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3. The value of the current histological scores and classifications of ANCA glomerulonephritis in predicting long-term outcome

Author

Stella, M, Locatelli, L, Sala, F, Reggiani, F, Calatroni, M, L'Imperio, V, Pagni, F, Maggiore, U, Moroni, G, Sinico, R, Stella, Matteo, Locatelli, Laura, Sala, Filippo Maria, Reggiani, Francesco, Calatroni, Marta, L'Imperio, Vincenzo, Pagni, Fabio, Maggiore, Umberto, Moroni, Gabriella, Sinico, Renato Alberto, Stella, M, Locatelli, L, Sala, F, Reggiani, F, Calatroni, M, L'Imperio, V, Pagni, F, Maggiore, U, Moroni, G, Sinico, R, Stella, Matteo, Locatelli, Laura, Sala, Filippo Maria, Reggiani, Francesco, Calatroni, Marta, L'Imperio, Vincenzo, Pagni, Fabio, Maggiore, Umberto, Moroni, Gabriella, and Sinico, Renato Alberto

Abstract

Background. Three different histological scores—histopathologic classification (Berden), Renal Risk Score (RRS) and the Mayo Clinic Chronicity Score (MCCS)—for anti-neutrophil cytoplasmic antibody (ANCA)-associated glomerulonephritis (ANCA-GN) were compared to evaluate their association with patient and kidney prognosis of ANCA-GN. Methods. Patients aged >18 years with at least 1 year of follow-up and biopsy-proven ANCA-GN entered this retrospective study. Renal biopsies were classified according to Berden’s classification, RRS and MCCS. The first endpoint was end-stage kidney disease (ESKD), defined as chronic dialysis or estimated glomerular filtration rate <15 mL/min/1.73 m2. The second endpoint was ESKD or death. Results. Of 152 patients 84 were males, with median age of 63.8 years and followed for 46.9 (interquartile range 12.8–119) months, 59 (38.8%) reached the first endpoint and 20 died. The Kaplan–Meier curves showed that Berden and RRS were associated with first (Berden: P = .004, RRS: P < .001) and second (Berden: P = .001, RRS: P < .001) endpoint, MCCS with the first endpoint only when minimal + mild vs moderate + severe groups were compared (P = .017), and with the second endpoint (P < .001). Among the clinical/histological presentation features, arterial hypertension [odds ratio (OR) = 2.75, confidence interval (95% CI) 1.50–5.06; P = .0011], serum creatinine (OR = 1.17, 95% CI 1.09–1.25; P < .0001), and the percentage of normal glomeruli (OR = 0.97, 95% CI 0.96–0.99; P = .009) were the independent predictors of ESKD at multivariate analysis. When the three scores were included in multivariate analysis, RRS (OR = 2.21, 95% CI 1.15–4.24; P = .017) and MCCS (OR = 2.03, 95% CI 1.04–3.95; P = .037) remained predictive of ESKD, but Berden (OR = 1.17, 95% CI 0.62–2.22; P = .691) did not. Conclusion. RRS and MCCS scores were independent predictors of kidney survival together with high serum creatinine and arterial hypertension at diagnosis

Published
2024

4. Changing Phenotypes and Clinical Outcomes Over Time in Microscopic Polyangiitis

Author

Uzzo, M, Maggiore, U, Sala, F, Reggiani, F, L'Imperio, V, Deliso, F, Calatroni, M, Moroni, G, Sinico, R, Uzzo M., Maggiore U., Sala F., Reggiani F., L'Imperio V., Deliso F., Calatroni M., Moroni G., Sinico R. A., Uzzo, M, Maggiore, U, Sala, F, Reggiani, F, L'Imperio, V, Deliso, F, Calatroni, M, Moroni, G, Sinico, R, Uzzo M., Maggiore U., Sala F., Reggiani F., L'Imperio V., Deliso F., Calatroni M., Moroni G., and Sinico R. A.

Abstract

Introduction: Diagnosis and management of microscopic polyangiitis (MPA) have evolved considerably over the past decades, but it is unknown whether clinical and histological presentation and patient and renal outcomes have changed accordingly. Methods: We compared clinical and histopathological characteristic at diagnosis, risk of death, end-stage kidney disease (ESKD), and relapse rate in patients diagnosed with MPA between 1980 and 2022, after grouping them in 2 periods (p): p1980-2001 and p2002-2022. We compared the mortality rate between the 2 periods using Kaplan-Meier estimator and Cox-regression, and competing risks of ESKD and death using the Aalen-Johansen estimator, Fine-Gray multiple regression, and multistate models. Results: Out of 187 patients, 77 were in p1980-2001 and 110 in p2002 to 2022. Patients in p2002 to 2022 were older (66.2 ± 14.0 SD vs. 57.7 ± 15.8; P < 0.001), had a better kidney function (estimated glomerular filtration rate [eGFR] 25.9 ± 24.8 vs. 21.5 ± 28.2 ml/min per 1.73 m2; P = 0.011) and a lower prevalence of the Berden sclerotic class (5.9 vs. 20.9%; P = 0.011). Despite a similar crude and adjusted patient survival, the risk of ESKD decreased during p2002 to 2022 (subdistribution hazard ratio [HR] 0.30, 95% confidence interval [CI]: 0.16-0.57; P < 0.001). The results remained significant after accounting for death after ESKD and after adjusting for potential confounders (HR 0.33 [95% CI: 0.18-0.63; P < 0.001]). The risk of relapse was numerically higher during p2002 to 2022 (subdistribution-HR 1.64 [95% CI: 0.95-2.83; P = 0.075]). Conclusion: MPA kidney involvement has become less severe over the past decades, leading to a reduced risk of ESKD and a higher relapse rate, despite a comparable risk of death.

Published
2023

5. OC03.03: Adnexal masses and risk of malignancy by radiomics: the future is now

Author

Chiappa, V., primary, Interlenghi, M., additional, Bascio, L. Spanò, additional, Salvatore, C., additional, Fruscio, R., additional, Ferrero, S., additional, Rosati, F., additional, De Meis, L., additional, Rolla, M., additional, Ficarelli, S., additional, Pino, I., additional, Franchi, D., additional, Mor, E., additional, Maggiore, U. Leone Roberti, additional, Bogani, G., additional, Raspagliesi, F., additional, and Castiglioni, I., additional

Published
2023
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8. Practice patterns and 90-day treatment-related morbidity in early-stage cervical cancer

