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1. SARS-CoV-2 infection in liver transplantation is associated with favorable outcomes: an Italian transplant registry study

Author

Rendina, M., primary, Barone, M., additional, Trapani, S., additional, Masiero, L., additional, Trerotoli, P., additional, Puoti, F., additional, Lupo, L.G., additional, Agnes, S., additional, Grieco, A., additional, Andorno, E., additional, Marenco, S., additional, Baccarani, U., additional, Toniutto, P., additional, Carraro, A., additional, Colecchia, A., additional, Cescon, M., additional, Morelli, M.C., additional, Cillo, U., additional, Burra, P., additional, Angeli, P., additional, Colledan, M., additional, Fagiuoli, S., additional, De Carlis, L., additional, Belli, L., additional, De Simone, P., additional, Carrai, P., additional, Di Benedetto, F., additional, De Maria, N., additional, Ettorre, G.M., additional, Giannelli, V., additional, Gruttadauria, S., additional, Volpes, R., additional, Mazzaferro, V., additional, Bhoori, S., additional, Romagnoli, R., additional, Martini, S., additional, Rossi, G., additional, Donato, F., additional, Rossi, M., additional, Ginanni Corradini, S., additional, Spada, M., additional, Maggiore, G., additional, Tisone, G., additional, Lenci, I., additional, Vennarecci, G., additional, Di Costanzo, G.G., additional, Vivarelli, M., additional, Svegliati Baroni, G., additional, Zamboni, F. o, additional, Mameli, L., additional, Tafuri, S., additional, Simone, S., additional, Gesualdo, L., additional, Cardillo, M., additional, and Di Leo, A., additional

Published
2022
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2. Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: results of the ELITA/EF-CLIF collaborative study (ECLIS)

Author

Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Belli, Luca S, Duvoux, Christophe, Artzner, Thierry, Bernal, William, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie-Caroline, Pageaux, George-Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, Francoise, Rabinovich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Fondevila, Costantino, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Jalan, Rajiv, FAGIUOLI, STEFANO, Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Belli, Luca S, Duvoux, Christophe, Artzner, Thierry, Bernal, William, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie-Caroline, Pageaux, George-Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, Francoise, Rabinovich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Fondevila, Costantino, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Jalan, Rajiv, and FAGIUOLI, STEFANO

Abstract

Background and aims: Liver transplantation (LT) has been proposed to be an effective salvage therapy even for the sickest patients with acute-on-chronic liver failure (ACLF). This large collaborative study was designed to address the current clinical practice and outcomes of ACLF patients wait listed (WL) for LT in Europe. Methods: Retrospective study including 308 consecutive ACLF patients, listed in 20 centres across 8 European countries, from January 2018 to June 2019. Results: 2677 patients received a LT, 1216 (45.4%) for decompensated cirrhosis (DC). Of these, 234 (19.2%) had ACLF at LT: ACLF-1, 58 (4.8%); ACLF-2, 78 (6.4%); and ACLF-3, 98 (8.1%). Wide variations were observed amongst countries: France and Germany had high rates of ACLF-2/3 (27-41%); Italy, Switzerland, Poland and Netherlands had medium rates (9-15%); and United Kingdom and Spain had low rates (3-5%) (p <.0001). One-year probability of survival after LT for patients with ACLF was 81% (95% CI 74-87). Pre-LT arterial lactate levels >4 mmol/L (HR 3.14, 95% CI 1.37-7.19), recent infection from multi-drug resistant organisms (HR 3.67, 95% CI 1.63-8.28), and renal replacement therapy (HR 2.74, 95% CI 1.37-5.51) were independent predictors of post-LT mortality. During the same period, 74 patients with ACLF died on the WL. In an intention-to-treat analysis, one-year survival of ACLF patients on the LT WL was 73% for ACLF-1 or -2 and 50% for ACLF-3. Conclusion: The results reveal wide variations in listing patients with ACLF in Europe despite favorable post-LT survival. Risk factors for mortality were identified, allowing a more precise prognostic assessment of ACLF patients for potential LT. Lay summary: Acute on chronic liver failure (ACLF) is a severe clinical condition for which liver transplantation is an effective therapeutic option. This study has demonstrated that in Europe, referral and access to liver transplantation (LT) for patients with ACLF needs to be harmonized to avoid inequities.

Published
2021

3. Recent trends and intention-to-treat survival of liver transplantation for nonalcoholic steatohepatitis: an Italian liver transplant registry study

Author

Vitale, A., primary, Trapani, S., additional, Burra, P., additional, Bertacco, A., additional, Romagnoli, R., additional, Martini, S., additional, De Simone, P., additional, Carrai, P., additional, Cescon, M., additional, Morelli, M.C., additional, De Carlis, L., additional, Belli, L., additional, Gruttadauria, S., additional, Volpes, R., additional, Colledan, M., additional, Fagiuoli, S., additional, Rossi, G., additional, Donato, F., additional, Di Benedetto, F., additional, De Maria, N., additional, Tedeschi, U., additional, Colecchia, A., additional, Ricci, A., additional, Rossi, M., additional, Cardillo, M., additional, and Cillo, U., additional

Published
2020
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5. Common issues in the management of patients in the waiting list and after liver transplantation

Author

Burra, P, Belli, L, Ginanni, Corradini, S, Volpes, R, Marzioni, M, Giannini, E, Toniutto, P, Carrai, P, Donato, F, Lanza-Galeota, A, Martini, S, Pasulo, L, Ponziani, F, Russo, F, Coppola, C, Forte, P, Mazzarelli, C, Merli, M, Montalbano, M, Picciotto, F, Rendina, M, Zanetto, A, Angeli, P, Foschi, F, Manini, M, Marzano, A, Perricone, G, Pianta, P, Tamè, M, De Maria, N, Domenicali, M, Ottobrelli, A, Picciotto, A, Ponti, L, Vizzini, G, Corradini, S, Bhoori, S, Ferri, F, Gaffuri, G, Lenci, I, Mameli, L, Morelli, M, and Piras, M. R.

