Philippe JEAN-PIERRE

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• Type de publi. : Article dans une revue
• Date de publi. : 01/05/2022
• Auteurs : Basma Akrout BrizardPhilippe CourtetIsabelle JaussentJorge Lopez-CastromanMarion LeboyerJean Pierre KahnCarolina Baeza-Velasco
• Organismes : Laboratoire de Psychopathologie et Processus de Santé Centre Hospitalier Régional Universitaire [Montpellier] Institut de Génomique Fonctionnelle Institut des Neurosciences de Montpellier Centre Hospitalier Universitaire de Nîmes Institut de Génomique Fonctionnelle IMRB - "Neuropsychiatrie translationnelle" [Créteil] CHU Henri Mondor [Créteil] Université de Lorraine Fondation Santé des Etudiants de France Laboratoire de Psychopathologie et Processus de Santé Centre Hospitalier Régional Universitaire [Montpellier] Institut de Génomique Fonctionnelle
• Publié dans Journal of Clinical Psychiatry le 27/10/2020

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Résumé : Background: Suicidal behaviors are known to be increased in people with epilepsy compared to the general population. However, few studies have explored the frequency of epilepsy in a large sample of suicide attempters, and scarce data exist about differences and similarities between epileptic attempters (EA) and nonepileptic attempters (NEA). The aim of this study was to explore the frequency of epilepsy as well as psychopathological and somatic factors among suicide attempters.Methods: In this multicenter cross-sectional study, 1,229 adults hospitalized for attempted suicide were included during the period between July 2001 and December 2015. They were assessed with the Mini-International Neuropsychiatric Interview for DSM-IV Axis I mental disorders. Data concerning sociodemographic and somatic diseases, including epilepsy, were collected.Results: Sixty-five patients (5.3%) had epilepsy. EA had significantly fewer mean ± SD years of education compared with NEA (11.2 ± 3.2 vs 12.1 ± 2.9; P = .011) as well as increased rates of head trauma (29.2% for EA vs 16.2% for NEA; P = .007), antiepileptic use (35.4% for EA vs 23.8% for NEA; P = .036), and lifetime substance abuse and/or dependance (49.2% for EA vs 36.1% for NEA; P = .034). Multivariate analyses showed that years of education, head trauma, and panic disorder with agoraphobia predicted belonging to the EA group.Conclusions: These results suggest that epilepsy is overrepresented among suicide attempters. Few psychopathological differences as well as differences in somatic comorbidities except head trauma were observed between EA and NEA in this sample. These results contribute to draw a clinical profile of people with epilepsy in the population of suicide attempters.

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• Type de publi. : Article dans une revue
• Date de publi. : 01/05/2022
• Auteurs : Pierre-Marie ChevillardMartine BataillerBenoît PiéguAnthony EstienneMarie-Claire BlacheJean-Philippe DuboisDelphine PillonPascal VaudinJoëlle DupontNathalie JustMartine Migaud
• Organismes : Physiologie de la reproduction et des comportements [Nouzilly] Physiologie de la reproduction et des comportements [Nouzilly] Physiologie de la reproduction et des comportements [Nouzilly] Physiologie de la reproduction et des comportements [Nouzilly] Physiologie de la reproduction et des comportements [Nouzilly] Physiologie de la reproduction et des comportements [Nouzilly] Physiologie de la reproduction et des comportements [Nouzilly] Physiologie de la reproduction et des comportements [Nouzilly] Physiologie de la reproduction et des comportements [Nouzilly] Physiologie de la reproduction et des comportements [Nouzilly] Physiologie de la reproduction et des comportements [Nouzilly]
• Publié dans Histochemistry and Cell Biology le 26/10/2020

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Résumé : Sheep, like most seasonal mammals, exhibit a cyclic adaptive reproductive physiology that allows ewes to give birth to their progeny during the spring when environmental conditions are favorable to their survival. This process relies on the detection of day length (or photoperiod) and is associated with profound changes in cellular plasticity and gene expression in the hypothalamic-pituitary-gonadal axis, mechanisms that are suggested to participate in the seasonal adaptation of neuroendocrine circuits. Recently, pituitary vascular growth has been proposed as a seasonally regulated process in which the vascular endothelial growth factor A (VEGFA), a well-known angiogenic cytokine, is suspected to play a crucial role. However, whether this mechanism is restricted to the pituitary gland or also occurs in the mediobasal hypothalamus (MBH), a crucial contributor to the control of the reproductive function, remains unexplored. Using newly developed image analysis tools, we showed that the arcuate nucleus (ARH) of the MBH exhibits an enhanced vascular density during the long photoperiod or non-breeding season, associated with higher expression of VEGFA. In the median eminence (ME), a structure connecting the MBH to the pituitary gland, higher VEGFA, kinase insert domain receptor (KDR/VEGFR2) and plasmalemma vesicle-associated protein (PLVAP) gene expressions were detected during the long photoperiod. We also found that VEGFA and its receptor, VEGFR2, are expressed by neurons and tanycytes in both the ARH and ME. Altogether, these data show variations in the MBH vasculature according to seasons potentially through a VEGFA-dependent pathway, paving the way for future studies aiming to decipher the role of these changes in the hypothalamic control of seasonal reproduction.