Author

Bogani, G, Donato, V, Scambia, G, Landoni, F, Ghezzi, F, Muzii, L, Panici, P, Raspagliesi, F, Casarin, J, Di Martino, G, Grassi, T, Perrone, A, De Iaco, P, Multinu, F, Berretta, R, Capozzi, V, Zupi, E, Centini, G, Pellegrino, A, Corso, S, Stevenazzi, G, Boschi, A, Comerci, G, Greco, P, Scutiero, G, Sopracordevole, F, Giorda, G, Fichera, M, Simoncini, T, Caretto, M, Sartori, E, Ferrari, F, Cianci, A, Sarpietro, G, Matarazzo, M, Giampaolino, P, Bifulco, G, Morelli, M, Dio, M, Ferrero, A, Biglia, N, Barra, F, Ferrero, S, Cianci, S, Chiantera, V, Sozzi, G, Ercoli, A, Schettini, S, Orlando, T, Cannone, F, Ettore, G, Puppo, A, Olearo, E, Leone Roberti Maggiore, U, Artuso, V, Palaia, I, Perniola, G, Tripodi, R, D'Auge, T, Cuccu, I, Fischetti, M, Santangelo, G, Casorelli, A, Giannini, A, D'Oria, O, Vizzielli, G, Restaino, S, Bergamini, A, Bocciolone, L, Plotti, F, Angioli, R, Mantovani, G, Ceccaroni, M, Cassini, C, Dominoni, M, Giambanco, L, Amodeo, S, Leo, L, Thommaset, R, Raimondo, D, Seracchioli, R, Malzoni, M, Falcone, F, Gorlero, F, Di Luca, M, Busato, E, Kilzie, S, Dell'Acqua, A, Scarfone, G, Vercellini, P, Petrillo, M, Capobianco, G, Ciavattini, A, Mereu, L, Scollo, P, Sorbi, F, Fambrini, M, Romano, F, Ricci, G, Trojano, G, Damiani, G, Consonni, R, Di Lorenzo, N, Lippolis, A, Tinelli, R, Aguzzoli, L, Mandato, V, Palomba, S, Tripodi, M, Calandra, D, Pellegrini, F, Zullo, F, Surico, D, Remorgida, V, Ruscitto, F, Beretta, P, Vizza, E, Bogani G., Donato V. D., Scambia G., Landoni F., Ghezzi F., Muzii L., Panici P. B., Raspagliesi F., Casarin J., Di Martino G., Grassi T., Perrone A. M., De Iaco P., Multinu F., Berretta R., Capozzi V. A., Zupi E., Centini G., Pellegrino A., Corso S., Stevenazzi G., Boschi A. C., Comerci G., Greco P., Scutiero G., Sopracordevole F., Giorda G., Fichera M., Simoncini T., Caretto M., Sartori E., Ferrari F., Cianci A., Sarpietro G., Matarazzo M. G., Giampaolino P., Bifulco G., Morelli M., Dio M. D., Ferrero A., Biglia N., Barra F., Ferrero S., Cianci S., Chiantera V., Sozzi G., Ercoli A., Schettini S., Orlando T., Cannone F. G., Ettore G., Puppo A., Olearo E., Leone Roberti Maggiore U., Artuso V., Palaia I., Perniola G., Tripodi R., D'Auge T. G., Cuccu I., Fischetti M., Santangelo G., Casorelli A., Giannini A., D'Oria O., Vizzielli G., Restaino S., Bergamini A., Bocciolone L., Plotti F., Angioli R., Mantovani G., Ceccaroni M., Cassini C., Dominoni M., Giambanco L., Amodeo S., Leo L., Thommaset R., Raimondo D., Seracchioli R., Malzoni M., Falcone F., Gorlero F., Di Luca M., Busato E., Kilzie S., Dell'Acqua A., Scarfone G., Vercellini P., Petrillo M., Capobianco G., Ciavattini A., Mereu L., Scollo P., Sorbi F., Fambrini M., Romano F., Ricci G., Trojano G., Damiani G. R., Consonni R., Di Lorenzo N., Lippolis A., Tinelli R., Aguzzoli L., Mandato V. D., Palomba S., Tripodi M., Calandra D., Pellegrini F., Zullo F., Surico D., Remorgida V., Ruscitto F., Beretta P., Vizza E., Bogani, G, Donato, V, Scambia, G, Landoni, F, Ghezzi, F, Muzii, L, Panici, P, Raspagliesi, F, Casarin, J, Di Martino, G, Grassi, T, Perrone, A, De Iaco, P, Multinu, F, Berretta, R, Capozzi, V, Zupi, E, Centini, G, Pellegrino, A, Corso, S, Stevenazzi, G, Boschi, A, Comerci, G, Greco, P, Scutiero, G, Sopracordevole, F, Giorda, G, Fichera, M, Simoncini, T, Caretto, M, Sartori, E, Ferrari, F, Cianci, A, Sarpietro, G, Matarazzo, M, Giampaolino, P, Bifulco, G, Morelli, M, Dio, M, Ferrero, A, Biglia, N, Barra, F, Ferrero, S, Cianci, S, Chiantera, V, Sozzi, G, Ercoli, A, Schettini, S, Orlando, T, Cannone, F, Ettore, G, Puppo, A, Olearo, E, Leone Roberti Maggiore, U, Artuso, V, Palaia, I, Perniola, G, Tripodi, R, D'Auge, T, Cuccu, I, Fischetti, M, Santangelo, G, Casorelli, A, Giannini, A, D'Oria, O, Vizzielli, G, Restaino, S, Bergamini, A, Bocciolone, L, Plotti, F, Angioli, R, Mantovani, G, Ceccaroni, M, Cassini, C, Dominoni, M, Giambanco, L, Amodeo, S, Leo, L, Thommaset, R, Raimondo, D, Seracchioli, R, Malzoni, M, Falcone, F, Gorlero, F, Di Luca, M, Busato, E, Kilzie, S, Dell'Acqua, A, Scarfone, G, Vercellini, P, Petrillo, M, Capobianco, G, Ciavattini, A, Mereu, L, Scollo, P, Sorbi, F, Fambrini, M, Romano, F, Ricci, G, Trojano, G, Damiani, G, Consonni, R, Di Lorenzo, N, Lippolis, A, Tinelli, R, Aguzzoli, L, Mandato, V, Palomba, S, Tripodi, M, Calandra, D, Pellegrini, F, Zullo, F, Surico, D, Remorgida, V, Ruscitto, F, Beretta, P, Vizza, E, Bogani G., Donato V. D., Scambia G., Landoni F., Ghezzi F., Muzii L., Panici P. B., Raspagliesi F., Casarin J., Di Martino G., Grassi T., Perrone A. M., De Iaco P., Multinu F., Berretta R., Capozzi V. A., Zupi E., Centini G., Pellegrino A., Corso S., Stevenazzi G., Boschi A. C., Comerci G., Greco P., Scutiero G., Sopracordevole F., Giorda G., Fichera M., Simoncini T., Caretto M., Sartori E., Ferrari F., Cianci A., Sarpietro G., Matarazzo M. G., Giampaolino P., Bifulco G., Morelli M., Dio M. D., Ferrero A., Biglia N., Barra F., Ferrero S., Cianci S., Chiantera V., Sozzi G., Ercoli A., Schettini S., Orlando T., Cannone F. G., Ettore G., Puppo A., Olearo E., Leone Roberti Maggiore U., Artuso V., Palaia I., Perniola G., Tripodi R., D'Auge T. G., Cuccu I., Fischetti M., Santangelo G., Casorelli A., Giannini A., D'Oria O., Vizzielli G., Restaino S., Bergamini A., Bocciolone L., Plotti F., Angioli R., Mantovani G., Ceccaroni M., Cassini C., Dominoni M., Giambanco L., Amodeo S., Leo L., Thommaset R., Raimondo D., Seracchioli R., Malzoni M., Falcone F., Gorlero F., Di Luca M., Busato E., Kilzie S., Dell'Acqua A., Scarfone G., Vercellini P., Petrillo M., Capobianco G., Ciavattini A., Mereu L., Scollo P., Sorbi F., Fambrini M., Romano F., Ricci G., Trojano G., Damiani G. R., Consonni R., Di Lorenzo N., Lippolis A., Tinelli R., Aguzzoli L., Mandato V. D., Palomba S., Tripodi M., Calandra D., Pellegrini F., Zullo F., Surico D., Remorgida V., Ruscitto F., Beretta P., and Vizza E.

Abstract

Background: To evaluate the impact of the Laparoscopic Approach to Cervical Cancer (LACC) Trial on patterns of care and surgery-related morbidity in early-stage cervical cancer. Methods: This is a retrospective, a multi-institutional study evaluating 90-day surgery-related outcomes of patients undergoing treatment for early-stage cervical cancer before (period I: 01/01/2016–06/01/2018) and after (period II: 01/01/2019–06/01/2021) the publication of the results of the LACC trial. Results: Charts of 1295 patients were evaluated: 581 (44.9%) and 714 (55.1%) before and after the publication of the LACC trial, respectively. After the publication of the LACC trial, the number of patients treated with minimally invasive radical hysterectomy decreased from 64.9% to 30.4% (p < 0.001). Overall, 90-day complications occurred in 110 (18.9%) and 119 (16.6%) patients in the period I and period II, respectively (p = 0.795). Similarly, the number of severe (grade 3 or worse) complications did not differ between the two periods (38 (6.5%) vs. 37 (5.1%); p = 0.297). Overall and severe 90-day complications were consistent between periods even evaluating stage IA (p = 0.471), IB1 (p = 0.929), and IB2 (p = 0.074), separately. Conclusions: The present investigation highlighted that in referral centers the shift from minimally invasive to open radical hysterectomy does not influence 90-day surgery-related morbidity.

Published
2022

9. Immunosuppression of HLA identical living-donor kidney transplant recipients: A systematic review.

Author

Pérez-Sáez, M.J., Montero, N., Oliveras, L., Redondo-Pachón, D., Martínez-Simón, D., Abramovicz, D., Maggiore, U., Mariat, C., Mjoen, G., Oniscu, G.C., Peruzzi, L., Sever, M.S., Watschinger, B., Velioglu, A., Demir, E., Gandolfini, I., Hellemans, R., Hilbrands, L.B., Pascual, J., Crespo, M., Pérez-Sáez, M.J., Montero, N., Oliveras, L., Redondo-Pachón, D., Martínez-Simón, D., Abramovicz, D., Maggiore, U., Mariat, C., Mjoen, G., Oniscu, G.C., Peruzzi, L., Sever, M.S., Watschinger, B., Velioglu, A., Demir, E., Gandolfini, I., Hellemans, R., Hilbrands, L.B., Pascual, J., and Crespo, M.

Abstract

Item does not contain fulltext, BACKGROUND: Kidney transplant (KT) recipients of HLA identical siblings (HLAid) have lower immunological risk, but there are no specific recommendations for immunosuppression. Our aim was to analyze evidence about results from HLAid living-donor recipients under different immunosuppression in the current era of immunological risk assessment. METHODS: Systematic review of studies describing associations between outcomes of HLAid living-donor KT recipients according to their immunological risk and applied immunosuppression. RESULTS: From 1351 studies, 16 (5636 KT recipients) were included in the analysis. All studies were retrospective, ten comparing immunosuppression strategies, and six immunological risk strata. Of those ten, six studies were published in 1990 or earlier and only three included tacrolimus. The evidence is poor, and the inclusion of calcineurin inhibitors does not demonstrate better results. Furthermore, only few studies describe different immunosuppression regimens according to the patient immunological risk and, in general, they do not include the assessment with new solid phase assays. CONCLUSIONS: There are no studies analyzing the association of outcomes of HLAid KT recipients with current immunological risk tools. In the absence of evidence, no decision or proposal of immunosuppression adapted to modern immunological risk assessment can be made currently by the Descartes Working Group., 01 december 2023

Published
2023

16. The Kidney Donor Profile Index (KDPI) of Marginal Donors Allocated by Standardized Pretransplant Donor Biopsy Assessment: Distribution and Association With Graft Outcomes

Author

Gandolfini, I., Buzio, C., Zanelli, P., Palmisano, A., Cremaschi, E., Vaglio, A., Piotti, G., Melfa, L., La Manna, G., Feliciangeli, G., Cappuccilli, M., Scolari, M.P., Capelli, I., Panicali, L., Baraldi, O., Stefoni, S., Buscaroli, A., Ridolfi, L., D’Errico, A., Cappelli, G., Bonucchi, D., Rubbiani, E., Albertazzi, A., Mehrotra, A., Cravedi, P., and Maggiore, U.

