Impact of targeted hypothermia in expanded-criteria organ donors on recipient kidney-graft function: study protocol for a multicentre randomised controlled trial (HYPOREME).

Introduction: Expanded-criteria donors (ECDs) are used to reduce the shortage of kidneys for transplantation. However, kidneys from ECDs are associated with an increased risk of delayed graft function (DGF), a risk factor for allograft loss and mortality. HYPOREME will be a multicentre randomised controlled trial (RCT) comparing targeted hypothermia to normothermia in ECDs, in a country where the use of machine perfusion for organ storage is the standard of care.

Psychosocial risk factors for impaired health-related quality of life in living kidney donors: results from the ELIPSY prospective study.

Living kidney donors' follow-up is usually focused on the assessment of the surgical and medical outcomes. Whilst the psychosocial follow-up is advocated in literature. It is still not entirely clear which exact psychosocial factors are related to a poor psychosocial outcome of donors.

[Kidney transplantation epidemiology in France].

Kidney transplantation activity in France is among the most important worldwide: in 2011, 2976 transplants have been performed (47.5 per million population), and the number of patients living with a functional graft is estimated around 30,000, representing 44.7% of all patients (n = 67,270) treated for end-stage renal failure.

Posttransplant major histocompatibility complex class I chain-related gene A antibodies and long-term graft outcomes in a multicenter cohort of 779 kidney transplant recipients.

Background: The impact of major histocompatibility class I chain-related A (MICA) antibodies on renal graft outcomes is unclear. The goal of this work was to assess the impact of posttransplant MICA antibodies, assayed at 1 year, with two commercially available kits, on long-term renal graft outcomes.

Methods: We retrospectively tested sera from 779 kidney transplant recipients with two single-antigen flow bead assays 1 year after transplantation.

[Living-donor kidney transplantation in the European countries and in North America (2001-2009)].

In front of kidney transplants shortage, the alternative of living donor renal transplantation is discussed. The purpose of this work is to compare, in 16 European countries and of North America having a consequent activity, the levels of living donor renal transplantation activities and their possible impact on kidney shortage, usually reported in a fragmented and punctual way. In 2009 and in spite of a light growth, the French rate of 3,5 living donor kidney transplantation per million people (pmp) was one of the weakest just before Italy and Finland.

Systemic and kidney toxicity of intraocular administration of vascular endothelial growth factor inhibitors.

Intravenous injection of angiogenesis-inhibitor drugs is used widely to treat cancers. Associated renal complications primarily involve proteinuria and hypertension, and thrombotic microangiopathies also have been described. Intravitreal anti-vascular endothelial growth factor (VEGF) therapy currently is used by ophthalmologists to treat neovascularization in age-related macular degeneration.

20-year follow-up results of a randomized controlled trial comparing antilymphocyte globulin induction to no induction in renal transplant patients.

Background: The purpose of this study was to determine the impact of antilymphocyte globulin (ALG)-induction on long-term outcomes of postrenal transplantation.

Methods: Between January 1985 and January 1986, 123 consecutive renal transplants from deceased donors were performed at a single institution. Patients were randomized into two groups: group 1 (n=63, 40+/-10 year) received cyclosporine (CsA), prednisone, and azathioprine; and group 2 (n=60, 36+/-9 year) received ALG-induction, CsA, and prednisone and delayed initiation (45-90 days posttransplantation) of azathioprine if the CsA dose was less than 4 mg/kg per day.

[Kidney transplantation].

Today, kidney transplantation is the treatment of choice for most patients with end-stage renal failure. However, because of the organ shortage, the limiting supply and increasing demand, needing transplants do not receive them. Chronic renal disease should be efficiently screened and prevented.

Analysis of skin cancer risk factors in immunosuppressed renal transplant patients shows high levels of UV-specific tandem CC to TT mutations of the p53 gene.

Immunosuppressed renal transplant recipients (RTRs) are predisposed to non-melanoma skin cancers (NMSCs), predominantly squamous cell carcinomas (SCCs). We have analyzed skin lesions from RTRs with aggressive tumors for p53 gene modifications, the presence of Human Papillomas Virus (HPV) DNA in relation to the p53 codon 72 genotype and polymorphisms of the XPD repair gene. We detected 24 p53 mutations in 15/25 (60%) NMSCs, 1 deletion and 23 base substitutions, the majority (78%) being UV-specific C to T transitions at bipyrimidine sites.

