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3. Dragon 1 Protocol Manuscript: Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy

Author

Korenblik, R., Olij, B., Aldrighetti, L. A., Hilal, M. Abu, Ahle, M., Arslan, B., van Baardewijk, L. J., Baclija, I., Bent, C., Bertrand, C. L., Björnsson, B., de Boer, M. T., de Boer, S. W., Bokkers, R. P. H., Rinkes, I. H. M. Borel, Breitenstein, S., Bruijnen, R. C. G., Bruners, P., Büchler, M. W., Camacho, J. C., Cappelli, A., Carling, U., Chan, B. K. Y., Chang, D. H., choi, J., Font, J. Codina, Crawford, M., Croagh, D., Cugat, E., Davis, R., De Boo, D. W., De Cobelli, F., De Wispelaere, J. F., van Delden, O. M., Delle, M., Detry, O., Díaz-Nieto, R., Dili, A., Erdmann, J. I., Fisher, O., Fondevila, C., Fretland, Å., Borobia, F. Garcia, Gelabert, A., Gérard, L., Giuliante, F., Gobardhan, P. D., Gómez, F., Grünberger, T., Grünhagen, D. J., Guitart, J., Hagendoorn, J., Heil, J., Heise, D., Herrero, E., Hess, G. F., Hoffmann, M. H., Iezzi, R., Imani, F., Nguyen, J., Jovine, E., Kalff, J. C., Kazemier, G., Kingham, T. P., Kleeff, J., Kollmar, O., Leclercq, W. K. G., Ben, S. Lopez, Lucidi, V., MacDonald, A., Madoff, D. C., Manekeller, S., Martel, G., Mehrabi, A., Mehrzad, H., Meijerink, M. R., Menon, K., Metrakos, P., Meyer, C., Moelker, A., Modi, S., Montanari, N., Navines, J., Neumann, U. P., Peddu, P., Primrose, J. N., Qu, X., Raptis, D., Ratti, F., Ridouani, F., Rogan, C., Ronellenfitsch, U., Ryan, S., Sallemi, C., Moragues, J. Sampere, Sandström, P., Sarriá, L., Schnitzbauer, A., Serenari, M., Serrablo, A., Smits, M. L. J., Sparrelid, E., Spüntrup, E., Stavrou, G. A., Sutcliffe, R. P., Tancredi, I., Tasse, J. C., Udupa, V., Valenti, D., Fundora, Y., Vogl, T. J., Wang, X., White, S. A., Wohlgemuth, W. A., Yu, D., Zijlstra, I. A. J., Binkert, C. A., Bemelmans, M. H. A., van der Leij, C., Schadde, E., and van Dam, R. M.

Published
2022
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5. Portal and hepatic vein embolization in perihilar cholangiocarcinoma

Author

Smits, J., primary, James, S., additional, Chau, S., additional, Korenblik, R., additional, Abreu De Carvalho, L., additional, Detry, O., additional, Erdmann, J., additional, Grünberger, T., additional, Neumann, U., additional, Sandström, P., additional, Sutcliffe, R., additional, Denys, A., additional, Melloul, E., additional, Dewulf, M., additional, Van Der Leij, C., additional, and Van Dam, R., additional

Published
2024
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7. Utilization of livers donated after circulatory death for transplantation - An international comparison

Author

Eden, J, Da Silva, R, Cortes-Cerisuelo, M, Croome, K, De Carlis, R, Hessheimer, A, Muller, X, de Goeij, F, Banz, V, Magini, G, Compagnon, P, Elmer, A, Lauterio, A, Panconesi, R, Widmer, J, Dondossola, D, Muiesan, P, Monbaliu, D, de Rosner van Rosmalen, M, Detry, O, Fondevila, C, Jochmans, I, Pirenne, J, Immer, F, Oniscu, G, de Jonge, J, Lesurtel, M, De Carlis, L, Taner, C, Heaton, N, Schlegel, A, Dutkowski, P, Eden, Janina, Da Silva, Richard Sousa, Cortes-Cerisuelo, Miriam, Croome, Kristopher, De Carlis, Riccardo, Hessheimer, Amelia J, Muller, Xavier, de Goeij, Femke, Banz, Vanessa, Magini, Giulia, Compagnon, Philippe, Elmer, Andreas, Lauterio, Andrea, Panconesi, Rebecca, Widmer, Jeannette, Dondossola, Daniele, Muiesan, Paolo, Monbaliu, Diethard, de Rosner van Rosmalen, Marieke, Detry, Olivier, Fondevila, Constantino, Jochmans, Ina, Pirenne, Jacques, Immer, Franz, Oniscu, Gabriel C, de Jonge, Jeroen, Lesurtel, Mickaël, De Carlis, Luciano G, Taner, C Burcin, Heaton, Nigel, Schlegel, Andrea, Dutkowski, Philipp, Eden, J, Da Silva, R, Cortes-Cerisuelo, M, Croome, K, De Carlis, R, Hessheimer, A, Muller, X, de Goeij, F, Banz, V, Magini, G, Compagnon, P, Elmer, A, Lauterio, A, Panconesi, R, Widmer, J, Dondossola, D, Muiesan, P, Monbaliu, D, de Rosner van Rosmalen, M, Detry, O, Fondevila, C, Jochmans, I, Pirenne, J, Immer, F, Oniscu, G, de Jonge, J, Lesurtel, M, De Carlis, L, Taner, C, Heaton, N, Schlegel, A, Dutkowski, P, Eden, Janina, Da Silva, Richard Sousa, Cortes-Cerisuelo, Miriam, Croome, Kristopher, De Carlis, Riccardo, Hessheimer, Amelia J, Muller, Xavier, de Goeij, Femke, Banz, Vanessa, Magini, Giulia, Compagnon, Philippe, Elmer, Andreas, Lauterio, Andrea, Panconesi, Rebecca, Widmer, Jeannette, Dondossola, Daniele, Muiesan, Paolo, Monbaliu, Diethard, de Rosner van Rosmalen, Marieke, Detry, Olivier, Fondevila, Constantino, Jochmans, Ina, Pirenne, Jacques, Immer, Franz, Oniscu, Gabriel C, de Jonge, Jeroen, Lesurtel, Mickaël, De Carlis, Luciano G, Taner, C Burcin, Heaton, Nigel, Schlegel, Andrea, and Dutkowski, Philipp

Abstract

Background and aim: Liver graft utilization rates are a hot topic due to the worldwide organ shortage and an increasing number of transplant candidates on waiting lists. Liver perfusion techniques have been introduced in several countries, and may help to increase the organ supply, as they potentially allow the assessment of livers before use. Methods: Liver offers were counted from donation after circulatory death (DCD) donors (Maastricht-type-III) arising during the past decade in eight countries, including Belgium, France, Italy, the Netherlands, Spain, Switzerland, UK, and US. Initial DCD-type-III liver offers were correlated with accepted, recovered and implanted livers. Results: A total number of 34`269 DCD livers were offered, resulting in 9`780 liver transplants (28.5%). The discard rates were highest in UK and US, ranging between 70 and 80%. In contrast, much lower DCD liver discard rates, e.g., between 30-40%, were found in Belgium, France, Italy, Spain and Switzerland. In addition, large differences were recognized in the use of various machine perfusion techniques, and in terms of risk factors in the cohorts of implanted livers. For example, the median donor age and functional donor warm ischemia were highest in Italy, e.g., >40minutes, followed by Switzerland, France, and the Netherlands. Importantly, such varying risk profiles of accepted DCD livers between countries did not translate into large differences in five-year graft survival rates, which ranged between 60-82% in this analysis. Conclusions: We highlight a significant number of discarded and consequently unused DCD liver offers. Countries with more routine use of in- and ex-situ machine perfusion strategies showed better DCD utilization rates without compromised outcome. Impact and implications: A significant number of Maastricht type III DCD livers are discarded across Europe and North America today. The overall utilization rate among eight Western countries is 28.5%, but varies significant

Published
2023

9. COVID-19 in liver transplant candidates: Pretransplant and post-transplant outcomes - An ELITA/ELTR multicentre cohort study

Author

Belli, L, Duvoux, C, Cortesi, P, Facchetti, R, Iacob, S, Perricone, G, Radenne, S, Conti, S, Patrono, D, Berlakovich, G, Hann, A, Pasulo, L, Castells, L, Faitot, F, Detry, O, Invernizzi, F, Magini, G, De Simone, P, Kounis, I, Morelli, M, Diaz Fontenla, F, Ericzon, B, Loinaz, C, Johnston, C, Gheorghe, L, Lesurtel, M, Romagnoli, R, Kollmann, D, Perera, M, Fagiuoli, S, Mirza, D, Coilly, A, Toso, C, Zieniewicz, K, Elkrief, L, Karam, V, Adam, R, Den Hoed, C, Merli, M, Puoti, M, De Carlis, L, Oniscu, G, Piano, S, Angeli, P, Fondevila, C, Polak, W, Belli L. S., Duvoux C., Cortesi P. A., Facchetti R., Iacob S., Perricone G., Radenne S., Conti S., Patrono D., Berlakovich G., Hann A., Pasulo L., Castells L., Faitot F., Detry O., Invernizzi F., Magini G., De Simone P., Kounis I., Morelli M. C., Diaz Fontenla F., Ericzon B. -G., Loinaz C., Johnston C., Gheorghe L., Lesurtel M., Romagnoli R., Kollmann D., Perera M. T. P. R., Fagiuoli S., Mirza D., Coilly A., Toso C., Zieniewicz K., Elkrief L., Karam V., Adam R., Den Hoed C., Merli M., Puoti M., De Carlis L., Oniscu G. C., Piano S., Angeli P., Fondevila C., Polak W. G., Belli, L, Duvoux, C, Cortesi, P, Facchetti, R, Iacob, S, Perricone, G, Radenne, S, Conti, S, Patrono, D, Berlakovich, G, Hann, A, Pasulo, L, Castells, L, Faitot, F, Detry, O, Invernizzi, F, Magini, G, De Simone, P, Kounis, I, Morelli, M, Diaz Fontenla, F, Ericzon, B, Loinaz, C, Johnston, C, Gheorghe, L, Lesurtel, M, Romagnoli, R, Kollmann, D, Perera, M, Fagiuoli, S, Mirza, D, Coilly, A, Toso, C, Zieniewicz, K, Elkrief, L, Karam, V, Adam, R, Den Hoed, C, Merli, M, Puoti, M, De Carlis, L, Oniscu, G, Piano, S, Angeli, P, Fondevila, C, Polak, W, Belli L. S., Duvoux C., Cortesi P. A., Facchetti R., Iacob S., Perricone G., Radenne S., Conti S., Patrono D., Berlakovich G., Hann A., Pasulo L., Castells L., Faitot F., Detry O., Invernizzi F., Magini G., De Simone P., Kounis I., Morelli M. C., Diaz Fontenla F., Ericzon B. -G., Loinaz C., Johnston C., Gheorghe L., Lesurtel M., Romagnoli R., Kollmann D., Perera M. T. P. R., Fagiuoli S., Mirza D., Coilly A., Toso C., Zieniewicz K., Elkrief L., Karam V., Adam R., Den Hoed C., Merli M., Puoti M., De Carlis L., Oniscu G. C., Piano S., Angeli P., Fondevila C., and Polak W. G.

