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1. A Bayesian methodology to improve prediction of early graft loss after liver transplantation derived from the Liver Match study

Author

Angelico, M., Cillo, U., Fagiuoli, S., Strazzabosco, M., Caraceni, P., Toniutto, P.L., Nanni Costa, A., Salizzoni, Torino M., Romagnoli, R., Bertolotti, G., Patrono, D., De Carlis, L., Slim, A., Mangoni, J.M.E., Rossi, G., Caccamo, L., Antonelli, B., Mazzaferro, V., Regalia, E., Sposito, C., Colledan, M., Corno, V., Tagliabue, F., Marin, S., Vitale, A., Gringeri, E., Donataccio, M., Donataccio, D., Baccarani, U., Lorenzin, D., Bitetto, D., Valente, U., Gelli, M., Cupo, P., Gerunda, G.E., Rompianesi, G., Pinna, A.D., Grazi, G.L., Cucchetti, A., Zanfi, C., Risaliti, A., Faraci, M.G., Tisone, G., Anselmo, A., Lenci, I., Sforza, D., Agnes, S., Di Mugno, M., Avolio, A.W., Ettorre, G.M., Miglioresi, L., Vennarecci, G., Berloco, P., Rossi, M., Ginanni Corradini, S., Molinaro, A., Calise, F., Scuderi, V., Cuomo, O., Migliaccio, C., Lupo, L., Notarnicola, G., Gridelli, B., Volpes, R., Li Petri, S., Zamboni, F., Carbotta, G., Dedola, S., Nardi, A., Marianelli, T., Gavrila, C., Ricci, A., Vespasiano, F., Angelico, Mario, Nardi, Alessandra, Romagnoli, Renato, Marianelli, Tania, Corradini, Stefano Ginanni, Tandoi, Francesco, Gavrila, Caius, Salizzoni, Mauro, Pinna, Antonio D., Cillo, Umberto, Gridelli, Bruno, De Carlis, Luciano G., Colledan, Michele, Gerunda, Giorgio E., Costa, Alessandro Nanni, and Strazzabosco, Mario

Published
2014
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2. Very Early Introduction of Everolimus in De Novo Liver Transplantation: Results of a Multicenter, Prospective, Randomized Trial

Author

Cillo, U, Saracino, L, Vitale, A, Bertacco, A, Salizzoni, M, Lupo, F, Colledan, M, Corno, V, Rossi, G, Reggiani, P, Baccarani, U, Bresadola, V, De Carlis, L, Mangoni, I, Ramirez Morales, R, Agnes, S, Nure, E, Cillo U., Saracino L., Vitale A., Bertacco A., Salizzoni M., Lupo F., Colledan M., Corno V., Rossi G., Reggiani P., Baccarani U., Bresadola V., De Carlis L., Mangoni I., Ramirez Morales R., Agnes S., Nure E., Cillo, U, Saracino, L, Vitale, A, Bertacco, A, Salizzoni, M, Lupo, F, Colledan, M, Corno, V, Rossi, G, Reggiani, P, Baccarani, U, Bresadola, V, De Carlis, L, Mangoni, I, Ramirez Morales, R, Agnes, S, Nure, E, Cillo U., Saracino L., Vitale A., Bertacco A., Salizzoni M., Lupo F., Colledan M., Corno V., Rossi G., Reggiani P., Baccarani U., Bresadola V., De Carlis L., Mangoni I., Ramirez Morales R., Agnes S., and Nure E.

Abstract

Early everolimus (EVR) introduction and tacrolimus (TAC) minimization after liver transplantation may represent a novel immunosuppressant approach. This phase 2, multicenter, randomized, open-label trial evaluated the safety and efficacy of early EVR initiation. Patients treated with corticosteroids, TAC, and basiliximab were randomized (2:1) to receive EVR (1.5 mg twice daily) on day 8 and to gradually minimize or withdraw TAC when EVR was stable at >5 ng/mL or to continue TAC at 6-12 ng/mL. The primary endpoint was the proportion of treated biopsy-proven acute rejection (tBPAR)–free patients at 3 months after transplant. As secondary endpoints, composite tBPAR plus graft/patient loss rate, renal function, TAC discontinuation rate, and adverse events were assessed. A total of 93 patients were treated with EVR, and 47 were controls. After 3 months from transplantation, 87.1% of patients with EVR and 95.7% of controls were tBPAR-free (P = 0.09); composite endpoint-free patients with EVR were 85% (versus 94%; P = 0.15). Also at 3 months, 37.6% patients were in monotherapy with EVR, and the tBPAR rate was 11.4%. Estimated glomerular filtration rate was significantly higher with EVR, as early as 2 weeks after randomization. In the study group, higher rates of dyslipidemia (15% versus 6.4%), wound complication (18.32% versus 0%), and incisional hernia (25.8% versus 6.4%) were observed, whereas neurological disorders were more frequent in the control group (13.9% versus 31.9%; P < 0.05). In conclusion, an early EVR introduction and TAC minimization may represent a suitable approach when immediate preservation of renal function is crucial.

Published
2019

3. Surgical Complications Requiring an Early Relaparotomy in HIV-Infected Liver Transplant Recipients: Risk Factors and Impact on Survival

Author

Pravisani, R, Baccarani, U, Isola, M, Mocchegiani, F, Lauterio, A, Righi, E, Magistri, P, Corno, V, Adani, G, Lorenzin, D, Di Sandro, S, Pagano, D, Bassetti, M, Gruttadauria, S, De Carlis, L, Vivarelli, M, Di Benedetto, F, Risaliti, A, Pravisani R., Baccarani U., Isola M., Mocchegiani F., Lauterio A., Righi E., Magistri P., Corno V., Adani G. L., Lorenzin D., Di Sandro S., Pagano D., Bassetti M., Gruttadauria S., De Carlis L., Vivarelli M., Di Benedetto F., Risaliti A., Pravisani, R, Baccarani, U, Isola, M, Mocchegiani, F, Lauterio, A, Righi, E, Magistri, P, Corno, V, Adani, G, Lorenzin, D, Di Sandro, S, Pagano, D, Bassetti, M, Gruttadauria, S, De Carlis, L, Vivarelli, M, Di Benedetto, F, Risaliti, A, Pravisani R., Baccarani U., Isola M., Mocchegiani F., Lauterio A., Righi E., Magistri P., Corno V., Adani G. L., Lorenzin D., Di Sandro S., Pagano D., Bassetti M., Gruttadauria S., De Carlis L., Vivarelli M., Di Benedetto F., and Risaliti A.