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• Type de publi. : Article dans une revue
• Date de publi. : 01/05/2022
• Auteurs : Gérard ReachLaurent BenarbiaPierre-Yves BenhamouBrigitte DelemerSéverine DuboisDidier GouetBruno GuerciNathalie JeandidierKarim LachgarGilles Le PapeRémy LeroyJean-Hugues MasgnauxPhilippe RacletYves ReznikJean-Pierre RivelinePauline SchaepelynckAnne VambergueBruno Vergès
• Organismes : Laboratory of Fundamental and Applied Bioenergetics = Laboratoire de bioénergétique fondamentale et appliquée
• Publié dans Patient Preference and Adherence le 27/10/2020

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Résumé : Background: Support programs are provided to people with diabetes to help them manage their disease. However, adherence to and persistence in support programs are often low, making it difficult to demonstrate their effectiveness. Aim: To identify the determinants of patients' perceived interest in diabetes support programs because it may be a powerful determinant of effective participation in such programs. Patients and methods: An online study conducted in April 2021 in metropolitan France on 600 people with diabetes recruited from a consumer panel. A 64-item psychosocial questionnaire including a question asking to evaluate the helpfulness of a support program was used. Univariate, multivariate, and multiple correspondence analyses were performed. Results: The existence of a typology, known as Unsafe/Safe, was discovered, in which patients with type 2 diabetes respond in two distinct ways. Type U (unsafe) patients, who believe that a support program would be helpful, are more likely to be nonadherent to their treatment, have high hemoglobin A1c levels, have at least one diabetic complication, lack information regarding their disease and treatment, rate the burden of their disease and impairment of their quality of life as high, worry about their future, and are pessimistic. Type S (safe) patients have the opposite characteristics. Type U patients can be dichotomized into two broad classes: one in which they lack information regarding disease and treatment and the other in which alterations in the quality of life and burden of the disease predominate. Insulin-treated patients give more importance to the lack of information, whereas noninsulin-treated patients complain primarily about the burden of the disease and impairment of quality of life. Conclusion: This study describes this new U/S typology, proposes a simple method based on a nine-item questionnaire to identify type U patients by calculating a Program Helpfulness Score described herein, and clarifies the nature of the intervention to be provided to them. This novel approach could be applied to other chronic diseases.