Abstract

Objective: Explore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course. Design: Data from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed. Results: From 21 February to 20 November 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centres in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32.7%) patients died after a median of 18 (10-30) days, with respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not significantly change between first (35.3%, 95% CI 23.9% to 50.0%) and second (26.0%, 95% CI 16.2% to 40.2%) waves. Multivariable Cox regression analysis showed Laboratory Model for End-stage Liver Disease (Lab-MELD) score of ≥15 (Model for End-stage Liver Disease (MELD) score 15-19, HR 5.46, 95% CI 1.81 to 16.50; MELD score≥20, HR 5.24, 95% CI 1.77 to 15.55) and dyspnoea on presentation (HR 3.89, 95% CI 2.02 to 7.51) being the two negative independent factors for mortality. Twenty-six patients underwent an LT after a median time of 78.5 (IQR 44-102) days, and 25 (96%) were alive after a median follow-up of 118 days (IQR 31-170). Conclusions: Increased mortality in LT candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of ≥15, was observed, with no significant difference between first and second waves of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).

Published
2021

10. Liver resection and ablation for squamous cell carcinoma liver metastases

Author

Engstrand, J, Abreu De Carvalho, LF, Aghayan, D, Balakrishnan, A, Belli, A, Björnsson, B, Dasari, BVM, Detry, O, Di Martino, M, Edwin, B, Erdmann, J, Fristedt, R, Fusai, G, Gimenez-Maurel, T, Hemmingsson, O, Hidalgo Salinas, C, Isaksson, B, Ivanecz, A, Izzo, F, Knoefel, WT, Kron, P, Lehwald-Tywuschik, N, Lesurtel, M, Lodge, JPA, Machairas, N, Marino, MV, Martin, V, Paterson, A, Rystedt, J, Sandström, P, Serrablo, A, Siriwardena, AK, Taflin, H, Van Gulik, TM, Yaqub, S, Özden, I, Ramia, JM, Sturesson, C, E-AHPBA Scientific And Research Committee, Engstrand, J [0000-0003-1123-7022], Aghayan, D [0000-0001-7051-3512], Belli, A [0000-0002-6252-573X], Detry, O [0000-0002-9436-6673], Di Martino, M [0000-0001-6510-7210], Hemmingsson, O [0000-0003-1732-168X], Lesurtel, M [0000-0003-2397-4599], Lodge, JPA [0000-0001-8771-4214], Machairas, N [0000-0003-3239-3905], Marino, MV [0000-0002-0466-4467], Rystedt, J [0000-0002-8865-9963], Yaqub, S [0000-0002-5696-2319], Ramia, JM [0000-0001-7734-9479], Sturesson, C [0000-0003-3451-2840], and Apollo - University of Cambridge Repository

Subjects
RISK, Liver Neoplasms, HEPATIC RESECTION, General Medicine, CANCER, Cohort Studies, NEUROENDOCRINE, Medicine and Health Sciences, SURVIVAL, Carcinoma, Squamous Cell, Humans, HEAD, Neoplasm Recurrence, Local, Retrospective Studies
Abstract

Funder: Region Stockholm, Funder: Region Stockholm (clinical postdoctoral appointment), BACKGROUND: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). METHOD: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. RESULTS: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). CONCLUSION: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.

Published
2021
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11. COVID-19 in an international European liver transplant recipient cohort

Author

Becchetti, C, Zambelli, M, Pasulo, L, Donato, M, Invernizzi, F, Detry, O, Dahlqvist, G, Ciccarelli, O, Morelli, M, Fraga, M, Svegliati-Baroni, G, van Vlierberghe, H, Coenraad, M, Romero, M, de Gottardi, A, Toniutto, P, Del Prete, L, Abbati, C, Samuel, D, Pirenne, J, Nevens, F, Dufour, J, Fagiuoli, S, Becchetti C, Zambelli MF, Pasulo L, Donato MF, Invernizzi F, Detry O, Dahlqvist G, Ciccarelli O, Morelli MC, Fraga M, Svegliati-Baroni G, van Vlierberghe H, Coenraad MJ, Romero MC, de Gottardi A, Toniutto P, Del Prete L, Abbati C, Samuel D, Pirenne J, Nevens F, Dufour JF, FAGIUOLI S, Becchetti, C, Zambelli, M, Pasulo, L, Donato, M, Invernizzi, F, Detry, O, Dahlqvist, G, Ciccarelli, O, Morelli, M, Fraga, M, Svegliati-Baroni, G, van Vlierberghe, H, Coenraad, M, Romero, M, de Gottardi, A, Toniutto, P, Del Prete, L, Abbati, C, Samuel, D, Pirenne, J, Nevens, F, Dufour, J, Fagiuoli, S, Becchetti C, Zambelli MF, Pasulo L, Donato MF, Invernizzi F, Detry O, Dahlqvist G, Ciccarelli O, Morelli MC, Fraga M, Svegliati-Baroni G, van Vlierberghe H, Coenraad MJ, Romero MC, de Gottardi A, Toniutto P, Del Prete L, Abbati C, Samuel D, Pirenne J, Nevens F, Dufour JF, and FAGIUOLI S

Abstract

Objective Knowledge on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in liver transplant recipients is lacking, particularly in terms of severity of the disease. The aim of this study was to describe the demographic, baseline clinical characteristics and early outcomes of a European cohort of liver transplant recipients with SARS-CoV-2 infection. Design We conducted an international prospective study across Europe on liver transplant recipients with SARS-CoV-2 infection confirmed by microbiological assay during the first outbreak of COVID-19 pandemic. Baseline characteristics, clinical presentation, management of immunosuppressive therapy and outcomes were collected. Results 57 patients were included (70% male, median (IQR) age at diagnosis 65 (57-70) years). 21 (37%), 32 (56%) and 21 (37%) patients had one cardiovascular disease, arterial hypertension and diabetes mellitus, respectively. The most common symptoms were fever (79%), cough (55%), dyspnoea (46%), fatigue or myalgia (56%) and GI symptoms (33%). Immunosuppression was reduced in 22 recipients (37%) and discontinued in 4 (7%). With this regard, no impact on outcome was observed. Forty-one (72%) subjects were hospitalised and 11 (19%) developed acute respiratory distress syndrome. Overall, we estimated a case fatality rate of 12% (95% CI 5% to 24%), which increased to 17% (95% CI 7% to 32%) among hospitalised patients. Five out of the seven patients who died had a history of cancer. Conclusion In this European multicentre prospective study of liver transplant recipients, COVID-19 was associated with an overall and in-hospital fatality rate of 12% (95% CI 5% to 24%) and 17% (95% CI 7% to 32%), respectively. A history of cancer was more frequent in patients with poorer outcome.

Published
2020

12. Preoperative risk score for prediction of long-term outcomes after hepatectomy for intrahepatic cholangiocarcinoma: Report of a collaborative, international-based, external validation study

Author

Brustia, R, Langella, S, Kawai, T, Fonseca, G, Schielke, A, Colli, F, Resende, V, Fleres, F, Roulin, D, Leyman, P, Giacomoni, A, Granger, B, Fartoux, L, De Carlis, L, Demartines, N, Sommacale, D, Sanches, M, Patrono, D, Detry, O, Herman, P, Okumura, S, Ferrero, A, Scatton, O, Uemoto, S, Perdigao, F, Nolasco, F, Laroche, S, Romagnoli, R, Famularo, S, Brustia R., Langella S., Kawai T., Fonseca G. M., Schielke A., Colli F., Resende V., Fleres F., Roulin D., Leyman P., Giacomoni A., Granger B., Fartoux L., De Carlis L., Demartines N., Sommacale D., Sanches M. D., Patrono D., Detry O., Herman P., Okumura S., Ferrero A., Scatton O., Uemoto S., Perdigao F., Nolasco F., Laroche S., Romagnoli R., Famularo S., Brustia, R, Langella, S, Kawai, T, Fonseca, G, Schielke, A, Colli, F, Resende, V, Fleres, F, Roulin, D, Leyman, P, Giacomoni, A, Granger, B, Fartoux, L, De Carlis, L, Demartines, N, Sommacale, D, Sanches, M, Patrono, D, Detry, O, Herman, P, Okumura, S, Ferrero, A, Scatton, O, Uemoto, S, Perdigao, F, Nolasco, F, Laroche, S, Romagnoli, R, Famularo, S, Brustia R., Langella S., Kawai T., Fonseca G. M., Schielke A., Colli F., Resende V., Fleres F., Roulin D., Leyman P., Giacomoni A., Granger B., Fartoux L., De Carlis L., Demartines N., Sommacale D., Sanches M. D., Patrono D., Detry O., Herman P., Okumura S., Ferrero A., Scatton O., Uemoto S., Perdigao F., Nolasco F., Laroche S., Romagnoli R., and Famularo S.

