Search

Your search keyword '"Perricone, G."' showing total 399 results
Start Over Author "Perricone, G."
399 results on '"Perricone, G."'

2. Economic Impact of European Liver and Intestine Transplantation Association (ELITA) Recommendations for Hepatitis B Prophylaxis After Liver Transplantation

Author

Cortesi, P, Vigano, R, Conti, S, Lenci, I, Volpes, R, Martini, S, Angelico, M, Fung, J, Buti, M, Coilly, A, Durand, F, Fondevila, C, Lebray, P, Nevens, F, Polak, W, Rizzetto, M, Zoulim, F, Perricone, G, Berenguer, M, Mantovani, L, Duvoux, C, Belli, L, Cortesi P. A., Vigano R., Conti S., Lenci I., Volpes R., Martini S., Angelico M., Fung J., Buti M., Coilly A., Durand F., Fondevila C., Lebray P., Nevens F., Polak W. G., Rizzetto M., Zoulim F., Perricone G., Berenguer M., Mantovani L. G., Duvoux C., Belli L. S., Cortesi, P, Vigano, R, Conti, S, Lenci, I, Volpes, R, Martini, S, Angelico, M, Fung, J, Buti, M, Coilly, A, Durand, F, Fondevila, C, Lebray, P, Nevens, F, Polak, W, Rizzetto, M, Zoulim, F, Perricone, G, Berenguer, M, Mantovani, L, Duvoux, C, Belli, L, Cortesi P. A., Vigano R., Conti S., Lenci I., Volpes R., Martini S., Angelico M., Fung J., Buti M., Coilly A., Durand F., Fondevila C., Lebray P., Nevens F., Polak W. G., Rizzetto M., Zoulim F., Perricone G., Berenguer M., Mantovani L. G., Duvoux C., and Belli L. S.

Abstract

The European Liver and Intestine Transplant Association, ELITA, promoted a Consensus Conference involving 20 experts across the world which generated updated guidelines on HBV prophylaxis in liver transplant candidates and recipients. This study explores the economic impact associated with the implementation of the new ELITA guidelines. To this aim, a condition-specific cohort simulation model has been developed to compare new and historical prophylaxis, including only pharmaceutical cost and using the European perspective. The target population simulated in the model included both prevalent and incident cases, and consisted of 6,133 patients after the first year, that increased to 7,442 and 8,743 patents after 5 and 10 years from its implementation. The ELITA protocols allowed a cost saving of around € 235.65 million after 5 years and € 540.73 million after 10 years; which was mainly due to early HIBG withdrawal either after the first 4 weeks or after the first year post Liver Transplantation (LT) depending on the virological risk at transplantation. Results were confirmed by sensitivity analyses. The money saved by the implementation of the ELITA guidelines would allow healthcare decision makers and budget holders to understand where costs could be reduced and resources re-allocated to different needs.

Published
2023

3. Intensive care management of acute-on-chronic liver failure

Author

Perricone, G, Artzner, T, De Martin, E, Jalan, R, Wendon, J, Carbone, M, Perricone G., Artzner T., De Martin E., Jalan R., Wendon J., Carbone M., Perricone, G, Artzner, T, De Martin, E, Jalan, R, Wendon, J, Carbone, M, Perricone G., Artzner T., De Martin E., Jalan R., Wendon J., and Carbone M.

Abstract

Acute-on-chronic liver failure (ACLF) is a clinical syndrome defined by an acute deterioration of the liver function associated with extrahepatic organ failures requiring intensive care support and associated with a high short-term mortality. ACLF has emerged as a major cause of mortality in patients with cirrhosis and chronic liver disease. ACLF has a unique pathophysiology in which systemic inflammation plays a key role; this provides the basis of novel therapies, several of which are now in clinical trials. Intensive care unit (ICU) therapy parallels that applied in the general ICU population in some organ failures but has peculiar differential characteristics in others. Critical care management strategies and the option of liver transplantation (LT) should be balanced with futility considerations in those with a poor prognosis. Nowadays, LT is the only life-saving treatment that can radically improve the long-term prognosis of patients with ACLF. This narrative review will provide insights on the current understanding of ACLF with emphasis on intensive care management.

Published
2023

5. Successful recovery from severe inverted Takotsubo cardiomyopathy after liver transplantation: The efficacy of extracorporeal membrane oxygenation (ECMO)

Author

Lauterio, A, Bottiroli, M, Cannata, A, de Carlis, R, Valsecchi, M, Perricone, G, Colombo, S, Buscemi, V, Zaniboni, M, Pedrazzini, G, Mondino, M, Russo, C, Fumagalli, R, de Carlis, L, Lauterio A., Bottiroli M., Cannata A., de Carlis R., Valsecchi M., Perricone G., Colombo S., Buscemi V., Zaniboni M., Pedrazzini G., Mondino M., Russo C., Fumagalli R., de Carlis L., Lauterio, A, Bottiroli, M, Cannata, A, de Carlis, R, Valsecchi, M, Perricone, G, Colombo, S, Buscemi, V, Zaniboni, M, Pedrazzini, G, Mondino, M, Russo, C, Fumagalli, R, de Carlis, L, Lauterio A., Bottiroli M., Cannata A., de Carlis R., Valsecchi M., Perricone G., Colombo S., Buscemi V., Zaniboni M., Pedrazzini G., Mondino M., Russo C., Fumagalli R., and de Carlis L.

Published
2022

6. Survey on hepatic sarcoidosis in Italy

Author

Corte, C. Della, primary, Reati, R., additional, Malinverno, F., additional, Arena, I., additional, Campigotto, M., additional, Cardinale, V., additional, Cespiati, A., additional, Degasperi, E., additional, Del Poggio, P., additional, Durante, E., additional, Federico, A., additional, Galati, G., additional, Germani, G., additional, Giannini, G., additional, Marin, R., additional, Martini, A., additional, Mazzarelli, C., additional, Mirici, F., additional, Missale, G., additional, Morana, E., additional, Morelli, M., additional, Pasulo, L., additional, Piras, M., additional, Perricone, G., additional, Pugliese, N., additional, Rapetti, R., additional, Rendina, M., additional, Sciarrone, S., additional, Simone, L., additional, Surace, L., additional, Strona, S., additional, Svegliati B, G., additional, Viganò, M., additional, Manes, G., additional, and Carbone, M., additional

Published
2023
Full Text
View/download PDF

7. Individualized HBIG withdrawal in an historical cohort of liver transplant recipients in Italy

Author

Viganò, R., primary, Lenci, I., additional, Carrai, P., additional, Volpes, R., additional, Martini, S., additional, Donato, MF., additional, Mazzarelli, C., additional, Farina, E., additional, Cocchis, D., additional, Perricone, G., additional, Pasulo, L., additional, Becchetti, C., additional, De Simone, P., additional, Romagnoli, R., additional, Fagiuoli, S., additional, Milana, M., additional, Petruccelli, S., additional, Baiocchi, L., additional, Di Benedetto, C., additional, Loglio, A., additional, D'Amico, F., additional, and Belli, L.S., additional

Published
2023
Full Text
View/download PDF

9. Impact of immunosuppressive therapy on the severity of COVID-19 in solid organ transplant recipients

Author

Merli, M, Pasulo, L, Perricone, G, Travi, G, Rossotti, R, Colombo, V, De Carlis, R, Chiappetta, S, Moioli, M, Minetti, E, Frigerio, M, De Carlis, L, Belli, L, Fagiuoli, S, Puoti, M, Merli M., Pasulo L., Perricone G., Travi G., Rossotti R., Colombo V. G., De Carlis R., Chiappetta S., Moioli M. C., Minetti E., Frigerio M., De Carlis L. G., Belli L., Fagiuoli S., Puoti M., Merli, M, Pasulo, L, Perricone, G, Travi, G, Rossotti, R, Colombo, V, De Carlis, R, Chiappetta, S, Moioli, M, Minetti, E, Frigerio, M, De Carlis, L, Belli, L, Fagiuoli, S, Puoti, M, Merli M., Pasulo L., Perricone G., Travi G., Rossotti R., Colombo V. G., De Carlis R., Chiappetta S., Moioli M. C., Minetti E., Frigerio M., De Carlis L. G., Belli L., Fagiuoli S., and Puoti M.