Abstract

Aim: We aimed to analyze the risk factors for early surgical complications requiring relaparotomy and the related impact on overall survival (OS) in HIV-infected patients submitted to liver transplantation. Methods: We performed a retrospective study on a nationwide multicenter cohort of 157 HIV-infected patients submitted to liver transplantation in 6 Italian transplant units between 2004 to 2014. Results: The median preoperative model for end-stage liver disease score was 18 (interquartile range 12-26.5). An early relaparotomy was performed in 24.8% of patients, and the underlying clinical causes were biliary leak (8.2%), bleeding (8.2%), intestinal perforation (4.5%), and suspected vascular complications (3.8%). The OS at 1, 3, and 5 years was 74.3%, 68.0%, and 60.0%, respectively, and an early relaparotomy was not a prognostic factor itself, but an increasing number of relaparotomies was associated with decreased survival (hazard ratio = 1.40, 95% confidence interval [CI] 1.07-1.81, P = .01). In the multivariate analysis, preoperative refractory ascites (odds ratio 3.32, 95% CI 1.18-6.47, P = .02) and Roux-en-Y choledochojejunostomy reconstruction (odds ratio 12.712, 95% CI 2.47-65.38, P ≤ .01) were identified as significant risk factors for early relaparotomy. Conclusions: In HIV-infected liver transplant recipients, an increasing number of early relaparotomies due to surgical complications did negatively affect the OS. Preoperative refractory ascites reflecting a severe portal hypertension and a difficult biliary tract reconstruction requiring a Roux-en-Y choledochojejunostomy were associated with an increased risk of early relaparotomy.

Published
2019

4. Early post-liver transplant surgical morbidity in HIV-infected recipients: risk factor for overall survival? A nationwide retrospective study

Author

Baccarani, U, Pravisani, R, Isola, M, Mocchegiani, F, Lauterio, A, Righi, E, Magistri, P, Corno, V, Adani, G, Lorenzin, D, Di Sandro, S, Pagano, D, Bassetti, M, Gruttadauria, S, Colledan, M, De Carlis, L, Vivarelli, M, Di Benedetto, F, Risaliti, A, Baccarani U., Pravisani R., Isola M., Mocchegiani F., Lauterio A., Righi E., Magistri P., Corno V., Adani G. L., Lorenzin D., Di Sandro S., Pagano D., Bassetti M., Gruttadauria S., Colledan M., De Carlis L., Vivarelli M., Di Benedetto F., Risaliti A., Baccarani, U, Pravisani, R, Isola, M, Mocchegiani, F, Lauterio, A, Righi, E, Magistri, P, Corno, V, Adani, G, Lorenzin, D, Di Sandro, S, Pagano, D, Bassetti, M, Gruttadauria, S, Colledan, M, De Carlis, L, Vivarelli, M, Di Benedetto, F, Risaliti, A, Baccarani U., Pravisani R., Isola M., Mocchegiani F., Lauterio A., Righi E., Magistri P., Corno V., Adani G. L., Lorenzin D., Di Sandro S., Pagano D., Bassetti M., Gruttadauria S., Colledan M., De Carlis L., Vivarelli M., Di Benedetto F., and Risaliti A.

Abstract

The aim of the study was to analyse the risk factors for early surgical complications requiring relaparotomy and the related impact on overall survival (OS) in HIV-infected patients submitted to liver transplantation. Thus a retrospective investigation was conducted on a nationwide multicentre cohort of 157 HIV patients submitted to liver transplantation in six Italian Transplant Units between 2004 and 2014. An early relaparotomy was performed in 24.8% of cases and the underlying clinical causes were biliary leak (8.2%), bleeding (8.2%), intestinal perforation (4.5%) and suspect of vascular complications(3.8%). No differences in terms of prevalence for either overall or cause-specific early relaparotomies were noted when compared with a non-HIV control group, matched for MELD, recipient age, HCV-RNA positivity and HBV prevalence. While in the control group an early relaparotomy appeared a negative prognostic factor, such impact on OS was not noted in HIV recipients. Nonetheless increasing number of relaparotomies were associated with decreased survival. In multivariate analysis, preoperative refractory ascites and Roux-en-Y choledochojejunostomy reconstruction were significant risk factors for early relaparotomy. To conclude, in HIV liver transplanted patients, an increasing number of early relaparotomies because of surgical complications does negatively affect the OS. Preoperative refractory ascites reflecting a severe portal hypertension and a difficult biliary tract reconstruction requiring a Roux-en-Y choledochojejunostomy are associated with increased risk of early relaparotomy.

Published
2019

5. Value of HCC-MELD Score in Patients With Hepatocellular Carcinoma Undergoing Liver Transplantation

Author

Guerrini, G, Pinelli, D, Marini, E, Corno, V, Guizzetti, M, Zambelli, M, Aluffi, A, Lincini, L, Fagiuoli, S, Lucianetti, A, Colledan, M, Guerrini GP, Pinelli D, Marini E, Corno V, Guizzetti M, Zambelli M, Aluffi A, Lincini L, Fagiuoli S, Lucianetti A, Colledan M, Guerrini, G, Pinelli, D, Marini, E, Corno, V, Guizzetti, M, Zambelli, M, Aluffi, A, Lincini, L, Fagiuoli, S, Lucianetti, A, Colledan, M, Guerrini GP, Pinelli D, Marini E, Corno V, Guizzetti M, Zambelli M, Aluffi A, Lincini L, Fagiuoli S, Lucianetti A, and Colledan M

Abstract

Context: Liver transplantation (LT) is considered the ideal therapy for patients with hepatocellular carcinoma (HCC) having cirrhosis but the shortage of liver donors and the risk of dropout from the wait list due to tumor progression severely limit transplantation. A new prognostic score, the HCC-model for end-stage liver disease (HCC-MELD), was developed by combining a-fetoprotein (AFP), MELD, and tumor size, to improve risk stratification of dropout in patients with HCC. Objectives: In this study, we investigated the ability of the HCC-MELD score in predicting the posttransplant for patients fulfilling Milan criteria (MC). Design: Two hundred patients with stage II tumor were retrospectively reviewed from a total of 1290 transplants performed at our institution from October 1997 through April 2015. Cox regression analysis was performed to identify the prognostic factors impacting the posttransplant survival. Results: Overall survival at 1, 5, and 10 years was 89.3%, 71.1%, and 67.2%, whereas disease-free survival was 86.4%, 66.5%, and 52.4%, respectively. Multivariate analysis showed HCC-MELD score (hazard ratio [HR] 39.6, P < .001) and microvascular invasion (HR 2.41, P = .002) to be independent risk factors for recurrence, whereas HCC diameter (HR 1.15, P = .041), HCC-MELD (HR 15.611, P = .006), and grading (HR 2.17, P = .03) proved to be predictive factors of poor overall survival. Conclusion: Our study showed the validity of the HCC-MELD equation in the evaluation of patients undergoing LT for HCC. This score offers a reliable method to assess the risk of waiting list dropout and predict post-transplantation outcomes.