Abstract

Purpose: A preoperative risk score (PRS) to predict outcome of patients with intrahepatic cholangiocarcinoma treated by liver surgery could be clinically relevant.To assess accuracy for broadly adoption, external validation of predictive models on independent datasets is crucial. The objective of this study was to externally validate the score for prediction of long-term outcomes after liver surgery for intrahepatic cholangiocarcinoma proposed by Sasaki et al. and based on preoperative albumin, neutrophil-to-lymphocytes-ratio, CA19-9 and tumor size. Methods: Patients treated by liver surgery for intrahepatic cholangiocarcinoma at 11 international HPB centers from 2001 to 2018 were included in the external validation cohort. Harrell's c-index and Hosmer-Lemeshow analyses were used to test PRS discrimination and calibration. Kaplan–Meier curve for risk groups as described in the original study were displayed. Results: A total of 355 patients with 174 deaths during the follow-up period (median = 41.7 months, IQR 32.8–50.6) were included. The median PRS value was 14.7 (IQR 10.7–20.6), with normal distribution across the cohort. A Cox regression on PRS covariates found coefficients similar to those of the derivation cohort, except for tumor size. Measures of discrimination estimated by Harrell's c-index was 0.61(95%CI:0.56–0.67) and Hosmer-Lemeshow p = 0.175. The Kaplan-Meyer estimation showed reasonable discrimination across risk groups, with 5years survival rate ranging from 20.1% to 0%. Conclusion: In this external validation cohort, the PRS had mild discrimination and poor calibration performance, similarly to the original publication. Nevertheless, its ability to identify different classes of risk is clinically useful, for a better tailoring of a therapeutic strategy.

Published
2020

13. Long-term outcome of liver transplantation for unresectable liver metastases from Neuroendocrine neoplasms: a Belgian retrospective multi-centre study

Author

UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, UCL - (SLuc) Service de gastro-entérologie, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, Bonaccorsi Riani, Eliano, Pulido Cloquell, Ignacio, Detry, O, Meurisse, N, Ysebaert, D, Pirenne, J, Verslype, C, Berrevoet, F, Vanlander, A, Lucidi, V, Coubeau, Laurent, Dahlqvist, Géraldine, Ciccarelli, Olga, Borbath, Ivan, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, UCL - (SLuc) Service de gastro-entérologie, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, Bonaccorsi Riani, Eliano, Pulido Cloquell, Ignacio, Detry, O, Meurisse, N, Ysebaert, D, Pirenne, J, Verslype, C, Berrevoet, F, Vanlander, A, Lucidi, V, Coubeau, Laurent, Dahlqvist, Géraldine, Ciccarelli, Olga, and Borbath, Ivan

Published
2022

14. Dragon 1 Protocol Manuscript: Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy.

Author

UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de chirurgie, UCL - (MGD) Service de radiologie - résonance magnétique, Korenblik, R, Olij, B, Aldrighetti, L A, Hilal, M Abu, Ahle, M, Arslan, B, van Baardewijk, L J, Baclija, I, Bent, C, Claude, Bertrand, Björnsson, B, de Boer, M T, de Boer, S W, Bokkers, R P H, Rinkes, I H M Borel, Breitenstein, S, Bruijnen, R C G, Bruners, P, Büchler, M W, Camacho, J C, Cappelli, A, Carling, U, Chan, B K Y, Chang, D H, Choi, J, Font, J Codina, Crawford, M, Croagh, D, Cugat, E, Davis, R, De Boo, D W, De Cobelli, F, De Wispelaere, Jean-François, van Delden, O M, Delle, M, Detry, O, Díaz-Nieto, R, Dili, Alexandra, Erdmann, J I, Fisher, O, Fondevila, C, Fretland, Å, Borobia, F Garcia, Gelabert, A, Gérard, L, Giuliante, F, Gobardhan, P D, Gómez, F, Grünberger, T, Grünhagen, D J, Guitart, J, Hagendoorn, J, Heil, J, Heise, D, Herrero, E, Hess, G F, Hoffmann, M H, Iezzi, R, Imani, F, Nguyen, J, Jovine, E, Kalff, J C, Kazemier, G, Kingham, T P, Kleeff, J, Kollmar, O, Leclercq, W K G, Ben, S Lopez, Lucidi, V, MacDonald, A, Madoff, D C, Manekeller, S, Martel, G, Mehrabi, A, Mehrzad, H, Meijerink, M R, Menon, K, Metrakos, P, Meyer, C, Moelker, A, Modi, S, Montanari, N, Navines, J, Neumann, U P, Peddu, P, Primrose, J N, Qu, X, Raptis, D, Ratti, F, Ridouani, F, Rogan, C, Ronellenfitsch, U, Ryan, S, Sallemi, C, Moragues, J Sampere, Sandström, P, Sarriá, L, Schnitzbauer, A, Serenari, M, Serrablo, A, Smits, M L J, Sparrelid, E, Spüntrup, E, Stavrou, G A, Sutcliffe, R P, Tancredi, I, Tasse, J C, Udupa, V, Valenti, D, Fundora, Y, Vogl, T J, Wang, X, White, S A, Wohlgemuth, W A, Yu, D, Zijlstra, I A J, Binkert, C A, Bemelmans, M H A, van der Leij, C, Schadde, E, van Dam, R M, UCL - SSS/IREC/IMAG - Pôle d'imagerie médicale, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - SSS/IREC/MONT - Pôle Mont Godinne, UCL - (MGD) Service de chirurgie, UCL - (MGD) Service de radiologie - résonance magnétique, Korenblik, R, Olij, B, Aldrighetti, L A, Hilal, M Abu, Ahle, M, Arslan, B, van Baardewijk, L J, Baclija, I, Bent, C, Claude, Bertrand, Björnsson, B, de Boer, M T, de Boer, S W, Bokkers, R P H, Rinkes, I H M Borel, Breitenstein, S, Bruijnen, R C G, Bruners, P, Büchler, M W, Camacho, J C, Cappelli, A, Carling, U, Chan, B K Y, Chang, D H, Choi, J, Font, J Codina, Crawford, M, Croagh, D, Cugat, E, Davis, R, De Boo, D W, De Cobelli, F, De Wispelaere, Jean-François, van Delden, O M, Delle, M, Detry, O, Díaz-Nieto, R, Dili, Alexandra, Erdmann, J I, Fisher, O, Fondevila, C, Fretland, Å, Borobia, F Garcia, Gelabert, A, Gérard, L, Giuliante, F, Gobardhan, P D, Gómez, F, Grünberger, T, Grünhagen, D J, Guitart, J, Hagendoorn, J, Heil, J, Heise, D, Herrero, E, Hess, G F, Hoffmann, M H, Iezzi, R, Imani, F, Nguyen, J, Jovine, E, Kalff, J C, Kazemier, G, Kingham, T P, Kleeff, J, Kollmar, O, Leclercq, W K G, Ben, S Lopez, Lucidi, V, MacDonald, A, Madoff, D C, Manekeller, S, Martel, G, Mehrabi, A, Mehrzad, H, Meijerink, M R, Menon, K, Metrakos, P, Meyer, C, Moelker, A, Modi, S, Montanari, N, Navines, J, Neumann, U P, Peddu, P, Primrose, J N, Qu, X, Raptis, D, Ratti, F, Ridouani, F, Rogan, C, Ronellenfitsch, U, Ryan, S, Sallemi, C, Moragues, J Sampere, Sandström, P, Sarriá, L, Schnitzbauer, A, Serenari, M, Serrablo, A, Smits, M L J, Sparrelid, E, Spüntrup, E, Stavrou, G A, Sutcliffe, R P, Tancredi, I, Tasse, J C, Udupa, V, Valenti, D, Fundora, Y, Vogl, T J, Wang, X, White, S A, Wohlgemuth, W A, Yu, D, Zijlstra, I A J, Binkert, C A, Bemelmans, M H A, van der Leij, C, Schadde, E, and van Dam, R M

Abstract

The DRAGON 1 trial aims to assess training, implementation, safety and feasibility of combined portal- and hepatic-vein embolization (PVE/HVE) to accelerate future liver remnant (FLR) hypertrophy in patients with borderline resectable colorectal cancer liver metastases. The DRAGON 1 trial is a worldwide multicenter prospective single arm trial. The primary endpoint is a composite of the safety of PVE/HVE, 90-day mortality, and one year accrual monitoring of each participating center. Secondary endpoints include: feasibility of resection, the used PVE and HVE techniques, FLR-hypertrophy, liver function (subset of centers), overall survival, and disease-free survival. All complications after the PVE/HVE procedure are documented. Liver volumes will be measured at week 1 and if applicable at week 3 and 6 after PVE/HVE and follow-up visits will be held at 1, 3, 6, and 12 months after the resection. Not applicable. DRAGON 1 is a prospective trial to assess the safety and feasibility of PVE/HVE. Participating study centers will be trained, and procedures standardized using Work Instructions (WI) to prepare for the DRAGON 2 randomized controlled trial. Outcomes should reveal the accrual potential of centers, safety profile of combined PVE/HVE and the effect of FLR-hypertrophy induction by PVE/HVE in patients with CRLM and a small FLR. Clinicaltrials.gov: NCT04272931 (February 17, 2020). Toestingonline.nl: NL71535.068.19 (September 20, 2019).