Published
2021

10. On-treatment serum albumin level can guide long-term treatment in patients with cirrhosis and uncomplicated ascites

Author

Caraceni, P, Tufoni, M, Zaccherini, G, Riggio, O, Angeli, P, Alessandria, C, Neri, S, Foschi, F, Levantesi, F, Airoldi, A, Simone, L, Svegliati-Baroni, G, Fagiuoli, S, Laffi, G, Cozzolongo, R, Di Marco, V, Sangiovanni, V, Morisco, F, Toniutto, P, Gasbarrini, A, De Marco, R, Piano, S, Nardelli, S, Elia, C, Roncadori, A, Baldassarre, M, Bernardi, M, Domenicali, M, Giannone, F, Antognoli, A, Merli, M, Pasquale, C, Gioia, S, Fasolato, S, Sticca, A, Campion, D, Risso, A, Saracco, G, Prestianni, L, Fidone, F, Maiorca, D, Rizzotto, A, Cappa, F, Lanzi, A, Neri, E, Visani, A, Mastroianni, A, Perricone, G, Alberti, A, Cesarini, L, Mazzarelli, C, Vangeli, M, Vigano, R, Marzioni, M, Capretti, F, Kostandini, A, Magini, G, Colpani, M, Gabbani, T, Marsico, M, Zappimbulso, M, Petruzzi, J, Calvaruso, V, Parrella, G, Caporaso, N, Auriemma, F, Guarino, M, Pugliese, F, Tortora, A, Leo, P, Angelico, M, De Leonardis, F, Pecchioli, A, Rossi, P, Raimondo, G, Cacciola, I, Elia, G, Negri, E, Dallio, M, Loguercio, C, Federico, A, Conte, D, Massironi, S, Natascia Celli, G, Rendina, M, Bringiotti, R, Castellaneta, N, Salerno, F, Boccia, S, Guarisco, R, Galioto, A, Cavallin, M, Andrealli, A, Caraceni P., Tufoni M., Zaccherini G., Riggio O., Angeli P., Alessandria C., Neri S., Foschi F. G., Levantesi F., Airoldi A., Simone L., Svegliati-Baroni G., Fagiuoli S., Laffi G., Cozzolongo R., Di Marco V., Sangiovanni V., Morisco F., Toniutto P., Gasbarrini A., De Marco R., Piano S., Nardelli S., Elia C., Roncadori A., Baldassarre M., Bernardi M., Domenicali M., Giannone F. A., Antognoli A., Merli M., Pasquale C., Gioia S., Fasolato S., Sticca A., Campion D., Risso A., Saracco G. M., Prestianni L., Fidone F., Maiorca D., Rizzotto A., Cappa F. M., Lanzi A., Neri E., Visani A., Mastroianni A., Perricone G., Alberti A. B., Cesarini L., Mazzarelli C., Vangeli M., Vigano R., Marzioni M., Capretti F., Kostandini A., Magini G., Colpani M., Gabbani T., Marsico M., Zappimbulso M., Petruzzi J., Calvaruso V., Parrella G., Caporaso N., Auriemma F., Guarino M., Pugliese F., Tortora A., Leo P., Angelico M., De Leonardis F., Pecchioli A., Rossi P., Raimondo G., Cacciola I., Elia G., Negri E., Dallio M., Loguercio C., Federico A., Conte D., Massironi S., Natascia Celli G. B., Rendina M., Bringiotti R., Castellaneta N. M., Salerno F., Boccia S., Guarisco R., Galioto A., Cavallin M., Andrealli A., Caraceni, P, Tufoni, M, Zaccherini, G, Riggio, O, Angeli, P, Alessandria, C, Neri, S, Foschi, F, Levantesi, F, Airoldi, A, Simone, L, Svegliati-Baroni, G, Fagiuoli, S, Laffi, G, Cozzolongo, R, Di Marco, V, Sangiovanni, V, Morisco, F, Toniutto, P, Gasbarrini, A, De Marco, R, Piano, S, Nardelli, S, Elia, C, Roncadori, A, Baldassarre, M, Bernardi, M, Domenicali, M, Giannone, F, Antognoli, A, Merli, M, Pasquale, C, Gioia, S, Fasolato, S, Sticca, A, Campion, D, Risso, A, Saracco, G, Prestianni, L, Fidone, F, Maiorca, D, Rizzotto, A, Cappa, F, Lanzi, A, Neri, E, Visani, A, Mastroianni, A, Perricone, G, Alberti, A, Cesarini, L, Mazzarelli, C, Vangeli, M, Vigano, R, Marzioni, M, Capretti, F, Kostandini, A, Magini, G, Colpani, M, Gabbani, T, Marsico, M, Zappimbulso, M, Petruzzi, J, Calvaruso, V, Parrella, G, Caporaso, N, Auriemma, F, Guarino, M, Pugliese, F, Tortora, A, Leo, P, Angelico, M, De Leonardis, F, Pecchioli, A, Rossi, P, Raimondo, G, Cacciola, I, Elia, G, Negri, E, Dallio, M, Loguercio, C, Federico, A, Conte, D, Massironi, S, Natascia Celli, G, Rendina, M, Bringiotti, R, Castellaneta, N, Salerno, F, Boccia, S, Guarisco, R, Galioto, A, Cavallin, M, Andrealli, A, Caraceni P., Tufoni M., Zaccherini G., Riggio O., Angeli P., Alessandria C., Neri S., Foschi F. G., Levantesi F., Airoldi A., Simone L., Svegliati-Baroni G., Fagiuoli S., Laffi G., Cozzolongo R., Di Marco V., Sangiovanni V., Morisco F., Toniutto P., Gasbarrini A., De Marco R., Piano S., Nardelli S., Elia C., Roncadori A., Baldassarre M., Bernardi M., Domenicali M., Giannone F. A., Antognoli A., Merli M., Pasquale C., Gioia S., Fasolato S., Sticca A., Campion D., Risso A., Saracco G. M., Prestianni L., Fidone F., Maiorca D., Rizzotto A., Cappa F. M., Lanzi A., Neri E., Visani A., Mastroianni A., Perricone G., Alberti A. B., Cesarini L., Mazzarelli C., Vangeli M., Vigano R., Marzioni M., Capretti F., Kostandini A., Magini G., Colpani M., Gabbani T., Marsico M., Zappimbulso M., Petruzzi J., Calvaruso V., Parrella G., Caporaso N., Auriemma F., Guarino M., Pugliese F., Tortora A., Leo P., Angelico M., De Leonardis F., Pecchioli A., Rossi P., Raimondo G., Cacciola I., Elia G., Negri E., Dallio M., Loguercio C., Federico A., Conte D., Massironi S., Natascia Celli G. B., Rendina M., Bringiotti R., Castellaneta N. M., Salerno F., Boccia S., Guarisco R., Galioto A., Cavallin M., and Andrealli A.

