Yannick Le Meur

Yannick Le Meur
Université de Bretagne Occidentale | UBO · Service de Néphrologie, Centre Hospitalier universitaire La Cavale Blanche, Brest

MD, PhD

About

297
Publications
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Publications

Publications (297)
Article
Introduction Le spectre des polykystoses hépato-rénales autosomiques (PKRAD) dominante est cliniquement et génétiquement hétérogène. Les variants monoalléliques perte de fonction de IFT140, codant une protéine responsable du transport ciliaire rétrograde, ont très récemment été mis en évidence dans des formes atypiques de PKRAD. Description L’obje...
Article
Introduction Plusieurs gènes impliqués dans la N-glycosylation, processus clé de maturation protéique, ont récemment été associés au spectre des polykystoses hépato-rénales autosomiques dominantes (PKRAD). Parmi eux, l’implication d’ALG8, codant pour l’ɑ-1,3-glucosyltransferase, a été rapportée dans 5 familles (Besse W et al., JCI 2017). Descripti...
Article
Full-text available
SARS-CoV-2 pandemic evolved in two consecutive waves over 2020. Improvements in the management of COVID-19 led to a reduction of mortality rates in hospitalized patients during the second wave. Whether this progress also benefited to kidney transplant recipients (KTR), a population particularly vulnerable to severe COVID-19, remained unclear. In Fr...
Article
Disorders of the autosomal dominant polycystic kidney disease (ADPKD) spectrum are characterized by the development of kidney cysts and progressive kidney function decline. PKD1 and PKD2, encoding polycystin (PC)1 and 2, are the two major genes associated with ADPKD; other genes include IFT140, GANAB, DNAJB11, and ALG9. Genetic testing remains inco...
Article
Approval of the vasopressin V2 receptor antagonist tolvaptan—based on the landmark TEMPO 3:4 trial—marked a transformation in the management of autosomal dominant polycystic kidney disease (ADPKD). This development has advanced patient care in ADPKD from general measures to prevent progression of chronic kidney disease to targeting disease-specific...
Article
Full-text available
Introduction Expanded-criteria donors (ECDs) are used to reduce the shortage of kidneys for transplantation. However, kidneys from ECDs are associated with an increased risk of delayed graft function (DGF), a risk factor for allograft loss and mortality. HYPOREME will be a multicentre randomised controlled trial (RCT) comparing targeted hypothermia...
Article
Cytomegalovirus (CMV) persists as the the most frequent opportunistic infection among solid organ transplant recipients. This multicentre trial aimed to test whether treatment with everolimus (EVR) could decrease the incidence of CMV DNAemia and disease. We randomized 186 CMV seropositive kidney transplant recipients in a 1:1 ratio to receive EVR o...
Article
Background M101 is an extracellular hemoglobin isolated from a marine lugworm and is present in the medical device HEMO2life®. The clinical investigation OXYOP was a paired kidney analysis (n = 60) designed to evaluate the safety and performance of HEMO2life® used as an additive to preservation solution in renal transplantation. The secondary effic...
Preprint
SARS-CoV-2 pandemic evolved in two consecutive waves over 2020 (for France: 1st wave from March 1 to July 31; and 2nd wave from August 1 to December 31). Improvements in the management of COVID-19 led to a reduction of mortality rates in hospitalized patients during the second wave. Whether this progress also benefited to kidney transplant recipien...
Article
Full-text available
The approval of the vasopressin V2-receptor antagonist tolvaptan - based on the landmark TEMPO 3:4 trial - has marked a transformation in the management of autosomal dominant polycystic kidney disease (ADPKD). This development has advanced patient care in ADPKD from general measures to prevent progression of chronic kidney disease to targeting dise...
Article
Full-text available
Mycophenolic acid (MPA) targets the inosine 5′-monophosphate dehydrogenase (IMPDH) of human lymphocytes. It is widely used as an immunosuppressant to prevent rejection in solid organ transplant (SOT) recipients who, incidentally, are at risk for Pneumocystis pneumonia (PCP). We hypothesized that MPA exerts selective pressure on P. jirovecii microor...
Article
Introduction La PKRAD est marquée par une hétérogénéité génétique. En plus de PKD1 et PKD2, codant les polycystine 1 et 2, de nouveaux gènes impliqués dans la biogenèse de ces protéines ont récemment été identifiés. Description Nous évaluons l’apport du SNG dans le diagnostic des maladies hépatorénales kystiques, au sein d’une cohorte de 269 patie...