Published
2022

15. Dragon 1 Protocol Manuscript:Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy

Author

Korenblik, R., Olij, B., Aldrighetti, L. A., Hilal, M. Abu, Ahle, M., Arslan, B., van Baardewijk, L. J., Baclija, I., Bent, C., Bertrand, C. L., Björnsson, B., de Boer, M. T., de Boer, S. W., Bokkers, R. P.H., Rinkes, I. H.M.Borel, Breitenstein, S., Bruijnen, R. C.G., Bruners, P., Büchler, M. W., Camacho, J. C., Cappelli, A., Carling, U., Chan, B. K.Y., Chang, D. H., choi, J., Font, J. Codina, Crawford, M., Croagh, D., Cugat, E., Davis, R., De Boo, D. W., De Cobelli, F., De Wispelaere, J. F., van Delden, O. M., Delle, M., Detry, O., Díaz-Nieto, R., Dili, A., Erdmann, J. I., Fisher, O., Fondevila, C., Fretland, Borobia, F. Garcia, Gelabert, A., Gérard, L., Giuliante, F., Gobardhan, P. D., Gómez, F., Grünberger, T., Grünhagen, D. J., Guitart, J., Hagendoorn, J., Heil, J., Heise, D., Herrero, E., Hess, G. F., Hoffmann, M. H., Iezzi, R., Imani, F., Nguyen, J., Jovine, E., Kalff, J. C., Kazemier, G., Kingham, T. P., Kleeff, J., Kollmar, O., Leclercq, W. K.G., Ben, S. Lopez, Lucidi, V., MacDonald, A., Madoff, D. C., Manekeller, S., Martel, G., Mehrabi, A., Mehrzad, H., Meijerink, M. R., Menon, K., Metrakos, P., Meyer, C., Moelker, A., Modi, S., Montanari, N., Navines, J., Neumann, U. P., Peddu, P., Primrose, J. N., Qu, X., Raptis, D., Ratti, F., Ridouani, F., Rogan, C., Ronellenfitsch, U., Ryan, S., Sallemi, C., Moragues, J. Sampere, Sandström, P., Sarriá, L., Schnitzbauer, A., Serenari, M., Serrablo, A., Smits, M. L.J., Sparrelid, E., Spüntrup, E., Stavrou, G. A., Sutcliffe, R. P., Tancredi, I., Tasse, J. C., Udupa, V., Valenti, D., Fundora, Y., Vogl, T. J., Wang, X., White, S. A., Wohlgemuth, W. A., Yu, D., Zijlstra, I. A.J., Binkert, C. A., Bemelmans, M. H.A., van der Leij, C., Schadde, E., van Dam, R. M., Korenblik, R., Olij, B., Aldrighetti, L. A., Hilal, M. Abu, Ahle, M., Arslan, B., van Baardewijk, L. J., Baclija, I., Bent, C., Bertrand, C. L., Björnsson, B., de Boer, M. T., de Boer, S. W., Bokkers, R. P.H., Rinkes, I. H.M.Borel, Breitenstein, S., Bruijnen, R. C.G., Bruners, P., Büchler, M. W., Camacho, J. C., Cappelli, A., Carling, U., Chan, B. K.Y., Chang, D. H., choi, J., Font, J. Codina, Crawford, M., Croagh, D., Cugat, E., Davis, R., De Boo, D. W., De Cobelli, F., De Wispelaere, J. F., van Delden, O. M., Delle, M., Detry, O., Díaz-Nieto, R., Dili, A., Erdmann, J. I., Fisher, O., Fondevila, C., Fretland, Borobia, F. Garcia, Gelabert, A., Gérard, L., Giuliante, F., Gobardhan, P. D., Gómez, F., Grünberger, T., Grünhagen, D. J., Guitart, J., Hagendoorn, J., Heil, J., Heise, D., Herrero, E., Hess, G. F., Hoffmann, M. H., Iezzi, R., Imani, F., Nguyen, J., Jovine, E., Kalff, J. C., Kazemier, G., Kingham, T. P., Kleeff, J., Kollmar, O., Leclercq, W. K.G., Ben, S. Lopez, Lucidi, V., MacDonald, A., Madoff, D. C., Manekeller, S., Martel, G., Mehrabi, A., Mehrzad, H., Meijerink, M. R., Menon, K., Metrakos, P., Meyer, C., Moelker, A., Modi, S., Montanari, N., Navines, J., Neumann, U. P., Peddu, P., Primrose, J. N., Qu, X., Raptis, D., Ratti, F., Ridouani, F., Rogan, C., Ronellenfitsch, U., Ryan, S., Sallemi, C., Moragues, J. Sampere, Sandström, P., Sarriá, L., Schnitzbauer, A., Serenari, M., Serrablo, A., Smits, M. L.J., Sparrelid, E., Spüntrup, E., Stavrou, G. A., Sutcliffe, R. P., Tancredi, I., Tasse, J. C., Udupa, V., Valenti, D., Fundora, Y., Vogl, T. J., Wang, X., White, S. A., Wohlgemuth, W. A., Yu, D., Zijlstra, I. A.J., Binkert, C. A., Bemelmans, M. H.A., van der Leij, C., Schadde, E., and van Dam, R. M.

Abstract

Study Purpose: The DRAGON 1 trial aims to assess training, implementation, safety and feasibility of combined portal- and hepatic-vein embolization (PVE/HVE) to accelerate future liver remnant (FLR) hypertrophy in patients with borderline resectable colorectal cancer liver metastases. Methods: The DRAGON 1 trial is a worldwide multicenter prospective single arm trial. The primary endpoint is a composite of the safety of PVE/HVE, 90-day mortality, and one year accrual monitoring of each participating center. Secondary endpoints include: feasibility of resection, the used PVE and HVE techniques, FLR-hypertrophy, liver function (subset of centers), overall survival, and disease-free survival. All complications after the PVE/HVE procedure are documented. Liver volumes will be measured at week 1 and if applicable at week 3 and 6 after PVE/HVE and follow-up visits will be held at 1, 3, 6, and 12 months after the resection. Results: Not applicable. Conclusion: DRAGON 1 is a prospective trial to assess the safety and feasibility of PVE/HVE. Participating study centers will be trained, and procedures standardized using Work Instructions (WI) to prepare for the DRAGON 2 randomized controlled trial. Outcomes should reveal the accrual potential of centers, safety profile of combined PVE/HVE and the effect of FLR-hypertrophy induction by PVE/HVE in patients with CRLM and a small FLR. Trial Registration: Clinicaltrials.gov: NCT04272931 (February 17, 2020). Toestingonline.nl: NL71535.068.19 (September 20, 2019).

Published
2022

16. A multicentre outcome analysis to define global benchmarks for donation after circulatory death liver transplantation

Author

Schlegel, A, van Reeven, M, Croome, K, Parente, A, Dolcet, A, Widmer, J, Meurisse, N, De Carlis, R, Hessheimer, A, Jochmans, I, Mueller, M, van Leeuwen, O, Nair, A, Tomiyama, K, Sherif, A, Elsharif, M, Kron, P, van der Helm, D, Borja-Cacho, D, Bohorquez, H, Germanova, D, Dondossola, D, Olivieri, T, Camagni, S, Gorgen, A, Patrono, D, Cescon, M, Croome, S, Panconesi, R, Flores Carvalho, M, Ravaioli, M, Caicedo, J, Loss, G, Lucidi, V, Sapisochin, G, Romagnoli, R, Jassem, W, Colledan, M, De Carlis, L, Rossi, G, Di Benedetto, F, Miller, C, van Hoek, B, Attia, M, Lodge, P, Hernandez-Alejandro, R, Detry, O, Quintini, C, Oniscu, G, Fondevila, C, Malagó, M, Pirenne, J, Ijzermans, J, Porte, R, Dutkowski, P, Taner, C, Heaton, N, Clavien, P, Polak, W, Muiesan, P, Schlegel, Andrea, van Reeven, Marjolein, Croome, Kristopher, Parente, Alessandro, Dolcet, Annalisa, Widmer, Jeannette, Meurisse, Nicolas, De Carlis, Riccardo, Hessheimer, Amelia, Jochmans, Ina, Mueller, Matteo, van Leeuwen, Otto B, Nair, Amit, Tomiyama, Koji, Sherif, Ahmed, Elsharif, Mohamed, Kron, Philipp, van der Helm, Danny, Borja-Cacho, Daniel, Bohorquez, Humberto, Germanova, Desislava, Dondossola, Daniele, Olivieri, Tiziana, Camagni, Stefania, Gorgen, Andre, Patrono, Damiano, Cescon, Matteo, Croome, Sarah, Panconesi, Rebecca, Flores Carvalho, Mauricio, Ravaioli, Matteo, Caicedo, Juan Carlos, Loss, George, Lucidi, Valerio, Sapisochin, Gonzalo, Romagnoli, Renato, Jassem, Wayel, Colledan, Michele, De Carlis, Luciano, Rossi, Giorgio, Di Benedetto, Fabrizio, Miller, Charles M, van Hoek, Bart, Attia, Magdy, Lodge, Peter, Hernandez-Alejandro, Roberto, Detry, Olivier, Quintini, Cristiano, Oniscu, Gabriel C, Fondevila, Constantino, Malagó, Massimo, Pirenne, Jacques, IJzermans, Jan Nm, Porte, Robert J, Dutkowski, Philipp, Taner, C Burcin, Heaton, Nigel, Clavien, Pierre-Alain, Polak, Wojciech G, Muiesan, Paolo, Schlegel, A, van Reeven, M, Croome, K, Parente, A, Dolcet, A, Widmer, J, Meurisse, N, De Carlis, R, Hessheimer, A, Jochmans, I, Mueller, M, van Leeuwen, O, Nair, A, Tomiyama, K, Sherif, A, Elsharif, M, Kron, P, van der Helm, D, Borja-Cacho, D, Bohorquez, H, Germanova, D, Dondossola, D, Olivieri, T, Camagni, S, Gorgen, A, Patrono, D, Cescon, M, Croome, S, Panconesi, R, Flores Carvalho, M, Ravaioli, M, Caicedo, J, Loss, G, Lucidi, V, Sapisochin, G, Romagnoli, R, Jassem, W, Colledan, M, De Carlis, L, Rossi, G, Di Benedetto, F, Miller, C, van Hoek, B, Attia, M, Lodge, P, Hernandez-Alejandro, R, Detry, O, Quintini, C, Oniscu, G, Fondevila, C, Malagó, M, Pirenne, J, Ijzermans, J, Porte, R, Dutkowski, P, Taner, C, Heaton, N, Clavien, P, Polak, W, Muiesan, P, Schlegel, Andrea, van Reeven, Marjolein, Croome, Kristopher, Parente, Alessandro, Dolcet, Annalisa, Widmer, Jeannette, Meurisse, Nicolas, De Carlis, Riccardo, Hessheimer, Amelia, Jochmans, Ina, Mueller, Matteo, van Leeuwen, Otto B, Nair, Amit, Tomiyama, Koji, Sherif, Ahmed, Elsharif, Mohamed, Kron, Philipp, van der Helm, Danny, Borja-Cacho, Daniel, Bohorquez, Humberto, Germanova, Desislava, Dondossola, Daniele, Olivieri, Tiziana, Camagni, Stefania, Gorgen, Andre, Patrono, Damiano, Cescon, Matteo, Croome, Sarah, Panconesi, Rebecca, Flores Carvalho, Mauricio, Ravaioli, Matteo, Caicedo, Juan Carlos, Loss, George, Lucidi, Valerio, Sapisochin, Gonzalo, Romagnoli, Renato, Jassem, Wayel, Colledan, Michele, De Carlis, Luciano, Rossi, Giorgio, Di Benedetto, Fabrizio, Miller, Charles M, van Hoek, Bart, Attia, Magdy, Lodge, Peter, Hernandez-Alejandro, Roberto, Detry, Olivier, Quintini, Cristiano, Oniscu, Gabriel C, Fondevila, Constantino, Malagó, Massimo, Pirenne, Jacques, IJzermans, Jan Nm, Porte, Robert J, Dutkowski, Philipp, Taner, C Burcin, Heaton, Nigel, Clavien, Pierre-Alain, Polak, Wojciech G, and Muiesan, Paolo

