{"id":30153,"date":"2025-07-08T09:10:16","date_gmt":"2025-07-08T07:10:16","guid":{"rendered":"https:\/\/u-paris.fr\/medecine\/?p=30153"},"modified":"2025-07-09T16:12:08","modified_gmt":"2025-07-09T14:12:08","slug":"the-lancet-serie-transplantation","status":"publish","type":"post","link":"https:\/\/u-paris.fr\/medecine\/the-lancet-serie-transplantation\/","title":{"rendered":"THE LANCET SERIE TRANSPLANTATION"},"content":{"rendered":"

[et_pb_section bb_built=\u00a0\u00bb1″ next_background_color=\u00a0\u00bb#000000″ inner_width=\u00a0\u00bbauto\u00a0\u00bb inner_max_width=\u00a0\u00bbnone\u00a0\u00bb][et_pb_row][et_pb_column type=\u00a0\u00bb3_4″][et_pb_text admin_label=\u00a0\u00bbIntro\u00a0\u00bb _builder_version=\u00a0\u00bb3.22.1″ module_id=\u00a0\u00bbintro\u00a0\u00bb text_text_shadow_horizontal_length=\u00a0\u00bbtext_text_shadow_style,%91object Object%93″ text_text_shadow_vertical_length=\u00a0\u00bbtext_text_shadow_style,%91object Object%93″ text_text_shadow_blur_strength=\u00a0\u00bbtext_text_shadow_style,%91object Object%93″ link_text_shadow_horizontal_length=\u00a0\u00bblink_text_shadow_style,%91object Object%93″ link_text_shadow_vertical_length=\u00a0\u00bblink_text_shadow_style,%91object Object%93″ link_text_shadow_blur_strength=\u00a0\u00bblink_text_shadow_style,%91object Object%93″ ul_text_shadow_horizontal_length=\u00a0\u00bbul_text_shadow_style,%91object Object%93″ ul_text_shadow_vertical_length=\u00a0\u00bbul_text_shadow_style,%91object Object%93″ ul_text_shadow_blur_strength=\u00a0\u00bbul_text_shadow_style,%91object Object%93″ ol_text_shadow_horizontal_length=\u00a0\u00bbol_text_shadow_style,%91object Object%93″ ol_text_shadow_vertical_length=\u00a0\u00bbol_text_shadow_style,%91object Object%93″ ol_text_shadow_blur_strength=\u00a0\u00bbol_text_shadow_style,%91object Object%93″ quote_text_shadow_horizontal_length=\u00a0\u00bbquote_text_shadow_style,%91object Object%93″ quote_text_shadow_vertical_length=\u00a0\u00bbquote_text_shadow_style,%91object Object%93″ quote_text_shadow_blur_strength=\u00a0\u00bbquote_text_shadow_style,%91object Object%93″ header_text_shadow_horizontal_length=\u00a0\u00bbheader_text_shadow_style,%91object Object%93″ header_text_shadow_vertical_length=\u00a0\u00bbheader_text_shadow_style,%91object Object%93″ header_text_shadow_blur_strength=\u00a0\u00bbheader_text_shadow_style,%91object Object%93″ header_2_text_shadow_horizontal_length=\u00a0\u00bbheader_2_text_shadow_style,%91object Object%93″ header_2_text_shadow_vertical_length=\u00a0\u00bbheader_2_text_shadow_style,%91object Object%93″ header_2_text_shadow_blur_strength=\u00a0\u00bbheader_2_text_shadow_style,%91object Object%93″ header_3_text_shadow_horizontal_length=\u00a0\u00bbheader_3_text_shadow_style,%91object Object%93″ header_3_text_shadow_vertical_length=\u00a0\u00bbheader_3_text_shadow_style,%91object Object%93″ header_3_text_shadow_blur_strength=\u00a0\u00bbheader_3_text_shadow_style,%91object Object%93″ header_4_text_shadow_horizontal_length=\u00a0\u00bbheader_4_text_shadow_style,%91object Object%93″ header_4_text_shadow_vertical_length=\u00a0\u00bbheader_4_text_shadow_style,%91object Object%93″ header_4_text_shadow_blur_strength=\u00a0\u00bbheader_4_text_shadow_style,%91object Object%93″ header_5_text_shadow_horizontal_length=\u00a0\u00bbheader_5_text_shadow_style,%91object Object%93″ header_5_text_shadow_vertical_length=\u00a0\u00bbheader_5_text_shadow_style,%91object Object%93″ header_5_text_shadow_blur_strength=\u00a0\u00bbheader_5_text_shadow_style,%91object Object%93″ header_6_text_shadow_horizontal_length=\u00a0\u00bbheader_6_text_shadow_style,%91object Object%93″ header_6_text_shadow_vertical_length=\u00a0\u00bbheader_6_text_shadow_style,%91object Object%93″ header_6_text_shadow_blur_strength=\u00a0\u00bbheader_6_text_shadow_style,%91object Object%93″ z_index_tablet=\u00a0\u00bb500″]<\/p>\n

