Programme Hospitalier Recherche Clinique, Institut Pasteur, Inserm, French Public Health Agency.

No abstract

These results suggest that preformed anti-HLA-Cw and anti-HLA-DP DSA are as deleterious as anti-HLA A/B/DR/DQ DSA. It justifies their inclusion in kidney allocation programs and in immunological risk stratification algorithms.

In cirrhotic patients, alveolar nitric oxide (NO) concentration is increased. This may be secondary to increased output of NO produced by the alveoli (V9A,NO) and/or to decreased lung transfer factor of NO. In advanced liver cirrhosis, NO produced by the alveoli may play a role in abnormalities of pulmonary haemodynamics and gas exchanges. In cirrhotic patients, we aimed to measure V9A,NO and to compare V9A,NO with pulmonary haemodynamics and gas exchange parameters.Measurements were performed in 22 healthy controls and in 29 cirrhotic patients, of whom eight had hepatopulmonary syndrome. Exhaled NO concentrations were measured at multiple expiratory flow rates to derive alveolar NO concentration. V9A,NO was the product of alveolar NO concentration by single breath lung transfer factor for NO.V9A,NO was increased in patients (median (range) 260 (177-341) nL?min) compared with controls (79 (60-90), p,0.0001). Alveolar-arterial oxygen tension difference failed to correlate with V9A,NO. However, cardiac index correlated positively and systemic vascular resistance correlated negatively with V9A, NO (r50.56, p50.004, respectively).In cirrhotic patients, NO was produced in excess by the alveolar compartment of the lungs. Alveolar NO production was associated with hyperdynamic circulatory syndrome but not with arterial oxygenation impairment.