Abstract

Background & Aims: The concept of benchmarking is established in the field of transplant surgery; however, benchmark values for donation after circulatory death (DCD) liver transplantation are not available. Thus, we aimed to identify the best possible outcomes in DCD liver transplantation and to propose outcome reference values. Methods: Based on 2,219 controlled DCD liver transplantations, collected from 17 centres in North America and Europe, we identified 1,012 low-risk, primary, adult liver transplantations with a laboratory MELD score of ≤20 points, receiving a DCD liver with a total donor warm ischemia time of ≤30 minutes and asystolic donor warm ischemia time of ≤15 minutes. Clinically relevant outcomes were selected and complications were reported according to the Clavien-Dindo-Grading and the comprehensive complication index (CCI). Corresponding benchmark cut-offs were based on median values of each centre, where the 75th-percentile was considered. Results: Benchmark cases represented between 19.7% and 75% of DCD transplantations in participating centres. The 1-year retransplant and mortality rates were 4.5% and 8.4% in the benchmark group, respectively. Within the first year of follow-up, 51.1% of recipients developed at least 1 major complication (≥Clavien-Dindo-Grade III). Benchmark cut-offs were ≤3 days and ≤16 days for ICU and hospital stay, ≤66% for severe recipient complications (≥Grade III), ≤16.8% for ischemic cholangiopathy, and ≤38.9 CCI points 1 year after transplant. Comparisons with higher risk groups showed more complications and impaired graft survival outside the benchmark cut-offs. Organ perfusion techniques reduced the complications to values below benchmark cut-offs, despite higher graft risk. Conclusions: Despite excellent 1-year survival, morbidity in benchmark cases remains high. Benchmark cut-offs targeting morbidity parameters offer a valid tool to assess the protective value of new preservation technologies in higher risk grou

Published
2022

17. Dragon 1 Protocol Manuscript: Training, Accreditation, Implementation and Safety Evaluation of Portal and Hepatic Vein Embolization (PVE/HVE) to Accelerate Future Liver Remnant (FLR) Hypertrophy

Author

Zorgeenheid Orthopaedie Medisch, MS Radiologie, MS CGO, Regenerative Medicine and Stem Cells, Cancer, Other research (not in main researchprogram), Experimentele Afdeling Longziekten, Korenblik, R, Olij, B, Aldrighetti, L A, Hilal, M Abu, Ahle, M, Arslan, B, van Baardewijk, L J, Baclija, I, Bent, C, Bertrand, C L, Björnsson, B, de Boer, M T, de Boer, S W, Bokkers, R P H, Rinkes, I H M Borel, Breitenstein, S, Bruijnen, R C G, Bruners, P, Büchler, M W, Camacho, J C, Cappelli, A, Carling, U, Chan, B K Y, Chang, D H, Choi, J, Font, J Codina, Crawford, M, Croagh, D, Cugat, E, Davis, R, De Boo, D W, De Cobelli, F, De Wispelaere, J F, van Delden, O M, Delle, M, Detry, O, Díaz-Nieto, R, Dili, A, Erdmann, J I, Fisher, O, Fondevila, C, Fretland, Å, Borobia, F Garcia, Gelabert, A, Gérard, L, Giuliante, F, Gobardhan, P D, Gómez, F, Grünberger, T, Grünhagen, D J, Guitart, J, Hagendoorn, J, Heil, J, Heise, D, Herrero, E, Hess, G F, Hoffmann, M H, Iezzi, R, Imani, F, Nguyen, J, Jovine, E, Kalff, J C, Kazemier, G, Kingham, T P, Kleeff, J, Kollmar, O, Leclercq, W K G, Ben, S Lopez, Lucidi, V, MacDonald, A, Madoff, D C, Manekeller, S, Martel, G, Mehrabi, A, Mehrzad, H, Meijerink, M R, Menon, K, Metrakos, P, Meyer, C, Moelker, A, Modi, S, Montanari, N, Navines, J, Neumann, U P, Peddu, P, Primrose, J N, Qu, X, Raptis, D, Ratti, F, Ridouani, F, Rogan, C, Ronellenfitsch, U, Ryan, S, Sallemi, C, Moragues, J Sampere, Sandström, P, Sarriá, L, Schnitzbauer, A, Serenari, M, Serrablo, A, Smits, M L J, Sparrelid, E, Spüntrup, E, Stavrou, G A, Sutcliffe, R P, Tancredi, I, Tasse, J C, Udupa, V, Valenti, D, Fundora, Y, Vogl, T J, Wang, X, White, S A, Wohlgemuth, W A, Yu, D, Zijlstra, I A J, Binkert, C A, Bemelmans, M H A, van der Leij, C, Schadde, E, van Dam, R M, Zorgeenheid Orthopaedie Medisch, MS Radiologie, MS CGO, Regenerative Medicine and Stem Cells, Cancer, Other research (not in main researchprogram), Experimentele Afdeling Longziekten, Korenblik, R, Olij, B, Aldrighetti, L A, Hilal, M Abu, Ahle, M, Arslan, B, van Baardewijk, L J, Baclija, I, Bent, C, Bertrand, C L, Björnsson, B, de Boer, M T, de Boer, S W, Bokkers, R P H, Rinkes, I H M Borel, Breitenstein, S, Bruijnen, R C G, Bruners, P, Büchler, M W, Camacho, J C, Cappelli, A, Carling, U, Chan, B K Y, Chang, D H, Choi, J, Font, J Codina, Crawford, M, Croagh, D, Cugat, E, Davis, R, De Boo, D W, De Cobelli, F, De Wispelaere, J F, van Delden, O M, Delle, M, Detry, O, Díaz-Nieto, R, Dili, A, Erdmann, J I, Fisher, O, Fondevila, C, Fretland, Å, Borobia, F Garcia, Gelabert, A, Gérard, L, Giuliante, F, Gobardhan, P D, Gómez, F, Grünberger, T, Grünhagen, D J, Guitart, J, Hagendoorn, J, Heil, J, Heise, D, Herrero, E, Hess, G F, Hoffmann, M H, Iezzi, R, Imani, F, Nguyen, J, Jovine, E, Kalff, J C, Kazemier, G, Kingham, T P, Kleeff, J, Kollmar, O, Leclercq, W K G, Ben, S Lopez, Lucidi, V, MacDonald, A, Madoff, D C, Manekeller, S, Martel, G, Mehrabi, A, Mehrzad, H, Meijerink, M R, Menon, K, Metrakos, P, Meyer, C, Moelker, A, Modi, S, Montanari, N, Navines, J, Neumann, U P, Peddu, P, Primrose, J N, Qu, X, Raptis, D, Ratti, F, Ridouani, F, Rogan, C, Ronellenfitsch, U, Ryan, S, Sallemi, C, Moragues, J Sampere, Sandström, P, Sarriá, L, Schnitzbauer, A, Serenari, M, Serrablo, A, Smits, M L J, Sparrelid, E, Spüntrup, E, Stavrou, G A, Sutcliffe, R P, Tancredi, I, Tasse, J C, Udupa, V, Valenti, D, Fundora, Y, Vogl, T J, Wang, X, White, S A, Wohlgemuth, W A, Yu, D, Zijlstra, I A J, Binkert, C A, Bemelmans, M H A, van der Leij, C, Schadde, E, and van Dam, R M

Published
2022

18. Long-term outcome of liver transplantation for unresectable liver metastases from Neuroendocrine neoplasms: a Belgian retrospective multi-centre study

