📇 Rhumatologue · NANCY · (54) · Libéral
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2 raisons identifiées
Expérience confirmée
33 ans d'exercice en rhumatologie — recul clinique solide
Délais de RDV courts dans la région
146.3 rhumatos / 100 000 hab. — département bien doté
33ans d'exercice (thèse 1993)
✨ Génération du profil synthétique IA en cours…
Données ANS publiques (Licence Ouverte 2.0) · Enrichissements MonRhumato 100 % opt-in · Toute personne référencée peut demander la suppression ou la rectification.
Source : catalogue national des thèses theses.fr (ABES). Ne couvre que les doctorats / HDR — les thèses d'exercice (DES) sont archivées dans les SCD universitaires.
CABINET DU DR THIERRY DELMAS
1 RUE MAZAGRAN, 54000 NANCY
Secteur de conventionnement non disponible (médecin hospitalier ou non présent dans l'Annuaire santé CNAM des libéraux conventionnés).
Lien Doctolib = recherche Google site:doctolib.fr (le 1er résultat est presque toujours le profil correct s'il existe).
Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2013
Purpose Post-transplantation lymphoproliferative disorder (PTLD) is associated with significant mortality in kidney transplant recipients. We conducted a prospective survey of the occurrence of PTLD in a French nationwide population of adult kidney recipients over 10 years. Patients and Methods A French registry was established to cover a nationwide population of transplant recipients and prospectively enroll all adult kidney recipients who developed PTLD between January 1, 1998, and December 31, 2007. Five hundred patient cases of PTLD were referred to the French registry. The prognostic factors for PTLD were investigated using Kaplan-Meier and Cox analyses. Results Patients with PTLD had a 5-year survival rate of 53% and 10-year survival rate of 45%. Multivariable analyses revealed that age > 55 years, serum creatinine level > 133 μmol/L, elevated lactate dehydrogenase levels, disseminated lymphoma, brain localization, invasion of serous membranes, monomorphic PTLD, and T-cell PTLD were independent prognostic indicators of poor survival. Considering five variables at diagnosis (age, serum creatinine, lactate dehydrogenase, PTLD localization, and histology), we constructed a prognostic score that classified patients with PTLD as being at low, moderate, high, or very high risk for death. The 10-year survival rate was 85% for low-, 80% for moderate-, 56% for high-, and 0% for very high–risk recipients. Conclusion This nationwide study highlights the prognostic factors for PTLD and enables the development of a new prognostic score. After validation in an independent cohort, the use of this score should allow treatment strategies to be better tailored to individual patients in the future.
Journal of the American Society of Nephrology : JASN · 2019
Significance Statement Although complement blockade is highly effective for preventing recurrence of atypical hemolytic uremic syndrome (HUS) after kidney transplant, debates regarding the use of eculizumab prophylaxis continue because of its very high cost. An individualized strategy—using eculizumab prophylaxis specifically in patients with moderate- to high-risk kidney transplants, determined by complement analysis and a medical history of a previous recurrence—was implemented in France in 2011 and subsequently adopted more widely. In the authors’ retrospective study of patients with atypical HUS in France, they found that prophylactic use of eculizumab almost abolished the risk of recurrence and significantly increased graft survival, especially in high-risk transplants. It also led to a substantial expansion after 2012 of the transplanted population among patients with atypical HUS and ESKD. These findings support use of eculizumab prophylaxis based on pretransplant risk stratification. Background Atypical hemolytic uremic syndrome (HUS) is associated with high recurrence rates after kidney transplant, with devastating outcomes. In late 2011, experts in France recommended the use of highly individualized complement blockade–based prophylaxis with eculizumab to prevent post-transplant atypical HUS recurrence throughout the country. Methods To evaluate this strategy’s effect on kidney transplant prognosis, we conducted a retrospective multicenter study from a large French nationwide registry, enrolling all adult patients with atypical HUS who had undergone complement analysis and a kidney transplant since January 1, 2007. To assess how atypical HUS epidemiology in France in the eculizumab era evolved, we undertook a population-based cohort study that included all adult patients with atypical HUS ( n =397) between 2007 and 2016. Results The first study included 126 kidney transplants performed in 116 patients, 58.7% and 34.1% of which were considered to be at a high and moderate risk of atypical HUS recurrence, respectively. Eculizumab prophylaxis was used in 52 kidney transplants, including 39 at high risk of recurrence. Atypical HUS recurred after 43 (34.1%) of the transplants; in four cases, patients had received eculizumab prophylaxis and in 39 cases they did not. Use of prophylactic eculizumab was independently associated with a significantly reduced risk of recurrence and with significantly longer graft survival. In the second, population-based cohort study, the proportion of transplant recipients among patients with ESKD and atypical HUS sharply increased between 2012 and 2016, from 46.2% to 72.3%, and showed a close correlation with increasing eculizumab use among the transplant recipients. Conclusions Results from this observational study are consistent with benefit from eculizumab prophylaxis based on pretransplant risk stratification and support the need for a rigorous randomized trial.
Source PubMed · Recherche par auteur (homonymes possibles, vérifier l'affiliation).
Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2013 · Journal Article
Caillard S, Porcher R, Provot F, Dantal J, et al.
Cureus · 2023 · Case Reports
Evbayiro U, Delmas T, Lat T
Journal of the American Society of Nephrology : JASN · 2019 · Journal Article
Zuber J, Frimat M, Caillard S, Kamar N, et al.