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Pascal Meylan

Pascal Meylan, MD, Associate Professor
++41 (0)21 314 4098
++41 (0)79 556 0682
pascal.meylan@chuv.ch

Research topics

Management of infections in transplant patients

Transplants patients are at increased risk of infections, due the the invasive procedures they undergo, and the immunosuppressive they receive to prevent rejection.

Among those infections, Cytomegalovirus (CMV) used to be the #1 cause for morbidity and mortality in transplants patients. Over the years, the development of antivirals with activity against CMV, and their use, to treat established infection, or more recently to prevent the appearance of disease (preemptive approach) or infection altogether (prophylactic approach) has greatly improved the immediate prognosis of CMV infection.  The identification of risk factors for severe or protracted CMV infection helps redirect resources toward the high risk patients.

Outstanding problems are the replacement of intravenous drugs by orally available drugs (pharmakokinetic and pharmakodynamic validation of valganciclovir), the fine tuning of the doses and duration of prophylactic regimens, the problem of delayed CMV infection and disease, observed in some patients after their prophylactic regimen is discontinued, as well as the role of CMV in the pathogenesis of chronic allograft injury.

These problems are addressed in collaboration with colleagues from the Centre de Transplantation d’organes and the Division de Pharmacologie clinique. In addition, we participate as a co-applicant to the Swiss Transplant Cohort Study (supported by the SNF), a tool in which we are currently organizing CMV intervention studies as well as studies of the role of innate immunity in the course of CMV infection.

In our responsability for diagnostic virology, we regularly meet clinically related problems that provide opportunities of studies with our Infectious Diseases colleagues, e.g. epidemiology of herpes simplex virus infections, the role of molecular diagnostic tools in the management of viral meningitis, or the clinical impact of diagnosing respiratory viruses.  

 

Current lab members
Name Position Contact
Céline Gardiol MD celine.gardiol@chuv.ch
Nitisha Pyndiah Grad. Student nitisha.pyndiah@chuv.ch
Noemi Ruiz Medical Student, Master med. Noemi.Ruiz@unil.ch

 

Selected publications


2011
1: Bizzini A, Marchetti O, Meylan P.
    Response to: Lack of intra-laboratory reproducibility in using Platelia Aspergillus enzyme immunoassay test for detection of Aspergillus galactomannan antigen.
Transpl Infect Dis. 2011 Dec 20.
2: Jackson Y, Dang T, Schnetzler B, Pascual M, Meylan P.
    Trypanosoma cruzi fatal reactivation in a heart transplant recipient in Switzerland.
J Heart Lung Transplant. 2011 Apr;30(4):484-5.
3: Kucera P, Gerber S, Marques-Vidal P, Meylan PR.
    Seroepidemiology of herpes simplex virus type 1 and 2 in pregnant women in Switzerland: an obstetric clinic based study.
Eur J Obstet Gynecol Reprod Biol. 2011 Oct 7.
4: Maire R, Meylan P.
    Paralysie faciale : mise à jour pour le praticien.
Rev Med Suisse. 2011;7:1901-7.
5: Manuel O, Humar A, Berutto C, Ely L, Giulieri S, Lien D, Meylan PR, Weinkauf J, Pascual M, Nador R, Aubert JD, Kumar D.
    Low-dose intradermal versus intramuscular trivalent inactivated seasonal influenza vaccine in lung transplant recipients.
J Heart Lung Transplant. 2011 Jun;30(6):679-84.
6: Meylan P.
    [Herpes simplex virus infections, an update for the practitioner].
Rev Med Suisse. 2011 Apr 27;7(292):886-8, 890-3.
7: Pascual A, Moessinger A, Gerber S, Meylan P; Swiss Paediatric Surveillance Unit (SPSU).
    Neonatal herpes simplex virus infections in Switzerland: results of a 6-year national prospective surveillance study.
Clin Microbiol Infect. 2011 Jul 26. doi: 10.1111/j.1469-0691.2011.03641.x.

