Author: "Olivier, Scatton" / Topic: medicine - Searchworks@Jio Institute Digital Library Search Results

224 results on '"Olivier, Scatton"'

1. Novel defatting strategies reduce lipid accumulation in primary human culture models of liver steatosis

Author: Lynda Aoudjehane, Jérémie Gautheron, Wilfried Le Goff, Claire Goumard, Julia Gilaizeau, Chan Sonavine Nget, Eric Savier, Muhammad Atif, Philippe Lesnik, Romain Morichon, Yves Chrétien, Yvon Calmus, Olivier Scatton, Chantal Housset, and Filomena Conti
Subjects: defatting, human hepatocytes, human precision-cut liver slices, liver transplantation, steatosis, triglycerides, Medicine, Pathology, RB1-214
Abstract: Normothermic perfusion provides a means to rescue steatotic liver grafts, including by pharmacological defatting. In this study, we tested the potential of new drug combinations to trigger defatting in three human culture models, primary hepatocytes with induced steatosis, primary hepatocytes isolated from steatotic liver, and precision-cut liver slices (PCLS) of steatotic liver. Forskolin, L-carnitine and a PPARα agonist were all combined with rapamycin, an immunosuppressant that induces autophagy, in a D-FAT cocktail. D-FAT was tested alone or in combination with necrosulfonamide, an inhibitor of mixed lineage kinase domain like pseudokinase involved in necroptosis. Within 24 h, in all three models, D-FAT induced a decrease in triglyceride content by 30%, attributable to an upregulation of genes involved in free fatty acid β-oxidation and autophagy, and a downregulation of those involved in lipogenesis. Defatting was accompanied by a decrease in endoplasmic reticulum stress and in the production of reactive oxygen species. The addition of necrosulfonamide increased the efficacy of defatting by 8%-12% in PCLS, with a trend towards increased autophagy. In conclusion, culture models, notably PCLS, are insightful to design strategies for liver graft rescue. Defatting can be rapidly achieved by combinations of drugs targeting mitochondrial oxidative metabolism, macro-autophagy and lipogenesis.
Published: 2020
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2. Standardized Technique of Selective Left Liver Vascular Exclusion During Laparoscopic Liver Resection for Benign and Malignant Tumors

Author: Claire Goumard, Chetana Lim, Morgan Vandermeulen, and Olivier Scatton
Subjects: medicine.medical_specialty, Blood transfusion, business.industry, medicine.medical_treatment, Mortality rate, Gastroenterology, Perioperative, medicine.disease, Surgery, Resection, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Embolism, 030220 oncology & carcinogenesis, Occlusion, medicine, 030211 gastroenterology & hepatology, Hepatectomy, business, Vein
Abstract: Tumors located close to major hepatic veins pose a technical challenge to standard laparoscopic liver resection. Hepatic outflow occlusion may reduce the risks of bleeding from hepatic vein and gas embolism. The aim of this study was to detail our standardized laparoscopic approach for a safe extrahepatic control of the common trunk of middle and left hepatic veins during laparoscopic liver resection and to assess its feasibility in patients with tumors located in both right and left lobes of the liver. Data of 25 consecutive patients who underwent laparoscopic liver resection with extrahepatic control of the common trunk of middle and left hepatic veins were reviewed. All patients underwent primary hepatectomy. The vast majority (84%) of patients had malignant tumors. The control of the common trunk of middle and left hepatic veins was achieved in 96% of patients. There were 14 (56%) major hepatectomies and 11 (44%) minor hepatectomies. Some form of vascular clamping was performed in 23 (62%) patients: Pringle maneuver in 17 (median time = 45 min; range, 10–109) and selective vascular exclusion of the liver in 6 patients (median time = 30 min; range, 15–94). The median duration of operation was 254 min (range, 70–441). There was one case (4%) of gas embolism but without any complications during the postoperative course. Conversion to open surgery was performed in 2 (7.7%) patients: 1 for oncologic reason and 1 for non-progression during the transection plane. Perioperative blood transfusion rate was nil. The overall morbidity rate was 24%. The laparoscopic approach for an extrahepatic control of the common trunk of middle and left hepatic veins is reproducible, safe, and effective, and can be applied during laparoscopic liver resection for tumors close to major hepatic veins.
Published: 2021

3. When Is a Critically Ill Cirrhotic Patient Too Sick to Transplant? Development of Consensus Criteria by a Multidisciplinary Panel of 35 International Experts

Author: Samir Jaber, Thomas Reiberger, Kim M. Olthoff, Jan Lerut, Kate Kronish, François Durand, Wim Laleman, Jody C. Olson, James Y. Findlay, Sumeet K. Asrani, Dana Tomescu, Victor W. Xia, Emmanuel Weiss, Fuat H. Saner, Paolo Muiesan, Constantino Fondevila, Annabel Blasi, Catherine Paugam-Burtz, Constantine J. Karvellas, Thierry Gustot, Olivier Scatton, Ram Subramanian, Javier Fernández, Koen Reyntjens, Pierre-François Laterre, Faouzi Saliba, Kenneth J. Simpson, Gianni Biancofiore, Olivier Soubrane, Eric Levesque, Claire Francoz, Frank Tacke, Gebhard Wagener, Mark Mc Phail, Antonio Daniele Pinna, M. Susan Mandell, MORNET, Dominique, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), European Foundation for Study of Chronic Liver Failure [Barcelona] (EF CLIF), Universitätsklinikum Essen [Universität Duisburg-Essen] (Uniklinik Essen), Baylor University, University of Pisa - Università di Pisa, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Université Catholique de Louvain = Catholic University of Louvain (UCL), Nokia Bell Labs [Paris-Saclay], University of Barcelona, Mayo Clinic [Rochester], Universitat de Barcelona (UB), Université libre de Bruxelles (ULB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), University of California [San Francisco] (UC San Francisco), University of California (UC), Catholic University of Leuven - Katholieke Universiteit Leuven (KU Leuven), Centre hépato-biliaire - CHB [Paul Brousse, Paris], Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse, University of Colorado Anschutz [Aurora], King‘s College London, University of Birmingham [Birmingham], Birmingham Women's and Children's NHS Foundation Trust, University of Kansas [Kansas City], Hospital of the University of Pennsylvania (HUP), Perelman School of Medicine, University of Pennsylvania-University of Pennsylvania, University of Bologna/Università di Bologna, University of Vienna [Vienna], University of Groningen [Groningen], Physiopathologie et traitement des maladies du foie, Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris-Saclay, Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), University of Edinburgh, Emory University School of Medicine, Emory University [Atlanta, GA], Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Fundeni Clinical Institute = Institutul Clinic Fundeni [Bucarest, Roumanie], David Geffen School of Medicine [Los Angeles], University of California [Los Angeles] (UCLA), University of California (UC)-University of California (UC), Columbia University College of Physicians and Surgeons, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, UCL - (SLuc) Service de soins intensifs, Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Université de Montpellier (UM)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), University of California [San Francisco] (UCSF), University of California, Hôpital Paul Brousse-Université Paris-Sud - Paris 11 (UP11), University of Pennsylvania [Philadelphia]-University of Pennsylvania [Philadelphia], University of Bologna, and University of California-University of California
Subjects: Liver Cirrhosis, medicine.medical_specialty, Consensus, [SDV.IMM] Life Sciences [q-bio]/Immunology, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Critical Illness, Medizin, MEDLINE, Delphi method, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030230 surgery, Liver transplantation, Severity of Illness Index, 03 medical and health sciences, 0302 clinical medicine, Multidisciplinary approach, Intensive care, Anesthesiology, Internal medicine, medicine, Humans, Intensive care medicine, Transplantation, Critically ill, business.industry, Graft Survival, Hepatology, Transplantation d'organes, 3. Good health, Liver Transplantation, [SDV.IMM]Life Sciences [q-bio]/Immunology, 030211 gastroenterology & hepatology, business
Abstract: BACKGROUND: Critically ill cirrhotic patients are increasingly transplanted, but there is no consensus about futile liver transplantation (LT). Therefore, the decision to delay or deny LT is often extensively debated. These debates arise from different opinions of futility among transplant team members. This study aims to achieve a multinational and multidisciplinary consensus on the definition of futility in LT and to develop well-articulated criteria for not proceeding with LT due to futility. METHODS: Thirty-five international experts from anesthesiology/intensive care, hepatology, and transplant surgery were surveyed using the Delphi method. More than 70% of similar answers to a question were necessary to define agreement. RESULTS: The panel recommended patient and graft survival at 1 year after LT to define futility. Severe frailty and persistent fever or 1 μg/kg per minute and a serum lactate level >9 mmol/L. CONCLUSIONS: Our expert panel provides a consensus on the definition of futile LT and on specific criteria for postponing or denying LT. A framework that may facilitate the decision if a patient is too sick for transplant is presented., SCOPUS: ar.j, info:eu-repo/semantics/published
Published: 2021

4. Adult human liver slice cultures: Modelling of liver fibrosis and evaluation of new anti-fibrotic drugs

Author: Olivier Scatton, Loriane Lair-Mehiri, Sylvie Lagaye, Jesintha Gaston, Jean-Christophe Vaillant, Vladimir A. Morozov, Pierre-Philippe Massault, Daria Kartasheva-Ebertz, Stanislas Pol, Immunobiologie des Cellules dendritiques, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Robert Koch Institute [Berlin] (RKI), Immunobiologie des Cellules Dendritiques, The authors are deeply indebted to the patients for their essential contribution to the work. We would like to acknowledge the members of the Departments of Digestive Surgery (Groupe Hospitalier La Pitié Salpétrière and Groupe Hospitalier Cochin, Assistance Publique–Hôpitaux de Paris (AP-HP), Paris, France) and the Department of Hepatology (Groupe Hospitalier Cochin, AP-HP, Paris, France), Dr. Jérôme Guéchot (Hôpital Saint-Antoine, Pôle de Biologie Médicale et Pathologie, AP-HP, Paris, France), Dr. Phuong Nhi Bories (Groupe Hospitalier Cochin, Service de Biochimie, AP-HP, Paris, France), the staff of Genomic (GENOM’IC) and Histology (HISTIM) facilities (Cochin Institute, Paris, France) for valuable assistance. We are grateful to Dr. Matthew Albert for the critical reading of the manuscript. Dr. Daria M. Kartasheva-Ebertz received a Ph.D. fellowship from AP-HP, Paris, France., LAGAYE, SYLVIE, and Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM)
Subjects: Nonalcoholic steatohepatitis, Alcoholic liver disease, Pathology, medicine.medical_specialty, Anti fibrotic, Hepatitis C virus, Liver fibrosis, [SDV.CAN]Life Sciences [q-bio]/Cancer, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, [SDV.CAN] Life Sciences [q-bio]/Cancer, Medicine, ComputingMilieux_MISCELLANEOUS, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Hepatology, Human liver, business.industry, Drugs, [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy, Human liver fibrosis, Basic Study, medicine.disease, 3. Good health, 030220 oncology & carcinogenesis, 030211 gastroenterology & hepatology, [SDV.IMM.IMM] Life Sciences [q-bio]/Immunology/Immunotherapy, business, Ex vivo model, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: International audience; BACKGROUNDLiver fibrosis can result in end-stage liver failure and death.AIMTo examine human liver fibrogenesis and anti-fibrotic therapies, we evaluated the three dimensional ex vivo liver slice (LS) model.METHODSFibrotic liver samples (F0 to F4 fibrosis stage according to the METAVIR score) were collected from patients after liver resection. Human liver slices (HLS) were cultivated for up to 21 days. Hepatitis C virus (HCV) infection, alcohol (ethanol stimulation) and steatosis (palmitate stimulation) were examined in fibrotic (F2 to F4) liver slices infected (or not) with HCV. F0-F1 HLS were used as controls. At day 0, either ursodeoxycholic acid (choleretic and hepatoprotective properties) and/or α-tocopherol (antioxidant properties) were added to standard of care on HLS and fibrotic liver slices, infected (or not) with HCV. Expression of the biomarkers of fibrosis and the triglyceride production were checked by quantitative reverse transcription polymerase chain reaction and/or enzyme-linked immunosorbent assay.RESULTSThe cultures were viable in vitro for 21 days allowing to study fibrosis inducers and to estimate the effect of anti-fibrotic drugs. Expression of the biomarkers of fibrosis and the progression to steatosis (estimated by triglycerides production) was increased with the addition of HCV and /or ethanol or palmitate. From day 15 of the follow-up studies, a significant decrease of both transforming growth factor β-1 and Procol1A1 expression and triglycerides production was observed when a combined anti-fibrotic treatment was applied on HCV infected F2-F4 LS cultures.CONCLUSIONThese results show that the human three dimensional ex vivo model effectively reflects the in vivo processes in damaged human liver (viral, alcoholic, nonalcoholic steatohepatitis liver diseases) and provides the proof of concept that the LS examined model permits a rapid evaluation of new anti-fibrotic therapies when used alone or in combination
Published: 2021

5. Clinical practice guidelines for the management of liver metastases from extrahepatic primary cancers 2021

Author: H. Takeda, Tomohiko Ukai, Masakazu Yamamoto, Makoto Ueno, Steven M. Strasberg, René Adam, Mariano E Giménez, Takuro Mizukami, Naohiro Okano, Palepu Jagannath, Ho-Seong Han, Katsunori Sakamoto, Masato Ozaka, Takayuki Ueno, Susumu Hijioka, Koji Asai, Yoo Seok Yoon, Keita Wada, Keiji Sano, Toru Beppu, Satoru Shikata, Takako Eguchi Nakajima, Tsutomu Tabata, Shingo Yamashita, Do Youn Oh, Yoichi Naito, Tadahiro Takada, Taizo Hibi, Junji Furuse, Masayuki Ohtsuka, Koichi Hayano, Tsann Long Hwang, Hee-Jung Wang, Masahiro Yoshida, Teijiro Hirashita, Nozomu Sakai, Shao Ciao Luo, Hisato Kawakami, Yukio Iwashita, Ryusei Matsuyama, Michael G. Sarr, Olivier Scatton, and Yasuhisa Mori
Subjects: medicine.medical_specialty, medicine.medical_treatment, Population, 030230 surgery, Malignancy, Systemic therapy, 03 medical and health sciences, 0302 clinical medicine, medicine, Hepatectomy, Humans, education, Grading (tumors), education.field_of_study, Hepatology, business.industry, General surgery, Standard treatment, Liver Neoplasms, medicine.disease, Clinical trial, Systematic review, 030220 oncology & carcinogenesis, Surgery, business
Abstract: Background Hepatectomy is standard treatment for colorectal liver metastases; however, it is unclear whether liver metastases from other primary cancers should be resected or not. The Japanese Society of Hepato-Biliary-Pancreatic Surgery therefore created clinical practice guidelines for the management of metastatic liver tumors. Methods Eight primary diseases were selected based on the number of hepatectomies performed for each malignancy per year. Clinical questions were structured in the population, intervention, comparison, and outcomes (PICO) format. Systematic reviews were performed, and the strength of recommendations and the level of quality of evidence for each clinical question were discussed and determined. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence and make recommendations. Results The eight primary sites were grouped into five categories based on suggested indications for hepatectomy and consensus of the guidelines committee. Fourteen clinical questions were devised, covering five topics: (1) diagnosis, (2) operative treatment, (3) ablation therapy, (4) the eight primary diseases, and (5) systemic therapies. The grade of recommendation was strong for one clinical question and weak for the other 13 clinical questions. The quality of the evidence was moderate for two questions, low for 10, and very low for two. A flowchart was made to summarize the outcomes of the guidelines for the indications of hepatectomy and systemic therapy. Conclusions These guidelines were developed to provide useful information based on evidence in the published literature for the clinical management of liver metastases, and they could be helpful for conducting future clinical trials to provide higher-quality evidence.
Published: 2020

6. Guidelines for Perioperative Care for Liver Transplantation: Enhanced Recovery After Surgery (ERAS) Recommendations

Author: Nicolas Demartines, Olivier Scatton, Helen Usher, Stephen J. Wigmore, Damiano Patrono, Eduardo Schiffer, Raffaele Brustia, Wellington Andraus, Emily Baird, Olivier Detry, Marieke T. de Boer, Stefano Skurzak, Gonzalo Rodriguez Laiz, Antoine Monsel, François Martin Carrier, Franck Vandenbroucke-Menu, Paulo Melgar, Philippe Compagnon, Abdourahamane Kaba, Luiz Marcelo Sá Malbouisson, Miriam Zeillemaker-Hoekstra, Gianni Biancofiore, Toshimi Kaido, Shinji Uemoto, Koen Reyntjen, Susan L. Orloff, and Carlijn I. Buis
Subjects: LIMITATIONS, medicine.medical_specialty, medicine.medical_treatment, MEDLINE, 030230 surgery, Liver transplantation, Perioperative Care, DELPHI TECHNIQUE, 03 medical and health sciences, DOUBLE-BLIND, Postoperative Complications, 0302 clinical medicine, IMMUNONUTRITION, HYPERGLYCEMIA, CENTER VOLUME, medicine, MANAGEMENT, Humans, Prospective Studies, Intensive care medicine, Prospective cohort study, Enhanced recovery after surgery, Transplantation, OUTCOMES, ddc:617, business.industry, Perioperative, Length of Stay, medicine.disease, Liver Transplantation, 3. Good health, Malnutrition, RECIPIENTS, UNIT, Perioperative care, Nasogastric intubation, 030211 gastroenterology & hepatology, Enhanced Recovery After Surgery, business
Abstract: BACKGROUND: Enhanced Recovery After Surgery (ERAS) is a multimodal, evidence-based, program of care developed to minimize the response to surgical stress, associated with reduced perioperative morbidity and hospital stay. This study presents the specific ERAS Society recommendations for liver transplantation (LT) based on the best available evidence and on expert consensus. METHODS: PubMed and ClinicalTrials.gov were searched in April 2019 for published and ongoing RCTs on LT in the last 15 years. Studies were selected by 5 independent reviewers, and were eligible if focusing on each validated ERAS items in the area of adult LT. An e-Delphi method was used with an extended interdisciplinary panel of experts to validate the final recommendations. RESULTS: Forty-three articles were included in the systematic review. Consensus was reached among experts after the second round. Patients should be screened for malnutrition and treated whenever possible. Prophylactic nasogastric intubation and prophylactic abdominal drainage may be omitted, and early extubation should be considered. Early oral intake, mobilization and multimodal-balanced analgesia are recommended. CONCLUSIONS: The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the e-Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol.PROSPERO CRD4201913279.
Published: 2022

7. Hypothermic Oxygenated Perfusion Versus Normothermic Regional Perfusion in Liver Transplantation From Controlled Donation After Circulatory Death

Author: Eric Savier, Kayvan Mohkam, Ailton Sepulveda, Federica Dondero, Philipp Dutkowski, Jean-Yves Mabrut, Laurent Sulpice, Heithem Jeddou, Pierre-Alain Clavien, Olivier Scatton, Petru Bucur, Mickael Lesurtel, Marc-Antoine Allard, Ephrem Salamé, Gabriella Pittau, Matteo Mueller, Xavier Muller, and Andrea Schlegel
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Retrospective cohort study, Liver transplantation, Surgery, law.invention, 03 medical and health sciences, 0302 clinical medicine, Randomized controlled trial, law, 030220 oncology & carcinogenesis, Donation, Cohort, Clinical endpoint, medicine, 030211 gastroenterology & hepatology, business, Perfusion, Cohort study
Abstract: Objective: To compare HOPE and NRP in liver transplantation from cDCD. Summary of Background Data: Liver transplantation after cDCD is associated with higher rates of graft loss. Dynamic preservation strategies such as NRP and HOPE may offer safer use of cDCD grafts. Methods: Retrospective comparative cohort study assessing outcomes after cDCD liver transplantation in 1 Swiss (HOPE) and 6 French (NRP) centers. The primary endpoint was 1-year tumor-death censored graft and patient survival. Results: A total of 132 and 93 liver grafts were transplanted after NRP and HOPE, respectively. NRP grafts were procured from younger donors (50 vs 61 years, P < 0.001), with shorter functional donor warm ischemia (22 vs 31 minutes, P < 0.001) and a lower overall predicted risk for graft loss (UK-DCD-risk score 6 vs 9 points, P < 0.001). One-year tumor-death censored graft and patient survival was 93% versus 86% (P = 0.125) and 95% versus 93% (P = 0.482) after NRP and HOPE, respectively. No differences in non-anastomotic biliary strictures, primary nonfunction and hepatic artery thrombosis were observed in the total cohort and in 32 vs. 32 propensity score-matched recipients Conclusion: NRP and HOPE in cDCD achieved similar post-transplant recipient and graft survival rates exceeding 85% and comparable to the benchmark values observed in standard DBD liver transplantation. Grafts in the HOPE cohort were procured from older donors and had longer warm ischemia times, and consequently achieved higher utilization rates. Therefore, randomized controlled trials with intention-to-treat analysis are needed to further compare both preservation strategies, especially for high-risk donor-recipient combinations.
Published: 2020

8. Outcomes after 3D laparoscopic and robotic liver resection for hepatocellular carcinoma: a multicenter comparative study

Author: Olivier Scatton, Niccolò Napoli, Chady Salloum, Daniel Azoulay, Antonella Tudisco, Chetana Lim, Claire Goumard, and Ugo Boggi
Subjects: Surgical margin, medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Hepatocellular carcinoma, medicine.medical_treatment, 3D vision, 030230 surgery, Resection, 03 medical and health sciences, Laparoscopic, 0302 clinical medicine, 3d vision, Robotic Surgical Procedures, Internal medicine, medicine, Humans, Hepatectomy, Retrospective Studies, Robotic, business.industry, Liver Neoplasms, Length of Stay, Hepatology, medicine.disease, Surgery, Treatment Outcome, Laparoscopy, 030211 gastroenterology & hepatology, business, Abdominal surgery
Abstract: The recent development of 3D vision in laparoscopic and robotic surgical systems raises the question of whether these two procedures are equivalent. The aim of this study was to evaluate the surgical and long-term oncological outcomes of 3D laparoscopic (3D-LLR) and robotic liver resection (RLR) for hepatocellular carcinoma (HCC). The data for operative time, morbidity, margins, and survival were reviewed for 3D-LLR and compared with RLR. From 2011 to 2017, 93 patients with HCC, including 58 (62%) with cirrhosis, underwent 3D-LLR [49 (53%)] or RLR [44 (47%)]. No difference was observed in operative time (269 vs. 252 min; p = 0.52), overall (27% vs. RLR: 16%; p = 0.49) and severe morbidity (4% vs. 2%; p = 0.77) or in the surgical margin width (9 vs. 11 mm; p = 0.30) between the 3D-LLR and RLR groups. The 3-year overall and recurrence-free survival rates after 3D-LLR and RLR were 82% and 24% and 91% (p = 0.16) and 48% (p = 0.18), respectively. The 3D-LLR and RLR systems provide comparable surgical margins with similar short- and long-term oncological outcomes.
Published: 2020

9. Cholangiocarcinoma Following Bariatric Surgery: a Prospective Follow-Up Single-Center Audit

Author: Jean-Michel Siksik, Nassiba Beghdadi, Laurent Genser, Jean-Christophe Vaillant, Judith Aron-Wisnewsky, Celia Turco, Chetana Lim, Olivier Scatton, Claire Goumard, Adriana Torcivia, and Jean-Michel Oppert
Subjects: medicine.medical_specialty, Percutaneous, Endocrinology, Diabetes and Metabolism, Gastric Bypass, Bariatric Surgery, 030209 endocrinology & metabolism, Single Center, Cholangiocarcinoma, Biliary disease, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Prospective Studies, Retrospective Studies, Nutrition and Dietetics, business.industry, Incidence (epidemiology), Cancer, Jaundice, medicine.disease, Obesity, Morbid, Surgery, Obstructive sleep apnea, Bile Ducts, Intrahepatic, Bile Duct Neoplasms, Diabetes Mellitus, Type 2, 030211 gastroenterology & hepatology, medicine.symptom, business, Dyslipidemia, Follow-Up Studies
Abstract: Cholangiocarcinoma (CC) incidence is rising worldwide. Obesity and its related metabolic impairments are associated with primitive liver malignancies including CC. While bariatric surgery (BS) is associated with decreased risk of incident cancer, few data are available regarding CC incidence, presentation, and management issues after BS. We retrospectively reviewed collected data on 1911 consecutive patients undergoing BS from 2010 to 2019. We recorded three cases (0.16%) of CC during the postoperative follow-up. All cases underwent a Roux-en-Y gastric bypass (RYGB) for class III obesity with metabolic diseases (i.e., type 2 diabetes mellitus, hypertension, dyslipidemia, and obstructive sleep apnea) without any personal or familial history of biliary disease. The patients presented with an inaugural jaundice or pruritus at 8, 12, and 13 months after RYBG, which enabled the diagnosis of metastatic CCs in all cases. In such palliative setting without access to the pancreato-biliary system, biliary drainage was ensured by a percutaneous trans-hepatic biliary drain. Chemotherapy was initiated in two patients. All the patients died within a delay of 2, 11, and 17 months after the diagnosis, respectively. The incidence of post-BS CC appears low, but the prognosis is poor because of advanced stages at diagnosis. These cases illustrate the difficulty to make both on-time diagnosis and optimal management of CC especially in patients operated of RYGB with limited access to the excluded anatomy.
Published: 2020

10. Surgical Glove Technique for Laparoscopic Liver Resection

Author: Olivier Scatton, Claire Goumard, Martin Tabath, and Chetana Lim
Subjects: medicine.medical_specialty, Blood transfusion, business.industry, Medical record, medicine.medical_treatment, Right triangular ligament, Operative mortality, Gastroenterology, Resection, Surgery, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, Coronary ligament, 030220 oncology & carcinogenesis, medicine, 030211 gastroenterology & hepatology, In patient, Complication, business
Abstract: Liver tumors located in segments 7 and 8 pose a technical challenge to standard laparoscopic liver resection. Intraoperative placement of a surgical glove behind the right liver after the right triangular ligament and coronary ligament are divided facilitates liver exposure during parenchymal transection and control of the bleeding at the deeper part of the parenchymal plane. The aim of this study was to describe our standardized technique in detail and to assess the feasibility of this technique in patients with different clinical backgrounds and clarify the limits of this technique. Medical records of 20 consecutive patients considered for laparoscopic liver resection using the surgical glove technique were reviewed. All patients had malignant disease and the vast majority of patients had colorectal metastatic tumors. Overall, 65% of patients had tumors located in segment 8. Placing the surgical water glove could be achieved without complication in all 20 patients. One surgical glove was used in this series (usually size 6.5 to 7.5 is an adequate size). Time for preparing the surgical green water glove was estimated to be less than 1 min. The mean duration of operation ranged from 136 to 332 min (median, 240 min). Intermittent Pringle’s maneuver was applied in all patients with a median time of 33 min. No additional intercostal trocars were required. There was no intraoperative blood transfusion or conversion to open surgery. The median maximum size of the tumor was 23 mm. There was no operative mortality. Overall morbidity was 30%. Surgical margins were negative in 80% of patients. The surgical glove technique is easy, reproducible, effective, and safe and can be applied to both laparoscopic and robotic liver resection.
Published: 2020

11. Liver transplantation for hepatocellular carcinoma after successful treatment of macrovascular invasion – a multi‐center retrospective cohort study

Author: Michela Assalino, Giulio Cesare Vitali, Marco Bongini, Neil Mehta, Sylvain Terraz, Enrico Gringeri, Laura Kulik, Axel Andres, Philippe Compagnon, Quirino Lai, M. Grat, Raffaele Brustia, Christian Toso, Thierry Berney, Pietro Majno, Olivier Scatton, Vatche G. Agopian, Neeta Vachharajani, Vincenzo Mazzaferro, Parissa Tabrizian, Krzysztof Zieniewicz, Umberto Cillo, and William C. Chapman
Subjects: medicine.medical_specialty, Carcinoma, Hepatocellular, medicine.medical_treatment, 030230 surgery, Liver transplantation, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Humans, In patient, Contraindication, Neoplasm Staging, Retrospective Studies, Transplantation, liver transplantation, downstaging, hepatocellular carcinoma, locoregional therapy, macrovascular invasion, tumor recurrence, business.industry, Medical record, Liver Neoplasms, Retrospective cohort study, medicine.disease, digestive system diseases, Treatment Outcome, Multicenter study, Hepatocellular carcinoma, 030211 gastroenterology & hepatology, alpha-Fetoproteins, Neoplasm Recurrence, Local, business
Abstract: Macrovascular invasion is considered a contraindication to liver transplantation for hepatocellular carcinoma (HCC) due to a high risk of recurrence. The aim of the present multicenter study was to explore the outcome of HCC patients transplanted after a complete radiological regression of the vascular invasion by locoregional therapies and define sub-groups with better outcomes. Medical records of 45 patients were retrospectively reviewed, and imaging was centrally assessed by an expert liver radiologist. In the 30 patients with validated diagnosis of macrovascular invasion, overall survival was 60% at 5 years. Pretransplant alpha-fetoprotein (AFP) value was significantly different between patients with and without recurrence (P = 0.019), and the optimal AFP cutoff was 10ng/ml (area under curve = 0.78). Recurrence rate was 11% in patients with pretransplant AFP < 10ng/ml. The number of viable nodules (P = 0.008), the presence of residual HCC (P = 0.036), and satellite nodules (P = 0.001) on the explant were also significantly different between patients with and without recurrence. Selected HCC patients with radiological signs of vascular invasion could be considered for transplantation, provided that they previously underwent successful treatment of the macrovascular invasion resulting in a pretransplant AFP < 10 ng/ml. Their expected risk of post-transplant HCC recurrence is 11%, and further prospective validation is needed.
Published: 2020

12. Pure laparoscopic versus open hemihepatectomy: a critical assessment and realistic expectations – a propensity score-based analysis of right and left hemihepatectomies from nine European tertiary referral centers

Author: Francesca Ratti, Brice Gayet, Panagiotis Lainas, Marc G. Besselink, Takayuki Kawai, Mathieu D'Hondt, Luca Aldrighetti, Mohammad Abu Hilal, Ibrahim Dagher, Federica Cipriani, Marcel J. van der Poel, Olivier Scatton, Morad Faoury, Mohammad Alzoubi, Giammauro Berardi, Bjørn Edwin, Roberto Troisi, Leonid Barkhatov, David Fuks, Cipriani, F., Alzoubi, M., Fuks, D., Ratti, F., Kawai, T., Berardi, G., Barkhatov, L., Lainas, P., Van der Poel, M., Faoury, M., Besselink, M. G., D'Hondt, M., Dagher, I., Edwin, B., Troisi, R. I., Scatton, O., Gayet, B., Aldrighetti, L., Abu Hilal, M., Graduate School, AGEM - Digestive immunity, AGEM - Endocrinology, metabolism and nutrition, AGEM - Re-generation and cancer of the digestive system, CCA - Cancer Treatment and Quality of Life, and Surgery
Subjects: Adult, Male, medicine.medical_specialty, Referral, Malignancy, Hemihepatectomy, Postoperative Complications, Blood loss, Ascites, medicine, Hepatectomy, Humans, Propensity Score, Laparoscopy, Aged, Aged, 80 and over, Right hepatectomy, Hepatology, medicine.diagnostic_test, business.industry, Liver Diseases, Laparoscopic major hepatectomy, Middle Aged, Laparoscopic liver resection, medicine.disease, Surgery, Europe, Propensity score matching, Female, Critical assessment, Left hepatectomy, medicine.symptom, Complication, business
Abstract: Introduction: A stronger evidence level is needed to confirm the benefits and limits of laparoscopic hemihepatectomies. Methods: Laparoscopic and open hemihepatectomies from nine European referral centers were compared after propensity score matching (right and left hemihepatectomies separately, and benign and malignant diseases sub-analyses). Results: Five hundred and forty-five laparoscopic hemihepatectomies were compared with 545 open. Laparoscopy was associated with reduced blood loss (P < 0.001), postoperative stay (P&nbsp
Published: 2020

13. Minimally Invasive Donor Hepatectomy for Adult Living Donor Liver Transplantation An International, Multi-institutional Evaluation of Safety, Efficacy and Early Outcomes