Published
2014
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17. Sentinel node mapping vs. sentinel node mapping plus back-up lymphadenectomy in high-risk endometrial cancer patients: Results from a multi-institutional study

Author

Bogani, G, Papadia, A, Buda, A, Casarin, J, Di Donato, V, Gasparri, M, Plotti, F, Pinelli, C, Paderno, M, Lopez, S, Perrone, A, Barra, F, Guerrisi, R, Brusadelli, C, Cromi, A, Ferrari, D, Chiapp, V, Signorelli, M, Maggiore, U, Ditto, A, Palaia, I, Ferrero, S, De Iaco, P, Angioli, R, Panici, P, Ghezzi, F, Landoni, F, Mueller, M, Raspagliesi, F, Bogani G., Papadia A., Buda A., Casarin J., Di Donato V., Gasparri M. L., Plotti F., Pinelli C., Paderno M. C., Lopez S., Perrone A. M., Barra F., Guerrisi R., Brusadelli C., Cromi A., Ferrari D., Chiapp V., Signorelli M., Maggiore U. L. R., Ditto A., Palaia I., Ferrero S., De Iaco P., Angioli R., Panici P. B., Ghezzi F., Landoni F., Mueller M. D., Raspagliesi F., Bogani, G, Papadia, A, Buda, A, Casarin, J, Di Donato, V, Gasparri, M, Plotti, F, Pinelli, C, Paderno, M, Lopez, S, Perrone, A, Barra, F, Guerrisi, R, Brusadelli, C, Cromi, A, Ferrari, D, Chiapp, V, Signorelli, M, Maggiore, U, Ditto, A, Palaia, I, Ferrero, S, De Iaco, P, Angioli, R, Panici, P, Ghezzi, F, Landoni, F, Mueller, M, Raspagliesi, F, Bogani G., Papadia A., Buda A., Casarin J., Di Donato V., Gasparri M. L., Plotti F., Pinelli C., Paderno M. C., Lopez S., Perrone A. M., Barra F., Guerrisi R., Brusadelli C., Cromi A., Ferrari D., Chiapp V., Signorelli M., Maggiore U. L. R., Ditto A., Palaia I., Ferrero S., De Iaco P., Angioli R., Panici P. B., Ghezzi F., Landoni F., Mueller M. D., and Raspagliesi F.

Abstract

Objective: Sentinel node mapping (SLN) has replaced lymphadenectomy for staging surgery in apparent early-stage low and intermediate risk endometrial cancer (EC). Only limited data about the adoption of SNM in high risk EC is still available. Here, we evaluate the outcomes of high-risk EC undergoing SNM (with or without back-up lymphadenectomy). Methods: This is a multi-institutional international retrospective study, evaluating data of high-risk (FIGO grade 3 endometrioid EC with myometrial invasion >50% and non-endometrioid histology) EC patients undergoing SNM followed by back-up lymphadenectomy and SNM alone. Results: Chart of consecutive 196 patients were evaluated. The study population included 83 and 113 patients with endometrioid and non-endometrioid EC, respectively. SNM alone and SNM followed by back-up lymphadenectomy were performed in 50 and 146 patients, respectively. Among patients having SNM alone, 14 (28%) were diagnosed with nodal disease. In the group of patients undergoing SNM plus back-up lymphadenectomy 34 (23.2%) were diagnosed with nodal disease via SNM. Back-up lymphadenectomy identified 2 (1%) additional patients with nodal disease (in the para-aortic area). Back-up lymphadenectomy allowed to remove adjunctive positive nodes in 16 (11%) patients. After the adoption of propensity-matched algorithm, we observed that patients undergoing SNM plus back-up lymphadenectomy experienced similar disease-free survival (p = 0.416, log-rank test) and overall survival (p = 0.940, log-rank test) than patients undergoing SLN alone. Conclusions: Although the small sample size, and the retrospective study design this study highlighted that type of nodal assessment did not impact survival outcomes in high-risk EC. Theoretically, back-up lymphadenectomy would be useful in improving the removal of positive nodes, but its therapeutic value remains controversial. Further prospective evidence is needed.

Published
2021

19. Recovery of dialysis patients with COVID-19: health outcomes 3 months after diagnosis in ERACODA

Author

Hemmelder, M. H., Noordzij, M., Vart, P., Hilbrands, L. B., Jager, K. J., Abrahams, A. C., Arroyo, D., Battaglia, Y., Ekart, R., Mallamaci, F., Malloney, S. -R., Oliveira, J., Rydzewski, A., Sridharan, S., Vogt, L., Duivenvoorden, R., Gansevoort, R. T., Franssen, C. F. M., van der Net, J. B., Essig, M., du Buf-Vereijken, P. W. G., van Ginneken, B., Maas, N., van Jaarsveld, B. C., Bemelman, F. J., Klingenberg-Salahova, F., Heenan-Vos, F., Vervloet, M. G., Nurmohamed, A., Abramowicz, D., Verhofstede, S., Maoujoud, O., Malfait, T., Fialova, J., Melilli, E., Fava, A., Cruzado, J. M., Perez, N. M., Lips, J., Krepel, H., Adilovic, H., Hengst, M., Konings, C. J. A. M., Braconnier, P., Weis, D., Gellert, R., Alferes, D. G., Radulescu, D., Zakharova, E. V., Ambuehl, P. M., Guidotti, R., Walker, A., Lepeytre, F., Rabate, C., Rostoker, G., Marques, S., Azasevac, T., Majstorovic, G. S., Katicic, D., Dam, M. T., Kruger, T., Brzosko, S., Liakopoulos, V., Zanen, A. L., Logtenberg, S. J. J., Fricke, L., Kuryata, O., Slebe, J. J. P., Abd ElHafeez, S., Kemlin, D., van de Wetering, J., Reinders, M. E. J., Hesselink, D. A., van Gestel, J. K., Eiselt, J., Kielberger, L., El-Wakil, H. S., Verhoeven, M. A. M., Logan, I., Canal, C., Facundo, C., Ramos, A. M., Debska-Slizien, A., Veldhuizen, N. M. H., Tigka, E., Polyzou Konsta, M. A., Panagoutsos, S., Postorino, A., Cambareri, F., Matceac, I., Nistor, I., Covic, A., Groeneveld, J. H. M., Jousma, J., Diekmann, F., Oppenheimer, F., Blasco, M., Pereira, T. A., dos Santos Junior, A. C. S., Arias-Cabrales, C., Crespo, M., Llinas-Mallol, L., Buxeda, A., Tarrega, C. B., Redondo-Pachon, D., Arenas Jimenez, M. D., Mendoza-Valderrey, A., Martins, A. C., Mateus, C., Alvila, G., Laranjinha, I., Hofstra, J. M., Siezenga, M. A., Franco, A., Castellano, S., Rodriguez-Ferrero, M. L., Manzanos, S. B., Haridian Sosa Barrios, R., Lemahieu, W., Bartelet, K., Dirim, A. B., Demir, E., Sever, M. S., Turkmen, A., Safak, S., Hollander, D. A. M. J., Kerckhoffs, A., Buttner, S., de Vries, A. P. J., Meziyerh, S., van der Helm, D., Mallat, M., Bouwsma, H., Petruliene, K., Verberk, I., van der Sande, F. M., Christiaans, M. H. L., Mohankumar, N., Luca, M. D., Tuglular, S. Z., Kramer, A., Beerenhout, C., Luik, P. T., Kerschbaum, J., Tiefenthaler, M., Watschinger, B., Adema, A. Y., Stepanov, V. A., Zulkarnaev, A. B., Turkmen, K., Gandolfini, I., Maggiore, U., Fliedner, A., Asberg, A., Mjoen, G., Miyasato, H., de Fijter, C. W. H., Mongera, N., Pini, S., de Biase, C., van de Logt, A. E., Maas, R., Lebedeva, O., Lopez, V., Reichert, L. J. M., Verhave, J., Titov, D., Parshina, E. V., Zanoli, L., Marcantoni, C., van Kempen, G., van Gils-Verrij, L. E. A., Harty, J. C., Meurs, M., Myslak, M., Lentini, P., den Deurwaarder, E., Stendahl, M., Rahimzadeh, H., Schouten, M., Rychlik, I., Cabezas-Reina, C. J., Roca, A. M., Nauta, F., Sahin, I., Goffin, E., Kanaan, N., Labriola, L., Devresse, A., Diaz-Mareque, A., Coca, A., de Arriba, G., Meijers, B. K. I., Naesens, M., Kuypers, D., Desschans, B., Tonnerlier, A., Wissing, K. M., Dedinska, I., Pessolano, G., Malik, S., Dounousi, E., Papachristou, E., Berger, S. P., Meijer, E., Sanders, J. S. F., Ozyilmaz, A., Ponikvar, J. B., Pernat, A. M., Kovac, D., Arnol, M., Molenaar, F. M., van Zuilen, A. D., Meijvis, S. C. A., Dolmans, H., Tantisattamo, E., Esposito, P., Krzesinski, J. -M., Barahira, J. D., Gallieni, M., Martin-Moreno, P. L., Guglielmetti, G., Guzzo, G., Toapanta, N., Soler, M. J., Luik, A. J., van Kuijk, W. H. M., Stikkelbroeck, L. W. H., Hermans, M. M. H., Rimsevicius, L., Righetti, M., Islam, M., Heitink-Ter Braak, N., Nephrology, ACS - Microcirculation, ACS - Diabetes & metabolism, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Clinical sciences, Faculteit Medische Wetenschappen/UMCG, Groningen Kidney Center (GKC), Cardiovascular Centre (CVC), Groningen Institute for Organ Transplantation (GIOT), Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, Medical Informatics, APH - Aging & Later Life, APH - Quality of Care, APH - Global Health, ACS - Pulmonary hypertension & thrombosis, APH - Health Behaviors & Chronic Diseases, and Internal Medicine

Subjects
Male, Outcome Assessment, survival, mental health status, COVID-19 Testing, SDG 3 - Good Health and Well-being, Renal Dialysis, functional health status, Outcome Assessment, Health Care, 80 and over, Humans, KIDNEY-TRANSPLANT, AcademicSubjects/MED00340, Aged, Aged, 80 and over, Transplantation, SARS-CoV-2, MORTALITY, COVID-19, Middle Aged, Health Care, Intensive Care Units, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Nephrology, dialysis, Original Article, Female, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11]
Abstract

Background Coronavirus disease 2019 (COVID-19)-related short-term mortality is high in dialysis patients, but longer-term outcomes are largely unknown. We therefore assessed patient recovery in a large cohort of dialysis patients 3 months after their COVID-19 diagnosis. Methods We analyzed data on dialysis patients diagnosed with COVID-19 from 1 February 2020 to 31 March 2021 from the European Renal Association COVID-19 Database (ERACODA). The outcomes studied were patient survival, residence and functional and mental health status (estimated by their treating physician) 3 months after COVID-19 diagnosis. Complete follow-up data were available for 854 surviving patients. Patient characteristics associated with recovery were analyzed using logistic regression. Results In 2449 hemodialysis patients (mean ± SD age 67.5 ± 14.4 years, 62% male), survival probabilities at 3 months after COVID-19 diagnosis were 90% for nonhospitalized patients (n = 1087), 73% for patients admitted to the hospital but not to an intensive care unit (ICU) (n = 1165) and 40% for those admitted to an ICU (n = 197). Patient survival hardly decreased between 28 days and 3 months after COVID-19 diagnosis. At 3 months, 87% functioned at their pre-existent functional and 94% at their pre-existent mental level. Only few of the surviving patients were still admitted to the hospital (0.8–6.3%) or a nursing home (∼5%). A higher age and frailty score at presentation and ICU admission were associated with worse functional outcome. Conclusions Mortality between 28 days and 3 months after COVID-19 diagnosis was low and the majority of patients who survived COVID-19 recovered to their pre-existent functional and mental health level at 3 months after diagnosis.