2010
1: Boillat Blanco N, Kuonen R, Bellini C, Manuel O, Estrade C, Mazza-Stalder J, Aubert JD, Sahli R, Meylan P.
    Chronic norovirus gastroenteritis in a double hematopoietic stem cell and lung transplant recipient.
Transpl Infect Dis. 2010 Aug 30. [Epub ahead of print]
2: Boillat Blanco N, Pascual M, Venetz JP, Nseir G, Meylan PR, Manuel O.
    Impact of a Preemptive Strategy After 3 Months of Valganciclovir Cytomegalovirus Prophylaxis in Kidney Transplant Recipients.
Transplantation. 2010 Nov 19. [Epub ahead of print]
3: Devanthéry O, Meylan P.
    Comparison of a multiplexed bead-based assay with an immunofluorescence and an enzyme-immuno assay for the assessment of Epstein-Barr virus serologic status.
Clin Microbiol Infect. 2010 Dec;16(12):1776-82. doi: 10.1111/j.1469-0691.2010.03204.x.
4: Ferry T, Hirschel B, Dang T, Meylan P, Delhumeau C, Rauch A, Weber R, Elzi L, Bernasconi E, Schmid P, Calmy A; Swiss HIV Cohort Study.
    Infrequent replication of parvovirus B19 and erythrovirus genotypes 2 and 3 among HIV-infected patients with chronic anemia.
Clin Infect Dis. 2010 Jan 1;50(1):115-8.
5: Fischer C, Meylan P, Bickle Graz M, Gudinchet F, Vaudaux B, Berger C, Roth-Kleiner M.
    Severe postnatally acquired cytomegalovirus infection presenting with colitis, pneumonitis and sepsis-like syndrome in an extremely low birthweight infant.
Neonatology. 2010 Jun;97(4):339-45.
6: Jaquiéry E, Jilek S, Schluep M, Meylan P, Lysandropoulos A, Pantaleo G, Du Pasquier RA.
    Intrathecal immune responses to EBV in early MS.
Eur J Immunol. 2010 Mar;40(3):878-87.
7: Kostaki M, Venetz JP, Nseir G, Meylan P, Sahli R, Pascual M, Laffitte E.
    Giant warts in a kidney transplant patient: regression with sirolimus.
Br J Dermatol. 2010 May;162(5):1148-50.
8: Manuel O, Pascual M, Perrottet N, Lamoth F, Venetz JP, Decosterd LA, Buclin T, Meylan PR.
    Ganciclovir exposure under a 450 mg daily dosage of valganciclovir for cytomegalovirus prevention in kidney transplantation: a prospective study.
Clin Transplant. 2010 Nov;24(6):794-800. doi: 10.1111/j.1399-0012.2009.01205.x.
9: Perrottet N, Manuel O, Lamoth F, Venetz JP, Sahli R, Decosterd LA, Buclin T, Pascual M, Meylan P.
    Variable viral clearance despite adequate ganciclovir plasma levels during valganciclovir treatment for cytomegalovirus disease in D+/R- transplant recipients.
BMC Infect Dis. 2010 Jan 6;10:2.
10: Soccal PM, Aubert JD, Bridevaux PO, Garbino J, Thomas Y, Rochat T, Rochat TS, Meylan P, Tapparel C, Kaiser L.
    Upper and lower respiratory tract viral infections and acute graft rejection in lung transplant recipients.
Clin Infect Dis. 2010 Jul 15;51(2):163-70.
11: Widmer N, Meylan P, Ivanyuk A, Aouri M, Decosterd LA, Buclin T.
    Oseltamivir in seasonal, avian H5N1 and pandemic 2009 A/H1N1 influenza: pharmacokinetic and pharmacodynamic characteristics.
Clin Pharmacokinet. 2010 Nov 1;49(11):741-65. doi: 10.2165/11534730-000000000-00000.

