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

Author

Perricone, Giovanni, Artzner, Thierry, De Martin, Eleonora, Jalan, Rajiv, Wendon, Julia, and Carbone, Marco

Subjects
Transplantation of organs, tissues, etc. -- Health aspects, Strategic planning (Business) -- Health aspects, Mortality -- United Kingdom -- Canada, Liver failure -- Health aspects, Liver cirrhosis -- Health aspects, Company business management, Health care industry
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., Author(s): Giovanni Perricone [sup.1], Thierry Artzner [sup.2], Eleonora De Martin [sup.3], Rajiv Jalan [sup.4] [sup.5], Julia Wendon [sup.6], Marco Carbone [sup.7] [sup.8] Author Affiliations: (1) Hepatology and Gastroenterology Unit, ASST [...]

Published
2023
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3. Arthroscopic Treatment of Hill-Sachs Lesions

Author

Franceschi, Francesco, de Sanctis, Edoardo Giovannetti, Perricone, Giovanni, Franceschetti, Edoardo, Milano, Giuseppe, editor, Grasso, Andrea, editor, Brzóska, Roman, editor, and Kovačič, Ladislav, editor

Published
2023
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5. SAT-025 “Early” vs “standard” liver transplantation in patients with severe alcoholic hepatitis

Author

Viganò, Raffaella, primary, Perricone, Giovanni, additional, Mazzarelli, Chiara, additional, Panariello, Adelaide, additional, Becchetti, Chiara, additional, Vangeli, Marcello, additional, Cucco, Monica, additional, Cesarini, Lucia, additional, Aprile, Francesca, additional, Luca’, Martina, additional, Dispienzieri, Giulia, additional, Roselli, Elena, additional, De Carlis, Luciano, additional, Airoldi, Aldo, additional, and Belli, Luca Saverio, additional

Published
2024
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6. FRI-171 Paediatric solid organ transplant recipients (SOTR) demonstrate greater serological response to initial SARS-CoV-2 vaccination than adult SOTR, and comparable rates of antibody degradation

Author

Ballester, María Pilar, primary, Laue, Tobias, additional, Meoli, Lilianeleny, additional, Uson, Eva, additional, Mutschler, Frauke, additional, Grabitz, Carl, additional, McLin, Valérie, additional, D'Antiga, Lorenzo, additional, Pujadas, Montserrat, additional, Carvalho-Gomes, Ângela, additional, Sahuco, Iván, additional, Bono, Ariadna, additional, D'Amico, Federico, additional, Viganò, Raffaella, additional, Sempere, Elena Diago, additional, Tormo, Beatriz, additional, Inglese, Elvira, additional, Martinez, Dani, additional, Riva, Antonio, additional, Sharma, Rajni, additional, Tsou, Hio Lam Phoebe, additional, Harris, Nicola, additional, Broekhoven, Annelotte, additional, Kikkert, Marjolein, additional, Morales, Shessy, additional, Myeni, Sebenzile, additional, Barciela, Mar Riveiro, additional, Palom, Adriana, additional, Zeni, Nicola, additional, Brocca, Alessandra, additional, Cussigh, Annarosa, additional, Cmet, Sara, additional, Escudero-García, Desamparados, additional, Stocco, Matteo, additional, Natola, Leonardo, additional, Ieluzzi, Donatella, additional, Paon, Veronica, additional, Sangiovanni, Angelo, additional, Farina, Elisa, additional, Benedetto, Clara Di, additional, Sanchez-Torrijos, Yolanda María, additional, Valera, Ana Lucena, additional, Roman, Eva, additional, Sanchez, Elisabet, additional, Sánchez-Aldehuelo, Rubén, additional, López-Cardona, Julia, additional, Canas-Perez, Itzel, additional, Jackson, Christine, additional, Jeyanesan, Dhaarica, additional, Morocho, Alejandro Esquivel, additional, Cola, Simone Di, additional, Lapenna, Lucia, additional, Zaccherini, Giacomo, additional, Bongiovanni, Deborah, additional, Zanaga, Paola, additional, Sayaf, Katia, additional, Hossain, Sabir, additional, Crespo, Javier, additional, Robles-Díaz, Mercedes, additional, Madejón, Antonio, additional, Degroote, Helena, additional, Fernández, Javier, additional, Korenjak, Marko, additional, Verhelst, Xavier, additional, Garcia-Samaniego, Francisco Javier, additional, Andrade, Raul J., additional, Iruzubieta, Paula, additional, Wright, Gavin, additional, Caraceni, Paolo, additional, Merli, Manuela, additional, Patel, Vishal C., additional, Gander, Amir, additional, Albillos, Agustín, additional, Soriano, German, additional, Donato, Maria Francesca, additional, Sacerdoti, David, additional, Toniutto, Pierluigi, additional, Buti, Maria, additional, Duvoux, Christophe, additional, Grossi, Paolo Antonio, additional, Berg, Thomas, additional, Polak, Wojciech, additional, Puoti, Massimo, additional, Bosch, Anna, additional, Belli, Luca Saverio, additional, Burra, Patrizia, additional, Russo, Francesco Paolo, additional, Coenraad, Minneke, additional, Panero, José Luis Calleja, additional, Perricone, Giovanni, additional, Chokshi, Shilpa, additional, Berenguer, Marina, additional, Clària, Joan, additional, Moreau, Richard, additional, Arroyo, Vicente, additional, Angeli, Paolo, additional, Sanchez, Cristina, additional, Ampuero, Javier, additional, Piano, Salvatore, additional, and Nicastro, Emanuele, additional

