Introduction:Telemonitoring has the potential to improve access to care and continuity of follow-up after kidney transplantation. Advanced practice nurses (APNs) play an increasingly important role in coordinating remote care pathways. This study evaluated patient experience with telemonitoring after renal transplantation, identified determinants of adherence, and clarified the role of APNs in this model. Methods:We conducted a single-center retrospective observational study including adult kidney transplant recipients enrolled in a telemonitoring program between April 2020 and April 2022. Patients were classified as active users (TOUCO), discontinued users (STOPCO), or never users (JAMCO). Satisfaction and experience were assessed through questionnaires. Platform activity and APN workload were analyzed using descriptive statistics. Results:Among 207 eligible patients, 110 responded to the survey (53%): 64 TOUCO (71%), 11 STOPCO (47%), and 35 JAMCO (37%). Active users reported high satisfaction with response time (89%), improved access to care (81%), and increased reassurance (75%). Ease of use (86%) and adequate information at enrollment were significantly associated with continued use. Major barriers included technical difficulties (≈80%) and loss of login credentials (>50%). During the study period, 5,214 platform events and more than 4,000 secure messages were recorded, reflecting sustained engagement. APNs required a mean workload of 3 hours per day to manage all active users on a daily basis. Conclusion:Telemonitoring after kidney transplantation is feasible and well accepted, improving perceived access to care and enhancing patient reassurance without measured clinical outcome differences. Adherence is driven primarily by organizational and technological factors rather than patient characteristics. APNs play a central role in ensuring continuity of care, triaging data, and maintaining patient engagement. Future studies should evaluate clinical outcomes and cost-effectiveness to support broader implementation.

Hemoglobin-based oxygen carriers have been developed to compensate the needs of blood for transfusions. Most of them were based on intracellular hemoglobin extracted from bovine or human blood, but unfortunately, this type of hemoglobin did not pass through the last steps of clinical trials. In this context, HEMARINA discovered a natural extracellular hemoglobin, possessing several advantages avoiding intracellular hemoglobin-related side effects. Many preclinical studies assessed the safety of M101 used in intravenous (IV) injection in rodents. To explore the safety of IV injections of M101 in large mammals, six dogs received each a single injection of liquid M101 according to a dose escalation with a 48 h follow-up. Then, two monkeys received multiple IV injections of the same dose of M101 every hour for seven hours. This study showed that single and multiple IV injections in dogs and monkeys did not cause clinical or histological lesions, nor did they induce immunological reactions. This makes M101 the best candidate to date for human use in emergency situations requiring blood and, in several diseases, causing hypoxia problems.

The natural extracellular hemoglobin of the lugworm Arenicola marina (AmHb) has many interesting characteristics: It carries 40 times more oxygen than human hemoglobin; has anti-inflammatory, antibacterial, and antioxidant properties; and is 250 times smaller than a red blood cell. It is nontoxic and nonimmunogenic. It is thus a very promising hemoglobin-based oxygen carrier. AmHb is extracted and purified in GMP conditions to produce a therapeutic molecule, called M101. It is used in various forms (liquid, hydrogel, and lyophilized) to respond to different situations of hypoxia in the healthcare field, such as organ preservation prior to transplantation, wound and burn healing, periodontitis, sickle cell disease, and red blood cell transfusions, particularly in emergency situations. Given these remarkable oxygen transport capacities, M101 could be misused for doping purposes. This article presents current and future developments in this molecule.

Mutational dynamics of SARS-CoV-2 in immunocompromised hosts, although well documented, remain a relatively unexplored mechanism. This study aims to compare the viral replication load and genetic diversity of SARS-CoV-2 in immunocompromised patients and non-immunocompromised individuals (NICs) from two major hospitals in Paris from January 2021 to May 2023. Cycle threshold (CT) values were measured by TaqPath COVID-19 RT-PCR (Thermo Fisher Scientific). The SARS-CoV-2 whole-genomes from 683 immunocompromised patients and 296 NICs was sequenced using Oxford Nanopore Technologies and used to determine lineage and mutational profile. All immunocompromised patients, but not oncology patients, had lower SARS-CoV-2 viral loads than NICs. The genetic distribution of SARS-CoV-2 was homogeneous between immunocompromised individuals and NICs, with more mutations in immunocompromised patients (IRR = 1,013). Indeed, extensive genomic analysis revealed several mutations specifically associated with immunosuppression status, such as S: T95I, S:N764K, M:Q19E and ORF10:L37F. Conversely, the S: R346K and NSP13:T127N mutations were more common in NICs. Immunocompromised patients have lower viral loads, probably due to their later diagnosis compared to NICs and oncology patients, who have better access to on-site SARS-CoV-2 testing and follow-up. In addition, mutational profiles differ between the two groups, with immunocompromised hosts accumulating more mutations compared to NICs.