Article
Introduction Le tolvaptan (JINARC®) est le premier traitement de la polykystose rénale autosomique dominante (PKRAD) dont la Commission de la Transparence (HAS) a défini les critères d’éligibilité en 2015. Description Crée en 2010, la cohorte GENKYST comprend 3200 patients dans 28 centres sur 13 départements du Grand Ouest Français. Méthodes Nous...
Article
Abdominal anatomy segmentation is crucial for numerous applications from computer-assisted diagnosis to image-guided surgery. In this context, we address fully-automated multi-organ segmentation from abdominal CT and MR images using deep learning. The proposed model extends standard conditional generative adversarial networks. Additionally to the d...
Article
Background: The first wave of the Covid-19 pandemic resulted in a drastic reduction in kidney transplantation and a profound change in transplant care in France. It is critical for kidney transplant centers to understand the behaviors, concerns and wishes of transplant recipients and waiting list candidates. Methods: French kidney patients were con...
Article
Cytomegalovirus (CMV) is the most common opportunistic pathogen affecting renal transplant recipients, especially in the first months. CMV‐seropositive renal transplant recipients (CMV R+) are at intermediate risk for CMV disease, but this risk is enhanced among CMV R+ receiving T‐cell depleting induction, compared to CMV R+ receiving non‐depleting...
Article
End stage kidney disease increase the risk of COVID-19 related death but how the kidney replacement strategy should be adapted during the pandemic is unknown. Chronic hemodialysis makes social distancing difficult to achieve. Alternatively, kidney transplantation could increase the severity of COVID-19 due to therapeutic immunosuppression and contr...
Article
Full-text available
There are no studies which have compared the risk of severe Covid‐19 and related mortality between transplant recipients and non‐transplant patients. We enrolled two groups of patients hospitalized for Covid‐19, i.e., kidney transplant recipients from the French Registry of Solid Organ Transplant (n=306) and a single‐center cohort of non‐transplant...
Article
Introduction Durant la pandémie de COVID-19, peu d’informations concernant la présentation clinique et le pronostic de cette infection chez les patients transplantés d’organe ont été rapportées. Description Nous avons mis en place un registre français sous l’égide de la Société francophone de transplantation pour recenser tous les cas de patients...
Article
Notwithstanding the ongoing coronavirus disease-2019 (Covid-19) pandemic, information on its clinical presentation and prognosis in recipients of a kidney transplant remain scanty. The aim of this registry-based observational study was to explore characteristics and clinical outcomes of recipients of kidney transplants included in the French nation...
Article
Purpose Kidney transplant recipients (KTRs) are frequently infected with chronic hepatitis C virus (HCV), which can increase the risk of graft loss. Active HCV infections among KTRs are associated with shorter survival times. The emergence of very efficient interferon-free treatments (direct-acting antivirals [DAAs]) has revolutionized prognoses fo...
Article
Monoallelic mutations of DNAJB11 were recently described in seven pedigrees with atypical clinical presentations of autosomal dominant polycystic kidney disease. DNAJB11 encodes one of the main cofactors of the endoplasmic reticulum chaperon BiP, a heat-shock protein required for efficient protein folding and trafficking. Here we conducted an inter...
Poster
Full-text available
The purpose of this poster is a Q&A about practical aspects about the use of tolvaptan in ADPKD
Article
The medical device M101 is an extracellular hemoglobin featuring high oxygen-carrying capabilities. Preclinical studies demonstrated its safety as an additive to organ preservation solutions and its beneficial effect on ischemia/reperfusion injuries. OXYOP is a multicenter open-label study evaluating for the first time the safety of M101 added (1 g...
Preprint
Full-text available
Objective : Abdominal anatomy segmentation is crucial for numerous applications from computer-assisted diagnosis to image-guided surgery. In this context, we address fully-automated multi-organ segmentation from abdominal CT and MR images using deep learning. Methods: The proposed model extends standard conditional generative adversarial networks....
Article
Full-text available
Background: In dialysis sessions, some data suggest that decreasing or even avoiding additional anticoagulation by heparin is possible among patients already treated with oral anticoagulation. However, the required dose of heparin may actually depend on the pre-dialysis international normalized ratio (INR), which varies from one session to another...
Article
Introduction Le traitement par tolvaptan représente un changement de paradigme dans la prise en charge de la polykystose rénale autosomique dominante (PKRAD). L’avis de la Commission de la Transparence de 2015 précise l’AMM européenne et détaille l’éligibilité clinique des patients au tolvaptan, mais ne décrit pas les aspects pratiques de prise en...
