Publications by authors named "Guillemain R"

Article Synopsis
  • Children with cystic fibrosis (CF) often face acute respiratory failure due to severe pulmonary exacerbations, leading to pediatric intensive care unit (PICU) admissions, with a focus on understanding their short and medium-term outcomes.
  • A study reviewed data from patients under 18 years old admitted to a French PICU over two decades, utilizing statistical methods to identify factors influencing mortality and the need for lung transplants.
  • Results indicated high mortality rates (up to 41% within 3 years post-discharge) and identified key risk factors like gender, certain blood gas levels, and pre-admission health conditions, highlighting the critical need for early consideration of lung transplants as a survival option.
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Objectives: Heart transplantation (HT) is the only life-extending therapy in adults with congenital heart disease (CHD) and end-stage heart failure. HT is considered at high risk in complex CHD given the anatomical complexity and past medical history. Little is known about long-term outcomes after HT in these patients.

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Aims: The prognostic value of 'high dose' loop diuretics in advanced heart failure outpatients is unclear. We aimed to assess the prognosis associated with loop diuretic dose in ambulatory patients awaiting heart transplantation (HT).

Methods And Results: All ambulatory patients (n = 700, median age 55 years and 70% men) registered on the French national HT waiting list between 1 January 2013 and 31 December 2019 were included.

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Aims: The epidemiology of sudden cardiac death (SCD) after heart transplantation (HTx) remains imprecisely described. We aimed to assess the incidence and determinants of SCD in a large cohort of HTx recipients, compared with the general population.

Methods And Results: Consecutive HTx recipients (n = 1246, 2 centres) transplanted between 2004 and 2016 were included.

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A 67-year-old patient with history of heart transplantation was referred for symptomatic severe tricuspid regurgitation. Diagnostic workup showed chordal ruptures on the septal and anterior leaflets, most likely related to endomyocardial biopsies. Given the high surgical risk, the patient was treated percutaneously, with good results persisting at 3 months.

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Little is known about localized osteoarticular Scedosporiosis (LOS). Most data come from case reports and small case series. Here we present an ancillary study of the nationwide French Scedosporiosis Observational Study (SOS), describing 15 consecutive cases of LOS diagnosed between January 2005 and March 2017.

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Objective: Immunocompromised patients have an increased risk of a severe form of COVID-19. The clinical efficacy of the tixagevimab/cilgavimab monoclonal antibody combination as pre-exposure prophylaxis against BA.1 and BA.

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Background: Little is known about targeted (antiviral or monoclonal antibody) anti-SARS-CoV-2 treatment in immunocompromised patients with COVID-19.

Objectives: To assess the real-life efficacy and tolerance of targeted treatment of COVID-19 in immunocompromised patients.

Patients And Methods: Single-centre retrospective case series of immunocompromised patients with COVID-19 between December 2021 and March 2022.

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Article Synopsis
  • The study evaluates the effectiveness of Forrester's perfusion/congestion profiles in predicting outcomes for non-inotrope advanced heart failure patients on the heart transplant waitlist in France.
  • Among the 837 patients assessed, those in 'warm-dry', 'cold-dry', 'warm-wet', and 'cold-wet' categories showed varying rates of adverse outcomes, with 'wet' profiles having significantly worse prognoses.
  • The findings highlight that persistent congestion is a critical factor impacting survival and treatment urgency for advanced heart failure patients awaiting transplantation.
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Introduction: Mammalian target of rapamycin (mTOR) inhibitors-associated pneumonitis (mTOR-IP) has long been described in solid organ recipients (T) patients but more recently in cancer (K) patients. Its overall characteristics have never been compared between these 2 populations. The aim of this study was to compare them in terms of presentation, severity and outcome in T and in K patients.

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Objective: Voriconazole is an antifungal treatment with central neurotoxicity. Modifications of the electroretinogram can explain some of its visual complications: visual hallucination, blurred vision, altered visual perception or photophobia. However, reports from the literature or the French pharmacovigilance centers evoked toxic optic neuropathy due to voriconazole.

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Article Synopsis
  • The study focuses on adults with congenital heart disease (ACHD), who often suffer from heart failure (HF) due to past surgeries and require better treatment data to improve their care.
  • Researchers will collect data from a multi-country register, the ARTORIA-R, identifying ACHD patients listed for heart transplantation from 1989-2020, using both retrospective and prospective methods.
  • The goal is to track outcomes like clinical worsening, death on the waiting list, and overall mortality after transplantation to enhance understanding and management of advanced heart failure in this population.
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Bacteriophages are a promising therapeutic strategy among cystic fibrosis and lung-transplanted patients, considering the high frequency of colonization/infection caused by pandrug-resistant bacteria. However, little clinical data are available regarding the use of phages for infections with . A 12-year-old lung-transplanted cystic fibrosis patient received two rounds of phage therapy because of persistent lung infection with pandrug-resistant .