Published
2018

14. Comorbidity burden conditions the prognostic performance of D-dimer in elderly patients with acute pulmonary embolism

Author

POLO FRIZ, H, Pezzetti, V, Orenti, A, Caleffi, A, Corno, V, Crivellari, C, Petri, F, Polo Friz, M, Punzi, V, Teruzzi, D, D'Oro, L, Giannattasio, C, Vighi, G, Cimminiello, C, Boracchi, P, POLO FRIZ, HERNAN FRANCISCO, Pezzetti, Valentina, Orenti, Annalisa, Caleffi, Alessandro, Corno, Valeria, Crivellari, Chiara, Petri, Francesco, Polo Friz, Melisa, Punzi, Veronica, Teruzzi, Daniela, d'Oro, Luca Cavalieri, Giannattasio, Cristina, Vighi, Giuseppe, Cimminiello, Claudio, BORACCHI, PATRIZIA, POLO FRIZ, H, Pezzetti, V, Orenti, A, Caleffi, A, Corno, V, Crivellari, C, Petri, F, Polo Friz, M, Punzi, V, Teruzzi, D, D'Oro, L, Giannattasio, C, Vighi, G, Cimminiello, C, Boracchi, P, POLO FRIZ, HERNAN FRANCISCO, Pezzetti, Valentina, Orenti, Annalisa, Caleffi, Alessandro, Corno, Valeria, Crivellari, Chiara, Petri, Francesco, Polo Friz, Melisa, Punzi, Veronica, Teruzzi, Daniela, d'Oro, Luca Cavalieri, Giannattasio, Cristina, Vighi, Giuseppe, Cimminiello, Claudio, and BORACCHI, PATRIZIA

Abstract

Introduction: The prognostic accuracy of D-dimer for risk assessment in acute Pulmonary Embolism (APE) patients may be hampered by comorbidities. We investigated the impact of comorbidity burden (CB) by using the Charlson Comorbidity Index (CCI), on the prognostic ability of D-dimer to predict 30 and 90-day mortality in hemodynamically stable elderly patients with APE. Methods: All patients aged >65 years with normotensive APE, consecutively evaluated in the Emergency Department since 2010 through 2014 were included in this retrospective cohort study. Area under the curve (AUC) and 1⁄2 Net Reclassification Improvement (NRI) were calculated. Results: Study population: 162 patients, median age: 79.2 years. The optimal cut-off value of CCI score for predicting mortality was ≤1 (Low CB) and >1 (High CB), AUC = 0.786. Higher levels of D-dimer were associated with an increased risk death at 30 (HR = 1.039, 95%CI:1.000–1.080, p = 0.049) and 90 days (HR = 1.039, 95%CI:1.009–1.070, p = 0.012). When added to simplified Pulmonary Embolism Severity Index (sPESI) score, D-dimer increased significantly the AUC for predicting 30-day mortality in Low CB (AUC = 0.778, 95%CI:0.620–0.937, 1⁄2NRI = 0.535, p = 0.015), but not in High CB patients (AUC = 0.634, 95%CI:0.460–0.807, 1⁄2 NRI = 0.248, p = 0.294). Similarly, for 90-day mortality D-dimer increased significantly the AUC in Low CB (AUC = 0.786, 95%CI:0.643–0.929, 1⁄2NRI = 0.424, p-value = 0.025), but not in High CB patients (AUC = 0.659, 95%CI:0.541–0.778, 1⁄2NRI = 0.354, p-value = 0.165). Conclusion: In elderly patients with normotensive APE, comorbidities condition the prognostic performance of D-dimer, which was found to be a better predictor of death in subjects with low CB. These results support multimarker strategies for risk assessment in this population.

Published
2019

17. Predictive value of nodule size and differentiation in HCC recurrence after liver transplantation

Author

Guerrini, G, Pinelli, D, Di Benedetto, F, Marini, E, Corno, V, Guizzetti, M, Aluffi, A, Zambelli, M, Fagiuoli, S, Luca, M, Lucianetti, A, Colledan, M, Guerrini GP, Pinelli D, Di Benedetto F, Marini E, Corno V, Guizzetti M, Aluffi A, Zambelli M, Fagiuoli S, Luca MG, Lucianetti A, Colledan M, Guerrini, G, Pinelli, D, Di Benedetto, F, Marini, E, Corno, V, Guizzetti, M, Aluffi, A, Zambelli, M, Fagiuoli, S, Luca, M, Lucianetti, A, Colledan, M, Guerrini GP, Pinelli D, Di Benedetto F, Marini E, Corno V, Guizzetti M, Aluffi A, Zambelli M, Fagiuoli S, Luca MG, Lucianetti A, and Colledan M

Abstract

Background Liver transplantation (LT) is considered the best treatment option for HCC patients with cirrhosis. However, the scarce availability of liver donors and the risk of dropout from the waiting list due to the tumor progression severely limit LT for HCC. In this study, we evaluate the survival and recurrence in a cohort of patients undergoing LT for HCC fulfilling “Milan Criteria” (MC) pre-LT. In this study, we propose the development of a new prognostic score which could improve the accuracy in predicting recurrence post-LT. Methods Between 1997 and 2011, out of 1010 LT performed in our unit, 131 patients had T2 staged HCC (inside MC). The prognostic model predicting HCC recurrence post-LT was derived from Cox regression analysis. The performance of this model was validated in an external cohort of 198 HCC patients transplanted at another center. Results Overall survival at 1–3–5 years was 87%, 74.4%, 68.2%, whereas recurrence-free survival was 94.1%, 81.4%, 77.6%, respectively. Predictive factors for recurrence-free survival included high tumor grading (HR 5.01; p = 0.006) and tumor diameter (HR 1.46; p = 0.045). According to this model, the estimated relative risk of HCC recurrence after LT is given by this formula: 0.382 × (Tumor size [cm]) + 1.613 × (if Grading 3–4). The ROC curve was 0.878 (p < 0.001) in predicting HCC recurrence. Conclusion In conclusion, our study showed that the use of this new prognostic score, taking into account maximal tumor diameter and tumor differentiation, improves the accuracy of Milan criteria in predicting HCC recurrence.