Article
Introduction Les AIC représentent la complication la plus sévère de la PKRAD et sont 5 fois plus fréquents que dans la population générale. Notre objectif est de réévaluer leur prévalence et de définir les facteurs prédisposants en cause. Méthodes La prévalence des AIC chez les patients atteints de PKRAD a été évaluée au sein de 27 centres de néph...
Article
Introduction La vasopressine a un rôle important dans physiopathologie de la croissance kystique chez les patients atteints de polykystose autosomique dominante (PKRAD). La valeur pronostique de la copeptine, portion C-terminale de la vasopressine, a fait l’objet d’études dans la PKRAD, mais son rôle en conjonction avec les autres marqueurs prédict...
Article
Introduction Selon certaines études, une diminution, voire une interruption de l’héparine est possible chez les patients hémodialysés chroniques déjà anticoagulés par antivitamines K (AVK) pour prévenir les coagulations de circuit. En pratique, la variabilité des INR rend cependant souvent difficile l’interruption totale d’héparine. Méthodes D’apr...
Article
Full-text available
Background: Post-transplant diabetes is a frequent and serious complication of kidney transplantation. There is currently no treatment to prevent or delay the disease. Nevertheless, identification of risk factors make it possible to target a population at risk of developing de novo diabetes. We hypothesized that a short-term treatment with vildagl...
Preprint
Background: Post-transplant diabetes is a frequent and serious complication of kidney transplantation. There is currently no treatment to prevent or delay the disease. Nevertheless, identification of risk factors make possible to target a population at risk to develop de novo diabetes. We hypothesized that a short term treatment with Vildagliptin m...
Article
Full-text available
Background Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. Methods In this...
Preprint
Background: Post-transplant diabetes is a frequent and serious complication of kidney transplantation. There is currently no treatment to prevent or delay the disease. Nevertheless, identification of risk factors make possible to target a population at risk to develop de novo diabetes. We hypothesized that a short term treatment with Vildagliptin m...
Preprint
Background: Post-transplant diabetes is a frequent and serious complication of kidney transplantation. There is currently no treatment to prevent or delay the disease. Nevertheless, identification of risk factors make possible to target a population at risk to develop de novo diabetes. We hypothesized that a short term treatment with Vildagliptin m...
Article
Full-text available
Introduction Different prolonged-release formulations of tacrolimus are available. To date, the pharmacokinetic (PK) profile of LCP-tacrolimus (LCPT; Envarsus®) has not been compared with PR-Tac (Advagraf®) in de novo kidney transplant recipients. These profiles will guide clinical recommendations for the initiation and dose titration strategies of...
Article
Full-text available
Background Despite advances in immunosuppressive therapy, kidney graft survival has failed to improve during the last decades. Ischemia/reperfusion injury (IRI) is one of the main pathophysiological mechanisms underlying delayed graft function, which is associated with poor long-term graft survival. Due to organ shortage, the proportion of grafts f...
Article
Introduction Les infections à CytoMegaloVirus (CMV) constituent une complication infectieuse majeure en transplantation rénale. Le principal facteur de risque reste le « mismatch » sérologique, lorsque le receveur non immunisé contre le CMV reçoit un greffon d’un donneur immunisé. Les patients greffés rénaux immunisés avant la greffe, dits CMV R+,...
Article
Introduction Le tolvaptan est maintenant disponible depuis plusieurs mois. Nous rapportons l’expérience du groupe Genkyst sur 66 patients traités. Patients/Matériels et méthodes Les patients polykystiques traités par le tolvaptan sont suivis prospectivement au sein de la cohorte Genkyst. Ils sont tous génotypés et un volume rénal calculé avant tra...
Article
Introduction La prévention des lésions d’ischémie reperfusion (IR) est un enjeu majeur en transplantation d’organe. Le dispositif médical HEMO2life® est un transporteur d’oxygène extrait d’Arenicola Marina, un ver marin, possédant une forte affinité pour l’oxygène et des capacités anti-oxydantes. Des études précliniques ont montré sa parfaite innoc...
Article
Introduction La PKRAD est marquée par une forte variabilité en terme d’âge de survenue de l’insuffisance rénale terminale (IRT). Chez 7 à 10 % des patients, l’étude génétique ne permet pas d’identifier la mutation en cause. La survenue de mutations du gène PKD1 de novo au stade embryonnaire précoce, ou mosaïsme, a été rapportée dans la littérature...
Article
Full-text available
Background: Cis-regulatory elements control gene expression over large distances through the formation of chromatin loops, which allow contact between enhancers and gene promoters. Alterations in cis-acting regulatory systems could be linked to human genetic diseases. Here, we analyse the spatial organization of a large region spanning the polycys...