Author: Jai Young Cho, François Cauchy, Akihiko Soyama, Satoshi Ogiso, Fernando Pardo, H.-D. Cho, Takeshi Takahara, Choon Hyuck David Kwon, Olivier Scatton, Ho-Seong Han, Daniel Cherqui, Olivier Soubrane, Roberto Troisi, Talia Baker, Gabriella Pittau, Susumu Eguchi, Gyu-Seong Choi, Ki-Hun Kim, Shinji Uemoto, Fernando Rotellar, Aude Vanlander, Go Wakabayashi, Soubrane, O., Eguchi, S., Uemoto, S., Kwon, C. H. D., Wakabayashi, G., Han, H. -S., Kim, K. -H., Troisi, R., Cherqui, D., Rotellar, F., Cauchy, F., Soyama, A., Ogiso, S., Choi, G. -S., Takahara, T., Cho, J. Y., Cho, H. -D., Vanlander, A., Pittau, G., Scatton, O., Pardo, F., and Baker, T.
Subjects: medicine.medical_specialty, Rehabilitation, Liver transplantation, medicine.diagnostic_test, business.industry, Living donor, medicine.medical_treatment, Retrospective cohort study, Perioperative, Surgery, Transplantation, 03 medical and health sciences, Minimal access surgical procedure, 0302 clinical medicine, 030220 oncology & carcinogenesis, Laparotomy, Medicine, 030211 gastroenterology & hepatology, Hepatectomy, business, Complication, Laparoscopy, Outcomes assessments
Abstract: Objective Evaluating the perioperative outcomes of minimally invasive (MIV) donor hepatectomy for adult live donor liver transplants in a large multi-institutional series from both Eastern and Western centers. Background Laparoscopic liver resection has become standard practice for minor resections in selected patients in whom it provides reduced postoperative morbidity and faster rehabilitation. Laparoscopic approaches in living donor hepatectomy for transplantation, however, remain controversial because of safety concerns. Following the recommendation of the Jury of the Morioka consensus conference to address this, a retrospective study was designed to assess the early postoperative outcomes after laparoscopic donor hepatectomy. The collective experience of 10 mature transplant teams from Eastern and Western countries was reviewed. Methods All centers provided data from prospectively maintained databases. Only left and right hepatectomies performed using a MIV technique were included in this study. Primary outcome was the occurrence of complications using the Clavien-Dindo graded classification and the Comprehensive Complication Index during the first 3 months. Logistic regression analysis was used to identify risk factors for complications. Results In all, 412 MIV donor hepatectomies were recorded including 164 left and 248 right hepatectomies. Surgical technique was either pure laparoscopy in 175 cases or hybrid approach in 237. Conversion into standard laparotomy was necessary in 17 donors (4.1%). None of the donors died. Also, 108 experienced 121 complications including 9.4% of severe (Clavien-Dindo 3-4) complications. Median Comprehensive Complication Index was 5.2. Conclusions This study shows favorable early postoperative outcomes in more than 400 MIV donor hepatectomy from 10 experienced centers. These results are comparable to those of benchmarking series of open standard donor hepatectomy.
Published: 2022

14. Living Donor Liver Transplantation Using the RAPID Technique in the Cirrhotic Setting Is Still in Its Developmental Stage

Author: Olivier Scatton and Chetana Lim
Subjects: Transplantation, medicine.medical_specialty, Developmental stage, Hepatology, business.industry, medicine.medical_treatment, MEDLINE, Liver transplantation, medicine.disease, Gastroenterology, Internal medicine, Carcinoma, Medicine, Surgery, business, Living donor liver transplantation
Published: 2021

15. Impact of the duration of normothermic regional perfusion on the results of liver transplant from controlled circulatory death donors: A retrospective, multicentric study

Author: Laurent Sulpice, Mickael Lesurtel, Eric Savier, Louise Barbier, Anne-Gaëlle Si Larbi, Claire Goumard, Marc Laffon, Fabien Robin, Marc-Antoine Allard, Olivier Soubrane, Gabriella Pittau, Petru Bucur, Ephrem Salamé, Xavier Muller, Olivier Scatton, Thomas Guillem, Federica Dondero, Emmanuelle Mercier, Jean-Christophe Venhard, CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Foch [Suresnes], CHU Pontchaillou [Rennes], Centre Hépato-Biliaire [Hôpital Paul Brousse] (CHB), Hôpital Paul Brousse-Assistance Publique - Hôpitaux de Paris, Centre d’Investigation Clinique [Tours] CIC 1415 (CIC ), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-Hôpital Bretonneau-Université de Tours (UT)-Institut National de la Santé et de la Recherche Médicale (INSERM), None, Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital de la Croix-Rousse [CHU - HCL], Hospices Civils de Lyon (HCL), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon, Hôpital Paul Brousse, Université Paris-Saclay, Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Paris Diderot - Paris 7 (UPD7), and Jonchère, Laurent
Subjects: [SDV]Life Sciences [q-bio], medicine.medical_treatment, ischemia-reperfusion injury, Regional perfusion, 030230 surgery, Liver transplantation, normothermic regional perfusion, Graft function, 03 medical and health sciences, delayed graft function, 0302 clinical medicine, Clinical endpoint, Medicine, Humans, In patient, Retrospective Studies, Transplantation, business.industry, Graft Survival, Organ Preservation, Time optimal, Circulatory death, Tissue Donors, controlled circulatory deceased donors, 3. Good health, Liver Transplantation, [SDV] Life Sciences [q-bio], Death, Perfusion, Anesthesia, 030211 gastroenterology & hepatology, business
Abstract: International audience; In France, the program of controlled donation after circulatory death (cDCD) was established with routine use of in situ normothermic regional perfusion (NRP). There is currently no consensus on its optimal duration. The purpose was to assess the impact of NRP duration on liver graft function and biliary outcomes. One-hundred and fifty-six liver recipients from NRP-cDCD donors from six French centers between 2015 and 2019 were included. Primary endpoint was graft function assessed by early allograft dysfunction (EAD, according to Olthoff's criteria) and MEAF (model for early allograft function) score. Overall, three (1.9%) patients had primary non-function, 30 (19.2%) patients experienced EAD, and MEAF score was 7.3 (+/- 1.7). Mean NRP duration was 179 (+/- 43) min. There was no impact of NRP duration on EAD (170 +/- 44 min in patients with EAD vs. 181 +/- 42 min in patients without, P = .286). There was no significant association between NRP duration and MEAF score (P = .347). NRP duration did neither impact on overall biliary complications nor on non-anastomotic biliary strictures (overall rates of 16.7% and 3.9%, respectively). In conclusion, duration of NRP in cDCD donors does not seem to impact liver graft function and biliary outcomes after liver transplantation. A 1 to 4-h perfusion represents an optimal time window.
Published: 2021

16. Bi-Functional Peptides as a New Therapeutic Tool for Hepatocellular Carcinoma

Author: Lorena Simón-Gracia, Eric Savier, Olivier Scatton, Frédéric Charlotte, Tambet Teesalu, Angelita Rebollo, Pierre Tufféry, Service d'hépatologie médicale [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), University of Tartu, Service d'Anatomie et cytologie pathologiques [CHU Pitié-Salpêtrière] (ACP), CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de Biologie Fonctionnelle et Adaptative (BFA (UMR_8251 / U1133)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Unité de Technologies Chimiques et Biologiques pour la Santé (UTCBS - UM 4 (UMR 8258 / U1022)), Institut de Chimie du CNRS (INC)-Université de Paris (UP)-Centre National de la Recherche Scientifique (CNRS)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Anatomie et cytologie pathologiques = Service de Pathologie [CHU Pitié-Salpêtrière] (ACP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), and Gestionnaire, HAL Sorbonne Université 5
Subjects: Liver tumor, Receptor expression, media_common.quotation_subject, education, Pharmaceutical Science, Peptide, Article, 03 medical and health sciences, Pharmacy and materia medica, 0302 clinical medicine, interfering peptides, medicine, Receptor, Internalization, 030304 developmental biology, media_common, chemistry.chemical_classification, [SDV.MHEP.EM] Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, 0303 health sciences, Predictive marker, Chemistry, tumor-penetrating peptides, hepatocellular carcinoma, [SDV.MHEP.EM]Life Sciences [q-bio]/Human health and pathology/Endocrinology and metabolism, medicine.disease, RS1-441, Apoptosis, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Cancer research
Abstract: International audience; Background: The interfering peptides that block protein–protein interactions have been receiving increasing attention as potential therapeutic tools. Methods: We measured the internalization and biological effect of four bi-functional tumor-penetrating and interfering peptides into primary hepatocytes isolated from three non-malignant and 11 hepatocellular carcinomas. Results: These peptides are internalized in malignant hepatocytes but not in non-malignant cells. Furthermore, the degree of peptide internalization correlated with receptor expression level and tumor aggressiveness levels. Importantly, penetration of the peptides iRGD-IP, LinTT1-IP, TT1-IP, and RPARPAR-IP induced apoptosis of the malignant hepatocytes without effect on non-malignant cells. Conclusion: Receptor expression levels correlated with the level of peptide internalization and aggressiveness of the tumor. This study highlights the potential to exploit the expression of tumor-penetrating peptide receptors as a predictive marker of liver tumor aggressiveness. These bi-functional peptides could be developed for personalized tumor treatment.
Published: 2021

17. Safety of sitagliptin in treatment of hepatocellular carcinoma in chronic liver disease patients

Author: Vincent Bondet, Eric Savier, Olivier Scatton, Clémence Hollande, Matthew L. Albert, Jeremy Boussier, Stanislas Pol, Alba Llibre, Vincent Mallet, Estelle Mottez, Tan Phuc Buivan, Bruno Charbit, Frédéric Charlotte, Darragh Duffy, Université Paris Cité (UPCité), Immunobiologie des Cellules dendritiques, Institut Pasteur [Paris] (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'hépatologie médicale [CHU Cochin], Hôpital Cochin [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Anatomie et cytologie pathologiques = Service de Pathologie [CHU Pitié-Salpêtrière] (ACP), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], Fondation ARC pour la Recherche sur le Cancer, BONDET, Vincent, Université de Paris (UP), Institut Pasteur [Paris]-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Anatomie et cytologie pathologiques [CHU Pitié-Salpêtrière] (ACP), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Population, Pharmaceutical Science, Chronic liver disease, Gastroenterology, sitagliptin, 03 medical and health sciences, 0302 clinical medicine, dipeptidyl peptidase 4, Internal medicine, medicine, Pharmacology (medical), neoadjuvant therapy, education, Adverse effect, Neoadjuvant therapy, Dipeptidyl peptidase-4, 030304 developmental biology, 0303 health sciences, education.field_of_study, business.industry, hepatocellular carcinoma, medicine.disease, 3. Good health, [SDV] Life Sciences [q-bio], Complementary and alternative medicine, 030220 oncology & carcinogenesis, Sitagliptin, Hepatocellular carcinoma, business, Adjuvant, leucocyte trafficking, medicine.drug
Abstract: International audience; Background & Aims : Systemic therapies for hepatocellular carcinoma (HCC) treatment have limited efficacy and poor safety. Dipeptidyl peptidase-4 inhibitors were initially developed and approved as treatment for type 2 diabetes, yet oral administration of sitagliptin has recently been shown to improve naturally occurring tumour immunity in animal models of HCC.Methods : We conducted a phase Ib clinical trial to evaluate the impact of a pre-operative 3-week DPP4 inhibitor (sitagliptin) treatment in HCC patients undergoing liver resection. The primary objective was to evaluate the safety of a sitagliptin treatment in each of the three groups of patients, according to an escalating dosage of sitagliptin (100, 200 and 600 mg/d). Secondary objectives included the assessment of DPP4 activity, cytokine expression in plasma samples and circulating immune populations.Results : Fourteen patients were included and analysed. In all three dose groups, no severe adverse event related to sitagliptin was reported. A significant inhibition of DPP4 activity was observed upon sitagliptin treatment, which prevented the N-terminal truncation of CXCL10, leading to a mobilization of circulating CD8+ T cells and eosinophils. Immunochemistry analysis showed a lymphoid infiltration in all tumour samples with the presence of a population of CXCR3+ T cells in all but one of the tumours. Positivity for CXCL10 (IP10) and CCR3 in tumour and/or stroma cells was found in all resection pieces.Conclusion : In summary, sitagliptin can be used safely in patients with chronic liver disease and HCC, and could be tested in phase 2 trial, as an adjuvant in combination with others drugs, for the treatment of HCC patients.
Published: 2021

18. Comment on: survival outcomes after portal vein embolization and liver resection compared with liver transplant for patients with extensive colorectal cancer liver metastases

Author: Olivier Scatton and Claire Goumard
Subjects: medicine.medical_specialty, business.industry, Colorectal cancer, Portal vein embolization, medicine, MEDLINE, business, medicine.disease, French Editorial from the ACHPBT, Surgery, Resection
Published: 2021

19. Infection of Human Liver Myofibroblasts by Hepatitis C Virus: A Direct Mechanism of Liver Fibrosis in Hepatitis C.

Author: Lynda Aoudjehane, Grégoire Bisch, Olivier Scatton, Christelle Granier, Jesintha Gaston, Chantal Housset, Philippe Roingeard, François-Loïc Cosset, Fabiano Perdigao, Pierre Balladur, Takaji Wakita, Yvon Calmus, and Filomena Conti
Subjects: Medicine, Science
Abstract: Chronic hepatitis C is a major cause of liver fibrosis and cirrhosis. It is generally accepted that inflammation that occurs in response to hepatocyte infection by the hepatitis C virus (HCV) is the main mechanism that triggers myofibroblast differentiation and stimulation in chronic hepatitis C. The aim of this study was to determine if HCV might infect human liver myofibroblasts (HLMF) and directly stimulate their fibrogenic activities.We evaluated the expression of the viral entry receptors, levels of HCV-RNA and HCV-protein and the expression of fibrosis markers in HLMF by using quantitative PCR, western blot and immunofluorescence analyses. Pseudoparticles (HCVpp) and cell culture-derived HCV (HCVcc) were used to study the ability of HLMF to support viral entry, replication and fibrosis induction.We showed that HLMF expressed all known molecules of the HCV receptor complex, i.e. CD81, LDL-R, scavenger receptor-BI, claudin-1 and occludin. These cells were also permissive to HCVpp entry. Inoculation with HCVcc caused short-term infection of these cells, as shown by their content in positive- and negative-strand HCV RNA, in core and NS3 viral proteins, and by their release of core protein levels in the culture supernatants. HCV infection stimulated myofibroblastic differentiation, proliferation and collagen production in these cells. In addition, evidence of in vivo infection was provided by the detection of positive- and negative-strand HCV RNA in preparations of HLMF obtained from HCV-infected patients.These findings indicate that HCV infection of HLMF can occur and trigger extracellular matrix overproduction, thereby contributing to the development of HCV-related liver fibrosis.
Published: 2015
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20. Liver transplantation from donors with Down Syndrome

Author: Eric Savier, G. Rousseau, Filomena Conti, Claire Goumard, Olivier Scatton, Fabiano Perdigao, Chetana Lim, Alessandra Mazzola, Benjamin Fernandez, CCSD, Accord Elsevier, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Haut-Lévêque [CHU Bordeaux], CHU Bordeaux [Bordeaux], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: Down syndrome, medicine.medical_specialty, Hepatology, business.industry, [SDV]Life Sciences [q-bio], medicine.medical_treatment, Gastroenterology, MEDLINE, Liver transplantation, medicine.disease, [SDV] Life Sciences [q-bio], 03 medical and health sciences, 0302 clinical medicine, 030225 pediatrics, Internal medicine, medicine, 030211 gastroenterology & hepatology, business, ComputingMilieux_MISCELLANEOUS
Abstract: International audience; No abstract available
Published: 2020

21. 2020 WSES guidelines for the detection and management of bile duct injury during cholecystectomy

Author: Roberto Bini, Boris Sakakushev, Carlos Domingo, Michele Pisano, Nassiba Beghdadi, Christian Cotsoglou, Giorgos Veloudis, Fikri M. Abu-Zidan, Franca Patrizi, Federica Gaiani, Mario Serradilla-Martin, Ronald V. Maier, Amine Benkabbou, Daniel Casanova, Marco Ceresoli, Anne Sophie Schneck, Angela Gurrado, Niccolò Allievi, Maria Clotilde Carra, Daniele Sommacale, Philip R. de Reuver, Gian Luigi de’Angelis, Salomone Di Saverio, Fernando Machado, Roberto Valinas, Felice Giuliante, Roberta Iadarola, Stefania Cimbanassi, Offir Ben-Ishay, Manuel Planells, Raffaele Romito, Richard P. G. ten Broek, Serena Langella, Giulio Cesare Vitali, Federico Gheza, Jeffry L. Kashuk, Miklosh Bala, Belinda De Simone, Nicola de’Angelis, Osvaldo Chiara, Umberto Maggi, Maria Conticchio, Raffaele Brustia, Olivier Scatton, Rami Rhaiem, Valerio Celentano, Juan Carlos Puyana, Alessandro Ferrero, Luca Ansaloni, Bruno M. Pereira, Stefan Hofmeyr, Alain Chichom Mefire, Francesco Decembrino, Giuliana Amaddeo, Bertrand Le Roy, Réal Lapointe, Francesco Brunetti, Kazuhiro Hiramatsu, Walter L. Biffl, Ruslan Alikhanov, Oreste Romeo, Mario Testini, Iradj Sobhani, Luigi Zorcolo, Luca Portigliotti, Reza Kianmanesh, Mohammad Azfar, Andrea De Palma, Andrew W. Kirkpatrick, Ewen M Harrison, Federico Coccolini, Enrico Andolfi, Roland Andersson, Alain Luciani, Andrew B. Peitzman, Aleix Martínez-Pérez, Yoram Kluger, Gustavo Pereira Fraga, Juan Pekolj, Dieter G. Weber, Behnam Sanei, Carlos A. Ordoñez, Fausto Catena, Giorgio Bianchi, Angel Henriquez, Riccardo Memeo, Fabiano Perdigao, Francesco Marchegiani, David Fuks, Marc Antoine Allard, Mohammed Lamine Sissoko, Raul Coimbra, Patrick Pessaux, Paschalis Gavriilidis, Filippo Landi, Tullio Piardi, Sandro Rizoli, De'Angelis, N, Catena, F, Memeo, R, Coccolini, F, Martinez-Perez, A, Romeo, O, De Simone, B, Di Saverio, S, Brustia, R, Rhaiem, R, Piardi, T, Conticchio, M, Marchegiani, F, Beghdadi, N, Abu-Zidan, F, Alikhanov, R, Allard, M, Allievi, N, Amaddeo, G, Ansaloni, L, Andersson, R, Andolfi, E, Azfar, M, Bala, M, Benkabbou, A, Ben-Ishay, O, Bianchi, G, Biffl, W, Brunetti, F, Carra, M, Casanova, D, Celentano, V, Ceresoli, M, Chiara, O, Cimbanassi, S, Bini, R, Coimbra, R, Luigi de'Angelis, G, Decembrino, F, De Palma, A, de Reuver, P, Domingo, C, Cotsoglou, C, Ferrero, A, Fraga, G, Gaiani, F, Gheza, F, Gurrado, A, Harrison, E, Henriquez, A, Hofmeyr, S, Iadarola, R, Kashuk, J, Kianmanesh, R, Kirkpatrick, A, Kluger, Y, Landi, F, Langella, S, Lapointe, R, Le Roy, B, Luciani, A, Machado, F, Maggi, U, Maier, R, Mefire, A, Hiramatsu, K, Ordonez, C, Patrizi, F, Planells, M, Peitzman, A, Pekolj, J, Perdigao, F, Pereira, B, Pessaux, P, Pisano, M, Puyana, J, Rizoli, S, Portigliotti, L, Romito, R, Sakakushev, B, Sanei, B, Scatton, O, Serradilla-Martin, M, Schneck, A, Sissoko, M, Sobhani, I, ten Broek, R, Testini, M, Valinas, R, Veloudis, G, Vitali, G, Weber, D, Zorcolo, L, Giuliante, F, Gavriilidis, P, Fuks, D, Sommacale, D, de’Angelis, Nicola [0000-0002-1211-4916], Apollo - University of Cambridge Repository, and de'Angelis, Nicola [0000-0002-1211-4916]
Subjects: Laparoscopic surgery, medicine.medical_specialty, RD1-811, medicine.medical_treatment, Iatrogenic Disease, education, Psychological intervention, Review, 030230 surgery, Guideline, Guidelines, Sciences du Vivant [q-bio]/Médecine humaine et pathologie, behavioral disciplines and activities, Laparoscopic cholecystectomy, Biliary duct injury, Magnetic resonance imaging, Antibiotic therapy, Computed tomography, Intraoperative Period, 03 medical and health sciences, Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14], 0302 clinical medicine, Quality of life, medicine, Humans, Cholecystectomy, Stage (cooking), Laparoscopy, medicine.diagnostic_test, RC86-88.9, business.industry, Bile duct, Kirurgi, General surgery, Medical emergencies. Critical care. Intensive care. First aid, medicine.anatomical_structure, Quality of Life, Emergency Medicine, 030211 gastroenterology & hepatology, Surgery, Bile Ducts, business, Complication
Abstract: Bile duct injury (BDI) is a dangerous complication of cholecystectomy, with significant postoperative sequelae for the patient in terms of morbidity, mortality, and long-term quality of life. BDIs have an estimated incidence of 0.4–1.5%, but considering the number of cholecystectomies performed worldwide, mostly by laparoscopy, surgeons must be prepared to manage this surgical challenge. Most BDIs are recognized either during the procedure or in the immediate postoperative period. However, some BDIs may be discovered later during the postoperative period, and this may translate to delayed or inappropriate treatments. Providing a specific diagnosis and a precise description of the BDI will expedite the decision-making process and increase the chance of treatment success. Subsequently, the choice and timing of the appropriate reconstructive strategy have a critical role in long-term prognosis. Currently, a wide spectrum of multidisciplinary interventions with different degrees of invasiveness is indicated for BDI management. These World Society of Emergency Surgery (WSES) guidelines have been produced following an exhaustive review of the current literature and an international expert panel discussion with the aim of providing evidence-based recommendations to facilitate and standardize the detection and management of BDIs during cholecystectomy. In particular, the 2020 WSES guidelines cover the following key aspects: (1) strategies to minimize the risk of BDI during cholecystectomy; (2) BDI rates in general surgery units and review of surgical practice; (3) how to classify, stage, and report BDI once detected; (4) how to manage an intraoperatively detected BDI; (5) indications for antibiotic treatment; (6) indications for clinical, biochemical, and imaging investigations for suspected BDI; and (7) how to manage a postoperatively detected BDI. Supplementary Information The online version contains supplementary material available at 10.1186/s13017-021-00369-w.
Published: 2021

22. Laparoscopic right hepatectomy using the caudal approach is superior to open right hepatectomy with anterior approach and liver hanging maneuver: a comparison of short-term outcomes

Author: Olivier Scatton, François Cauchy, Ailton Sepulveda, Tomoaki Yoh, Bertrand Le Roy, Anne-Sophie Schneck, Takayuki Kawai, Safi Dokmak, Olivier Soubrane, Olivier Farges, and Claire Goumard
Subjects: Adult, Male, medicine.medical_specialty, Time Factors, medicine.medical_treatment, Operative Time, 030230 surgery, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Hepatectomy, Humans, Medicine, In patient, Propensity Score, Aged, Retrospective Studies, Aged, 80 and over, business.industry, Liver Neoplasms, Perioperative, Length of Stay, Middle Aged, Hepatology, Surgery, Liver, Propensity score matching, Female, Laparoscopy, 030211 gastroenterology & hepatology, Anterior approach, business, Complication, Follow-Up Studies, Abdominal surgery
Abstract: A standardized laparoscopic right hepatectomy (LRH) approach named the “caudal approach” was recently reported. Yet, the value of this approach compared with state-of-the-art open right hepatectomy (ORH) remains unknown. The purpose of this study was therefore to compare the short-term outcomes of LRH using the caudal approach and ORH with anterior approach and liver hanging maneuver. One-hundred eleven consecutive patients who underwent LRH with caudal approach were prospectively collected; 346 patients who underwent ORH with anterior approach and liver hanging maneuver were enrolled as a control group. Propensity score matching (PSM) of patients in a ratio of 1: 1 was conducted and the perioperative outcomes were compared. After PSM, two well-balanced groups of 72 patients each were analyzed and compared. The conversion rate in the LRH group was 18.1%. Perioperative blood loss and transfusion rates were significantly lower in the LRH group as compared to the ORH group (median, 200 ml vs. 500 ml, p
Published: 2019

23. LCR1 and LCR2, two multi‐analyte blood tests to assess liver cancer risk in patients without or with cirrhosis

Author: Thierry Poynard, Luminita Bonyhay, Vincent Thibault, Chantal Housset, Olivier Lucidarme, Françoise Imbert-Bismut, An Ngo, Dominique Thabut, Eric Savier, Daniel Eyraud, Laetitia Fartoux, Marika Rudler, F. Drane, Pascal Lebray, Yen Ngo, Mona Munteanu, Olivier Scatton, Olivier Deckmyn, Raluca Pais, Marc Antoine Valantin, Olivier Rosmorduc, Joseph Moussalli, Valentina Peta, Frédéric Charlotte, Vlad Ratziu, Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, Cirrhosis, [SDV.CAN]Life Sciences [q-bio]/Cancer, Chronic liver disease, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Blood test, Pharmacology (medical), 030212 general & internal medicine, Hepatology, medicine.diagnostic_test, Proportional hazards model, business.industry, Cancer, Retrospective cohort study, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, medicine.disease, 3. Good health, Lcr1 and Lcr2 Blood Tests for Hepatoma Screening, 030211 gastroenterology & hepatology, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Original Article, Liver cancer, business, Cohort study
Abstract: International audience; BACKGROUND: No blood test has been shown to be effective in the prediction of primary liver cancer in patients without cirrhosis.AIM: To construct and internally validate two sequential tests for early prediction of liver cancer. These tests enable an algorithm which could improve the performance of the standard surveillance protocol recommended (imaging with or without AFP), limited to patients with cirrhosis.METHODS: We performed a retrospective analysis in prospectively collected specimens from an ongoing cohort. We designed an early sensitive high-risk test (LCR1) that combined (using Cox model) hepatoprotective proteins (apolipoproteinA1, haptoglobin) with known risk factors (gender, age, gammaglutamyltranspeptidase), and a marker of fibrosis (alpha2-macroglobulin). To increase the specificity, we then combined (LCR2) these components with alpha-fetoprotein.RESULTS: A total of 9892 patients, 85.9% without cirrhosis, were followed up for 5.9 years [IQR: 4.3-9.4]. LCR1 and LCR2 time-dependent AUROCs were not different in construction and validation randomised subsets. Among 2027 patients with high-LCR1 then high-LCR2, 167 cancers (113 with cirrhosis, 54 without cirrhosis) were detected, that is 12 patients needed to screen one cancer. The negative predictive value was 99.5% (95% CI 99.0-99.7) in the 2026 not screened patients (11 cancers without cirrhosis) higher than the standard surveillance, which detected 113 cancers in 755 patients screened, that is seven patients needed to screen one cancer, but with a lower negative predictive value 98.0% (97.5-98.5; Z = 4.3; P < 0.001) in 3298 not screened patients (42 cancers without cirrhosis).CONCLUSIONS: In patients with chronic liver disease the LCR1 and LCR2 tests identify those with a high risk of liver cancer, including in those without cirrhosis. NCT01927133.
Published: 2018

24. Half of Postoperative Deaths After Hepatectomy may be Preventable

Author: Eric Vibert, Emmanuel Boleslawski, Olivier Scatton, Yves-Patrice Le Treut, Olivier Farges, Mustapha Adham, Jean-Marc Regimbeau, Laurent Christophe, Philippe Bachellier, Iman Khaoudy, Olivier Soubrane, and Jean Yves Mabrut
Subjects: Male, medicine.medical_specialty, medicine.medical_treatment, MEDLINE, 030230 surgery, Resection, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Internal medicine, medicine, Hepatectomy, Humans, Prospective cohort study, Aged, Retrospective Studies, business.industry, Retrospective cohort study, 030220 oncology & carcinogenesis, Population study, Female, Root Cause Analysis, Surgery, France, Root cause analysis, business, Cohort study
Abstract: To perform a retrospective root-cause analysis of the causes of postoperative mortality after hepatectomy.Mortality after liver resection has not decreased over the past decade.The study population was a prospective cohort of hepatectomies performed at hepatic, pancreatic, and biliary (HPB) centers between October 2012 and December 2014. Of the 1906 included patients, 90 (5%) died within 90 days of surgery. Perioperative data were retrieved from the original medical records. The root-cause analysis was performed independently by a senior HBP-surgeon and a surgical HBP-fellow. The objectives were to record the cause of death and then assess whether (1) the attending surgeon had identified the cause of death and what was it?, (2) the intra- and postoperative management had been appropriate, (3) the patient had been managed according to international guidelines, and (4) death was preventable. A typical root cause of death was defined.The cause of death was identified by the index surgeon and by the root-cause analysis in 84% and 88% of cases, respectively. Intra- and postoperative management procedures were inadequate in 33% and 23% of the cases, respectively. Guidelines were not followed in 57% of cases. Overall, 47% of the deaths were preventable. The typical root cause of death was insufficient evaluation of the tumor stage or tumor progression in a patient with malignant disease resulting in a more invasive procedure than expected.Measures to ensure compliance with guidelines and (in the event of unexpected operative findings) better within-team communication should be implemented systematically.
Published: 2018

25. Immune Profiling of Combined Hepatocellular- Cholangiocarcinoma Reveals Distinct Subtypes and Activation of Gene Signatures Predictive of Response to Immunotherapy

Author: Daniele Sommacale, Fouad Lafdil, Olivier Scatton, Hong Son Trinh, Thi Lan Tran, Christophe Tournigand, David Gentien, Isabelle Brocheriou, Van To Ta, Cong Trung Nguyen, Giuliana Amaddeo, Jean-Charles Nault, Luca Di Tommaso, Van Ky Le, Camille Boulagnon-Rombi, Stefano Caruso, Jessica Zucman-Rossi, Patrick Soussan, Manon Allaire, Jérémy Augustin, Hélène Regnault, Alain Luciani, Aurélie Beaufrère, Julien Calderaro, Valérie Paradis, Sébastien Mulé, Vincent Leroy, Frédéric Charlotte, Audrey Rapinat, Pascale Maillé, Anaïs Pujals, Raffaele Brustia, Alexis Laurent, Rami Rhaiem, Loëtitia Favre, and Jean-Michel Pawlotsky
Subjects: Adult, Male, Cancer Research, Carcinoma, Hepatocellular, medicine.medical_treatment, Antigen presentation, Inflammation, Malignancy, Subclass, Cholangiocarcinoma, Neoplasms, Multiple Primary, Immune system, medicine, Humans, Aged, Aged, 80 and over, Innate immune system, business.industry, Liver Neoplasms, Immunotherapy, Middle Aged, medicine.disease, Treatment Outcome, Oncology, Bile Duct Neoplasms, Cancer research, Immunohistochemistry, Female, medicine.symptom, business, Forecasting
Abstract: Purpose: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare malignancy associated with an overall poor prognosis. We aimed to investigate the immune profile of cHCC-CCA and determine its impact on disease outcome. Experimental Design: We performed a multicenter study of 96 patients with cHCC-CCA. Gene expression profile was analyzed using nCounter PanCancer IO 360 Panel. Densities of main immune cells subsets were quantified from digital slides of IHC stainings. Genetic alterations were investigated using targeted next-generation sequencing. Results: Two main immune subtypes of cHCC-CCA were identified by clustering analysis: an “immune-high” (IH) subtype (57% of the cases) and an “immune-low” (IL) subtype (43% of the cases). Tumors classified as IH showed overexpression of genes related to immune cells recruitment, adaptive and innate immunity, antigen presentation, cytotoxicity, immune suppression, and inflammation (P < 0.0001). IH cHCC-CCAs also displayed activation of gene signatures recently shown to be associated with response to immunotherapy in patients with HCC. Quantification of immunostainings confirmed that IH tumors were also characterized by higher densities of immune cells. Immune subtypes were not associated with any genetic alterations. Finally, multivariate analysis showed that the IH subtype was an independent predictor of improved overall survival. Conclusions: We have identified a subgroup of cHCC-CCA that displays features of an ongoing intratumor immune response, along with an activation of gene signatures predictive of response to immunotherapy in HCC. This tumor subclass is associated with an improved clinical outcome. These findings suggest that a subset of patients with cHCC-CCA may benefit from immunomodulating therapeutic approaches.
Published: 2021

26. Laparoscopic versus open liver resection for intrahepatic cholangiocarcinoma: Report of an international multicenter cohort study with propensity score matching