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Vers une M\u00e9decine de Transplantation plus \u00c9quitable, Pr\u00e9cise et Innovante<\/strong><\/p>\n

La transplantation d\u2019organes solides est une avanc\u00e9e m\u00e9dicale majeure, mais reste confront\u00e9e \u00e0 des d\u00e9fis persistants li\u00e9s \u00e0 l\u2019acc\u00e8s \u00e9quitable<\/strong>, la p\u00e9nurie d\u2019organes <\/strong>et l\u2019optimisation du suivi post-greffe<\/strong>. <\/em><\/p>\n

Trois publications publi\u00e9es aujourd\u2019hui, dont l\u2019une port\u00e9e par le Pr. Alexandre Loupy<\/strong>, Professeur des universit\u00e9s praticien hospitalier (AP-HP\/ UFR de M\u00e9decine) et n\u00e9phrologue \u00e0 l\u2019h\u00f4pital Necker, dans The Lancet <\/strong>dressent un panorama complet des avanc\u00e9es scientifiques, technologiques et politiques dans ce domaine.<\/em><\/p>\n<\/div>\n<\/div>\n<\/div>\n

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\u00a9\u00a0<\/p>\n<\/div>\n<\/div>\n<\/div>\n

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Une crise mondiale d\u2019acc\u00e8s et de disponibilit\u00e9<\/strong><\/p>\n

Seule une infime partie des besoins mondiaux en transplantation est actuellement couverte : moins de 10 % selon l\u2019OMS<\/strong>. Les obstacles sont nombreux, allant de l\u2019absence d\u2019infrastructure nationale dans de nombreux pays \u00e0 des crit\u00e8res trop stricts d\u2019acceptabilit\u00e9 des greffons. \u00c0 titre d\u2019exemple, environ 50 000 organes sont rejet\u00e9s chaque ann\u00e9e rien qu\u2019aux \u00c9tats-Unis et en Europe<\/strong>, souvent \u00e0 cause de jugements cliniques incertains.<\/p>\n

Des solutions technologiques \u00e9mergent : la perfusion ex vivo permet de restaurer et d\u2019\u00e9valuer des organes auparavant jug\u00e9s non viables. Des efforts sont \u00e9galement d\u00e9ploy\u00e9s pour mieux utiliser les organes de donneurs avec h\u00e9patite C ou VIH, gr\u00e2ce \u00e0 des traitements antiviraux efficaces. Ces approches ont permis d\u2019\u00e9largir le nombre de greffes, mais ne suffisent pas \u00e0 r\u00e9pondre \u00e0 la demande.<\/p>\n

La m\u00e9decine de pr\u00e9cision post-transplantation<\/strong><\/p>\n

Malgr\u00e9 une r\u00e9duction drastique des rejets aigus depuis les ann\u00e9es 1980, les effets secondaires \u00e0 long terme des immunosuppresseurs (infections, cancers, maladies cardiovasculaires) nuisent \u00e0 la survie des greffons et \u00e0 la qualit\u00e9 de vie des patients. Le virage vers une m\u00e9decine personnalis\u00e9e<\/strong>, fond\u00e9e sur des biomarqueurs innovants et l\u2019intelligence artificielle<\/strong>, promet une meilleure stratification des risques et des traitements plus cibl\u00e9s.<\/p>\n

