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Biomedical subjects

M Busson

Publications and source records attributed to M Busson.

At least 73 records · Page 4Linked to original sources

[Early failure in kidney transplantation].

Parameters of early failure in kidney transplantation have been analyzed from 507 transplantations with transplant loss in the first month, selected among the 7541 cadaveric kidney transplantations performed in France between 1985 and 1989. These failures represent 6.7 percent of the population transplanted over this period of time, 68.6 percent of the failures that occurred in the first 3 months post-grafting, and 47 percent of the total number of the first year failures. Comparing patients with and without transplant failure in the first month, sex of the donor and the recipient, ABO group of the donor and the recipient, origin of the kidney, cold ischemia time, HLA compatibility, dialysis duration, number of previous transplantations, showed no influence on the occurrence of early failure. Three parameters appeared to be significant risk factors: donor's age less than 5 years, P = 0.00001; recipient's age less than 5 years, P = 0.05; pregraft immunization, P = 0.002. Furthermore, multifactorial analysis showed that the absence of HLA compatibilities between donor and recipient in hyperimmunized patients also has a significant influence on early graft loss. However, comparison of these same parameters in patients with transplant failure within the first month and between 2 and 12 months post-grafting revealed that the influence of these 4 significant parameters is longstanding and that none of them is specific of the precocity of graft loss.

Adolescent↗

[Heart-lung transplantation. Causes of failure in the first postoperative month].

The aim of the study was to assess the cause of heart and heart-lung transplants failure during the first month following surgery. Data were collected from France Transplant records from 1985 to 1989. Two thousand and ninety one heart transplantations were collected. Four hundred and fifty one patients died in the first month; only 290 records were fully analyzed among them. Failure was due to: early graft failure (33 percent), infection (17 percent), multiple organs failure (18 percent), rejection (9 percent), others (23 percent). Related factors were: lack of experience from the team, prolonged organ preservation, patient's youth, severe heart failure. One hundred and fifty two heart-lung transplantations were collected. From 1985 to 1987, the first month failure average exceeded 60 percent, post-operative infections and early graft failures being the main causes (65 percent). Since the last 2 years, mortality has been decreasing (40 percent). Prolonged organ preservation appears to be a major related factor.

Adolescent↗

[Estimation of the number of kidney recipients with a functional graft in France, from 1975 to 1994].

The evolution observed in the number of kidney grafts performed in France and the number of recipients living with a functional graft is described. Using the data collected between 1975 and 1988 and the graft survival rates, the size of this population for the 5 forthcoming years can be predicted. The annual number of kidney grafts will stabilize at 2,750 in 1993, if we assume a limit of 50 grafts per million inhabitants, which is the maximum rate currently observed in several regions of France. At this level, the organs used for kidney retransplantations would begin to reduce the availability of kidney first grafts. These predictions are based on the assumption that no major adverse change will occur in the current organ procurement policy. The total number of kidney recipients would then reach about 17,700 in 1994. This population has increased fivefold since 1980 and will double in the forthcoming years. Henceforth, plans for financial and human resources to ensure the follow-up of this population should be implemented.

Adolescent↗

A retrospective and prospective study of the number of kidney transplants in 31 countries.

The aim of the present study was to try to predict the number of cadaveric kidney transplantations (CKT) that will be performed in the year 1993. The raw data regarding the number of renal transplants that have been performed annually since 1975 in 31 countries, which were divided into six groups, were collected from published reports and confirmed by a questionnaire sent to all centers. The annual number of grafts was estimated using an exponential model, highly correlated with retrospective data (r2 greater than 0.99). Predictions for 1993 were extrapolated. The growth of transplantation activity is limited by a shortage of available donor organs. The maximum number of grafts was arbitrarily set at 40 per million population, which is the maximum rate currently observed. The total number of CKT carried out between 1975 and 1986 was 114,000; this will probably exceed 280,000 in 1993. The yearly activity in 1987 exceeded 16,500 and is expected to reach approximatively 26,000 grafts in 1993.

Africa, Northern↗

[Informational structure of the national registry of bone marrow donor volunteers].

Successful Bone Marrow Transplantations with unrelated donors can be performed providing that donor and recipient are totally HLA-A, B, DR identical. To find such a suitable donor it is necessary to type a large pool of volunteers for HLA in histocompatibility laboratories. We have built a network of 36 micro-computers AT 286 for updating local files and for translating data to the national file of donors maintained on a main computer (VAX 8250). The main computer communicates regularly using modems with local computers in order to update data and exchange information. After one year of functioning, users are well satisfied with the computers system which locates regularly potential donors for recipients waiting for a graft.

Bone Marrow Transplantation↗

Multiple drug combinations with "low-dose" cyclosporin for renal transplantation. Multivariate analysis of risk factors determining short-term graft survival within one renal transplant center.

The factors affecting graft survival in transplant recipients receiving cyclosporin (CsA) are still being debated. Our report is based on an analysis of 202 successive transplantations performed in our institution from May 1984 to December 1986, using low-dose CsA as the basic means of immunosuppression. A total of 142 patients received the triple combination CsA, azathioprine (AZA), and corticosteroids. Sixty patients received a prophylactic combination of CsA, corticosteroids, and antilymphocyte globulins (ALG). From January to December 1986, both regimens were compared in a prospective randomized trial. The factors that affect graft survival were analyzed using the Cox multivariate hazard analysis. The relative risks were calculated for pretransplant baseline risk factors and for outcome-dependent post-transplant risk factors for surviving grafts at 1 month. Transplants performed with a prolonged ischemia time and patients whose graft did not function immediately were statistically at higher risk of graft loss. Adding prophylactic ALG to CsA was associated with better graft survival. Patients who experienced more than 1 rejection crisis and patients whose 1-month CsA dose was lower than or equal to 5 mg/kg per day were also at significantly higher risk of further graft loss. Neither HLA matching, peak panel reactivity, age of the recipient, occurrence of post-transplant renal dysfunction nor 1-month renal function affected the short-term graft outcome.

Adrenal Cortex Hormones↗

[Influence of the anti-HLA immunization profile before grafting on the outcome of renal transplant].

A retrospective study of HLA immunization profile before a first graft of unrelated kidney in 212 immunized recipients (with an initial peak greater than or equal to 25%) shows that one can define at least 3 groups of responder with a different graft outcome. Recipients with either weak or strong variance of HLA antibody (VP) before graft (group I: VP less than 230 and group III: VP greater than 830) have a significantly lower graft survival: 54% (p = 0.006) and 45% (p = 0.002) respectively at 4 years, than recipients of group II (230 less than VP less than 830) for whom the prognosis is of 77% after the same time period. If similar results are observed on independent series, VP would be of a great interest for the definition of a new classification of responders, and on a practical level for the choice of renal transplant.

Antibodies↗