Author: Raffaele Brustia, Alexis Laurent, Claire Goumard, Serena Langella, Daniel Cherqui, Takayuki Kawai, Olivier Soubrane, Francois Cauchy, Olivier Farges, Benjamin Menahem, Christian Hobeika, Rami Rhaiem, Daniele Sommacale, Shinya Okumura, Stefan Hofmeyr, Alessandro Ferrero, François-René Pruvot, Jean-Marc Regimbeau, David Fuks, Eric Vibert, Olivier Scatton, Julio Abba, René Adam, Mustapha Adham, Marc-Antoine Allard, Ahmet Ayav, Daniel Azoulay, Philippe Bachellier, Pierre Balladur, Louise Barbier, Julien Barbieux, Emmanuel Boleslawski, Karim Boudjema, M. Bougard, Emmanuel Buc, Petru Bucur, Antoine Carmelo, Denis Chatelain, Jean Chauvat, Zineb Cherkaoui, Laurence Chiche, Mircea Chirica, Oriana Ciacio, Tatiana Codjia, Fabio Colli, Luciano De Carlis, Jean-Robert Delpero, Nicolas Demartines, Olivier Detry, Marcelo Dias Sanches, Momar Diouf, Alexandre Doussot, Christian Ducerf, Mehdi El Amrani, Jacques Ewald, Jean-Marc Fabre, Hervé Fagot, Simone Famularo, Léo Ferre, Francesco Fleres, Gilton Marques Fonseca, Brice Gayet, Alessandro Giacomoni, Jean-Francois Gigot, E. Girard, Nicolas Golse, Emilie Gregoire, Jean Hardwigsen, Paulo Herman, Thevi Hor, François Jehaes, Ali-Reza Kianmanesh, Shohei Komatsu, Sophie Laroche, Christophe Laurent, Yves-Patrice Le Treut, K. Lecolle, Philippe Leourier, Emilie Lermite, Mikael Lesurtel, Christian Letoublon, Paul Leyman, Jean Lubrano, Jean-Yves Mabrut, Georges Mantion, Ugo Marchese, Riccardo Memeo, Guillaume Millet, Kayvan Mohkam, André Mulliri, Fabrice Muscari, Francis Navarro, Francisco Nolasco, Takeo Nomi, Jean Nunoz, Gennaro Nuzzo, Nassima Oudafal, Gerard Pascal, Guillaume Passot, D. Patrice, Damiano Patrono, François Paye, Fabiano Perdigao, Patrick Pessaux, Niccolo Petrucciani, Gabriella Pittau, C. Ratajczak, Artigas Raventos, Lionel Rebibo, Vivian Resende, Michel Rivoire, Renato Romagnoli, Didier Roulin, Antonio Sa-Cunha, Ephrem Salame, Astrid Schielke, Lilian Schwarz, Michel Scotte, François-Regis Souche, Bertrand Suc, Michele Tedeschi, Alexandre Thobie, Boris Trechot, Stéphanie Truant, Olivier Turini, Shinji Uemoto, Xavier Unterteiner, Charles Vanbrugghe, and Jean Zemour
Subjects: medicine.medical_specialty, Cholangiocarcinoma, Cohort Studies, Postoperative Complications, Open Resection, medicine, Hepatectomy, Humans, Propensity Score, Intrahepatic Cholangiocarcinoma, Retrospective Studies, business.industry, Proportional hazards model, Hazard ratio, Perioperative, Confidence interval, Surgery, Bile Ducts, Intrahepatic, Treatment Outcome, Bile Duct Neoplasms, Liver, Propensity score matching, Laparoscopy, business, Cohort study
Abstract: Intrahepatic cholangiocarcinoma is a rare disease with a poor prognosis. In patients where surgical resection is possible, outcome is influenced by perioperative morbidity and lymph node status. Laparoscopic liver resection is associated with improved clinical and oncological outcomes in primary and metastatic liver cancer compared with open liver resection, but evidence on intrahepatic cholangiocarcinoma is still insufficient. The primary aim of this study was to compare overall survival for a large series of patients treated for intrahepatic cholangiocarcinoma by open or laparoscopic approach. Secondary objectives were to compare disease-free survival, predictors of death, and recurrence.Patients treated with laparoscopic or open liver resection for intrahepatic cholangiocarcinoma from 2000 to 2018 from 3 large international databases were analyzed retrospectively. Each patient in the laparoscopic resection group (case) was matched with 1 open resection control (1:1 ratio), through a propensity score calculated on clinically relevant preoperative covariates. Overall and disease-free survival were compared between the matched groups. Predictors of mortality and recurrence were analyzed with Cox regression, and the Textbook Outcomes were described.During the study period, 855 patients met the inclusion criteria (open liver resection = 709, 82.9%; laparoscopic liver resection = 146, 17.1%). Two groups of 89 patients each were analyzed after propensity score matching, with no significant difference regarding pre- and postoperative variables. Overall survival at 1, 3, and 5 years was 92%, 75%, and 63% in the laparoscopic liver resection group versus 92%, 58%, and 49% in the open liver resection group (P = .0043). Adjusted Cox regression revealed severe postoperative complications (hazard ratio: 10.5, 95% confidence interval [1.01-109] P = .049) and steatosis (hazard ratio: 13.8, 95% confidence interval [1.23-154] P = .033) as predictors of death, and transfusion (hazard ratio: 19.2, 95% confidence interval [4.04-91.4] P.001) and severe postoperative complications (hazard ratio: 4.07, 95% confidence interval [1.15-14.4] P = .030) as predictors of recurrence.The survival advantage of laparoscopic liver resection over open liver resection for intrahepatic cholangiocarcinoma is equivocal, given historical bias and missing data.
Published: 2021

27. Acquired diaphragmatic hernia after hepatectomy and liver transplantation in adults and children: A case series and literature review

Author: Olivier Scatton, Sophie Chopinet, Olivier Boillot, Antoinette Lasseur, Valentine Martin, Rémi Dubois, Emilie Gregoire, and Jérôme Dumortier
Subjects: Liver surgery, Surgical repair, Hernia, diaphragmatic, medicine.medical_specialty, Liver transplantation, business.industry, medicine.medical_treatment, Whole liver, medicine.disease, Asymptomatic, Surgery, Adults and children, medicine, Hepatectomy, General Materials Science, Diaphragmatic hernia, Original Article, medicine.symptom, Complication, business
Abstract: Backgrounds/Aims Acquired diaphragmatic hernia is a rare complication following liver surgery in adult and pediatric patients. This study aims to describe main features occurring in adult and pediatric patients after liver surgery and report an up-date review of the literature. Methods All adult and pediatric patients who were diagnosed with postoperative acquired diaphragmatic hernia in Lyon and Marseille University Hospitals were included in this study. Diagnosis, clinical, radiologic, and therapeutic data were analysed retrospectively from medical papers and/or electronic records. Results Thirteen adults with a median age of 50 years (range, 30–67 years) and 5 children aged 2.4 years (range, 0.9–4 years) were diagnosed with acquired diaphragmatic hernia after a median time of 65.1 (range, 1.8–244.7) and 2 (range, 0.33–10.9) months, respectively, following surgeries (5 live-donor right hepatectomies, 5 right and 1 left hepatectomies for tumors and cysts, and 2 whole liver transplantations in adults; and 5 liver transplantations with left lateral section in children). Eleven patients presented digestive and/or thoracic symptoms whereas seven were asymptomatic and diagnosed by routine imaging follow-up. All patients were re-operated with a median delay of 2.4 months (range, 0–25.3 months) for adults and 1 day (range, 0–2 days) for children. Two recurrences resulted in a secondary surgical repair. Conclusions Acquired diaphragmatic hernia is a rare and potentially serious event after liver surgery. Recognition and surgical repair of this particular complication should be considered in the setting of unexplained abdominal and/or thoracic symptoms. Preventive measures should be taken intraoperatively.
Published: 2021

28. Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area

Author: Olivier Seror, Daniele Sommacale, Alain Luciani, Nathalie Ganne-Carrié, Pierre Balladur, Violaine Ozenne, Manon Allaire, Ailton Sepulveda, François Cauchy, Clémence Hollande, Giuliana Amaddeo, Lorraine Blaise, Hélène Regnault, Marco Dioguardi Burgio, François Paye, Mohamed Bouattour, Chetana Lim, Pierre-Philippe Massault, Vincent Leroy, Anthony Dohan, Edouard Larrey, Stanislas Pol, Françoise Roudot-Thoraval, Raffaele Brustia, Sanaa El Mouhadi, Olivier Scatton, Marie Lequoy, Valérie Vilgrain, Jean-Charles Nault, CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: Cirrhosis, Hepatocellular carcinoma, medicine.medical_treatment, TACE, Trans-arterial-chemo-embolization, Liver transplantation, law.invention, MTB, multi-disciplinary tumour board, MELD, Model for End stage Liver Disease, 0302 clinical medicine, Model for End-Stage Liver Disease, Interquartile range, law, Immunology and Allergy, OR, Odd Ratio, AP-HP, Assistance Publique-Hôpitaux de Paris, BCLC, Barcelona Clinic Liver Cancer, Gastroenterology, ICU, intensive care unit, Intensive care unit, 3. Good health, Management, 030220 oncology & carcinogenesis, 2019-nCoV, 030211 gastroenterology & hepatology, medicine.medical_specialty, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, LT, liver transplantation, Article, AFP, Alpha-fetoprotein, 03 medical and health sciences, IR, interventional radiology, Internal medicine, Internal Medicine, medicine, lcsh:RC799-869, IQR, interquartile range, Intention-to-treat analysis, Hepatology, AFEF, Societé Francaise d’Hépatologie, business.industry, COVID-19, SIRT, Selective internal radiation therapy, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Odds ratio, medicine.disease, PCR-RT, PCR real time, aOR, adjusted OR, CI, Confidence Interval, digestive system diseases, ITT, intention to treat, LR, liver resection, CT, computerized-tomography, EASL, European Association of Study of Liver, lcsh:Diseases of the digestive system. Gastroenterology, HCC, hepatocellular carcinoma, business
Abstract: Background Patients affected by HCC represent a vulnerable population during the COVID-19 pandemic and may suffer from the unusual allocation of healthcare resources. The aim of this study was to determine the impact of the COVID-19 pandemic on the management of HCC patients within six French referral centers of the metropolitan area of Paris. Materials and methods We performed a multicenter, retrospective, cross-sectional study on the management of patients affected by HCC during the first six weeks of COVID-19 pandemic (exposed), compared to the same period in 2019 (unexposed). Were included all patients discussed in multidisciplinary tumor meeting (MTB) and/or undergoing radiological or surgical programmed procedure during the study period, in a curative or palliative intent. Endpoints were the number of patients with a modification in the treatment strategy, or a delay in decision-to-treatment. Results After screening, n=670 patients were included (n=293 Exposed to COVID, n=377 Unexposed to COVID). A decrease of the numbers of patients with HCC presented in MTB in 2020 (p=0.034) and with a first diagnosis of HCC (n=104 Exposed to COVID, n=143 Unexposed to COVID, p=0.083) was find. Modification in the treatment strategy was observed in 13.1% of patients, with no differences between the two periods. Nevertheless 21.5% versus 9.5% of patients experienced a treatment delay longer than 1 month in 2020 compared to 2019 (p, Graphical abstract, Highlights • In COVID period, a decrease of the numbers of patients with hepatocellular carcinoma presented in Multidisciplinary Tumour Board and, in particular, with a first diagnosis of HCC was find. • Globally, modification in the treatment strategy was observed in 13.1% of patients, with no differences between the two periods but the main reason was significantly different in 2020 compared to 2019: COVID-19 in 2020 vs tumour progression in 2019. • More than 21% of patients experienced a treatment delay longer than 1 month in COVID period compared to 9.5% in 2019 , specially, in subgroup with active, recurrent HCC. The main reasons for the delay of treatment in 2020 was COVID-19 infection related • In 2020, 7.1% of patients had a diagnosis of an active COVID-19 infection and 4/21 (19.1%) died., During COVID pandemic era, less patients with hepatocellular carcinoma (HCC) have been presented in multidisciplinary tumor bord, specially with a first diagnosis of HCC
Published: 2021

29. Impact of Sarcopenia on Clinical Outcomes of Patients Undergoing Simultaneous Liver and Kidney Transplantation: A Cohort Study

Author: R. Brustia, Jérôme Tourret, Nassera Ouali, Benoit Barrou, Muhammad Atif, Filomena Conti, A. Mazzola, Olivier Scatton, Bianca Magro, Sorbonne Université (SU), Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Urgences néphrologiques et transplantation rénale [CHU Tenon], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Tenon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Infection, Anti-microbiens, Modélisation, Evolution (IAME (UMR_S_1137 / U1137)), Université Paris 13 (UP13)-Université Paris Diderot - Paris 7 (UPD7)-Université Sorbonne Paris Cité (USPC)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Urologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Université Pierre et Marie Curie - Paris 6 (UPMC), Sorbonne Université - Faculté de Médecine (SU FM), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and Oncovet
Subjects: Male, Sarcopenia, medicine.medical_specialty, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Liver transplantation, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, Internal medicine, medicine, Humans, Kidney transplantation, Dialysis, Hepatology, business.industry, Gastroenterology, Postoperative complication, Middle Aged, medicine.disease, Kidney Transplantation, Liver Transplantation, Transplantation, Treatment Outcome, 030220 oncology & carcinogenesis, Cohort, Female, 030211 gastroenterology & hepatology, business, Cohort study
Abstract: International audience; Background: The impact of sarcopenia in patients undergoing simultaneous liver and kidney transplantation (SLKT) has not been fully delineated. The aim of this single-centre-cohort-study was to evaluate the impact of sarcopenia on the clinical outcomes. Methods: Between 2003 and 2018, 79 patients underwent SLKT. Sarcopenia was assessed via the total psoas muscle area (TPA) at the level of the 3rd. lumbar vertebra. Sarcopenia threshold was TPA < 1460 mm2 (women) and
Published: 2021

30. International study on the outcome of locoregional therapy for liver transplant in hepatocellular carcinoma beyond Milan criteria

Author: Helena Degroote, Federico Piñero, Charlotte Costentin, Andrea Notarpaolo, Ilka F. Boin, Karim Boudjema, Cinzia Baccaro, Aline Lopes Chagas, Philippe Bachellier, Giuseppe Maria Ettorre, Jaime Poniachik, Fabrice Muscari, Fabrio Di Benedetto, Sergio Hoyos Duque, Ephrem Salame, Umberto Cillo, Adrián Gadano, Claire Vanlemmens, Stefano Fagiuoli, Fernando Rubinstein, Patrizia Burra, Daniel Cherqui, Marcelo Silva, Hans Van Vlierberghe, Christophe Duvoux, Filomena Conti, Olivier Scatton, Pierre Henri Bernard, Claire Francoz, Francois Durand, Sébastien Dharancy, Marie-lorraine Woehl, Alexis Laurent, Sylvie Radenne, Jérôme Dumortier, Armand Abergel, Louise Barbier, Pauline Houssel-Debry, Georges Philippe Pageaux, Laurence Chiche, Victor Deledinghen, Jean Hardwigsen, J. Gugenheim, M. Altieri, Marie Noelle Hilleret, Thomas Decaens, Aline Chagas, Paulo Costa, Elaine Cristina de Ataide, Emilio Quiñones, Sebastián Marciano, Margarita Anders, Adriana Varón, Alina Zerega, Alejandro Soza, Martín Padilla Machaca, Diego Arufe, Josemaría Menéndez, Rodrigo Zapata, Mario Vilatoba, Linda Muñoz, Ricardo Chong Menéndez, Martín Maraschio, Luis G. Podestá, M. Fauda, A. Gonzalez Campaña, Lucas McCormack, Juan Mattera, Adrian Gadano, Ilka S.F. Fatima Boin, Jose Huygens Parente García, Flair Carrilho, Giulia Magini, Lucia Miglioresi, Martina Gambato, Fabrizio Di Benedetto, Cecilia D’Ambrosio, Alessandro Vitale, Michele Colledan, Domenico Pinelli, Paolo Magistri, Giovanni Vennarecci, Marco Colasanti, Valerio Giannelli, Adriano Pellicelli, Cizia Baccaro, Callebout Eduard, Iesari Samuele, Dekervel Jeroen, Schreiber Jonas, Pirenne Jacques, Verslype Chris, Ysebaert Dirk, Michielsen Peter, Lucidi Valerio, Moreno Christophe, Detry Olivier, Delwaide Jean, Troisi Roberto, Lerut Jan Paul, Ghent University Hospital, Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) (IAB), Centre Hospitalier Universitaire [Grenoble] (CHU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Etablissement français du sang - Auvergne-Rhône-Alpes (EFS)-Centre National de la Recherche Scientifique (CNRS)-Université Grenoble Alpes (UGA), Centre Hospitalier Universitaire [Grenoble] (CHU), Arcispedale S Maria Nuova, University of Campinas [Campinas] (UNICAMP), CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES), CHU Strasbourg, Hôpital de Rangueil, CHU Toulouse [Toulouse], Universidad de Antioquia = University of Antioquia [Medellín, Colombia], CHU Trousseau [Tours], Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon), Hospital Papa Giovanni XXIII (Hosp P Giovanni XXIII), Service d'hépato-gastro-entérologie [APHP Henri Mondor], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Degroote, H, Piñero, F, Costentin, C, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Chagas, A, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Di Benedetto, F, Duque, S, Salame, E, Cillo, U, Gadano, A, Vanlemmens, C, Fagiuoli, S, Rubinstein, F, Burra, P, Cherqui, D, Silva, M, Van Vlierberghe, H, Duvoux, C, Universidade Estadual de Campinas = University of Campinas (UNICAMP), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Cellules Souches, Plasticité Cellulaire, Médecine Régénératrice et Immunothérapies (IRMB), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM), Université de Rennes (UR), and Centre Hospitalier Universitaire de Toulouse (CHU Toulouse)
Subjects: RFA, LRT, Hepatocellular carcinoma, ITT, University of California San Francisco downstaging, medicine.medical_treatment, RC799-869, Liver transplantation, Gastroenterology, United Network for Organ Sharing, SHR, hazard ratio, 0302 clinical medicine, HR, UCSF-DS, HCC, 10. No inequality, All-comer, Milan criteria, AC, all-comers, Hazard ratio, intention to treat, Diseases of the digestive system. Gastroenterology, 3. Good health, MVI, MVI, microvascular invasion, 030220 oncology & carcinogenesis, liver resection, 030211 gastroenterology & hepatology, radiofrequency ablation, Cohort study, UNOS, medicine.medical_specialty, education, AFP, LT, liver transplantation, 03 medical and health sciences, alpha-foetoprotein, Downstaging, UNOS, United Network for Organ Sharing, TACE, medicine.disease, HR, hazard ratio, UCSF downstaging protocol, AC, ITT, intention to treat, PEI, Clinical trial, DS, downstaging, SHR, subdistribution hazard ratio, locoregional therapies, percutaneous ethanol ablation, AFP, alpha-foetoprotein, EASL, European Association for the Study of the Liver, [SDV]Life Sciences [q-bio], microvascular invasion, LR, LT, Medicine and Health Sciences, UCSF-DS, University of California San Francisco downstaging, Immunology and Allergy, MC, DS, PEI, percutaneous ethanol ablation, all-comers, liver transplantation, waiting list, COMPETING RISKS, CANCER, Research Article, European Association for the Study of the Liver, ALPHA-FETOPROTEIN, MC, Milan criteria, WL, waiting list, EASL, VALIDATION, Internal medicine, Internal Medicine, medicine, subdistribution hazard ratio, WL, LRT, locoregional therapies, RFA, radiofrequency ablation, transarterial chemoembolisation, Intention-to-treat analysis, Hepatology, business.industry, TACE, transarterial chemoembolisation, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, All-comers, Alpha-foetoprotein, HCC, hepatocellular carcinoma, LR, liver resection, MODEL, Transplantation, business
Abstract: Background & Aims Good outcomes after liver transplantation (LT) have been reported after successfully downstaging to Milan criteria in more advanced hepatocellular carcinoma (HCC). We aimed to compare post-LT outcomes in patients receiving locoregional therapies (LRT) before LT according to Milan criteria and University of California San Francisco downstaging (UCSF-DS) protocol and ‘all-comers’. Methods This multicentre cohort study included patients who received any LRT before LT from Europe and Latin America (2000–2018). We excluded patients with alpha-foetoprotein (AFP) above 1,000 ng/ml. Competing risk regression analysis for HCC recurrence was conducted, estimating subdistribution hazard ratios (SHRs) and corresponding 95% CIs. Results From 2,441 LT patients, 70.1% received LRT before LT (n = 1,711). Of these, 80.6% were within Milan, 12.0% within UCSF-DS, and 7.4% all-comers. Successful downstaging was achieved in 45.2% (CI 34.8–55.8) and 38.2% (CI 25.4–52.3) of the UCSF-DS group and all-comers, respectively. The risk of recurrence was higher for all-comers (SHR 6.01 [p, Graphical abstract, Highlights • Successful downstaging from UCSF criteria resulted in a similar outcome compared with the group initially within Milan criteria. • Patients within UCSF-DS criteria and with AFP values below or equal to 20 ng/ml at listing have excellent survival and recurrence rates. • All-comers have a higher recurrence after downstaging to Milan criteria, with frequent microvascular invasion in the explant.
Published: 2021

31. Liver transplant from controlled donation after circulatory death donors with normothermic regional perfusion versus donation after drain death donors

Author: Chetana Lim, Olivier Scatton, Eric Savier, Gestionnaire, Hal Sorbonne Université, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Pathologies biliaires, fibrose et cancer du foie [CRSA], Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Pathologies biliaires, fibrose et cancer du foie [CHU Saint-Antoine], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP]
Subjects: Brain Death, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, Regional perfusion, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030230 surgery, Liver transplantation, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Transplantation, Hepatology, business.industry, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Circulatory death, Tissue Donors, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Donation after brain death, Liver Transplantation, Perfusion, Donation, Anesthesia, 030211 gastroenterology & hepatology, Surgery, business
Abstract: International audience; We read with great interest the recent article of Ruiz et al.(1) and would like to congratulate the authors. Also, we would like to make some important comments. Ruiz et al. reported the outcomes of liver transplantation (LT) from controlled donation after circulatory death (cDCD) donors with normothermic regional perfusion (NRP) (from 2015 to 2019, 100 patient) versus donation after brain death (DBD) donors (from 2015 to 2019, 200 patients).
Published: 2021

32. Novel Composite Endpoint for Assessing Outcomes in Liver Transplantation: Arterial and Biliary Complication–Free Survival

Author: Joan Fabregat, Josefina Lopez-Dominguez, Olivier Scatton, Emilio Ramos, Alba Cachero, Pierre Rufat, Daniel Azoulay, Claire Goumard, Fabiano Perdigao, Yann De Rycke, Chetana Lim, Eric Savier, Laura Lladó, Geraldine Rousseau, Chady Salloum, Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Centre de Pharmacoépidémiologie de l'AP-HP (Cephepi), Service de Département de santé publique, Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], Service de Département d'Information Médicale [CHU Pitié-Salpêtrière] (DIM), Hôpital Paul Brousse, Institut d'Investigació Biomèdica de Bellvitge [Barcelone] (IDIBELL), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service de Département de santé publique [CHU Pitié-Salpêtrière], and HAL-SU, Gestionnaire
Subjects: medicine.medical_specialty, Multivariate analysis, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, medicine.medical_treatment, Biliary complication, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030230 surgery, Liver transplantation, Gastroenterology, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Medicine, Humans, Proportional Hazards Models, Retrospective Studies, Transplantation, Hepatology, business.industry, Hazard ratio, Graft Survival, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Circulatory death, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, 3. Good health, Liver Transplantation, Clinical trial, [SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie, Cohort, 030211 gastroenterology & hepatology, Surgery, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Complication, business
Abstract: International audience; Transplant and patient survival are the validated endpoints to assess the success of liver transplantation (LT). This study evaluates arterial and biliary complication-free survival (ABCFS) as a new metric. ABC, considered as an event, was an arterial or biliary complication of Dindo-Clavien grade ≥III complication dated at the interventional, endoscopic, or surgical treatment required to correct it. ABCFS was defined as the time from the date of LT to the dates of first ABC, death, relisting, or last follow-up (transplant survival is time from LT to repeat LT or death). Following primary whole LT (n = 532), 106 ABCs occurred and 99 (93%) occurred during the first year after LT. An ABC occurring during the first year after LT (overall rate 19%) was an independent factor associated with transplant survival (hazard ratio [HR], 3.17; P < 0.001) and patient survival (HR, 2.7; P = 0.002) in univariate and multivariate analyses. This result was confirmed after extension of the cohort to splitliver graft, donation after circulatory death, or re-LT (n = 658). Data from 2 external cohorts of primary whole LTs (n = 249 and 229, respectively) confirmed that the first-year ABC was an independent prognostic factor for transplant survival but not for patient survival. ABCFS was correlated with transplant and patient survival (ρ = 0.85 [95% CI, 0.78-0.90] and 0.81 [95% CI, 0.71-0.88], respectively). Preoperative factors known to influence 5-year transplant survival influenced ABCFS after 1 year of follow-up. The 1-year ABCFS was indicative of 5-year transplant survival. ABCFS is a reproducible metric to evaluate the results of LT after 1 year of follow-up and could serve as a new endpoint in clinical trials.
Published: 2021

33. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

Author: Dmitri, Nepogodiev, Joana Ff Simoes, Elizabeth, Li, Maria, Picciochi, James, C Glasbey, Glauco, Baiocchi, Ruth, Blanco-Colino, Daoud, Chaudhry, Ehab, Alameer, Kariem, El-Boghdadly, Funmilola, Wuraola, Dhruva, Ghosh, Rohan, R Gujjuri, Ewen, M Harrison, Herman, Lule, Haytham, Kaafarani, Mohammad, Khosravi, Irmgard, Kronberger, Sezai, Leventoğlu, Harvinder, Mann, Kenneth, A Mclean, Mengistu Gebreyohanes Mengesha, Maria Marta Modolo, Faustin, Ntirenganya, Lisa, Norman, Oumaima, Outani, Riinu, Pius, Peter, Pockney, Ahmad Uzair Qureshi, April Camilla Roslani, Sohei, Satoi, Catherine, Shaw, Aneel, Bhangu, Omar, M Omar, Waheed-Ul-Rahman, Ahmed, Leah, Argus, Alasdair, Ball, Edward, P Bywater, Amanpreet, Brar, Brett, E Dawson, Irani, Duran, Muhammed, Elhadi, Conor, S Jones, Sivesh, K Kamarajah, James, M Keatley, Samuel, Lawday, Ella, J Marson, Riinu, Ots, Irène, Santos, Elliott, H Taylor, Isobel, M Trout, Chris, Varghese, Mary, L Venn, William, Xu, Irida, Dajti, Arben, Gjata, Salah Eddine Oussama Kacimi, Luis, Boccalatte, Daniel, Cox, Philip, Townend, Felix, Aigner, Irmgard Elisabeth Kronberger, Elgun, Samadov, Amer, Alderazi, Kamral, Hossain, Greg, Padmore, Gabrielle van Ramshorst, Ismaïl, Lawani, Anis, Cerovac, Samir, Delibegovic, Gustavo Mendonça Ataíde Gomes, Igor Lima Buarque, Muhammad, Gohar, Mihail, Slavchev, Chukwuemeka, Nwegbu, Arnav, Agarwal, Janet, Martin, Joshua, Ng-Kamstra, Maricarmen, Olivos, Wenhui, Lou, Dong-Lin, Ren, Jose Andres Calvache, Carlos, J Perez Rivera, Ana Danic Hadzibegovic, Tomislav, Kopjar, Jakov, Mihanovic, Pablo Mijahil Avilés Jiménez, Nikolaos, Gouvas, Jaroslav, Klat, René, Novysedlák, Nicolas, Amisi, Peter, Christensen, Alaa, El-Hussuna, Sylvia, Batista, Eddy, Lincango-Naranjo, Sameh, Emile, Danilo Alfonso Arévalo Sandoval, Hailu, Dhufera, Samuel, Hailu, Mengistu, G Mengesha, Joonas, H Kauppila, Alexis, P Arnaud, Zaza, Demetrashvili, Markus, Albertsmeier, Hans, Lederhuber, Markus, W Löffler, Daniel Kwesi Acquah, Bernard, Ofori, Stephen, Tabiri, Symeon, Metallidis, Georgios, Tsoulfas, Maria-Lorena, Aguilera-Arevalo, Gustavo, Recinos, Tamás, Mersich, Dániel, Wettstein, Gabriele, Kembuan, Peiman Brouki Milan, Mohammad Hossein Khosravi, Masoud, Mozafari, Ahmed, Hilmi, Helen, Mohan, Oded, Zmora, Gaetano, Gallo, Francesco, Pata, Gianluca, Pellino, Yuki, Fujimoto, Naoto, Kuroda, Mohamad, K Abou Chaar, Faris, Ayasra, Ildar, Fakhradiyev, Intisar Hisham Said Hamdun, Jang, Jin-Young, Mohammad, Jamal, Lina, Karout, Aiste, Gulla, Fanjandrainy, Rasoaherinomenjanahary, Luc Hervé Samison, Iran Irani Durán Sánchez, Diana Samantha Gonzalez, Laura, Martinez, María José Martínez, Alejandra, Nayen, Antonio Ramos-De la Medina, Jade, Nunez, Pueya Rashid Nashidengo, Rakesh, Shah, Ashish Lal Shrestha, Pascal, Jonker, Schelto, Kruijff, Milou, Noltes, Pieter, Steinkamp, Deborah, Wright, Lukman, Abdur-Rahman, Adesoji, Ademuyiwa, Adewale, Adisa, Babatunde, Osinaike, Justina, Seyi-Olajide, Omolara, Williams, Emmanuel, Williams, Sofija, Pejkova, Zainab Al Balushi, Raza, Sayyed, Mustafa Abo Mohsen, Sadi, A Abukhalaf, Moises, Cukier, Hugo, Gomez-Fernandez, Sebastian Shu Yip, Ximena Paola Vasquez Ojeda, Marie Dione Sacdalan, Piotr, Major, José, Azevedo, Miguel, F Cunha, Ahmad, Zarour, Eduard-Alexandru, Bonci, Ionut, Negoi, Sergey, Efetov, Viktor, Kochetkov, Andrey, Litvin, Jc Allen Ingabire, Georges, Bucyibaruta, Ntirenganya, Faustin, Sosthene, Habumuremyi, Alphonsine, Imanishimwe, Haragirimana Jean de Dieu, Emmanuel, Munyaneza, Isaie, Ncogoza, Abdourahmane, Ndong, Dejan, Radenkovic, Min Hoe Chew, Frederick, Koh, James, Ngu, Arpád, Panyko, Uros, Bele, Jurij Aleš Košir, Hassan, Daoud, Ana Maria Minaya Bravo, Umesh, Jayarajah, Dakshitha, Wickramasinghe, Mohammed Elmujtba Adam Essa Adam, Martin, Rutegård, Malin, Sund, Michel, Adamina, Eleftherios, Gialamas, Karoline, Horisberger, Muhammad, Alshaar, Abel, Huang, Varut, Lohsiriwat, Shane, Charles, Haithem, Jlassi, Arda, Isik, Hervé Monka Lekuya, Slava, Kopetskyi, Hayder, Alsaadi, Sattar, Alshryda, Osaid, Alser, Brittany, Bankhead-Kendall, Kerry, Breen, Hassan, Mashbari, Fernando Bonilla Cal, Hamza, Al-Naggar, Mayaba, Maimbo, Dennis, Mazingi, Tom, Abbott, Melika, Akhbari, Ruth, Benson, Shivam, Bhanderi, Bruce, Biccard, Edward, Caruana, Sohini, Chakrabortee, Reema, Chapatwala, Ainhoa, Costas-Chavarri, Andreas, K Demetriades, Anant, Desai, Salomone Di Saverio, Thomas, Drake, John, Edwards, Jonathan, Evans, Marco, Fiore, Samuel, Ford, Christina, Fotopoulou, Alexander, Fowler, Kaori, Futaba, Ian, Ganly, Harelimana Grace James, Ewen, Griffiths, Alessandro, Gronchi, Peter, Hutchinson, Gabriella Yael Hyman, Joseph, Incorvia, Ritu, Jain, Michael, Jenkinson, Tabassum, Khan, Stephen Richard Knight, Angelos, Kolias, Søren, Kudsk-Iversen, Tsun Yu Kwan, Elaine, Leung, Julio, Mayol, Siobhan, Mckay, John, G Meara, Emily, Mills, Susan, Moug, Akshay, Patel, Roberto, Perinotti, Henry, E Rice, Keith, Roberts, Andrew, Schache, Richard, Shaw, Neil, Smart, Matthew, Stephens, Grant, D Stewart, Ella, Teasdale, Peter, Vaughan-Shaw, Raghavan, Vidya, Naomi, Wright, Natalie, Zimmelman, Ervis, Agastra, Dariel, Thereska, Sergio Martin Lucchini, Veronica, Laudani, Carina, Chwat, Ivana Ines Pedraza Salazar, Diana Alejandra Pantoja Pachajoa, Agustin, Duro, José Alfredo Calderón Arancibia, Giuliana, D'Aulerio, Nagendra, Dudi-Venkata, Natasha, Egoroff, Shebani, Farik, Natalie, Lott, Jana-Lee, Moss, Sarah, Rennie, Lorwai, Tan, Uyen Giao Vo, David, Watson, David, Watters, Tim, Bright, Paul, Hollington, Xuanyu, Zhou, Hidde, M Kroon, Anthony, Farfus, John, Barker, Eleanor, Watson, Sean, Stevens, Haider, Latif, Amanda Caroline Dawson, Alwin, Chuan, Vijayaragavan, Muralidharan, Enoch, Wong, Travis, Ackermann, Maurizio, Pacilli, Russell, Hodgson, Alexander, Heriot, Peter, Choong, Wendy, Brown, Surjit, Lidder, Justin, Yeung, Luke, Traeger, Guillermo, Regalo, Ralph, Gourlay, Sarit, Badiani, Cherry, Koh, Soni, Putnis, Fayza, Haider, Ashrarur Rahman Mitul, Niels, Komen, Bert, Dhondt, Serge, Cappeliez, Manon, Pigeolet, Martijn, Schoneveld, Jasper, Stijns, Wouter, Oosterlinck, Nicolas, Flamey, Cyrille, Kpangon, Mouhamed, Agbadebo, Sèmèvo Romaric Tobome, Aldo Vieira Barros, Samuel Aguiar Júnior, Heloisa Galvão do Amaral Campos, Jefferson, Gross, Felipe José Fernandez Coimbra, Luiz Paulo Kowalski, Fabiana, Makdissi, Suely, Nakagawa, Joao Pedreira Duprat Neto, Jose Guilherme Vartanian, Guilherme, Yazbek, Stenio, C Zequi, Ronald, Flumignan, Natalia, Jaworska, Angela, Dell, Harsha, Shanthanna, Abdollah, Behzadi, Carolyn, Nessim, Michelle, Mozel, Pascal, St-Germain, Crispin, Russell, Gary, Groot, Najib, Safieddine, Duminda, Wijeysundera, Antoine, Eskander, Sami, Chadi, Shawn, Mackenzie, Alana, Flexman, Fernando, Heredia, Julio, Villanueva, Sofia, Waissbluth, Roberto, Macchiavello, Mario, I Escudero, Tyare, Fuentes, Ximena, Mimica, Dinimo Bolivar Saenz, Lina, Caicedo, Juan Pablo Alzate, Joaquin, Luna, Nestor Fabian Pedraza Alonso, Camilo Ortiz Silva, Juliana, Rodriguez, Liliana, Silva-Igua, Martha Luz Torres, Lina María Trujillo, Albaro José Nieto Calvache, Julián, Balanta-Melo, Rafael, Figueroa-Casanova, Oscar-Julián, García-Montoya, Carlos Andres Marulanda Toro, Marcela Velez Botero, Maria Clara Mendoza Arango, Eneida Diaz Martinez, Valentina Gutiérrez Perdomo, Emileth, Montenegro, Julia, Rodriguez-Abreu, Dolores, Mejía, Galal, Abouelnagah, Sameh, Shehata, Ahmed Hossam Eldin Fouad Rida, Ramy, A Hassan, Mahmoud, M Saad, Mohamed Reda Loaloa, Badr, Mostafa, Mohamed, Qassem, Mohamed, Fahmy, Hesham, Abozied, Ahmed, Y Azzam, Sherief, Ghozy, Asser, Sallam, Ahmed, Shehta, Mohamed, Abdelkhalek, Rehab, Samaka, Amr, Morsy, Ahmed Elshawadfy Sherif, Abraham, Negussie, Tigist, Fisseha, Kibruyisfaw, Shumbash, Metasebia, Abebe, Seid Mohammed Yasin, Yemisirach Bizuneh Akililu, Abebe, Megersa, Teshome, Tefera, Melatework, Assefa, Bahru, Atnafu, Bereket, Tsegaye, Yoseph Solomon Bezabih, Silamlak, Sisay, Kebebe, Bekele, Moa, Jira, Habtamu, Derilo, Eyueal, 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Mohammed Shadrul Alam, Akm Khairul Basher, Shahnoor, Islam, M Nazmul Islam, S, Sabbir, Karim, Muntasir, Faisel, Sadia, Khan, Iftekhar Ibne Mannan, Nawshin, Nazia, Malissa, Bentham, Sasha, Corbin, Alex, Doyle, Asha, Eastmond, Amelia, Haynes, Margaret, O'Shea, Emil, Phillips, Keisha, Walkes, Evgeniy, L Artyushkov, Mark, L Kaplan, Vladislav, Straltsov, Yauheniya, Litvina, Alexei, Lyzikov, Victor, E Tihmanovich, Mafalda, Borges, Tim, Brits, Nicolas De Hous, Stefan De Wachter, Tomas, Menovsky, Xavier, Mortiers, Dorien, Vermeulen, Nils, Vleminckx, Dirk, Ysebaert, Julie, Bontinck, Danny, Bulthé, Ricky, Rasschaert, Anne-Sophie Van Haver, Koen Van Belle, Laurence, Verstraeten, Manon, Vounckx, Sébastien, D'Ulisse, Yasmine De Bruyne, Badih El Nakadi, Tessely, Heloise, Matteo, Luisetto, Sotirios, Marinakis, Maxime, Maton, Claire, Viste, Elke Van Daele, Mathieu, Vandeputte, Marc, Duinslaeger, Daniel, Jacobs-Tulleneers-Thevissen, Yanina, Jansen, Ward, Janssens, Rastislav, Kunda, Nouredin, Messaoudi, Michael, Ruyssers, Ellen Van Eetvelde, Marian, Vanhoeij, Jef Van den Eynde, Raf Van den Eynde, Ahmed, M Chaoui, Marcellin, Akpla, Souliath, Lawani, Hermann, Agossou, Hulrich Aouagbe Behanzin, Covalic, Bokossa, Hubert, Dewanon, Hugues, Yome, Alassan, Boukari, Oswald, Gbehade, Labissi Francois Amossou, Francis, Dossou, Tatjana, Barišić, Miran, Boras, Zdrinko, Brekalo, Ivana Čuljak Blagojević, Ana, Damjanović, Vedran, Dragisic, Ana Dugandžić Šimić, Filip, Gunaric, Martin, Kajic, Darko, Knežević, Tanja, Krešić, Valentina, Lasić, Ludvig, Letica, Vlatka, Martinovic, Iva, Mikulic, Josip, Miskovic, Hrvoje, Pehar, Pejana, Rastović, Irena, Sesar, Violeta, Šetka-Čuljak, Martina, Soljic, Dejan, Tiric, Vajdana, Tomić, Anja, Vasilj, Igor, Hudic, Renato Aguera Oliver, Felipe Azenha Lamonica, Jorge De Medeiros, Henrique Donizetti Bianchi Florindo, Rodolfo Jose Favaretto Filho, Fernanda Costa Pereira, Rodrigo, Rodrigues, Antonio Antunes Rodrigues Junior, Fernanda Ruiz de Andrade, Maisa, Salvetti, 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Juliana Sanchez, David Mauricio Solano Varela, Paula Torres Gomez, Marcial, Trillos, Ana María Vargas Patiño, Felipe, Vargas-Barato, Juan Pablo Villate Leon, María Alejandra Wagner Useche, Jesus, Acosta, Adriana, Almeciga, Luis Becerra Mendez, Rafael Jose Beltran, Ana, Bonilla, Miguel, Buitrago, Marino, Cabrera, Pedro Hernando Calderon Quiroz, Diego, Camacho-Nieto, Carlos Andrés Carvajal Fierro, Sergio Cervera Bonilla, Sandra, Diaz, Helena, Facundo, Jorge, Forero, Mauricio Garcia Mora, Karena Victoria Garcia Tirado, German Fabian Godoy Perez, Felipe, Gonzalez, Oscar, Guevara, Jairo Alonso Hernandez, David Ricardo Herrera Mora, Juan David Lalinde, Carlos, Lehmann, Eduardo Leon Llanos, Byron Eduardo Lopez De Mesa Lopez, Ivan, Mariño, Monica, Medina, Raúl Eduardo Pinilla Morales, Angela, Puerto, Andrea, Quintero-Ortíz, Juliana Rendón Hernández, Elio Fabio Sánchez Cortés, Alvaro Eduardo Sánchez Hernández, Raul, Suarez, Oscar, Suescun, Marco, Vanegas, Rodolfo, Varela, Jorge Luis Velez 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Alvarez, Cesar David Galindo Regino, Angela Maria Giraldo Velasquez, Carlos Enrique Melo Moreno, Jorman, H Tejada, Jesus Hernan Tovar, German Alirio Tovar, Edison Alexander Benavides Hernández, Claudia Milena Orozco-Chamorro, Gustavo Adolfo Angel, Christian Ali Buesaquillo, Victor David Olave Montaño, Andrés, Sánchez-Gómez, Daniela Patricia Escalante Ureche, Jairo Martinez Garrido, Eben-Ezer, Genda, Fabrice, Eboma, Kristina, Bitunjac, Karlo, Grulović, Marijana, Vučković, Goran, Šantak, Emanuel, Borovic, Ana Bosak Versic, Damir, Hasandić, Natasa Poldan Grabar, Suzana Srsen Medancic, Lucija, Brkic, Sara, Cokarić, Petra Pavic Palac, Zeljka, Samac, Josipa, Tomić, Marija, Vrdoljak, Ivan, Bacic, Bernarda, Bakmaz, Nikolina Bratošević Vučičić, Domagoj, Brzic, Samir, Canovic, Emilio, Dijan, Maja Grgec Dragicevic, Robert, Karlo, Suzana, Konjevoda, Petra, Kovačević, Ivan, Kovačić, Frane, Markulić, Luka, Matak, Domagoj, Morović, Gordan, Perišić, Andrea, Simic, Neven, Skitarelić, Matea, Veršić, 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Baelum, Mark Bremholm Ellebaek, Signe Bremholm Ellebaek, Anders, Hogh, Maria, Acosta, Yancy, Acosta, Pedro, Baez, Luis Alfredo Betances, Luis Rodolfo Bonilla, Daniel, Cabreja, Wilton Cabrera Cruz, María Mabel Collado Expósito, Aldo, Crespo, Octavio, Cruz-Pineda, Claudio Samuel D'óleo García, Pedro, Díaz, Remberto, Escoto, Jatnna, Figueroa, Luis, Garcia, U Garcia-Dubus Rodriguez, Humberto, Gomez, Adrian, Grullon, Fatherin, Guerrero, Lillian, Guzman, Thelma Rocío Jiménez Mosquea, Engels, Lazala, Ariela, Lopez, Leeany Maletta Francisco, Jhomayri, Mercado, Herisardy, Munoz, Jeffrey, Paulino, Maricely Ambar Perez Fernandez, Rudeily, Reyes, Lilia Rosa Reyes Guilamo, Ruben, Rivas, Claudia Alejandra Rivas Torres, Ada, Rodríguez, Madelin Tamar Rosario Villa, Eleazar, Santana, Joel, Soto, Nassin, Tactuk, Cristina Kristel Tonos Sardiñas, Raul, Ubinas, Jose, Victoria, Aaron, Villegas, Ricardo, Acra-Tolari, Larissa, Beltran, Luis Fernand Betances, Alejandro, Blaubach, Denisse Idalia Campos Mejía, Nathalia, Capellan, María Fernanda Cedeño Bruzual, Saray Cordero Spencer, Gabriella Cuevas Lantigua, Luis De Jesus, Gabriela, Díaz, Pedro Pablo Díaz Vásquez, Karla, Disla, Jesús Antonio Echavarría Uceta, Paola Irina Eusebio Jimenez, Damaris, Fernandez, Marlin Fernandez Camilo, Jiomar Manuel Figueroa Germosen, Maruel, Fortunato, Leyla Gabriel Fernández, Alicia German Dihmes, Héctor, Herrera, Elizabeth Leon Cuevas, Jose Alejandro Mata, Mirian Mateo De La Cruz, Dolores Mejia De la Cruz, Marcos, Mirambeaux, Fabio Ortiz De La Cruz, Henry, Paulino, Gabriela, Pelletier, Merycarla, Pichardo, Rodriguez Pumarol Próspero Enrique, Julio, Rivas, Ann Stephany Sanchez Marmolejos, Roman Santana Santana, Irina Suero Almanzar, María Magdalena Vásquez Sánchez, Nicolás, Campuzano, José Ricardo Negrete Ocampo, Maria, Armas, Alvaro Santiago LeMarie Guerra, Gustavo León Vizcaya, Omar Ahmed Abdelwahab, Ahmed, O Elmehrath, Mohammed Ezzat Mostafa, Gamal, Amira, Ibrahim, Sallam, Mohamed, Sherief, Ahmed, 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Maher, Hosain, Ahmed, Hossam, Hamza Hussein Aly Salama Aly, Mohamed, Ibrahim, Abdelrahman, Ibrahim, Nourhan, Ibrahim, Noha Mohamed Salah Ibrahim Moussa Hamouda, Monica, Iskander, Islam, Khalifa, Mostafa, Kotb, Nada, Mahmoud, Alaa Mahmoud Abo Shabana, Nora, Mamdouh, Maram, Metwalli, Khaled, Metwally, Mahmoud, Moghazy, Moustafa, Mohamed, Mohamed, Mourad, Esraa, Moustafa, Kamilia, Mubarek, Nour Eldin Nader, Ahmed, Nasser, Samaa, Omar, Mostafa Shehata Qatora, Mohamed, Ragab, Marawan, Ragal, Dina, Ramadan, Rana, Ramadan, Sara, Ramadan, John, Romany, Ahmed, Sabry, Yasmeen, Said, Sara, Salamah, Ahmed Mostafa Saleh, Mona Saleh Mesbah Mohamed Elkaffas, Alaa, Salem, Hashem, Salim, Ahmed, Samih, Ahmed Samir Abdelaal, Ahmed, Shaheen, Yassmeen Sharafeldin Mohammed, Abdelrahman, Shehata, Mohamed, Shemeis, Karim, Shenit, Mennatallah, Sheta, Asmaa, Soffar, Yousef, Tanas, Ahmed, Tarek, Nermin, Yehia, Omar Khaled Mohamed Eid, Ammar Yasser Abdulfattah, Ahmed, Elsaghir, Mohamed Fouad Elganainy, Omar Ibrahim Elsayed, Omar, Elmandouh, Omar, Hamam, Mostafa Ahmed Shehata, Areej, A Abdelaziz, Ahmed, M Abbas, Wael Abd El-Ghani, Hossam Aldein, S Abd Elazeem, Mustafa Abd Elsayed, Ahmed Yassien Abd-Elkariem, Shimaa, Abdalla, Mahmoud, Abdel-Aleem, Khaled, Abdelazeem, Mahmoud, Abdelfattah, Mohammed, Abdelhafez, Mohamed, M Abdelkarem, Ali, Abdelraouf, Lamess, Abdullaha, Hossam, Abubeih, Moaiad Eldin Ahmed, Nagm Eldin Abu Elnga Ahmed, Ahmed, Ahmed, Sarah Ahmed Saad, Sherif, Alaa, Ali, Alhussaini, Abdelrahman Ahmed Abdelrahman Ali, Ibrahim, Ali, Wagdi, Ali, Mohamed Ali Mohamed, Mohamed, Ashraf, Muhammad, Bassiouni, Mohamed, G El-Adawy, Mohammad, El-Sharkawi, Hussein, Elkhayat, Khaled, Elmaghraby, Shady, Elsdfy, Mohamed, Elsharkawy, Almoutaz, Eltayeb, Mohamed Esmat Mohamed, Esraa, Essam, Mahmoud, Fahd, Osama, Farouk, Rabea, Gadelkareem, Ahmed, Ghoneim, Mohammed Hamada Takrouney, Ahmed, Hamdan, Abd El-Rahman Hamed, Ahmad, Hasan, Mohamed Abdelghafor Hassanin, Islam, Hawal, Kerollos, Henes, Mohamed Omar Herdan, Helal, F Hetta, Omar, Ibrahem, Mostafa, Ibrahim, Islam, H Ibrahim, Mahmoud, Kamel, Mohamed, Khallaf, Shrouk, M Elghazaly, Abobakr, Mahfouz, Osman, Mahmoud, Wesam, Mahran, Doha, Mahrous, Abadeer, Marsis, Ayman, Mohamed, Aliae Mohamed Hussein, Amr Mohamed Sayed, Mahmoud, M Mohammed, Ahmed, Mokhtar, Fatma, A Monib, Ahmed, Nageeb, Mariam Albatoul Nageh, Mohammed, Nageh, Nehal Gamal Omar, Abdelrahman, Ragab, Abdelrahman, Ramadan, Abdallah Rashad Temerik, Aya, Sabry, Hadeer, Safwat, Omar, Salah, Ahmed Elhussiny Salah Mahmoud, Ahmed, Saleh, Mahmoud, Sallam, Ahmed, Samir, Reem, Sayad, Esraa, Sayed, Ahmed, S Sedik, Mohammed, Shahine, Antonios, Soliman, Wael, Soliman, Mohamed Gamal Taher, Randa, Wanees, Ebrahim Ahmed Yousof, Ahmed, Youssef, Omar Zein Elabedeen, Ahmed Emad Sayed Hassan, Shrouk Abdel Fattah, Ahmed, Abostate, Samar, Ali, Saad Ali Saad Salama, Mohamed, Allam, Ahmed, Alsadek, Ebrahim, Arafa, Ahmed, Barakat, Mohammed El Sherpiny, Gehad, Elbehairy, Mahmoud, Eleisawy, 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Krause, Frank, Meyer, Salmai, Turial, Bilal, Al-Nawas, Marco Johannes Battista, Jan, Goedeke, Annette, Hasenburg, Julia, Heider, Lena Katharina Mueller, Simon, Zeller, Sina Louisa Patrizia Jentschura, Karl-Friedrich, Kowalewski, Maximilian, Kriegmair, David, Männle, Christoph, Reissfelder, Nicole, Rotter, Claudia, Scherl, Steffen, Seyfried, Andreas, Kirschniak, Jens, Rolinger, Peter, Wilhelm, Franz, G Bader, Stephanie, Ottl, Alexandra Viktoria Behr, Alexandros, Diamantis, Andreas, Fichter, Florian, Grill, Matthias, Heck, Daniel, Jira, Michael, Kallmayer, Florestan, Koll, Stefan, Luhne, Bernhard, Meyer, Robert, Patachia, Ilaria, Pergolini, Seyer, Safi, Christoph, Schäffer, Moritz, Schirren, Helmut, Wegmann, Markus, Wirth, Zhaojun, Zhu, Ughur, Aghamaliyev, Mahmoud, Almaghrabi, Wolfgang, Böcker, Jan, Bruder, Konstantin, Frank, Viktoria, Herterich, Verena, Huber, Matthias, Ilmer, Christian, Kammerlander, Carl, Neuerburg, Viktor, H von Ehrlich-Treuenstätt, Jens, Werner, Nikolaus, Börner, 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Massimiliano, Gennaro, Lorenzo, Giannini, Marcello, Guaglio, Marco, Guzzo, Andrea, Leva, Alberto, Macchi, Elena, Manzo, Fabio, Martinelli, Ilaria, Mattavelli, Vincenzo Maria Mazzaferro, Francesco, Raspagliesi, Luigi, Rolli, Laura, Sala, Roberto, Salvioni, Mario, Santinami, Silvia, Segattini, Luca, Sorrentino, Carlotta, Zaborra, Alexandre, Anesi, Gianmaria Casoni Pattacini, Mattia Di Bartolomeo, Francesca, Pecchini, Arrigo, Pellacani, Micaela, Piccoli, Federico, Fusini, Andrea, Gattolin, Marco, Migliore, Roberto, Rimonda, Diego, Sasia, Elisabetta, Travaglio, Federica, Brunetti, Marco, Cereda, Marco, Ceresoli, Luca, Cigagna, Cristina, Dell'Oro, Alessandro, Fogliati, Robert, Fruscio, Tommaso, Grassi, Maini Marzia Isabella, Luca Carlo Nespoli, Massimo, Oldani, Sara, Ornaghi, Nicolò, Tamini, Carmine, Antropoli, Antonio, Castaldi, Alessio, Palumbo, Gaia, Altieri, Umberto, Bracale, Francesco, Corcione, Marcello De Luca, Giovanni Domenico De Palma, Maria Michela Di Nuzzo, Ruggero, Lionetti, 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Matteo, Filardo, Marika Sharmayne Milani, Franco, Ragni, Andrea de Manzoni Garberini, Edoardo, Baldini, Diana, Carpaneto, Michele, Cauteruccio, Corrado, Ciatti, Luigi, Conti, Serena, Gattoni, Pietro, Maniscalco, Gerardo, Palmieri, Calogero Puma Pagliarello, Giuseppe, Caristo, Raffaele, Galleano, Michele, Malerba, Marcello, Calabrò, Francesca, Farnesi, Elia Giuseppe Lunghi, Andrea, Muratore, Nicoletta Sveva Pipitone Federico, Joel Reuben Abel, Lorenzo, Andreani, Darienzo, Antonio, Vittorio, Aprile, Riccardo, Balestri, Giacomo, Benettini, Stefano, Berrettini, Luca, Bruschini, Massimo, Chiarugi, Federico, Coccolini, Simone, Colangeli, Camilla, Cremonini, Lodovica Cristofani Mencacci, Iacopo, Dallan, Silvia De Santi, Gregorio Di Franco, Lorena Di Girolami, Giacomo, Fiacchini, Niccolò, Furbetta, Stylianos, Korasidis, Marco, Lucchi, Andrea, Morandi, Luca, Morelli, Serena, Musetti, Carlo Maria Neri, Matteo, Palmeri, Miriana, Picariello, Francesco, Porcelli, Marco, Puccini, Nicolo, Roffi, Erica, Statuti, Dario, Tartaglia, Alberto, Tonelli, Matteo, Vianini, Gianluca, Baronio, Mauro, Montuori, Enrico, Pinotti, Stefano Maria Massimiliano Basso, Federica, Maffeis, Paolo, Ubiali, Lorenzo, Aguzzoli, Saverio, Coiro, Giuseppe, Falco, Vincenzo Dario Mandato, Valentina, Mastrofilippo, Simone, Mele, Caterina, Baldi, Carlo, Corbellini, Gianluca Matteo Sampietro, Massimo, Dugo, Mauro, Garino, Chiara, Marafante, Antonio, Masciandaro, Elisabetta, Moggia, Alessandra, Murgese, Felice Eugenio Agro, Gabriella Teresa Capolupo, Filippo, Carannante, Marco, Caricato, Vincenzo, Denaro, Erica, Mazzotta, Rocco, Papalia, Giuseppe, Pascarella, Alessandro, Strumia, Biagio, Zampogna, Matteo, Cinquepalmi, Marco, Colasanti, Celeste Del Basso, Federica, Falaschi, Nicola, Guglielmo, Roberto Luca Meniconi, Alessandra, Pecoraro, Sofia, Usai, Giacomo, Crescentini, Antonella, Larcinese, Emanuele, Picone, Giovanni, Sinibaldi, Annamaria, Agnes, Salvatore, Agnes, Sergio, Alfieri, Francesco, Belia, Valentina, Bianchi, Giuseppe, Bianco, Alberto, Biondi, Paola, Campennì, Valerio, Cozza, Sabatino, D'Archi, Domenico, D'Ugo, Veronica De Simone, Marta Di Grezia, Sofia Di Lorenzo, Federica, Ferracci, Valeria, Fico, Gianluca, Franceschini, Pietro, Fransvea, Giulio, Gasparini, Luca, Gordini, Antonio La Greca, Francesco, Litta, Celestino Pio Lombardi, Angelo Alessandro Marra, Angelo, Parello, Marco Maria Pascale, Romeo, Patini, Gilda, Pepe, Roberto, Persiani, Caterina, Puccioni, Carlo, Ratto, Fausto, Rosa, Gianmarco, Saponaro, Lorenzo, Scardina, Tedesco, Silvia, Giuseppe, Tropeano, Maria, Benevolo, Daniele, Bugada, Flaminia, Campo, Maria Gabriella Dona, Valentina, Manciocco, Paolo, Marchesi, Riccardo, Mastroianni, Francesco, Mazzola, Silvia, Moretto, Raul, Pellini, Gerardo, Petruzzi, Barbara, Pichi, Giuseppe, Simone, Gabriele, Tuderti, Jacopo, Zocchi, Luigi Marino Cosentino, Andrea, Sagnotta, Roberta, Angelico, Vittoria, Bellato, Michela, Campanelli, Marzia, Franceschilli, Michele, Grande, Giorgio, Lisi, Tommaso Maria Manzia, Lorenzo, Petagna, Bruno, Sensi, Giuseppe, Sica, Leandro, Siragusa, Giuseppe, Tisone, Marco, Assenza, Barbara, Binda, Massimo, Biondi, Gioia, Brachini, Placido, Bruzzaniti, Mauro, Casagrande, Flavia, Ciccarone, Pierfranco Maria Cicerchia, Bruno, Cirillo, Daniele, Crocetti, Giancarlo, D'Ambrosio, Vito, D'Andrea, Francesca De Felice, Giorgio De Toma, Carlo Della Rocca, Giulia, Duranti, Pietro, Familiari, Enrico, Fiori, Giovanni Battista Fonsi, Alessandro, Frati, Stefania La Rocca, Filippo La Torre, Pierfrancesco, Lapolla, Giovanni, Marruzzo, Simona, Meneghini, Andrea, Mingoli, Andrea, Picchetto, Antonella, Polimeni, Diego, Ribuffo, Maurizio, Salvati, Antonio, Santoro, Paolo, Sapienza, Luigi, Simonelli, Valentino, Valentini, Martina, Zambon, Giuseppa, Zancana, Emma, Zuppi, Simone, D'Annunzio, Cosimo De Nunzio, Silvia, Fiorelli, Mohsen, Ibrahim, Chiara, Loffredo, Domenico, Massullo, Cecilia, Menna, Rocco, Monica, Massimiliano, Pelli, Erino Angelo Rendina, Leonardo, Teodonio, Andrea, Tubaro, Giulio, Argenio, Giulio, Accarino, Accarino, Giancarlo, Antonio Nicola Giordano, Luca, Cardinali, Elisa, Sebastiani, Grazia, Travaglini, Erika, Andreatta, Emanuele Luigi Giuseppe Asti, Daniele, Bernardi, Luigi, Bonavina, Caterina, Froiio, Andrea, Lovece, Chiara, Copelli, Alfonso, Manfuso, Pasquale Di Maio, Marco, Giudice, Oreste, Iocca, Rosario, Cennamo, Tommaso, Cornali, Francesco Di Marzo, Cristian, Altana, Francesco, Bussu, Giampiero, Capobianco, Anna Giacomina Carta, Sandro, Ciccarello, Maria Laura Cossu, Pietrina, Cottu, Giacomo De Riu, Salvatore, Dessole, Francesco, Dessole, Salvatora, Dettori, Carlo, Doria, Alessandro, Fancellu, Claudio, F Feo, Giorgio Carlo Ginesu, Giuliana, Giuliani, Marco Giuseppe Iannuccelli, Massimo, Madonia, Roberto, Mancino, Olindo, Massarelli, Gianfranco, Meloni, Fabio, Milia, Andrea, Mulliri, Teresa, Perra, Marco, Petrillo, Antonio, Piras, Franco, Piredda, Francesco, Pisanu, Alberto, Porcu, Davide, Rizzo, Angelino, Sanna, Antonio Mario Scanu, Fabrizio, Scognamillo, Damiano, Soma, Anna Rita Tanca, Alessandro, Tedde, Matteo, Tedde, Luigi Angelo Vaira, Andrea Bartalini Cinughi de Pazzi, Osvaldo Carpineto Samorani, Daniele, Fusario, Luigi, Marano, Gaia, Oldrà, Anna Lisa Pesce, Stefania Angela Piccioni, Luca, Resca, Vincenzo, Ricchiuti, Franco, Roviello, Vinno, Savelli, Alberto, Abrate, Pierpaolo, Bordoni, Lorenzo, Bosio, Guglielmo, Clarizia, Francesco, Fleres, Marco, Franzini, Antonio, Fratto, Pierluigi, Giumelli, Alessandro, Grechi, Alessandro, Longhini, Fabrizio, Lorusso, Elisa, Scarnecchia, Federica, Scolari, Alessandro, Spolini, Vincenzo, Maiuri, Matteo, Papandrea, Arturo, Roncone, Lorenzo, Conti, Andrea, Rizzi, Marco, Rovagnati, Alberto, Brolese, Tommaso, Cai, Francesco Antonio Ciarleglio, Francesca, Dalprà, Gianni, Malossini, Liliana, Mereu, Irene, Tamanini, Saverio, Tateo, Giovanni, Viel, Enrico, Battistella, Paolo Boscolo Rizzo, Cristoforo, Fabbris, Marco, Massani, Giacomo, Spinato, Roberta, Tutino, Ugo, Grossi, Alessandro, Iacomino, Simone, Novello, Maurizio, Romano, Serena, Rossi, Giulio, Santoro, Giacomo, Zanus, Sokol, Trungu, Giada, Aizza, Gabriele, Bellio, Selene, Bogoni, Marina, Bortul, Biagio, Casagranda, Sara, Cortinovis, Nicolò de Manzini, Davide, Drigo, Paola, Germani, Manuela, Mastronardi, Lucia, Paiano, Silvia, Palmisano, Pier Luigi Filosso, Francesco, Guerrera, Matteo, Marro, Mauro, Rinaldi, Enrico, Ruffini, Stefano, Salizzoni, Laura, Bardelli, Mattia, Berselli, Giacomo, Borroni, Eugenio, Cocozza, Matteo, Desio, Bottazzoli, Elisa, Giuseppe, Ietto, Valentina, Iori, Domenico, Iovino, Lorenzo, Livraghi, Valentina, Marchionini, Stefano, Megna, Emma Amal Nahal, Mara, Palumbo, Valeria, Quintodei, Alessandra, Zullo, Lucrezia, D'Alimonte, Giovanni, Pirozzolo, Chiara, Vignotto, Tommaso, Campagnaro, Andrea, Caravati, Simone, Conci, Carlotta De Cristofaro, Gabriele, Gecchele, Tommaso, Giuliani, Jacopo, Graziosi, Alfredo, Guglielmi, Salvatore, Paiella, Corrado, Pedrazzani, Tommaso, Pollini, Simone, Rattizzato, Andrea, Ruzzenente, Roberto, Salvia, Giulia, Turri, Matilde, Bacchion, Giovanni, Butturini, Andrea, Casaril, Alessandro, Giardino, Harmony, Impellizzeri, Marco, Inama, Frigerio, Isabella, Gianluigi, Moretto, Marco De Zuanni, Enrica, Deiana, Mario, Guglielmo, Alessandro, Broglia, Claudia, Casarini, Caterina Costanza Zingaretti, Marta, Bonaldi, Giovanni, Cesana, Francesco, Mastriale, Stefano, Olmi, Matteo Uccelli Yasuyuki Fukami, Takuya, Saito, Tsuyoshi, Sano, Naoki, Hirai, Kazuyoshi, Hirota, Tetsuya, Kushikata, Tasuku, Oyama, Junichi, Saito, Katsuhiko, Ishibashi, Mizue, Kamiyama, Kyongsuk, Son, Kentaroh, Tarao, Takayuki, Yamada, Toshiya, Shiga, Chisaki, Aze, Yoshihiko, Deguchi, Hirotoshi, Hasegawa, Tatsuki, Hoshino, Yasushi, Innami, Hiroyuki, Inoue, Shingo, Ito, Takeshi, Nomura, Tomomi, Ogihara, Reina, Okada, Takashi, Ouchi, Yuri, Sekiya, Keikoku, Tachibana, Emi, Takano, Masae, Yamamoto, Shuko, Matsuda, Yuka, Matsuki, Kenji, Shigemi, Teruyuki, Hiraki, Yui, Inoue, Shosaburo, Jotaki, Tatsuro, Abe, Masatoshi, Eto, Junichi, Inokuchi, Eiji, Kashiwagi, Fumio, Kinoshita, Satoshi, Kobayashi, Ken, Lee, Takashi, Matsumoto, Keisuke, Monji, Hidekazu, Naganuma, Masaki, Shiota, Ario, Takeuchi, Shinju, Obara, Saori, Takatsuki, Saori, Tanaka, Koji, Iida, Kota, Kagawa, Shuichiro, Neshige, Tomohiro, Chaki, Naoyuki, Hirata, Satoshi, Kazuma, Motonobu, Kimizuka, Sho, Kumita, Noriaki, Nishihara, Sato, Satoshi, Atsushi, Sawada, Shunsuke, Tachibana, Michiaki, Yamakage, Yuta, Nakamura, Kozo, Sato, Tomoya, Irie, Tomoko, Irisawa, Eiki, Kanemaru, Yuko, Koga, Yoshihiko, Chiba, Jun, Makino, Shinnosuke, Ohama, Shinichiro, Okada, Kano, Teruaki, Tatsuya, Kida, Tomohide, Takei, Kazuhiro, Hanazaki, Hiroyuki, Kitagawa, Tsutomu, Namikawa, Toshiyuki, Mizota, Chikashi, Takeda, Shintaro, Yagi, Hiroshi, Imai, Makoto, Ishitobi, Manabu, Kato, Kouhei, Nishikawa, Takeshi, Sasaki, Hiroshi, Yonekura, Akihiro, Kanaya, Daisuke, Irimada, Haruka, Ishikawa, Kaiho, 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Mubaydeen, Husam, Sarayrah, Mohammad Abdel Elah, A Tarawneh, Mohammad Yousef Karasneh, Amany, Zurgan, Mohammad, Alassaf, Sayel, H Alzraikat, Justin, Z Amarin, Ahmed, Hijjawi, Haya, H Suradi, Louay, Y Zaghlol, Ahmad, Abdalah, Ghaida, Abdallah, Ammar Abu Tarieh, Tareq, Abu-Libdeh, Faisal, Abualteen, Murad Al Abdallah, Zakaria Al Bdour, Seif Al Dahabrh, Farah, Al-Kasaji, Zaid Al-Sheikh Ali, Mohammad, Al-Thaher, Tareq, Alnajjar, Mohannad, Alqedrh, Mohammad, Alsaleh, Mohammad, Alzaatreh, Ghandi, Amayreh, Yazeed, Ayasra, Ahmad, Eid, Ibrahim, Ghayada, Khaled Moh'd Ahmed Hasanein, Anas, Hassouneh, Raid, Hijazeen, Majedah, Hmeidan, Ahmed, Khaled, Barihan, Khasawneh, Omar, Kifayeh, Yasser, Lafi, Jasem, Seba, Qusai, Semrin, Fda, Sma, Mohammad, Theab, Haitham, Tumeh, Muna Aba