32 research outputs found

    Personalized therapy for mycophenolate:Consensus report by the international association of therapeutic drug monitoring and clinical toxicology

    Get PDF
    When mycophenolic acid (MPA) was originally marketed for immunosuppressive therapy, fixed doses were recommended by the manufacturer. Awareness of the potential for a more personalized dosing has led to development of methods to estimate MPA area under the curve based on the measurement of drug concentrations in only a few samples. This approach is feasible in the clinical routine and has proven successful in terms of correlation with outcome. However, the search for superior correlates has continued, and numerous studies in search of biomarkers that could better predict the perfect dosage for the individual patient have been published. As it was considered timely for an updated and comprehensive presentation of consensus on the status for personalized treatment with MPA, this report was prepared following an initiative from members of the International Association of Therapeutic Drug Monitoring and Clinical Toxicology (IATDMCT). Topics included are the criteria for analytics, methods to estimate exposure including pharmacometrics, the potential influence of pharmacogenetics, development of biomarkers, and the practical aspects of implementation of target concentration intervention. For selected topics with sufficient evidence, such as the application of limited sampling strategies for MPA area under the curve, graded recommendations on target ranges are presented. To provide a comprehensive review, this report also includes updates on the status of potential biomarkers including those which may be promising but with a low level of evidence. In view of the fact that there are very few new immunosuppressive drugs under development for the transplant field, it is likely that MPA will continue to be prescribed on a large scale in the upcoming years. Discontinuation of therapy due to adverse effects is relatively common, increasing the risk for late rejections, which may contribute to graft loss. Therefore, the continued search for innovative methods to better personalize MPA dosage is warranted.</p

    Speciation and release kinetics of the fission products Mo, Cs, Ba and I from nuclear fuels in severe accident conditions

    No full text
    International audienceA speciation and release kinetics study of the gaseous fission products freed fromnuclear fuels in conditions of severe accident (temperature range 1300°C –2500°C) as a function of the applied thermodynamic conditions is carried out usingthe experimental feedback collected at CEA within the VERCORS and VERDONprograms. The nature of the major species involved are deduced from the analysis of thespecific features of the Cs-Mo-Ba-I-O chemical system in the composition range ofirradiated nuclear fuels. Stable gaseous Cs and Ba molybdate species, i.e. Cs2Mo2O7Cs_2Mo_2O_7 (g)and BaMoO4(g)BaMoO_4 (g), clearly predominates in oxidising conditions, whichcontributes to increase significantly the released fraction of molybdenum ascompared to reducing conditions.An analytical model accounting for thermo-chemistry in the release rate ofchemically reactive elements is applied to estimate the release of Cs, I, Mo and Bain severe accident conditions. Good agreement is achieved with on-linemeasurement

    Electrochemical characterisation of the Ce(IV) limiting carbonate complex

    Get PDF
    International audienc

    3D simulation of a power ramp including oxygen thermo-diffusion and its impact on thermochemistry

    No full text
    International audienceThis paper presents the coupling of the thermochemical solver ANGE (Advanced Gibbs Energy Minimizer) with an oxygen thermo-diffusion model. The coupling is implemented within the fuel performance code ALCYONE co-developed by CEA, EDF and FRAMATOME within the PLEIADES environment. An application to a 3D simulation of a power ramp on a Cr-doped UO 2 fuel is developed. Post-ramp EPMA measurements of chromia doped fuel show reduction of chromium and molybdenum oxides in the central part of the pellet, indicative of thermo-diffusion of oxygen. These phenomena are well reproduced by the coupled thermo-chemical-mechanical simulations. Impact of oxygen redistribution on speciation of fission products is then studied. Chemical state of caesium, iodine and tellurium is important as regard PCI, as they can form gaseous species (CsI(g),_{(g),} I (g),_{(g),} I(2g),_{(2g),} TeI(2g)_{(2g)}) that can react with the cladding and induce SCC. Release of gaseous species and concentration of chemically reactive iodine compounds near the cladding are calculated in order to investigate I-SCC