Renal transplant biopsy remains the gold standard for etiological diagnosis of graft dysfunction and subsequent management. When percutaneous renal biopsy (PRB) is contraindicated due to bleeding risk or limited percutaneous access, the fluoroscopy-guided transvenous femoral renal transplant biopsy (TFRB) might be a valuable alternative. This study aims to describe the TFRB technique, its safety, and efficacy. All patients who underwent TFRB at our institution between 2020 and 2023 were retrospectively analyzed. Procedure outcomes, patients’ characteristics and follow-up data were collected. Adverse events were graded using the Adverse Events Classification of the Society of Interventional Radiology. From January 2020 to December 2023, 109 patients (median age 61.2 years (Interquartile range (IQR), 54.5–68.6) ; 49 males (45.0

BACKGROUND: Legionnaires disease (LD) is a rare, life -threatening opportunistic bacterial infection that poses a significant risk to patients with impaired cell -mediated immunity such as solid organ transplant recipients. However, the epidemiologic features, clinical presentation, and outcomes of LD in this population are poorly described. RESEARCH QUESTION: What are the clinical manifestations, radiologic presentation, risk factors for severity, treatment, and outcome of LD in solid organ transplant recipients? STUDY DESIGN AND METHODS: In this 10 -year multicenter retrospective cohort study in France, where LD notification is mandatory, patients were identified by hospital discharge databases. Diagnosis of LD relied on positive culture findings from any respiratory sample, positive urinary antigen test (UAT) results, positive specific serologic findings, or a combination thereof. Severe LD was defined as admission to the ICU. RESULTS: One hundred one patients from 51 transplantation centers were eligible; 64 patients (63.4%) were kidney transplant recipients. Median time between transplantation and LD was 5.6 years (interquartile range, 1.5-12 years). UAT results were positive in 92% of patients (89/97). Among 31 patients with positive culture findings in respiratory samples, Legionella pneumophila serogroup 1 was identified in 90%. Chest CT imaging showed alveolar consolidation in 98% of patients (54 of 57), ground -glass opacity in 63% of patients (36 of 57), macronodules in 21% of patients (12 of 57), and cavitation in 8.8% of patients (5 of 57). Fifty-seven patients (56%) were hospitalized in the ICU. In multivariate analysis, severe LD was associated with negative UAT findings at presentation (P = .047), lymphopenia (P = .014), respiratory symptoms (P = .010), and pleural effusion (P = .039). The 30 -day and 12 -month mortality rates were 8% (8 of 101) and 20% (19 of 97), respectively. In multivariate analysis, diabetes mellitus was the only factor associated with 12 -month mortality (hazard ratio, 3.2; 95% OR, 1.19-8.64; P = .022). INTERPRETATION: LD is a late and severe complication occurring in solid organ transplant recipients that may present as pulmonary nodules on which diabetes impacts its long-term prognosis.

BACKGROUND:Cardiac arrest (CA) causes renal ischemia in one-third of brain-dead kidney donors before procurement. We hypothesized that the graft function depends on the time interval between CA and organ procurement. METHODS:We conducted a retrospective population-based study on a prospectively curated database. We included 1469 kidney transplantations from donors with a history of resuscitated CA in 2015-2017 in France. CA was the cause of death (primary CA) or an intercurrent event (secondary CA). The main outcome was the percentage of delayed graft function, defined by the use of renal replacement therapy within the first week posttransplantation. RESULTS:Delayed graft function occurred in 31.7% of kidney transplantations and was associated with donor function, vasopressors, cardiovascular history, donor and recipient age, body mass index, cold ischemia time, and time to procurement after primary cardiac arrest. Short cold ischemia time, perfusion device use, and the absence of cardiovascular comorbidities were protected by multivariate analysis, whereas time <3 d from primary CA to procurement was associated with delayed graft function (odds ratio 1.38). CONCLUSIONS:This is the first description of time to procurement after a primary CA as a risk factor for delayed graft function. Delaying procurement after CA should be evaluated in interventional studies.