Zaid, Alaa, Abazeed, Bader, Abbad, Osaid, Abbadi, Nizar, Abu-Ishkerih, Malk, Al-Osta, Reham, Al-Zyadat, Bashar Omar Falah Alawneh, Majd, Alhattab, Mohd Mujahed Alkurdieh, Ziad, Awwad, Mohammad, Hammouri, Hamzeh, Hussein, 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Alameen, Rehab, Alarabi, Alarabi, Alarabi, Aisha, Alelwany, Abdulkarim, Alesmail, Noran, Algadi, Khuloud, Almaqrahi, Hadel, Alosta, Mohamed, Alsharedi, Rasha, Bashir, Mahmoud Ben Ghrema, Sari Bin Nour, Sofian, Elbarouni, Ahmed, Elhadi, Abdulmohimen, A Elkhadar, Esraa, Elkouba, Nabiha, Elmsherghi, Abdulmohimen, Gammoudi, Abdulraouf, Ghariba, Fatima Zayed Gjam, Arwa, Haidar, Hala, Helal, Mohammed, Huwaysh, Ahmed Khalid Alhadheeri, Eslam, Kriem, Halim, Osman, Mohamed Ali Ossman, Marwah, Shilfeet, Laila, Turshani, Nouran, Albishty, Abdulmueti, Alhadi, Salem, Ali, Manal Ahmed Altoumi, Sumayyah Ghayth Bahroun, Eman, Younes, Hana, Atarabulsi, Mohamed, Elshaibi, Abdullmujeeb, Othman, Hayat Ben Hasan, Najat Shaban Ben Hasan, Rabab Shaban Ben Hasan, Vidmantas, Barauskas, Edvinas, Dainius, Zilvinas, Dambrauskas, Albertas, Dauksa, Inga, Dekeryte, Rita, Gudaityte, Kristijonas, Jasaitis, Akvilė, Koženiauskaitė, Virgilijus, Krasauskas, Ausra, Lukosiute-Urboniene, Almantas, Maleckas, Romualdas, 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Rakotoarisoa, Maharo, Ramifehiarivo, Solonirina Harinarindra Ranaivoson, Hajamihamina Marina Parfaite Randriantsoa, Narindra Njarasoa Mihaja Razafimanjato, Jeannie Ba Razafindrahita, Solofoarimanana, Solofoarimanana, Guillaume Odilon Tsiambanizafy, Rakotonaivo Mamisoa Judicaël, Corinne Eulalie Solo, Tojomamy Herinjaka Ralaizafindraibe, Fanonjomahasoa Safiry Andofenohasina, Hanta, Rasataharifetra, Vanona Barijaona Razafindraibe, Angelin Sablon Herinirina, Andre, Das, Thanga, Ganapathy, Yohesuwary, Gunarasa, Kalyani, Mariapan, Maathichsudhaar, Muniandy, Mohd Firdauss Osman, Mohd Azem Fathi Mohammad Azmi, Jien Yen Soh, Wan Zainira Wan Zain, Andee Dzulkarnaen Zakaria, Zaidi, Zakaria, Kheng Hooi Chan, Firdaus, Hayati, Syamim, Johan, Jin Jiun Mah, Ratha Krishnan Sriram, Sentilnathan, Subramaniam, Nur Shahirah Binti Muhammad Shahimi, Khairul Hazim Hamdan, Mohd Razali Ibrahim, Guhan, Muthkumaran, Ju Ann Tan, Mohana Raj Thanapal, Dayang Anita Abdul Aziz, Mae-Lynn, Bastion, Mohd Hairul Nizam 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Sainal, Mat Salleh Sarif, Richelle, Chua, Aini Fahriza Ibrahim, Abdul Rauf Bin Ahmad, Yii Ling Lau, Ka Yee Liew, Kandasami, Palayan, Hui Yu Wong, Jasiah, Zakaria, Nor Azimah Abd Aziz, Norazila Abdul Rahim, Noorneza Abdul Rahman, Bahiyah, Abdullah, Mohamed Faizal Bin Sikkandar, Fatin, Firman, Nik Mohd Hazleigh, Intan Kartika Kamarudin, Shahril, Khalid, Mohd Fairudz Mohd Miswan, Akmal Zulayla Mohd Zahid, Norasyikin, Mustafa, Kadhim, Obaid, Mohd Yusoff Bin Yahaya Yahaya, Ahmad Ramzi Yusoff, Predrag, Andrejevic, Jeremy Borg Myatt, Svetlana, Brincat, Clifford, Caruana, Kurt Lee Chircop, Francesca, Chircop, Daniel Mario Chircop, Charles, Cini, Viktoria, Czok, Melanie, Farrugia, Gabriella, Grima, Fatimah Mj Hassan Almukhariq, Esther, Muscat, Darryl, Pisani, Mohsin Hassan Khan Roshan, Nicholas, Schembri, Mohamed, Shoukry, Neville, Spiteri, Gilbert, Tanti, Ziad Aboharp Hasan, Alberto Bazan Soto, Cedillo Rodrìguez Jonathan Rubén, Gustavo Esteban Lugo Zamudio, David Gerardo Miranda Gómez, José 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Uros, Bumbasirevic, Zoran, Dzamic, Boris, Kajmaković, Bogomir, Milojevic, Nebojša, Prijović, Marko, Zivkovic, Aleksandar, Lazic, Nebojsa, Mitrovic, Dejan, Stevanovic, Marko, Buta, Ana, Cvetkovic, Igor, Djurisic, Merima, Goran, Zorka, Inic, Andjela, Ivezić, Nikola, Jeftic, Marko, Jevric, Vladimir, Jokic, Milan, Kocic, Zoran, Kozomara, Ivan, Markovic, Srdjan, Nikolic, Nada, Santrac, Nevena, Savković, Igor, Spurnic, Dobrica, Stevic, Dejan, Stojiljkovic, Jovana, Tripkovic, Nikola, Vucic, Milan, Zegarac, Tatjana, Dejanovic, Vladimir, Djukic, Srdjan, Marinković, Miljan, Milanovic, Nemanja, Pijanovic, Milena, Radosavljevic, Predrag, Savic, Dejan, Stojakov, Rastko, Živić, Sinisa, Ducic, Mikan, Lazovic, Jovana, Bojičić, Vladica, Cuk, Jovan, Juloski, Aleksandar, Karamarkovic, Marko, Kenic, Bojan, Kovacevic, Igor, Krdzic, Vladan, Milutinović, Vladimir, Djan, Velicko, Trajkovic, Dragana, Zivkovic, Aleksandar, Đermanović, Danica, Golijanin, Dejan, Lukic, Zoran, Radovanovic, Dragana, Radovanovic, Sanja, Zahorjanski, Adrian, Chiow, Jun Xian Hing, Lip Seng Lee, Sey Kiat Terence Lim, Chi Wei Mok, Su-Ming, Tan, Hiang Jin Tan, Hana, Arbab, Candy, Choo, Doris Mae Dimatatac, Yee, Low, Hui Wen Chua, Tousif, Kabir, Sabrina, Ngaserin, Lester, Ong, Kiat Tee Benita Tan, Alvin, Tan, Wei-Wen, Ang, Yew-Lam, Chong, Jeffrey, J Leow, Biquan, Liu, Ming Ngan Aloysius Tan, Ern Yu Tan, Kar Yong Wong, Sharon, Yeo, Ladislav, Czako, Branislav, Gális, Kristián, Šimko, Radoslav, Morochovič, Martin, Paulo, Marián, Sedlák, Jan, Grosek, Ales, Tomazic, Leyla Al Mahdawi, Nuhi, Arslani, Andrej, Avsenak, Andrej, Bergauer, Krešimir, Blažević, Dejan, Bratus, Dalibor, Cankoski, Andrej, Cokan, Bojana, Crnobrnja, Andraz, Dovnik, Vojko, Flis, Samo, Fokter, Urska, Gajsek, Minja, Gregorič, Marko, Hazabent, Tomaz, Jagric, Niko, Kavčič, Jure, Knez, Nina, Kobilica, Rok, Kovačič, Lara, Lukman, Urska, Marolt, Jan, Mlakar, Tamara, Mohorko, Andrej, Moličnik, Ivan, Perić, Stojan, Potrč, Milena Senica Verbic, Mateja, Sirše, Jerneja, Vidmar, Adnan Sayid Abdo, Abdifatah Dahir Ali, Abdilaahi Ahmed Hayir, Sadiq, Ibrahim, Afnan, Nuh, Kadra, Omar, Ridwan, Saeed, Nikita, Blake, Cassandra, Ferreira, Corne, Nel, Colin, Noel, Marcel de Kock, Nathan, Kaplan, Emile, Kayombo, Paballo Clinton Khaeane, Asha, Malan, Wikus Wessel Mulder, Daylen, Rutledge, Cornel, Steyn, Gert, Steyn, Naser, Almgla, Mohamed, Daoub, Hammaad, Gamieldien, Thomas, Hilton, Nazmie, Kariem, Maahir, Kariem, Christo, Kloppers, Maritz, Laubscher, Wanga, Mtimkulu, Walid, Mugla, Daniel, Nel, Ferhana, Gool, Timothy, Hardcastle, Wasim, Mahomed, Nivashen, Pillay, Kayla, Rossini, Stephanie Van Straten, Annamart, Laubscher, Adelaide, Lee, Mohammed Yusuf Parker, Sinead, Quirke, Therese Du Preez, Adeline, Jacobs, Reinier, Swart, Modise Zacharia Koto, Neha, Kumar, Imraan, Sardiwalla, Mapuor, Areu, Juan Campos Garcia, Paula, Ferrara, Christoph José Klein Zampaña, Raquel, Lopez, Hernan, Sandoval, Guillermo, Carreño, German Mínguez Ruiz, Conrado Andrés Ros, Raquel Angulo Artal, Luis, Barbier, Guillermo, García-Operé, Marta, Jiménez-Jiménez, Héctor, Marín, Mikel, Oñate, Luis Antonio Pascua-Gómez, María Alexandra Pesántez Peralta, Ibabe Villalabeitia Ateca, Ladislao Cayetano Paniagua, Joan, Camí, Pablo, Collera, Martínez, David, Carlos Javier Gómez Díaz, Jordi Querolt Coll, M Dolors Rosines Cubells, Cristina Soto Montesinos, Guillermo, Triana, Marina, Xicola, Alfonso, Alias, Albert, Baduell, Mariano, Balaguer-Castro, María Pilar Camacho Carrasco, Marina Cámara Vallejo, Borja Campuzano Bitterling, Guillem, Claret, Francisco, J Cuesta-González, Alberto Di Somma, Joaquim Enseñat Nora, Neus, Fabregas, Ada Ferrer Fuertes, Abel, Ferrés, Cesar, Ginesta, Jose Juan Gonzalez Sanchez, Isabel, Gracia, Jhon Alexander Hoyos Castro, Montsant, Jornet-Gibert, Xavier, Morales, Alejandra, Mosteiro-Cadaval, Leire, Pedrosa, José Poblete Carrizo, Marina, Renau-Cerrillo, Luis Alberto Reyes Figueroa, Pedro Roldan Ramos, Jordi Rumià Arboix, Marta, Sabater-Martos, Josep, M Segur, Thomaz, E Topczewski, Jorge, Torales, Ramon, Torné, Pere, Torner, Ricard, Valero, Marian, Vives-Barquiel, Eulalia, Ballester, Alberto Basterra Rincon, Vitiello, Giulia, Belén Martin Arnau, Marta, Gil, Silvia, Martin, Monica, Serrano-Navidad, Mauricio Agüero Mariño, Núria Casanova Torrequebrada, Berta Fabregó Capdevila, Adrián López Campillo, Gemma, Mancebo, Ester, Miralpeix, Blanca, Montcusí, Marina, Munarriz, Ariadna, Salvadó, Josep, M Sole-Sedeno, Clara Téllez Marquès, Ana Centeno Álvarez, Ruth Lopez Gonzalez, Luisana Riba Combatti, Andrea Sanz Llorente, Miguel Bejarano Serrano, Blanca Capdevila Vilaró, Maria Coronas Soucheiron, Mario Cuesta Argos, Irene de Haro Jorge, Yaiza Galvañ Félix, Luis, García-Aparicio, Rebeca, Leal, Albert Malet Contreras, Irene, Martínez-Padilla, Clara, Massaguer, Ines Moraleda Gudayol, María Elena Muñoz Fernández, Paco, Parri, Cristina Pérez Costoya, Javier, Rojas-Ticona, Leopoldo Tapia Moral, Francisco, Vicario, Francesc Angles Crespo, David Bosch Garcia, Berta, Escudero, Carlos Garcia Cardona, Sergi, Bellmunt-Montoya, Javier de la Torre, Úrsula, Acosta, Iago Alvarez Saez, Eva Andreu Riobello, Fernando Ascanio Gosling, Jose, Bagan, Irene, Brana, Bartomeu, Caimari, Marta Cicuendez López Ocaña, Anna, Conesa, Alba de Pablo García-Cuenca, Natalija, Dediulia, Francesc, Duran-Valles, Jordi Giralt López de Sagredo, Maria Jose Gomez-Jurado, Ernesto, Guerra-Farfan, Juan Sebastian Guillén, María Guisasola Rabés, Viviana Andrea Hernández Angel, Maria Jurado Ruiz, Yuri, Loaiza, Manuel, Lopez, Susana, Manrique, Maria Dolores Mateo Arzo, Joan, Minguell-Monyart, Enric Miret Alomar, Sonia Monreal Clua, Víctor Morales Ariza, Clara Morales Comas, Judith, Murillo, Jose Maria Nieto Rodriguez, Elena Vilardell Ortiz, Jorge, Pamias, Montserrat Pascual Pascual Arellano, Remei Perera Sarri, Aleix Pons Bartroli, Nil, Prat, Alfredo Pueyo Ferrer, Rosa Pujol Pina, Jordi, Raurich-Leandro, Maria José Reche Padilla, Joaquín Rivero Déniz, Natalia, Rodriguez, Manuel Saez Barba, Vanessa Sanchez Torrents, Berta, Serrano, María Sol Siliato Robles, Christian Siso Raber, Iñigo, Soler, Maria Carmen Suescun López, Jordi Teixidor Serra, Cristina, Tello-Díaz, Marta Utrilla Pérez, Ramon, Vilallonga, Irene Vives Roselló, Vázquez García César, Mireia, Gili-Bueno, Carlos Gomez Roig, Gloria, González, Aamer, Malik, Maria Del Mar Martí-Ejarque, Mario Rafael Medina Hernández, Carolina, Pozo, Laura, Ruiz-Villa, Nuria, Sierra, Antonio, Valle, Susana, Velasquez, Mirentxu, Arrieta, Daniel, Escobar, Arkaitz, Lara, Alicia, Rojo, Idoia, Villamor, Javier Aitor Zabala Lopez-Maturana, Begoña, Estraviz, Laura Fernández Gómez Cruzado, Melania González de Miguel, David, Lecumberri, Victor Luis Gomez Corujo, Silvia, Bleda, Joaquin De Haro, Carlos, Martínez-Pinedo, David, Padilla-Valverde, Rafael Picón Rodríguez, Francisco Javier Redondo Calvo, Daniel, Sanchez-Pelaez, Alfonso Espinosa Ruiz, Eduardo, Rodriguez, Ignacio Alcalá Rueda, Gonzalo Díaz Tapia, Alvaro Sanchez Barrueco, Maria Dieguez López, Isabel López García, Pilar López-Toribio López, Marina, Bosch, Carolina Curtis Martínez, Alba Fernández Candela, Sandra Lario Pérez, Cristina Lillo García, Clara López de Lerma Martínez de Carneros, Francisco López Rodríguez-Arias, Inmaculada, Oller, Saray, Quinto, Luis, Sánchez-Guillén, Antonio Sanchís López, Álvaro, Soler-Silva, Daniel Triguero Cánovas, Victoria Garcia Peces, Estefania, Hernández-García, Guillermo, Plaza, Rafael Abad Alonso, Francisca Aranda Lozano, Marta Calvo Fernández, Eneko Del Pozo Andres, Josune Etxabe Gurrutxaga, Francisco Javier Fernández Pablos, Francisco Javier Ibáñez-Aguirre, Begoña Ochoa Villalabeitia, Natalia, Ortega, Amaia Sanz Larrainzar, Irune Vicente Rodriguez, Javier Jimenez Miramón, Jose, M Jover, Tamara, Llamero, Jose Luis Ramos Rodriguez, Ainhoa Valle Rubio, Maria Teresa Albiol, Codina, Antonio, Clara, Codony, Ramon Farres Coll, Cristina Farrés Pla, Nuria Gomez Romeu, Santiago, Lopez-Ben, Marcel, Pujadas, Berta, Tió, Francesc, Tuca, Elizabeth, Bárcena, Esther Brea Gómez, Antonio Francisco Guisado Calderón, Elisabeth Fernandez Castro, Montserrat Mairal Fraile, Oscar, Pastor, Cristina García Amador, Raquel Latorre Fragua, Marta, Allue, Pablo, Colsa, Teresa Gimenez Maurel, Raúl Latorre Tomey, Luis Francisco Martín Anoro, Luca, Ponchietti, Alejandra Utrilla Fornals, Carlo, Brugiotti, Carlos Jiménez Viñas, Fátima, Sena-Ruiz, Julio, Plata-Bello, Octavio, Arencibia, Daniel Gonzalez Garcia-Cano, Maria, Laseca, Antonio, Navarro-Sánchez, David Ortiz López, Maria, Pelloni, Sara, Berrocal, Elima Pilar Cagigal Ortega, Jorge, Calvera, Iria, Cervera, Patricia Díaz Peña, Silvia Verónica Domínguez Ovejas, Francisco, Donis, Patricia Fernández Bernabé, Gema, Fraga, Raúl Garcés García, Antonio, García, Elena Garcia De Castro, Antonio García Domínguez, Miguel Angel García García, Judit, Gonzalez, Carles Heredia Llinàs, Inés, Hernández, Norberto Herrera Merino, Carmen Lucero León Gámez, Ana Luis Siles, Maria Marqueta De Salas, Paula Martinez Pascual, Almudena Ortiz Simón, Laura, Osuna, Marta Perez Gonzalez, Antonio Ramos Bonilla, Lorena Rodríguez Gómez, Jose Luis Uquillas, Miguel Angel Alonso Prieto, Marta, Ballesteros-Pomar, Sara Busto Suarez, Mario, Castaño, Laura Castillo Pardo, Mario De Arriba Alonso, Fernando Diez Burón, Anna Farrés Rabanal, Diego Fernández-Samos Fernández, David, Garcia, Cristina García Pérez, Miguel García Sanz, Cesar, Gracia, Javier, Gualis, Gonzalo Gutiérrez Carrillo, Mateo, Hevia, Eva Higuera Miguélez, Gregorio, Laguna, Cristina Lombardia Gonzalez de Lera, Pablo López Martínez, Pasquale, Maiorano, Sergio Marcos Contreras, Elio Martín Gutiérrez, Marta, Molina, Irene, Perez, Teresa Renedo Villar, Luis Angel Suarez Gonzalez, Eva Alvarez Torres, Luz Bueno Rey, Zulay Adriana Calderon Barajas, Ana, M Castaño-Leon, Aida, Fernández, Pablo Garcia Pimentel, Luis, Jimenez-Roldan, Meta, Levstek, Rosalia Navarro Casado, Claudia Olea Vielba, Ana Maria Parada Rodriguez, Igor, Paredes, Patricia, Pascual-Cambero, Miguel Saiz Sánchez-Buitrago, Claudia Sarrais Polo, Victor Zarza Fernandez de Alegria, Mireya, Bonet, Alberto Encinas Vicente, Jose Miguel Villacampa Auba, Maria Dolores Burgueño, Patricia Serrano Méndez, Thomas, W Jorgensen, Mercedes, Martin, Mónica, Huecas, Felipe, Velasco, Verónica Alen Villamayor, Santiago Alonso Bartolomé, Miguel Alonso Juarranz, Luis Felipe Ávila-Ramírez, Javier Buendia Pérez, Barbara, Burgos-Blasco, Enrique Camarero Rodríguez, Paula Campelos Fernández, Claudia, Celotti, Marco Ciappara Paniagua, Ignacio, Cristobal, Alejandro Encinas Bascones, Elena, Fernandez-Martin, Inés Gil Prados, Jesus Gimeno Hernandez, Maria Alejandra Giraldo, Manuel Gomez Cervantes, Noemi Guemes Villahoz, Araceli Hernández Ramos, Maria Cruz Iglesias Moreno, Bibiana Lasses Martínez, Francisco Leyva Rodríguez, Leyre López Antoñanzas, Javier Martín Monterrubio, Jose Maria Martinez-de-la-Casa, Lourdes Montero Cruces, Jesús Moreno Sierra, Jose Maria Muguerza, Alexia Victoria Paluso Montero, Natalia Pérez Romero, Adriana, Poch, Jaime Rodríguez de Alarcón, Adriana Ruano Campos, Rebeca Ruiz Roman, Patricia Saez Carlin, Cristina Sánchez Del Pueblo, Lidia Sotillo Valenzuela, Armando, Galvan, Miguel Ángel García Ureña, Enrique, González, Manuel Medina Pedrique, Alvaro Robin Valle de Lersundi, Carlos San Miguel, Juan, Aragón-Chamizo, Monica, Ballon, Jose, M Barrio, Beatriz Castro Catalan, Laura Cebolla Rojas, Renan Carlo Colombari, Miguel Cuende Diez, Paula Dujovne Lindenbaum, Oscar, Gil-de-Sagredo, Silvia Kayser Mata, Pablo Lozano Lominchar, Yeniffer Tatiana Moreno Salazar, Angela, Moreno-Gutierrez, Melanie, Morote, Uxue, Murgoitio, Nikolas Palma Caucig, Lucía Polanco Pujol, Alejandro, Prosperi, María Belén Ramírez Senent, Diego Fernando Ruiz Chiriboga, Mercedes, Sanz, Maria, Tudela, María Adrien Lara, Raquel, Alarza, Isabel Alonso Sebastian, Mariano Artés Caselles, Laura, Calles-Sastre, Marcos Casas Sánchez, Aritz Equisoain Azcona, Lucía, Fuentes, Lucia Gil Cidoncha, Sofía Herrero Gámiz, Eva Iglesias Garcia, Jose Luis Lucena De La Poza, Mª Eugenia Marín Martínez, Pilar Martín Rodrigo, Joaquin Manuel Muñoz Rodríguez, Verónica, Polaino, Alberto Pueyo Rabanal, Xabier Remirez Arriaga, Xiana, Rial, Miguel Sánchez Suárez, Maria Eugenia Torguet Muñoz, Borja Bazán Inostroza, Lara Blanco Terés, Alba Correa Bonito, Angela de la Hoz, Gustavo, Eisenberg, Javier Garcia Septiem, Jose Maria Lopesino, Rocio, Maqueda, Elena, Martin-Perez, Jose Luis Muñoz de Nova, Julia Revuelta Ramírez, Ana Rodríguez Sánchez, Álvaro Valdés de Anca, Laura Colao García, David Díaz Pérez, Enrique Esteban Agustí, Pablo Galindo Jara, Ana Belén Gallardo, Cesar, Garcia, Maria Gutierrez Samaniego, Miguel Angel Hernandez Bartolome, Lorenzo, Rabadan, Barriga Sánchez Raquel, Beatriz, Diéguez, Miguel, Hernández-García, Carolina Alfonso Carrillo, María Belén Alonso Bartolomé, Estibaliz, Alvarez, Mario, Alvarez-Gallego, Paula, Aragón-Ramos, Pablo Cesar Arteaga Asensio, Luis Asensio Gomez, Diego, Carrion, Nuria, Chavarrias, Alvaro de Arriba, Jose Antonio Gazo Martínez Gazo, Alberto Gegúndez Simón, Juan Gómez Rivas, Natalia Gonzalez Alcolea, Carolina, Gonzalez-Gomez, Sara Gortázar de Las Casas, María Alexandra Heras Garceau, Alicia Hernández Gutierrez, Luis, Lassaletta, Fuad Samir Lopez Fernández, Marta, Mancheño, Blanca, Mateos-Serrano, Isabel Pascual Miguelañez, Maria Fernanda Pedrero Escalas, Julio, Peñarrocha, Yolanda, Perez, Maria Isabel Prieto-Nieto, Teresa Rivera Schmitz, Laura, Rodrigáñez, Ines, Rubio-Perez, Isabel Sanchez Cuadrado, José Ignacio Sánchez Méndez, Jorge Fernando Tone, Carlos Toribio Vazquez, Aitor, Urbieta, Diego Córdova García, Francisca Garcia-Moreno Nisa, Laura, Jiménez, Inmaculada, Lasa, Belen, Matías-García, Fernando, Mendoza-Moreno, Marina Pérez González, Ana Sánchez Gollarte, Alejandro Sanchez Pellejero, Cristina Vera Mansilla, Rafael, Barberá, Lourdes, Montes-Jovellar, Sara Fra Fernández, Nicolas Moreno Mata, Barbara, Algar-Yañez, Gutiérrez, Bérénice, Olga De La Varga-Martínez, Paula, Fernandez-Valdes-Bango, Sandra Maria Gadin-Lopez, José María Martínez-Gómiz, Elena, Nieto-Moreno, Ana, Nieto-Moreno, Montserrat Ocampos Hernandez, Maria Laura Pelegrina-Lopez, Alicia Ruiz Escobar, Elena, Sáez-Ruiz, Beatriz, Vazquez-Rivero, Antonio, Lara, Belén Vielva Del Campo, Fernando Alcaide Matas, Simbad, Costas-Ochoa, José María García Pérez, Elizabeth, Marmol, Paula Troncoso Pereira, Maria Del Pilar Concejo Cutoli, Juan Ramón Gómez López, Juan Carlos Martín Del Olmo, Paloma Guillamot Ruano, Javier Páramo Zunzunegui, Antonio Albarracín Marín Blázquez, Alfonso, Aliaga-Sanchez, Marta María Arroyo Domingo, Miriam Artés Artés, Ana Isabel Avellaneda Camarena, Aida, Blaya, Emny Rochell Bobadilla Romero, Pedro Vicente Fernández-Fernández, Lorena Galindo Iñiguez, Víctor Javier García Porcel, Clara Giménez Francés, Antonio Javier Gomez Poveda, Rebeca Gonzalez Celdran, Francisco Miguel González Valverde, Laura Guillamon Vivancos, Elena, Gurrea-Almela, Alejandra Jara Maquilón, Jose David Jimenez Parra, Abd Al Aziz Lanagrán Torres, Raquel Lax Perez, Carmen Maria Lopez Lopez, Francisco, Machado, Alfonso Marco Garrido, Florencio Manuel Marin Martinez, Victoria Martínez Muñoz, Esther, Medina, Olimpia, Molina, José Manuel Muñoz Camarena, Julian, Onate, Pedro Antonio Parra Baños, Emilio Peña Ros, Enrique, Rubio, Marina Sánchez Robles, Carlos Sanchez Rodriguez, María Valero Soriano, María Teresa Yepes García, Felipe, Alconchel, Andrés Balaguer Román, Valentín, Cayuela, Ana, Conesa, Ana Delegido García, Pedro José Gil Vázquez, Paula Gómez Valles, Francisco, Gómez-Bosch, Vicente, J León-Muñoz, Francisco, Martínez, Alvaro, Navarro-Barrios, Tatiana, Nicolás-López, Pablo Ramirez Romero, Emiliano, Cano-Trigueros, María Concepcion Alonso González, Leticia Gómez Viana, Ana Pastor Zapata, Elisa Contreras Saiz, Tamara Díaz Vico, Maria, Fernandez-Hevia, Luis Joaquín García Flórez, Raquel, Rodríguez-Uria, Sandra, Sanz, Lorena, Solar-Garcia, Aida Suárez Sánchez, Jaume, Gelonch, Dietmar, Reinaldo, Miriam Abdulkarim Polo, Asier, Aguirre, Marta Alomar Bofill, Santiago, Baena, Ashish, Bartakke, Carmen Cabeza Oliver, Marta Castro Suárez, José Andrés Cifuentes Rodenas, Olga Claramonte Bellmunt, Ant Onia Crespí Mir, Anabel De La Llave Serralvo, Mar, Escales, Isabel Rosa Fernández Burgos, Pablo Gandia Gonzalez, Juan Lliteras Jorge, María Cristina Martínez Canto, Javier, Mata, Andreu, Morell, Naila, Pagès, Sara Pérez Palao, Cristian Plaza Valiente, Catalina Ramon Barcelo, Carmen Reyero Fernández, Albert Reyes Claret, Leticia Rodriguez Vaquero, Maialen Saez de Vicuña Salinas, Pilar Santos Cidon, Concepcion, Segura, Aina, Serra, Maria Serra Guivernau, Maria Soler Pedrola, Marta, Tasende, Marta Torrent Lluch, María Inmaculada Valldeperas Hernández, Rosa-Maria, Yañez-Lpez, Andrea, Craus-Miguel, Laura Fernández Vega, Natalia Pujol Cano, Juan José Segura-Sampedro, Laura Colet Oliver, Ivan Dot Pascuet, Mireia, Duart, Isabel Tello Galindo, Eduardo Arrea Salto, Jaume Cámara Cabrera, Marta Camats Terré, Juan Gabriel Castro Ríos, Marta de la Rosa-Estadella, Anna, Fernandez-Colorado, Anna, Gasulla-Rodriguez, Antonio, Gimenez-Gaibar, Elena, Gonzalez, Yeray Maldonado Sotoca, Matilde, Molina-Corbacho, Montserrat Monfort Mira, Josep, Rodoreda, Marta Santos Espí, Arnau Verdaguer Figuerola, Elisa Angela Diego-Alonso, Jaime, López-Sánchez, Luis, Muñoz-Bellvis, Jacobo, Trebol, Borja, Aguinagalde, Cristina Gabriela Alzate Arsuaga, Ainhoa Andres Imaz, Iñigo, Arana, Coro Aranzabal Urrutia, Mikel, Armendariz, Lorena, Arrabal, Iñigo, Augusto, Adolfo, Beguiristain, Laura, Busto, Ainhoa, Cuevas, Itziar De Ariño, Alejandro, Elúa, Leticia, Fernandez, Arantza, Fernandez-Monge, Lander, Gallego, Alba, Garcia, Amaia Garcia Dominguez, Gregorio, Garmendia, Carmen, Grañén, Pelayo Hevia Rodríguez, Maria, Iraola, José Miguel Izquierdo, Aintzane, Lizarazu, Jon Ander Lizarbe, Claudia Cristina Lopes Moreira, Iker, López, Ruth Marquina González, Tania, Pastor, Adrián Recio Ayesa, Ana Paula Riverola Aso, Carballo, Rodríguez, Araceli, Rodrìguez, Maria Inmaculada Ruiz Montesinos, Patricia, Torres, Jose, Undabeitia, Ainara, Villafruela, Maria Barrionuevo Ramos, David, Blanco, Marta, Calderón, Eva Corral Rubio, Angel, Cuadrado-García, Daniela, Cubek, Ignacio, Fariña, Maria Fernandez LLorente, Natalia Flores Amador, Mariana García Virosta, Luis Garcia-Sancho Tellez, Adelina Gonzalez Martinez, María, Hernandez, Rubén Herreros Ruiz-Valdepeñas, Carmen Jimenez Sanchez, Eduardo Llamazares Cobo, María, López, Javier, López-Martin, Teresa Martínez Marivela, Luis Miguel Martinez Parra, Paloma Maté Mate, Paloma, Medrano, Manuel Moriche Carretero, Sara Núñez O'Sullivan, Manuel Ortega Oria de Rueda, María Begoña Pastor Nieto, Clara, Pérez, Antonio, L Picardo, Remedios Revilla Amores, Carmen Rodríguez Haro, Jose Alberto Rojo López, Fatima Sanchez Cabezudo Noguera, Cristina, Sanz, Daniel Serralta de Colsa, Cristina Valor Garcia, Marta Velasco Martinez, Iván Andújar Lara, Aranzazu, Calero-Lillo, Enrique, López-Ruiz, Alberto Díaz García, Alejandro Menéndez Moreno, Luis Eduardo Pérez-Sánchez, Ángela, Pascual, Miguel Adeba García, Marta Alonso Fernández, Javier Alvarez Gama, Roberto, Ballestero, Loreto Berjon De La Vega, Paola Calleja Hermosa, Mariana, Carrillo-Rivas, Alfonso, Casado, Andrea, Cerveró, Bonifacio Cimadevilla Calvo, Patricia Corriols Noval, Paloma de la Dehesa Cueto-Felgueroso, Miren Jasone Diez Zapirain, José Estevez Tesouro, José Antonio Fernández-Dívar Sánchez, Lucia Garcia Alcalde, Juan García Cardo, Tito García Moreno, Daniel, García-López, Belen Garcia-Montesinos Perea, Miren Gonzalez Benito, Rocio, Gonzalez-Aguado, Miguel Ángel Gordo Vega Gordo-Vega, Jose, Gutierrez-Banos, Jaime Jimeno Fraile, Yolanda Jubete Castañeda, Patricia Lopez Gomez, Antonia Jesús López López, David Mato Mañas, Carmelo, Morales-Angulo, Dieter, Morales-Garcia, Sara, Naranjo, Jose Luis Rabago, Jose Manuel Rabanal, Rocio Revuelta Zorrilla, Adriana Reyes Echeverría, Juan Carlos Rodríguez-Sanjuán, Juan Ramón Sanz, Isabel Simal Badiola, Guillermo, Tejón, Enrique Toledo Martínez, Raquel Varea Malo, Begoña, Fadrique, Tania, Funes, Elena González Revilla, Isaias, Alarcón, Daniel Aparicio Sánchez, Pablo Beltran Miranda, Carmen, Cepeda-Franco, María Josefa Cuevas López, Sandra, Dios-Barbeito, Virginia María Durán Muñoz-Cruzado, Carlos Gonzalez De Pedro, Rosa, M Jimenez-Rodriguez, Francisco, Manresa-Manresa, Gabriel, Marin, Cristobalina, Martin-Garcia, Sara, Martínez-Núñez, Juan Manuel Martos Martinez, Lucas, Mengíbar, Felipe Pareja Ciuro, Eduardo Perea Del Pozo, Veronica Pino Diaz, José, Pintor-Tortolero, Claudia, Quintero-Pérez, Maria Luisa Reyes Diaz, Mercedes Rubio Manzanares Dorado, Alejandro Sanchez Arteaga, Ana, Senent-Boza, Luis, Tallon-Aguilar, Jose, Tinoco-Gonzalez, Luis-Cristobal, Capitan-Morales, Juan Cintas Catena, Javier, Valdes-Hernandez, María Del Campo Lavilla, Alina López De Fernández, Miriam Abellan Lucas, Alba Diaz Padillo, Maria Gómez Romero, Linda Grace Puerto Tamayo, El Mostafa El Yaqine Er Raoudi, Melody García Domínguez, María Ángeles Gascón Domínguez, Marta González Pérez, Alba Hernáez Arzoz, Joana San Anton, Cristian, Ruminot, Hander Guillermo Acosta Diaz, Daniella, Laguado, Kristina, Aghababyan, Alba, Jr, Enrique, Artigues, Rocío, Belda, Miguel, Beltran, Jose Ignacio Blanes, Elena Campos Carot, Miriam, Cantos, Laura, Costa, Carolina Ferrer Gomez, José María Gallego Sánchez, Oscar, Gil-Albarova, Juan, Gilabert-Estellés, Emilio Lopez Alcina, Isabel López Sánchez, Severiano Marin Bertolin, Carolina, Martinez-Perez, Antonio Melero Abellán, Claudia Mulas Fernández, Beatriz, Novoa, Ruth, Nuñez, Pablo Renovell Ferrer, Guijarro-Jorge, Ricardo, Carolina Soledad Romero Garcia, Miguel Sanfeliu Giner, Silvia, M West, Enrique, Zapater, Ignacio, Miranda, Ana, Monís, Alejandro Roselló Añón, María José Sangüesa, Jorge Sanz Romera, Marcos, Adrianzén, Maria Barrios Carvajal, Mireia, Bauzá, Ana Benítez Riesco, Jose Antonio Carbonell Lopez, María-Carmen, Fernández-Moreno, Ricardo Gadea Mateo, Francisco, Garcia, Maris Luisa García-Pérez, Luisa Paola Garzon, Ana, Izquierdo, Maria Lapeña Rodríguez, Carlos, León-Espinoza, Fernando, Lopez, Rosa Martí Fernández, Sara Martínez Castro, Berta Monleón López, Isabel Mora Oliver, David, Moro-Valdezate, Ernesto Muñoz Sornosa, Sara Palomares Casasús, Leticia Pérez Santiago, Mara Albert Fort, Reyes, Balanzá, Lorena Bermell Marco, Carla Carratalá Pérez, Claudia Pilar Clemente Tomas, Marta, Córcoles, Jose Ángel Diez Ares, Carlos Domingo Del Pozo, Nuria Estellés Vidagany, Gonzalo, Garrigos, Mar Gimeno Gimeno Vicente, Blanca Alastrue Giner, Segundo, Gomez-Abril, Paloma, Gonzalez, Paula Gonzálvez Guardiola, Guillermo Sebastian Martínez Fernández, Charo Martínez García, Lucía, Martínez-Costa, Luz María Moratalla Charcos, Sergio Navarro Martínez, Carmen, Payá-Llorente, Álvaro Pérez Rubio, Nuria, Peris, Eduardo Picazo Pineda, Jordi Planelles Gómez, Francisco Ripoll Vidal, Andrea, Roca, Enrique, Salmerón-González, Raquel Segura Roselló, Ramon Trullenque Juan, Cristina Verdejo Gimeno, Jose Miguel Zaragozá García, Gema Zomeño Bravo, Marcos Bruna Esteban, Hanna, Cholewa, Milton de Jesus, Matteo, Frasson, Luis Oliver García, Héctor, J Aguado, Antonio Jose Alonso Villalba, Francisco, Ardura, Carmen Elena Badillo Bercebal, María Bedate Núnez, Alvarez-Ramos Begoña Aranzazu, Juan Beltrán de Heredia, Hugo, Bermejo, Juan Berrocal Cuadrado, Maria Bragado González, Juan, Bustamante-Munguira, Raul Calvo Gonzalez, Yolanda, Carrascal, Ana Belén Casas Marcos, María Carmen Cervera, Sergio Chávez Valladares, Ángel Cilleruelo Ramos, Susana, Cortes, Jesús, Crespo-Sanjuán, María, Cuaresma, Luis Antonio Cuellar Martin, Carlos Ferreras García, Alvaro, Fuentes-Martín, Abel, Ganso, Elena García García, Luis, Garcia-Florez, Virginia, Garcia-Virto, Juan, Gatón, Julio Alberto Gobernado Tejedor, Tania Gómez Sanz, Jose Ignacio González Martín, María Begoña Gregorio Crespo, Ana Herranz Arriero, Jose, Herreros, Marta Ibáñez Nieto, César, Infante, Carlos, Jezieniecki, Moises, Juarez, Gregorio de Jesus Labrador Hernandez, Ana Patricia Legido Morán, Ricardo León Fernández, Alejandro, Leon-Andrino, Almudena, Llorente, Maria Lopez Pais, Mauricio Loucel Bellino, Sergio, Martin, Miguel Angel Martin-Ferrero, Gonzalo Martinez Municio, Elvira Mateos Alvarez, José María Matilla, Luis María Merino Peñacoba, Mario, Montes-Manrique, Fernando Natal Álvarez, David, C Noriega, Henar Nuñez Del Barrio, Francisco Javier Ortiz de Solórzano Aurusa, Lucía, Pañeda, Victoria Pascual Escudero, Miguel Pascual Samaniego, Adela, Pereda, Marta Pérez Febles, Laura, Pesquera, Maria, Plata, Emma Puertas Ruiz, Mario, Rodriguez-Lopez, Alejandro Romero de Diego, Ana, Ruano, María Ruiz Soriano, Cristina Sánchez Torralvo, Silvia Santiago Maniega, Bárbara, Segura-Méndez, Clarisa Simon Perez, José, Soro-García, Paula Suárez Mansilla Suárez-Mansilla, Jeancarlos Trujillo Díaz, Mª Esther Valsero Herguedas, Andrea Vazquez Fernandez, Eduardo Velasco García, Ana, Zabalza, Álvaro Zamora Horcajada, Fernando Acebes García, Enrique Asensio Díaz, Martín, Bailón, Alejandro David Bueno Cañones, Alvaro Centeno Velasco, Ekta Choolani Bhojwani, Fernando Labarga Rodríguez, Sara, Mambrilla, Pablo, Marcos-Santos, Toledano, Miguel, David Pacheco Sánchez, Baltasar, Pérez-Saborido, Pilar, Pinto, Katherine, Plua, Javier Sanchez Gonzalez, Vicente, Simo, Rosalía Velasco López, Sandra Veleda Belanche, Fabiola Eugenia Michel Campos, Iciar Muñoz Lindez, Maria, Balluerca, Maite, Camuera, Pablo, Helguera, Imanol, Herrero, Patricia Paunero Vazquez, María, Sánchez-Rubio, Isami, Soeda, María Dolores Arribas Del Amo, Vicente Manuel Borrego Estella, Estefania, Casas, Néstor Castán Villanueva, Daniel Delfau Lafuente, Elena Delgado Blanco, María, Domingo, Ismael Gil Romea, Azucena, Gonzalo, Emilio Lagunas