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• Type de publi. : Article dans une revue
• Date de publi. : 01/05/2022
• Auteurs : Christina BergqvistLaura FertittaKhaled EzzedineArnaud JannicOuidad ZehouSalah FerkalPatrick CombemaleSébastien BarbarotJuliette Mazereeuw-HautierÉmilie SbidianPierre WolkensteinHenri AdamskiClarisse Baumann-MorelChristine BellannéEric BiethPascal BousquetChristian BrandtXavier BalgueriePierre CastelnauYves ChaixJacqueline Chevrant-BretonEvelyne ColletJean‐françois CunyPascal ChastagnerMarie‐lorraine ChandeclercEmmanuel CheuretPascal CintasHélène DollfusChristian DerancourtValérie Drouin-GarraudMichel d'IncanHélène de LeersnyderOlivier DereureDiane DoumarNicolas FabreChristine FrancannetLaurence FaivreFlorence FellmannNathalie Feugier-FavierDominique GaillardAlice GoldenbergLucie Guyant-MarechalBernard GuillotJean‐sebastien GuillamoSmail Hadj‐rabiaDominique Hamel-TeillacIsabelle KemlinJean‐philippe LacourVeronique LaithierNathalie LesavreStanislas LyonnetKim MaincentSophie MaradeixLaurent MachetEva MansatNicolas MeyerMonique MozelleJean Christophe Moreno Celine MoretEric PuzenatBéatrice ParfaitStéphane PinsonEric PasmantDiana RodriguezJean‐françois StalderElisabeth SchweitzerClaire ThalamasChristel Thauvin-RobinetDominique VidaudMichel VidaudAlain VerloesJacques Zeller
• Organismes : CHU Henri Mondor [Créteil] Hôpital Necker - Enfants Malades [AP-HP] Epidemiology in Dermatology and Evaluation in Therapeutics CHU Henri Mondor [Créteil] CHU Henri Mondor [Créteil] Epidemiology in Dermatology and Evaluation in Therapeutics CHU Henri Mondor [Créteil] Centre Léon Bérard [Lyon] Physiopathologie des Adaptations Nutritionnelles Centre Hospitalier Universitaire de Toulouse Epidemiology in Dermatology and Evaluation in Therapeutics Centre d'Investigation Clinique Henri Mondor Epidemiology in Dermatology and Evaluation in Therapeutics Institut Mondor de Recherche Biomédicale Centre Hospitalier Universitaire [Rennes] Centre Hospitalier Universitaire de Toulouse Laboratoire de Neurobiologie et Pharmacologie Cardiovasculaire Laboratoire de pharmacologie et toxicologie neurocardiovasculaire CHU Rouen Imaging, Brain & Neuropsychiatry Toulouse NeuroImaging Center Centre Hospitalier Universitaire de Toulouse Service de Dermatologie [Rennes] = Dermatology [Rennes] Centre d'Investigation Clinique [Rennes] Service de Dermatologie (CHU de Dijon) Centre de Recherche en Automatique de Nancy Service Neurologie Pédiatrique [CHU Toulouse] Département Neurologie [CHU Toulouse] Centre Hospitalier Universitaire [Strasbourg] Centre Hospitalier de Gap Service de génétique [Rouen] Imagerie Moléculaire et Stratégies Théranostiques CHU Gabriel Montpied [Clermont-Ferrand] Pathogenesis and Control of Chronic and Emerging Infections Pharmacochimie et Biologie pour le Développement Service Génétique Médicale [CHU Clermont-Ferrand] Lipides - Nutrition - Cancer [Dijon - U1231] FHU TRANSLAD (CHU de Dijon) Université de Lausanne = University of Lausanne Imaging, Brain & Neuropsychiatry
• Publié dans Journal of the European Academy of Dermatology and Venereology le 27/10/2020

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Résumé : Background: Neurofibromatosis 1 (NF1) is one of the most common inherited disorders characterized by mutations in the tumour suppressor gene NF1. Its clinical manifestations are highly variable and unpredictable. A specific NF1 mutation does not predict the severity or complications of the disease. Objective: The objective of this study was to build an empirical classification scheme without any a priori hypotheses to identify the underlying NF1 subtypes that best explain the observed heterogeneity. Methods: We performed latent class analysis (LCA) of 1351 consecutive NF1 patients aged >17 years seen between 2002 and 2014. Data and phenotypic features were collected prospectively on a standardized form. Results: The median age was 36.8 (17-81) years. A three-class model showed the best fit: 706 (52%) belonged to the LC1 'Cutaneous neurofibromas' class having preferentially cutaneous neurofibromas (99%), plexiform neurofibromas (63%) and blue-red macules (29%); 593 (44%) belonged to the LC2 'Subcutaneous neurofibromas' class characterized by the presence of at least 10 subcutaneous neurofibromas (21%) and a familial form (77%) and 52 (4%) belonged to the LC3 'Dysmorphic phenotype' class characterized by dysmorphic features (78%) and learning difficulties (87%). Patients in LC1 had a higher likelihood of developing scoliosis (RR = 1.7, 95% confidence interval (CI) [1.2-2.4]). Patients in LC2 were more likely to be men (RR = 1.4, 95% CI [1.1-1.7]). Patients in LC3 were at higher risk of having an optic pathway glioma (RR = 4.8, 95% CI [1.9-11.8]) and epilepsy (RR = 4.5, 95% CI [1.8-11.6]). Conclusion: Our findings invite the performance of a larger cohort study to test whether the various latent classes reflect different underlying genetic modifiers of these phenotypic traits.