Author

Bonaccorsi Riani, Eliano, Pulido Cloquell, Ignacio, Detry, O, Meurisse, N, Ysebaert, D, Pirenne, J, Verslype, C, Berrevoet, F, Vanlander, A, Lucidi, V, Coubeau, Laurent, Dahlqvist, Géraldine, Ciccarelli, Olga, Borbath, Ivan, UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, UCL - (SLuc) Service de gastro-entérologie, UCL - SSS/IREC - Institut de recherche expérimentale et clinique, and UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie

Published
2022

19. COVID-19 in an international European liver transplant recipient cohort

Author

Becchetti, C., Zambelli, M. F., Pasulo, L., Donato, M. F., Invernizzi, F., Detry, O., Dahlqvist, G., Ciccarelli, O., Morelli, M. C., Fraga, M., Svegliati-Baroni, G., Van Vlierberghe, H., Coenraad, M. J., Romero, M. C., De Gottardi, A., Toniutto, P., Del Prete, L., Abbati, C., D'Alessandro, Samuel, Pirenne, J., Nevens, F., Dufour J., -F, and COVID-LT group, Burra, Patrizia, Becchetti, C, Zambelli, M, Pasulo, L, Donato, M, Invernizzi, F, Detry, O, Dahlqvist, G, Ciccarelli, O, Morelli, M, Fraga, M, Svegliati-Baroni, G, van Vlierberghe, H, Coenraad, M, Romero, M, de Gottardi, A, Toniutto, P, Del Prete, L, Abbati, C, Samuel, D, Pirenne, J, Nevens, F, Dufour, J, Fagiuoli, S, COVID-LT group, Colledan, M., Fagiuoli, S., Camagni, S., Delwaide, J., Vitale, G., Moradpour, D., Pascual, M., Allegrini, G., Tarsetti, F., Giustizieri, U., Rota, L., Artru, F., Saouli, A.C., Burra, P., Gambato, M., Scalera, I., Petridis, I., Marques, H.P., Welker, M.W., UCL - SSS/IREC/CHEX - Pôle de chirgurgie expérimentale et transplantation, UCL - (SLuc) Service de chirurgie et transplantation abdominale, UCL - (SLuc) Service de gastro-entérologie, and UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie

Subjects
myalgia, Male, medicine.medical_specialty, medicine.medical_treatment, infectious disease, Pneumonia, Viral, 030230 surgery, Liver transplantation, Chronic liver disease, Cohort Studies, 03 medical and health sciences, Betacoronavirus, chronic liver disease, orthotopic liver transplantation, 0302 clinical medicine, Internal medicine, Case fatality rate, medicine, Humans, Prospective Studies, Prospective cohort study, 610 Medicine & health, Survival rate, Pandemics, Aged, Hepatology, business.industry, SARS-CoV-2, Liver Diseases, Gastroenterology, COVID-19, Middle Aged, medicine.disease, Liver Transplantation, Europe, Hospitalization, Survival Rate, Coronavirus Infections/diagnosis, Coronavirus Infections/epidemiology, Coronavirus Infections/therapy, Female, Liver Diseases/mortality, Liver Diseases/surgery, Liver Diseases/virology, Pneumonia, Viral/diagnosis, Pneumonia, Viral/epidemiology, Pneumonia, Viral/therapy, Cohort, 030211 gastroenterology & hepatology, medicine.symptom, business, Coronavirus Infections, Cohort study
Abstract

ObjectiveKnowledge on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in liver transplant recipients is lacking, particularly in terms of severity of the disease. The aim of this study was to describe the demographic, baseline clinical characteristics and early outcomes of a European cohort of liver transplant recipients with SARS-CoV-2 infection.DesignWe conducted an international prospective study across Europe on liver transplant recipients with SARS-CoV-2 infection confirmed by microbiological assay during the first outbreak of COVID-19 pandemic. Baseline characteristics, clinical presentation, management of immunosuppressive therapy and outcomes were collected.Results57 patients were included (70% male, median (IQR) age at diagnosis 65 (57–70) years). 21 (37%), 32 (56%) and 21 (37%) patients had one cardiovascular disease, arterial hypertension and diabetes mellitus, respectively. The most common symptoms were fever (79%), cough (55%), dyspnoea (46%), fatigue or myalgia (56%) and GI symptoms (33%). Immunosuppression was reduced in 22 recipients (37%) and discontinued in 4 (7%). With this regard, no impact on outcome was observed. Forty-one (72%) subjects were hospitalised and 11 (19%) developed acute respiratory distress syndrome. Overall, we estimated a case fatality rate of 12% (95% CI 5% to 24%), which increased to 17% (95% CI 7% to 32%) among hospitalised patients. Five out of the seven patients who died had a history of cancer.ConclusionIn this European multicentre prospective study of liver transplant recipients, COVID-19 was associated with an overall and in-hospital fatality rate of 12% (95% CI 5% to 24%) and 17% (95% CI 7% to 32%), respectively. A history of cancer was more frequent in patients with poorer outcome.

Published
2020

24. COVID-19 in Liver Transplant Candidates: Pre- and Post-Transplant Outcome

Author

Giovanni P, Hann A, Invernzzi F, lesurtel m, G. Magini, François Faitot, C. Morelli, Stefano Fagiuoli, Karam, Damiano Patrono, Renato Romagnoli, Diaz-Fontenla F, Kounis I, C. Fondevila, zieniewicz k, Rita Facchetti, Paolo Cortesi, Paolo De Simone, Elkrief L, Mirza D, Iacob S, Caroline M. den Hoed, Gheorghe L, Sylvie Radenne, Bo Göran Ericzon, Marco Merli, Lluis Castells, Carmelo Loinaz, Christophe Duvoux, Roberto Fumagalli, Berlakovic G, Sara Conti, Christian Toso, Perera T, Luca S. Belli, Wojciech G. Polak, Massimo Puoti, Luciano Dc, Kollmann D, Detry O, Luisa Pasulo, and Audrey Coilly

Subjects
medicine.medical_specialty, education.field_of_study, Cirrhosis, business.industry, Proportional hazards model, medicine.medical_treatment, Population, Liver transplantation, medicine.disease, Vaccination, Respiratory failure, Internal medicine, medicine, media_common.cataloged_instance, European union, business, education, media_common, Cause of death
Abstract

Background: The impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course is presently unknown. Methods: Data from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and analyzed. Findings: From February 21st to November 20th, 2020, 136 adult cases with laboratory confirmed SARS-CoV-2 infection from 33 centers in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32·7%) patients died after a median of 18 (10-30) days, respiratory failure being the major cause (33/37, 89·2%). The 60-day mortality risk did not significantly change between first (35·3%, 95% CI 23·9-50·0) and second wave (26·0%, 95% CI 16·2-40·2). Multivariable Cox regression analysis showed lab-MELD score ≥15 (MELD 15-19 HR 6·09, 95% CI 2·01-18·45; MELD ≥20 HR 5·21, 95% CI 1·76-15·45) and dyspnea on presentation (HR 4·10, 95% CI 2·09-8·06) being the two negative independent factors for mortality. The mortality risk reached 49·2% (31/63) in patients with decompensated cirrhosis and lab-MELD score ≥15. Twenty-six patient received a LT after a median time of 78.5 (IQR 44-102) days and 25 (96%) are alive after median follow-up of 118 days (IQR 31-170). Interpretation: Increased mortality in LT candidates with COVID-19 (32·7%), reaching 49·2% in those with decompensated cirrhosis and lab-MELD score ≥15, with no significant difference between first and second wave of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with decompensated cirrhosis supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%). Funding: No funding source. Declaration of Interests: None to declare. Ethics Approval Statement: Data was collected in accordance with General Data Protection Regulation (GDPR), the European Union legislation and the ELTR privacy policy. Reg. HCB/2020/0479 released by CLINICAL RESEARCH ETHICS COMMITTEE from Hospital Clinic Barcelona

Published
2021
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25. Protective role of tacrolimus, deleterious role of age and comorbidities in liver transplant recipients with Covid-19: results from the ELITA/ELTR multi-center European study

Author

Belli LS, Fondevila C, Cortesi PA, Conti S, Karam V, Adam R, Coilly A, Ericzon BG, Loinaz C, Cuervas-Mons V, Zambelli M, Llado L, Diaz F, Invernizzi F, Patrono D, Faitot F, Bhooori S, Pirenne J, Perricone G, Magini G, Castells L, Detry O, Cruchaga PM, Colmenero J, Berrevoet F, Rodriguez G, Ysebaert D, Radenne S, Metselaar H, Morelli C, De Carlis L, Polak WG, Duvoux C, and ELITA-ELTR COVID-19 Registry

Subjects
Liver transplantation, COVID-19, Tacrolimus, Outcome
Abstract

BACKGROUND AND AIMS: Despite concerns that liver transplant (LT) recipients may be at increased risk of unfavorable outcomes from COVID-19 due the high prevalence of co-morbidities, immunosuppression and ageing, a detailed analysis of their effects in large studies is lacking. METHODS: Data from adult LT recipients with laboratory confirmed SARS-CoV2 infection were collected across Europe. All consecutive patients with symptoms were included in the analysis. RESULTS: Between March 1st and June 27th2020, data from 243 adult symptomatic cases from 36 centers and 9 countries were collected. Thirty-nine (16%) were managed as outpatients while 204 (84%) required hospitalization including admission to the ICU (39/204, 19.1%). Forty-nine (20.2%) patients died after a median of 13.5 (10-23) days, respiratory failure was the major cause. After multivariable Cox regression analysis, age >70 (HR, 4.16; 95% CI, 1.78-9.73) had a negative effect and tacrolimus (TAC) use (HR, 0.55; 95% CI, 0.31-0.99) had a positive independent effect on survival. The role of co-morbidities was strongly influenced by the dominant effect of age where comorbidities increased with the increasing age of the recipients. In a second model excluding age, both diabetes (HR, 1.95; 95% CI, 1.06-3.58) and chronic kidney disease (HR, 1.97; 95% CI, 1.05-3.67) emerged as associated with death CONCLUSIONS: Twenty-five per cent of patients requiring hospitalization for Covid-19 died, the risk being higher in patients older than 70 and with medical co-morbidities, such as impaired renal function and diabetes. Conversely, the use of TAC was associated with a better survival thus encouraging clinicians to keep TAC at the usual dose.