Lostao, Noelia Lete Aguirre, Yaiza Martinez Lahoz, Jesús Víctor Pérez-Tierra Ruiz, Maria Del Mar Soriano, Isabel Valero Lázaro, Esmeralda Carnicer Escusol, Guillermo Pola Bandres, Juan Luis Blas Laina, Beatriz, Cros, Patricio Andrés Freile Pazmiño, David, Garcia-Aguilera, Ana Mejía Casado, Ana, Nogués, Issa Talal El-Abur, Carlos, Yánez, Isabel Gascon Ferrer, Carlos, Gracia-Roche, Ursula María Jariod Ferrer, María Victoria Simón Sanz, Tomas, Uson, Waseem, Ahamed, Sumudu, Jayasinghe, Eranda, Karunadasa, Prathibha, Nelihela, Sujeewa Priyantha Bandara Thalgaspitiya, Dickson, Wickramarathna, Nagenthiram, Harivallavan, Pirashanthan, Nagarasa, Eranga, Perera, Kanapathipillai, Piratheep, Vithranage Srimantha Dewsiri Rodrigo, Meera, Thayalan, Rajendram, Thayaparren, Arulprashanth, Arulanantham, Kanishka De Silva, Gagana, Ganga, Anuja Nadeeshan Kumarasinghe, Mahanada, Udukala, Koculen, Vimaleswaran, Prashanthan, Yogarajah, Ravindri, Jayasinghe, Probhodana, Ranaweera, Mohamed, Rishard, Dharmabandhu, N Samarasekera, Sanjeewa, Seneviratne, Sivasuriya, Sivaganesh, Chamal, Fernando, Nishantha, Mendis, Balasingam, Balagobi, Balasupramaniam, Sathesan, Lanka, Dasanayake, Malitha, Patabendige, Wickramasooriya, Dj, Kugarajh, Ganeshapillai, Sathyamoorthy, Prasanna, Dileepa, Ediriweera, Sumudu, Kumarage, Asanka, Jayawardane, Athula, Kaluarachchi, Pituwala Liyanage Adithya Sirisena, Abubakr, Abubakr, Hozifa, Mohamed, Ismail, Mustafa, Mogahid, Sharfeldein, Samir, Ismail, Reem, Musa, Monira, Sarih, Mussab, Abaker, Eman Adam Abdalla, Mohamad, Abdelbagi, Alsafe, Adlan, Ahmed, Alnaeem, Safa, Atyah, Yasir, Awad, Rsheeda, Dawelbait, Mohamed El Hag, Ibrahim, Elbashir, Sami, Eldirdiri, Samwal, Eldirdiri, Mohammed Eltahier Abdalla Omer, Lana Abdalgadir Ahmed Mohamed, Hiba Hassan Rehmtallah Ahmed, Mohammed Balla Yousif Balla, Abdulmoiz, Aljafari, Abdulmalek, Aljafari, Elsagad, Mohamed, Abdulkader, Mohammad, Abdulkader, Shaar, Mohamed Nafea Shaar, Maab Hussein Yousif Elhafiz, Mohammed Husien Yosif Elhafiz, Abubakr Ali Mohammed Alhassan Humidan, Almigdad, Ali, Hisham, Eljack, Mohamedyasin, Elrashid, Manhal, Ahmed, Albrra, Alhag, Douaa, Ali, Mohammed Ahmed Babikir, Imad, Bakheit, Hytham K, S Hamid, Sami, Mohamed, Walid, Shaban, Nidhal, Siddig, Mohamed, Suliman, Rihab Yasir Abdelmagid, Abubaker, Yassin, Omer, Abbas, Eltahir, Abdelrahim, Muhammed, Ahmed, Mohamed, Elobaid, Adil, Hashim, Ali, Mohamed, Omer, Mohamed, Khalid, Osman, Abdallah, Yousif, Safaa, Abdulaal, Marwa, Elsadig, Mohammed, Hussain, Malaz Amir Ataalmanan, Doha Amir AtaAlmanan, Tebyan Amir AtaAlmanan, Alaa, Elgaili, Maria, Mohamed, Usra, Omara, Alkhansa, Osman, Amna, Osman, Safaa, Saad, Abdelkareem, Ahmed, Ali Adil Ali Karar, Aya, Alhassan, Mohanad, Alsidig, Mohamed, Eljack, Mohammed Ibrahim Mohammed Ali, Awad Kamal Awad Osman, Liena, Mohamed, Samah Ibrahim Omer Mohamed Osman Mohamed Osman, Altayeb, Mohammed, Ayman, Mohammed, Khadija, Muhmmed, Eltahir, Musa, Egbal Sahal Abdelmajed, Khalid Z M, Y Hamid, Omnia M, M Yousif, Mahmoud, Saleh, Osman, Bashir, Yassein, Elhussein, Omar, Madani, Eva, Angenete, Jennifer, Park, Lars, Gillberg, Monir, Jawad, Linas, Pieteris, Yousif, Saeed, Sergej, Safonov, Martin, Spångfors, Henrik, Andersson, Hans, Bahlmann, Karin Björnström Karlsson, Michelle, Chew, Lara, Daham, Lina De Geer, Helen, Didriksson, Gunilla, Gagnö, Carina, Jonsson, Anna, Oscarsson, Pamela, Buchwald, Mathilde, Delorme, Marie-Louise, Lydrup, Shahin, Mohseni, Arvid, Pourlotfi, Souheil, Reda, Kajsa, Anderin, Nina, Blomme, Josefin, Segelman, Malin, Simlund, Anders, Thorell, Fredrik, Wogensen, Daniel, Danielsson, Peter, Elbe, Rebecka, Hultgren, Boel, Hynning, Fredrik, Klevebro, Karin, Lind, Ebba, K Lindqvist, Carl, Montan, Ernesto, Sparrelid, Clara Svenberg Lind, Jeremy, Wales, Andreas, Älgå, Martin, Nordberg, Emil, Pieniowski, Ioannis, Gkekas, Niklas, Löfgren, Karolina, Niska, Robert, Zürner, Silvio, Däster, Otto, Kollmar, Savas, Soysal, Stephanie, Taha-Mehlitz, Athanasios, Tampakis, Dominik Valentin Flury, Marie, Heyne-Pietschmann, Gregor Jan Kocher, Ana, M Calinescu, Barbara, Wildhaber, Markus, Gass, Jürg, Metzger, Andreas, Scheiwiller, Lukas, Briner, Oliver, Dwidar, Steven, Grandjean, Pietro, Ricciardi, Alexandra, Calmels, Christodoulou, Michel, Morena, Antonilli, Dimitrios, Christoforidis, Alessandra, Cristaudi, Jacopo, Galafassi, Maria Luisa Gasparri, Francesco, Mongelli, Martino, Munini, Andrea, Papadia, Sotirios Georgios Popeskou, Alex, Alfieri, Thomas, Bächler, Matteo, Giardini, Christian, Gingert, Laura, Guglielmetti, Inna, Meyer, Tobias, Müller, Daniel, Schöni, Folco, Solimene, Frank, Weidner, Marco, Bueter, Daniel, Gero, Amelie, Müller, Carmen, Portenkirchner, Andreas, Thalheimer, Jeannette, Widmer, Ahmad, Hmaideh, Alaa, Kour, Saleem, Swaes, Omar, Alannaz, Ramez, Aljasem, Ezeddin, Dabbagh, M Wafa Hamoud Alhussein, Amr, Hamza, Mazen, Mohammad, Abd El-Fattah Mouhandes, Mohamad, Shareeda, Mohammad Nour Shashaa, Mousa, Sifat, Sheraa, Tahhan, Rahaf, Toutounji, Mohamed, Abdulrahman, Albaraa, Abdulsalam, Ziad Al Jarad, Hala, Alayyoubi, Dina, Alfarra, Ahmad, Alhamid, Mahmoud, Alnasser, Mulham, Gharib, Ruwaid, Gharib, Obaida, Kabel, Osama, Kherallah, Abdulqader, Klaho, Mohamed Shukri Najjar, Ahmad, Razouk, Joud, Shiekhoni, Wael, Alkhaleel, Amira, Almosa, Mohammad, Aloulou, Maen, Alzaeem, Khaled, Arnaout, Muhamad Zakaria Brimo Alsaman, Mohamad, Estanbouli, Hanadi, Hawa, Ahmad Nbrass Kabawi, Ghina, Maarawi, Yehia, Mashhadany, Sana Shaikh Torab, Waleed, Abd, Tayma Abd Alghafour, Hani, Abdalnour, Nazeeh Al Aktaa, Marwan Al Aliwy, M Maher Al Arje, Tasneem Al Najjar, Ahmad, Al-Mouakeh, Ahmad, Aldakhil, Aos, Alhamid, Hasan, Alhasan, Mohamad Shadi Alkarrash, Jumaa, Alkhamis, Sara, Alshekh, Ahmad Yamen Arnaout, Oula, Azizeh, Mohammed, Dalaleh, Aghyad, Danial, Zain, Douba, Raghad, Ghadri, Mohammad Maen Ghannam, Anas, Ghawi, Luma Haj Kassem, M Yasser Halwani, Shahed, Hamadieh, Mohammad, Hanino, Ala Aldeen Hasan, Haya, Jawish, Nasr Ullah Kabbani, Saadullah, Kabbany, Mohamad, Kadi, Lama, Kadoura, Ahmad Amir Kayali, Ammar, Kayyali, Aya, Kelzia, Amana, Kezze, Abdullah, Khalaf, Maymona, Khayata, Mohammad Nour Kitaz, Mohammad, Kour, Raghad, Makki, Ruqaya, Masri, Joseph, Masri, Noor, Masri, Muhammad, Mazketly, Shiar, Mustafa, Ezzeldin, Nashed, Yaman Qoudra Danial, Hasan, Raslan, Rima, Salem, Mohammed Asaad Salem, Thabet Sayed Bakir, Manaf, Sharabaji, Majd Sheikh Alganameh, Duaa Sheikh Kadro, Joudy, Shurbatji, Mohammad Noor Sultan, Dana, Sultan, Hala, Swied, Bakri Tarras Jarkas, Tayf, Toutounji, Fadi, Ward, Rama, Zazo, Aya, Zazo, Zainab, Zeino, Mohamed, Alaktaa, Wael, Alsado, Hala, Fares, Nouran, Hawa, Hamza, Ibrahim, Abdulmonem, Kawas, Mourad, Niazi, Bayan, Toutounji, Mohammad, Abdow, Mohamad, Ahmad, Tareq, Ahmad, Rawan Al Azhar, Hiba Al Hage Diab, Rahaf Al Mulke, Mohammad, Al-Jadaan, Ahmad, Alhussein, Zahra, Alnajem, Omar, Alneser, Bayan, Alsaid, Elias, Azar, Lubna, Bakr, Ammar, Hamza, Yara, Houdifa, Sami, Jomaa, Samer, Kefo, Hiba, Mardini, Alaa, Mohammad, Fadi, Rayya, Fatima, Razzouk, Mohannad, Saleh, Anwar, Shamandi, Ammar Youzkatli Alkhatib, Omar Abdul Salam, Dany, Ajami, Mohammad, Alhamid, Ahmad, Alkhaledi, Danny, Hadidi, Massa, Jabra, Mamdouh, Kallas, Antoine, Laktine, Joelle, Naem, Naya, Naoum, Ghena Mohammed Fawaz Ashour, Ahmad, Alhouri, Deema, Fallouh, Ahmad, N Mohammad, Ahmad, Rmman, Ali, Slitin, Christine, Tanos, Ibrahim, Wakim, Hanaa, Zahrawi, Majd, Abouassi, Layth, Abouassi, Ayham, Aboutrab, Basel, Ahmad, Ahmad Mustafa Ahmad, Aya, Ahmad, Afaf, Ahmad, Mohamad, Alabras, Mohammad, Albasheer, Ola, Alkasser, Mhd Khaled Alkasser, Ali, Alkhdor, Marah, Azkoul, Mohammad Karam Chaaban, Haya, Deeb, Basel, Jazieh, Basel, Kouz, Youssef, Kozah, Raied, Mohamad, Ammar, Mohammad, Mhd Zied Nasri, Mohammed Mouaz Shebani, Mohammed, Shwin, Alaa, Sommaq, Amal, Youssef, Tala Al Asadi, Suhad, Alkhateb, Rasha Khalil Alsayyad, Roula, Altom, Mhd Amin Alzabibi, Batoul, Bakkar, Hlma, Ismail, Salma Khadem Alsrouji, Sara, Melhem, Mohamad, Sankari, Mosa, Shibani, Noura, Shujaa, Ibrahim, Adham, Salma, Al-Houssami, Maram, Balouli, Yazan, Rahmeh, Simon, Yanni, Sally, Yousef, Aline, Ahmad, Marah, Ali, Abdulrahman, Almjersah, Aya, Almoustafa, Hiba, Dahhan, Bashar Haj Hassan, Alaa, Hamdan, Salah, Hammed, Rawan, Harfoush, Rama, Hasan, Natalie, Jarkas, Moufid, Mahfoud, Ahmed, Moussa, Alaa, Sulaiman, Siba, Suliman, Yu-Ning, Hu, Jun-Neng, Roan, Meng-Ta, Tsai, Yi-Chen, Wang, Thammawat, Parakonthun, Nicha, Srisuworanan, Voraboot, Taweerutchana, Somcharoen, Saeteng, Sophon, Siwachat, Apichat, Tantraworasin, Danielle, Dimsoy, Shane, Khan, Akash, Ramsaroop, Shivanand, Ramsubhagh, Karim, Ayed, Oussama, Baraket, Mohamed Hedi Ghalloussi, Abbassi, Imed, Nahla, Kechiche, Waad, Farhat, Ammar, Houssem, Erdal Birol Bostanci, Volkan, Oter, Erol, Pişkin, Cihangir, Akyol, Sibel, Demirel, Mehmet Ali Koç, Can, Konca, Özge, Yanık, Basak, Bolukbasi, Huseyin, Gobut, Emre, Gülçek, Kerim, Karabulut, Ramazan, Kozan, Farshad, Noori, Elif, Özeller, Can, Şahin, Ali, Yalcinkaya, Mesut, Yavaş, Aydın, Yavuz, Utku, Akgor, Omer, Cennet, Hilmi Anil Dincer, Murat, Gultekin, Nazlı, Orhan, Mustafa, Oruç, Serdar, Culcu, Lütfi, Doğan, Cemil, Yüksel, Alp, Yildiz, Aybala, Yildiz, Perihan, Ekmekçi, Baturay Kansu Kazbek, Ülkü Ceren Köksoy, Deniz Serim Korkmaz, Zeynep Şahan Çetinkaya, Elif Aybeniz Yildirim, Hakan, Yilmaz, Metin, Yığman, Nasuh Utku Dogan, Selen, Doğan, Mehmet, Sakinci, Ozgen, Isik, Murat, Şen, Tuncay, Yılmazlar, Utku, Özgen, Ugur, Sungurtekin, Yener, Aydin, Ilker, Ince, Ali Bilal Ulas, Hüseyin Cahit Yalçın, Mehmet, Kaplan, Tuğba, Kaplan, Elif Tugce Kaplan, Afag, Aghayeva, Bilgi, Baca, Inci, Sahin, Zumrud, Aliyeva, Akif Enes Arikan, Erman, Aytac, Onur, Dülgeroğlu, Volkan, Ozben, Cihan, Uras, Emre, Sivrikoz, Ismail Ahmet Bilgin, Bahadır, Bozkırlı, Güralp Onur Ceyhan, Ismail, Hamzaoglu, Halil, Kara, Tayfun, Karahasanoğlu, Olus, Api, Mehmet, Ceyhan, Aylin Pelin Cil, Telce Aysen Gurbuz, Cumhur, B Lent Urman, Ahmet, Akbas, Yunus Emre Aktimur, Yuksel, Altinel, Fikret, Calikoglu, Serdar, Demirgan, Ahmet Guray Durmaz, Gulcin, Ercan, Candas, Ercetin, Hasim Furkan Gullu, Nadir Adnan Hacım, Serhat, Meriç, Kamil, Özdoğan, Merve, Tokocin, Mehmet Alim Turgut, Talar, Vartanoglu, Hakan, Yigitbas, Hüsnü, Aydın, Ece, Bahçeci, Mestan, Bilmez, Elif, Binboğa, Sinan, Binboga, Gokhan, Demirayak, Bengi, Demirayak, Keziban, Doğan, Ahmet Cem Dural, Murat, Ekin, Sina, Ferahman, Fatih, Guven, Mehmet, Karabulut, Sema, Karakaş, Selçuk, Köse, Ayşe Büşra Önder, Ismail Umut Onur, Nuri Alper Sahbaz, Levent, Yaşar, Ulviye, Yigit, Güneş Özlem Yıldız, Ümmühan Zeynep Bilgili, Bayram, Doğan, Cevper, Ersoz, Abdullah, Ilktac, Senad, Kalkan, Eyyüb Selim Ünlü, Halil, Alis, Süleyman, Büyükaşık, Burak, Kankaya, Oguzkagan, Batikan, Ensar, Çakır, Musa Murat Caliskan, Mahmut Emin Çiçek, Anil, Demir, Selim, Doğan, Emre, Erdoğan, Mert, Güler, Muhammed, Gürlük, Ufuk Oguz Idiz, Rozan, Kaya, Cebrail, Oğuz, Ömer Akay Ömer, Serkan Süleyman Özpak, Hüsnü, Şevik, Mert Mahsuni Sevinc, Cihad, Tatar, Oğuzhan, Tekin, 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Yanar, Ahmet, Akmercan, Gül, Çakmak, Tuncay, Kötan, Tunc, Lacin, Ayten, Saracoglu, M Umit Ugurlu, Tumay, Umuroglu, Tevfik Kıvılcım Uprak, Esra Yamansavci Şirzai, Bedrettin, Yıldızeli, Elif, Baran, Emre, Bozkurt, Sinan, Ömeroğlu, Mert, Tanal, Aydın Eray Tufan, Mehmet, Uludag, Gürkan, Yetkin, Murat, Kalın, Omer Faruk Ozkan, Hanife Şeyda Ülgür, Tayfun, Bisgin, Muhammet Berkay Sakaoglu, Selman, Sökmen, Deniz, Caglar, Candan, Cicek, Demre, Delipinar, Emre, Divarci, Egemen, Ozdemir, Hilmican, Ulman, Seda Dilek Yetut, Feyme, Zafer, Ismail, Sert, Burçin, Abud, Murat, Akalin, Cengiz, Aydin, Bulent, Calik, Emine Burcu Cigsar, Semra Demirli Atıcı, Ayberk, Dursun, Mustafa, Emiroglu, Hüseyin, Erdinç, Tayfun, Kaya, Gizem, Kilinc, Yasemin, Kirmizi, Merve Dilara Öney, Mustafa Onur Oztan, Semra, Salimoğlu, Cem, Tugmen, İbrahim, Uyar, Sertaç Ata Güler, Alican, Güreşin, Ozan Can Tatar, Nihat Zafer Utkan, Kemal, Arslan, Mustafa Bilal Hamarat, Ismail, Hasirci, Mehmet Serkan Ozkent, Mehmet Eşref Ulutaş, 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Malaz, Abbakar, Vanessa, Badas, Radu, Chirvasuta, Joe, Drybrough, Alexandra, Hamshere, Annabelle, Harrison, Rebecca, Ireson, Nelson, Kamali, Abigail, Lau, Sumant, Luhana, Luisa, Macdonald, Barbara, Ribeiro, Alistair, Savage, Tanisha, Sharma, Paul, Swift, Rachel, Taute, Stephanie, Alford, Chase, Elswick, J Quentin Clemens, John Michael DiBianco, Anna, Faris, Mark, Hemmila, Giulia, I Lane, Lena, Napolitano, Jane, J Wong, Shelly, Abramowicz, Dina, Amin, Steven, Roser, Daniel, Beswick, Elisa, Birnbaum, Khaled, Campa, Carolyn, Chabuz, Brandon, Chapman, Nicole, Christian, Marco Del Chiaro, Adam, Dyas, Anna, Gergen, Anne, Getz, Ana, Gleisner, Ryan, Griffin, Laura, Harmon, Scott, Hirsch, Victoria, Huynh, Juan Pablo Idrovo, Laura, Leonard, Helen, Madsen, Robert, Mcintyre, Robert, Meguid, Kenny, Rodriguez, Richard, Schulick, Christopher, Scott, Lauren, Steward, Camille, Stewart, Malcolm, Su, Sarah, Tevis, Daniel, Thieu, Shane, Urban, Catherine, Velopulos, Jon, Vogel, Thomas, Vogler, Kristen, Vossler, Michael, Weyant, Franklin, Wright, Erika, Bengtson, Mary, Bokenkamp, Hannah, Chacon, W Drew Fielder, Alex, Haynes, Charlotte, Heron, Charles, Hill, Cole, Holan, Hannah, Kay, Brian, Kelley, Sabino, Lara, Kathryn, Mcelhinney, E Charles Osterberg, Sharmila, Paul, Christopher, Riley, Ayane, Rossano, Romil, Shah, Ifeoluwa, Shoyombo, Pooja, Srikanth, Pedro, Teixeira, Marc, Trust, Marian, Williams-Brown, Benjamin, Bigelow, Ijezie, Ikwuezunma, Amit, Jain, Harsha, Malapati, Ivy, Mannoh, Adam, Margalit, Sarah, Rapaport, Srikrishna Vangipuram Suresh, Dominique, Vervoort, Lekha, Yesantharao, Zhang, Bo, Hossam, Abdou, Megan, Anders, Jose, Diaz, Michael, Mazzeffi, Peter, Rock, Salim, Afshar, Andrea, Balthazar, Laura, Carlson, Karen, Carver, Michael, Kurtz, Craig, D McClain, Meena, Nathan, Caleb, Nelson, Nathalie, Roy, Rachel, Saunders, Amir, Taghinia, Vivian, Williams, Allison, Brown, Zara, Cooper, Joshua, Jolissaint, David, Mahvi, Barbara, Okafor, Chandrajit, Raut, Vanessa, Roxo, Ciersten, Burks, Allen, Zhou, Djanira, Fernandes, Maha, Haqqani, Nicolette, Jabbour, David, Novikov, Joseph, Sabra, Paul, Tornetta, Lauren, Tracy, Keianna, Vogel, Joanna, Wang, Shawn, Wang, Shaun, Wason, Emily, Berner, Ander Dorken Gallastegi, Mohamad El Moheb, Anthony, Gebran, Marilyn, Heng, Santiago Lozano Calderon, Michael, Mctague, Christopher, Melnic, Andy, Park, Anna, Goldenberg-Sandau, Rebecca, Platoff, Lisa, Shea, Debra, Manning, Romeeka, Perkins, Samuel, Ross, Kyle, Thompson, Grace, Chang, Dustin, Dehart, Jared, Ourieff, Rosalinda, Alvarado, Anuradha, Bhama, Daniel, Deziel, Amir, Dorafshar, Henry, Govekar, Brian, Gulack, Dana, Hayden, George, Kokosis, Andrea, Madrigrano, Keith, Millikan, Jonathan, Myers, Cristina, O'Donoghue, Philip, Omotosho, Sam, Pappas, Srikumar, Pillai, Thea, Price, Scott, Schimpke, Ami, Shah, Deana, Shenaq, Nicole, Siparsky, Alfonso, Torquati, Peter, Tsambarlis, Srinivas, Vourganti, Al-Faraaz, Kassam, Ralph, Quillin, Mauro, Bravo, Elyad, Ekrami, Kai, Li, Alparslan, Turan, Cassie, Decker, Elizabeth, A Hennessy, Thomas, Schroeppel, Zachery, Stillman, Gary, Schwartz, Salah, Aoun, James, Caruso, Clay, Burlew, Julie, Clark, Kendyll, Gartrelle, David, Kwon, Kristin, Colling, Andrew, Barbas, Raquel, Bartz, Sarah, K Dotters-Katz, Tressa, Ellett, Etienne, Flamant, Hesham, Gabr, Dilraj, Grewal, George, Kasotakis, David, Kerr, Vijay, Krishnamoorthy, Alexander, Lazarides, Justin, Ma, Sachin, Mehta, Lucy, Meyer, Courtney, Mitchell, Demetrios, Moris, Diego, Schaps, Zohal, Ghulam-Jelani, Motasem, Refaat, Torre, Soderlund, Amna, Ali, Airi, Katoh, Krista, Kaups, Leigh Ann O'Banion, Yazen, Qumsiyeh, Jessica, Simpkins-Fresno, Murad, Almasri, Gauri, Kulkarni, Hisham, Marwan, Mohammad, Mehdi, Rasaq, Olaosebikan, Camilo, Velasquez, Rodrigo, Arrangoiz, Jeronimo Garcialopez De Llano, Adrian, Legaspi, Maria Fernanda Mijares Olivo, Amit, Sastry, Vanitha, Vasudevan, Hector, Garcia-Chavez, Atif, Iqbal, Yesenia, Rojas-Khalil, Malke, Asaad, Charles, Butler, Cameron, Gaskill, Patrick, Hensley, Jose, Karam, Matthew, Katz, Huan, Nguyen, Alberto, Pieretti, Christina, L Roland, Perel, Baral, D David Beahm, German, Berbel, Andres, Bur, Shea, Carver, Austin, Findley, Christopher, A Guidry, Megan, Hedlund, Corey, Hounschell, Sean, Kumer, Kelsey, E Larson, Derek, Marlor, Madhuri, Reddy, Scott, Turner, Alissa, Urich, Alexander, Cavalea, Brian, Daley, Bailey, Humphreys, Rachel, Savoy, Mary, Leech, Andrew, Loehrer, Kari, Rosenkranz, Avi, Bhavaraju, Nolan, Bruce, Lyle, Burdine, Kyle, Kalkwarf, Mary, Kimbrough, Garrett, Klutts, Joseph, Margolick, Tamara, Osborn, Anna, Privratsky, Matthew, Roberts, Jennifer, Baker, Peyman, Benharash, Ronald, W Busuttil, Robert, B Cameron, Joseph, Dinorcia, Joseph, Hadaya, Farnaz, Haji, Lien, Hua-Feng, Catherine, Juillard, Minna, Lee, Garrett, Salzman, Gregory, Senofsky, Richard, J Shemin, Jeannie, Shen, Carlie, Thompson, Areti, Tillou, Elizabeth, Bruenderman, Samuel, Carson, Clayton, Ellis, Farid, Kehdy, Robert C, G Martin 2nd, Tyler, Mouw, Amy, Wise, Linda, Britton-Zier, Julie, Dunn, Benjamin, Massey, Chathurika Samudani Dhanasekara, Thomas, Wyatt, Daniel, Abbott, Eugene, Foley, Stephanie, Savage, Patrick, Schwartz, Syed Nabeel Zafar, Lauren, Camp, Ruth, A Lewit, Alessia, Cioci, Amber, Collier, Gareth, Gilna, Neha, Goel, Joshua, Kronenfeld, Rebecca, Saberi, Eva, Urrechaga, Juan, Figueroa, Basil, Karam, Rachel, Morris, Christopher, J LaRocca, Archana, Ramaswamy, Steven, Waisbren, Jacob, Ankeny, Rahel, Ghebre, Jane Yuet Ching Hui, Eric, Jensen, Jordan, Mattson, Rachel, Vogel, Emily, Colonna, Frederick, Endorf, Rachel, M Nygaard, Alva, Bethurum, Rohan, Bhalla, David, Bichell, Christopher, Bonfield, Silky, Chotai, Michael, Dewan, Alexander, Hawkins, Aimal, Khan, J Matthew Kynes, Alexandra, Mata, Christopher, Wallis, Camila, Walters, Alice, Wang, Irving, Zamora, Lindsey, Zamora, Marah, Maayah, Melanie, Sion, Sarah, Ullrich, Dalia, Alqunaibit, Kiah, Andrews, Danielle, Friedman, John, Mcnelis, Yasmin, Abedin, Brian, Batko, Anthony, Colon, Sofia, Gabrilovich, Carma, Goldstein, Christina, Gory, Janmejay, Hingu, Brian, Leoce, Anh, Nguyen, Guergana, Panayotova, Ruchi, Ram, Deviney, Rattigan, Jerette, Schultz, Sara, Solar, John, Stein, Grace, Tsui, Elizabeth, Warnack, Apostolos, Gaitanidis, Leon, Naar, Robert, Sinyard, Sophia, Angelides, Laura, Fitzmaurice, Alexander, Himstead, Mehraneh, Jafari, Zeljka, Jutric, Kari, Kansal, Lydia, Kirillova, Isabella, Kuo, Kapila, Patel, Erika Linmey Tay Lasso, Maki, Yamamoto, Maleeha, Ahmad, Steven, Chang, Gary Alan Bass, Benjamin, Braslow, Daniel, Dempsey, Caoimhe, Duffy, Daniel, Holena, Jonathan, Imran, John, Keogh, Cara, Lorenzi, Niels, Martin, Mark, Seamon, Lauren, Huckaby, Katrina, Morgan, Caroline, Rieser, Lauren, Rosenblum, Cindy, Teng, J Michael DiMaio, Mohanad, Hamandi, Mary, Hoffman, Allison, T Lanfear, Michael, Connolly, Benjamin, Hall, Tareq, Kheirbek, Elizabeth, Renaud, Kevin, Behm, Judy, Boughey, Kristin Cardiel Nunez, Sean, Cleary, Mihai, Dumbrava, Travis, Grotz, James, Jakub, Rahul, Kanade, David, Larson, Sherief, Shawki, Dennis, Wigle, Haradeen, Dhillon, Avni, Suri, Leonardo Weber Graeff, Ahmed, Elshabrawy, Grace Ihsiu Todd, Mark, Davies, Yan, Qi, Walter, Biffl, Kathryn, Schaffer, Sarah, Averbach, Terry, Curry, Alexandra, Schwartz, Mary Kathryn Abel, Veronica, Andaya, Kristina, Benirschke, Katherine, Bigay, Marissa, Boeck, Lee-Lynn, Chen, Lee-May, Chen, Huey-Lan, Chern, Amanda, Compadre, Patricia, Conroy, Alexa, Glencer, Patrick, Ha, Barbara Cs Hamilton, Johannes, R Kratz, Rondall, Lane, Rex, H Lee, Brenda, Nunez-Garcia, Richard, O'Donnell, Doruk, Ozgediz, Paul, Park, Ankit, Sarin, Ipsit, Shah, Bonnie, Sheu, Madhulika, Varma, Katherine, Wai, Rosanna, Wustrack, Mary Jue Xu, Melissa, Zimel, Pedro, Escobar, Meredid Maldonado Santiago, Mohammad, Azam, Asad, Choudhry, Eric, Hammond, William, Marx, Jihad, Abbas, Somya, Al-Embideen, Carol, Angel, Bailea, Bobich, Raul, Bosio, Gregory, Georgiadis, Tahir, Jamil, Maria, Kenner, Meghan, Lark, Tamara, Maghathe, Sonia, Masih, Gabriel, Naimy, Kristin, O'Mara-Gardner, Emily, Rady, Roberta, Redfern, Jack, Sample, Joseph, Sferra, Kaitlyn, Sharp, Jessica, Shoemaker, Stephen, Stanek, John, Stengle, Hibba, Sumra, Jeffrey, M Sutton, Faris, Azar, Anne, Fischer, Jaymie, Henry, Lawrence, Lottenberg, Mario, Rueda, Sasha, Thiel, Adel, Bozorgzadeh, John, Kelly, Armando Salim Munoz Abraham, Erin, Scott, Camila, Haro, Andrés, Pouy, Gastón, Acuña, Sofia, Álvarez, Ana Carmen Carbajal, Fabiola, Castedo, Diego, Pereiranuñez, Helena, Sobrero, Josefina, Tarigo, Rafat, Al-Saban, Fatima, Al-Eryani, Siham Al Maqtari, Sahar, Al-Maqtari, Mahmmoud, Abdualqader, Majed, Aeed, Ghadeer Al Sanany, Anwaar Al Dhafif, Buthina Al Jarmozi, Saba, Al-Ameri, Awsan, Al-Dhaheri, Dhyia Alhuq Al-Surimi, Amira, Alakhdury, Sabreen, Alashmali, Zainab, Alattas, Manar, Alduba'Ai, Hamdan, Aldumaini, Wafa, Alhaddad, Abdelrahman, Alharazi, Nawal, Alhemyari, Adnan, Alhumaida, Maniee, Aljabri, Hassan, Almarashi, Zuhoor, Almohanady, Marwa, Alodine, Nooraldin, Alqasemi, Basma, Alqudaimi, Ansam Mohammed Ghaleb Alrobaiee, Mohammed, Alsabri, Radfan, Alsalal, Ramzi, Alsayadi, Musaed, Alsayadi, Reem, Alshaipani, Ebrahim, Alsharabi, Nora, Atiah, Hadeel, Bajjah, Muhib, Esmael, Asma, Ghallab, Rana, Ghannam, Adwa'A, Hamid, Lina, Hashem, Sara, Saif, Shaima, Sayad, Nawras, Shaban, Amatallah Hadi Shamsan, Sarah, Shream, Amal, Shukri, Shahd, Zeid, Nabila, Abdullah, Abdulrahman Faisal Al-Garadi, Ahmed, M Ali Al-Radhi, Norhan, Naji, Shaima'A, Nasser, Areej Taha Al Anaib, Ebrahim, Abdurab, Fadhl Al Muhtadi, Amer, Al-Hebbah, Ahmed, Al-Madhrahi, Shehab, Al-Mahdi, Sakhr Abdulhakeem Al-Maswari, Ayman, Al-Oqabi, Zakarya Abdullah Al-Zaazaai, Karim, Al-Zazay, Ali, Alafif, Asem, Albzzaz, Lina, Alqalisi, Mohammed, Alrezami, Haneen, Alshargabi, Mokhtar, Alshargabi, Hossam, Ghanem, Kareem, Saeed, Rasheed, Shalabi, Fareed, Showqi, Miriam, Maimbo, Catherine, Mkandawire, Mulaya, Mubambe, Theresa, Nkole, Vanessa, Savopoulos, Patricia, Shinondo, Chabwera, Shumba, Penias, Tembo, Shelton, Chivanga, Ngqabutho, Dube, Handsome, Dube, Daniel, Dzinotyiwei, Ronald, Makanda, Moses, Mangena, Partson, Maphosa, Derek, Matsika, Proud, Mawere, Nkosikhona, Moyo, Assel, Moyo, Arnold, Muguwu, Simbarashe, Mungazi, Garikai, Mwale, Gamuchirai, Ndabvonga, Mambote Crispin Olivier Ntoto, Hardlife, Ranganai, Ernesto Sánchez Castillo, Oltah, Tshuma, Grace, Gwini, Vimbai Moyana Muguto, Gilbert, Moyo, Trust, Mushawarima, Tinashe, Shoko, Rorisang, Jamela, Marvellous, Machiri, Eric, Shumba, Antony, Chengahomwe, Yemurai, Bikwa, Maxwell, Chimhina, Jeremy, Marume, Kudzayi, Munanzvi, Precious G, T Mutambanengwe, Federico, Ferrari, Marco, Fontanella, Franco, Odicino, Romano, Vito, Nepogodiev D, Emanuele Cammarata, Sofia Campanella, Daniela Canzonieri, Adriana Cordova, Federico De Michele, Ettore Dinoto, Mara Franza, Leo Licari, Daniele Matta, Domenico Mirabella, Felice Pecoraro, Roberto Pirrello, Pierfrancesco Pugliese, Fernando Rosatti, Giuseppe Salamone, Francesca Toia, Massimiliano Tripoli, Nepogodiev, D, Rosati, R, Surgery, Medicine and Pharmacy academic/administration, Basic (bio-) Medical Sciences, Surgical clinical sciences, Faculty of Medicine and Pharmacy, Gastroenterology, Medical Oncology, Clinical sciences, Breda, João, ARD - Amsterdam Reproduction and Development, Paediatric Surgery, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, AGEM - Endocrinology, metabolism and nutrition, Graduate School, Tytgat Institute for Liver and Intestinal Research, Laura Alberici, Filippo Antonacci, Alessandro Arena, Angela Belvedere, Fabio Bernagozzi, Paolo Bernante, Pietro Bertoglio, Lorenzo Bianchi, Maria Bisulli, Barbara Bonfanti, Safia Boussedra, Jury Brandolini, Crescenzo Cacciapuoti, Stefano Cardelli, Riccardo Casadei, Matteo Cescon, Alessandro Cipolli, Riccardo Cipriani, Alfredo Conti, Luca Contu, Francesco Costa, Niccolo’ Daddi, Eugenia De Crescenzo, Pierandrea De Iaco, Alessandra De Palma, Massimo Del Gaudio, Anna Nunzia Della Gatta, Giampiero Dolci, Giulia Dondi, Matteo Droghetti, Sergio Nicola Forti Parri, Elena Garelli, Chiara Gelati, Giuliana Germinario, Federico A. Giorgini, Carlo Ingaldi, Elio Jovine, Kenji Kawamukai, Antonio Lanci Lanci, Raffaele Lombardi, Maria Elisa Lozano Miralles, Claudio Marchetti, Michele Masetti, Francesco Minni, Daniele Morezzi, Daniele Parlanti, Alice Pellegrini, Anna Myriam Perrone, Anna paola Pezzuto, Marco Pignatti, Gianluigi Pilu, Valentina Pinto, Gilberto Poggioli, Silvana Bernadetta Puglisi, Diego Raimondo, Matteo Ravaioli, Claudio Ricci, Sara Ricciardi, Francesco Ricotta, Roberta Rizzo, Angela Romano, Matteo Rottoli, Riccardo Schiavina, Renato Seracchioli, Matteo Serenari, Margherita Serra, Piergiorgio Solli, Gioia Sorbi, Mario Taffurelli, Marta Tanzanu, Achille Tarsitano, Marco Tesei, Gabriele Vago, Tommaso Violante, Simone Zanotti, Tommaso Frisoni, leonardo solaini, giorgio ercolani, Fruscio, R, Ornaghi, S, Collaborative, Covidsurg, Collaborative, Globalsurg, Palmisano, Silvia, de Manzini, Nicolo', Žundienė, Laura, Dulskas, Audrius, Kuliavas, Justas, Čekauskas, Albertas, Kielaitė-Gulla, Aistė, Poškus, Tomas, Strupas, Kęstutis, Želvys, Arūnas, COVIDSurg Collaborative, GlobalSurg Collaborative, Department of Surgery, HUS Abdominal Center, Simoes, Jff, Li, E, Picciochi, M, Glasbey, Jc, Baiocchi, G, Blanco-Colino, R, Chaudhry, D, Alameer, E, El-Boghdadly, K, Wuraola, F, Ghosh, D, Gujjuri, Rr, Harrison, Em, Lule, H, Kaafarani, H, Khosravi, M, Kronberger, I, Leventoglu, S, Mann, H, Mclean, Ka, Mengistu, Gm, Modolo, Mm, Ntirenganya, F, Norman, L, Outani, O, Pius, R, Pockney, P, Qureshi, Au, Roslani, Ac, Satoi, S, Shaw, C, Bhangu, A, Omar, Om, Ahmed, Wur, Argus, L, Ball, A, Bywater, Ep, Brar, A, Dawson, Be, Duran, I, Elhadi, M, Jones, C, Kamarajah, Sk, Keatley, Jm, Lawday, S, Marson, Ej, Ots, R, Santos, I, Taylor, Eh, Trout, Im, Varghese, C, Venn, Ml, Xu, W, Dajti, I, Gjata, A, Kacimi, Seo, Boccalatte, L, Cox, D, Townend, P, Aigner, F, Kronberger, Ie, Samadov, E, Alderazi, A, Hossain, K, Padmore, G, van Ramshorst, G, Lawani, I, Cerovac, A, Delibegovic, S, Gomes, Gma, Buarque, Il, Gohar, M, Slavchev, M, Nwegbu, C, Agarwal, A, Martin, J, Ng-Kamstra, J, Olivos, M, Lou, Wh, Ren, Dl, Calvache, Ja, Rivera, Cjp, Hadzibegovic, Ad, Kopjar, T, Mihanovic, J, Jimenez, Pma, Gouvas, N, Klat, J, Novysedlak, R, Amisi, N, Christensen, P, El-Hussuna, A, Batista, S, Lincango-Naranjo, E, Emile, S, Sandoval, Daa, Dhufera, H, Hailu, S, Mengesha, Mg, Kauppila, Jh, Arnaud, Ap, Demetrashvili, Z, Albertsmeier, M, Lederhuber, H, Loffler, Mw, Acquah, Dk, Ofori, B, Tabiri, S, Metallidis, S, Tsoulfas, G, Aguilera-Arevalo, Ml, Recinos, G, Mersich, T, Wettstein, D, Kembuan, G, Milan, Pb, Khosravi, Mh, Mozafari, M, Hilmi, A, Mohan, H, Zmora, O, Gallo, G, Pata, F, Pellino, G, Fujimoto, Y, Kuroda, N, Abou Chaar, Mk, Ayasra, F, Fakhradiyev, I, Hamdun, Ih, Jin-Young, J, Jamal, M, Karout, L, Gulla, A, Rasoaherinomenjanahary, F, Samison, Lh, Sanchez, Iid, Gonzalez, D, Martinez, L, Martinez, Mj, Nayen, A, and Ramos-De la Medina, A
Subjects: Male, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], MULTICENTER, infectious diseases, 0302 clinical medicine, 030202 anesthesiology, Anesthesiology, Cirugía, 80 and over, Prospective Studies, Young adult, Child, Lung, Aged, 80 and over, COVID-19, delay, SARS-CoV-2, surgery, timing, SARS‐CoV‐2 infection, Operative, Child, Preschool, Pneumonia & Influenza, Infection, Cohort study, Human, medicine.medical_specialty, Clinical Sciences, Sars-cov-2, GlobalSurg Collaborative, Settore MED/28 - MALATTIE ODONTOSTOMATOLOGICHE, 03 medical and health sciences, Clinical Research, Biodefense, Correspondence, Humans, PULMONARY COMPLICATIONS, CRIANÇAS EM IDADE PRÉ-ESCOLAR, Aged, Science & Technology, Cirurgia, Prevention, Infant, Odds ratio, Pneumonia, Prospective Studie, Clinical research, Surgery, Human medicine, 610 Medizin und Gesundheit, 1109 Neurosciences, Internationality, Settore MED/29 - CHIRURGIA MAXILLOFACCIALE, Settore MED/18 - CHIRURGIA GENERALE, Adolescent, Adult, Cohort Studies, Female, Middle Aged, Surgical Procedures, Operative, Time, Young Adult, Practice Guidelines as Topic, gastroenterology, Medicine and Health Sciences, 030212 general & internal medicine, Prospective cohort study, Mortality rate, Covid19, Infectious Diseases, Patient Safety, medicine.symptom, 6.4 Surgery, Life Sciences & Biomedicine, 610 Medicine & health, COVID-19, SARS-CoV-2, delay, surgery, timing, Asymptomatic, NO, COVIDSurg Collaborative, Vaccine Related, All institutes and research themes of the Radboud University Medical Center, medicine, Mortalitat, ddc:610, Mortality, Preschool, LS7_4, Surgical Procedures, business.industry, Neurosciences, Evaluation of treatments and therapeutic interventions, 1103 Clinical Sciences, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Anesthesiology and Pain Medicine, Emerging Infectious Diseases, Good Health and Well Being, Mortalidad, Cohort Studie, business
Abstract: Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. ispartof: ANAESTHESIA vol:76 issue:6 pages:748-758 ispartof: location:England status: published
Published: 2021