Published
2022

21. Assessment of pre-donation glomerular filtration rate: going back to basics

Author

Mariat, Christophe, Mjoen, G., Watschinger, B., Sever, M.S., Crespo, M., Peruzzi, L., Hilbrands, L.B., Maggiore, U., Mariat, Christophe, Mjoen, G., Watschinger, B., Sever, M.S., Crespo, M., Peruzzi, L., Hilbrands, L.B., and Maggiore, U.

Abstract

Item does not contain fulltext

Published
2022

22. Issues regarding COVID-19 in kidney transplantation in the ERA of the Omicron variant: a commentary by the ERA Descartes Working Group

Author

Gandolfini, I., Crespo, M., Hellemans, R., Maggiore, U., Mariat, C., Mjoen, G., Oniscu, G.C., Peruzzi, L., Sever, M.S., Watschinger, B., Hilbrands, L.B., Gandolfini, I., Crespo, M., Hellemans, R., Maggiore, U., Mariat, C., Mjoen, G., Oniscu, G.C., Peruzzi, L., Sever, M.S., Watschinger, B., and Hilbrands, L.B.

Abstract

Contains fulltext : 283474.pdf (Publisher’s version ) (Open Access), The Omicron variant, which has become the dominant strain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) worldwide, brings new challenges to preventing and controlling the infection. Moreover, the widespread implementation of vaccination policies before and after transplantation, and the development of new prophylactic and treatment strategies for coronavirus disease 2019 (COVID-19) over the past 12-18 months, has raised several new issues concerning kidney transplant recipients. In this special report, the ERA DESCARTES (Developing Education Science and Care for Renal Transplantation in European States) Working Group addresses several questions related to everyday clinical practice concerning kidney transplant recipients and to the assessment of deceased and live kidney donors: what is the current risk of severe disease and of breakthrough infection, the optimal management of immunosuppression in kidney transplant recipients with COVID-19, the role of passive immunization and the efficacy of antiviral drugs in ambulatory patients, the management of drug-to-drug interactions, safety criteria for the use of SARS-CoV-2-positive donors, issues related to the use of T cell depleting agents as induction treatment, and current recommendations for shielding practices.

Published
2022

23. Ethical and medical dilemmas in paid living kidney donor transplantation

Author

Sever, M.S., Biesen, W. Van, Vanholder, R., Mallick, N., London, G., Schena, F.P., Nagy, J., Buturovic-Ponikvar, J., Heering, P., Maggiore, U., Mariat, C., Watschinger, B., Oniscu, G., Peruzzi, L., Gandolfini, I., Hellemans, R., Abramowicz, D., Pascual, J., Hilbrands, L.B., Sever, M.S., Biesen, W. Van, Vanholder, R., Mallick, N., London, G., Schena, F.P., Nagy, J., Buturovic-Ponikvar, J., Heering, P., Maggiore, U., Mariat, C., Watschinger, B., Oniscu, G., Peruzzi, L., Gandolfini, I., Hellemans, R., Abramowicz, D., Pascual, J., and Hilbrands, L.B.

Abstract

Item does not contain fulltext, Due to the shortage of deceased and genetically- or emotionally-related living donors, living unrelated paid donor (LURpD) kidney transplantation has been considered; however, this practice may result in medical, ethical and social dilemmas, induce organ trading (commodification), and even criminal activities. Commodification also risks undermining public trust in the transplant system and impeding the development of proper altruistic or deceased donor programs by ignoring altruism, volunteerism, and dignity. However, despite many objections by authoritative organizations, black market practices are involved in up to 10% of all transplants worldwide. The authors strongly discourage any payment or rewards for organ donation, and instead urge the governments of all countries to provide adequate and accessible kidney health care. However, it is an undeniable fact that paid-living donor transplantation is increasing despite all objections, disapprovals and regulations. We feel it as our responsibility not to ignore this uncertain and undesirable practice, but rather to underline the necessity for strict rules and prohibitions to minimize unacceptable medical, social and ethical risks as long as it exists. Furthermore, economic profit, be it direct or indirect, must not be the goal of those involved, and the employment of intermediaries must be avoided entirely. Additionally, the donor should be in a position where not donating has no detrimental effect on his/her future in any way (free agency). In our view, every country has the obligation and responsibility to provide adequate kidney health care and to make kidney transplantation accessible to those in need. This provision is key to stop transplant tourism and commercialization of kidney transplantation. The nephrology community has a duty to establish structures that optimize organ availability within strict ethical limits. The legal position of LURpD varies considerably worldwide. Strictly respecting each country's

Published
2022

24. Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Author

Bogani, G., Scambia, Giovanni, Cimmino, C., Fanfani, Francesco, Costantini, Barbara, Loverro, Matteo, Ferrandina, Maria Gabriella, Landoni, F., Bazzurini, L., Grassi, T., Vitobello, D., Siesto, G., Perrone, A. M., Zanagnolo, V., De Iaco, P., Multinu, F., Ghezzi, F., Casarin, J., Berretta, R., Capozzi, V. A., Zupi, E., Centini, G., Pellegrino, Antonio Agostino, Corso, S., Stevenazzi, G., Montoli, Stefano, Boschi, A. C., Comerci, Gianluca, Greco, Pierfrancesco, Martinello, R., Sopracordevole, F., Giorda, G., Simoncini, T., Caretto, M., Sartori, E., Ferrari, F., Cianci, A., Sarpietro, G., Matarazzo, M. G., Zullo, F., Bifulco, G., Morelli, Marco, Ferrero, A., Biglia, N., Barra, F., Ferrero, S., Maggiore, U. L. R., Cianci, Stefano, Chiantera, V., Ercoli, Alfredo, Sozzi, G., Martoccia, A., Schettini, Sergio Crescenzo, Orlando, T., Cannone, F. G., Ettore, G., Puppo, A., Borghese, M., Martinelli, C., Muzii, L., Di Donato, V., Driul, L., Restaino, S., Bergamini, A., Candotti, G., Bocciolone, L., Plotti, F., Angioli, R., Mantovani, G., Ceccaroni, Marcello, Cassani, C., Dominoni, M., Giambanco, L., Amodeo, Silvia, Leo, Maria Laura, Thomasset, R., Raimondo, D., Seracchioli, R., Malzoni, M., Gorlero, F., Di Luca, M., Busato, E., Kilzie, S., Dell'Acqua, Antonio, Scarfone, G., Vercellini, P., Petrillo, Marco, Dessole, S., Capobianco, G., Ciavattini, A., Delli Carpini, G., Giannella, L., Mereu, L., Tateo, S., Sorbi, F., Fambrini, M., Cicogna, S., Romano, Federica, Ricci, Giuseppe, Trojano, G., Consonni, R., Cantaluppi, S., Lippolis, A., Tinelli, R., D'Ippolito, G., Aguzzoli, L., Mandato, V. D., Palomba, S., Calandra, D., Rosati, M., Gallo, C., Surico, D., Remorgida, V., Ruscitto, F., Beretta, P., Panici, P. B., Raspagliesi, F., Scambia G. (ORCID:0000-0003-2758-1063), Fanfani F. (ORCID:0000-0003-1991-7284), Costantini B., Loverro M., Ferrandina G. (ORCID:0000-0003-4672-4197), Pellegrino A., Montoli S., Comerci G., Greco P., Morelli M., Cianci S., Ercoli A., Schettini S., Ceccaroni M., Amodeo S., Leo L., Dell'acqua A. (ORCID:0000-0002-8697-3115), Petrillo M., Romano F., Ricci G., Bogani, G., Scambia, Giovanni, Cimmino, C., Fanfani, Francesco, Costantini, Barbara, Loverro, Matteo, Ferrandina, Maria Gabriella, Landoni, F., Bazzurini, L., Grassi, T., Vitobello, D., Siesto, G., Perrone, A. M., Zanagnolo, V., De Iaco, P., Multinu, F., Ghezzi, F., Casarin, J., Berretta, R., Capozzi, V. A., Zupi, E., Centini, G., Pellegrino, Antonio Agostino, Corso, S., Stevenazzi, G., Montoli, Stefano, Boschi, A. C., Comerci, Gianluca, Greco, Pierfrancesco, Martinello, R., Sopracordevole, F., Giorda, G., Simoncini, T., Caretto, M., Sartori, E., Ferrari, F., Cianci, A., Sarpietro, G., Matarazzo, M. G., Zullo, F., Bifulco, G., Morelli, Marco, Ferrero, A., Biglia, N., Barra, F., Ferrero, S., Maggiore, U. L. R., Cianci, Stefano, Chiantera, V., Ercoli, Alfredo, Sozzi, G., Martoccia, A., Schettini, Sergio Crescenzo, Orlando, T., Cannone, F. G., Ettore, G., Puppo, A., Borghese, M., Martinelli, C., Muzii, L., Di Donato, V., Driul, L., Restaino, S., Bergamini, A., Candotti, G., Bocciolone, L., Plotti, F., Angioli, R., Mantovani, G., Ceccaroni, Marcello, Cassani, C., Dominoni, M., Giambanco, L., Amodeo, Silvia, Leo, Maria Laura, Thomasset, R., Raimondo, D., Seracchioli, R., Malzoni, M., Gorlero, F., Di Luca, M., Busato, E., Kilzie, S., Dell'Acqua, Antonio, Scarfone, G., Vercellini, P., Petrillo, Marco, Dessole, S., Capobianco, G., Ciavattini, A., Delli Carpini, G., Giannella, L., Mereu, L., Tateo, S., Sorbi, F., Fambrini, M., Cicogna, S., Romano, Federica, Ricci, Giuseppe, Trojano, G., Consonni, R., Cantaluppi, S., Lippolis, A., Tinelli, R., D'Ippolito, G., Aguzzoli, L., Mandato, V. D., Palomba, S., Calandra, D., Rosati, M., Gallo, C., Surico, D., Remorgida, V., Ruscitto, F., Beretta, P., Panici, P. B., Raspagliesi, F., Scambia G. (ORCID:0000-0003-2758-1063), Fanfani F. (ORCID:0000-0003-1991-7284), Costantini B., Loverro M., Ferrandina G. (ORCID:0000-0003-4672-4197), Pellegrino A., Montoli S., Comerci G., Greco P., Morelli M., Cianci S., Ercoli A., Schettini S., Ceccaroni M., Amodeo S., Leo L., Dell'acqua A. (ORCID:0000-0002-8697-3115), Petrillo M., Romano F., and Ricci G.