Abstract

Background & Aims: The ANSWER study reported that long-term albumin administration in patients with cirrhosis and uncomplicated ascites improves survival. During treatment, serum albumin increased within a month and remained stable thereafter. In this post hoc analysis, we aimed to determine whether on-treatment serum albumin levels could guide therapy. Methods: Logistic regression was used to assess the association between baseline serum albumin and mortality, as well as to determine on-treatment factors associated with mortality and to predict the achievement of a given on-treatment serum albumin level. Survival was assessed by Kaplan-Meier estimates and second-order polynomial regression. Patients whose on-treatment serum albumin remained below normal were compared with a subset of patients from the control arm matched by principal score. Results: Baseline serum albumin was closely associated with 18-month mortality in untreated patients; albumin treatment almost effaced this relationship. On-treatment serum albumin and MELD-Na at month 1 were the sole independent variables associated with mortality. Second-order polynomial regression revealed that survival improved in parallel with increased 1-month on-treatment serum albumin. Kaplan-Meier estimations showed that any value of 1-month on-treatment serum albumin (0.1 g/dl intervals) in the range 2.5–4.5 g/dl discriminated patient survival. In the normal range of serum albumin, the best discriminant value was 4.0 g/dl. Compared to untreated patients, survival even improved in patients whose on-treatment serum albumin remained below normal. Conclusion: Baseline serum albumin per se should not guide the decision to start albumin therapy. Conversely, 1-month on-treatment serum albumin levels are strongly associated with outcomes and could guide the use of albumin – 4.0 g/dl being the target threshold. However, even patients whose serum albumin remains below normal benefit from long-term albumin administration. Lay

Published
2021

11. 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

12. Mild Course of SARS-CoV-2 Infection in a Liver Transplant Recipient Undergoing Plasma Exchange and Defibrotide for Acute Graft Rejection

Author

Merli, M, Alteri, C, Colagrossi, L, Perricone, G, Chiappetta, S, Travi, G, Campisi, D, Pugliano, M, Vecchi, M, Orcese, C, Rossini, S, De Carlis, L, Vismara, C, Belli, L, Perno, C, Puoti, M, Merli M., Alteri C., Colagrossi L., Perricone G., Chiappetta S., Travi G., Campisi D., Pugliano M. T., Vecchi M., Orcese C., Rossini S., De Carlis L., Vismara C., Belli L., Perno C. F., Puoti M., Merli, M, Alteri, C, Colagrossi, L, Perricone, G, Chiappetta, S, Travi, G, Campisi, D, Pugliano, M, Vecchi, M, Orcese, C, Rossini, S, De Carlis, L, Vismara, C, Belli, L, Perno, C, Puoti, M, Merli M., Alteri C., Colagrossi L., Perricone G., Chiappetta S., Travi G., Campisi D., Pugliano M. T., Vecchi M., Orcese C., Rossini S., De Carlis L., Vismara C., Belli L., Perno C. F., and Puoti M.

Published
2021

13. Brake wear induced PM10 emissions during the world harmonised light-duty vehicle test procedure-brake cycle

Author

Liu, Y, Wu, S, Chen, H, Federici, M, Perricone, G, Li, Y, Lv, G, Munir, S, Luo, Z, and Mao, B

Subjects
Renewable Energy, Sustainability and the Environment, Strategy and Management, Industrial and Manufacturing Engineering, General Environmental Science
Abstract

In this work, the particulate matter less than 10 μm (PM10) emissions from a medium-sized passenger vehicle's front brake wear were studied using a finite element analysis (FEA) and experimental approaches. The world harmonised light-duty vehicle test procedure-brake (WLTP-B) cycle was chosen to simulate real-world driving. An electrical low-pressure impactor (ELPI+) was used to count the brake wear particles on a brake dynamometer sealed in a chamber. In addition, a machine learning method, namely, extreme gradient boosting (XGBoost), was employed to capture the feature importance rankings of braking conditions contributing to brake wear PM10 emissions. The simulated PM10 emissions were quite consistent with the measured ones, with an overall relative error of 9%, indicating that the proposed simulation approach is promising to predict brake wear PM10 during the WLTP-B cycle. The simulated and experimental PM10 emission factors during the WLTP-B cycle were 6.4 mg km−1 veh−1 and 7.0 mg km−1 veh−1, respectively. Among the 10 trips of the WLTP-B cycle, the measured PM10 of trip #10 was the largest contributor, accounting for 49% of total PM10 emissions. On the other hand, the XGBoost results revealed that the top five most important factors governing brake wear PM10 emissions were dissipation energy, initial braking speed, final rotor temperature, braking power, and deceleration rate. From the perspective of friendly driving behaviour and regulation, limiting severe braking and high-speed braking has the potential to reduce PM10 emissions from brake wear.

Published
2022

14. Clinical outcome indicators in chronic hepatitis B and C: A primer for value-based medicine in hepatology

Author

Strazzabosco, M, Cortesi, P, Conti, S, Okolicsanyi, S, Rota, M, Ciaccio, A, Cozzolino, P, Fornari, C, Gemma, M, Scalone, L, Cesana, G, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Zavaglia, C, Perricone, G, Munari, L, Mantovani, L, Belli, L, Strazzabosco M., Cortesi P. A., Conti S., Okolicsanyi S., Rota M., Ciaccio A., Cozzolino P., Fornari C., Gemma M., Scalone L., Cesana G., Fabris L., Colledan M., Fagiuoli S., Ideo G., Zavaglia C., Perricone G., Munari L. M., Mantovani L. G., Belli L. S., Strazzabosco, M, Cortesi, P, Conti, S, Okolicsanyi, S, Rota, M, Ciaccio, A, Cozzolino, P, Fornari, C, Gemma, M, Scalone, L, Cesana, G, Fabris, L, Colledan, M, Fagiuoli, S, Ideo, G, Zavaglia, C, Perricone, G, Munari, L, Mantovani, L, Belli, L, Strazzabosco M., Cortesi P. A., Conti S., Okolicsanyi S., Rota M., Ciaccio A., Cozzolino P., Fornari C., Gemma M., Scalone L., Cesana G., Fabris L., Colledan M., Fagiuoli S., Ideo G., Zavaglia C., Perricone G., Munari L. M., Mantovani L. G., and Belli L. S.

Abstract

Background & Aims: Chronic liver diseases (CLDs) are major health problems that require complex and costly treatments. Liver-specific clinical outcome indicators (COIs) able to assist both clinicians and administrators in improving the value of care are presently lacking. The Value-Based Medicine in Hepatology (VBMH) study aims to fill this gap, devising and testing a set of COIs for CLD, that could be easily collected during clinical practice. Here we report the COIs generated and recorded for patients with HBV or HCV infection at different stages of the disease. Methods/Results: In the first phase of VBMH study, COIs were identified, based on current international guidelines and literature, using a modified Delphi method and a RAND 9-point appropriateness scale. In the second phase, COIs were tested in an observational, longitudinal, prospective, multicentre study based in Lombardy, Italy. Eighteen COIs were identified for HBV and HCV patients. Patients with CLD secondary to HBV (547) or HCV (1391) were enrolled over an 18-month period and followed for a median of 4 years. The estimation of the proposed COIs was feasible in the real-word clinical practice and COI values compared well with literature data. Further, the COIs were able to capture the impact of new effective treatments like direct-acting antivirals (DAAs) in the clinical practice. Conclusions: The COIs efficiently measured clinical outcomes at different stages of CLDs. While specific clinical practice settings and related healthcare systems may modify their implementation, these indicators will represent an important component of the tools for a value-based approach in hepatology and will positively affect care delivery.