Background Legionnaires disease (LD) is a rare, life-threatening opportunistic bacterial infection that poses a significant risk to patients with impaired cell-mediated immunity such as solid organ transplant recipients. However, the epidemiologic features, clinical presentation, and outcomes of LD in this population are poorly described. Research Question What are the clinical manifestations, radiologic presentation, risk factors for severity, treatment, and outcome of LD in solid organ transplant recipients? Study Design and Methods In this 10-year multicenter retrospective cohort study in France, where LD notification is mandatory, patients were identified by hospital discharge databases. Diagnosis of LD relied on positive culture findings from any respiratory sample, positive urinary antigen test (UAT) results, positive specific serologic findings, or a combination thereof. Severe LD was defined as admission to the ICU. Results One hundred one patients from 51 transplantation centers were eligible; 64 patients (63.4%) were kidney transplant recipients. Median time between transplantation and LD was 5.6 years (interquartile range, 1.5-12 years). UAT results were positive in 92% of patients (89/97). Among 31 patients with positive culture findings in respiratory samples, Legionella pneumophila serogroup 1 was identified in 90%. Chest CT imaging showed alveolar consolidation in 98% of patients (54 of 57), ground-glass opacity in 63% of patients (36 of 57), macronodules in 21% of patients (12 of 57), and cavitation in 8.8% of patients (5 of 57). Fifty-seven patients (56%) were hospitalized in the ICU. In multivariate analysis, severe LD was associated with negative UAT findings at presentation (P = .047), lymphopenia (P = .014), respiratory symptoms (P = .010), and pleural effusion (P = .039). The 30-day and 12-month mortality rates were 8% (8 of 101) and 20% (19 of 97), respectively. In multivariate analysis, diabetes mellitus was the only factor associated with 12-month mortality (hazard ratio, 3.2; 95% OR, 1.19-8.64; P = .022). Interpretation LD is a late and severe complication occurring in solid organ transplant recipients that may present as pulmonary nodules on which diabetes impacts its long-term prognosis.

BACKGROUND:We assessed the prognostic value of serological humoral markers measured one month after the last dose of the primary COVID-19 vaccine course for predicting the risk of severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 infection over the following six months in specific populations. METHODS:ANRS0001SCOV-POPART is a French nationwide multicenter prospective observational cohort study assessing the immune response to Covid-19 vaccines routinely administered to 11 subgroups of patients with chronic disease and a control group. Participants from the ANRS0001S COV-POPART were included if they received at least two doses of Covid-19 vaccine for the primary vaccine course, had measurements of anti-Spike, anti-receptor binding domain (RBD) IgG-specific or neutralizing antibodies one month after the end of the primary vaccine course, without being infected by SARS-CoV-2 before the measurement. SARS-CoV-2 infections defined by a positive PCR/antigenic test or seroconversion to detectable anti nucleocapsid antibodies were evaluated until the first COVID-19 booster injection. Cox proportional hazards models taking into account interval-censored data were implemented to estimate the association between each antibody level and the risk of SARS-CoV-2 infection. Predictive performances were evaluated by the area under the receiving operating characteristic curve (AUROC). RESULTS:Two thousand five hundred seventy adults from a specific population and 1,123 from the control group were included. The cumulative probabilities of SARS-CoV-2 infections at five months after serological measurement were 6.0% 95% confidence interval: [5.0; 7.9] and 10.1% 95% confidence interval: [8.3; 11.9], respectively. Higher levels of anti-Spike IgG antibody were associated with a lower risk of SARS-CoV-2 infections in the control group, but not in the specific populations. Among the specific populations, AUROC were 74.5%, 74.9%, and 72.4% for anti-Spike IgG, anti-RBD IgG, and neutralizing antibodies, respectively. AUROC were superior in the specific populations, 82.0%, 81.2%, and 81.4% for anti-Spike IgG, anti-RBD IgG, and neutralizing antibodies, respectively. CONCLUSIONS:Vaccine-induced antibody response after the primary course of Covid-19 infection only moderately discriminated between participants developing a SARS-CoV-2 infection during the Omicron wave. TRIAL REGISTRATION:NCT04824651 (first posted: 2021-04-01).