Abstract

Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.

Published
2022

25. Characteristics and patterns of care of endometrial cancer before and during COVID-19 pandemic

Author

Bogani, G, Scambia, G, Cimmino, C, Fanfani, F, Costantini, B, Loverro, M, Ferrandina, G, Landoni, F, Bazzurini, L, Grassi, T, Vitobello, D, Siesto, G, Perrone, A, Zanagnolo, V, De Iaco, P, Multinu, F, Ghezzi, F, Casarin, J, Berretta, R, Capozzi, V, Zupi, E, Centini, G, Pellegrino, A, Corso, S, Stevenazzi, G, Montoli, S, Boschi, A, Comerci, G, Greco, P, Martinello, R, Sopracordevole, F, Giorda, G, Simoncini, T, Caretto, M, Sartori, E, Ferrari, F, Cianci, A, Sarpietro, G, Matarazzo, M, Zullo, F, Bifulco, G, Morelli, M, Ferrero, A, Biglia, N, Barra, F, Ferrero, S, Leone Roberti Maggiore, U, Cianci, S, Chiantera, V, Ercoli, A, Sozzi, G, Martoccia, A, Schettini, S, Orlando, T, Cannone, F, Ettore, G, Puppo, A, Borghese, M, Martinelli, C, Muzii, L, Di Donato, V, Driul, L, Restaino, S, Bergamini, A, Candotti, G, Bocciolone, L, Plotti, F, Angioli, R, Mantovani, G, Ceccaroni, M, Cassani, C, Dominoni, M, Giambanco, L, Amodeo, S, Leo, L, Thomasset, R, Raimondo, D, Seracchioli, R, Malzoni, M, Gorlero, F, Di Luca, M, Busato, E, Kilzie, S, Dell'Acqua, A, Scarfone, G, Vercellini, P, Petrillo, M, Dessole, S, Capobianco, G, Ciavattini, A, Delli Carpini, G, Giannella, L, Mereu, L, Tateo, S, Sorbi, F, Fambrini, M, Cicogna, S, Romano, F, Ricci, G, Trojano, G, Consonni, R, Cantaluppi, S, Lippolis, A, Tinelli, R, D'Ippolito, G, Aguzzoli, L, Mandato, V, Palomba, S, Calandra, D, Rosati, M, Gallo, C, Surico, D, Remorgida, V, Ruscitto, F, Beretta, P, Benedetti Panici, P, Raspagliesi, F, Bogani, Giorgio, Scambia, Giovanni, Cimmino, Chiara, Fanfani, Francesco, Costantini, Barbara, Loverro, Matteo, Ferrandina, Gabriella, Landoni, Fabio, Bazzurini, Luca, Grassi, Tommaso, Vitobello, Domenico, Siesto, Gabriele, Perrone, Anna Myriam, Zanagnolo, Vanna, De Iaco, Pierandrea, Multinu, Francesco, Ghezzi, Fabio, Casarin, Jvan, Berretta, Roberto, Capozzi, Vito A, Zupi, Errico, Centini, Gabriele, Pellegrino, Antonio, Corso, Silvia, Stevenazzi, Guido, Montoli, Serena, Boschi, Anna Chiara, Comerci, Giuseppe, Greco, Pantaleo, Martinello, Ruby, Sopracordevole, Francesco, Giorda, Giorgio, Simoncini, Tommaso, Caretto, Marta, Sartori, Enrico, Ferrari, Federico, Cianci, Antonio, Sarpietro, Giuseppe, Matarazzo, Maria Grazia, Zullo, Fulvio, Bifulco, Giuseppe, Morelli, Michele, Ferrero, Annamaria, Biglia, Nicoletta, Barra, Fabio, Ferrero, Simone, Leone Roberti Maggiore, Umberto, Cianci, Stefano, Chiantera, Vito, Ercoli, Alfredo, Sozzi, Giulio, Martoccia, Angela, Schettini, Sergio, Orlando, Teresa, Cannone, Francesco G, Ettore, Giuseppe, Puppo, Andrea, Borghese, Martina, Martinelli, Canio, Muzii, Ludovico, Di Donato, Violante, Driul, Lorenza, Restaino, Stefano, Bergamini, Alice, Candotti, Giorgio, Bocciolone, Luca, Plotti, Francesco, Angioli, Roberto, Mantovani, Giulia, Ceccaroni, Marcello, Cassani, Chiara, Dominoni, Mattia, Giambanco, Laura, Amodeo, Silvia, Leo, Livio, Thomasset, Raphael, Raimondo, Diego, Seracchioli, Renato, Malzoni, Mario, Gorlero, Franco, Di Luca, Martina, Busato, Enrico, Kilzie, Sami, Dell'Acqua, Andrea, Scarfone, Giovanna, Vercellini, Paolo, Petrillo, Marco, Dessole, Salvatore, Capobianco, Giampiero, Ciavattini, Andrea, Delli Carpini, Giovanni, Giannella, Luca, Mereu, Liliana, Tateo, Saverio, Sorbi, Flavia, Fambrini, Massimiliano, Cicogna, Stefania, Romano, Federico, Ricci, Giuseppe, Trojano, Giuseppe, Consonni, Roberto, Cantaluppi, Simona, Lippolis, Antonio, Tinelli, Raffaele, D'Ippolito, Giovanni, Aguzzoli, Lorenzo, Mandato, Vincenzo D, Palomba, Stefano, Calandra, Davide, Rosati, Maurizio, Gallo, Cinzia, Surico, Daniela, Remorgida, Valentino, Ruscitto, Francesco, Beretta, Paolo, Benedetti Panici, Pierluigi, Raspagliesi, Francesco, Bogani, G, Scambia, G, Cimmino, C, Fanfani, F, Costantini, B, Loverro, M, Ferrandina, G, Landoni, F, Bazzurini, L, Grassi, T, Vitobello, D, Siesto, G, Perrone, A, Zanagnolo, V, De Iaco, P, Multinu, F, Ghezzi, F, Casarin, J, Berretta, R, Capozzi, V, Zupi, E, Centini, G, Pellegrino, A, Corso, S, Stevenazzi, G, Montoli, S, Boschi, A, Comerci, G, Greco, P, Martinello, R, Sopracordevole, F, Giorda, G, Simoncini, T, Caretto, M, Sartori, E, Ferrari, F, Cianci, A, Sarpietro, G, Matarazzo, M, Zullo, F, Bifulco, G, Morelli, M, Ferrero, A, Biglia, N, Barra, F, Ferrero, S, Leone Roberti Maggiore, U, Cianci, S, Chiantera, V, Ercoli, A, Sozzi, G, Martoccia, A, Schettini, S, Orlando, T, Cannone, F, Ettore, G, Puppo, A, Borghese, M, Martinelli, C, Muzii, L, Di Donato, V, Driul, L, Restaino, S, Bergamini, A, Candotti, G, Bocciolone, L, Plotti, F, Angioli, R, Mantovani, G, Ceccaroni, M, Cassani, C, Dominoni, M, Giambanco, L, Amodeo, S, Leo, L, Thomasset, R, Raimondo, D, Seracchioli, R, Malzoni, M, Gorlero, F, Di Luca, M, Busato, E, Kilzie, S, Dell'Acqua, A, Scarfone, G, Vercellini, P, Petrillo, M, Dessole, S, Capobianco, G, Ciavattini, A, Delli Carpini, G, Giannella, L, Mereu, L, Tateo, S, Sorbi, F, Fambrini, M, Cicogna, S, Romano, F, Ricci, G, Trojano, G, Consonni, R, Cantaluppi, S, Lippolis, A, Tinelli, R, D'Ippolito, G, Aguzzoli, L, Mandato, V, Palomba, S, Calandra, D, Rosati, M, Gallo, C, Surico, D, Remorgida, V, Ruscitto, F, Beretta, P, Benedetti Panici, P, Raspagliesi, F, Bogani, Giorgio, Scambia, Giovanni, Cimmino, Chiara, Fanfani, Francesco, Costantini, Barbara, Loverro, Matteo, Ferrandina, Gabriella, Landoni, Fabio, Bazzurini, Luca, Grassi, Tommaso, Vitobello, Domenico, Siesto, Gabriele, Perrone, Anna Myriam, Zanagnolo, Vanna, De Iaco, Pierandrea, Multinu, Francesco, Ghezzi, Fabio, Casarin, Jvan, Berretta, Roberto, Capozzi, Vito A, Zupi, Errico, Centini, Gabriele, Pellegrino, Antonio, Corso, Silvia, Stevenazzi, Guido, Montoli, Serena, Boschi, Anna Chiara, Comerci, Giuseppe, Greco, Pantaleo, Martinello, Ruby, Sopracordevole, Francesco, Giorda, Giorgio, Simoncini, Tommaso, Caretto, Marta, Sartori, Enrico, Ferrari, Federico, Cianci, Antonio, Sarpietro, Giuseppe, Matarazzo, Maria Grazia, Zullo, Fulvio, Bifulco, Giuseppe, Morelli, Michele, Ferrero, Annamaria, Biglia, Nicoletta, Barra, Fabio, Ferrero, Simone, Leone Roberti Maggiore, Umberto, Cianci, Stefano, Chiantera, Vito, Ercoli, Alfredo, Sozzi, Giulio, Martoccia, Angela, Schettini, Sergio, Orlando, Teresa, Cannone, Francesco G, Ettore, Giuseppe, Puppo, Andrea, Borghese, Martina, Martinelli, Canio, Muzii, Ludovico, Di Donato, Violante, Driul, Lorenza, Restaino, Stefano, Bergamini, Alice, Candotti, Giorgio, Bocciolone, Luca, Plotti, Francesco, Angioli, Roberto, Mantovani, Giulia, Ceccaroni, Marcello, Cassani, Chiara, Dominoni, Mattia, Giambanco, Laura, Amodeo, Silvia, Leo, Livio, Thomasset, Raphael, Raimondo, Diego, Seracchioli, Renato, Malzoni, Mario, Gorlero, Franco, Di Luca, Martina, Busato, Enrico, Kilzie, Sami, Dell'Acqua, Andrea, Scarfone, Giovanna, Vercellini, Paolo, Petrillo, Marco, Dessole, Salvatore, Capobianco, Giampiero, Ciavattini, Andrea, Delli Carpini, Giovanni, Giannella, Luca, Mereu, Liliana, Tateo, Saverio, Sorbi, Flavia, Fambrini, Massimiliano, Cicogna, Stefania, Romano, Federico, Ricci, Giuseppe, Trojano, Giuseppe, Consonni, Roberto, Cantaluppi, Simona, Lippolis, Antonio, Tinelli, Raffaele, D'Ippolito, Giovanni, Aguzzoli, Lorenzo, Mandato, Vincenzo D, Palomba, Stefano, Calandra, Davide, Rosati, Maurizio, Gallo, Cinzia, Surico, Daniela, Remorgida, Valentino, Ruscitto, Francesco, Beretta, Paolo, Benedetti Panici, Pierluigi, and Raspagliesi, Francesco