Published
2020

15. Outcomes of Liver Transplant for Adults With Wilson’s Disease

Author

Ferrarese, A, Morelli, M, Carrai, P, Milana, M, Angelico, M, Perricone, G, Belli, L, Marrone, G, Grieco, A, Martini, S, Manini, M, Fagiuoli, S, Toniutto, P, Galeota Lanza, A, Bhoori, S, Petta, S, Giannini, E, Burra, P, Ferrarese A., Morelli M. C., Carrai P., Milana M., Angelico M., Perricone G., Belli L. S., Marrone G., Grieco A., Martini S., Manini M. A., Fagiuoli S., Toniutto P., Galeota Lanza A., Bhoori S., Petta S., Giannini E. G., Burra P., Ferrarese, A, Morelli, M, Carrai, P, Milana, M, Angelico, M, Perricone, G, Belli, L, Marrone, G, Grieco, A, Martini, S, Manini, M, Fagiuoli, S, Toniutto, P, Galeota Lanza, A, Bhoori, S, Petta, S, Giannini, E, Burra, P, Ferrarese A., Morelli M. C., Carrai P., Milana M., Angelico M., Perricone G., Belli L. S., Marrone G., Grieco A., Martini S., Manini M. A., Fagiuoli S., Toniutto P., Galeota Lanza A., Bhoori S., Petta S., Giannini E. G., and Burra P.

Abstract

Wilson’s disease (WD) is a rare genetic disorder with protean manifestations. Even if liver transplantation (LT) could represent an effective therapeutic option for patients with end-stage liver disease, it has remained controversial in the presence of neuropsychiatric involvement. This study aimed to examine the frequency of adult LT for WD in Italy, focusing on the disease phenotype at the time of LT. A retrospective, observational, multicenter study was conducted across Italy exploring the frequency and characteristics of adults transplanted for WD between 2006 and 2016. A total of 29 adult WD patients underwent LT during the study period at 11 Italian LT centers (accounting for 0.4% of all LTs performed), and 27 of them were considered in this analysis (male/female, n = 9/18; age at LT, 29 years [19-60 years]; median Model for End-Stage Liver Disease score at LT, 27 [6-49]). Isolated hepatic phenotype was the indication for LT in 17 (63%) patients, whereas 2 (7%) patients underwent LT for neurological impairment on compensated liver disease. Overall 1- and 5-year patient survival was excellent (88% and 83%, respectively). Neuropsychiatric symptoms early after LT completely recovered in only a few patients. In conclusion, WD remains an uncommon, unusual indication for LT in Italy, displaying good post-LT graft and patient survival. Because isolated neuropsychiatric involvement represents a rare indication to LT, more data are needed to properly assess the value of LT for WD in this subset of patients.

Published
2020

16. Reply to: Correspondence on “High rates of 30-day mortality in patients with cirrhosis and COVID-19”

Author

Iavarone, M, D'Ambrosio, R, Lampertico, P, Rimondi, A, Soria, A, Bonfanti, P, Triolo, M, Fagiuoli, S, Pugliese, N, Aghemo, A, Del Poggio, P, Perricone, G, Belli, L, Massironi, S, Luca, M, Invernizzi, P, Spinetti, A, Carriero, C, Buscarini, E, Pedaci, M, Vigano, M, Rumi, M, Iavarone M., D'Ambrosio R., Lampertico P., Rimondi A., Soria A., Bonfanti P., Triolo M., Fagiuoli S., Pugliese N., Aghemo A., Del Poggio P., Perricone G., Belli L. S., Massironi S., Luca M., Invernizzi P., Spinetti A., Carriero C., Buscarini E., Pedaci M., Vigano M., Rumi M. G., Iavarone, M, D'Ambrosio, R, Lampertico, P, Rimondi, A, Soria, A, Bonfanti, P, Triolo, M, Fagiuoli, S, Pugliese, N, Aghemo, A, Del Poggio, P, Perricone, G, Belli, L, Massironi, S, Luca, M, Invernizzi, P, Spinetti, A, Carriero, C, Buscarini, E, Pedaci, M, Vigano, M, Rumi, M, Iavarone M., D'Ambrosio R., Lampertico P., Rimondi A., Soria A., Bonfanti P., Triolo M., Fagiuoli S., Pugliese N., Aghemo A., Del Poggio P., Perricone G., Belli L. S., Massironi S., Luca M., Invernizzi P., Spinetti A., Carriero C., Buscarini E., Pedaci M., Vigano M., and Rumi M. G.

Published
2020

17. Location and allocation: inequity of access to liver transplantation for patients with severe acute‐on‐chronic liver failure in Europe