    Coupled modeling of irradiated fuel thermochemistry and gas diffusion during severe accidents

    No full text
    In this paper, a novel approach where irradiated fuel thermochemistry and gas release are coupled is presented in details and illustrated by the simulations of some tests of the VERCORS program characterized by increasing temperatures and varying gas composition in the furnace (oxidizing or reducing conditions). At each step of the tests, the oxidation/reduction of the nuclear fuel and the fission product chemical speciation are precisely assessed thanks to a thermochemical equilibrium calculation relying on the OpenCalphad thermochemical solver and on a built-in thermochemical database derived from the SGTE database and completed by a solid solution model for the U-O-fission product system. Fission product releases are estimated from the chemically reactive gases that form in the fuel (according to the thermochemical calculation) and from a gas diffusion model based on the equivalent sphere model. The gas diffusion model takes into account not only the noble gases available in the fuel prior to the test but also the chemically reactive gases that form during the test. It is shown that the proposed coupled approach provides a consistent estimation of fission product release (I, Te, Cs, Mo, Ba) during the VERCORS tests in spite of the simple gas diffusion mechanism considered in the simulations (no distinction between the fission products). The proposed coupled approach is used to test some thermochemical hypotheses to improve the calculated release of some fission products (Ba, Mo)

    Modeling of fission product release during severe accidents with the fuel performance code ALCYONE

    No full text
    This paper presents simulations of four tests performed on medium to high burnup fuel during the VERCORS and VERDON experimental programs. The tests are representative of a Severe Accident (SA) sequence with a temperature increase up to fuel-clad melting and oxidizing/reducing conditions within the furnace. The simulations are performed with the fuel performance code ALCYONE where irradiated fuel thermochemistry and fission gas release are coupled. In this paper, the impact of the radial burnup and Fission Product (FP) profiles within the fuel pellet on the FP release from the sample during the SA sequence is studied. Simulations of the fuel sample behavior during nominal irradiation in commercial reactors are first performed to assess the initial state of the fuel. The simulations of the SA sequences include a burnup dependent fission gas release model. The simulated release curves of various volatile and semi-volatile FPs (Xe, I, Te, Cs, Mo and Ba) are compared successfully to online measurements. The impact of the burnup and FP radial profiles on both the thermochemical equilibria within the pellet and the FP release kinetics is discussed. It is shown that the FP release from the fuel pellets is not significantly increased by the consideration of the burnup and FP radial profiles. This conclusion is due to the limited radial extension of the peaked burnup radial profile in the fuel pellet and to the uniform temperature of the fuel samples

    Experimental Evidence of Oxygen Thermo-Migration in PWR UO2_2 Fuels during Power Ramps using In-situ Oxido-Reduction Indicators

    No full text
    International audienceThe present study describes the in-situ electrochemical modifications which affect irradiated PWR UO2_2 fuels in the course of a power ramp, by means of in-situ oxido-reduction indicators such as chromium or neo-formed chemical phases. It is shown that irradiated fuels (of nominal stoichiometry close to 2.000) under temperature gradient such as that occurring during high power transients are submitted to strong oxido-reduction perturbations, owing to radial migration of oxygen from the hot center to the cold periphery of the pellet. The oxygen redistribution, similar to that encountered in Sodium Fast Reactors fuels, induces a massive reduction/precipitation of the fission products Mo, Ru, Tc and Cr (if present) in the high temperature pellet section and the formation of highly oxidized neo-formed grey phases of U4_4O9_9 type in its cold section, of lower temperature.The parameters governing the oxidation states of UO2_2 fuels under power ramps are finally debated from a cross-analysis of our results and other published information. The potential chemical benefits brought by oxido-reductive additives in UO2_2 fuel such as chromium oxide, in connection with their oxygen buffering properties, are discussed
    corecore