Abstract

Objective: Coronavirus disease 2019 (COVID-19) outbreak has correlated with the disruption of screening activities and diagnostic assessments. Endometrial cancer (EC) is one of the most common gynecological malignancies and it is often detected at an early stage, because it frequently produces symptoms. Here, we aim to investigate the impact of COVID-19 outbreak on patterns of presentation and treatment of EC patients. Methods: This is a retrospective study involving 54 centers in Italy. We evaluated patterns of presentation and treatment of EC patients before (period 1: March 1, 2019 to February 29, 2020) and during (period 2: April 1, 2020 to March 31, 2021) the COVID-19 outbreak. Results: Medical records of 5,164 EC patients have been retrieved: 2,718 and 2,446 women treated in period 1 and period 2, respectively. Surgery was the mainstay of treatment in both periods (p=0.356). Nodal assessment was omitted in 689 (27.3%) and 484 (21.2%) patients treated in period 1 and 2, respectively (p<0.001). While, the prevalence of patients undergoing sentinel node mapping (with or without backup lymphadenectomy) has increased during the COVID-19 pandemic (46.7% in period 1 vs. 52.8% in period 2; p<0.001). Overall, 1,280 (50.4%) and 1,021 (44.7%) patients had no adjuvant therapy in period 1 and 2, respectively (p<0.001). Adjuvant therapy use has increased during COVID-19 pandemic (p<0.001). Conclusion: Our data suggest that the COVID-19 pandemic had a significant impact on the characteristics and patterns of care of EC patients. These findings highlight the need to implement healthcare services during the pandemic.

Published
2022

27. COVID-19 and kidney transplantation: an Italian Survey and Consensus

Author

Vistoli, F., Furian, L., Maggiore, U., Caldara, R., Cantaluppi, V., Ferraresso, M., Zaza, G., Cardillo, M., Biancofiore, G., Menichetti, F., Russo, A., Turillazzi, E., Di Paolo, M., Grandaliano, G., Boggi, U., Brunori, G., Petrini, F., Valenza, F., Lavezzo, B., Bonucchi, D., Capocasale, E., Grossi, P., Ponticelli, C., Sandrini, S., Schena, F. P., Segoloni, G., Biancone, L., Boschiero, L., Rigotti, P., Comai, G., Bossini, N., Minetti, E., Iaria, G., Ambrosini, A., Messa, P. G., Boscutti, G., Carmellini, M., Caputo, F., Ranghino, A., De Rosa, P., Federico, S., Veroux, M., Cirami, C., Nordio, M., Citterio, F., Piredda, G. B., Pretagostini, R., De Paolis, P., Rampino, T., Pisani, F., Cappelli, G., Secchi, A., Salis, P., Gastaldon, F., Mallamaci, F., Strologo, L. D., Taglioni, C., Teresa, P., Peruzzi, L., Gesualdo, L., Gotti, E., Feltracco, P., and Paoletti, E.

Subjects
Nephrology, medicine.medical_specialty, Consensus, Pneumonia, Viral, 030232 urology & nephrology, 030204 cardiovascular system & hematology, Organ transplantation, law.invention, Kidney transplantation, 03 medical and health sciences, Betacoronavirus, 0302 clinical medicine, law, Intensive care, Internal medicine, Pandemic, medicine, Living Donors, Settore MED/14 - NEFROLOGIA, Antimicrobial stewardship, Humans, Viral, Position papers and Guidelines, Survey, Pandemics, business.industry, SARS-CoV-2, Public health, COVID-19, Pneumonia, medicine.disease, Coronavirus Infections, Kidney Transplantation, Intensive care unit, Family medicine, business
Abstract

Italy was the first Western country to face the COVID-19 pandemic. Here we report the results of a national survey on kidney transplantation activity in February and March 2020, and the results of a three-round Delphi consensus promoted by four scientific societies: the Italian Society of Organ Transplantation, the Italian Society of Nephrology, the Italian Society of Anesthesia and Intensive Care, and the Italian Group on Antimicrobial Stewardship. All 41 Italian transplant centers were invited to express their opinion in the Delphi rounds along with a group of seven experts. The survey revealed that, starting from March 2020, there was a decline in kidney transplantation activity in Italy, especially for living-related transplants. Overall, 60 recipients tested positive for SARS-CoV2 infection, 57 required hospitalization, 17 were admitted to the ICU, and 11 died. The online consensus had high response rates at each round (95.8%, 95.8%, and 89.5%, respectively). Eventually, 27 of 31 proposed statements were approved (87.1%), 12 at the first or second round (38.7%), and 3 at the third (9.7%). Based on the Italian experience, we discuss the reasons for the changes in kidney transplantation activity during the COVID-19 pandemic in Western countries. We also provide working recommendations for the organization and management of kidney transplantation under these conditions. Electronic supplementary material The online version of this article (10.1007/s40620-020-00755-8) contains supplementary material, which is available to authorized users.