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Fichiers liés : Acad Dermatol Venereol - 2022 - Bergqvist - Identification of three clinical neurofibromatosis 1 subtypes Latent class.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 01/05/2022
• Auteurs : Arnaud PagèsNadège CostaMichaël MouniéPhilippe CestacPhilipe Barreto de SoutoYves RollandBruno VellasLaurent MolinierBlandine Juillard-CondatBruno VellasSophie GuyonnetIsabelle CarriéLauréane BrigitteCatherine FaisantFrançoise LalaJulien DelrieuHélène VillarsEmeline CombrouzeCarole BadufleAudrey ZuerasSandrine AndrieuChristelle CantetChristophe MorinGabor Abellan van KanCharlotte DupuyYves RollandCéline CaillaudPierre-Jean OussetFrançoise LalaSherry WillisSylvie BellevilleBrigitte Gilbert-DussardierFrancine FontaineJean-François DartiguesIsabelle MarcetFleur DelvaAlexandra FoubertSandrine CerdaMarie-Noëlle CuffiCorinne CostesOlivier RouaudPatrick ManckoundiaValérie QuipourtSophie MarilierEvelyne FranonLawrence BoriesMarie-Laure PaderMarie-France BassetBruno LapoujadeValérie FaureMichael Li Yung TongChristine Malick-LoiseauEvelyne Cazaban-CampistronFrançoise DesclauxColette BlatgeThierry DantoineCécile Laubarie-MouretIsabelle SaulnierJean-Pierre ClémentMarie-Agnès PicatLaurence Bernard-BourzeixStéphanie WilleboisIléana DésormaisNoëlle CardinaudMarc BonnefoyPierre LivetPascale RebaudetClaire GédéonCatherine BurdetFlavien TerracolAlain PesceStéphanie RothSylvie ChaillouSandrine LouchartKristel SudresNicolas LebrunNadège Barro-BelayguesJacques TouchonKarim BennysAudrey GabelleAurélia RomanoLynda TouatiCécilia MarelliCécile PaysPhilippe RobertFranck DuffClaire GervaisSébastien GonfrierYannick GasnierSerge BordesDanièle BegorreChristian CarpuatKhaled KhalesJean-François LefebvreSamira Misbah El IdrissiPierre SkolilJean-Pierre SallesCarole DufouilStéphane LehéricyMarie ChupinJean-François ManginAli BouhayiaMichèle AllardFrédéric RicolfiDominique DuboisMarie Paule Bonceour MartelFrançois CottonAlain BonaféStéphane ChanaletFrançoise HugonFabrice BonnevilleChristophe CognardFrançois CholletPierre PayouxThierry VoisinJulien DelrieuSophie PeifferAnne HitzelMichèle AllardMichel ZancaJacques MonteilJacques DarcourtLaurent MolinierHélène DerumeauxNadège CostaBertrand PerretClaire VinelSylvie Caspar-BauguilPascale Olivier-AbbalSandrine AndrieuChristelle CantetNicola Coley
• Organismes : Centre d'Epidémiologie et de Recherche en santé des POPulations Institut universitaire de France Equipe EQUITY (CERPOP) Equipe EQUITY (CERPOP) Equipe AGING (CERPOP) Equipe AGING (CERPOP) Equipe AGING (CERPOP) Equipe AGING (CERPOP) Equipe EQUITY (CERPOP) Equipe BIOETHICS (CERPOP) Equipe AGING (CERPOP) Equipe AGING (CERPOP)
• Publié dans Drugs and Aging le 01/11/2020

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Résumé : Introduction: Potentially inappropriate medication prescribing (PIP) among older patients is associated with an increased risk of adverse events and hospitalization, and sometimes increased healthcare costs. Objective: The aim of this study was to explore the association between healthcare costs and PIP exposure among older patients. Methods: Analyses were conducted using data from the Multidomain Alzheimer Preventive Trial (MAPT). A computer algorithm was constructed to detect PIP based on various different explicit criteria-based tools, and the results were expressed in number of medication-related potential non-compliances (MRNCs). A prescription was considered potentially inappropriate if there were one or more MRNCs. We performed a cost analysis from the French National Health Insurance perspective, and also performed a multivariate analysis to identify the association between healthcare costs and PIP (number of MRNCs). Results: The computer algorithm analyzed medication prescribing from included patients (N = 1525 aged 75.3 ± 4.4 years; 64% women [n = 978]). PIP was associated with increased total healthcare costs and non-medication healthcare costs after adjusting for potential confounders. We also noted that healthcare costs tended to increase with the number of MRNCs. The mean additional healthcare costs were €517, €921, and €1669 per patient and year for patients with one or two MRNCs, three or four MRNCs, and five or more MRNCs, respectively, in comparison with patients with appropriate medication prescriptions. Conclusion: These observations led us to conclude that interventions focused on reducing PIP could result in savings. Trial registration: ClinicalTrials.gov: NCT00672685.