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Background: Since the first successful facial transplantation in 2005, the benefits of this procedure in terms of aesthetics, functionality, and quality of life have been firmly established. However, despite immunosuppressive treatment, long-term survival of the allograft might be compromised by chronic antibody-mediated rejection (CAMR), leading to irreversible necrosis of the tissue. In the absence of therapeutic options, this complication is inevitably life-threatening.

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Article Synopsis
  • The study focuses on cardiac allograft vasculopathy (CAV), a significant cause of mortality in heart transplant patients, aiming to identify different progression patterns of CAV and the factors influencing these trajectories.
  • Researchers monitored 1,301 heart transplant recipients from multiple academic centers, analyzing numerous angiographies and medical parameters to forecast CAV development and its association with patient mortality.
  • Four distinct CAV progression profiles were discovered: no CAV progression, late-onset slow progression, mild progression, and accelerated progression, with specific early predictors identified that could help in understanding and managing CAV in patients.
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Background: Molecular biology has emerged as a potential companion to histology for the diagnosis of rejection after heart transplantation. Reverse transcriptase multiplex ligation-dependent probe amplification (RT-MLPA) is a technique of targeted gene expression analysis suitable for formalin-fixed paraffin-embedded (FFPE) biopsies. Our aim was to assess RT-MLPA for the diagnosis of allograft rejection in heart transplantation.

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Article Synopsis
  • Current understanding suggests that microvascular inflammation (MVI) from antibody responses is primarily responsible for graft failure, but about half of the renal transplant recipients with MVI show no antibody involvement in their histological damage.
  • Genetic analysis reveals that these patients often have mismatched donor HLA I and recipient inhibitory killer cell immunoglobulin-like receptors (KIRs).
  • Further research indicates that the lack of HLA I signals from graft endothelial cells leads to the activation of natural killer (NK) cells, causing endothelial damage, and this process can be inhibited with the mTOR inhibitor rapamycin.
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Article Synopsis
  • - Belatacept (BTC) is used to prevent graft rejection in kidney transplant patients and was studied in heart transplant recipients from January 2014 to October 2018, focusing on its impact on renal function and safety.
  • - Among 40 patients, those who started BTC within the first 3 months showed a significant improvement in kidney function (GFR increased by 59% within a month), while late starters faced more rejection episodes.
  • - The study noted a 76% rate of changes in immunosuppressive therapy, primarily to conserve kidney function, with a median follow-up of 24 months, indicating BTC's effectiveness but also highlighting complications like DSA development and treatment discontinuations.
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Bronchiolitis obliterans syndrome is the main limitation for long-term survival after lung transplantation. Some specific B cell populations are associated with long-term graft acceptance. We aimed to monitor the B cell profile during early development of bronchiolitis obliterans syndrome after lung transplantation.

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Purpose: The purpose of this study was first to evaluate the imaging-related cumulative post-transplantation radiation dose in cystic fibrosis (CF) lung transplantation (LT) recipients and second, to identify the occurrence and type of malignancies observed after LT.

Materials And Methods: A total of 52 patients with CF who underwent LT at our institution between January 2001 and December 2006 with at least 3 years of survival were retrospectively included. There were 27 men and 25 women with a mean age of 24.

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Article Synopsis
  • Chronic bronchiolitis obliterans syndrome (BOS) significantly affects long-term survival in lung transplant patients, but the immune mechanisms and predictive biomarkers remain unclear.
  • This study aimed to analyze blood T-lymphocyte profiles to see if they could predict BOS development in lung transplant recipients by assessing CD4 and CD8 T cells at various time points.
  • The results showed a notably higher percentage of CD4CD25FoxP3 T cells in patients who developed BOS, suggesting it could serve as an effective biomarker for predicting BOS in post-transplant patients.
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Hepatitis E virus (HEV) can induce chronic infections in the case of immunosuppression, which are sometimes not cured with ribavirin. Furthermore, sofosbuvir is a highly potent inhibitor of HCV polymerase and was shown to inhibit HEV genotype-3 replication in vitro. We report here the outcome of sofosbuvir/ribavirin therapy on a chronic HEV infection in a heart transplant recipient non-responder to ribavirin.

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Background: Club Cell Secretory Protein (CCSP) G38A polymorphism has recently been involved in lung epithelial susceptibility to external injuries. Lung transplantation (LT) is currently limited by ischemia-reperfusion injury leading to primary graft dysfunction (PGD). We thus hypothesized that donor CCSP G38A polymorphism might impact the risk of PGD after LT.

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