Published
2016

18. A Multistep, Consensus-Based Approach to Organ Allocation in Liver Transplantation: Toward a 'Blended Principle Model'

Author

Cillo, U, Burra, P, Mazzaferro, V, Belli, L, Pinna, Ad, Spada, M, Nanni Costa, A, Toniutto, P, Avolio, A, Cescon, M, Romagnoli, Renato, Santaniello, W, Rossi, M, Corno, V, Caraceni, P, Coco, B, Fraquelli, M, Rendina, M, Angelico, M, Fagiuoli, S, Bruno, R, Costa, An, Ridolfi, L, R, Pretagostini, R, Amoroso, Antonio, Biancofiore, G, De Gasperi, A, Rocca, Gd, Feltracco, P, Colli, A, Sacchini, D, Pegoraro, R, Gardini, I, Pipit, P, Maffeo, C, Rossellini, S. r., Cillo, U, Burra, P, Mazzaferro, V, Belli, L, Pinna, A, Spada, M, Nanni Costa, A, Toniutto, P, Avolio, A, Cescon, M, Regalia, E, Romagnoli, R, Santaniello, W, Rossi, M, Corno, V, Caraceni, P, Coco, B, Fraquelli, M, Rendina, M, Angelico, M, Fagiuoli, S, Bruno, R, Costa, A, De Feo, T, Ridolfi, L, Pretagostini, R, Amoroso, A, Biancofiore, G, De Gasperi, A, Della Rocca, G, Feltracco, P, Colli, A, Sacchini, D, Pegoraro, R, Gardini, I, Cillo U, Burra P, Mazzaferro V, Belli L, Pinna AD, Spada M, Nanni Costa A, Toniutto P, Avolio A, Cescon M, Romagnoli R, Santaniello W, Rossi M, Corno V, Caraceni P, Coco B, Fraquelli M, Rendina M, Angelico M, Fagiuoli S, Bruno R, Costa AN, Ridolfi L, Pretagostini R, Amoroso A, Biancofiore G, De Gasperi A, Rocca GD, Feltracco P, Colli A, Sacchini D, Pegoraro R, Gardini I, Pipit P, Maffeo C, and Rossellini SR

Subjects
medicine.medical_specialty, organ allocation, medicine.medical_treatment, media_common.quotation_subject, MEDLINE, Liver transplantation, allocation, consensus, Liver transplantation, Severity of Illness Index, Organ transplantation, Scientific evidence, Decision Support Techniques, Health care rationing, Jury, medicine, Algorithms, Health Care Rationing, Humans, Italy, Liver Diseases, Liver Transplantation, Patient Selection, Immunology and Allergy, Pharmacology (medical), media_common, Settore MED/12 - Gastroenterologia, Transplantation, liver transplantation, business.industry, liver transplantation, organ allocation, Surgery, Settore MED/18 - Chirurgia Generale, surgical procedures, operative, Family medicine, business, Working group
Abstract

Since Italian liver allocation policy was last revised (in 2012), relevant critical issues and conceptual advances have emerged, calling for significant improvements. We report the results of a national consensus conference process, promoted by the Italian College of Liver Transplant Surgeons (for the Italian Society for Organ Transplantation) and the Italian Association for the Study of the Liver, to review the best indicators for orienting organ allocation policies based on principles of urgency, utility, and transplant benefit in the light of current scientific evidence. MELD exceptions and hepatocellular carcinoma were analyzed to construct a transplantation priority algorithm, given the inequity of a purely MELD-based system for governing organ allocation. Working groups of transplant surgeons and hepatologists prepared a list of statements for each topic, scoring their quality of evidence and strength of recommendation using the Centers for Disease Control grading system. A jury of Italian transplant surgeons, hepatologists, intensivists, infectious disease specialists, epidemiologists, representatives of patients' associations and organ-sharing organizations, transplant coordinators, and ethicists voted on and validated the proposed statements. After carefully reviewing the statements, a critical proposal for revising Italy's current liver allocation policy was prepared jointly by transplant surgeons and hepatologists.

Published
2015

25. The successful management of a Bronchoesophageal fistula after lung transplantation: a case report

Author

Camagni, S, Lucianetti, A, Ravelli, P, Di Dedda, G, Bonanomi, E, Corno, V, Aluffi, A, Pinelli, D, Zambelli, M, Guizzetti, M, Parigi, P, Colledan, M, Camagni S, Lucianetti A, Ravelli P, Di Dedda GB, Bonanomi E, Corno V, Aluffi A, Pinelli D, Zambelli MF, Guizzetti M, Parigi P, Colledan M, Camagni, S, Lucianetti, A, Ravelli, P, Di Dedda, G, Bonanomi, E, Corno, V, Aluffi, A, Pinelli, D, Zambelli, M, Guizzetti, M, Parigi, P, Colledan, M, Camagni S, Lucianetti A, Ravelli P, Di Dedda GB, Bonanomi E, Corno V, Aluffi A, Pinelli D, Zambelli MF, Guizzetti M, Parigi P, and Colledan M

Abstract

We describe an unprecedented, disastrous complication after bilateral lung transplantation (BLT), a bilateral bronchial dehiscence with a right bronchoesophageal fistula leading to life-threatening septic shock. We also report the successful endoscopic management of this complication by double stenting and stress the efficacy of the multidisciplinary approach to this critical case.