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• Type de publi. : Article dans une revue
• Date de publi. : 01/05/2022
• Auteurs : Salim Si-MohamedSara BoccaliniHugo LacombeAdja DiawMohammad VarastehPierre-Antoine RodeschRiham DessoukyMarjorie VillienValérie Tatard-LeitmanThomas BochatonPhilippe CoulonYoad YagilElias LahoudKlaus ErhardB. RicheEric BonnefoyGilles RioufolGérard FinetCyrille BergerotL. BousselJoël GreffierPhilippe Douek
• Organismes : Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé Modeling & analysis for medical imaging and Diagnosis Centre de Recherche en Acquisition et Traitement de l'Image pour la Santé Modeling & analysis for medical imaging and Diagnosis
• Publié dans Radiology le 28/10/2020

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• Type de publi. : Article dans une revue
• Date de publi. : 01/05/2022
• Auteurs : Aurelien MarabellePhilippe CassierMarwan FakihSteven KaoDorte NielsenAntoine ItalianoTormod Kyrre GurenMarloes van DongenKristen SpencerGiovanni Mendonca BarianiPaolo AsciertoArmando SantoroManisha ShahJamil AsselahSyma IqbalShunji TakahashiSarina Piha-PaulPatrick OttArkendu ChatterjeeFan JinKevin NorwoodJean-Pierre Delord
• Organismes : Centre de Recherches en Cancérologie de Toulouse Oncopole Claudius Regaud Institut Universitaire du Cancer de Toulouse - Oncopole
• Publié dans The Lancet Gastroenterology & Hepatology le 22/10/2020

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• Type de publi. : Article dans une revue
• Date de publi. : 30/04/2022
• Auteurs : Maha KooliAntoine HeraudHenri-Pierre CharlesBastien GiraudRoman GauchiMona EzzadeenKevin MambuV. EgloffJean-Philippe Noël
• Organismes : Laboratoire Fonctions Innovantes pour circuits Mixtes Laboratoire Fonctions Innovantes pour circuits Mixtes Laboratoire Fonctions Innovantes pour circuits Mixtes Laboratoire Fonctions Innovantes pour circuits Mixtes Laboratoire Fonctions Innovantes pour circuits Mixtes Laboratoire Fonctions Innovantes pour circuits Mixtes Laboratoire Fonctions Innovantes pour circuits Mixtes Laboratoire Fonctions Innovantes pour circuits Mixtes Laboratoire Fonctions Innovantes pour circuits Mixtes
• Publié dans ACM Journal on Emerging Technologies in Computing Systems le 02/11/2020

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Résumé : This article presents Computational SRAM (C-SRAM) solution combining In- and Near-Memory Computing approaches. It allows performing arithmetic, logic, and complex memory operations inside or next to the memory without transferring data over the system bus, leading to significant energy reduction. Operations are performed on large vectors of data occupying the entire physical row of C-SRAM array, leading to high performance gains. We introduce the C-SRAM solution in this article as an integrated vector processing unit to be used by a scalar processor as an energy-efficient and high performing co-processor. We detail the C-SRAM system design on different levels: (i) circuit design and silicon proof of concept, (ii) system interface and instruction set architecture, and (iii) high-level software programming and simulation. Experimental results on two complete memory-bound applications, AES and MobileNetV2, show that the C-SRAM implementation achieves up to 70× timing speedup and 37× energy reduction compared to scalar architecture, and up to 17× timing speedup and 5× energy reduction compared to SIMD architecture.

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• Type de publi. : Article dans une revue
• Date de publi. : 27/04/2022
• Auteurs : Romain DemeulemeesterNicolas SavyMichaël MouniéLaurent MolinierCyrille DelpierrePierre DellamonicaClotilde AllavenaPascal PugliesseLise CuzinPhilippe Saint-PierreNadège Costa
• Organismes : Centre Hospitalier Universitaire de Toulouse Centre d'Epidémiologie et de Recherche en santé des POPulations Institut de Mathématiques de Toulouse UMR5219 Centre Hospitalier Universitaire de Toulouse Centre d'Epidémiologie et de Recherche en santé des POPulations Centre Hospitalier Universitaire de Toulouse Equipe EQUITY (CERPOP) Equipe EQUITY (CERPOP) Centre Hospitalier Universitaire de Nice Centre Hospitalier Universitaire de Nantes = Nantes University Hospital Centre Hospitalier Universitaire de Nice Equipe EQUITY (CERPOP) Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique] Institut de Mathématiques de Toulouse UMR5219 Institut Universitaire de Technologie - Paul Sabatier Centre Hospitalier Universitaire de Toulouse Equipe EQUITY (CERPOP)
• Publié dans BMC Health Services Research le 01/11/2020