Published
2020

28. Clinical triage of patients on kidney replacement therapy presenting with COVID-19: An ERACODA registry analysis

Author

Mitra, S., Jayanti, A., Vart, P., Coca, A., Gallieni, M., Ovrehus, M. A., Midtvedt, K., Abd Elhafeez, S., Gandolfini, I., Buttner, S., Franssen, C. F. M., Hemmelder, M. H., Van Der Net, J. B., Essig, M., Du Buf-Vereijken, P. W. G., Van Ginneken, B., Maas, N., Vogt, L., Van Jaarsveld, B. C., Jager, K. J., Bemelman, F. J., Klingenberg-Salahova, F., Heenan-Vos, F., Vervloet, M. G., Nurmohamed, A., Abramowicz, D., Verhofstede, S., Maoujoud, O., Malfait, T., Fialova, J., Melilli, E., Fava, A., Cruzado, J. M., Perez, N. M., Lips, J., Krepel, H., Adilovic, H., Hengst, M., Rydzewski, A., Gellert, R., Oliveira, J., Alferes, D. G., Zakharova, E. V., Ambuehl, P. M., Walker, A., Winzeler, R., Lepeytre, F., Rabate, C., Rostoker, G., Marques, S., Azasevac, T., Katicic, D., Dam, M. T., Kruger, T., Brzosko, S., Zanen, A. L., Logtenberg, S. J. J., Fricke, L., Slebe, J. J. P., Kemlin, D., Van De Wetering, J., Reinders, M. E. J., Eiselt, J., Kielberger, L., El-Wakil, H. S., Verhoeven, M. A. M., Canal, C., Facundo, C., Ramos, A. M., Debska-Slizien, A., Veldhuizen, N. M. H., Tigka, E., Konsta, M. A. P., Panagoutsos, S., Mallamaci, F., Postorino, A., Cambareri, F., Covic, A., Matceac, I., Nistor, I., Cordos, M., Groeneveld, J. H. M., Jousma, J., Marjolijn Van Buren, Diekmann, F., Tiago Assis Pereira, Santos, A. C. S., Arias-Cabrales, C., Crespo, M., Llinas-Mallol, L., Buxeda, A., Tarrega, C. B., Redondo-Pachon, D., Jimenez, M. D. A., Hofstra, J. M., Franco, A., Arroyo, D., Rodriguez-Ferrero, M. L., Manzanos, S. B., Barrios, R. H. S., Avila, G., Laranjinha, I., Mateus, C., Lemahieu, W., Bartelet, K., Dirim, A. B., Sever, M. S., Demir, E., Safak, S., Turkmen, A., Hollander, D. A. M. J., De Vries, A. P. J., Meziyerh, S., Van Der Helm, D., Mallat, M., Bouwsma, H., Sridharan, S., Petruliene, K., Maloney, S. -R., Verberk, I., Van Der Sande, F. M., Christiaans, M. H. L., Mohankumar, N., Di Luca, M., Tuglular, S. Z., Kramer, A., Beerenhout, C., Luik, P. T., Kerschbaum, J., Tiefenthaler, M., Watschinger, B., Adema, A. Y., Stepanov, V. A., Zulkarnaev, A. B., Turkmen, K., Fliedner, A., Asberg, A., Mjoen, G., Miyasato, H., De Fijter, C. W. H., Mongera, N., Pini, S., De Biase, C., Duivenvoorden, R., Hilbrands, L., Kerckhoffs, A., Van De Logt, A. -E., Maas, R., Lebedeva, O., Lopez, V., Verhave, J., Reichert, L. J. M., Titov, D., Parshina, E. V., Zanoli, L., Marcantoni, C., Van Gils-Verrij, L. E. A., Harty, J. C., Meurs, M., Myslak, M., Battaglia, Y., Lentini, P., Den Deurwaarder, E., Stendahl, M., Rahimzadeh, H., Schouten, M., Rychlik, I., Cabezas-Reina, C. J., Roca, A. M., Nauta, F., Goffin, E., Kanaan, N., Labriola, L., Devresse, A., Diaz-Mareque, A., Meijers, B. K. I., Naesens, M., Kuypers, D., Desschans, B., Tonnelier, A., Wissing, K. M., De Arriba, G., Dedinska, I., Pessolano, G., Maggiore, U., Malik, S., Papachristou, E., Gansevoort, R. T., Noordzij, M., Berger, S. P., Meijer, E., Ozyilmaz, A., Sanders, J. S. F., Ponikvar, J. B., Arnol, M., Pernat, A. M., Kovac, D., Ekart, R., Abrahams, A. C., Molenaar, F. M., Van Zuilen, A. D., Meijvis, S. C. A., Dolmans, H., Tantisattamo, E., Esposito, P., Krzesinski, J. -M., Barahira, J. D., Sabiu, G., Martin-Moreno, P. L., Guglielmetti, G., Guzzo, G., Toapanta, N., Soler, M. J., Luik, A. J., Van Kuijk, W. H. M., Stikkelbroeck, L. W. H., Hermans, M. M. H., Rimsevicius, L., Righetti, M., Islam, M., Braak, N. H. -T., Nephrology, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Interne Geneeskunde, RS: Carim - V02 Hypertension and target organ damage, Groningen Kidney Center (GKC), ACS - Diabetes & metabolism, AII - Inflammatory diseases, AII - Infectious diseases, Internal Medicine, and Clinical sciences

Subjects
kidney, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), medicine.medical_treatment, Pulmonary insufficiency, infectious diseases, Kidney, Second presentation, Interquartile range, Internal medicine, medicine, Humans, Registries, Mortality, AcademicSubjects/MED00340, Dialysis, Aged, Transplantation, second presentation, business.industry, SARS-CoV-2, COVID-19, medicine.disease, mortality, Triage, Hospitalization, Renal Replacement Therapy, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Nephrology, Oxygen Saturation, dialysis, Original Article, Hemodialysis, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], Presentation (obstetrics), business, transplantation
Abstract

Background Patients on kidney replacement therapy (KRT) are at very high risk of coronavirus disease 2019 (COVID-19). The triage pathway for KRT patients presenting to hospitals with varying severity of COVID-19 illness remains ill-defined. We studied the clinical characteristics of patients at initial and subsequent hospital presentations and the impact on patient outcomes. Methods The European Renal Association COVID-19 Database (ERACODA) was analysed for clinical and laboratory features of 1423 KRT patients with COVID-19 either hospitalized or non-hospitalized at initial triage and those re-presenting a second time. Predictors of outcomes (hospitalization, 28-day mortality) were then determined for all those not hospitalized at initial triage. Results Among 1423 KRT patients with COVID-19 [haemodialysis (HD), n = 1017; transplant, n = 406), 25% (n = 355) were not hospitalized at first presentation due to mild illness (30% HD, 13% transplant). Of the non-hospitalized patients, only 10% (n = 36) re-presented a second time, with a 5-day median interval between the two presentations (interquartile range 2–7 days). Patients who re-presented had worsening respiratory symptoms, a decrease in oxygen saturation (97% versus 90%) and an increase in C-reactive protein (26 versus 73 mg/L) and were older (72 vs 63 years) compared with those who did not return a second time. The 28-day mortality between early admission (at first presentation) and deferred admission (at second presentation) was not significantly different (29% versus 25%; P = 0.6). Older age, prior smoking history, higher clinical frailty score and self-reported shortness of breath at first presentation were identified as risk predictors of mortality when re-presenting after discharge at initial triage. Conclusions This study provides evidence that KRT patients with COVID-19 and mild illness can be managed effectively with supported outpatient care and with vigilance of respiratory symptoms, especially in those with risk factors for poor outcomes. Our findings support a risk-stratified clinical approach to admissions and discharges of KRT patients presenting with COVID-19 to aid clinical triage and optimize resource utilization during the ongoing pandemic.

Published
2021

29. EP23.15: Diagnostic performance of the IOTA two‐step strategy in an oncological referral centre.

Author

Albertini, G.C., Ortelli, G., Bogani, G., Palladino, S., Maggiore, U. Leone Roberti, Raspagliesi, F., and Chiappa, V.

Subjects
BENIGN tumors, MEDIAN (Mathematics), DATA analysis, HISTOLOGY, RETROSPECTIVE studies
Abstract

This article, titled "Diagnostic performance of the IOTA two-step strategy in an oncological referral centre," provides an external validation of the "IOTA two-step strategy" in women with adnexal masses referred to the Fondazione IRCCS Istituto Nazionale dei Tumori. The study analyzed data from 1,200 patients with adnexal masses, excluding those already in follow-up and those without good-quality follow-up data. The main outcome was the classification of tumors as benign or malignant based on histology or clinical and ultrasound information during at least one year of conservative follow-up. The study found that the "IOTA two-step strategy" had good diagnostic performance in predicting malignancy in this high-risk population. [Extracted from the article]

Published
2024
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30. EPV140/#62 Survival outcomes in endometrial cancer patients having lymphadenectomy, sentinel node mapping plus back-up lymphadenectomy and sentinel node mapping alone

Author

Bogani, G, primary, Ghezzi, F, additional, Angioli, R, additional, Papadia, A, additional, Buda, A, additional, Di Donato, V, additional, Plotti, F, additional, De Iaco, P, additional, Perrone, AM, additional, Ferrero, S, additional, Roberti Maggiore, U Leone, additional, Gasparri, ML, additional, Casarin, J, additional, Muzii, L, additional, Mueller, M, additional, Malzoni, M, additional, Landoni, F, additional, Benedetti Panici, P, additional, and Raspagliesi, F, additional

Published
2021
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31. 101 Hysteroscopic compared to cervical injection for sentinel node detection in endometrial cancer: a multicenter prospective randomized controlled trial

Author

Ditto, A, primary, Roberti Maggiore, U Leone, additional, Martinelli, F, additional, Bogani, G, additional, Signorelli, M, additional, Chiappa, V, additional, Evangelista, MT, additional, Casarin, J, additional, Ghezzi, F, additional, Perrone, AM, additional, De Iaco, P, additional, Scollo, P, additional, Scibilia, G, additional, Giorda, G, additional, Paolini, B, additional, Lo Vullo, S, additional, Mariani, L, additional, and Raspagliesi, F, additional

Published
2021
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32. 319 Gynecologic malignancies in the era of precision medicine

Author

Mantiero, M, primary, Ducceschi, M, additional, Bini, M, additional, Lopez, S, additional, Duca, M, additional, Damian, S, additional, Ditto, A, additional, Martinelli, F, additional, Roberti Maggiore, U Leone, additional, Bogani, G, additional, Signorelli, M, additional, Bertolina, F, additional, Chiappa, V, additional, Paolini, B, additional, Agnelli, L, additional, and Raspagliesi, F, additional

Published
2021
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33. 100 Uterine serous carcinoma: role of surgery, risk factors and oncologic outcomes. Experience of a tertiary center

Author

Ditto, A, primary, Lopez, S, additional, Martinelli, F, additional, Bogani, G, additional, Lo Vullo, S, additional, Roberti Maggiore, U Leone, additional, Brusadelli, C, additional, Paolini, B, additional, Ducceschi, M, additional, Mantiero, M, additional, Chiappa, V, additional, Signorelli, M, additional, Evangelista, MT, additional, Mariani, L, additional, and Raspagliesi, F, additional

Published
2021
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37. Microablative Fractional CO2 Laser for Vulvovaginal Atrophy in Women With a History of Breast Cancer: A Pilot Study at 4-week Follow-up

Author

Salvatore, S. Nappi, R.E. Casiraghi, A. Ruffolo, A.F. Degliuomini, R. Parma, M. Leone Roberti Maggiore, U. Athanasiou, S. Candiani, M.