Published
2015

26. Comorbidity assessment as predictor of short and long-term mortality in elderly patients with hemodynamically stable acute pulmonary embolism

Author

Polo Friz, H, Corno, V, Orenti, A, Buzzini, C, Crivellari, C, Petri, F, Polo Friz, M, Punzi, V, Teruzzi, D, Cavalieri d'Oro, L, Giannattasio, C, Vighi, G, Cimminiello, C, Boracchi, P, GIANNATTASIO, CRISTINA, BORACCHI, PATRIZIA, Polo Friz, H, Corno, V, Orenti, A, Buzzini, C, Crivellari, C, Petri, F, Polo Friz, M, Punzi, V, Teruzzi, D, Cavalieri d'Oro, L, Giannattasio, C, Vighi, G, Cimminiello, C, Boracchi, P, GIANNATTASIO, CRISTINA, and BORACCHI, PATRIZIA

Abstract

Elderly patients presenting with acute pulmonary embolism (PE) frequently have significant underlying comorbidities which may condition the prognosis. The current study aimed to determine the ability of Charlson comorbidity index (CCI) score to predict short and long-term mortality in elderly patients with hemodynamically stable acute PE. All hemodynamically stable patients aged >65 years with acute PE, evaluated in the Emergency Department since 2010 through 2014, were included in this retrospective cohort study. CCI, simplified pulmonary embolism severity index (sPESI) scores and vital status were recorded. Were included 162 patients with confirmed PE, out of 657 suspected cases (24.7%). Median age: 79.2 years, 74.1% presented an sPESI > 1 and 61.1% a CCI > 1. The overall 30, 90-day and 2-year mortality was 11.7% (95%CI 6.6–16.6), 19.8% (95%CI 13.4–25.7) and 31.8% (95%CI 24.1–38.8). For 30-day mortality sPESI showed an AUC 0.642 (95%CI 0.511–0.772) and adding CCI as covariate did not increase its prognostic performance. For 90-day mortality, in an adjusted model including sPESI and CCI, CCI showed a HR 1.282 (95%CI 1.151–1.429, p-value < 0.001), and sPESI a HR = NS(p-value = 0.267). For 2-year mortality, in an adjusted model including sPESI and CCI, CCI showed a HR 1.295 (95%CI 1.180–1.421, p-value < 0.001) and sPESI a HR = NS(p-value = 0.353). In elderly patients with hemodynamically stable PE, the CCI score was found to be an independent predictor of mortality. CCI shows a significantly better ability to predict 90-day and 2-year mortality than sPESI. The assessment of comorbidity burden by using the CCI score may be proposed as an useful tool to predict mortality in these patients.

Published
2017

28. COMBINED 'EN BLOC' LIVER-PANCREAS TRANSPLANTATION USING WHOLE SIZE AND SPLIT LIVER GRAFTS

Author

Corno, V, Pinelli, D, Zambelli, M, Aluffi, A, Guizzetti, M, Rota, G, Rocha, C, Lucianetti, A, Fagiuoli, S, Remuzzi, G, Trevisan, R, Colledan, M, Corno V, Pinelli D, Zambelli M, Aluffi A, Guizzetti M, Rota G, Rocha C, Lucianetti A, Fagiuoli S, Remuzzi G, Trevisan R, Colledan M, Corno, V, Pinelli, D, Zambelli, M, Aluffi, A, Guizzetti, M, Rota, G, Rocha, C, Lucianetti, A, Fagiuoli, S, Remuzzi, G, Trevisan, R, Colledan, M, Corno V, Pinelli D, Zambelli M, Aluffi A, Guizzetti M, Rota G, Rocha C, Lucianetti A, Fagiuoli S, Remuzzi G, Trevisan R, and Colledan M

Published
2011

30. LUNG TRANSPLANTATION IN CHILDREN: A SINGLE CENTER EXPERIENCE

Author

Corno, V, Dezza, M, Lucianetti, A, Pinelli, D, Stroppa, P, Bravi, M, Zambelli, M, Aluffi, A, Guizzetti, M, Codazzi, D, Colledan, M, Corno V, Dezza M, Lucianetti A, Pinelli D, Stroppa P, Bravi M, Zambelli M, Aluffi A, Guizzetti M, Codazzi D, Colledan M, Corno, V, Dezza, M, Lucianetti, A, Pinelli, D, Stroppa, P, Bravi, M, Zambelli, M, Aluffi, A, Guizzetti, M, Codazzi, D, Colledan, M, Corno V, Dezza M, Lucianetti A, Pinelli D, Stroppa P, Bravi M, Zambelli M, Aluffi A, Guizzetti M, Codazzi D, and Colledan M

Published
2011

31. PEDIATRIC LIVER-KIDNEY TRANSPLANTATION: A SINGLE CENTER EXPERIENCE

Author

Corno, V, Lucianetti, A, Stroppa, P, Pinelli, D, Gotti, E, Bravi, M, Rota, G, Locatelli, G, Codazzi, D, Remuzzi, G, Colledan, M, Corno V, Lucianetti A, Stroppa P, Pinelli D, Gotti E, Bravi M, Rota G, Locatelli G, Codazzi D, Remuzzi G, Colledan M, Corno, V, Lucianetti, A, Stroppa, P, Pinelli, D, Gotti, E, Bravi, M, Rota, G, Locatelli, G, Codazzi, D, Remuzzi, G, Colledan, M, Corno V, Lucianetti A, Stroppa P, Pinelli D, Gotti E, Bravi M, Rota G, Locatelli G, Codazzi D, Remuzzi G, and Colledan M

Published
2011

32. THE IMPACT OF INTRAOPERATIVE TRANSFUSION OF BLOOD PRODUCT ON SURVIVAL AFTER PAEDIATRIC LIVER TRANSPLANTATION

Author

Nacoti, M, Lorusso, F, Buoro, S, Vedovati, S, Brambillasca, P, Naldi, L, Corno, V, Colledan, M, Benigni, A, Carrara, B, Pirola, C, Sonzogni, V, Nacoti M, Lorusso F, Buoro S, Vedovati S, Brambillasca P, Naldi L, Corno V, Colledan M, Benigni A, Carrara B, Pirola C, Sonzogni V, Nacoti, M, Lorusso, F, Buoro, S, Vedovati, S, Brambillasca, P, Naldi, L, Corno, V, Colledan, M, Benigni, A, Carrara, B, Pirola, C, Sonzogni, V, Nacoti M, Lorusso F, Buoro S, Vedovati S, Brambillasca P, Naldi L, Corno V, Colledan M, Benigni A, Carrara B, Pirola C, and Sonzogni V