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Résumé : Background: In a context where the economic burden of HIV is increasing as HIV patients now have a close to normal lifespan, the availability of generic antiretrovirals commonly prescribed in 2017 and the imminence of patent expiration are expected to provide substantial savings in the coming years. This article aims to assess the economic impact of these generic antiretrovirals in France and specifically over a five-year period. Methods: An agent-based model was developed to simulate patient trajectories and treatment use over a five-year period. By comparing the results of costs for trajectories simulated under different predefined scenarios, a budget impact model can be created and sensitivity analyses performed on several parameters of importance. Results: The potential economic savings from 2019 to 2023 generated by generic antiretrovirals range from €309 million when the penetration rate of generics is set at 10% to €1.5 billion at 70%. These savings range from €984 million to €993 million as the delay between patent and generic marketing authorisation varies from 10 to 15 years, and from €965 million to €993 million as the Negotiated Price per Unit (NPU) of generics at market-entry varies from 40 to 50% of the NPU for patents. Discussion: This economic savings simulation could help decision makers to anticipate resource allocations for further innovation in antiretrovirals therapies as well as prevention, especially by funding the Pre-Exposure Prophylaxis (PrEP) or HIV screening.

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Fichiers liés : s12913-022-07859-w.pdf

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• Type de publi. : Article dans une revue
• Date de publi. : 26/04/2022
• Auteurs : Claire DelacôteMathilde FavreMedhi El AmraniMassih NingarhariElise LemaitreLine Carolle Ntandja-WandjiPierre BauvinEmmanuel BoleslawskiGuillaume Y. MilletStéphanie TruantPhilippe MathurinAlexandre LouvetValérie CanvaGilles LebuffeFrançois René PruvotSébastien DharancyGuillaume Lassailly
• Organismes : Institute for Translational Research in Inflammation - U 1286 Université Grenoble Alpes - UFR Médecine Centre de Recherche des Cordeliers Service des Maladies de l'Appareil Digestif et de la Nutrition [CHRU Lille] Institute for Translational Research in Inflammation - U 1286 Lille Inflammation Research International Center - U 995 Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 Laboratoire Interuniversitaire de Biologie de la Motricité Institut universitaire de France Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 Service des Maladies de l'Appareil Digestif et de la Nutrition [CHRU Lille] Institute for Translational Research in Inflammation - U 1286 Centre Hospitalier Régional Universitaire [CHU Lille] Hôpital Claude Huriez [Lille] Hôpital Claude Huriez [Lille] Groupe de Recherche sur les formes Injectables et les Technologies Associées - ULR 7365 Institute for Translational Research in Inflammation - U 1286 Hôpital Claude Huriez [Lille] Institute for Translational Research in Inflammation - U 1286
• Publié dans United European Gastroenterology Journal le 29/10/2020

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Résumé : Abstract Liver transplant (LT) candidates with a body mass index (BMI) over 40 kg/m 2 have lower access to a liver graft without clear explanation. Thus, we studied the impact of obesity on the waiting list (WL) and aimed to explore graft proposals and refusal. Method Data between January 2007 and December 2017 were extracted from the French prospective national database: CRISTAL. Competing risk analyses were performed to evaluate predictors of receiving LT. Competitive events were (1) death/WL removal for disease aggravation or (2) improvement. The link between grade obesity, grafts propositions, and reason for refusal was studied. Results 15,184 patients were analysed: 10,813 transplant, 2847 death/dropout for aggravation, 748 redirected for improvement, and 776 censored. Mortality/dropout were higher in BMI over 35 (18% vs. 14% 1 year after listing) than in other candidates. In multivariate analysis, BMI>35, age, hepatic encephalopathy, and ascites were independent predictors of death/dropout. Candidates with a BMI ≥ 35 kg/m 2 had reduced access to LT, without differences in graft proposals. However, grafts refusal was more frequent especially for ‘morphological incompatibility’ (14.9% vs. 12.7% p < 0.01). Conclusion BMI over 35 kg/m 2 reduces access to LT with increased risk of dropout and mortality. Increased mortality and dropout could be due to a lower access to liver graft secondary to increased graft refusal for morphological incompatibility.

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