Published
2024
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7. THU-161 Hepatic sarcoidosis diagnosis and management: an italian multicenter study

Author

Corte, Cristina Della, primary, D'Amato, Daphne, additional, Rocchetti, Adele, additional, Viganò, Mauro, additional, Martini, Andrea, additional, Morelli, Maria Cristina, additional, Terracciani, Francesca, additional, Campigotto, Michele, additional, Pugliese, Nicola, additional, Giannini, Edoardo, additional, Simone, Loredana, additional, Malinverno, Federica, additional, Reati, Raffaella, additional, Degasperi, Elisabetta, additional, Federico, Alessandro, additional, Mangoni, Emanuele Durante, additional, Missale, Gabriele, additional, Svegliati-Baroni, Gianluca, additional, Morana, Ester, additional, Rapetti, Rachele, additional, Lorenzo, Surace, additional, Arena, Ilaria, additional, Cespiati, Annalisa, additional, Del Poggio, Paolo, additional, Germani, Giacomo, additional, Marin, Renato, additional, Federica, Mirici, additional, Rosaria, Piras Maria, additional, Perricone, Giovanni, additional, Sciarrone, Salvatore, additional, Rendina, Maria Grazia, additional, Strona, Silvia, additional, Giampaolo, Luca, additional, Montagnese, Sara, additional, Saibeni, Simone, additional, Manes, Giampiero, additional, and Carbone, Marco, additional

Published
2024
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8. SAT-034 Acute-on-chronic liver failure in severe acute alcoholic hepatitis: impact on management, prognostication, and urgency of liver transplantation

Author

Perricone, Giovanni, primary, Mazzarelli, Chiara, additional, Viganò, Raffaella, additional, Prandoni, Paola, additional, Vangeli, Marcello, additional, Aprile, Francesca, additional, Cucco, Monica, additional, Becchetti, Chiara, additional, Stigliano, Rosa, additional, Cesarini, Lucia, additional, Scaravaglio, MIki, additional, Monti, Gianpaola, additional, Lauterio, Andrea, additional, Airoldi, Aldo, additional, and Belli, Luca Saverio, additional

Published
2024
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9. OS-038-YI Real-world practice patterns on the use of terlipressin in patients with cirrhosis and acute kidney injury-results from the ICA-GLOBAL AKI study

Author

Ma, Ann Thu, primary, Juanola, Adrià, additional, Patidar, Kavish, additional, Barone, Anna, additional, Incicco, Simone, additional, Kulkarni, Anand, additional, Pérez-Hernández, José Luis, additional, Wentworth, Brian, additional, Asrani, Sumeet, additional, Alessandria, Carlo, additional, Abdelkader, Nadia Abdelaaty, additional, Wong, Yu Jun, additional, Xie, Qing, additional, Pyrsopoulos, Nikolaos T., additional, Kim, Sung-Eun, additional, Fouad, Yasser, additional, Torre, Aldo, additional, Reyes, Eira Cerda, additional, Diaz-Ferrer, Javier, additional, Maiwall, Rakhi, additional, Simonetto, Douglas, additional, Papp, Maria, additional, Orman, Eric, additional, Perricone, Giovanni, additional, Solé, Cristina, additional, Lange, Christian M., additional, Farias, Alberto, additional, Pereira, Gustavo, additional, Gadano, Adrian, additional, Caraceni, Paolo, additional, Thévenot, Thierry, additional, Verma, Nipun, additional, Kim, Jeong Han, additional, Vorobioff, Julio D., additional, Cordova-Gallardo, Jacqueline, additional, Ivashkin, Vladimir, additional, Roblero, Juan Pablo, additional, Maan, Raoel, additional, Toledo, Claudio, additional, Riggio, Oliviero, additional, Fassio, Eduardo, additional, Marino, Mónica, additional, Nabilou, Puria, additional, Vargas, Victor, additional, Merli, Manuela, additional, Goncalves, Luciana Lofego, additional, Rabinowich, Liane, additional, Krag, Aleksander, additional, Balcar, Lorenz, additional, Montes, Pedro, additional, Mattos, Angelo Z., additional, Bruns, Tony, additional, Nur, Abdulsemed Mohammed, additional, Laleman, Wim, additional, Estupiñan, Enrique Carrera, additional, Cabrera, Maria Cecilia, additional, Girala, Marcos, additional, Samant, Hrishikesh, additional, Raevens, Sarah, additional, Madaleno, Joao, additional, Kim, W. Ray, additional, Arab, Juan Pablo, additional, Presa, José, additional, Ferreira, Carlos Noronha, additional, Galante, Antonio, additional, Roux, Olivier, additional, Allegretti, Andrew S., additional, Takkenberg, R. Bart, additional, Harputluoglu, Murat, additional, Marciano, Sebastián, additional, Sarin, Shiv Kumar, additional, Ginès, Pere, additional, Angeli, Paolo, additional, Solà, Elsa, additional, and Piano, Salvatore, additional