Subjects
medicine.medical_specialty, Alcoholic liver disease, DAAs, HBV recurrence, Immunosuppression, Liver transplantation, Antiviral Agents, Hepatitis C, Chronic, Humans, Italy, Liver Diseases, Alcoholic, Recurrence, Societies, Medical, Disease Management, Liver Transplantation, Waiting Lists, Hepatology, Gastroenterology, medicine.medical_treatment, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Medical, Internal medicine, medicine, In patient, Chronic, Disease management (health), business.industry, Liver Diseases, General surgery, Hcv recurrence, Evidence-based medicine, Alcoholic, medicine.disease, Hepatitis C, surgical procedures, operative, Waiting list, 030211 gastroenterology & hepatology, Societies, business
Abstract

The present document contains the recommendations of an expert panel of transplant hepatologists, appointed by the Italian Association for the Study of the Liver (AISF), on how to manage the most common aspects of liver transplantation: the topics covered include: new treatments for HCV in patients on the waiting list for liver transplantation; antiviral treatments in patients with HCV recurrence after liver transplantation; prophylaxis for HBV recurrence after liver transplantation; indications for liver transplantation in alcoholic liver disease; and Immunosuppressive therapy. The statements on each topic were approved by participants at the AISF Transplant Hepatologist Expert Meeting (organized by the Permanent Committee on Liver Transplantation in Mondello on 4–5 October 2015), and are graded according to the Oxford classification of levels of evidence.

Published
2017

6. 03:18 PM Abstract No. 75 Portal cavernoma revascularization through splenic access in symptomatic portal hypertension: a paradigm shift in interventional radiology

Author

Rampoldi, A., primary, Barbosa, F., additional, Di Sandro, S., additional, Nichelatti, M., additional, De Gasperi, A., additional, De Nicola, S., additional, Vercelli, R., additional, Migliorisi, C., additional, Mazzarelli, C., additional, Solcia, M., additional, Airoldi, A., additional, Belli, L., additional, and De Carlis, L., additional

Published
2019
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7. Development of a model based on case-mix analysis to predict 6-month patient survival after liver transplantation: a multicenter Italian study

Author

Avolio, A., primary, Lai, Q., additional, Franco, A., additional, Bianco, G., additional, Calia, R., additional, Spoletini, G., additional, Agnes, S., additional, Grieco, A., additional, Rossi, M., additional, Corradini, S. Ginanni, additional, Vivarelli, M., additional, Benedetti, A., additional, Lupo, L., additional, Rendina, M., additional, Colledan, M., additional, Fagiuoli, S., additional, Cescon, M., additional, Donato, C., additional, Zamboni, F., additional, Mameli, L., additional, De Carlis, L., additional, Belli, L., additional, Rossi, G., additional, Donato, F., additional, Mazzaferro, V., additional, Bhoori, S., additional, Di Benedetto, F., additional, De Maria, N., additional, Santaniello, W., additional, Di Costanzo, G., additional, Gruttadauria, S., additional, Volpes, R., additional, De Simone, P., additional, Carrai, P., additional, Spada, M., additional, Nobile, V., additional, Ettorre, G., additional, Giannelli, V., additional, Tisone, G., additional, Lenci, I., additional, Romagnoli, R., additional, Martini, S., additional, Risaliti, A., additional, Toniutto, P., additional, Tedeschi, U., additional, Carraro, A., additional, Burra, P., additional, and Cillo, U., additional

Published
2019
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9. Effectiveness and safety of DAA treatment for recurrent hepatitis C after liver transplantation: The NAVIGATOR Lombardia-Veneto network

Author

Invernizzi, F., primary, Pasulo, L., additional, Aghemo, A., additional, Puoti, M., additional, Zaltron, S., additional, Maggiolo, F., additional, Rizzardini, G., additional, Fargion, S., additional, Sacchi, P., additional, Gulminetti, R., additional, Zuin, M., additional, Quirino, T., additional, Rumi, M.G., additional, Pan, A., additional, Grossi, P., additional, Rossini, A., additional, Corbellini, A., additional, Uberti Foppa, C., additional, Belli, L., additional, Piovesan, S., additional, Angeli, P., additional, Chemello, L., additional, Russo, F.P., additional, Burra, P., additional, Vincenzi, V., additional, Cattelan, A.M., additional, Carolo, G., additional, Capra, F., additional, Carlotto, G., additional, Rovere, P.A., additional, Lobello, S., additional, Scotton, P., additional, Panese, S., additional, Fabris, P., additional, Alberti, A., additional, Lampertico, P., additional, and Fagiuoli, S., additional

Published
2018
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10. A method for establishing allocation equity among patients with and without hepatocellular carcinoma on a common liver transplant waiting list

Author

Vitale, A, Volk, Ml, De Feo TM, Burra, P, Frigo, Ac, Ramirez Morales, R, De Carlis, L, Belli, L, Colledan, M, Fagiuoli, S, Rossi, G, Andorno, E, Baccarani, U, Regalia, E, Vivarelli, M, Donataccio, M, Russo, Fp, Angeli, P, for Liver Transplantation North Italy Transplant program (NITp) working group, Cillo, U., Vitale, A, Volk, M, De Feo, T, Burra, P, Frigo, A, Ramirez Morales, R, DE CARLIS, L, Belli, L, Colledan, M, Fagiuoli, S, Rossi, G, Andorno, E, Baccarani, U, Regalia, E, Vivarelli, M, Donataccio, M, and Cillo, U

Subjects
Adult, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Tissue and Organ Procurement, Waiting Lists, Hepatocellular carcinoma, medicine.medical_treatment, Liver transplantation, Gastroenterology, Severity of Illness Index, End Stage Liver Disease, Liver disease, Model for End-Stage Liver Disease, Interquartile range, Internal medicine, Medicine, Humans, Proportional Hazards Models, Cirrhosi, Hepatology, Surgical oncology, Cirrhosis, Clinical decision making, business.industry, Proportional hazards model, Hazard ratio, Liver Neoplasms, Transplant Waiting List, Middle Aged, medicine.disease, digestive system diseases, Markov Chains, Italy, Female, business, Monte Carlo Method
Abstract