A 56-year-old kidney transplant recipient (transplantation 15 years prior for end-stage kidney failure from presumed arterionephrosclerosis, with no major complications, with estimated glomerular filtration rate of 30 ml/min per 1.73 m2) was admitted for worsening dyspnea, and orthopnea. She noted a beating mass, at the site of the kidney transplant.

Objectives: : We aimed to investigate the 1-month humoral response to two or three doses of a messenger RNA coronavirus disease 2019 (COVID-19) vaccine as a primary vaccination regimen in specific populations compared with that in healthy adults. Methods: Agence Nationale Recherche contre le Sida (ANRS)0001SeCOV-POPART (NCT04824651) is a French nation-wide, multi-centre, prospective, observational cohort study assessing theimmune response to COVID-19 vaccines routinely administered to 11 sub-groups of patients with chronic conditions and two control groups. Patients and controls who received at least two vaccine doses and whose results 1 month after the second dose were available were included. The humoral response was assessed 1 month after the first, second and third doses (if applicable) based on the percentage of responders (positive for anti-Spike severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] IgG antibodies), geometric means of antiSpike SARS-CoV-2 IgG antibodies (enzyme-linked immunosorbent assay) and proportion of participants with anti-SARS-CoV-2-specific neutralizing antibodies (in vitro neutralization assay for the original SARSCoV-2 strain). All analyses were centralized. Results: We included 4091 participants in this analysis: 2979 participants from specific sub-populations and 1112 controls. Only 522 (17.5%) participants from the specific populations received three doses as a primary vaccination regimen. Patients living with human immunodeficiency virus, cancer and diabetes had high percentages of responders after two doses, whereas patients with solid organ transplants, allogeneic hematopoietic stem cell transplants and hypogammaglobulinaemia had the lowest percentage of responders (35.9% [95% CI, 29.2e43.0], 57.4% [95% CI, 48.1e66.3] and 77.1% [95% CI, 65.6e86.3], respectively). In those who received the third dose, the percentage of responders reached 54.2% (95% CI, 42.9e65.2) (vs. 32.3% [95% CI, 16.7e51.4] after 2 doses) among those with solid organ transplants and 73.9% (95% CI, 58.9e85.7) (vs. 56.1% [95% CI, 46.2e65.7] after 2 doses) among those with hematopoietic stem cell transplants. Similar results were found with anti-SARS-CoV-2-specific neutralizing antibodies. Conclusions: A lower humoral response to COVID-19 vaccines was observed in the specific populations compared with that in the controls. The third dose of this vaccine in the primary regimen had a positive effect on the percentages of patients who developed anti-Spike IgG antibodies and specific neutralizing antibodies. Paul Loubet, Clin Microbiol Infect 2023;29:388.e1e388.e8 (c) 2022 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Background Preventing ischemia‒reperfusion injury (IRI) is a major issue in kidney transplantation, particularly for transplant recipients receiving a kidney from extended criteria donors (ECD). The main consequence of IRI is delayed graft function (DGF). Hypoxia is one of the key factors in IRI, suggesting that the use of an oxygen carrier as an additive to preservation solution may be useful. In the OxyOp trial, we showed that the organs preserved using the oxygen carrier HEMO2life® displayed significantly less DGF. In the OxyOp2 trial, we aim to definitively test and quantify the efficacy of HEMO2life® for organ preservation in a large population of kidney grafts. Methods OxyOp2 is a prospective, multicenter, randomized, comparative, single-blinded, parallel-group study versus standard of care in renal transplantation. After the selection of a suitable donor according to the inclusion/exclusion criteria, both kidneys will be used in the study. Depending on the characteristics of the donor, both kidneys will be preserved either in static cold storage (standard donors) or on machine perfusion (for ECD and deceased-after-cardiac-death donors (DCD)). The kidneys resulting from one donor will be randomized: one to the standard-of-care arm (organ preserved in preservation solution routinely used according to the local practice) and the other to the active treatment arm (HEMO2life® on top of routinely used preservation solution). HEMO2life® will be used for ex vivo graft preservation at a dose of 1 g/l preservation solution. The primary outcome is the occurrence of DGF, defined as the need for renal replacement therapy during the first week after transplantation. Discussion The use of HEMO2life® in preservation solutions is a novel approach allowing, for the first time, the delivery of oxygen to organs. Improving graft survival by limiting ischemic lesions is a major public-health goal in the field of organ transplantation. Trial registration ClinicalTrials.gov, ID: NCT04181710 . registered on November 29, 2019.