Author

Artzner, T, Bernal, W, Belli, L, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinowich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Besch, C, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Fondevila, C, Duvoux, C, Jalan, R, Viganò, R, Mazzarelli, C, Lauterio, A, Giacomoni, A, Donato, F, Lampertico, P, Pasulo, L, Fagiuoli, S, Colledan, M, Cristina Morelli, M, Vitale, G, Ottobrelli, A, Patrono, D, Romagnoli, R, Petridis, I, Cillo, U, Germani, G, Burra, P, Bachellier, P, Schneider, F, Castelain, V, Addeo, P, Deridder, M, Caroline Sacleux Audrey Coilly, S, Faouzi, S, Samuel, D, Guichon, C, Faure, S, Ursic‐bedoya, J, Colmenero, J, Toapanta, D, Hernández‐tejero, M, Vinaixa, C, den Hoed, C, Haan, J, Della Penna, A, Erhard Uschner, F, Welker, M, Zeuzem, S, Bechstein, W, Goossens, N, Raszeja‐wyszomirska, J, Rabinovich, L, Katarey, D, Agarwal, B, Artzner, Thierry, Bernal, William, Belli, Luca S, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie‐Caroline, Pageaux, George‐Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, François, Rabinowich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Besch, Camille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Fondevila, Constantino, Duvoux, Christophe, Jalan, Rajiv, Viganò, Raffaella, Mazzarelli, Chiara, Lauterio, Andrea, Giacomoni, Alessandro, Donato, Francesca, Lampertico, Pietro, Pasulo, Luisa, Fagiuoli, Stefano, Colledan, Michele, Cristina Morelli, Maria, Vitale, Giovanni, Ottobrelli, Antonio, Patrono, Damiano, Romagnoli, Renato, Petridis, Ioannis, Cillo, Umberto, Germani, Giacomo, Burra, Patrizia, Bachellier, Philippe, Schneider, Francis, Castelain, Vincent, Addeo, Pietro, Deridder, Mathilde, Caroline Sacleux Audrey Coilly, Sophie, Faouzi, Saliba, Adam, Rene, Samuel, Didier, Guichon, Celine, Faure, Stéfanie, Ursic‐Bedoya, Josè, Fondevila, Costantino, Colmenero, Jorde, Toapanta, David, Hernández‐Tejero, María, Vinaixa, Carmen, Polak, Wojciech G., den Hoed, Caroline, Haan, Jubi E., Della Penna, Andrea, Erhard Uschner, Frank, Welker, Martin, Zeuzem, Stefan, Bechstein, Wolf, Goossens, Nicolas, Raszeja‐Wyszomirska, Joanna, Rabinovich, Liane, Katarey, Dev, Agarwal, Banwari, Artzner, T, Bernal, W, Belli, L, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinowich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Besch, C, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Fondevila, C, Duvoux, C, Jalan, R, Viganò, R, Mazzarelli, C, Lauterio, A, Giacomoni, A, Donato, F, Lampertico, P, Pasulo, L, Fagiuoli, S, Colledan, M, Cristina Morelli, M, Vitale, G, Ottobrelli, A, Patrono, D, Romagnoli, R, Petridis, I, Cillo, U, Germani, G, Burra, P, Bachellier, P, Schneider, F, Castelain, V, Addeo, P, Deridder, M, Caroline Sacleux Audrey Coilly, S, Faouzi, S, Samuel, D, Guichon, C, Faure, S, Ursic‐bedoya, J, Colmenero, J, Toapanta, D, Hernández‐tejero, M, Vinaixa, C, den Hoed, C, Haan, J, Della Penna, A, Erhard Uschner, F, Welker, M, Zeuzem, S, Bechstein, W, Goossens, N, Raszeja‐wyszomirska, J, Rabinovich, L, Katarey, D, Agarwal, B, Artzner, Thierry, Bernal, William, Belli, Luca S, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie‐Caroline, Pageaux, George‐Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, François, Rabinowich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Besch, Camille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Fondevila, Constantino, Duvoux, Christophe, Jalan, Rajiv, Viganò, Raffaella, Mazzarelli, Chiara, Lauterio, Andrea, Giacomoni, Alessandro, Donato, Francesca, Lampertico, Pietro, Pasulo, Luisa, Fagiuoli, Stefano, Colledan, Michele, Cristina Morelli, Maria, Vitale, Giovanni, Ottobrelli, Antonio, Patrono, Damiano, Romagnoli, Renato, Petridis, Ioannis, Cillo, Umberto, Germani, Giacomo, Burra, Patrizia, Bachellier, Philippe, Schneider, Francis, Castelain, Vincent, Addeo, Pietro, Deridder, Mathilde, Caroline Sacleux Audrey Coilly, Sophie, Faouzi, Saliba, Adam, Rene, Samuel, Didier, Guichon, Celine, Faure, Stéfanie, Ursic‐Bedoya, Josè, Fondevila, Costantino, Colmenero, Jorde, Toapanta, David, Hernández‐Tejero, María, Vinaixa, Carmen, Polak, Wojciech G., den Hoed, Caroline, Haan, Jubi E., Della Penna, Andrea, Erhard Uschner, Frank, Welker, Martin, Zeuzem, Stefan, Bechstein, Wolf, Goossens, Nicolas, Raszeja‐Wyszomirska, Joanna, Rabinovich, Liane, Katarey, Dev, and Agarwal, Banwari

Abstract

Background: There is growing evidence that liver transplantation (LT) is the most effective treatment for acute-on-chronic liver failure grade-3 (ACLF-3). This study examines whether and how this evidence translates into practice by analyzing the variability in intensive care unit (ICU) admissions, listing strategies and LT activity for ACLF-3 patients across transplant centers in Europe. Methods: Consecutive patients who were admitted to the ICU with ACLF-3, whether or not they were listed and/or transplanted with ACLF-3 between 2018 and 2019 were included across 20 transplantation centers. Results: 351 patients with ACLF-3 were included: 33 had been listed prior to developing ACLF-3 and 318 had not been listed at the time of admission to the ICU. There was no correlation between the number of unlisted ACLF-3 patients admitted to the ICU and the number listed or transplanted whilst in ACLF-3 across centers. In contrast, there was a correlation between the number of patients listed and the number transplanted whilst in ACLF-3. 21% of patients who were listed whilst in ACLF-3 died on the waiting list or were delisted. The percentage of LT for ACLF-3 patients varied from 0%-29% of patients transplanted with decompensated cirrhosis across centers (average = 8%), with an I2 index of 68% (95% CI: 49%-80%), showing substantial heterogeneity among centers. The one-year survival for all patients with ACLF-3 was significantly higher in centers that listed and transplanted more ACLF-3 patients (>10 patients) than in centers that listed and transplanted fewer: respectively 36% vs. 20%, p = 0.012. Conclusion: Patients with ACLF-3 face inequity of access to LT across Europe. Wait-listing strategies for ACLF-3 patients influence their access to LT and, ultimately, their survival.

Published
2022

20. 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

21. Performance of the model for end-stage liver disease score for mortality prediction and the potential role of etiology

Author

D'Amico, G, Maruzzelli, L, Airoldi, A, Petridis, I, Tosetti, G, Rampoldi, A, D'Amico, M, Miraglia, R, De Nicola, S, La Mura, V, Solcia, M, Volpes, R, Perricone, G, Sgrazzutti, C, Vanzulli, A, Primignani, M, Luca, A, Malizia, G, Federico, A, Dallio, M, Andriulli, A, Iacobellis, A, Addario, L, Garcovich, M, Gasbarrini, A, Chessa, L, Salerno, F, Gobbo, G, Merli, M, Ridola, L, Baroni, G, Tarantino, G, Caporaso, N, Morisco, F, Pozzoni, P, Colli, A, Belli, L, D'Amico, Gennaro, Maruzzelli, Luigi, Airoldi, Aldo, Petridis, Ioannis, Tosetti, Giulia, Rampoldi, Antonio, D'Amico, Mario, Miraglia, Roberto, De Nicola, Stella, La Mura, Vincenzo, Solcia, Marco, Volpes, Riccardo, Perricone, Giovanni, Sgrazzutti, Cristiano, Vanzulli, Angelo, Primignani, Massimo, Luca, Angelo, Malizia, Giuseppe, Federico, Alessandro, Dallio, Marcello, Andriulli, Angelo, Iacobellis, Angelo, Addario, Luigi, Garcovich, Matteo, Gasbarrini, Antonio, Chessa, Luchino, Salerno, Francesco, Gobbo, Giulia, Merli, Manuela, Ridola, Lorenzo, Baroni, Gianluca Svegliati, Tarantino, Giuseppe, Caporaso, Nicola, Morisco, Filomena, Pozzoni, Pietro, Colli, Agostino, Belli, Luca Saverio, D'Amico, G, Maruzzelli, L, Airoldi, A, Petridis, I, Tosetti, G, Rampoldi, A, D'Amico, M, Miraglia, R, De Nicola, S, La Mura, V, Solcia, M, Volpes, R, Perricone, G, Sgrazzutti, C, Vanzulli, A, Primignani, M, Luca, A, Malizia, G, Federico, A, Dallio, M, Andriulli, A, Iacobellis, A, Addario, L, Garcovich, M, Gasbarrini, A, Chessa, L, Salerno, F, Gobbo, G, Merli, M, Ridola, L, Baroni, G, Tarantino, G, Caporaso, N, Morisco, F, Pozzoni, P, Colli, A, Belli, L, D'Amico, Gennaro, Maruzzelli, Luigi, Airoldi, Aldo, Petridis, Ioannis, Tosetti, Giulia, Rampoldi, Antonio, D'Amico, Mario, Miraglia, Roberto, De Nicola, Stella, La Mura, Vincenzo, Solcia, Marco, Volpes, Riccardo, Perricone, Giovanni, Sgrazzutti, Cristiano, Vanzulli, Angelo, Primignani, Massimo, Luca, Angelo, Malizia, Giuseppe, Federico, Alessandro, Dallio, Marcello, Andriulli, Angelo, Iacobellis, Angelo, Addario, Luigi, Garcovich, Matteo, Gasbarrini, Antonio, Chessa, Luchino, Salerno, Francesco, Gobbo, Giulia, Merli, Manuela, Ridola, Lorenzo, Baroni, Gianluca Svegliati, Tarantino, Giuseppe, Caporaso, Nicola, Morisco, Filomena, Pozzoni, Pietro, Colli, Agostino, and Belli, Luca Saverio

Abstract

Although discrimination of the model for end stage liver disease (MELD) is generally considered acceptable, its calibration is still unclear. In a validation study, we assessed the discrimination and calibration performance of 3 versions of the model: original MELD-TIPS, used to predict survival after transjugular intra-hepatic portosystemic shunt (TIPS); classic MELD-Mayo; MELD-UNOS, used by United Network for Organ Sharing (UNOS). Recalibration and model updating were also explored.