Abstract

Background: Breast cancer (BC) is the most common female cancer worldwide. Menopausal symptoms are a well-known side effect in women with BC and have a significant negative impact on quality of life (QoL) and sexuality. Nowadays, hormonal replacement therapy and local estrogens are the most common prescriptions to treat vulvovaginal (VVA) symptoms. However, in women with a history of BC, proper therapy for such conditions remains an often inadequately addressed clinical problem. A treatment with microablative fractional CO2 laser (MLT) can produce a remodeling of the vaginal connective tissue without causing damage to the surrounding tissue. The aim of this pilot study is to assess the efficacy and safety of MLT for treating VVA symptoms in women with a history of BC at 20-week follow-up since the first laser treatment. Patients and Methods: Women with BC and VVA symptoms were enrolled in the study and treated with 5 laser applications (one every 4 weeks). The rate of satisfied patients at 20 weeks of follow-up was evaluated with a 5-point Likert scale. Changes of the Vaginal Health Index (VHI) after treatment was compared with baseline. Effects of the laser treatment on VVA symptoms was measured using a 10-cm visual analog scale (VAS). Changes in overall QoL were assessed with a generic QoL questionnaire: the Short Form 12 (SF-12) that we analyzed considering its physical (PCS12) and mental (MCS12) domains. Sexual function was evaluated by the Female Sexual Function Index (FSFI). Results: In this prospective cohort study, we enrolled 40 women with a history of BC and who currently were or (Group 2) who had been (Group 1) on treatment with endocrine therapy for their condition. Six (15.0%) women were very satisfied, 25 (62.5%) were satisfied, 6 (15.0%) were uncertain, and 3 (7.5%) were dissatisfied with the MLT. VVA symptoms and VHI improved significantly at 20 weeks from baseline (P < .05) with no differences between the 2 groups (P > .05). In terms of QoL measured by the SF-12, the PCS12 and the MCS12 significantly improved at the 20-week follow-up. A significant improvement in total FSFI and in all domains was reported in both study groups (P < .05) with no differences between groups (P > .05). Conclusion: MLT was safe and effective in treating VVA symptoms in women with a history of BC, irrespective of being previously or currently on endocrine therapies. © 2021 Elsevier Inc.

Published
2021

38. Long-term risks after kidney donation: how do we inform potential donors? A survey from DESCARTES and EKITA transplantation working groups

Author

Mjøen, G., Maggiore, U., Kessaris, N., Kimenai, D., Watschinger, B., Mariat, C., Sever, M.S., Crespo, M., Peruzzi, L., Spasovski, G., Sørensen, S.S., Heemann, U., Pascual, J., Viklicky, O., Courtney, A.E., Hadaya, K., Wagner, L., Nistor, I., Hadjianastassiou, V., Durlik, M., Helanterä, I., Oberbauer, R., Oniscu, G., Hilbrands, L.B., Abramowicz, D., Mjøen, G., Maggiore, U., Kessaris, N., Kimenai, D., Watschinger, B., Mariat, C., Sever, M.S., Crespo, M., Peruzzi, L., Spasovski, G., Sørensen, S.S., Heemann, U., Pascual, J., Viklicky, O., Courtney, A.E., Hadaya, K., Wagner, L., Nistor, I., Hadjianastassiou, V., Durlik, M., Helanterä, I., Oberbauer, R., Oniscu, G., Hilbrands, L.B., and Abramowicz, D.

Abstract

Item does not contain fulltext, BACKGROUND: Publications from the last decade have increased knowledge regarding long-term risks after kidney donation. We wanted to perform a survey to assess how transplant professionals in Europe inform potential kidney donors regarding long-term risks. The objectives of the survey were to determine how they inform donors and to what extent, and to evaluate the degree of variation. METHODS: All transplant professionals involved in the evaluation process were considered eligible, regardless of the type of profession. The survey was dispatched as a link to a web-based survey. The subjects included questions on demographics, the information policy of the respondent and the use of risk calculators, including the difference of relative and absolute risks and how the respondents themselves understood these risks. RESULTS: The main finding was a large variation in how often different long-term risks were discussed with the potential donors, i.e. from always to never. Eighty percent of respondents stated that they always discuss the risk of end-stage renal disease, while 56% of respondents stated that they always discuss the risk of preeclampsia. Twenty percent of respondents answered correctly regarding the relationship between absolute and relative risks for rare outcomes. CONCLUSIONS: The use of written information and checklists should be encouraged. This may improve standardization regarding the information provided to potential living kidney donors in Europe. There is a need for information and education among European transplant professionals regarding long-term risks after kidney donation and how to interpret and present these risks.

Published
2021

39. Management of the kidney transplant patient with Cancer: Report from a Multidisciplinary Consensus Conference

Author

Romagnoli, Jacopo, Tagliaferri, Luca, Acampora, Anna, Bianchi, V., D'Ambrosio, Viola, D'Aviero, A., Esposito, I., Hohaus, Stefan, Iezzi, Roberto, Lancellotta, V., Maiolo, E., Maiorano, Brigida Anna, Paoletti, Fabio, Peris, Ketty, Posa, Alessandro, Preziosi, Francesco, Rossi, E., Scaletta, Giuseppe, Schinzari, Giovanni, Spagnoletti, Gionata, Tanzilli, A., Scambia, Giovanni, Tortora, Giampaolo, Valentini, Vincenzo, Maggiore, U., Grandaliano, Giuseppe, Romagnoli J. (ORCID:0000-0002-7153-0346), Tagliaferri L. (ORCID:0000-0003-2308-0982), Acampora A., D'Ambrosio V., Hohaus S. (ORCID:0000-0002-5534-7197), Iezzi R. (ORCID:0000-0002-2791-481X), Maiorano B. A., Paoletti F., Peris K. (ORCID:0000-0002-5237-0463), Posa A., Preziosi F., Scaletta G., Schinzari G. (ORCID:0000-0001-6105-7252), Spagnoletti G. (ORCID:0000-0003-2626-8147), Scambia G. (ORCID:0000-0003-2758-1063), Tortora G. (ORCID:0000-0002-1378-4962), Grandaliano G. (ORCID:0000-0003-1213-2177), Romagnoli, Jacopo, Tagliaferri, Luca, Acampora, Anna, Bianchi, V., D'Ambrosio, Viola, D'Aviero, A., Esposito, I., Hohaus, Stefan, Iezzi, Roberto, Lancellotta, V., Maiolo, E., Maiorano, Brigida Anna, Paoletti, Fabio, Peris, Ketty, Posa, Alessandro, Preziosi, Francesco, Rossi, E., Scaletta, Giuseppe, Schinzari, Giovanni, Spagnoletti, Gionata, Tanzilli, A., Scambia, Giovanni, Tortora, Giampaolo, Valentini, Vincenzo, Maggiore, U., Grandaliano, Giuseppe, Romagnoli J. (ORCID:0000-0002-7153-0346), Tagliaferri L. (ORCID:0000-0003-2308-0982), Acampora A., D'Ambrosio V., Hohaus S. (ORCID:0000-0002-5534-7197), Iezzi R. (ORCID:0000-0002-2791-481X), Maiorano B. A., Paoletti F., Peris K. (ORCID:0000-0002-5237-0463), Posa A., Preziosi F., Scaletta G., Schinzari G. (ORCID:0000-0001-6105-7252), Spagnoletti G. (ORCID:0000-0003-2626-8147), Scambia G. (ORCID:0000-0003-2758-1063), Tortora G. (ORCID:0000-0002-1378-4962), and Grandaliano G. (ORCID:0000-0003-1213-2177)

Abstract

Introduction: Cancer is the second most common cause of mortality and morbidity in Kidney Transplant Recipients (KTRs). Immunosuppression can influence the efficacy of cancer treatment and modification of the immunosuppressive regimen may restore anti-neoplastic immune responses improving oncologic prognosis. However, patients and transplant physicians are usually reluctant to modify immunosuppression, fearing rejection and potential graft loss. Due to the lack of extensive and recognised data supporting how to manage the immunosuppressive therapy in KTRs, in the context of immunotherapy, chemotherapy, radiotherapy and loco-regional treatments, a Consensus Conference was organised under the auspices of the European Society of Organ Transplantation and the Italian Society of Organ Transplantation. The conference involved a multidisciplinary group of transplant experts in the field across Europe. Methods: The overall process included a) the formulation of 12 specific questions based on the PICO methodology, b) systematic literature review and summary for experts for each question, c) a two-day conference celebration and the collection of experts' agreements. The conference was articulated in three sessions: “Immunosuppressive therapy and immunotherapy”, “Systemic therapy”, “Integrated Therapy”, while the final experts' agreement was collected with a televoting procedure and defined according to the majority criterion. Results: Twenty-six European experts attended the conference and expressed their vote. A total of 14 statements were finally elaborated and voted. Strong agreement was found for ten statements, moderate agreement for two, moderate disagreement for one and uncertainty for the last one. Conclusions: The consensus statements provide guidance to transplant physicians caring for kidney transplant recipients with cancer and indicate key aspects that need to be addressed by future clinical research.

Published
2021

41. How should I manage immunosuppression in a kidney transplant patient with COVID-19? An ERA-EDTA DESCARTES expert opinion

Author

Maggiore, U., Abramowicz, D., Crespo, M., Mariat, C., Mjoen, G., Peruzzi, L., Sever, M.S., Oniscu, G.C., Hilbrands, L.B., Watschinger, B., Maggiore, U., Abramowicz, D., Crespo, M., Mariat, C., Mjoen, G., Peruzzi, L., Sever, M.S., Oniscu, G.C., Hilbrands, L.B., and Watschinger, B.

Abstract

Contains fulltext : 220660.pdf (Publisher’s version ) (Closed access)

Published
2020

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