Background & Aims:The current organ allocation system for liver transplantation (LT) creates an imbalance between patients with and without hepatocellular carcinoma (HCC). We describe a model designed to re-establish allocation equity among patient groups using transplant benefit as the common endpoint. Methods:We enrolled consecutive adult patients entering the waiting list (WL group, n = 2697) and undergoing LT (LT group, n = 1702) during the period 2004‐2009 in the North Italy Transplant program area. Independent multivariable regressions (WL and LT models) were created for patients without HCC and for those with stage T2 HCC. Monte Carlo simulation was used to create distributions of transplant benefit, and covariates such as Model for End-stage Liver Disease (MELD) and alpha-fetoprotein (AFP) were combined in regression equations. These equations were then calibrated to create an ‘‘MELD equivalent’’ which matches HCC patients to non-HCC patients having the same numerical MELD score. Results:Median 5 year transplant benefit was 15.12 months (8.75‐25.35) for the non-HCC patients, and 28.18 months (15.11‐36.38) for the T2-HCC patients (p

Published
2014

15. Pre-emptive post-transplant HCV treatment with IFN-free DAA: Preliminary results from a pilot study

Author

Pasulo, L., primary, Di Benedetto, C., additional, Mazzarelli, C., additional, Iegri, C., additional, Mangiola, F., additional, Perricone, G., additional, Viganò, R., additional, Colledan, M., additional, De Carlis, L., additional, Corti, A., additional, Mazza, E., additional, De Gasperi, A., additional, Marchesi, M., additional, Donato, F., additional, Fagiuoli, S., additional, and Belli, L., additional

Published
2016
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16. Liver transplantation in HIV-positive patients: The initial experience

Author

Di Benedetto, C., primary, Iegri, C., additional, Pasulo, L., additional, Travi, G., additional, Moioli, C., additional, Colledan, M., additional, De Carlis, L., additional, Mazzarelli, C., additional, Cologni, G., additional, Corti, A., additional, Mazza, E., additional, Marchesi, M., additional, De Gasperi, A., additional, Mangoni, I., additional, Mangiola, F., additional, Belli, L., additional, Fagiuoli, S., additional, and Puoti, M., additional

Published
2016
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17. Influence of Donor and Recipient Gender on Liver Transplantation Outcomes in Europe: A Eltr Study

Author

Germani, G., primary, Ferrarese, A., additional, Adam, R., additional, Karam, V., additional, Belli, L., additional, O’Grady, J., additional, Mirza, D., additional, Klempnauer, J., additional, Cherqui, D., additional, Pratschke, J., additional, Jamieson, N., additional, Salizzoni, M., additional, Hidalgo, H., additional, Lerut, J., additional, Paul, A., additional, Garcia-Valdecasas, J.C., additional, Rodriguez, F.S.J., additional, and Burra, P., additional

Published
2016
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19. Potential net health benefit of pre-transplant Sofosbuvir to prevent recurrence of HCV infection after liver transplantation: A multicenter, cohort model study

Author

Vitale, A., primary, Spolverato, G., additional, Burra, P., additional, De Feo, T.M., additional, Belli, L., additional, Donato, F., additional, Svegliati Baroni, G., additional, Marianelli, T., additional, Picciotto, A., additional, Toniutto, P., additional, Bhoori, S., additional, Passigato, N., additional, Lucà, M.G., additional, Cillo, U., additional, and Fagiuoli, S., additional

Published
2014
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20. Long-term maintenance of sustained virological response in liver transplant recipients treated for recurrent hepatitis C

Author

Ponziani, Francesca Romana, primary, Viganò, Raffaella, additional, Iemmolo, Rosa Maria, additional, Donato, Maria Francesca, additional, Rendina, Maria, additional, Toniutto, Pierluigi, additional, Pasulo, Luisa, additional, Morelli, Maria Cristina, additional, Burra, Patrizia, additional, Miglioresi, Lucia, additional, Merli, Manuela, additional, Di Paolo, Daniele, additional, Fagiuoli, Stefano, additional, Gasbarrini, Antonio, additional, Pompili, Maurizio, additional, Belli, L., additional, Gerunda, G.E., additional, Marino, M., additional, Montalti, R., additional, Di Benedetto, F., additional, De Ruvo, N., additional, Rigamonti, C., additional, Colombo, M., additional, Rossi, G., additional, Di Leo, A., additional, Lupo, L., additional, Memeo, V., additional, Bringiotti, R., additional, Zappimbulso, M., additional, Bitetto, D., additional, Vero, V., additional, Colpani, M., additional, Fornasiere, E., additional, Pinna, A.D., additional, Morelli, M.C., additional, Bertuzzo, V., additional, De Martin, E., additional, Senzolo, M., additional, Ettorre, G.M., additional, Visco-Comandini, U., additional, Antonucci, G., additional, Angelico, M., additional, Tisone, G., additional, Giannelli, V., additional, and Giusto, M., additional

Published
2014
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21. P885 RECIPIENT AND DONOR GENDER MATCH PREDICTS THE OUTCOME OF ANTIVIRAL THERAPY FOR RECURRENT HEPATITIS C

Author

Bitetto, D., primary, Pecere, S., additional, Pasulo, L., additional, Belli, L., additional, Iemmolo, R.M., additional, Morelli, M.C., additional, Donato, F., additional, Burra, P., additional, Rendina, M., additional, Ponziani, F.R., additional, Miglioresi, L., additional, Di Paolo, D., additional, Merli, M., additional, Gasbarrini, A., additional, Toniutto, P., additional, and Fagiuoli, S., additional

Published
2014
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22. The impact of IL-28B polymorphism and diabetes on SVR after antiviral therapy (AT) for post-liver transplant (LT) HCV recurrence

Author

Bitetto, D., primary, Vero, V., additional, Pecere, S., additional, Belli, L., additional, Iemmolo, R.M., additional, Morelli, M.C., additional, Donato, F., additional, Burra, P., additional, Rendina, M., additional, Ponziani, F.R., additional, Miglioresi, L., additional, Di Paolo, D., additional, Merli, M., additional, Gasbarrini, A., additional, Ginanni-Corradini, S., additional, Falleti, E., additional, De Feo, T., additional, Toniutto, P., additional, and Fagiuoli, S., additional

Published
2014
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23. Recipient and donor gender match predicts the outcome of antiviral therapy for recurrent hepatitis C