Published
2021

22. 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

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

Author

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

Abstract

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

Published
2021

24. Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020

Author

Lazzerini, M., Sforzi, I., Trapani, S., Biban, P., Silvagni, D., Villa, G., Tibaldi, J., Bertacca, L., Felici, E., Perricone, G., Parrino, R., Gioe, C., Lega, S., Conte, Fabrizio Paolo Massimo, Marchetti, Fabio, Magista, A., Berlese, P., Martelossi, S., Vaienti, F., Valletta, E., Mauro, Michele, Dall'Amico, R., Fasoli, S., Gatto, Antonio, Chiaretti, Antonio, Dragovic, D., Pascolo, P., Pilotto, C., Liguoro, I., Miorin, E., Saretta, F., Trobia, G. L., Di Stefano, A., Orlandi, Armando, Cardinale, F., Lubrano, R., Testa, A., Binotti, M., Moressa, V., Barbi, E., Armocida, B., Mariani, I., Conte M., Marchetti F., Mauro M., Gatto A., Chiaretti A. (ORCID:0000-0002-9971-1640), Orlandi A. (ORCID:0000-0001-5253-4678), Lazzerini, M., Sforzi, I., Trapani, S., Biban, P., Silvagni, D., Villa, G., Tibaldi, J., Bertacca, L., Felici, E., Perricone, G., Parrino, R., Gioe, C., Lega, S., Conte, Fabrizio Paolo Massimo, Marchetti, Fabio, Magista, A., Berlese, P., Martelossi, S., Vaienti, F., Valletta, E., Mauro, Michele, Dall'Amico, R., Fasoli, S., Gatto, Antonio, Chiaretti, Antonio, Dragovic, D., Pascolo, P., Pilotto, C., Liguoro, I., Miorin, E., Saretta, F., Trobia, G. L., Di Stefano, A., Orlandi, Armando, Cardinale, F., Lubrano, R., Testa, A., Binotti, M., Moressa, V., Barbi, E., Armocida, B., Mariani, I., Conte M., Marchetti F., Mauro M., Gatto A., Chiaretti A. (ORCID:0000-0002-9971-1640), and Orlandi A. (ORCID:0000-0001-5253-4678)

Abstract

BackgroundVery few studies describe factors associated with COVID-19 diagnosis in children.AimWe here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy.MethodsWe included cases aged 0-18 years tested between 23 February and 24 May 2020. Our primary analysis focused on children tested because of symptoms/signs suggestive of COVID-19.ResultsAmong 2,494 children tested, 2,148 (86.1%) had symptoms suggestive of COVID-19. Clinical presentation of confirmed COVID-19 cases included besides fever (82.4%) and respiratory signs or symptoms (60.4%) also gastrointestinal (18.2%), neurological (18.9%), cutaneous (3.8%) and other unspecific influenza-like presentations (17.8%). In multivariate analysis, factors significantly associated with SARS-CoV-2 positivity were: exposure history (adjusted odds ratio (AOR): 39.83; 95% confidence interval (CI): 17.52-90.55; p < 0.0001), cardiac disease (AOR: 3.10; 95% CI: 1.19-5.02; p < 0.0001), fever (AOR: 3.05%; 95% CI: 1.67-5.58; p = 0.0003) and anosmia/ageusia (AOR: 4.08; 95% CI: 1.69-9.84; p = 0.002). Among 190 (7.6%) children positive for SARS-CoV-2, only four (2.1%) required respiratory support and two (1.1%) were admitted to intensive care; all recovered.ConclusionRecommendations for SARS-CoV-2 testing in children should consider the evidence of broader clinical features. Exposure history, fever and anosmia/ageusia are strong risk factors in children for positive SARS-CoV-2 testing, while other symptoms did not help discriminate positive from negative individuals. This study confirms that COVID-19 was a mild disease in the general paediatric population in Italy. Further studies are needed to understand risk, clinical spectrum and outcomes of COVID-19 in children with pre-existing conditions.

Published
2021

30. Liver transplant recipients with Covid-19: results from an Italian multicenter cohort

Author

Mazzarelli, C., primary, Viganò, R., additional, Perricone, G., additional, Merli, M., additional, Pasulo, L., additional, Invernizzi, F., additional, Bhoori, S., additional, Morelli, M.C., additional, Patrono, D., additional, Sandro, S. Di, additional, Cortesi, P., additional, Angrisani, D., additional, De Nicola, S., additional, Vangeli, M., additional, and Belli, L.S., additional

Published
2021
Full Text
View/download PDF

31. Liver transplant candidates and SARS-CoV-2 infection: Results from an Italian multicenter cohort

Author

Perricone, G., primary, Vigano, R., additional, Mazzarelli, C., additional, Travi, G., additional, Pasulo, L., additional, Invernizzi, F., additional, Morelli, M.C., additional, Patrono, D., additional, Sandro, S. Di, additional, De Simone, P., additional, Facchetti, R., additional, Angrisani, D., additional, De Nicola, S., additional, Airoldi, A., additional, Vangeli, M., additional, and Belli, e L.S., additional

Published
2021
Full Text
View/download PDF

32. Delisting HCV-infected liver transplant candidates who improved after viral eradication: Outcome 2 years after delisting

Author

Perricone, G, Duvoux, C, Berenguer, M, Cortesi, P, Vinaixa, C, Facchetti, R, Mazzarelli, C, Rockenschaub, S, Martini, S, Morelli, C, Monico, S, Volpes, R, Pageaux, G, Fagiuoli, S, Belli, L, Perricone G., Duvoux C., Berenguer M., Cortesi P. A., Vinaixa C., Facchetti R., Mazzarelli C., Rockenschaub S. -R., Martini S., Morelli C., Monico S., Volpes R., Pageaux G. -P., Fagiuoli S., Belli L. S., Perricone, G, Duvoux, C, Berenguer, M, Cortesi, P, Vinaixa, C, Facchetti, R, Mazzarelli, C, Rockenschaub, S, Martini, S, Morelli, C, Monico, S, Volpes, R, Pageaux, G, Fagiuoli, S, Belli, L, Perricone G., Duvoux C., Berenguer M., Cortesi P. A., Vinaixa C., Facchetti R., Mazzarelli C., Rockenschaub S. -R., Martini S., Morelli C., Monico S., Volpes R., Pageaux G. -P., Fagiuoli S., and Belli L. S.