Published
2011

33. Lung Transplantation With Grafts From Elderly Donors: A Single-Center Experience

Author

Dezza, M, Parigi, P, Corno, V, Lucianetti, A, Pinelli, D, Zambelli, M, Guizzetti, M, Aluffi, A, Tagliabue, F, Platto, M, Codazzi, D, Triggiani, M, Colledan, M, Dezza MC, Parigi PC, Corno V, Lucianetti A, Pinelli D, Zambelli M, Guizzetti M, Aluffi A, Tagliabue F, Platto M, Codazzi D, Triggiani M, Colledan M, Dezza, M, Parigi, P, Corno, V, Lucianetti, A, Pinelli, D, Zambelli, M, Guizzetti, M, Aluffi, A, Tagliabue, F, Platto, M, Codazzi, D, Triggiani, M, Colledan, M, Dezza MC, Parigi PC, Corno V, Lucianetti A, Pinelli D, Zambelli M, Guizzetti M, Aluffi A, Tagliabue F, Platto M, Codazzi D, Triggiani M, and Colledan M

Abstract

Introduction. Use of extended criteria donors is one of the strategies to face the scarcity of donors for lung transplantation.Methods. Between November 2002 and May 2009, we performed 52 LTs in 50 recipients, 10 of whom (group A) received lungs from donors aged 55 years or older (median, 58.5; range, 56-66 years) for comparison with 28 patients (group B) transplanted with lungs from donors younger than 55 years (median, 25.5; range, 15-54 years). We excluded 9 children and 3 recipients of combined liver plus lung transplantations from the study.Results. Recipient age, gender, and indications for transplantation did not differ significantly between the 2 groups. Neither were there significant differences in PaO2/FiO2 ratios before lung retrieval, or length of the ischemic time The first PaO2/FiO2 on arrival to the intensive care unit (ICU) and the median length of ICU stay were similar. All patients, except 2 who died in the operating theatre, were extubated between 3 and 216 hours after the transplantation. Hospital mortality was similar in both groups: 3 patients in group A and 2 in group B (P = .1). The median portions of the predicted 1-second forced expiratory volume (FEV1) at 6 months after transplantation did not differ in the 2 groups: 62.4% in group A versus 70% in group B (P = .85).Conclusion. Lung grafts from donors older than 55 years can be effectively used for transplantation, thus increasing the total organ pool.

Published
2010

34. COMBINED LIVER-KIDNEY TRANSPLANTATION IN CHILDREN: A SINGLE CENTER EXPERIENCE

Author

Corno, V, Lucianetti, A, Stroppa, P, Gotti, E, Bravi, M, Rota, G, Bonanomi, E, Locatelli, G, Codazzi, D, Remuzzi, G, Colledan, M, Corno V, Lucianetti A, Stroppa P, Gotti E, Bravi M, Rota G, Bonanomi E, Locatelli G, Codazzi D, Remuzzi G, Colledan M, Corno, V, Lucianetti, A, Stroppa, P, Gotti, E, Bravi, M, Rota, G, Bonanomi, E, Locatelli, G, Codazzi, D, Remuzzi, G, Colledan, M, Corno V, Lucianetti A, Stroppa P, Gotti E, Bravi M, Rota G, Bonanomi E, Locatelli G, Codazzi D, Remuzzi G, and Colledan M

Published
2010

35. D-MELD, a Powerful Predictor of Graft Survival after Liver Transplantation. Long-Term Results of a Multicenter Italian Study

Author

Avolio, A, Cillo, U, Rossi, M, Colledan, M, Tisone, G, Rossi, G, Gerunda, G, Valente, U, Lupo, L, Ettorre, G, Grieco, A, Vitale, A, Lai, Q, Pinelli, D, Anselmo, A, Caccamo, L, Montalti, R, Morelli, N, Rendina, M, Vennarecci, G, Angeli, P, Corno, V, Antonelli, B, Gaspari, R, Gelli, M, Boscarino, G, Nicolotti, N, Costa, R, Angelico, M, Corradini, S, Gasbarrini, A, Di Leo, A, Agnes, S, Avolio AW, Cillo U, Rossi M, Colledan M, Tisone G, Rossi G, Gerunda G, Valente U, Lupo L, Ettorre G, Grieco A, Vitale A, Lai Q, Pinelli D, Anselmo A, Caccamo L, Montalti R, Morelli N, Rendina M, Vennarecci G, Angeli P, Corno V, Antonelli B, Gaspari R, Gelli M, Boscarino G, Nicolotti N, Costa R, Angelico M, Corradini SG, Gasbarrini A, Di Leo A, Agnes S, Avolio, A, Cillo, U, Rossi, M, Colledan, M, Tisone, G, Rossi, G, Gerunda, G, Valente, U, Lupo, L, Ettorre, G, Grieco, A, Vitale, A, Lai, Q, Pinelli, D, Anselmo, A, Caccamo, L, Montalti, R, Morelli, N, Rendina, M, Vennarecci, G, Angeli, P, Corno, V, Antonelli, B, Gaspari, R, Gelli, M, Boscarino, G, Nicolotti, N, Costa, R, Angelico, M, Corradini, S, Gasbarrini, A, Di Leo, A, Agnes, S, Avolio AW, Cillo U, Rossi M, Colledan M, Tisone G, Rossi G, Gerunda G, Valente U, Lupo L, Ettorre G, Grieco A, Vitale A, Lai Q, Pinelli D, Anselmo A, Caccamo L, Montalti R, Morelli N, Rendina M, Vennarecci G, Angeli P, Corno V, Antonelli B, Gaspari R, Gelli M, Boscarino G, Nicolotti N, Costa R, Angelico M, Corradini SG, Gasbarrini A, Di Leo A, and Agnes S

Published
2010

37. LIVER TRANSPLANTATION FOR CRIGLER-NAJJAR SYNDROME TYPE 1: LONG TERM RESULTS

Author

Corno, V, Stroppa, P, Dezza, M, Lucianetti, A, Pinelli, D, Tagliabue, F, Bravi, M, Guizzetti, M, Zambelli, M, Aluffi, A, Al Hashash, M, Colledan, M, Corno V, Stroppa P, Dezza MC, Lucianetti A, Pinelli D, Tagliabue F, Bravi M, Guizzetti M, Zambelli M, Aluffi A, Al Hashash M, Colledan M, Corno, V, Stroppa, P, Dezza, M, Lucianetti, A, Pinelli, D, Tagliabue, F, Bravi, M, Guizzetti, M, Zambelli, M, Aluffi, A, Al Hashash, M, Colledan, M, Corno V, Stroppa P, Dezza MC, Lucianetti A, Pinelli D, Tagliabue F, Bravi M, Guizzetti M, Zambelli M, Aluffi A, Al Hashash M, and Colledan M