Article
Polycystic kidney disease: diagnosis, progressive profile, prognostic elements. Autosomal dominant polycystic kidney disease can lead to end-stage renal disease but is also complicated by infectious, digestive, cardiovascular and hepatic problems. The diagnosis is easy in the presence of a family history, but its exclusion is sometimes difficult. I...
Article
Autosomal-dominant polycystic kidney disease (ADPKD) is characterized by the progressive development of kidney cysts, often resulting in end-stage renal disease (ESRD). This disorder is genetically heterogeneous with ∼7% of families genetically unresolved. We performed whole-exome sequencing (WES) in two multiplex ADPKD-like pedigrees, and we analy...
Article
Following the discovery of (R)-roscovitine's beneficial effects in three polycystic kidney disease (PKD) mouse models, cyclin-dependent kinases (CDKs) inhibitors are investigated as potential treatments. We have used various affinity chromatography approaches to identify the molecular targets of roscovitine and its more potent analogue (S)-CR8 in h...
Article
Background: Renal cancer accounts for 3% of adult malignancies; renal cell carcinoma (RCC) represents 80% of all renal cancers, and is characterized by late recurrences. Recurrences after kidney transplantation are associated with a high mortality rate. We aimed to determine if recurrences are linked to tumor characteristics and to delays between...
Article
Introduction Le pronostic rénal dans la polykystose rénale autosomique dominante (PKRAD) est variable. La mesure du volume rénal total (VRT) ou du VRT ajusté à la taille (VRTat) est largement utilisée tant comme outil pronostic que comme critère de jugement dans les essais thérapeutiques. Les méthodes de référence de mesure du VRT sont longues et f...
Article
Introduction Le déficit en cobalamine C (cblC) est la plus fréquente erreur innée du métabolisme de la vitamine B12. Cette pathologie est souvent révélée dans l’enfance, avec une symptomatologie neurologique prédominante. Quelques cas de microangiopathies thrombotiques (MAT) rénales liées au déficit en cblC ont été préalablement rapportés, chez l’e...
Article
Introduction En 2010, Berden propose une classification histopathologique des vascularites à ANCA basée sur l’étude des ponctions biopsies rénale (PBR) réparties en quatre classes : focale, croissant, mixte et scléreuse. Il montre que le pronostic rénal est corrélé à la classe histologique. Nous vérifions ici la valeur pronostique de cette classifi...
Article
Full-text available
Background: The PROPKD score has been proposed to stratify the risk of progression to end-stage renal disease in autosomal dominant polycystic kidney disease (ADPKD) subjects. We aimed to assess its prognostic value in a genotyped subgroup of subjects from the Tolvaptan Phase 3 Efficacy and Safety Study in Autosomal Dominant Polycystic Kidney Dise...
Article
Full-text available
Background: PKD2-related autosomal dominant polycystic kidney disease (ADPKD) is widely acknowledged to be of milder severity than PKD1-related disease, but population-based studies depicting the exact burden of the disease are lacking. We aimed to revisit PKD2 prevalence, clinical presentation, mutation spectrum, and prognosis through the Genkyst...
Article
Full-text available
ADHERE was a randomized, open-label, Phase IV study comparing renal function at Week 52 postkidney transplant, in patients who received prolonged- release tacrolimus-based immunosuppressive regimens. On Days 0–27, patients received prolonged-release tacrolimus (initially 0.2 mg/kg/day), corticosteroids, and mycophenolate mofetil (MMF). Patients wer...
Article
Introduction Définir de façon précise le poids sec des patients hémodialysés chroniques est complexe. L’impédancemétrie permet une évaluation rapide et non invasive de la composition corporelle. L’objectif de l’étude est de comparer la surcharge hydrique estimée par un impédancemètre multicentrique, le Z Hydra® Bioparhom, Méditor, à l’ultrafiltrati...
Article
Full-text available
Autosomal-dominant polycystic kidney disease (ADPKD) is a common, progressive, adult-onset disease that is an important cause of end-stage renal disease (ESRD), which requires transplantation or dialysis. Mutations in PKD1 or PKD2 (∼85% and ∼15% of resolved cases, respectively) are the known causes of ADPKD. Extrarenal manifestations include an inc...
Article
Full-text available
Acute renal rejection is a major risk factor for chronic allograft dysfunction and long-term graft loss. We performed a genome-wide association study to detect loci associated with biopsy-proven acute T cell-mediated rejection occurring in the first year after renal transplantation. In a discovery cohort of 4127 European renal allograft recipients...