2009
1: Du Pasquier R, Meylan P, Kaiser L, Lalive PH.
    [Viral encephalitis: update].
Rev Med Suisse. 2009 Apr 29;5(201):968-70, 972-3.
2: Garbino J, Soccal PM, Aubert JD, Rochat T, Meylan P, Thomas Y, Tapparel C, Bridevaux PO, Kaiser L.
    Respiratory viruses in bronchoalveolar lavage: a hospital-based cohort study in adults.
Thorax. 2009 May;64(5):399-404.
3: Méan M, Schaller MD, Asner S, Meylan P, Pagani JL, Tarr P, Eggimann P.
    Thymoma, immunodeficiency, and herpes simplex virus infections.
Med Mal Infect. 2009 May;39(5):344-7.
4: Manuel O, Meylan PR, van Delden C.
    [Management of infection after organ transplantation by the primary care physician].
Rev Med Suisse. 2009 Apr 1;5(197):722-6.
5: Perrottet N, Csajka C, Pascual M, Manuel O, Lamoth F, Meylan P, Aubert JD, Venetz JP, Soccal P, Decosterd LA, Biollaz J, Buclin T.
    Population pharmacokinetics of ganciclovir in solid-organ transplant recipients receiving oral valganciclovir.
ob Agents Chemother. 2009 Jul;53(7):3017-23.
6: Perrottet N, Decosterd LA, Meylan P, Pascual M, Biollaz J, Buclin T.
    Valganciclovir in adult solid organ transplant recipients: pharmacokinetic and pharmacodynamic characteristics and clinical interpretation of plasma concentration measurements.
Clin Pharmacokinet. 2009;48(6):399-418. doi: 10.2165/00003088-200948060-00006.
7: Rosselet A, Vu DH, Meylan P, Chaubert AS, Schapira M, Pascual M, Aubert V, Tissot JD, Duchosal MA.
    Associations of serum EBV DNA and gammopathy with post-transplant lymphoproliferative disease.
Clin Transplant. 2009 Jan-Feb;23(1):74-82.
8: Senn L, Kovacsovics T, Tarr PE, Meylan P
    Peritoneal tuberculosis after imatinib therapy.
Arch Intern Med. 2009 Feb 9;169(3):312-3.
9: Tapparel C, Cordey S, Van Belle S, Turin L, Lee WM, Regamey N, Meylan P, Mühlemann K, Gobbini F, Kaiser L.
    New molecular detection tools adapted to emerging rhinoviruses and enteroviruses.
J Clin Microbiol. 2009 Jun;47(6):1742-9.

2008
1: Carron PN, Yerly S, Ksontini R, Meylan P, Calandra T.
    [Pyoderma gangrenosum: diagnostic and therapeutic challenge]
Rev Med Suisse. 2008 Sep 10;4(170):1938-40, 1942-3.
2: Fontana-Binard L, Schultze D, Rojanavisut BS, Krüger DH, Dollenmaier G, Zanetti G, Meylan P.
    [First case of nephropathia epidemica acquired in Switzerland]
Rev Med Suisse. 2008 Jun 25;4(163):1572-5.
3: Jilek S, Schluep M, Meylan P, Vingerhoets F, Guignard L, Monney A, Kleeberg J, Le Goff G, Pantaleo G, Du Pasquier RA.
    Strong EBV-specific CD8+ T-cell response in patients with early multiple sclerosis.
Brain. 2008 Jul;131(Pt 7):1712-21.
4: Lamoth F, Jayet PY, Aubert JD, Rotman S, Mottet C, Sahli R, Lautenschlager I, Pascual M, Meylan P.
    Case report: human herpesvirus 6 reactivation associated with colitis in a lung transplant recipient.
J Med Virol. 2008 Oct;80(10):1804-7.
5: Lamoth F, Manuel O, Venetz JP, Faouzi M, Meylan P, Pascual M.
    What is the impact of late-onset cytomegalovirus disease after valganciclovir prophylaxis in kidney transplantation?
Transplantation. 2008 Nov 15;86(9):1323-4.
6: Lamoth F, Pascual M, Erard V, Venetz JP, Nseir G, Meylan P.
    Low-dose cidofovir for the treatment of polyomavirus-associated nephropathy: two case reports and review of the literature.
Antivir Ther. 2008;13(8):1001-9.
7: Leung Ki EL, Venetz JP, Meylan P, Lamoth F, Ruiz J, Pascual M.
    Cytomegalovirus infection and new-onset post-transplant diabetes mellitus.
Clin Transplant. 2008 Mar-Apr;22(2):245-9
8: Meylan P, Vollenweider P, Gianinazzi F, Monti M.
    [Varicella pneumonia]
Praxis (Bern 1994). 2008 Sep 24;97(19):1037-43.
9: Perrottet N, Robatel C, Meylan P, Pascual M, Venetz JP, Aubert JD, Berger MM, Decosterd LA, Buclin T.
    Disposition of valganciclovir during continuous renal replacement therapy in two lung transplant recipients.
J Antimicrob Chemother. 2008 Jun;61(6):1332-5.
10: Wasserfallen JB, Kast-Brückner M, Manuel O, Venetz JP, Meylan PR, Pascual M.
    Cost-effectiveness of a new combined immunosuppressive and anti-infectious regimen in kidney transplantation.
Int J Technol Assess Health Care. 2008 Summer;24(3):312-7.


Last Update on 16.01.2012 - Publication credits - Legal information

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