Published
2009

38. LIVER TRANSPLANTATION FOR PRIMARY SCLEROSING CHOLANGITIS IN CHILDREN: A SINGLE CENTER EXPERIENCE

Author

Dezza, M, Stroppa, P, Corno, V, Sonzogni, A, Bravi, M, Tagliabue, F, Pinelli, D, Guizzetti, M, Zambelli, M, Aluffi, A, Lucianetti, A, Colledan, M, Dezza MC, Stroppa P, Corno V, Sonzogni A, Bravi M, Tagliabue F, Pinelli D, Guizzetti M, Zambelli M, Aluffi A, Lucianetti A, Colledan M, Dezza, M, Stroppa, P, Corno, V, Sonzogni, A, Bravi, M, Tagliabue, F, Pinelli, D, Guizzetti, M, Zambelli, M, Aluffi, A, Lucianetti, A, Colledan, M, Dezza MC, Stroppa P, Corno V, Sonzogni A, Bravi M, Tagliabue F, Pinelli D, Guizzetti M, Zambelli M, Aluffi A, Lucianetti A, and Colledan M

Published
2009

39. INTRA OPERATIVE HEPATIC BLOOD FLOW IN PEDIATRIC SPLIT LIVER TRANSPLANTATION, CORRELATION WITH THE OUTCOME

Author

Alhashash, M, Zambelli, M, Vezzoli, S, Lucianetti, A, Aluffi, A, Corno, V, Guizzetti, M, Pinelli, D, Tagliabue, F, Dezza, C, Colledan, M, Alhashash M, Zambelli M, Vezzoli S, Lucianetti A, Aluffi A, Corno V, Guizzetti M, Pinelli D, Tagliabue F, Dezza C, Colledan M, Alhashash, M, Zambelli, M, Vezzoli, S, Lucianetti, A, Aluffi, A, Corno, V, Guizzetti, M, Pinelli, D, Tagliabue, F, Dezza, C, Colledan, M, Alhashash M, Zambelli M, Vezzoli S, Lucianetti A, Aluffi A, Corno V, Guizzetti M, Pinelli D, Tagliabue F, Dezza C, and Colledan M

Published
2009

40. DONORS AND RECIPIENTS CHARACTERISTICS ASSOCIATED WITH LIVER GRAFT FAILURE IN CHIRROTIC RECIPIENTS: A EUROPEAN SINGLE CENTRE EXPERIENCE

Author

Dezza, M, Fagiuoli, S, Corno, V, Gaffuri, G, Verga, G, Pinelli, D, Bertolini, G, Lucianetti, A, Colledan, M, Dezza MC, Fagiuoli S, Corno V, Gaffuri G, Verga G, Pinelli D, Bertolini G, Lucianetti A, Colledan M, Dezza, M, Fagiuoli, S, Corno, V, Gaffuri, G, Verga, G, Pinelli, D, Bertolini, G, Lucianetti, A, Colledan, M, Dezza MC, Fagiuoli S, Corno V, Gaffuri G, Verga G, Pinelli D, Bertolini G, Lucianetti A, and Colledan M

Published
2009

41. LIVER TRANSPLANTATION FOR BILIARY ATRESIA: OUTCOME AT A HIGH VOLUME CENTER

Author

Corno, V, Dezza, M, Stroppa, P, Lucianetti, A, Sonzogni, A, Pinelli, D, Bravi, M, Tagliabue, F, Guizzetti, M, Zambelli, M, Aluffi, A, Platto, M, Codazzi, D, Colledan, M, Corno V, Dezza MC, Stroppa P, Lucianetti A, Sonzogni A, Pinelli D, Bravi M, Tagliabue F, Guizzetti M, Zambelli M, Aluffi A, Platto M, Codazzi D, Colledan M, Corno, V, Dezza, M, Stroppa, P, Lucianetti, A, Sonzogni, A, Pinelli, D, Bravi, M, Tagliabue, F, Guizzetti, M, Zambelli, M, Aluffi, A, Platto, M, Codazzi, D, Colledan, M, Corno V, Dezza MC, Stroppa P, Lucianetti A, Sonzogni A, Pinelli D, Bravi M, Tagliabue F, Guizzetti M, Zambelli M, Aluffi A, Platto M, Codazzi D, and Colledan M

Published
2009

42. VACUUM ASSISTED CLOSURE FOR MANAGEMENT OF COMPLICATED ABDOMINAL WOUNDS AFTER PAEDIATRIC LIVER TRANSPLANTATION

Author

Tagliabue, F, Dezza, M, Corno, V, Lucianetti, A, Pinelli, D, Aluffi, A, Guizzetti, M, Zambelli, M, De Ponti, S, Platto, M, Al Hashash, M, Marin, S, Colledan, M, Tagliabue F, Dezza MC, Corno V, Lucianetti A, Pinelli D, Aluffi A, Guizzetti M, Zambelli M, De Ponti S, Platto M, Al Hashash M, Marin S, Colledan M, Tagliabue, F, Dezza, M, Corno, V, Lucianetti, A, Pinelli, D, Aluffi, A, Guizzetti, M, Zambelli, M, De Ponti, S, Platto, M, Al Hashash, M, Marin, S, Colledan, M, Tagliabue F, Dezza MC, Corno V, Lucianetti A, Pinelli D, Aluffi A, Guizzetti M, Zambelli M, De Ponti S, Platto M, Al Hashash M, Marin S, and Colledan M

Published
2009

43. SPLIT LIVER TRANSPLANTATION IN CHILDREN: A 10 YEARS SINGLE CENTER EXPERIENCE

Author

Corno, V, Dezza, M, Lucianetti, A, Pinelli, D, Tagliabue, F, Guizzetti, M, Zambelli, M, Aluffi, A, Bravi, M, Stroppa, P, Codazzi, D, Torre, G, Colledan, M, Corno V, Dezza MC, Lucianetti A, Pinelli D, Tagliabue F, Guizzetti M, Zambelli M, Aluffi A, Bravi M, Stroppa P, Codazzi D, Torre G, Colledan M, Corno, V, Dezza, M, Lucianetti, A, Pinelli, D, Tagliabue, F, Guizzetti, M, Zambelli, M, Aluffi, A, Bravi, M, Stroppa, P, Codazzi, D, Torre, G, Colledan, M, Corno V, Dezza MC, Lucianetti A, Pinelli D, Tagliabue F, Guizzetti M, Zambelli M, Aluffi A, Bravi M, Stroppa P, Codazzi D, Torre G, and Colledan M