34. Influence of surgical approach and quality of resection on the probability of cure for early-stage HCC occurring in cirrhosis

Author: C. Hobeika, Lilian Schwarz, Olivier Soubrane, J.-C. Nault, Ephrem Salamé, François Cauchy, Louise Barbier, Chetana Lim, Alexis Laurent, Olivier Scatton, Service d’Hépatologie [Hôpital Beaujon], Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Hôpital Jean Verdier [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Laboratoire de Recherche Vasculaire Translationnelle (LVTS (UMR_S_1148 / U1148)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Paris Cité (UPCité)-Université Sorbonne Paris Nord, Service de gastro-entérologie [CHU Trousseau], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Ischémie Reperfusion en Transplantation d’Organes Mécanismes et Innovations Thérapeutiques ( IRTOMIT), Université de Poitiers-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Charles Nicolle [Rouen], CHU Rouen, Normandie Université (NU)-Normandie Université (NU), Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de gastro-entérologie [Henri Mondor AP-HP, Créteil], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Département d'hépato-gastro-entérologie [Hôpital Trousseau : CHRU Tours], CHU Trousseau [APHP], Service de Gastroentérologie [Hôpital Beaujon], Centre de recherche sur l'Inflammation (CRI (UMR_S_1149 / ERL_8252 / U1149)), Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université Paris Cité (UPCité), Salvy-Córdoba, Nathalie, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Paris (UP)-Université Sorbonne Paris Nord, Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Poitiers, Hôpital Henri Mondor-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional Universitaire de Tours (CHRU TOURS)-CHU Trousseau [APHP], Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS)-Université de Paris (UP), Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), and Centre Hospitalier Régional Universitaire de Tours (CHRU Tours)-CHU Trousseau [APHP]
Subjects: DFS, disease-free survival, [SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery, Hepatocellular carcinoma, 030230 surgery, 0302 clinical medicine, Model for End-Stage Liver Disease, Clinical endpoint, Immunology and Allergy, Textbook outcome, Stage (cooking), LLR, laparoscopic liver resection, education.field_of_study, AFP, alpha-fetoprotein, Hazard ratio, TO, textbook outcome, Gastroenterology, Laparoscopic liver resection, 3. Good health, CT, computed tomography, IMM, Institut Mutualiste Montsouris, 030220 oncology & carcinogenesis, CCI, Comprehensive Complication Index, Research Article, LOS, length of stay, medicine.medical_specialty, Population, [SDV.CAN]Life Sciences [q-bio]/Cancer, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, ISGLS, International Study Group of Liver Surgery, MELD, model for end-stage liver disease, OS, overall survival, 03 medical and health sciences, [SDV.CAN] Life Sciences [q-bio]/Cancer, Internal medicine, Internal Medicine, medicine, lcsh:RC799-869, education, ALBI, albumin-bilirubin, Hepatology, Proportional hazards model, business.industry, Statistical cure, OLR, open liver resection, Quality of care, VIF, variance inflation factor, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Odds ratio, HR, hazard ratio, [SDV.MHEP.HEG] Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, OR, odds ratio, HPB, hepato-pancreatico-biliary, PHLF, post-hepatectomy liver failure, LR, liver resection, Propensity score matching, lcsh:Diseases of the digestive system. Gastroenterology, business
Abstract: Background & Aims The quality of surgical care of patients with HCC is associated with improved long-term prognosis and may also be influenced by the type of surgical approach. The present study aimed at evaluating the role of the laparoscopic approach on quality of surgical care and long-term prognosis in optimal HCC surgical candidates. Methods All consecutive patients undergoing open (OLR) or laparoscopic liver resection (LLR) for early-stage HCC in cirrhosis (METAVIR F4) at 5 French expert hepato-pancreatico-biliary centres between 2010 and 2018 were enrolled. Quality of surgical care was defined by textbook outcome (TO), a combination of 6 criteria representing ideal hospitalisation. Factors associated with TO were determined on multivariate analysis. Comparison between LLR and OLR was performed after propensity score matching (PSM). The primary endpoint was disease-free survival (DFS). Statistical cure was modelled using a non-mixture model. Results Overall, 425 patients were included. Median follow-up was 42.0 months. LLR was performed in 267 (62.8%) patients. TO was achieved in 140 (32.9%) patients. LLR was independently associated with TO (odds ratio [OR] 2.81; 95% CI 1.29–6.12; p = 0.009). After PSM, LLR patients cumulated higher number of TO criteria than OLR patients (5 vs. 4; p = 0.012). The 1-, 3-, and 5-year DFS of LLR patients with and without TO were 82.3%, 64.4%, and 62.5%, and 76.9%, 51.4%, and 30.2%, respectively (p = 0.003). On multivariable Cox regression, TO was independently associated with improved DFS (hazard ratio 0.34; p = 0.001). The cure fraction of the whole population was 24.4%. Patients achieving TO had increased cure fraction than patients not achieving TO (32.6% vs. 18.1%). Conclusions Quality of surgical care improves the prognosis of patients with early-stage HCC and is promoted by the laparoscopic approach. Lay summary The overall quality of surgical care, as measured by TO, plays a pivotal role in the prognosis and, in particular, on the probability of statistical cure of patients with resectable early-stage HCC occurring in cirrhosis. By influencing TO, laparoscopy has an indirect impact on the probability of cure and long-term management of these patients. This study strongly supports the promising curative role of mini-invasive treatments for early-stage HCC, such as low-difficulty LLR., Graphical abstract, Highlights • Homogeneous population of 425 resected patients with early-stage HCC in cirrhosis. • Textbook outcome following liver resection was achieved in 32.9% of patients. • The minimal invasive approach increases the chance of achieving a textbook outcome. • Textbook outcome following liver resection improves DFS and probability of cure. • Minimal invasive treatments of early HCC have a promising curative effect.
Published: 2020

35. COVID-19 in a liver transplant recipient: Could iatrogenic immunosuppression have prevented severe pneumonia? A case report

Author: Alessandra Mazzola, Olivier Scatton, Mohammed Atif, Valérie Pourcher, Filomena Conti, Juliana Pappatella, Chetana Lim, Anna Sessa, University of Naples Federico II, Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre d'Immunologie et de Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Gestionnaire, Hal Sorbonne Université, University of Naples Federico II = Università degli studi di Napoli Federico II, Centre d'Immunologie et des Maladies Infectieuses (CIMI), Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Centre de Recherche Saint-Antoine (CRSA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Subjects: Graft Rejection, Male, Pediatrics, medicine.medical_specialty, Nausea, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Anosmia, Liver transplantation, medicine.disease_cause, Severity of Illness Index, 03 medical and health sciences, Immunocompromised Host, 0302 clinical medicine, Gastrointestinal symptom, Case report, Medicine, Humans, Lung, Coronavirus, Immunosuppression Therapy, business.industry, SARS-CoV-2, Gastroenterology, COVID-19, Immunosuppression, General Medicine, Middle Aged, Tacrolimus, 3. Good health, Dysgeusia, [SDV] Life Sciences [q-bio], 030220 oncology & carcinogenesis, Vomiting, 030211 gastroenterology & hepatology, medicine.symptom, business, Tomography, X-Ray Computed, Infection
Abstract: International audience; Background: Coronavirus disease (COVID) is a new and highly contagious infectious disease caused by the coronavirus (COVID-19 or severe acute respiratory syndrome coronavirus 2). There is limited data regarding the incidence and management of COVID-19 in immunocompromised patients' post-transplantation. In the pre-COVID-19 era, these patients were already at an increased risk of developing opportunistic infections. These often manifested with atypical symptoms.Case summary: We report another case of uneventful COVID-19 pneumonia in a 58-year old male who was 18 mo' post liver transplantation. He received tacrolimus monotherapy since July 2019. The clinical manifestations included only epigastric pain radiating to the right hypochondrium, nausea and vomiting. He had no fevers, cough, shortness of breath, anosmia or dysgeusia even if the chest computed tomography scan revealed an extension of the multiple patchy ground-glass density shadows to the upper lobe of the left lung too. He was hospitalised and received a course of oral chloroquine (200 mg × 3 per day) for a period of 10 d. Interestingly, the COVID 19 infection was uneventful though there were no modifications to his tacrolimus dosing. He was successfully discharged. We performed subsequent follow-up via telemedicine.Conclusion: In light of the current pandemic, it is even more important to identify how the liver recipient's patients present and are managed, especially for immunosuppression treatment.
Published: 2020

36. Impact of the first Covid-19 outbreak on liver transplantation activity in France: A snapshot

Author: Olivier Bastien, Chetana Lim, Géraldine Malaquin, François Kerbaul, Olivier Scatton, Filomena Conti, Célia Turco, and Olivier Soubrane
Subjects: Adult, Brain Death, 2019-20 coronavirus outbreak, medicine.medical_specialty, Tissue and Organ Procurement, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, coronavirus, liver procurement, North east, Liver transplantation, LT, liver transplantation, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Pandemic, medicine, Humans, Organ donation, Pandemics, COVID-19, coronavirus disease 2019, Retrospective Studies, liver transplantation, Hepatology, business.industry, Gastroenterology, COVID-19, Outbreak, ICU, intensive care unit, 030220 oncology & carcinogenesis, Original Article, ABM, Agence de la Biomédecine, 030211 gastroenterology & hepatology, France, Adult liver, business
Abstract: Highlights • The global pandemic of Coronavirus Disease 2019 has drastically affected liver transplantation programs worldwide. • There was a significant decrease in the number of organ donations and liver transplantations performed in France. • The North East area which was the main Coronavirus Disease 2019 cluster area had > 25% decrease of the multiorgan procurement and liver transplantations in 2020 compared to 2019., Background The global pandemic of Coronavirus Disease 2019 (COVID-19) has potentially affected liver transplantation (LT) programs worldwide. The aim of this study was to determine whether the COVID-19 outbreak affected organ donation and LT activity in France. Methods Data on the number of brain-dead donor procurements and adult liver transplantations were compared between two periods (1st January- 31st May 2019 vs. 1st January-31st May 2020). Main findings There was a 28% decrease in the number of organ donations in 2020 (543 in 2020vs. 752 organ donations in 2019). A 22% decrease in the number of liver transplantations was also observed: 435 in 2020 vs. 556 LTs in 2019. Overall, the North East area which was the main COVID-19 cluster area, had > 25% decrease of the multiorgan procurement (-33% compared to 2019), and liver transplantation (-26% compared to 2019) activities in 2020 Conclusion This analysis confirmed that during the COVID-19 outbreak there was a significant decrease in the number of organ donations and liver transplantations performed in France.
Published: 2020
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37. Pulmonary infection after hepatic resection: Associated factors and impact on outcomes

Author: D. Eyraud, Eric Savier, Louis Lemoine, Benjamin Granger, Yann Loncar, Olivier Scatton, Diane Lastennet, Nicolas Tartrat, and Jean-Christophe Vaillant
Subjects: medicine.medical_specialty, Carcinoma, Hepatocellular, Blood transfusion, medicine.medical_treatment, Gastroenterology, Pulmonary Disease, Chronic Obstructive, Postoperative Complications, Laparotomy, Internal medicine, medicine, Hepatectomy, Humans, Laparoscopy, Retrospective Studies, COPD, Hepatology, medicine.diagnostic_test, business.industry, Liver Neoplasms, Retrospective cohort study, Pneumonia, Odds ratio, Length of Stay, medicine.disease, Treatment Outcome, Liver, business
Abstract: Postoperative pulmonary complications are frequent after hepatectomy. The aim of this retrospective study was to use preoperative and intraoperative data to establish specific factors associated with post-hepatectomy pneumonia (PHPN).Patients underwent minor or major hepatectomy for cancer or non-cancer treatment. Surgical procedure was performed by laparoscopy or laparotomy. PHPN was defined as a new radiologic finding associated with fever, leucocytosis and purulent bronchial secretions. The incidence, associated factors and prognosis of PHPN were investigated.In 399 patients undergoing planned hepatectomy, 49 (12.3%) developed pneumonia. Of 81 patients (20.3%) with cirrhosis, 77 were Child-Pugh A and 4 were Child-Pugh B. Hepatectomy indication was cancer in 331 patients (of which metastasis in 213). Laparoscopy rate was 31.3%. In multivariate analysis, the main factors statistically associated with PHPN were: chronic obstructive pulmonary disease (COPD) (odds ratio [OR] = 4.17; 95% confidence interval [CI], 1.60-10.84; P = 0.003), intraoperative blood transfusion (OR = 2.46; 95% CI 1.01-5.70; P = 0.001), laparotomy (OR = 3.01; 95% CI 1.09-8.27; P = 0.03), and nasogastric tube maintained at day 1 (OR = 2.09; 95% CI 1.03-4.22; P = 0.04). Length of stay was significantly different between groups without PHPN (10.2 days) versus with PHPN (26.4 days; P 0.001). Intra-hospital and one-year mortality were greater in the PHPN group than the pneumonia-free group (8.16 vs 0% and 18.4 vs 3.4%, respectively; P 0.001).COPD, transfusion and laparotomy (versus laparoscopy) are factors associated with PHPN and impaired survival.
Published: 2022

38. Association of shear-wave elastography with clinical outcomes post-liver transplantation

Author: Eric Savier, Mathilde Wagner, Olivier Lucidarme, Tom Boeken, Olivier Scatton, Elsa Mbarki, Université Paris Cité (UPCité), Hôpital Européen Georges Pompidou [APHP] (HEGP), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpitaux Universitaires Paris Ouest - Hôpitaux Universitaires Île de France Ouest (HUPO), Health data- and model- driven Knowledge Acquisition (HeKA), Inria de Paris, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria)-Centre de Recherche des Cordeliers (CRC (UMR_S_1138 / U1138)), École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité)-École Pratique des Hautes Études (EPHE), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Université Paris Cité (UPCité), Laboratoire d'Imagerie Biomédicale [Paris] (LIB), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CRSA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, medicine.medical_treatment, Population, Liver transplantation, Conventional ultrasound, 03 medical and health sciences, 0302 clinical medicine, Liver stiffness, medicine, Humans, Bile ducts, education, Ultrasonography, Retrospective Studies, [SPI.ACOU]Engineering Sciences [physics]/Acoustics [physics.class-ph], Shear wave elastography, education.field_of_study, Hepatology, medicine.diagnostic_test, business.industry, Ultrasound, Gastroenterology, End-stage liver disease, Surgery, Liver Transplantation, Transplantation, Treatment Outcome, Liver, 030220 oncology & carcinogenesis, Elasticity Imaging Techniques, 030211 gastroenterology & hepatology, Elastography, business
Abstract: Purpose Two-dimensional shear-wave elastography (2D-SWE) assessment of liver stiffness has the advantage of being obtained during conventional ultrasound. Liver-stiffness values on 2D-SWE for grafted livers are unknown, as are their potential link to post-transplantation morbidity. This study was undertaken to determine liver-stiffness values on 2D-SWE for grafted livers without complications, and examine relationships between liver-stiffness values on 2D-SWE and early post-operative arterial or biliary complications. Methods In our facility, all liver-transplant recipients are entered in a comprehensive surgical database, where donor, procedure and recipient characteristics are described. All patients underwent systematic 2D-SWE assessment. Potential relationships were analyzed between liver-stiffness findings and donor, procedure and recipient characteristics, and follow-up events, including death, arterial or biliary complications, graft removal and allograft-dysfunction scores. Results Liver-stiffness values on 2D-SWE of 337 ultrasound examinations from 165 liver-transplant recipients were collected retrospectively. Median time from transplantation to 2D-SWE examination was 149 days, with median follow-up at 36 months. The mean ± SD stiffness value for grafts without complications was 7.3 ± 2.3 kPa; it was significantly higher during the first 90 days (8.2 ± 2.5 kPa) post-transplant than after 1 year (7.0 ± 2.4 kPa) (P = 0.01). Patients with biliary complications during the first-year post-transplantation had significantly higher mean liver-stiffness values on 2D-SWE than those without, respectively: 9.8 ± 7.0 vs 7.5 ± 1.8 kPa (P = 0.01). Conclusions Post-transplantation patients without complications had stiffer livers than the general population, with higher values during the first 90 days after surgery. Liver-stiffness values on 2D-SWE were significantly higher for patients with biliary, but not arterial, complications.
Published: 2020