Abstract

Backgrounds & Aims: Treating patients with decompensated cirrhosis with direct-acting antiviral (DAA) therapy while on the waiting list for liver transplantation results in substantial improvement of liver function allowing 1 in 4 patients to be removed from the waiting list or delisted, as reported in a previous study promoted by the European Liver and Intestine Transplant Association (ELITA). The aim of this study was to report on clinical outcomes of delisted patients, including mortality risk, hepatocellular carcinoma development and clinical decompensation requiring relisting. Methods: One hundred and forty-two HCV-positive patients on the liver transplant waiting list for decompensated cirrhosis, negative for hepatocellular carcinoma, between February 2014 and June 2015 were treated with DAA therapy and were prospectively followed up. Results: Forty-four patients (30.9%) were delisted following clinical improvement. This percentage was higher than in the original study because of a number of patients being delisted long after starting DAAs. The median Child-Pugh and MELD score of delisted patients was 5.5 and 9 respectively. Four patients were relisted, because of HCC diagnosis in 1 case and 3 patients developed ascites. One further patient died (2.4%) because of rapidly progressing hepatocellular carcinoma twenty-two months after delisting. Of the 70 patients who received a liver graft, 9 died (13%). Conclusions: Antiviral therapy allows for a long-term improvement of liver function and the delisting of one-third of treated patients with risk of liver-related complications after delisting being very low.

Published
2018

33. The optimal timing of hepatitis C therapy in liver transplant-eligible patients: Cost-effectiveness analysis of new opportunities

Author

Cortesi, P, Belli, L, Facchetti, R, Mazzarelli, C, Perricone, G, De Nicola, S, Cesana, G, Duvoux, C, Mantovani, L, Strazzabosco, M, Cortesi, P. A., Belli, L. S., Facchetti, R., Mazzarelli, C., Perricone, G., De Nicola, S., Cesana, G., Duvoux, C., Mantovani, L. G., Strazzabosco, M., Cortesi, P, Belli, L, Facchetti, R, Mazzarelli, C, Perricone, G, De Nicola, S, Cesana, G, Duvoux, C, Mantovani, L, Strazzabosco, M, Cortesi, P. A., Belli, L. S., Facchetti, R., Mazzarelli, C., Perricone, G., De Nicola, S., Cesana, G., Duvoux, C., Mantovani, L. G., and Strazzabosco, M.

Abstract

Different strategies of DAAs treatment are currently possible both pre- and postliver transplantation (LT). Clinical and economic consequences of these strategies still need to be adequately investigated; this study aims at assessing their cost-effectiveness. A decision analytical model was created to simulate the progression of HCV-infected patients listed for decompensated cirrhosis (DCC) or for hepatocellular carcinoma (HCC). Three DAAs treatment strategies were compared: (i) a 12-week course of DAAs prior to transplantation (PRE-LT), (ii) a 4-week course of DAAs starting at the time of transplantation (PERI-LT) and (iii) a 12-week course of DAAs administered at disease recurrence (POST-LT). The population was substratified according to HCC presence and, in those without HCC, according to the MELD score at listing. Data on DAAs effectiveness were estimated using a cohort of patients still followed by 11 transplant centres of the European Liver and Intestine Transplant Association and by data available in the literature. In this study, PRE-LT treatment strategy was dominant for DCC patients with MELD<16 and cost-effective for those with MELD16-20, while POST-LT strategy emerged as cost-effective for DCC patients with MELD>20 and for those with HCC. Sensitivity analyses confirmed PRE-LT as the cost-effective strategy for patients with MELD≤20. In conclusion, PRE-LT treatment is cost-effective for patients with MELD≤20 without HCC, while treatments after LT are cost-effective in cirrhotic patients with MELD>20 and in those with HCC. It is worth reminding, though, that the final choice of a specific regimen at the patient level will have to be personalized based on clinical, social and transplant-related factors

Published
2018

34. High rates of 30-day mortality in patients with cirrhosis and COVID-19

Author

Iavarone, M, D'Ambrosio, R, Soria, A, Triolo, M, Pugliese, N, Del Poggio, P, Perricone, G, Massironi, S, Spinetti, A, Buscarini, E, Viganò, M, Carriero, C, Fagiuoli, S, Aghemo, A, Belli, L, Lucà, M, Pedaci, M, Rimondi, A, Rumi, M, Invernizzi, P, Bonfanti, P, Lampertico, P, Iavarone, Massimo, D'Ambrosio, Roberta, Soria, Alessandro, Triolo, Michela, Pugliese, Nicola, Del Poggio, Paolo, Perricone, Giovanni, Massironi, Sara, Spinetti, Angiola, Buscarini, Elisabetta, Viganò, Mauro, Carriero, Canio, Fagiuoli, Stefano, Aghemo, Alessio, Belli, Luca S, Lucà, Martina, Pedaci, Marianna, Rimondi, Alessandro, Rumi, Maria Grazia, Invernizzi, Pietro, Bonfanti, Paolo, Lampertico, Pietro, Iavarone, M, D'Ambrosio, R, Soria, A, Triolo, M, Pugliese, N, Del Poggio, P, Perricone, G, Massironi, S, Spinetti, A, Buscarini, E, Viganò, M, Carriero, C, Fagiuoli, S, Aghemo, A, Belli, L, Lucà, M, Pedaci, M, Rimondi, A, Rumi, M, Invernizzi, P, Bonfanti, P, Lampertico, P, Iavarone, Massimo, D'Ambrosio, Roberta, Soria, Alessandro, Triolo, Michela, Pugliese, Nicola, Del Poggio, Paolo, Perricone, Giovanni, Massironi, Sara, Spinetti, Angiola, Buscarini, Elisabetta, Viganò, Mauro, Carriero, Canio, Fagiuoli, Stefano, Aghemo, Alessio, Belli, Luca S, Lucà, Martina, Pedaci, Marianna, Rimondi, Alessandro, Rumi, Maria Grazia, Invernizzi, Pietro, Bonfanti, Paolo, and Lampertico, Pietro

Abstract

Background & Aims: Coronavirus disease 2019 (COVID-19) poses a major health threat to healthy individuals and those with comorbidities, but its impact on patients with cirrhosis is currently unknown. Herein, we aimed to evaluate the impact of COVID-19 on the clinical outcome of patients with cirrhosis. Methods: In this multicentre retrospective study, patients with cirrhosis and a confirmed severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection were enrolled between 1st and 31th March 2020. Clinical and biochemical data at diagnosis of COVID-19 and at the last outpatient visit were obtained through review of medical records. Results: Fifty patients with cirrhosis and confirmed SARS-CoV-2 infection were enrolled (age 67 years, 70% men, 38% virus-related, 52% previously compensated cirrhosis). At diagnosis, 64% of patients presented fever, 42% shortness of breath/polypnea, 22% encephalopathy, 96% needed hospitalization or a prolonged stay if already in hospital. Respiratory support was necessary in 71%, 52% received antivirals, 80% heparin. Serum albumin significantly decreased, while bilirubin, creatinine and prothrombin time significantly increased at COVID-19 diagnosis compared to last available data. The proportion of patients with a model for end-stage liver disease (MELD) score ≥15 increased from 13% to 26% (p = 0.037), acute-on-chronic liver failure and de novo acute liver injury occurred in 14 (28%) and 10 patients, respectively. Seventeen patients died after a median of 10 (4–13) days from COVID-19 diagnosis, with a 30-day-mortality rate of 34%. The severity of lung and liver (according to CLIF-C, CLIF-OF and MELD scores) diseases independently predicted mortality. In patients with cirrhosis, mortality was significantly higher in those with COVID-19 than in those hospitalized for bacterial infections. Conclusion: COVID-19 is associated with liver function deterioration and elevated mortality in patients with cirrhosis. Lay summary: Coronavirus

