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1.
Nephrologie ; 25(1): 23-8, 2004.
Article in French | MEDLINE | ID: mdl-15022870

ABSTRACT

This study explored the access to the French national renal transplantation waiting list and the waiting time before transplantation for the patients with ESRD on dialysis living in the FOT. Overseas health authorities gave data on ESRD incidence and prevalence. Data on patients registered between 1997 and 2000 were extracted from the French national waiting list (390 patients from the FOT and 9378 from continental France). Registered prevalence of ESRD in FOT (726 to 1418 per million population (pmp)) were higher than continental France (580 pmp). The yearly incidence of registration on the national French waiting list was 36 pmp. The same figure was observed in the FAT (French Guyana and Caribbean's islands: 36.8 to 43 pmp), very low in New Caledonia and Tahiti (7.7 and 18.1 pmp), and very high in the Reunion Island, where a renal transplantation unit is available (77.5 pmp). Median waiting times before transplantation varied significantly, FAT: 35.4 months, Reunion Island: 9.9 months, Pacific Territories: 8.8 months and the Metropolitan territory: 12.2 months. After adjustment on risk factors known to be associated with the waiting times before transplantation, we still observed a longer waiting time for patients from FAT (RR = 1,4, p < 0.05) and a lower waiting time for patients from Reunion Island (RR = 0.6, p < 0.001) compared to waiting time observed in patients from continental France. Consequently, transplantation teams in FAT must be developed.


Subject(s)
Health Services Accessibility/statistics & numerical data , Kidney Transplantation/statistics & numerical data , France/epidemiology , French Guiana/epidemiology , Guadeloupe/epidemiology , Humans , Kidney Failure, Chronic/epidemiology , Kidney Failure, Chronic/surgery , Martinique/epidemiology , New Caledonia/epidemiology , Polynesia/epidemiology , Reunion/epidemiology , Waiting Lists
2.
Transfusion ; 41(9): 1120-5, 2001 Sep.
Article in English | MEDLINE | ID: mdl-11552068

ABSTRACT

BACKGROUND: The routes of transmission of human herpes virus 8 (HHV-8) remain unclear. In particular, HHV-8 transmission by blood components and organ transplantation is still debated and raises public health issues. The objective of this study was to determine the prevalence of anti-HHV-8 in selected populations of persons or patients with or without risk factors for the transmission of viral infections, in order to determine the routes of HHV-8 transmission. STUDY DESIGN AND METHODS: A total of 1431 persons or patients at low or high risk of sexually, blood-, or graft-transmitted viral infections were tested by means of a standardized immunofluorescence serologic assay detecting anti-HHV-8. RESULTS: The persons or patients could be classified into three distinct groups according to anti-HHV-8 prevalence: a low prevalence group (0.0% to 5.0%), including healthy blood donors, healthy pregnant women, multiply transfused patients with thalassemia major, and IV drug users; an intermediate prevalence group (5.0% to 20.0%), including organ donors, kidney transplant recipients, and multiply transfused patients with sickle cell disease; a high prevalence group (>20.0%), including HIV-negative persons at high risk of sexually-transmitted viral infections, and HIV-infected homosexual men and heterosexuals. CONCLUSION: The sexual route appears to be the main route of HHV-8 transmission; bloodborne transmission of HHV-8, if it exists, is rare. In contrast, organ transplantation recipients might be exposed to HHV-8 transmission by the transplanted organ, which raises the issue of systematic screening of organ donors.


Subject(s)
Antibodies, Viral/analysis , Blood Transfusion , Herpesviridae Infections/transmission , Herpesvirus 8, Human/immunology , Organ Transplantation , Sexual Behavior , Adult , Female , Humans , Male , Middle Aged , Risk Factors , Seroepidemiologic Studies , Tissue Donors
4.
Rev Prat ; 47(18 Spec No): S22-7, 1997 Nov 15.
Article in French | MEDLINE | ID: mdl-9501592

ABSTRACT

Despite progress realised in transplantation and organ procurement, there is an increasing gap between the number of patients on the national waiting list and the number of harvested organs. As a result, the appropriate organs must be matched with the appropriate patient, with two constraints: equity and efficacy. In a context of lack of organs, another public health problematic is to conciliate both the interests of a given patient and the interests of those on the waiting lists. In 1996, the French secretary of state for health instituted a public consultation committee chaired by the vice-president of the Comité consultatif national d'éthique, Counsellor Jean Michaud, to study organ allocation rules and to plan recommendations for the future. Using, as a starting point, the allocation rules initiated in the past by France Transplant and transiently applied by l'Etablissement français des Greffes, the committee conducted a large audition of health care professionals concerned with transplantation, individuals qualified in ethics, laws, sociology or ethnology, politicians and a sample representation of the population. A new corpus of allocation rules and procedures was then defined according to the committee recommendations and the advice of all medico-surgical transplantation teams, and published as a ministerial order in the Journal officiel de la République française in november 1996. It specifies shared principles and organ by organ specific allocation rules.


Subject(s)
Tissue and Organ Procurement , Transplantation Conditioning/methods , France , Humans , Organ Transplantation , Patient Selection
5.
Rev Prat ; 47(18 Spec No): S28-31, 1997 Nov 15.
Article in French | MEDLINE | ID: mdl-9501593

ABSTRACT

Organ and tissue procurement strongly increased during the past decades to become a common activity among accredited hospitals. Structuring efficient regional organ procurement organisations appear as an important goal in order to offer the relevant number and quality of transplants to the patients on the national waiting list maintained by the Etablissement français des Greffes. Two structures acting together coordinate organ and tissue procurement: (i)accredited hospitals allocate some medical and non medical personal interfacing; (ii) the Etablissement français des Greffes through one of its seven regional units or its national unit. These units are in charge with the operational responsibility of multiorgan and tissue retrieval co-ordination in their geographical area, with organ allocation and with an institutional role of local and regional organ procurement development and promotion.


Subject(s)
Tissue and Organ Procurement/organization & administration , Transplantation Conditioning/methods , Transplantation/methods , France , Humans
16.
Anesth Analg (Paris) ; 38(9-10): 555-7, 1981.
Article in French | MEDLINE | ID: mdl-6277210

ABSTRACT

Cytomegalovirus infections are transmitted among adults by transfusion of fresh blood. This benign infection is characterised by a single febrile syndrome that appears, on an average, 22 days after the transfusion and may last as long as 6 weeks. Hematological anomalies are significant: inversion of the leucocytic formula with high rate of mononucleosis, founded on the presence of hyperbasophilic mononuclear cells that appears about the 30th day, will be confirmed when the virus is isolated in mononuclear cells and in urine and by means of situation fo C. M. V. antibodies. Those post-transfusion C. M. V. infections are frequent after extra-corporeal circulation but only appear clinically in 1 p. cent of cases.


Subject(s)
Cytomegalovirus Infections/etiology , Puerperal Infection/etiology , Transfusion Reaction , Adult , Cesarean Section , Cytomegalovirus Infections/diagnosis , Female , Humans , Pregnancy
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