Published
2021

26. Liver resection and ablation for squamous cell carcinoma liver metastases

Author

Engstrand, J. de Carvalho, L. F. Abreu Aghayan, D. and Balakrishnan, A. Belli, A. Bjornsson, B. Dasari, B. V. M. and Detry, O. Di Martino, M. Edwin, B. Erdmann, J. and Fristedt, R. Fusai, G. Gimenez-Maurel, T. Hemmingsson, O. and Salinas, C. Hidalgo Isaksson, B. Ivanecz, A. Izzo, F. and Knoefel, W. T. Kron, P. Lehwald-Tywuschik, N. Lesurtel, M. Lodge, J. P. A. Machairas, N. Marino, M. V. Martin, V. Paterson, A. Rystedt, J. Sandstrom, P. Serrablo, A. and Siriwardena, A. K. Taflin, H. Van Gulik, T. M. Yaqub, S. and Ozden, I. Ramia, J. M. Sturesson, C. E AHPBA Sci Res Comm

Abstract

Background: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). Method: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. Results: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). Conclusion: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.

Published
2021

27. Liver resection and ablation for squamous cell carcinoma liver metastases

Author

Engstrand, J., de Carvalho, L. F. Abreu, Aghayan, D., Balakrishnan, A., Belli, A., Bjornsson, B., Dasari, B. V. M., Detry, O., Di Martino, M., Edwin, B., Erdmann, J., Fristedt, R., Fusai, G., Gimenez-Maurel, T., Hemmingsson, O., Salinas, C. Hidalgo, Isaksson, Bengt, Ivanecz, A., Izzo, F., Knoefel, W. T., Kron, P., Lehwald-Tywuschik, N., Lesurtel, M., Lodge, J. P. A., Machairas, N., Marino, M. V., Martin, V., Paterson, A., Rystedt, J., Sandstrom, P., Serrablo, A., Siriwardena, A. K., Taflin, H., Van Gulik, T. M., Yaqub, S., Ozden, I., Ramia, J. M., Sturesson, C., Engstrand, J., de Carvalho, L. F. Abreu, Aghayan, D., Balakrishnan, A., Belli, A., Bjornsson, B., Dasari, B. V. M., Detry, O., Di Martino, M., Edwin, B., Erdmann, J., Fristedt, R., Fusai, G., Gimenez-Maurel, T., Hemmingsson, O., Salinas, C. Hidalgo, Isaksson, Bengt, Ivanecz, A., Izzo, F., Knoefel, W. T., Kron, P., Lehwald-Tywuschik, N., Lesurtel, M., Lodge, J. P. A., Machairas, N., Marino, M. V., Martin, V., Paterson, A., Rystedt, J., Sandstrom, P., Serrablo, A., Siriwardena, A. K., Taflin, H., Van Gulik, T. M., Yaqub, S., Ozden, I., Ramia, J. M., and Sturesson, C.

Abstract

Background: Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). Method: Members of the European-African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. Results: Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). Conclusion: Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.

Published
2021
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28. Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis.

Author

UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (MGD) Service de chirurgie, Heil, J, Korenblik, R, Heid, F, Bechstein, W O, Bemelmans, M, Binkert, C, Björnsson, B, Breitenstein, S, Detry, O, Dili, Alexandra, Dondelinger, R F, Gerard, L, Giménez-Maurel, T, Guiu, B, Heise, D, Hertl, M, Kalil, J A, Klein, J J, Lakoma, A, Neumann, U P, Olij, B, Pappas, S G, Sandström, P, Schnitzbauer, A, Serrablo, A, Tasse, J, Van der Leij, C, Metrakos, P, Van Dam, R, Schadde, E, UCL - SSS/IREC/GAEN - Pôle d'Hépato-gastro-entérologie, UCL - (MGD) Service de chirurgie, Heil, J, Korenblik, R, Heid, F, Bechstein, W O, Bemelmans, M, Binkert, C, Björnsson, B, Breitenstein, S, Detry, O, Dili, Alexandra, Dondelinger, R F, Gerard, L, Giménez-Maurel, T, Guiu, B, Heise, D, Hertl, M, Kalil, J A, Klein, J J, Lakoma, A, Neumann, U P, Olij, B, Pappas, S G, Sandström, P, Schnitzbauer, A, Serrablo, A, Tasse, J, Van der Leij, C, Metrakos, P, Van Dam, R, and Schadde, E

Abstract

The extent of liver resection for tumours is limited by the expected functional reserve of the future liver remnant (FRL), so hypertrophy may be induced by portal vein embolization (PVE), taking 6 weeks or longer for growth. This study assessed the hypothesis that simultaneous embolization of portal and hepatic veins (PVE/HVE) accelerates hypertrophy and improves resectability. All centres of the international DRAGON trials study collaborative were asked to provide data on patients who had PVE/HVE or PVE on 2016-2019 (more than 5 PVE/HVE procedures was a requirement). Liver volumetry was performed using OsiriX MD software. Multivariable analysis was performed for the endpoints of resectability rate, FLR hypertrophy and major complications using receiver operating characteristic (ROC) statistics, regression, and Kaplan-Meier analysis. In total, 39 patients had undergone PVE/HVE and 160 had PVE alone. The PVE/HVE group had better hypertrophy than the PVE group (59 versus 48 per cent respectively; P = 0.020) and resectability (90 versus 68 per cent; P = 0.007). Major complications (26 versus 34 per cent; P = 0.550) and 90-day mortality (3 versus 16 per cent respectively, P = 0.065) were comparable. Multivariable analysis confirmed that these effects were independent of confounders. PVE/HVE achieved better FLR hypertrophy and resectability than PVE in this collaborative experience.

Published
2021

29. Protective role of tacrolimus, deleterious role of age and comorbidities in liver transplant recipients with Covid-19: results from the ELITA/ELTR multi-center European study

Author

Belli, L, Fondevila, C, Cortesi, P, Conti, S, Karam, V, Adam, R, Coilly, A, Ericzon, B, Loinaz, C, Cuervas-Mons, V, Zambelli, M, Llado, L, Diaz, F, Invernizzi, F, Patrono, D, Faitot, F, Bhooori, S, Pirenne, J, Perricone, G, Magini, G, Castells, L, Detry, O, Cruchaga, P, Colmenero, J, Berrevoet, F, Rodriguez, G, Ysebaert, D, Radenne, S, Metselaar, H, Morelli, C, De Carlis, L, Polak, W, Duvoux, C, Belli, Luca S, Fondevila, Constantino, Cortesi, Paolo A, Conti, Sara, Karam, Vincent, Adam, Rene, Coilly, Audrey, Ericzon, Bo Goran, Loinaz, Carmelo, Cuervas-Mons, Valentin, Zambelli, Marco, Llado, Laura, Diaz, Fernando, Invernizzi, Federica, Patrono, Damiano, Faitot, Francois, Bhooori, Sherrie, Pirenne, Jacques, Perricone, Giovanni, Magini, Giulia, Castells, Lluis, Detry, Oliver, Cruchaga, Pablo Mart, Colmenero, Jordi, Berrevoet, Frederick, Rodriguez, Gonzalo, Ysebaert, Dirk, Radenne, Sylvie, Metselaar, Herold, Morelli, Cristina, De Carlis, Luciano, Polak, Wojciech G, Duvoux, Christophe, Belli, L, Fondevila, C, Cortesi, P, Conti, S, Karam, V, Adam, R, Coilly, A, Ericzon, B, Loinaz, C, Cuervas-Mons, V, Zambelli, M, Llado, L, Diaz, F, Invernizzi, F, Patrono, D, Faitot, F, Bhooori, S, Pirenne, J, Perricone, G, Magini, G, Castells, L, Detry, O, Cruchaga, P, Colmenero, J, Berrevoet, F, Rodriguez, G, Ysebaert, D, Radenne, S, Metselaar, H, Morelli, C, De Carlis, L, Polak, W, Duvoux, C, Belli, Luca S, Fondevila, Constantino, Cortesi, Paolo A, Conti, Sara, Karam, Vincent, Adam, Rene, Coilly, Audrey, Ericzon, Bo Goran, Loinaz, Carmelo, Cuervas-Mons, Valentin, Zambelli, Marco, Llado, Laura, Diaz, Fernando, Invernizzi, Federica, Patrono, Damiano, Faitot, Francois, Bhooori, Sherrie, Pirenne, Jacques, Perricone, Giovanni, Magini, Giulia, Castells, Lluis, Detry, Oliver, Cruchaga, Pablo Mart, Colmenero, Jordi, Berrevoet, Frederick, Rodriguez, Gonzalo, Ysebaert, Dirk, Radenne, Sylvie, Metselaar, Herold, Morelli, Cristina, De Carlis, Luciano, Polak, Wojciech G, and Duvoux, Christophe

Abstract

BACKGROUND AND AIMS: Despite concerns that liver transplant (LT) recipients may be at increased risk of unfavorable outcomes from COVID-19 due the high prevalence of co-morbidities, immunosuppression and ageing, a detailed analysis of their effects in large studies is lacking.METHODS: Data from adult LT recipients with laboratory confirmed SARS-CoV2 infection were collected across Europe. All consecutive patients with symptoms were included in the analysis.RESULTS: Between March 1st and June 27th2020, data from 243 adult symptomatic cases from 36 centers and 9 countries were collected. Thirty-nine (16%) were managed as outpatients while 204 (84%) required hospitalization including admission to the ICU (39/204, 19.1%). Forty-nine (20.2%) patients died after a median of 13.5 (10-23) days, respiratory failure was the major cause. After multivariable Cox regression analysis, age >70 (HR, 4.16; 95% CI, 1.78-9.73) had a negative effect and tacrolimus (TAC) use (HR, 0.55; 95% CI, 0.31-0.99) had a positive independent effect on survival. The role of co-morbidities was strongly influenced by the dominant effect of age where comorbidities increased with the increasing age of the recipients. In a second model excluding age, both diabetes (HR, 1.95; 95% CI, 1.06-3.58) and chronic kidney disease (HR, 1.97; 95% CI, 1.05-3.67) emerged as associated with death CONCLUSIONS: Twenty-five per cent of patients requiring hospitalization for Covid-19 died, the risk being higher in patients older than 70 and with medical co-morbidities, such as impaired renal function and diabetes. Conversely, the use of TAC was associated with a better survival thus encouraging clinicians to keep TAC at the usual dose.