Author

Bitetto, D., primary, Pecere, S., additional, Pasulo, L., additional, Belli, L., additional, Iemmolo, R.M., additional, Morelli, M.C., additional, Donato, F., additional, Burra, P., additional, Rendina, M., additional, Ponziani, F.R., additional, Miglioresi, L., additional, Di Paolo, D., additional, Merli, M., additional, Gasbarrini, A., additional, Toniutto, P., additional, and Fagiuoli, S., additional

Published
2014
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24. Erratum to 'A method for establishing allocation equity among patients with and without hepatocellular carcinoma on a common liver transplant waiting list' [J Hepatol 2013;60:290–297]

Author

Vitale, A., Volk, M. L., De Feo, T. M., Burra, P, Frigo, A. C., Ramirez Morales, R., De Carlis, L., Belli, L., Colledan, M., Fagiuoli, S., Rossi, G., Andorno, E., Baccarani, U., Regalia, E., Vivarelli, M., Donataccio, M., Russo, F. P., Cillo, U., and Liver Transplantation North Italy Transplant program working group

Subjects
medicine.medical_specialty, Hepatology, business.industry, General surgery, medicine.medical_treatment, Equity (finance), Transplant Waiting List, Liver transplantation, medicine.disease, Surgery, Hepatocellular carcinoma, medicine, Regalia, business
Abstract

Erratum to ‘‘A method for establishing allocation equity among patients with and without hepatocellular carcinoma on a common liver transplant waiting list’’ [J Hepatol 2013;60:290–297] Alessandro Vitale, Michael L. Volk, Tullia Maria De Feo, Patrizia Burra1,⇑, Anna Chiara Frigo, Rafael Ramirez Morales, Luciano De Carlis, Luca Belli, Michele Colledan, Stefano Fagiuoli, Giorgio Rossi, Enzo Andorno, Umberto Baccarani, Enrico Regalia, Marco Vivarelli, Matteo Donataccio, Umberto Cillo, on behalf of the Liver Transplantation North Italy Transplant program (NITp) working group

Published
2014

25. GENOTYPE 2 AND 3 RECCURENT HEPATITIS C AFTER LIVER TRANSPLANTATION: EXCELLENT RESULTS WITH SUBOPTIMAL DOSES OF ANTIVIRAL THERAPY

Author

Vigano, R, Ponziani, F, Belli, L, Vangeli, M, Pinzello, G, Gasbarrini, A, Pasulo, L, De Martin, E, Burra, R, Pompili, M, Colledan, M, Cillo, U, Fagiuoli, S, Vigano R, Ponziani FR, Belli LS, Vangeli M, Pinzello G, Gasbarrini A, Pasulo L, De Martin E, Burra R, Pompili M, Colledan M, Cillo U, Fagiuoli S, Vigano, R, Ponziani, F, Belli, L, Vangeli, M, Pinzello, G, Gasbarrini, A, Pasulo, L, De Martin, E, Burra, R, Pompili, M, Colledan, M, Cillo, U, Fagiuoli, S, Vigano R, Ponziani FR, Belli LS, Vangeli M, Pinzello G, Gasbarrini A, Pasulo L, De Martin E, Burra R, Pompili M, Colledan M, Cillo U, and Fagiuoli S

Published
2009

26. 85 INTERACTION BETWEEN CYCLOSPORINE AND RECIPIENT IL-28B RS12979860 C>T GENETIC POLYMORPHISMS IN THE ACHIEVEMENT OF SUSTAINED VIRAL RESPONSE FOR RECURRENT HEPATITIS C

Author

Bitetto, D., primary, Falleti, E., additional, Fornasiere, E., additional, Belli, L., additional, Viganò, R., additional, Fagiuoli, S., additional, Pasulo, L., additional, Donato, F., additional, Rigamonti, C., additional, Rendina, M., additional, De Martin, E., additional, Burra, P., additional, Ponziani, F.R., additional, Gasbarrini, A., additional, Ginanni-Corradini, S., additional, Cmet, S., additional, Cussigh, A., additional, De Feo, T., additional, Fabris, C., additional, and Toniutto, P., additional

Published
2012
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27. F-46 Graft survival is worse in HCV positive females transplanted with male donor grafts

Author

Belli, L., primary, Romagnoli, R., additional, Rossi, M., additional, Gerunda, G.E., additional, Pinna, A.D., additional, Agnes, S., additional, Spada, M., additional, Colledan, M., additional, Tisone, G., additional, De Carlis, L., additional, Baccarani, U., additional, Mazzaferro, V., additional, Ettorre, G.M., additional, Cillo, U., additional, Calise, F., additional, Cuomo, O., additional, Lupo, L., additional, Corradini, S. Ginanni, additional, Zamboni, F., additional, Marianelli, T., additional, Risaliti, A., additional, Patrono, D., additional, Li Petri, S., additional, Tagliabue, F., additional, Mangoni, J.M.E., additional, Antonelli, B., additional, Sposito, C., additional, Gringeri, E., additional, Rompianesi, G., additional, Sforza, D., additional, Cucchetti, A., additional, Miglioresi, L., additional, Donataccio, M., additional, Gelli, M., additional, Gavrila, C., additional, Nardi, A., additional, and Angelico, M., additional

Published
2012
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28. OC-24 Interaction between cyclosporine and recipient IL-28B rs12979860 C>T genetic polymorphisms in the achievement of sustained viral response for recurrent hepatitis C

Author

Bitetto, D., primary, Falleti, E., additional, Fornasiere, E., additional, Belli, L., additional, Viganò, R., additional, Fagiuoli, S., additional, Pasulo, L., additional, Donato, F., additional, Rigamonti, C., additional, Rendina, M., additional, De Martin, E., additional, Burra, P., additional, Ponziani, F.R., additional, Gasbarrini, A., additional, Corradini, S. Ginanni, additional, Cmet, S., additional, Cussigh, A., additional, De Feo, T., additional, Fabris, C., additional, and Toniutto, P., additional

Published
2012
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29. T.N.49 FIBROSIS PROGRESSION IN NON RESPONDERS TO ANTIVIRAL TREATMENT (AT) FOR HCV RECURRENCE FOLLOWING LIVER TRANSPLANTATION (LT)

