Publications by authors named "E Savier"

80 Publications

Naive and memory CD4 T cell subsets can contribute to the generation of human Tfh cells.

iScience 2022 Jan 3;25(1):103566. Epub 2021 Dec 3.

Sorbonne Université, INSERM, UMRS 959, Immunology-Immunopathology-Immunotherapy (i3), Paris, France.

CD4 T follicular helper cells (Tfh) promote B cell maturation and antibody production in secondary lymphoid organs. By using an innovative culture system based on splenocyte stimulation, we studied the dynamics of naive and memory CD4 T cells during the generation of a Tfh cell response. We found that both naive and memory CD4 T cells can acquire phenotypic and functional features of Tfh cells. Moreover, we show here that the transition of memory as well as naive CD4 T cells into the Tfh cell profile is supported by the expression of pro-Tfh genes, including transcription factors known to orchestrate Tfh cell development. Using this culture system, we provide pieces of evidence that HIV infection differentially alters these newly identified pathways of Tfh cell generation. Such diversity in pathways of Tfh cell generation offers a new framework for the understanding of Tfh cell responses in physiological and pathological contexts.
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http://dx.doi.org/10.1016/j.isci.2021.103566DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8693005PMC
January 2022

Influence of the ABO Blood Group System on Hepatocellular Carcinoma Recurrence After Liver Transplantation.

Transplantation 2021 Dec 27. Epub 2021 Dec 27.

Liver Transplant and Surgery Department, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France. Cancer Research Center of Lyon, INSERM 1052/CNRS 5285 Unit, Lyon, France. Department of Hepatology, Hôpital Européen Georges Pompidou, Paris, France. Department of Hepatology, Hôpital Jean Verdier, Bondy, France. Liver Transplant and Surgery Department, Hôpital Trousseau, Tours, France. Liver Transplant and Surgery Department, Hôpital Pontchaillou, Rennes, France. Liver Transplant and Surgery Department, Hôpital Paul Brousse, AP-HP, Villejuif, France. Liver Transplant and Surgery Department, Hôpital de la Pitié-Sapétrière, AP-HP, Paris, France. Liver Transplant and Surgery Department, Hôpital Rangueil, Toulouse, France. Liver Transplant and Surgery Department, Hôpital Henri Mondor, Créteil, France. Liver Transplant and Surgery Department, Hôpital Jean Minjoz, Besançon, France. Department of Hepatology, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Lyon, France. Faculty of Medicine Paris V, Paris, France. Department of HPB surgery and liver transplantation, Hôpital Beaujon, AP-HP, Clichy, France.

Background: The ABO blood group system may influence tumorigenesis, but its prognostic value in liver transplantation (LT) for hepatocellular carcinoma (HCC) has never been assessed.

Methods: All consecutive patients who underwent LT for HCC between 2013 and 2017 at 9 centers were analyzed. Predictors of tumor recurrence were identified using multivariable analysis, while comparison between group A and non-A recipients was performed after propensity score matching.

Results: Among 925 LT recipients, 406 were blood group A, 94 group B, 380 group O, and 45 group AB. On multivariable analysis, group A was associated with tumor recurrence (hazard ratio [HR] = 1.574 [95% confidence interval; 95% CI = 1.034-2.394] P = 0.034). After propensity score matching, 1- and 5-y recurrence rates were 7.4% and 20.1% in group A recipients versus 3.3% and 13.2% in non-A recipients (HR = 1.66 [95% CI = 1.12-2.45], P = 0.011). One and 5-y recurrence-free survivals were 85.2% and 66.8% in group A recipients versus 88.5% and 71.3% in non-A recipients (HR = 1.38 [95% CI = 1.01-1.90], P = 0.045). Among recipients within Milan criteria (n = 604), 1- and 5-y recurrence rates were 5.8% and 12.7% in group A recipients versus 3.1% and 12.2% in non-A recipients (HR = 1.197 [95% CI = 0.721-1.987], P = 0.485). Among recipients outside Milan criteria (n = 182), 1- and 5-y recurrence rates were 12.1% and 43.8% in group A recipients versus 3.9% and 15.6% in non-A recipients (HR = 3.175 [95% CI = 1.526-6.608], P = 0.002).

Conclusions: ABO blood system influences the oncological outcome of recipients undergoing LT for HCC. Its incorporation in the prognostication model of LT for HCC may allow improving the management of LT candidates.
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http://dx.doi.org/10.1097/TP.0000000000004004DOI Listing
December 2021

Auxiliary Liver Transplantation for Cirrhosis: From APOLT to RAPID: A Scoping Review.

