, defined as oxygen use for more than 15 hours a day, is the primary and most validated form of home oxygen treatment for patients with severe chronic hypoxemia, showing survival benefits.
  • Other proposed oxygen therapy modalities include using oxygen for moderate hypoxemia, ambulatory care for severe exertional hypoxemia, and nocturnal therapy for nighttime low oxygen levels.
  • The manuscript aims to review evidence supporting various home oxygen therapy methods for conditions like chronic obstructive pulmonary disease and interstitial lung disease, along with recommendations from expert groups on long-term oxygen therapy use.
View Article and Find Full Text PDF
Article Synopsis
  • The study examines lung transplantation (LT) outcomes in patients aged 65 and older compared to younger recipients, emphasizing that age shouldn't be a strict barrier for the procedure.
  • Researchers conducted a retrospective analysis of patients who underwent LT at Bichat Hospital, tracking 90-day mortality and other long-term health markers.
  • Results showed that while elderly patients had better short-term lung function post-transplant, their overall survival rates and mortality within the first year were similar to those of younger patients.
View Article and Find Full Text PDF

Background: Circulating extracellular vesicles (EVs) have shown promising results as noninvasive biomarkers for predicting disease outcomes in solid organ transplantation. Because in situ graft cell expression of the tolerogenic molecule HLA-G is associated with acceptance after lung transplantation (LTx), we hypothesized that plasma EV-bound HLA-G (HLA-GEV) levels could predict chronic lung allograft dysfunction (CLAD) development.

Methods: We analyzed 78 LTx recipients from the Cohort-for-Lung-Transplantation cohort, all in a stable (STA) state within the first year post-LTx.

View Article and Find Full Text PDF
Article Synopsis
  • Early diagnosis of kidney damage after lung transplantation is crucial due to its negative impact on patient prognosis.
  • A study analyzed 100 kidney biopsies from lung transplant patients, finding that chronic renal dysfunction was the main reason for biopsy, revealing a variety of chronic kidney lesions.
  • Key factors linked to the risk of progressing to end-stage renal disease included postoperative dialysis, high levels of proteinuria, and significant glomerulosclerosis, highlighting the need for timely nephrologist referrals.
View Article and Find Full Text PDF

In patients with pulmonary emphysema and mild to moderate airflow limitation, one does not expect the features marked exertional dyspnea and hypoxemia as well as a profound decrease in diffusing capacity of the lung for carbon monoxide (DLCO). Here we describe this phenotype and its prognosis. From our database, we retrospectively selected cases associating emphysema, exertional breathlessness, O requirement at least upon exercise, forced expiratory volume in 1 sec (FEV) ≥ 50% predicted, and DLCO ≤ 50% predicted, without associated combined pulmonary fibrosis and emphysema, right-to-left shunt, or severe pulmonary hypertension.

View Article and Find Full Text PDF
Article Synopsis
  • Human metapneumovirus (hMPV) is a major cause of respiratory infections, and this study focused on adult patients with hMPV-related lower respiratory tract infections to evaluate their clinical features and outcomes.
  • A total of 208 patients were studied, with a median age of 74 years; most patients had coexisting health issues, and common symptoms included difficulty breathing and cough, while pneumonia was the most frequent diagnosis.
  • The study found that 18% of patients had a complicated course requiring intensive care, with a notable increased risk in those with bacterial coinfections, suggesting the need for careful monitoring and potential early intervention in this population.
View Article and Find Full Text PDF

Background: The age profile of organ donors and patients on lung transplantation (LT) waiting lists have changed over time. In Europe, the donor population has aged much more rapidly than the recipient population, making allocation decisions on lungs from older donors common. In this study we assessed the impact of donor and recipient age discrepancy on LT outcomes in the UK and France.

View Article and Find Full Text PDF

Background: Respiratory syncytial virus (RSV) is widely recognized as a cause of acute respiratory failure in infants and immunocompromised patients. However, RSV can also contribute to acute respiratory failure in adults, particularly among the elderly population. The objective of this study was to analyze the clinical characteristics and outcomes of immunocompetent adults hospitalized for RSV infection.