Author

De Martin, E., primary, Senzolo, M., additional, Ponziani, F.R., additional, Pasulo, L., additional, Gasbarrini, A., additional, Vigano', R., additional, Belli, L., additional, Donato, F., additional, Angelico, M., additional, Di Paolo, D., additional, Rendina, M., additional, Miglioresi, L., additional, Grazi, G., additional, Morelli, M.C., additional, Toniutto, P., additional, Merli, M., additional, Jemmolo, M., additional, Gerunda, G.E., additional, Fagiuoli, S., additional, and Burra, P., additional

Published
2010
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31. Genotypes 2 and 3 recurrent hepatitis C after liver transplantation: Excellent results with suboptimal doses of antiviral therapy

Author

Viganò, R., primary, Ponziani, F.R., additional, Belli, L., additional, Vangeli, M., additional, Pinzello, G., additional, Gasbarrini, A., additional, Pasulo, L., additional, De Martin, E., additional, Burra, P., additional, Boninsegna, S., additional, Pompili, M., additional, Colledan, M., additional, Cillo, U., additional, and Fagiuoli, S., additional

Published
2009
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42. A comparative clinical study on the effects of cardiopulmonary bypass with different flows and pressures on skeletal muscle cell metabolism in patients undergoing coronary bypass grafting

Author

Canale, S. Del, primary, Vezzani, A., additional, Belli, L., additional, Coffrini, E., additional, Guariglia, A., additional, Ronda, N., additional, Vitali, P., additional, Beghi, C., additional, Fesani, F., additional, Borghetti, A., additional, and Fiaccadori, E., additional

Published
1990
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43. Similar survival but higher and delayed hepatocellular carcinoma recurrence in HIV-positive compared to negative cirrhotics undergoing liver transplantation

Author

Roberto Rossotti, Marco Merli, Chiara Mazzarelli, Riccardo Maria De Carlis, Giovanna Travi, Marta Vecchi, Raffaella Viganò, Andrea Lauterio, Alessandro Raimondi, Luca Saverio Belli, Luciano Gregorio De Carlis, Massimo Puoti, Rossotti, R, Merli, M, Mazzarelli, C, De Carlis, R, Travi, G, Vecchi, M, Vigano, R, Lauterio, A, Raimondi, A, Belli, L, De Carlis, L, and Puoti, M

Subjects
Liver transplantation, HCC recurrence, Hepatology, HCV, Gastroenterology, HIV, DAA
Abstract

Background: Liver transplantation (LT) represents the best therapeutic option for hepatocellular carcinoma (HCC) and end-stage liver disease (ESLD). Although HIV infection does not seem to lower survival rates, HCV and HCC recurrence appear more harmful. Aims: To compare the overall survival after LT; evaluate the impact of anti-HCV direct-acting agents (DAA); assess the rate of HCC recurrence in HIV-positive and negative patients. Methods: Subjects with HCV/HBV infection who underwent LT for HCC or ESLD from 2012 to 2019 were retrospectively evaluated. Results: Study population included 299 individuals, 31 (10.4%) were HIV-positive. Overall mortality was similar (16.1% versus 19.0%, p = 0.695). HCC recurrence was observed in 6 HIV-positive (19.4%) and in 17 negative subjects (6.3%, p = 0.022). Time to relapse was 831 days in HIV-positive and 315 days in negative patients (p = 0.046). Cox model found a significant role for HIV in univariate analysis but, after adjusting for variables, extra-hepatic tumor was the only factor associated to recurrence (aHR 56.379, p < 0.001). Conclusions: Post-LT survival improved after DAA availability and HIV has no impact on mortality. A higher and delayed rate of HCC recurrence was observed in co-infected individuals: surveillance protocols should be strengthened along time in this population.

Published
2023

44. Liver transplantation for severe alcoholic hepatitis: A multicenter Italian study

Author

Giacomo Germani, Debora Angrisani, Giovanni Addolorato, Manuela Merli, Chiara Mazzarelli, Claudia Tarli, Barbara Lattanzi, Adelaide Panariello, Paola Prandoni, Lucia Craxì, Giovanni Forza, Alessandra Feltrin, Andrea Ronzan, Paolo Feltracco, Antonio Grieco, Salvatore Agnes, Antonio Gasbarrini, Massimo Rossi, Luciano De Carlis, Francesco D’Amico, Umberto Cillo, Luca S. Belli, Patrizia Burra, Germani Giacomo, Belli Luca Saverio, Addolorato Giovanni, Merli Manuela, Mazzelli Chiara, Tarli Claudia, Lattanzi Barbara, Angrisani Debora, Panariello Adelaide, Craxì Lucia, Forza Giovanni, Feltrin Alessandra, Ronza Andrea, Feltracco Paolo, Cillo Umberto, Burra Patrizia, Germani, G, Angrisani, D, Addolorato, G, Merli, M, Mazzarelli, C, Tarli, C, Lattanzi, B, Panariello, A, Prandoni, P, Craxi, L, Forza, G, Feltrin, A, Ronzan, A, Feltracco, P, Grieco, A, Agnes, S, Gasbarrini, A, Rossi, M, De Carlis, L, Francesco, D, Cillo, U, Belli, L, and Burra, P

Subjects
Male, clinical decision-making, Transplantation, Waiting Lists, alcoholism and substance abuse, Hepatitis, Alcoholic, Patient Selection, alllocation, Settore MED/09 - MEDICINA INTERNA, clinical research/practice, liver transplantation/hepatology, alcoholic hepatiti, Middle Aged, Liver Transplantation, Recurrence, MED/18 - CHIRURGIA GENERALE, Humans, Immunology and Allergy, Female, ethic, Pharmacology (medical), Liver transplant
Abstract