Des outils comme l\u2019algorithme iBox<\/strong> pour les greffons r\u00e9naux, r\u00e9cemment valid\u00e9 comme crit\u00e8re d\u2019essai clinique par l\u2019EMA<\/strong> et la FDA,<\/strong> repr\u00e9sentent un tournant. De m\u00eame, le d\u00e9veloppement de tests sanguins non invasifs<\/strong> visant \u00e0 d\u00e9tecter pr\u00e9cocement les rejets permettrait de r\u00e9duire le recours aux biopsies, souvent lourdes et peu informatives.<\/p>\n

L\u2019enjeu crucial de l\u2019\u00e9quit\u00e9<\/strong><\/p>\n

Les auteurs insistent sur le r\u00f4le des d\u00e9terminants sociaux dans les in\u00e9galit\u00e9s d\u2019acc\u00e8s<\/strong> : les minorit\u00e9s raciales, les populations rurales et les patients \u00e0 faible revenu sont syst\u00e9matiquement d\u00e9savantag\u00e9s dans les pays riches<\/strong>, comme aux \u00c9tats-Unis. Le manque de coordination entre professionnels de sant\u00e9, l\u2019opacit\u00e9 des crit\u00e8res d\u2019\u00e9ligibilit\u00e9, les barri\u00e8res financi\u00e8res et la m\u00e9fiance institutionnelle aggravent ces \u00e9carts.<\/p>\n

La transformation de la transplantation d\u2019organes passe donc par une triple r\u00e9volution <\/strong>: technologique<\/strong>, m\u00e9dicale<\/strong> et politique<\/strong>. Pour qu\u2019elle profite \u00e0 tous les patients, les avanc\u00e9es scientifiques doivent \u00eatre soutenues par des politiques \u00e9quitables<\/strong>, un meilleur partage des ressources<\/strong> et une transparence accrue<\/strong>. Comme le r\u00e9sument les auteurs : \u00ab la transplantation est un succ\u00e8s de la m\u00e9decine moderne \u2014 \u00e0 condition de ne pas en faire un privil\u00e8ge<\/em>. \u00bb<\/p>\n

Trois\u00a0webinaires\u00a0seront propos\u00e9s sur ces sujets, en juillet par soci\u00e9t\u00e9 Europ\u00e9enne<\/strong> (ESOT), internationale<\/strong> (TTS), et Am\u00e9ricaine<\/strong> (AST) et The Lancet.<\/strong><\/p>\n

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\u00c0<\/span> lire aussi<\/h2>\n

[\/et_pb_text][et_pb_blog _builder_version=\u00a0\u00bb3.21″ posts_number=\u00a0\u00bb4″ include_categories=\u00a0\u00bb13″ show_author=\u00a0\u00bboff\u00a0\u00bb show_date=\u00a0\u00bboff\u00a0\u00bb show_pagination=\u00a0\u00bboff\u00a0\u00bb border_width_bottom_fullwidth=\u00a0\u00bb1px\u00a0\u00bb border_color_bottom_fullwidth=\u00a0\u00bbrgba(51,51,51,0.18)\u00a0\u00bb custom_padding=\u00a0\u00bb||50px|\u00a0\u00bb module_id=\u00a0\u00bbpage_type_blog\u00a0\u00bb header_level=\u00a0\u00bbh4″ \/][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"

Vers une M\u00e9decine de Transplantation plus \u00c9quitable, Pr\u00e9cise et Innovante
\nLa transplantation d\u2019organes solides est une avanc\u00e9e m\u00e9dicale majeure, mais reste confront\u00e9e \u00e0 des d\u00e9fis persistants li\u00e9s \u00e0 l\u2019acc\u00e8s \u00e9quitable, la p\u00e9nurie d\u2019organes et l\u2019optimisation du suivi post-greffe.
\n Lire la suite THE LANCET SERIE TRANSPLANTATION<\/span><\/a><\/p>\n","protected":false},"author":234,"featured_media":30157,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"categories":[1],"tags":[],"coauthors":[28],"class_list":["post-30153","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-medecine"],"_links":{"self":[{"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/posts\/30153","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/users\/234"}],"replies":[{"embeddable":true,"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/comments?post=30153"}],"version-history":[{"count":5,"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/posts\/30153\/revisions"}],"predecessor-version":[{"id":30187,"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/posts\/30153\/revisions\/30187"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/media\/30157"}],"wp:attachment":[{"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/media?parent=30153"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/categories?post=30153"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/tags?post=30153"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/u-paris.fr\/medecine\/wp-json\/wp\/v2\/coauthors?post=30153"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}