39. Pledget-armed suture for intraoperative bleeding control during laparoscopic liver resection (with video)

Author: Claire Goumard, Riccardo Memeo, Olivier Scatton, Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, [SDV]Life Sciences [q-bio], Suture Techniques, Blood Loss, Surgical, General Medicine, Intraoperative bleeding, Surgery, Resection, 03 medical and health sciences, 0302 clinical medicine, Bleeding control, Suture (anatomy), 030220 oncology & carcinogenesis, medicine, Hepatectomy, Humans, 030211 gastroenterology & hepatology, Laparoscopy, business
Published: 2020

40. Anticipating Potential Perioperative Complication: In Reply to Monden and Colleagues

Author: Célia Turco, Chetana Lim, Claire Goumard, and Olivier Scatton
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, General surgery, medicine.medical_treatment, MEDLINE, Perioperative, Postoperative Complications, Liver, medicine, Hepatectomy, Humans, Surgery, Laparoscopy, Complication, business
Published: 2020

41. Response to: development of a machine perfusion device for cold-to-warm machine perfusion

Author: Claire Goumard, Jérôme Danion, Olivier Scatton, Jérôme Pelissie, Cécile Legallais, and Eric Savier
Subjects: Perfusion, Machine perfusion, Hepatology, Liver, business.industry, Gastroenterology, Medicine, Humans, Organ Preservation, business, Biomedical engineering
Published: 2020

42. The impact of Coronavirus 19 disease on liver transplantation in France: The sickest first approach?

Author: Valérie Pourcher, Géraldine Malaquin, Muhammad Atif, Olivier Scatton, A. Mazzola, François Kerbaul, Antoine Monsel, Filomena Conti, CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Dysoxie, suractivité : aspects cellulaires et intégratifs thérapeutiques (DS-ACI / UMR MD2), Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre National de la Recherche Scientifique (CNRS), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Service d'Anesthésie réanimation [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Agence de la biomédecine [Saint-Denis la Plaine], Institut Pierre Louis d'Epidémiologie et de Santé Publique (iPLESP), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], Centre de Recherche Saint-Antoine (CRSA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Subjects: 2019-20 coronavirus outbreak, Waiting Lists, [SDV]Life Sciences [q-bio], Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), medicine.medical_treatment, Pneumonia, Viral, Disease, Liver transplantation, medicine.disease_cause, Risk Assessment, Article, Betacoronavirus, medicine, Humans, Pandemics, Coronavirus, Hepatology, biology, Viral Epidemiology, business.industry, SARS-CoV-2, Patient Selection, Gastroenterology, COVID-19, biology.organism_classification, medicine.disease, Virology, Kidney Transplantation, Tissue Donors, Liver Transplantation, Intestines, Pneumonia, Practice Guidelines as Topic, Heart Transplantation, France, Pancreas Transplantation, business, Coronavirus Infections, Lung Transplantation
Abstract: Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre-including this research content-immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
Published: 2020

43. Acute liver failure and HELLP syndrome: A clinical case and literature review

Author: Fabiano Perdigao, Alessandra Mazzola, Filomena Conti, Claire Goumard, Frédéric Charlotte, Olivier Scatton, Muhammad Atif, and Bianca Magro
Subjects: Adult, medicine.medical_specialty, HELLP Syndrome, HELLP syndrome, medicine.medical_treatment, Liver transplantation, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Pregnancy, medicine, Humans, Hematoma, Hepatology, business.industry, Cesarean Section, Liver Diseases, Gastroenterology, Liver failure, Emergency Caesarean Section, Emergency department, Liver Failure, Acute, medicine.disease, Surgery, 030220 oncology & carcinogenesis, Gestation, 030211 gastroenterology & hepatology, Female, Clinical case, business
Abstract: Summary Background HELLP syndrome is a pregnancy-related liver disease associated with increased maternal and foetal mortality. In rare cases, it can lead to the development of a subcapsular hepatic haematoma as well as its rupture. This rupture is life-threatening if not urgently treated. Method We describe a clinical case of HELLP syndrome involving a ruptured subcapsular liver haematoma and contextualise this with a literature overview. Clinical case A 39-year-old woman of 40 weeks’ gestation presented to her local Emergency Department with symptoms and serology classically associated with HELLP syndrome. However, she clinically deteriorated and developed a ruptured subcapsular haematoma. She underwent an emergency Caesarean section at her initial hospital. Upon clinical stabilisation, she was transferred to our transplant unit for an urgent liver transplant. Conclusion LT is a life-saving procedure for patients with acute liver failure secondary to HELLP syndrome. These patients should be immediately referred to a high-volume transplant centre.
Published: 2020

44. Novel defatting strategies reduce lipid accumulation in primary human culture models of liver steatosis

Author: Claire Goumard, Wilfried Le Goff, Eric Savier, Filomena Conti, Olivier Scatton, Philippe Lesnik, Yvon Calmus, Chan Sonavine Nget, Jérémie Gautheron, Chantal Housset, Lynda Aoudjehane, Romain Morichon, Julia Gilaizeau, Muhammad Atif, Yves Chrétien, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Institute of cardiometabolism and nutrition (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie Digestive, Hépato-Bilio-pancréatique et Transplantation Hépatique [CHU Pitié-Salpétrière], CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre d'Immunologie et de Maladies Infectieuses (CIMI), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Centre National de la Recherche Scientifique (CNRS), Unité Mixte de Service Production et Analyse de données en Sciences de la vie et en Santé (PASS), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'hépatologie [CHU Saint-Antoine], CHU Saint-Antoine [AP-HP], Centre de Référence des Maladies Rares - Maladies Inflammatoires des Voies Biliaires et Service d’Hépatologie [CHU Saint-Antoine], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Sorbonne Université-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université-Sorbonne Université (SU), Sorbonne Université (SU), Gestionnaire, Hal Sorbonne Université, Unité de Recherche sur les Maladies Cardiovasculaires, du Métabolisme et de la Nutrition = Research Unit on Cardiovascular and Metabolic Diseases (ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Centre d'Immunologie et des Maladies Infectieuses (CIMI), Cytométrie et Imagerie Saint-Antoine (CISA), Unité Mixte de Service d'Imagerie et de Cytométrie [CHU Saint-Antoine] (UMS LUMIC), Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), and Service d'Hépato-gastro-entérologie [CHU Saint-Antoine]
Subjects: Male, 0301 basic medicine, Steatosis, Human hepatocytes, medicine.medical_treatment, [SDV]Life Sciences [q-bio], lcsh:Medicine, Medicine (miscellaneous), Pharmacology, Liver transplantation, 0302 clinical medicine, Immunology and Microbiology (miscellaneous), Cells, Cultured, ComputingMilieux_MISCELLANEOUS, chemistry.chemical_classification, Sulfonamides, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Fatty Acids, Middle Aged, 3. Good health, [SDV] Life Sciences [q-bio], Lipogenesis, Female, 030211 gastroenterology & hepatology, lcsh:RB1-214, Signal Transduction, Research Article, Human precision-cut liver slices, Necroptosis, Neuroscience (miscellaneous), [SDV.BC]Life Sciences [q-bio]/Cellular Biology, Models, Biological, General Biochemistry, Genetics and Molecular Biology, Defatting, 03 medical and health sciences, Downregulation and upregulation, lcsh:Pathology, medicine, Humans, Triglycerides, Acrylamides, Reactive oxygen species, lcsh:R, Autophagy, Lipid Metabolism, medicine.disease, Fatty Liver, 030104 developmental biology, chemistry, Hepatocytes, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Normothermic perfusion provides a means to rescue steatotic liver grafts, including by pharmacological defatting. In this study, we tested the potential of new drug combinations to trigger defatting in three human culture models, primary hepatocytes with induced steatosis, primary hepatocytes isolated from steatotic liver, and precision-cut liver slices (PCLS) of steatotic liver. Forskolin, L-carnitine and a PPARα agonist were all combined with rapamycin, an immunosuppressant that induces autophagy, in a D-FAT cocktail. D-FAT was tested alone or in combination with necrosulfonamide, an inhibitor of mixed lineage kinase domain like pseudokinase involved in necroptosis. Within 24 h, in all three models, D-FAT induced a decrease in triglyceride content by 30%, attributable to an upregulation of genes involved in free fatty acid β-oxidation and autophagy, and a downregulation of those involved in lipogenesis. Defatting was accompanied by a decrease in endoplasmic reticulum stress and in the production of reactive oxygen species. The addition of necrosulfonamide increased the efficacy of defatting by 8%-12% in PCLS, with a trend towards increased autophagy. In conclusion, culture models, notably PCLS, are insightful to design strategies for liver graft rescue. Defatting can be rapidly achieved by combinations of drugs targeting mitochondrial oxidative metabolism, macro-autophagy and lipogenesis., Summary: This study describes a defatting cocktail that has been proven to function in three relevant steatotic human culture models without cytotoxicity, and which could be employed in the reduction of steatosis in donor livers during liver transplantation.
Published: 2020

45. Consequences of Extended Spectrum Beta-Lactamase-Producing Enterobacteriaceae and Methicillin-Resistant Staphylococcus aureus Carriage in Awaiting Liver Transplant Patients

Author: Olivier Scatton, Claire Goumard, Salvatore Battaglia, Ciro Celsa, Calogero Cammà, Denis Bernard, Bianca Magro, Mona Munteanu, Valerie Martinez, A. Mazzola, Filomena Conti, HAL-SU, Gestionnaire, Service d'Hépato-Gastro-Entérologie [CHU Pitié-Salpêtrière], CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Università degli studi di Palermo - University of Palermo, Centre de Recherche Saint-Antoine (CRSA), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU), Institut de Cardiométabolisme et Nutrition = Institute of Cardiometabolism and Nutrition [CHU Pitié Salpêtrière] (IHU ICAN), Service de Chirurgie Générale, Viscérale et Endocrinienne [CHU Pitié-Sapêtrière], Service de Maladies Infectieuses et Tropicales [CHU Pitié-Salpêtrière], Service d'Anesthésie réanimation [CHU Pitié-Salpêtrière], Sezione di Gastroenterologia, Di.Bi.M.I.S., University of Palermo, Italy, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Centre de Recherche Saint-Antoine (CR Saint-Antoine), Sorbonne Université (SU)-Institut National de la Santé et de la Recherche Médicale (INSERM)-CHU Saint-Antoine [AP-HP], Institut de Cardiométabolisme et Nutrition - Institute of Cardiometabolism and Nutrition, Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Magro B., Mazzola A., Munteanu M., Goumard C., Martinez V., Bernard D., Scatton O., Battaglia S., Celsa C., Camma C., and Conti F.
Subjects: Male, Methicillin-Resistant Staphylococcus aureus, medicine.medical_specialty, Cirrhosis, medicine.medical_treatment, ESBLE, Liver transplantation, medicine.disease_cause, Severity of Illness Index, beta-Lactamases, beta-Lactamase, End Stage Liver Disease, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Enterobacteriaceae, Retrospective Studie, Risk Factors, Internal medicine, Severity of illness, Medicine, Humans, Aged, Retrospective Studies, 0303 health sciences, Transplantation, [SDV.MHEP] Life Sciences [q-bio]/Human health and pathology, Hepatology, 030306 microbiology, business.industry, Risk Factor, cirrhosis, Enterobacteriaceae Infections, Retrospective cohort study, Middle Aged, medicine.disease, Enterobacteriaceae Infection, Methicillin-resistant Staphylococcus aureus, 3. Good health, Liver Transplantation, Carriage, Cohort, 030211 gastroenterology & hepatology, Surgery, fecal carriage, Female, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: Infections in patients with cirrhosis are associated with liver-related complications (LRCs), especially in patients awaiting liver transplantation (LT). The aim of this study was to evaluate the impact of methicillin-resistant Staphylococcus aureus (MRSA) and extended spectrum beta-lactamase colonization on infections and LRCs for patients on the wait list and on infections after LT. We retrospectively included 250 of 483 patients with cirrhosis who were placed on the wait list for LT from December 2015 to January 2018. These patients were screened for MRSA or extended spectrum beta-lactamase–producing Enterobacteriaceae (ESBLE) at the time of wait-list placement and after LT. Of the patients, 76% were male with a mean age of 57.5±10 years, and the most frequent cause of liver disease was alcohol (39%). Median Model for End-Stage Liver Disease (MELD) score was 19 (12-28). Only 1 patient was positive for MRSA; 19% of patients (n=47) had ESBLE fecal carriage at the time of wait-list placement and 15% (n=37) had it after LT. Infection-free survival on the wait list and after LT, according to fecal carriage status, was not statistically different between 2 groups. LRC-free survival at 6 and 12months was significantly lower in ESBLE fecal carriage (HR, 1.6; P =0.04). MELD score >19 (HR, 3.0; P=0.01) and occurrence of infection during the first 3months on the wait list (HR, 4.13; P&nbsp
Published: 2020

46. Laparoscopic versus open resection of intrahepatic cholangiocarcinoma: nationwide analysis

Author: Eric Vibert, C. Hobeika, Patrick Pessaux, Y.P. Le Treut, O Turini, B Menahem, M.-A. Allard, J Barbieux, F Jehaes, Julio Abba, J Ewald, J Hardwigsen, B Trechot, J.-M. Regimbeau, L Ferre, M Lesurtel, E Lermite, M. El Amrani, E Buc, C VanBrugghe, U Marchese, P. Balladur, F Muscari, René Adam, A. Sa Cunha, Emilie Gregoire, Takayuki Kawai, Brice Gayet, Daniel Cherqui, Olivier Farges, J Lubrano, T Hor, N Petrucciani, J Chauvat, François Paye, M Bougard, Emmanuel Boleslawski, F R Souche, Edouard Girard, L. Schwarz, S Okumura, M Tedeschi, Alexis Laurent, J.-M. Fabre, A Carmelo, Ephrem Salamé, P Leourier, T Codjia, Christian Letoublon, A Thobie, S Truant, G Millet, X Unterteiner, Lionel Rebibo, Z Cherkaoui, Riccardo Memeo, J Nunèz, Olivier Scatton, Petru Bucur, Takeo Nomi, H Fagot, Nicolas Golse, C Ratajczak, M Chirica, Shohei Komatsu, Louise Barbier, D Patrice, K Lecolle, François Cauchy, Claire Goumard, Olivier Soubrane, François-René Pruvot, Gabriella Pittau, Christian Ducerf, Guillaume Passot, Oriana Ciacio, Christophe Laurent, N Oudafal, David Fuks, Kayvan Mohkam, A.-R. Kianmanesh, B Suc, Jean-Yves Mabrut, A Mulliri, J Zemour, L Chiche, Université Paris Cité (UPCité), Hôpital Beaujon [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Institut Mutualiste de Montsouris (IMM), Université Paris Descartes - Paris 5 (UPD5), Centre Hospitalier Régional Universitaire de Tours (CHRU Tours), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Université de Montpellier (UM), Hôpital Claude Huriez [Lille], CHU Lille, Chirurgie digestive [CHU Amiens], CHU Amiens-Picardie, Simplification des soins chez les patients complexes - UR UPJV 7518 (SSPC), Université de Picardie Jules Verne (UPJV), Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), L'Institut hospitalo-universitaire de Strasbourg (IHU Strasbourg), Institut National de Recherche en Informatique et en Automatique (Inria)-l'Institut de Recherche contre les Cancers de l'Appareil Digestif (IRCAD)-Les Hôpitaux Universitaires de Strasbourg (HUS)-La Fédération des Crédits Mutuels Centre Est (FCMCE)-L'Association pour la Recherche contre le Cancer (ARC)-La société Karl STORZ, Institut de Recherche Contre les Cancers de l'Appareil Digestif-European Institute of Telesurgery (IRCAD/EITS), CHU Strasbourg, CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Physiopathologie et traitement des maladies du foie, Université Paris-Sud - Paris 11 (UP11)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hôpital Paul Brousse, Centre de Recherche Saint-Antoine (CRSA), and Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Sorbonne Université (SU)
Subjects: Male, medicine.medical_specialty, [SDV]Life Sciences [q-bio], [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030230 surgery, Cholangiocarcinoma, 03 medical and health sciences, 0302 clinical medicine, Open Resection, medicine, Humans, Laparoscopic resection, Blood Transfusion, Laparoscopy, Propensity Score, Lymph node, Intrahepatic Cholangiocarcinoma, Aged, Retrospective Studies, medicine.diagnostic_test, business.industry, Odds ratio, Length of Stay, Middle Aged, Survival Analysis, Surgery, Dissection, medicine.anatomical_structure, Treatment Outcome, Bile Duct Neoplasms, 030220 oncology & carcinogenesis, Propensity score matching, Lymph Node Excision, Female, Bile Ducts, France, business
Abstract: Background The relevance of laparoscopic resection of intrahepatic cholangiocarcinoma (ICC) remains debated. The aim of this study was to compare laparoscopic (LLR) and open (OLR) liver resection for ICC, with specific focus on textbook outcome and lymph node dissection (LND). Methods Patients undergoing LLR or OLR for ICC were included from two French, nationwide hepatopancreatobiliary surveys undertaken between 2000 and 2017. Patients with negative margins, and without transfusion, severe complications, prolonged hospital stay, readmission or death were considered to have a textbook outcome. Patients who achieved both a textbook outcome and LND were deemed to have an adjusted textbook outcome. OLR and LLR were compared after propensity score matching. Results In total, 548 patients with ICC (127 LLR, 421 OLR) were included. Textbook-outcome and LND completion rates were 22.1 and 48.2 per cent respectively. LLR was independently associated with a decreased rate of LND (odds ratio 0.37, 95 per cent c.i. 0.20 to 0.69). After matching, 109 patients remained in each group. LLR was associated with a decreased rate of transfusion (7.3 versus 21.1 per cent; P = 0.001) and shorter hospital stay (median 7 versus 14 days; P = 0.001), but lower rate of LND (33.9 versus 73.4 per cent; P = 0.001). Patients who underwent LLR had lower rate of adjusted TO completion than patients who had OLR (6.5 versus 17.4 per cent; P = 0.012). Conclusion The laparoscopic approach did not substantially improve quality of care of patients with resectable ICC.
Published: 2020

47. Impact on Oncological Outcomes and Intent-to-Treat Survival of Resection Margin for Transplantable Hepatocellular Carcinoma in All-Comers and in Patients with Cirrhosis: A Multicenter Study

Author: Maria Teresa Albiol-Quer, Ernest Castro-Gutiérrez, Cyrille Feray, Margarida Casellas-Robert, Claire Goumard, Chetana Lim, Olivier Rosmorduc, Laura Lladó, Chady Salloum, Olivier Scatton, Emilio Ramos, Juli Busquets, Joan Figueras, Santiago López-Ben, and Daniel Azoulay
Subjects: Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, Carcinoma, Hepatocellular, medicine.medical_treatment, Salvage therapy, 030230 surgery, Liver transplantation, Gastroenterology, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Carcinoma, Hepatectomy, Humans, Survival rate, Aged, Salvage Therapy, business.industry, Liver Neoplasms, Margins of Excision, Middle Aged, medicine.disease, Intention to Treat Analysis, Liver Transplantation, Survival Rate, Treatment Outcome, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Resection margin, Surgery, Female, Neoplasm Recurrence, Local, business
Abstract: The outcomes of liver resection (LR) with a narrow margin in patients with transplantable hepatocellular carcinoma (HCC) have not been studied. The aim was to assess whether narrow margin following up-front LR impacts the incidence, timing, pattern, and transplantability of tumor recurrence in patients with initially transplantable HCC. All initially transplantable HCC patients undergoing hepatectomy with either narrow (
Published: 2020

48. Benchmark performance of laparoscopic left lateral sectionectomy and right hepatectomy in expert centers

Author: F.-R. Pruvot, C. Hobeika, S Truant, Patrick Pessaux, M.-A. Allard, M Tedeschi, Kayvan Mohkam, A. Sa Cunha, Julio Abba, J Chauvat, Riccardo Memeo, Takayuki Kawai, Christian Ducerf, T Codjia, François Paye, N Oudafal, Alexis Laurent, J Nunèz, F Jehaes, Takeo Nomi, M Chirica, Jean-Yves Mabrut, A Mulliri, C VanBrugghe, David Fuks, J Barbieux, Ephrem Salamé, Eric Vibert, L Ferre, Y.P. Le Treut, Oriana Ciacio, F R Souche, Emmanuel Boleslawski, A Thobie, Z Cherkaoui, Daniel Cherqui, S Okumura, M Bougard, B Trechot, Shohei Komatsu, M. El Amrani, Olivier Soubrane, J.-M. Regimbeau, F Muscari, L Chiche, E Buc, J.-M. Fabre, M Lesurtel, B Suc, Brice Gayet, B Menahem, P. Balladur, O Turini, A.-R. Kianmanesh, Nicolas Golse, François Cauchy, Emilie Gregoire, J Ewald, J Hardwigsen, J.-Y. Mabrut, Claire Goumard, C Ratajczak, Edouard Girard, P Leourier, L. Schwarz, J Zemour, Christian Letoublon, Gabriella Pittau, Guillaume Passot, Christophe Laurent, E Lermite, Jean-Marc Regimbeau, A Carmelo, G Millet, X Unterteiner, D Patrice, U Marchese, A. Laurent, J Lubrano, Lionel Rebibo, H Fagot, K Lecolle, T Hor, Olivier Scatton, Petru Bucur, René Adam, N Petrucciani, and Louise Barbier
Subjects: 0301 basic medicine, Male, Percentile, medicine.medical_specialty, medicine.medical_treatment, Patient Readmission, Resection, 03 medical and health sciences, 0302 clinical medicine, Postoperative Complications, medicine, Hepatectomy, Humans, In patient, Blood Transfusion, Mortality, Severe complication, Quality Indicators, Health Care, Hepatology, business.industry, General surgery, Liver Neoplasms, Margins of Excision, Odds ratio, Composite indicator, Length of Stay, Hospitals, Benchmarking, 030104 developmental biology, Outcome and Process Assessment, Health Care, Health Care Surveys, 030211 gastroenterology & hepatology, Female, Laparoscopy, France, Benchmark, laparoscopic liver resection, left lateral sectionectomy, quality of care, right hepatectomy, textbook outcome, Complication, business
Abstract: Background & Aims Herein, we aimed to establish benchmark values – based on a composite indicator of healthcare quality – for the performance of laparoscopic left lateral sectionectomy (LLLS) and laparoscopic right hepatectomy (LRH) using data from expert centers. Methods Data from a nationwide multicenter survey including all patients undergoing LLLS and LRH between 2000 and 2017 were analyzed. Textbook outcome (TO) completion was considered in patients fulfilling all 6 of the following characteristics: negative margins, no transfusion, no complication, no prolonged hospital stay, no readmission and no mortality. For each procedure, a cut-off laparoscopic liver resection (LLR) volume by center was associated with TO on multivariable analysis. These cut-offs defined the expert centers. The benchmark values were set at the 75th percentile of median outcomes among these expert centers. Results Among 4,400 LLRs performed in 29 centers, 855 patients who underwent LLLS and 488 who underwent LRH were identified. The overall incidences of TO after LLLS and LRH were 43.7% and 23.8%, respectively. LLR volume cut-offs of 25 LLR/year (odds ratio [OR] 2.45; bootstrap 95% CI 1.65–3.69; p = 0.001) and 35 LLR/year (OR 2.55; bootstrap 95% CI 1.34–5.63; p = 0.003) were independently associated with completion of TO after LLLS and LRH, respectively. Eight centers for LLLS and 6 centers for LRH, including 516 and 346 patients undergoing LLLS/LRH respectively, reached these cut-offs and were identified as expert centers. After LLLS, benchmark values of severe complication, mortality and TO completion were defined as ≤5.3%, ≤1.2% and ≥46.6%, respectively. After LRH, benchmark values of severe complication, mortality and TO completion were ≤20.4%, ≤2.8% and ≥24.2%, respectively. Conclusions This study provides an up-to-date reference on the benchmark performance of LLLS and LRH in expert centers. Lay summary In a nationwide French survey of laparoscopic liver resection, expert centers were defined according to the completion of a textbook outcome, which is a composite indicator of healthcare quality. Benchmark values regarding intra-operative details and outcomes were established using data from 516 patients with laparoscopic left lateral sectionectiomy and 346 patients with laparoscopic right hepatectomy from expert centers. These values should be used as a reference point to improve the quality of laparoscopic resections.
Published: 2020

49. Definition and Prospective Assessment of Functional Recovery After Liver Transplantation: A New Objective Consensus-Based Metric for Safe Discharge

Author: Mickael Lesurtel, Sébastien Dharancy, Emmanuel Boleslawski, R. Brustia, Antoine Monsel, Olivier Scatton, René Adam, Jérôme Dumortier, Filoména Conti, Louise Barbier, CHU Pitié-Salpêtrière [AP-HP], and Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)
Subjects: medicine.medical_specialty, Future studies, Consensus, Delphi Technique, medicine.medical_treatment, Pilot Projects, [SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery, 030230 surgery, Liver transplantation, 03 medical and health sciences, 0302 clinical medicine, Hospital discharge, Medicine, Humans, Prospective Studies, Patient discharge, Transplantation, Hepatology, business.industry, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology, Functional recovery, Checklist, Patient Discharge, 3. Good health, Liver Transplantation, Systematic review, Emergency medicine, 030211 gastroenterology & hepatology, Surgery, Metric (unit), business
Abstract: Background Standardized discharge criteria are critical to reduce the risk of premature discharge and avoid unnecessary days in hospital. No such criteria exist for patients who have undergone liver transplantation. Objective To achieve a consensus-based checklist of criteria for safe patient discharge after liver transplantation. Design Mixed-method study including: (1) systematic literature review and expert discussion to draft a first checklist of discharge criteria after liver transplantation, defining when a patient has recovered and is ready for hospital discharge (functional recovery); (2) an exploratory online e-Delphi study; (3) a single-center, pilot study to test the checklist feasibility; and (4) a final e-Delphi study with an extended interdisciplinary panel of experts to validate the final checklist. Results The first round provided a 10-point discharge checklist: five 'patient-centered' items derived from discharge criteria after liver surgery, and five 'graft-centered' items derived from expert discussion. The restricted-panel (9 expert) e-Delphi provided 100% consensus after the second round, with slight modifications of the criteria. During the pilot study, 19 of 45 patients (42.2%) included fulfilled the complete checklist (100% of 10 items) after a median of 16 (8-21) days (functional recovery) and a median length of stay of 20 (9-24) days. The item termed 'minimum serum tacrolimus level in the target on two consecutive blood samples' had the lowest completion rate, at 47% of patients (n=21), and the longest fulfilment time, at a median of 13 (9-15) days. The extended-panel (66 experts) e-Delphi provided 95-98% consensus after the third round, with slight modifications of the criteria. Conclusions This study provided substantial consensus on discharge criteria after liver transplantation. We anticipate that these criteria will be useful in clinical practice to guide patient discharge and increase the comparability of results between future studies.
Published: 2020

50. Impact of cirrhosis in patients undergoing laparoscopic liver resection in a nationwide multicentre survey

Author: C. Hobeika, O Turini, J Barbieux, J Ewald, J Hardwigsen, Julio Abba, U Marchese, Patrick Pessaux, C Ratajczak, F Jehaes, J Lubrano, P Leourier, B Menahem, N Oudafal, M Tedeschi, M Lesurtel, B Trechot, J.-M. Regimbeau, Eric Vibert, A Carmelo, David Fuks, G Millet, X Unterteiner, T Codjia, J-M Fabre, Emilie Gregoire, D Patrice, C VanBrugghe, M-A Allard, Shohei Komatsu, M. El Amrani, Takeo Nomi, J Zemour, Lionel Rebibo, Kayvan Mohkam, J Nunèz, M Chirica, F Muscari, B Suc, Y-P le Treut, H Fagot, Riccardo Memeo, Brice Gayet, Olivier Scatton, Petru Bucur, K Lecolle, E Lermite, Edouard Girard, Emmanuel Boleslawski, L Ferre, F-R Pruvot, Louise Barbier, Christian Letoublon, Gabriella Pittau, Z Cherkaoui, Nicolas Golse, M Bougard, Guillaume Passot, Takayuki Kawai, Christophe Laurent, L Chiche, René Adam, Alexis Laurent, T Hor, N Petrucciani, A Thobie, P. Balladur, A-R Kianmanesh, F R Souche, A Mulliri, L. Schwarz, J-Y Mabrut, S Okumura, François Cauchy, S Truant, François Paye, Claire Goumard, E Salamé, Christian Ducerf, Oriana Ciacio, A. Sa Cunha, E Buc, Daniel Cherqui, J Chauvat, Oliver Soubrane, Institut de Recherche sur les Maladies Virales et Hépatiques (IVH), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM), and AFC-LLR-2018 study group
Subjects: Liver Cirrhosis, Male, medicine.medical_specialty, Carcinoma, Hepatocellular, Cirrhosis, Aucun, Sciences du Vivant [q-bio]/Médecine humaine et pathologie, Gastroenterology, Disease-Free Survival, liver, cirrhosis, laparoscopic liver resection, 03 medical and health sciences, Postoperative Complications, 0302 clinical medicine, Risk Factors, Internal medicine, medicine, Carcinoma, Hepatectomy, Humans, Risk factor, Propensity Score, Aged, Retrospective Studies, Cause of death, business.industry, Mortality rate, Liver Neoplasms, Retrospective cohort study, Odds ratio, Middle Aged, medicine.disease, Population Surveillance, 030220 oncology & carcinogenesis, Propensity score matching, Female, Laparoscopy, 030211 gastroenterology & hepatology, Surgery, business, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract: The aim was to analyse the impact of cirrhosis on short-term outcomes after laparoscopic liver resection (LLR) in a multicentre national cohort study.This retrospective study included all patients undergoing LLR in 27 centres between 2000 and 2017. Cirrhosis was defined as F4 fibrosis on pathological examination. Short-term outcomes of patients with and without liver cirrhosis were compared after propensity score matching by centre volume, demographic and tumour characteristics, and extent of resection.Among 3150 patients included, LLR was performed in 774 patients with (24·6 per cent) and 2376 (75·4 per cent) without cirrhosis. Severe complication and mortality rates in patients with cirrhosis were 10·6 and 2·6 per cent respectively. Posthepatectomy liver failure (PHLF) developed in 3·6 per cent of patients with cirrhosis and was the major cause of death (11 of 20 patients). After matching, patients with cirrhosis tended to have higher rates of severe complications (odds ratio (OR) 1·74, 95 per cent c.i. 0·92 to 3·41; P = 0·096) and PHLF (OR 7·13, 0·91 to 323·10; P = 0·068) than those without cirrhosis. They also had a higher risk of death (OR 5·13, 1·08 to 48·61; P = 0·039). Rates of cardiorespiratory complications (P = 0·338), bile leakage (P = 0·286) and reoperation (P = 0·352) were similar in the two groups. Patients with cirrhosis had a longer hospital stay than those without (11 versus 8 days; P = 0·018). Centre expertise was an independent protective factor against PHLF in patients with cirrhosis (OR 0·33, 0·14 to 0·76; P = 0·010).Underlying cirrhosis remains an independent risk factor for impaired outcomes in patients undergoing LLR, even in expert centres.El objetivo de este estudio fue analizar el impacto de la cirrosis en los resultados a corto plazo después de la resección hepática laparoscópica (laparoscopic liver resection, LLR) en un estudio de cohortes multicéntrico nacional. MÉTODOS: Este estudio retrospectivo incluyó todos los pacientes sometidos a LLR en 27 centros entre 2000 y 2017. La cirrosis se definió como fibrosis F4 en el examen histopatológico. Los resultados a corto plazo de los pacientes con hígado cirrótico (cirrhotic liver CL) (pacientes CL) y los pacientes con hígado no cirrótico (non-cirrhotic liver, NCL) (pacientes NCL) se compararon después de realizar un emparejamiento por puntaje de propension del volumen del centro, las características demográficas y del tumor, y la extensión de la resección.Del total de 3.150 pacientes incluidos, se realizó LLR en 774 (24,6%) pacientes CL y en 2.376 (75,4%) pacientes NCL. Las tasas de complicaciones graves y mortalidad en el grupo de pacientes CL fueron del 10,6% y 2,6%, respectivamente. La insuficiencia hepática posterior a la hepatectomía (post-hepatectomy liver failure, PHLF) fue la principal causa de mortalidad (55% de los casos) y se produjo en el 3,6% de los casos en pacientes CL. Después del emparejamiento, los pacientes CL tendieron a tener tasas más altas de complicaciones graves (razón de oportunidades, odds ratio, OR 1,74; i.c. del 95% 0,92-0,41; P = 0,096) y de PHLF (OR 7,13; i.c. del 95% 0,91-323,10; P = 0,068) en comparación con los pacientes NCL. Los pacientes CL estuvieron expuestos a un mayor riesgo de mortalidad (OR 5,13; i.c. del 95% 1,08-48,6; P = 0,039) en comparación con los pacientes NCL. Los pacientes CL presentaron tasas similares de complicaciones cardiorrespiratorias graves (P = 0,338), de fuga biliar (P = 0,286) y de reintervenciones (P = 0,352) que los pacientes NCL. Los pacientes CL tuvieron una estancia hospitalaria más larga (11 versus 8 días; P = 0,018) que los pacientes NCL. La experiencia del centro fue un factor protector independiente de PHLF (OR 0,33; i.c. del 95% 0,14-0,76; P = 0,010) pacientes CL. CONCLUSIÓN: La presencia de cirrosis subyacente sigue siendo un factor de riesgo independiente de peores resultados en pacientes sometidos a resección hepática laparoscópica, incluso en centros con experiencia.
Published: 2020

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