There is increasing evidence that early liver transplantation (eLT), performed within standardized protocols can improve survival in severe alcoholic hepatitis (sAH). The aim of the study was to assess outcomes after eLT for sAH in four Italian LT centers and to compare them with non-responders to medical therapy excluded from eLT. Patients admitted for sAH (2013–2019), according to NIAAA criteria, were included. Patients not responding to medical therapy were placed on the waiting list for eLT after a strict selection. Histological features of explanted livers were evaluated. Posttransplant survival and alcohol relapse were evaluated. Ninety-three patients with severe AH were evaluated (65.6% male, median [IQR] age: 47 [42–56] years). Forty-five of 93 patients received corticosteroids, 52 of 93 were non-responders and among these, 20 patients were waitlisted. Sixteen patients underwent LT. Overall, 6-, 12-, and 24-month survival rates were 100% significantly higher compared with non-responders to medical therapy who were denied LT (45%, 45%, and 36%; p&nbsp

Published
2022

45. Optimising the clinical strategy for autoimmune liver diseases: Principles of value-based medicine

Author

Marta Gemma, Stefano Fagiuoli, Luca Fabris, Gaetano Ideo, Matteo Rota, Marco Carbone, Giancarlo Cesana, S. Okolicsanyi, Luca Maria Munari, Michele Colledan, A. Ciaccio, Paolo Cortesi, Luciana Scalone, Laura Cristoferi, Lorenzo G. Mantovani, Mario Strazzabosco, Luca S. Belli, Carbone, M, Cristoferi, L, Cortesi, P, Rota, M, Ciaccio, A, Okolicsanyi, S, Gemma, M, Scalone, L, Cesana, G, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Belli, L, Munari, L, Mantovani, L, and Strazzabosco, M

Subjects
Male, 0301 basic medicine, Delphi Technique, Delphi method, Autoimmune hepatitis, Tertiary Care Centers, 0302 clinical medicine, MED/12 - GASTROENTEROLOGIA, Multidisciplinary approach, Outcome Assessment, Health Care, Prospective Studies, Incidence, Primary sclerosing cholangitis, Electronic medical record, Clinical performance, Benchmarking, Middle Aged, Primary sclerosing cholangiti, Hepatitis, Autoimmune, Italy, Primary biliary cholangiti, Value-based medicine, Critical Pathways, Molecular Medicine, Female, 030211 gastroenterology & hepatology, Adult, medicine.medical_specialty, Primary biliary cholangitis, Molecular Biology, MED/42 - IGIENE GENERALE E APPLICATA, Cholangitis, Sclerosing, Autoimmune hepatiti, Autoimmune Diseases, Orphan drug, 03 medical and health sciences, medicine, Humans, Intensive care medicine, MED/01 - STATISTICA MEDICA, Aged, Quality Indicators, Health Care, business.industry, medicine.disease, Survival Analysis, 030104 developmental biology, business, Follow-Up Studies
Abstract

Background Autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis represent the three major autoimmune liver diseases (AILDs). Their management is highly specialized, requires a multidisciplinary approach and often relies on expensive, orphan drugs. Unfortunately, their treatment is often unsatisfactory, and the care pathway heterogeneous across different centers. Disease-specific clinical outcome indicators (COIs) able to evaluate the whole cycle of care are needed to assist both clinicians and administrators in improving quality and value of care. Aim of our study was to generate a set of COIs for the three AILDs. We then prospectively validated these indicators based on a series of consecutive patients recruited at three tertiary clinical centers in Lombardy, Italy. Methods In phase I using a Delphi method and a RAND 9-point appropriateness scale a set of COIs was generated. In phase II the indicators were applied in a real-life dataset. Results Two-hundred fourteen patients were enrolled and followed-up for a median time of 54 months and the above COIs were recorded using a web-based electronic medical record program. The COIs were easy to collect in the clinical practice environment and their values compared well with the available natural history studies. Conclusions We have generated a comprehensive set of COIs which sequentially capture different clinical outcome of the three AILDs explored. These indicators represent a critical tool to implement a value-based approach to patients with these conditions, to monitor, compare and improve quality through benchmarking of clinical performance and to assess the significance of novel drugs and technologies. This article is part of a Special Issue entitled: Cholangiocytes in Health and Diseaseedited by Jesus Banales, Marco Marzioni, Nicholas LaRusso and Peter Jansen.

Published
2018

46. Clinical outcome in solid organ transplant recipients with COVID-19: A single-center experience

Author

Marco Merli, Giovanna Travi, Roberto Rossotti, Valeriana Giuseppina Colombo, Andrea Lauterio, Maria Frigerio, Luca S. Belli, Alice Sacco, E Minetti, Giovanni Perricone, Massimo Puoti, Luciano De Carlis, Travi, G, Rossotti, R, Merli, M, Sacco, A, Perricone, G, Lauterio, A, Colombo, V, De Carlis, L, Frigerio, M, Minetti, E, Belli, L, and Puoti, M

Subjects
Male, medicine.medical_specialty, 2019-20 coronavirus outbreak, Fever, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Single Center, Antiviral Agents, Outcome (game theory), Lopinavir, Organ transplantation, Betacoronavirus, medicine, Humans, Immunology and Allergy, transplant, Pharmacology (medical), Letters to the Editor, Intensive care medicine, Letter to the Editor, Pandemics, Aged, Retrospective Studies, Transplantation, Ritonavir, SARS-CoV-2, business.industry, COVID-19, Interferon-beta, Organ Transplantation, Middle Aged, Transplant Recipients, Drug Combinations, Spain, Female, Radiography, Thoracic, Coronavirus Infections, Solid organ transplantation, business, Immunosuppressive Agents, Hydroxychloroquine
Abstract

The clinical characteristics, management, and outcome of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after solid organ transplant (SOT) remain unknown. We report our preliminary experience with 18 SOT (kidney [44.4%], liver [33.3%], and heart [22.2%]) recipients diagnosed with COVID-19 by March 23, 2020 at a tertiary-care center at Madrid. Median age at diagnosis was 71.0 ± 12.8 years, and the median interval since transplantation was 9.3 years. Fever (83.3%) and radiographic abnormalities in form of unilateral or bilateral/multifocal consolidations (72.2%) were the most common presentations. Lopinavir/ritonavir (usually associated with hydroxychloroquine) was used in 50.0% of patients and had to be prematurely discontinued in 2 of them. Other antiviral regimens included hydroxychloroquine monotherapy (27.8%) and interferon-β (16.7%). As of April 4, the case-fatality rate was 27.8% (5/18). After a median follow-up of 18 days from symptom onset, 30.8% (4/13) of survivors developed progressive respiratory failure, 7.7% (1/13) showed stable clinical condition or improvement, and 61.5% (8/13) had been discharged home. C-reactive protein levels at various points were significantly higher among recipients who experienced unfavorable outcome. In conclusion, this frontline report suggests that SARS-CoV-2 infection has a severe course in SOT recipients.