Objective. Data about efficacy and safety of the latest COVID-19 treatments as nirmatrelvir/ritonavir (n/r) or Sotrovimab is scarce in solid organ transplant recipients in the Omicron era. This study aims at describing the outcome of kidney transplant recipients (KTRs) presenting Omicron infection according to their management: n/r, sotrovimab or no specific treatment. Patients and methods. We conducted a monocentric, retrospective observational study, including KTRs diagnosed Omicron infection between January and May 1st 2022 and compared their outcome (primary outcome defined as hospital admission for COVID-19 within a month after symptoms onset) according to early COVID-19 management. Results. Forty-five patients were included: 22 treated (12 n/r, 10 sotrovimab) and 23 with no specific treatment. The groups were statistically comparable. Two patients were admitted for COVID-19: one in each group, resulting in a non-different probability of the primary outcome at on month (p=0.9). Three patients presented tacrolimus overdose including two with acute kidney injury. Conclusions. There was no difference in outcome according to early therapeutic management: n/r, sotrovimab or no specific treatment. Our study both underlines a decreased severity of Omicron COVID-19 in KTRs (probably related to vaccinal immunity and decreased virulence of Omicron) and a potential severe adverse effects with n/r.

Abstract Background The duration of humoral response in immunocompromised populations according to the number of doses in the primary vaccine regimen and the number of booster doses is little known. Methods Participants from the French national multi-center prospective cohort study ANRS0001S COV-POPART were included (11 specific subpopulations and 2 control groups (18-64 years and over 65 years)). We evaluated the immune response to COVID-19 vaccines up to 6 months after the second dose, distinguishing participants having received two or three doses in their initial vaccination scheme and those with or without a booster dose before 6 months. Participants with positive anti-nucleocapsid (NP) antibodies or SARS-CoV-2 infection during follow-up were excluded. Serological (ELISA EuroImmun®) and seroneutralisation (in vitro neutralization assay, original strain) tests were carried out centrally. Results 3724 participants were included: 2756 from specific subpopulations and 968 controls. Participants in specific sub-populations and the control groups mostly received two doses of BNT162b2 (68.6% and 83.6%, respectively). Fifteen percent of participants in a specific sub-population received 3 doses within their initial vaccine scheme (mostly solid organ transplants (SOT) and Hematopoietic stem cell transplants (HCT)) and 11.2% received a booster dose within 6 months after a median time of 5 months after the last dose. The control groups and all specific sub-populations who received two doses as the primary regimen, except solid SOT and HCT groups, increased their anti-Spike and seroneutralisation titer after a booster dose (Figure 1A and 1C). The booster dose had little effect on participants who received three doses as a primary vaccination regimen compared to those who did not receive the booster dose (Figure 1B and 1D). 6-month median (IQR) anti-Spike IgG titers (BAU/mL) in specific subpopulations who received two (A) and three doses (B) within their initial vaccine scheme. 6-month seroneutralisation titers in specific subpopulations who received two (C) and three doses (D) within their initial vaccine scheme. Solid organ transplantation (SOT), hematopoietic stem cell transplantation (HCT), chronic renal failure (CKD), systemic autoimmune diseases (SAD), inflammatory rheumatic diseases (IRD), multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMOSD). Conclusion A booster dose in those who received 2 doses as a primary vaccination regimen increased 6-month humoral responses in almost all sub-populations except SOT and HSCT. The effect of booster doses in those receiving three doses as a primary vaccination regimen was low, reflecting the profound immunosuppression of these patients. Disclosures Paul LOUBET, MD, PhD, Astrazeneca: Advisor/Consultant|Astrazeneca: Board Member|Moderna: Board Member|Pfizer: Advisor/Consultant|Pfizer: Board Member Odile Launay, MD, PhD, Moderna: Advisor/Consultant|Pfizer: Advisor/Consultant|Pfizer: Board Member