Published
2020

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

Author

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

Published
2020

36. Coronaviruses and Immunosuppressed Patients: The Facts During the Third Epidemic

Author

Merli, M, Perricone, G, Lauterio, A, Prosperi, M, Travi, G, Roselli, E, Petrò, L, De Carlis, L, Belli, L, Puoti, M, Merli, Marco, Perricone, Giovanni, Lauterio, Andrea, Prosperi, Manlio, Travi, Giovanna, Roselli, Elena, Petrò, Laura, De Carlis, Luciano, Belli, Luca, Puoti, Massimo, Merli, M, Perricone, G, Lauterio, A, Prosperi, M, Travi, G, Roselli, E, Petrò, L, De Carlis, L, Belli, L, Puoti, M, Merli, Marco, Perricone, Giovanni, Lauterio, Andrea, Prosperi, Manlio, Travi, Giovanna, Roselli, Elena, Petrò, Laura, De Carlis, Luciano, Belli, Luca, and Puoti, Massimo

Published
2020

37. Point of view of the Italians pediatric scientific societies about the pediatric care during the COVID-19 lockdown: What has changed and future prospects for restarting

Author

Lubrano, R., Villani, Andrea, Berrettini, S., Caione, Paolo, Chiara, A., Costantino, A., Formigari, R., Franzoni, E., Gattinara, G. C., Giustardi, A., La Marca, G., Lionetti, P., Lima, M., Maffei, C., Malamisura, M., Manzoni, G., Marseglia, G. L., Memeo, A., Mosca, F., Perricone, G., Peruzzi, L., Piacentini, G., Pozzobon, G., Riva, E., Tesoro, S., Zampino, Giuseppe, Zanetto, F., Zecca, M., Bloise, S., Villani A., Caione P., Zampino G. (ORCID:0000-0003-3865-3253), Lubrano, R., Villani, Andrea, Berrettini, S., Caione, Paolo, Chiara, A., Costantino, A., Formigari, R., Franzoni, E., Gattinara, G. C., Giustardi, A., La Marca, G., Lionetti, P., Lima, M., Maffei, C., Malamisura, M., Manzoni, G., Marseglia, G. L., Memeo, A., Mosca, F., Perricone, G., Peruzzi, L., Piacentini, G., Pozzobon, G., Riva, E., Tesoro, S., Zampino, Giuseppe, Zanetto, F., Zecca, M., Bloise, S., Villani A., Caione P., and Zampino G. (ORCID:0000-0003-3865-3253)

Abstract

Background: The coronavirus disease 2019 (COVID-19) is currently rare in children and they seem to have a milder disease course and better prognosis than adults. However, SARS-Cov-2 pandemic has indirectly caused problems in pediatric medical assistance. In view of this we wanted to draw a picture of what happened during health emergency and analyze future prospects for restarting. Methods: We involved the Italian pediatric scientific societies institutionally collected in the Italian Federation of Associations and Scientific Societies of the Pediatric Area (FIARPED); We sent a questionnaire to all scientific societies about the pediatric care activity during the COVID-19 emergency and future perspectives for the phase of post-containment. Results: The analysis of the questionnaires showed significant decrease of:admission, outpatient visits and specialist consultancy activities during the COVID-19 emergency, primarily linked to the fear of infection. Instead it was increased the serious degree of diseases admitted. Most of scientific societies maintained the relationship with chronic patients through some form of telemedicine, reporting a strong positive opinion about this modality. Finally showed the need to give life a new approach for hospitalizations and outpatient visits through a greater use of telemedicine, educational programs on families and a more decisive role of family pediatricians. Conclusions: Our study highlighted many aspects that can be improved in pediatric care. We think that It will be necessary a new shared strategy to improve the management and continuity of care for pediatric patients, primarily developing a network of collaboration between families, family pediatrician and hospitals and by enhancing the use of new methods of telecommunications.

Published
2020

39. Reply to: Correspondence on “High rates of 30-day mortality in patients with cirrhosis and COVID-19”

Author

Iavarone, Massimo, primary, D'Ambrosio, Roberta, additional, Lampertico, Pietro, additional, Iavarone, M., additional, D’Ambrosio, R., additional, Rimondi, A., additional, Lampertico, P., additional, Soria, A., additional, Bonfanti, P., additional, Triolo, M., additional, Fagiuoli, S., additional, Pugliese, N., additional, Aghemo, A., additional, Del Poggio, P., additional, Perricone, G., additional, Belli, L.S., additional, Massironi, S., additional, Lucà, M., additional, Invernizzi, P., additional, Spinetti, A., additional, Carriero, C., additional, Buscarini, E., additional, Pedaci, M., additional, Viganò, M., additional, and Rumi, M.G., additional

Published
2020
Full Text
View/download PDF

42. Sarcopenia in liver transplant candidates

Author

Mazzarelli, C., primary, Viganò, R., additional, Perricone, G., additional, Vangeli, M., additional, De Gasperi, A., additional, Mazza, E., additional, Prosperi, M., additional, Vanzulli, A., additional, Fusco, M., additional, Mariani, A., additional, Ferla, F., additional, De Carlis, L.G., additional, and Belli, L.S., additional

Published
2020
Full Text
View/download PDF

46. Common issues in the management of patients in the waiting list and after liver transplantation

Author

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

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

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

Published
2017

47. PRE-EMPTIVE POST-TRANSPLANT HCV TREATMENT WITH IFN-FREE DAA: PRELIMINARY RESULTS FROM A PILOT STUDY

Author

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

Published
2016

49. Impact of DAAs on liver transplantation: Major effects on the evolution of indications and results. An ELITA study based on the ELTR registry

Author

Belli, LS, Perricone, G, Adam, R, Cortesi, PA, Strazzabosco, M, Facchetti, R, Karam, V, Salizzoni, M, Andujar, RL, Fondevila, C, De Simone, P, Morelli, C, Fabregat-Prous, J, Samuel, D, Agarwaal, K, Gonzales, EM, Charco, R, Zieniewicz, K, De Carlis, L, Duvoux, C, and ELITA

Subjects
EtOH, Waiting list, HCV, HBV, NASH, digestive system diseases, Liver Transplantation
Abstract

Background & Aims: Direct-acting antivirals (DAAs) have dramatically improved the outcome of patients with hepatitis C virus (HCV) infection including those with decompensated cirrhosis (DC). We analyzed the evolution of indications and results of liver transplantation (LT) in the past 10 years in Europe, focusing on the changes induced by the advent of DAAs. Methods: This is a cohort study based on data from the European Liver Transplant Registry (ELTR). Data of adult LTs performed between January 2007 to June 2017 for HCV, hepatitis B virus (HBV), alcohol (EtOH) and non-alcoholic steatohepatitis (NASH) were analyzed. The period was divided into different eras: interferon (IFN/RBV; 2007-2010), protease inhibitor (PI; 2011-2013) and second generation DAA (DAA; 2014-June 2017). Results: Out of a total number of 60,527 LTs, 36,382 were performed in patients with HCV, HBV, EtOH and NASH. The percentage of LTs due to HCV-related liver disease varied significantly over time (p

Published
2018

Catalog

Books, media, physical & digital resources
See catalog results