View Article and Find Full Text PDF

Background: Light chain deposition disease (LCDD) is a very rare entity. Clinical manifestations of LCDD vary according to the organs involved. Data on pulmonary LCDD are scarce and limited to small series or case reports.

View Article and Find Full Text PDF

Background: Interstitial lung disease associated with genetic disorders of the surfactant system is a rare entity in adults that can lead to lung transplantation. Our objective was to describe the outcome of these patients after lung transplantation.

Methods: We conducted a retrospective, multicentre study, on adults who underwent lung transplantation for such disease in the French lung transplant centres network, from 1997 to 2018.

View Article and Find Full Text PDF

Background And Aim: Germline mutations of telomere-related genes (TRG) induce multiorgan dysfunction, and liver-specific manifestations have not been clearly outlined. We aimed to describe TRG mutations-associated liver diseases.

Approach And Results: Retrospective multicenter analysis of liver disease (transaminases > 30 IU/L and/or abnormal liver imaging) in patients with TRG mutations.

View Article and Find Full Text PDF

Objectives: This study described the demographic characteristics, clinical presentation, treatment, and outcomes of solid organ transplant recipients who were admitted to our center for infection. It also determined factors associated with a poor outcome, and compares early and late period infections.

Methods: In this retrospective observational study, conducted at a tertiary care center in France between October 2017 and March 2019, infectious outcomes of patients with solid organ transplant where studied.

View Article and Find Full Text PDF

Background: Antifibrotic agents (AFAs) are now standard-of-care for idiopathic pulmonary fibrosis (IPF). Concerns have arisen about the safety of these drugs in patients undergoing lung transplantation (LTx).

Methods: We performed a multi-centre, nationwide, retrospective, observational study of French IPF patients undergoing LTx between 2011 and 2018 to determine whether maintaining AFAs in the peri-operative period leads to increased bronchial anastomoses issues, delay in skin healing and haemorrhagic complications.

View Article and Find Full Text PDF

Cushing's syndrome is an iatrogenic event occurring during co-administration of inhaled corticosteroids and potent inhibitors of P450 cytochromes. We report the clinical case of a 29-year-old woman with a past history of asthma treated with inhaled fluticasone propionate (FP), chronic pulmonary aspergillosis and allergic bronchopulmonary aspergillosis (ABPA) treated with itraconazole (ITZ), and Mycobacterium xenopi infection treated with moxifloxacin (MXF), ethambutol (EMB) and clarithromycin (CLR). Four months after initiation of antibiotic and antifungal medication, the patient contracted Cushing's syndrome.

View Article and Find Full Text PDF

A 24-year-old Senegalese woman without remarkable history except anemia and iron deficiency related to excessive menstrual bleeding and sickle cell trait was admitted to our internal medicine department with 4-month fever, weight loss (-13 kg), dyspnea for limited efforts, intermittent productive cough, and bilateral metacarpophalangeal (MCP) and interphalangeal arthralgia. She was born and lived in France. She traveled previously to Senegal in 2015.

View Article and Find Full Text PDF

spp. are associated with respiratory infections in immunocompromised hosts. A link with bronchial complications after lung transplantation (LTx) has been suggested.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF
Article Synopsis
  • The study examined the presence and effects of culture-positive preservation fluid (PF) in lung transplant patients from 2015 to 2020, finding that 30.6% had PF that tested positive for microorganisms.
  • Common bacteria like Staphylococcus aureus and Escherichia coli were identified, and a significant portion of culture-positive samples were polymicrobial.
  • Patients with culture-positive PF experienced lower 30-day survival rates (85.5%) compared to those with culture-negative PF (94.7%), prompting the need for further research to understand the implications and management of culture-positive PF.
View Article and Find Full Text PDF
Article Synopsis
  • * Traditional desensitization methods for these patients often have limitations, making it difficult to find suitable donors.
  • * The presented case is the first successful use of imlifidase for a highly sensitized lung transplant candidate, leading to a successful bilateral lung transplant.
View Article and Find Full Text PDF