Systematic screening for prostate cancer is widely recommended in candidates for renal transplant at the time of listing. There are concerns that overdiagnosis of low-risk prostate cancer may result in reducing access to transplant without demonstrated oncological benefits. The objective of the study was to assess the outcome of newly diagnosed prostate cancer in candidates for transplant at the time of listing, and its impact on transplant access and transplant outcomes according to treatment options. This retrospective study was conducted over 10 years in 12 French transplant centers. Patients included were candidates for renal transplant at the time of prostate cancer diagnosis. Demographical and clinical data regarding renal disease, prostate cancer, and transplant surgery were collected. The primary outcome of the study was the interval between prostate cancer diagnosis and active listing according to treatment options. Overall median time from prostate cancer diagnosis to active listing was 25.0 months [16.4-40.2], with statistically significant differences in median time between the radiotherapy and the active surveillance groups (p = .03). Prostate cancer treatment modalities had limited impact on access and outcome of renal transplantation. Active surveillance in low-risk patients does not seem to compromise access to renal transplantation, nor does it impact oncological outcomes.

Abstract Background We evaluated the immune response to COVID-19 vaccines in several specific populations at high risk of severe COVID-19. Methods Participants from the French national multi-center prospective cohort study ANRS0001S COV-POPART were included (11 specific subpopulations: and 2 control groups (18–64 years and over 65 years)). In this preliminary analysis patients and controls who had received at least two vaccine doses have been included. Percentages (95% confidence intervals (CI)) of participants with anti-Spike SARS-CoV-2 IgG antibodies (ELISA) and specific neutralizing antibodies (in vitro neutralization assay) were evaluated at one month after the second dose of COVID-19 vaccine. Results 3703 were included: 2650 participants from specific subpopulations (171 solid cancers, 160 SOT, 100 HCT, 91 chronic renal failures, 141 systemic autoimmune diseases, 157 autoimmune inflammatory rheumatic diseases, 361 multiple sclerosis (MS) or neuromyelitis optica spectrum disorders, 61 hypogammaglobulinemia, 401 diabetic, 739 obeses non-diabetic and 476 HIV) and 1053 controls (893: 18–64 years and 160 over 65 years). Median age was 51.7 years [InterQuartile range: 40.8 – 60.9] and 50.7% were male. Most of the participants received BNT162b2 vaccine (86.4%). In the control group, 100% (95%CI: 99.6;100.0) of those aged 18–64 and 99.4% (96.6; 100.0) of those over 65 years developed anti-Spike IgG antibodies. PLWHIV, cancer and diabetic patients had high rate of responders after two doses with 98.3% (97.2;99.1), 93.0% (88.1;96.3) and 92.0% (88.9;94.5), respectively. The lowest percentage of responders was found in patients with SOT (13.8% (8.8;20.1), HSCT (34.0% (24.8;44.2) and hypogammaglobulinemia (52.5% 39.3;65.4). In both control groups, the frequency of neutralizing antibodies was similar to the anti-Spike IgG antibody response. In the immunodeficient populations, neutralizing antibodies responders tended to be less frequent than anti-Spike antibodies responders. Similar trends than for IgG antibody were identified (Figure 1). Anti-Spike and Neutralizing antibody (Ab) responses (95% CI) one month after the second dose of COVID-19 vaccine in specific and control populations. Conclusion Lower COVID-19 vaccine humoral response was observed in specific populations than in controls, especially in patients with hypogammaglobulinemia, HSCT and SOT. Disclosures Paul LOUBET, MD, PhD, pfizer: Board Member Odile Launay, MD, PhD, AstraZeneca: Financial|GlaxoSmithKline: Advisor/Consultant|GlaxoSmithKline: Grant/Research Support|Johnson & Johnson: Advisor/Consultant|Johnson & Johnson: Grant/Research Support|MD: Advisor/Consultant|Moderna: Advisor/Consultant|MSD: Data safety monitoring board|Pfizer: Advisor/Consultant|Pfizer: Grant/Research Support|Sanofi Pasteur: Advisor/Consultant|Sanofi Pasteur: Grant/Research Support|Sanofi Pasteur: Data safety monitoring board.