Published
2020

47. Recent trends and intention-to-treat survival of liver transplantation for nonalcoholic steatohepatitis: an Italian liver transplant registry study

Author

N. De Maria, S. Trapani, M.C. Morelli, Renato Romagnoli, L. De Carlis, Stefano Fagiuoli, Riccardo Volpes, Paola Carrai, Silvia Martini, Francesco Donato, Massimo Cardillo, Michele Colledan, U Tedeschi, Lino Belli, Alessandra Bertacco, P. De Simone, Salvatore Gruttadauria, Marcos A. Rossi, Matteo Cescon, Alessandro Vitale, Antonio Colecchia, P. Burra, U. Cillo, Gemma Rossi, A. Ricci, F. Di Benedetto, Vitale, A, Trapani, S, Burra, P, Bertacco, A, Romagnoli, R, Martini, S, De Simone, P, Carrai, P, Cescon, M, Morelli, M, De Carlis, L, Belli, L, Gruttadauria, S, Volpes, R, Colledan, M, Fagiuoli, S, Rossi, G, Donato, F, Di Benedetto, F, De Maria, N, Tedeschi, U, Colecchia, A, Ricci, A, Rossi, M, Cardillo, M, and Cillo, U

Subjects
Nonalcoholic steatohepatitis, medicine.medical_specialty, Intention-to-treat analysis, liver transplantation, Hepatology, business.industry, Registry study, Internal medicine, medicine.medical_treatment, Gastroenterology, medicine, Liver transplantation, business
Published
2020

48. Survival of patients treated with sorafenib for hepatocellular carcinoma recurrence after liver transplantation: A systematic review and meta-analysis

Author

Calogero Cammà, Andrea Mancuso, Antonio Galvano, Claudio Zavaglia, Marco Enea, Giovanni Perricone, Giuseppe Cabibbo, A. Mazzola, Luca S. Belli, Mancuso A., Mazzola A., Cabibbo G., Perricone G., Enea M., Galvano A., Zavaglia C., Belli L., and Camma C.

Subjects
Niacinamide, Phenylurea Compound, Oncology, Sorafenib, medicine.medical_specialty, Carcinoma, Hepatocellular, Hepatocellular carcinoma, medicine.medical_treatment, Antineoplastic Agents, Liver transplantation, Antineoplastic Agent, Recurrence, Internal medicine, medicine, Humans, In patient, Postoperative Period, Prospective cohort study, Liver transplant, Survival rate, Cause of death, Hepatology, business.industry, Phenylurea Compounds, Liver Neoplasms, Gastroenterology, medicine.disease, Liver Transplantation, Survival Rate, Receptors, Vascular Endothelial Growth Factor, Liver Neoplasm, Meta-analysis, Neoplasm Recurrence, Local, business, Human, medicine.drug
Abstract

Background: Data on survival and safety of sorafenib for hepatocellular carcinoma recurrence after liver transplant are still equivocal. Aim: We performed a meta-analysis of published studies, with the aim of estimating the 1-year rates of survival, analysing the variability in survival rates and, finally, identifying the factors associated with a longer survival. Methods: Data from 8 of the 17 selected studies were pooled, while the other 9 were excluded because survival rates were missing. All included studies were retrospective. Results: Overall, the 1-year survival ranged from 18% to 90%. Tumour progression was the main cause of death. The second cause was bleeding, reported only in patients undergoing m-Tor inhibitor therapy. The pooled estimate of 1-year survival was 63%. There was a significant heterogeneity among studies (. P

Published
2015

49. Under-dilated TIPS Associate With Efficacy and Reduced Encephalopathy in a Prospective, Non-randomized Study of Patients With Cirrhosis

Author

Tommaso Di Maira, Stefano Fagiuoli, Rita Golfieri, Umberto Arena, Fabio Marra, Stefano Gitto, Stefano Colopi, Alessandro Cannavale, Filippo Schepis, Pietro Torricelli, Luca S. Belli, Pietro Quaretti, Giacomo Laffi, Angelo Luca, Cristian Caporali, Roberto Agazzi, Roberto Miraglia, Federico Banchelli, Nicola De Maria, Guido Marzocchi, Ilaria Fiorina, Roberto Nani, Antonio Rampoldi, Erica Villa, Mario De Santis, Raffaele Bruno, Lorenzo Paolo Moramarco, Guadalupe Garcia-Tsao, Aldo Airoldi, Francesco Vizzutti, Fabrizio Fanelli, L. Rega, Matteo Renzulli, Cristina Mosconi, Fabrizio Di Benedetto, Schepis, F, Vizzutti, F, Garcia-Tsao, G, Marzocchi, G, Rega, L, De Maria, N, Di Maira, T, Gitto, S, Caporali, C, Colopi, S, De Santis, M, Arena, U, Rampoldi, A, Airoldi, A, Cannavale, A, Fanelli, F, Mosconi, C, Renzulli, M, Agazzi, R, Nani, R, Quaretti, P, Fiorina, I, Moramarco, L, Miraglia, R, Luca, A, Bruno, R, Fagiuoli, S, Golfieri, R, Torricelli, P, Di Benedetto, F, Belli, L, Banchelli, F, Laffi, G, Marra, F, Villa, E, Schepis, Filippo, Vizzutti, Francesco, Garcia-Tsao, Guadalupe, Marzocchi, Guido, Rega, Luigi, De Maria, Nicola, Di Maira, Tommaso, Gitto, Stefano, Caporali, Cristian, Colopi, Stefano, De Santis, Mario, Arena, Umberto, Rampoldi, Antonio, Airoldi, Aldo, Cannavale, Alessandro, Fanelli, Fabrizio, Mosconi, Cristina, Renzulli, Matteo, Agazzi, Roberto, Nani, Roberto, Quaretti, Pietro, Fiorina, Ilaria, Moramarco, Lorenzo, Miraglia, Roberto, Luca, Angelo, Bruno, Raffaele, Fagiuoli, Stefano, Golfieri, Rita, Torricelli, Pietro, Di Benedetto, Fabrizio, Belli, Luca Saverio, Banchelli, Federico, Laffi, Giacomo, Marra, Fabio, and Villa, Erica