Published
2009

44. USE OF INHALED NITRIOC OXIDE (Ino) AFTER LIVER TRANSPLANTATION IN CHILDREN AFFECTED BY HEPATO-PULMONARY SYNDROME

Author

Corno, M, Corno, V, Vedovati, S, Marchesi, R, Pellicioli, I, Tartufari, A, Melzi, M, Favarato, M, Torre, G, Colledan, M, Codazzi, D, Corno M, Corno V, Vedovati S, Marchesi R, Pellicioli I, Tartufari A, Melzi M, Favarato M, Torre G, Colledan M, Codazzi D, Corno, M, Corno, V, Vedovati, S, Marchesi, R, Pellicioli, I, Tartufari, A, Melzi, M, Favarato, M, Torre, G, Colledan, M, Codazzi, D, Corno M, Corno V, Vedovati S, Marchesi R, Pellicioli I, Tartufari A, Melzi M, Favarato M, Torre G, Colledan M, and Codazzi D

Published
2008

45. Pre-emptive diagnostic and therapeutic approach of anastomotic biliary strictures after pediatric liver transplantation

Author

Corno, V, Locatelli, L, Pinelli, D, Lucianetti, A, Sonzogni, A, Agazzi, R, Dezza, M, Guizzetti, M, Zambelli, M, Vedovati, S, Codazzi, D, Torre, G, Colledan, M, Corno V, Locatelli L, Pinelli D, Lucianetti A, Sonzogni A, Agazzi R, Dezza MC, Guizzetti M, Zambelli M, Vedovati S, Codazzi D, Torre G, Colledan M, Corno, V, Locatelli, L, Pinelli, D, Lucianetti, A, Sonzogni, A, Agazzi, R, Dezza, M, Guizzetti, M, Zambelli, M, Vedovati, S, Codazzi, D, Torre, G, Colledan, M, Corno V, Locatelli L, Pinelli D, Lucianetti A, Sonzogni A, Agazzi R, Dezza MC, Guizzetti M, Zambelli M, Vedovati S, Codazzi D, Torre G, and Colledan M

Published
2008

46. PRE-EMPTIVE MANAGEMENT OF ANASTOMOTIC BILIARY STRICTURES AFTER PEDIATRIC LIVER TRANSPLANTATION

Author

Corno, V, Locatelli, L, Lucianetti, A, Pinelli, D, Sonzogni, A, Nani, R, Agazzi, R, Dezza, M, Zambelli, M, Guizzetti, M, Candusso, M, Stroppa, P, Codazzi, D, Torre, G, Colledan, M, Corno V, Locatelli L, Lucianetti A, Pinelli D, Sonzogni A, Nani R, Agazzi R, Dezza MC, Zambelli M, Guizzetti M, Candusso M, Stroppa P, Codazzi D, Torre G, Colledan M, Corno, V, Locatelli, L, Lucianetti, A, Pinelli, D, Sonzogni, A, Nani, R, Agazzi, R, Dezza, M, Zambelli, M, Guizzetti, M, Candusso, M, Stroppa, P, Codazzi, D, Torre, G, Colledan, M, Corno V, Locatelli L, Lucianetti A, Pinelli D, Sonzogni A, Nani R, Agazzi R, Dezza MC, Zambelli M, Guizzetti M, Candusso M, Stroppa P, Codazzi D, Torre G, and Colledan M

Published
2008

47. Split liver transplantation: 10 years experience at a high volume center

Author

Corno, V, Pinelli, D, Dezza, M, Lucianetti, A, Guizzetti, M, Zambelli, M, Giovanelli, M, Tagliabue, F, Bravi, M, Stroppa, P, Luca, M, Fagiuoli, S, Codazzi, D, Torre, G, Colledan, M, Corno V, Pinelli D, Dezza M, Lucianetti A, Guizzetti M, Zambelli M, Giovanelli M, Tagliabue F, Bravi M, Stroppa P, Luca M, Fagiuoli S, Codazzi D, Torre G, Colledan M, Corno, V, Pinelli, D, Dezza, M, Lucianetti, A, Guizzetti, M, Zambelli, M, Giovanelli, M, Tagliabue, F, Bravi, M, Stroppa, P, Luca, M, Fagiuoli, S, Codazzi, D, Torre, G, Colledan, M, Corno V, Pinelli D, Dezza M, Lucianetti A, Guizzetti M, Zambelli M, Giovanelli M, Tagliabue F, Bravi M, Stroppa P, Luca M, Fagiuoli S, Codazzi D, Torre G, and Colledan M

Published
2008

48. 10 YEARS EXPERIENCE WITH SPLIT LIVER TRANSPLANTATION

Author

Corno, V, Pinelli, D, Lucianetti, A, Dezza, M, Guizzetti, M, Zambelli, M, Tagliabue, F, Giovanelli, M, Bravi, M, Stroppa, P, Verga, G, Codazzi, D, Fagiuoli, S, Torre, G, Colledan, M, Corno V, Pinelli D, Lucianetti A, Dezza M, Guizzetti M, Zambelli M, Tagliabue F, Giovanelli M, Bravi M, Stroppa P, Verga G, Codazzi D, Fagiuoli S, Torre G, Colledan M, Corno, V, Pinelli, D, Lucianetti, A, Dezza, M, Guizzetti, M, Zambelli, M, Tagliabue, F, Giovanelli, M, Bravi, M, Stroppa, P, Verga, G, Codazzi, D, Fagiuoli, S, Torre, G, Colledan, M, Corno V, Pinelli D, Lucianetti A, Dezza M, Guizzetti M, Zambelli M, Tagliabue F, Giovanelli M, Bravi M, Stroppa P, Verga G, Codazzi D, Fagiuoli S, Torre G, and Colledan M

Published
2008

49. PEDIATRIC LIVER-KIDNEY TRANSPLANTATION: A SINGLE CENTER EXPERIENCE

Author

Corno V, Lucianetti A, Stroppa P, Pinelli D, Gotti E, Bravi M, Rota G, Locatelli G, Codazzi D, Remuzzi G, Colledan M, Corno, V, Lucianetti, A, Stroppa, P, Pinelli, D, Gotti, E, Bravi, M, Rota, G, Locatelli, G, Codazzi, D, Remuzzi, G, and Colledan, M

Subjects
Combined transplantation
Published
2011

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