Our understanding of the involvement of the gut microbiota (GM) in human health has expanded exponentially over the last few decades, particularly in the fields of metabolism, inflammation, and immunology. Immunosuppressive treatment (IST) prescribed to solid organ transplant (SOT) recipients produces GM changes that affect these different processes. This review aims at describing the current knowledge of how IST changes the GM. Overall, SOT followed by IST results in persistent changes in the GM, with a consistent increase in proteobacteria including opportunistic pathobionts. In mice, Tacrolimus induces dysbiosis and metabolic disorders, and alters the intestinal barrier. The transfer of the GM from Tacrolimus-treated hosts confers immunosuppressive properties, suggesting a contributory role for the GM in this drug's efficacy. Steroids induce dysbiosis and intestinal barrier alterations, and also seem to depend partly on the GM for their immunosuppressive and metabolic effects. Mycophenolate Mofetil, frequently responsible for digestive side effects such as diarrhea and colitis, is associated with pro-inflammatory dysbiosis and increased endotoxemia. Alemtuzumab, m-TOR inhibitors, and belatacept have shown more marginal impact on the GM. Most of these observations are descriptive. Future studies should explore the underlying mechanism of IST-induced dysbiosis in order to better understand their efficacy and safety characteristics.

American Journal of TransplantationVolume 22, Issue 9 p. 2273-2275 CONTINUING MEDICAL EDUCATION Gingival hypertrophy in a kidney transplant recipient Abderrahmane Mabrouk, Abderrahmane Mabrouk Assistance Publique—Hôpitaux de Paris AP-HP, Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, FranceSearch for more papers by this authorYanis Tamzali, Corresponding Author Yanis Tamzali yanis.tamzali@aphp.fr orcid.org/0000-0003-0710-8869 Assistance Publique—Hôpitaux de Paris AP-HP, Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, France Sorbonne Université, INSERM UMR 1138, Paris, France Correspondence Yanis Tamzali, Assistance Publique—Hôpitaux de Paris AP-HP, Pitié-Salpêtrière Hospital, Medical and surgical department of kidney transplantation, Paris, France and Sorbonne Université, INSERM UMR 1138, Paris, France. Email: yanis.tamzali@aphp.frSearch for more papers by this authorBenoit Barrou, Benoit Barrou orcid.org/0000-0001-7128-1565 Assistance Publique—Hôpitaux de Paris AP-HP, Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, France Sorbonne Université, INSERM U 1082, Paris, FranceSearch for more papers by this authorJérôme Tourret, Jérôme Tourret orcid.org/0000-0003-2998-6531 Assistance Publique—Hôpitaux de Paris AP-HP, Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, France Sorbonne Université, INSERM UMR 1138, Paris, FranceSearch for more papers by this author Abderrahmane Mabrouk, Abderrahmane Mabrouk Assistance Publique—Hôpitaux de Paris AP-HP, Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, FranceSearch for more papers by this authorYanis Tamzali, Corresponding Author Yanis Tamzali yanis.tamzali@aphp.fr orcid.org/0000-0003-0710-8869 Assistance Publique—Hôpitaux de Paris AP-HP, Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, France Sorbonne Université, INSERM UMR 1138, Paris, France Correspondence Yanis Tamzali, Assistance Publique—Hôpitaux de Paris AP-HP, Pitié-Salpêtrière Hospital, Medical and surgical department of kidney transplantation, Paris, France and Sorbonne Université, INSERM UMR 1138, Paris, France. Email: yanis.tamzali@aphp.frSearch for more papers by this authorBenoit Barrou, Benoit Barrou orcid.org/0000-0001-7128-1565 Assistance Publique—Hôpitaux de Paris AP-HP, Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, France Sorbonne Université, INSERM U 1082, Paris, FranceSearch for more papers by this authorJérôme Tourret, Jérôme Tourret orcid.org/0000-0003-2998-6531 Assistance Publique—Hôpitaux de Paris AP-HP, Pitié-Salpêtrière Hospital, Medical and Surgical Department of Kidney Transplantation, Paris, France Sorbonne Université, INSERM UMR 1138, Paris, FranceSearch for more papers by this author First published: 30 August 2022 https://doi.org/10.1111/ajt.17110 Abderrahmane Mabrouk and Yanis Tamzali contributed equally to this work. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume22, Issue9September 2022Pages 2273-2275 AST and ASTS members - please log in via your Society website for full journal access.AST Members >> ASTS Members >> RelatedInformation

A low anti-spike antibody response of 28.6% was observed 28 days after BNT162b2 vaccine second dose among 133 solid organ transplant recipients without previous coronavirus disease 2019 (COVID-19). No serious adverse events were recorded. Four severe COVID-19 cases were reported between or after the 2 doses. Our data suggest to change the vaccine strategy.