[The new French rules for the attribution of renal transplants].

The French rules for the attribution of a kidney transplant are regularly evaluated and modified according to scientific progress, evolution of the waiting list and of health policies. Modifications, initiated by the Transplantation Commission of the French-speaking Society of Nephrology, have been introduced in 2004 by the Etablissement français des Greffes and aim at decreasing the number of patients on the waiting list having difficult access to transplantation because of their immunogenetic characteristics (rare ABO or HLA group, HLA immunization). Four points are concerned: 1/ better definition of hyperimmunisation; 2/ introduction of a program based on "acceptable mismatches" as a new priority for hyperimmunized patients; 3/ suppression of the full-match priority to non-immunized patients; 4/ attribution to immunized patients (anti-HLA antibodies=5-80%) who have difficult access to a transplant, of priorities similar to those followed for hyperimmunized patients.

High pulse pressure associated with cardiovascular events in patients with type 2 diabetes undergoing hemodialysis.

Background: The aims of this study were to examine systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP), and pulse pressure (PP) in patients with type 2 diabetes undergoing hemodialysis (HD), and to assess the relationships between these parameters and cardiovascular (CV) events such as coronary heart disease and congestive cardiac failure.

Methods: A total of 80 Afro-Caribbean type 2 diabetic patients undergoing hemodialysis in three centers in Guadeloupe, French West Indies, were included in this cross-sectional study. Pre- and postdialysis BP were recorded.

Living with a functioning kidney transplant at 74 yr or older: a national epidemiological study.

The number of older patients living with a functioning kidney graft is increasing. However the safety of the immunosuppressive treatment and quality of life in this population have not yet been determined. All patients grafted in France since 1969, born before the January 1 1926 and living with a functioning graft on January 1 2000 were included in this national study including all 34 French transplant centers.

The case to abandon human leukocyte antigen matching for kidney allocation: would it be wise to throw out the baby with the bathwater?

Since major histocompatibility (MHC) antigen matching was introduced in the early 1970s as the key factor determining kidney transplant allocation, several studies, mainly arising from organ-sharing organizations in the United States and Europe, have debated this complex issue. The first fundamental concern is the interaction of human leukocyte antigen matching with other transplant outcome risk factors, for example, prolongation of ischemia and matching for age. Much concordant data advocate restraining MHC antigen-based allocation in terms of space and time limits.

Quality of life in adult survivors beyond 10 years after liver, kidney, and heart transplantation.

Background: The yearly increasing survival rates testify to the success of transplantation, but questions remain relating to the quality of life (QOL) associated with long-term survival.

Methods: A sample of 126 liver recipients (Liver-R), 229 kidney recipients (Kidney-R), and 113 heart recipients (Heart-R) with more than 10 years posttransplant follow-up were included in the study with a response rate of 86%. Respondents were matched with healthy subjects recruited from general population (GP).

[Kidney grafts from elderly donors].

FROM AN EPIDEMIOLOGICAL POINT OF VIEW: The epidemiology of renal transplantation had greatly changed over the past 10 years. The increasing number of patients with renal failure and candidates for transplantation increases the demand for grafts, whereas the sampling rate of organs remains stable. The mean age of the donors is rising, hence underlining the question of the use of organs of so-called "borderline" quality.

Multivariate analysis of donor risk factors for graft survival in kidney transplantation.

Background: The results of the transplantation of marginal donor kidneys remain controversial. This study aimed to investigate the impact of donor risk factors as predictors of kidney-graft outcome.

Methods: Allograft failure risk factors were studied in 7,209 cadaveric kidney-transplant recipients reporting to the Etablissement français des Greffes (EfG) from 1996 to 2000, of which 544 (7.

Prognostic value of quantitative Kaposi sarcoma--associated herpesvirus load in posttransplantation Kaposi sarcoma.

Organ transplant recipients have a higher risk of Kaposi sarcoma (KS). A quantitative real-time polymerase chain reaction assay was developed to evaluate KS-associated herpesvirus (KSHV) as a prognostic tool in transplant recipients with KS. Forty-three patients who developed KS after transplantation were included in a cross-sectional study to correlate virus load with transplantation or KS parameters.