Ann Surg 2021 Dec 14. Epub 2021 Dec 14.

Department of Digestive, Hepato-Biliary and Pancreatic Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France Department of Digestive and Oncologic Surgery, Liver Transplantation Unit, University Hospital of Besançon, Besançon, France Centre de Recherche de Saint-Antoine (CRSA), INSERM, UMRS-938, Paris, France Department of Surgery and Transplantation, Ankara University Scholl of Medicine, Ankara, Turkey. Sorbonne Université, Paris, France Department of Digestive Surgery, Institut Mutualiste Montsouris, Paris, France.

Objective: To survey the available literature regarding the use of auxiliary liver transplantation (ALT) in the setting of cirrhosis.

Summary Background: ALT is a type of LT procedure in which part of the cirrhotic liver is resected and part of the liver graft is transplanted. The cirrhotic liver left in situ acts as an auxiliary liver until the graft has reached sufficient volume. Recently, a two-stage concept named RAPID (Resection And Partial LIver segment 2/3 transplantation with Delayed total hepatectomy) was developed, which combines hypertrophy of the small graft followed by delayed removal of the native liver.

Methods: A scoping review of the literature on ALT for cirrhosis was performed, focusing on the historical background of RAPID and the status of RAPID for this indication. The new comprehensive nomenclature for hepatectomy ("New World" terminology) was used in this review.

Results: A total of 72 cirrhotic patients underwent ALT [heterotopic (n = 34), orthotopic (APOLT, n = 34 including 5 followed by resection of the native liver at the second stage) and RAPID (n = 4)]. Among the 9 two-stage LTs (APOLT, n = 5; RAPID, n = 4), portal blood flow modulation was performed in 6 patients by deportalization of the native liver (n = 4), portosystemic shunt creation (n = 1), splenic artery ligation (n = 3) or splenectomy (n = 1). The delay between the first and second stages ranged from 18 to 90 days. This procedure led to an increase in the graft-to-recipient weight ratio between 33% and 156%. Eight patients were alive at the last follow-up.

Conclusions: Two-stage LT and, more recently, the RAPID procedure are viable options for increasing the number of transplantations for cirrhotic patients by using small grafts.
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http://dx.doi.org/10.1097/SLA.0000000000005336DOI Listing
December 2021

Re: Surgical tracheotomy.

J Visc Surg 2021 Nov 23. Epub 2021 Nov 23.

Department of Digestive, Hepatobiliary and Liver Transplantation, Hopitaux Universitaires Pitié- Salpetrière-Charles Foix, Paris, France.

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http://dx.doi.org/10.1016/j.jviscsurg.2021.11.002DOI Listing
November 2021

Impact of the duration of normothermic regional perfusion on the results of liver transplant from controlled circulatory death donors: A retrospective, multicentric study.

Clin Transplant 2021 Nov 14:e14536. Epub 2021 Nov 14.

Department of Digestive Surgery and Liver Transplantation, University Hospital of Tours, University of Tours, Tours, France.

In France, the program of controlled donation after circulatory death (cDCD) was established with routine use of in situ normothermic regional perfusion (NRP). There is currently no consensus on its optimal duration. The purpose was to assess the impact of NRP duration on liver graft function and biliary outcomes. One-hundred and fifty-six liver recipients from NRP-cDCD donors from six French centers between 2015 and 2019 were included. Primary endpoint was graft function assessed by early allograft dysfunction (EAD, according to Olthoff's criteria) and MEAF (model for early allograft function) score. Overall, three (1.9%) patients had primary non-function, 30 (19.2%) patients experienced EAD, and MEAF score was 7.3 (±1.7). Mean NRP duration was 179 (±43) min. There was no impact of NRP duration on EAD (170±44 min in patients with EAD vs. 181±42 min in patients without, P = .286). There was no significant association between NRP duration and MEAF score (P = .347). NRP duration did neither impact on overall biliary complications nor on non-anastomotic biliary strictures (overall rates of 16.7% and 3.9%, respectively). In conclusion, duration of NRP in cDCD donors does not seem to impact liver graft function and biliary outcomes after liver transplantation. A 1 to 4-h perfusion represents an optimal time window.
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http://dx.doi.org/10.1111/ctr.14536DOI Listing
November 2021
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