Published
2021

30. Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis

Author

Heil, J., Korenblik, R., Heid, F., Bechstein, W. O., Bemelmans, M., Binkert, C., Björnsson, Bergthor, Breitenstein, S., Detry, O., Dili, A., Dondelinger, R. F., Gerard, L., Gimenez-Maurel, T., Guiu, B., Heise, D., Hertl, M., Kalil, J. A., Klein, J. J., Lakoma, A., Neumann, U. P., Olij, B., Pappas, S. G., Sandström, Per, Schnitzbauer, A., Serrablo, A., Tasse, J., Van der Leij, C., Metrakos, P., Van Dam, R., Schadde, E., Heil, J., Korenblik, R., Heid, F., Bechstein, W. O., Bemelmans, M., Binkert, C., Björnsson, Bergthor, Breitenstein, S., Detry, O., Dili, A., Dondelinger, R. F., Gerard, L., Gimenez-Maurel, T., Guiu, B., Heise, D., Hertl, M., Kalil, J. A., Klein, J. J., Lakoma, A., Neumann, U. P., Olij, B., Pappas, S. G., Sandström, Per, Schnitzbauer, A., Serrablo, A., Tasse, J., Van der Leij, C., Metrakos, P., Van Dam, R., and Schadde, E.

Abstract

Y Background: The extent of liver resection for tumours is limited by the expected functional reserve of the future liver remnant (FRL), so hypertrophy may be induced by portal vein embolization (PVE), taking 6 weeks or longer for growth. This study assessed the hypothesis that simultaneous embolization of portal and hepatic veins (PVE/HVE) accelerates hypertrophy and improves resectability. Methods: All centres of the international DRAGON trials study collaborative were asked to provide data on patients who had PVE/HVE or PVE on 2016-2019 (more than 5 PVE/HVE procedures was a requirement). Liver volumetry was performed using OsiriX MD software. Multivariable analysis was performed for the endpoints of resectability rate, FLR hypertrophy and major complications using receiver operating characteristic (ROC) statistics, regression, and Kaplan-Meier analysis. Results: In total, 39 patients had undergone PVE/HVE and 160 had PVE alone. The PVE/HVE group had better hypertrophy than the PVE group (59 versus 48 per cent respectively; P=0.020) and resectability (90 versus 68 per cent; P=0.007). Major complications (26 versus 34 per cent; P=0.550) and 90-day mortality (3 versus 16 per cent respectively, P = 0.065) were comparable. Multivariable analysis confirmed that these effects were independent of confounders. Conclusion: PVE/HVE achieved better FLR hypertrophy and resectability than PVE in this collaborative experience.

Published
2021
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31. Liver Resection and Ablation for Squamous Cell Carcinoma Liver Metastases

Author

Engstrand, J; https://orcid.org/0000-0003-1123-7022, Abreu de Carvalho, L F, Aghayan, D; https://orcid.org/0000-0001-7051-3512, Balakrishnan, A, Belli, A; https://orcid.org/0000-0002-6252-573X, Björnsson, B, Dasari, B V M, Detry, O; https://orcid.org/0000-0002-9436-6673, Di Martino, M; https://orcid.org/0000-0001-6510-7210, Edwin, B, Erdmann, J, Fristedt, R, Fusai, G, Gimenez-Maurel, T, Hemmingsson, O; https://orcid.org/0000-0003-1732-168X, Hidalgo Salinas, C, Isaksson, B, Ivanecz, A, Izzo, F, Knoefel, W T, Kron, P, Lehwald-Tywuschik, N, Lesurtel, M; https://orcid.org/0000-0003-2397-4599, Lodge, J P A; https://orcid.org/0000-0001-8771-4214, Machairas, N; https://orcid.org/0000-0003-3239-3905, Marino, M V; https://orcid.org/0000-0002-0466-4467, Martin, V, Paterson, A, Rystedt, J; https://orcid.org/0000-0002-8865-9963, Sandström, P, et al, Engstrand, J; https://orcid.org/0000-0003-1123-7022, Abreu de Carvalho, L F, Aghayan, D; https://orcid.org/0000-0001-7051-3512, Balakrishnan, A, Belli, A; https://orcid.org/0000-0002-6252-573X, Björnsson, B, Dasari, B V M, Detry, O; https://orcid.org/0000-0002-9436-6673, Di Martino, M; https://orcid.org/0000-0001-6510-7210, Edwin, B, Erdmann, J, Fristedt, R, Fusai, G, Gimenez-Maurel, T, Hemmingsson, O; https://orcid.org/0000-0003-1732-168X, Hidalgo Salinas, C, Isaksson, B, Ivanecz, A, Izzo, F, Knoefel, W T, Kron, P, Lehwald-Tywuschik, N, Lesurtel, M; https://orcid.org/0000-0003-2397-4599, Lodge, J P A; https://orcid.org/0000-0001-8771-4214, Machairas, N; https://orcid.org/0000-0003-3239-3905, Marino, M V; https://orcid.org/0000-0002-0466-4467, Martin, V, Paterson, A, Rystedt, J; https://orcid.org/0000-0002-8865-9963, Sandström, P, and et al

Abstract

Background Limited evidence exists to guide the management of patients with liver metastases from squamous cell carcinoma (SCC). The aim of this retrospective multicentre cohort study was to describe patterns of disease recurrence after liver resection/ablation for SCC liver metastases and factors associated with recurrence-free survival (RFS) and overall survival (OS). Method Members of the European–African Hepato-Pancreato-Biliary Association were invited to include all consecutive patients undergoing liver resection/ablation for SCC liver metastases between 2002 and 2019. Patient, tumour and perioperative characteristics were analysed with regard to RFS and OS. Results Among the 102 patients included from 24 European centres, 56 patients had anal cancer, and 46 patients had SCC from other origin. RFS in patients with anal cancer and non-anal cancer was 16 and 9 months, respectively (P = 0.134). A positive resection margin significantly influenced RFS for both anal cancer and non-anal cancer liver metastases (hazard ratio 6.82, 95 per cent c.i. 2.40 to 19.35, for the entire cohort). Median survival duration and 5-year OS rate among patients with anal cancer and non-anal cancer were 50 months and 45 per cent and 21 months and 25 per cent, respectively. For the entire cohort, only non-radical resection was associated with worse overall survival (hazard ratio 3.21, 95 per cent c.i. 1.24 to 8.30). Conclusion Liver resection/ablation of liver metastases from SCC can result in long-term survival. Survival was superior in treated patients with liver metastases from anal versus non-anal cancer. A negative resection margin is paramount for acceptable outcome.

Published
2021

34. Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis

Author

Heil, J, primary, Korenblik, R, additional, Heid, F, additional, Bechstein, W O, additional, Bemelmans, M, additional, Binkert, C, additional, Björnsson, B, additional, Breitenstein, S, additional, Detry, O, additional, Dili, A, additional, Dondelinger, R F, additional, Gerard, L, additional, Giménez-Maurel, T, additional, Guiu, B, additional, Heise, D, additional, Hertl, M, additional, Kalil, J A, additional, Klein, J J, additional, Lakoma, A, additional, Neumann, U P, additional, Olij, B, additional, Pappas, S G, additional, Sandström, P, additional, Schnitzbauer, A, additional, Serrablo, A, additional, Tasse, J, additional, Van der Leij, C, additional, Metrakos, P, additional, Van Dam, R, additional, and Schadde, E, additional

Published
2021
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39. Laparoscopic liver resection of benign liver tumors

Author

Descottes, B., Glineur, D., Lachachi, F., Valleix, D., Paineau, J., Hamy, A., Morino, M., Bismuth, H., Castaing, D., Savier, E., Honore, P., Detry, O., Legrand, M., Azagra, J.S., Goergen, M., Ceuterick, M., Marescaux, J., Mutter, D., Hemptinne, B., Troisi, R., Weerts, J., Dallemagne, B., Jehaes, C., Gelin, M., Donckier, V., Aerts, R., Topal, B., Bertrand, C., Mansvelt, B., Krunckelsven, L., Herman, D., Kint, M., Totte, E., Schockmel, R., and Gigot, J.F.

Published
2003
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42. Preoperative risk score for prediction of long-term outcomes after hepatectomy for intrahepatic cholangiocarcinoma: Report of a collaborative, international-based, external validation study

Author

Brustia, R., primary, Langella, S., additional, Kawai, T., additional, Fonseca, G Marques, additional, Schielke, A., additional, Fartoux, L., additional, Colli, F., additional, Fleres, F., additional, Famularo, S., additional, Giacomoni, A., additional, Sommacale, D., additional, Patrono, D., additional, Detry, O., additional, Hermann, P., additional, Okumura, S., additional, and Scatton, O., additional

Published
2020
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