Subjects
Male, medicine.medical_specialty, Cirrhosis, medicine.medical_treatment, Liver, liver, portal hypertensive bleeding, portal hypertensive complications, treatment, vascular disease, Hemodynamics, Inferior vena cava, 03 medical and health sciences, 0302 clinical medicine, Model for End-Stage Liver Disease, Vascular Disease, Ascites, medicine, Humans, Prospective Studies, Aged, Hepatology, Vascular disease, business.industry, Incidence, Gastroenterology, Stent, Middle Aged, medicine.disease, Fibrosis, Surgery, Treatment, Treatment Outcome, Italy, Portal Hypertensive Bleeding, medicine.vein, Hepatic Encephalopathy, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, Portasystemic Shunt, Transjugular Intrahepatic, medicine.symptom, business, Transjugular intrahepatic portosystemic shunt
Abstract

Background & Aims: Portosystemic encephalopathy (PSE) is a major complication of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement. Most devices are self-expandable polytetrafluoroethylene-covered stent grafts (PTFE-SGs) that are dilated to their nominal diameter (8 or 10 mm). We investigated whether PTFE-SGs dilated to a smaller caliber (under-dilated TIPS) reduce PSE yet maintain clinical and hemodynamic efficacy. We also studied whether under-dilated TIPS self-expand to nominal diameter over time. Methods: We performed a prospective, non-randomized study of 42 unselected patients with cirrhosis who received under-dilated TIPS (7 and 6 mm) and 53 patients who received PTFE-SGs of 8 mm or more (controls) at referral centers in Italy. After completion of this study, dilation to 6 mm became the standard and 47 patients were included in a validation study. All patients were followed for 6 months; Doppler ultrasonography was performed 2 weeks and 3 months after TIPS placement and every 6 months thereafter. Stability of PTFE-SG diameter was evaluated by computed tomography analysis of 226 patients with cirrhosis whose stent grafts increased to 6, 7, 8, 9, or 10 mm. The primary outcomes were incidence of at least 1 episode of PSE grade 2 or higher during follow up, incidence of recurrent variceal hemorrhage or ascites, incidence of shunt dysfunction requiring TIPS recanalization, and reduction in porto-caval pressure gradient. Results: PSE developed in a significantly lower proportion of patients with under-dilated TIPS (27%) than controls (54%) during the first year after the procedure (P =.015), but the proportions of patients with recurrent variceal hemorrhage or ascites did not differ significantly between groups. No TIPS occlusions were observed. These results were confirmed in the validation cohort. In an analysis of self-expansion of stent grafts, during a mean follow-up period of 252 days after placement, none of the PTFE-SGs self-expanded to the nominal diameter in hemodynamically relevant sites (such as portal and hepatic vein vascular walls). Conclusions: In prospective, non-randomized study of patients with cirrhosis, we found under-dilation of PTFE-SGs during TIPS placement to be feasible, associated with lower rates of PSE, and effective.

Published
2018

50. HGV/GBV-C infection in liver transplant recipients: antibodies to the viral E2 envelope glycoprotein protect from de novo infection

Author

Enrico Silini, Luca Belli, Albert B. Alberti, Margherita Asti, Antonella Cerino, Morena Bissolati, Gianfranco Rondinara, Luciano De Carlis, Domenico Forti, Mario U. Mondelli, Gaetano Ideo, Silini, E, Belli, L, Alberti, A, Asti, M, Cerino, A, Bissolati, M, Rondinara, G, De Carlis, L, Forti, D, Mondelli, M, and Ideo, G

Subjects
Adult, Male, medicine.medical_specialty, Cirrhosis, Hepatitis, Viral, Human, medicine.medical_treatment, Recurrent hepatiti, Liver transplantation, Anti-E2 antibodie, Virus, Flaviviridae, Liver disease, Viral Envelope Proteins, Recurrence, Internal medicine, Humans, Medicine, Hepatitis Antibodies, GBV-C, Liver transplant, Hepatitis, Hepatology, biology, business.industry, HGV, Middle Aged, biology.organism_classification, medicine.disease, Hepatitis C, Virology, Liver Transplantation, Transplantation, Immunology, RNA, Viral, Female, business
Abstract

Background/Aims: Liver transplantation for end-stage liver cirrhosis provides a useful model to investigate the pathogenetic role of hepatotropic viral agents. Recently, a new member of the Flaviviridae family, provisionally named HGV/GBV-C virus, has been associated with acute and chronic non A–E hepatitis. We studied 136 patients with cirrhosis consecutively transplanted at out institution for evidence of hepatitis G virus infection and correlation with the patients' clinical course. MEthods: All patients survived for at least 6 months after transplantation (median follow-up 44 months) and underwent routine liver biopsies. Hepatitis G virus infection was studied using both direct viral RNA identification by RT-PCR and indirect detection of antibodies to the E2 glycoprotein. Results: There was high frequency of the hepatitis G virus among patients undergoing liver transplantation, with HGV RNA and anti-E2 prevalence rates of 18.4% and 26.5%, respectively. HGV RNA prevalences significantly increased after transplantation (47.8%), with 47.3% rate of new infections in susceptible subjects. Anti-E2 antibodies were significantly more prevalent among patients transplanted for HCV-related cirrhosis and represented a strong protective factor against hepatitis G virus reinfection or recurrent infection. No correlation was found between HGV RNA or anti-E2 prevalences and survival after transplantation or rates of recurrent liver damage. Conclusions: All available evidence suggests that, although liver transplant patients are heavily exposed to hepatitis G virus both before and after transplantation, hepatitis G virus does not induce liver disease in this setting. Most infections appear to be self-limited and induce a protective immunity which is marked by the presence of anti-E2 antibodies.

Published
1998

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