Published
2024
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10. THU-092 Enrolling patients in ACLF trials-the need to increase ACLF awareness (DHELIVER trial)

Author

Thabut, Dominique, primary, Rudler, Marika, additional, Janczewska, Ewa, additional, van der Merwe, Schalk, additional, Nevens, Frederik, additional, Lannes, Adrien, additional, Lasser, Luc, additional, Reiberger, Thomas, additional, Brjalin, Vadim, additional, Pavlova, Desislava, additional, Selcanova, Svetlana Adamcova, additional, Katzarov, Krum, additional, Draganov, Ventseslav, additional, Collienne, Christine, additional, Bureau, Christophe, additional, Saviano, Antonio, additional, Toniutto, Pierluigi, additional, González, Javier Martínez, additional, Sánchez, Jordi, additional, Borissova, Julia, additional, Genov, Jordan, additional, Nikolov, Ivaylo, additional, Gustot, Thierry, additional, Pageaux, Georges-Philippe, additional, Antonini, Teresa, additional, Borentain, Patrick, additional, Leroy, Vincent, additional, Perricone, Giovanni, additional, Grønbæk, Henning, additional, Maasoumy, Benjamin, additional, Bruns, Tony, additional, Pukitis, Aldis, additional, Kupčinskas, Juozas, additional, Stardelova, Kalina Grivcheva, additional, Dimitrova, Magdalena Genadieva, additional, Todorovska, Beti, additional, Eggermont, Fabienne, additional, Vainilovich, Yelena, additional, Lin, Frederic, additional, Gordillo, Noelia, additional, Goddemaer, Griet, additional, Najimi, Mustapha, additional, and Sokal, Etienne, additional

Published
2024
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11. LBP-026 The global prospective observational study to evaluate the role of ‘liver transplantation in patients with cirrhosis and severe acuteon-chronic liver failure (CHANCE)’: study design, demographics and overall outcome

Author

Gustot, Thierry, primary, Bernal, William, additional, Fernández, Javier, additional, Diaz, Juan Manuel, additional, de la Peña-Ramirez, Carlos, additional, Farias, Alberto, additional, Zitelli, Patricia Momoyo, additional, Kuo, Alexander, additional, Nissen, Nicholas, additional, Marciano, Sebastián, additional, Gadano, Adrian, additional, Westbrook, Rachel, additional, Bateman, Rebecca, additional, Rammohan, Ashwin, additional, Jothimani, Dinesh, additional, Sudhindran, Surendran, additional, Valsan, Arun, additional, Ruiz, Pablo, additional, Pagano, Giulia, additional, Bagulho, Luis, additional, Marques, Hugo Pinto, additional, Belli, Luca Saverio, additional, Perricone, Giovanni, additional, Selzner, Nazia, additional, Tsien, Cynthia, additional, Gallegos-Orozco, Juan F., additional, Kemmer, Nyingi, additional, Dhanireddy, Kiran, additional, Mendizaba, Manuel, additional, Pages, Josefina, additional, Lindenmeyer, Christina, additional, Eghtesad, Bijan, additional, Lucidi, Valerio, additional, Elkrief, Laure, additional, Raszeja-Wyszomirska, Joanna, additional, Anders, Margarita, additional, Nadalin, Silvio, additional, Siniscalchi, Antonio, additional, Tosetti, Giulia, additional, Vinaixa, Carmen, additional, Kriss, Michael, additional, Jalal, Prasun, additional, Michard, Baptiste, additional, Angeli, Paolo, additional, Castro-Narro, Graciela, additional, Boudjema, Karim, additional, Shetty, Kirti, additional, den Hoed, Caroline, additional, Carone, Lívia, additional, Yilmaz, Sezai, additional, Mattos, Angelo Z., additional, Martin-Mateos, Rosa, additional, Brol, Maximilian Joseph, additional, Yoshizumi, Tomoharu, additional, Durand, Francois, additional, Radenne, Sylvie, additional, Te, Helen, additional, Campos-Varela, Isabel, additional, Laleman, Wim, additional, Ohira, Masahiro, additional, Eguchi, Susumu, additional, Engelmann, Cornelius, additional, Braun, Felix, additional, Sinclair, Marie, additional, Bedoya, José Ursic, additional, Loinaz, Carmelo, additional, Perera, Thamara, additional, Soin, Arvinder Singh, additional, Liu, Ken, additional, Raevens, Sarah, additional, Bishop, Rebecca, additional, Simpson, Kenneth J., additional, Akamatsu, Nobuhisa, additional, Chien, Yong Chee, additional, Berlakovich, Gabriela, additional, Zuluaga, Juan Ignacio Marin, additional, Stein, Lance, additional, Tokat, Yaman, additional, Hernaez, Ruben, additional, Duvoux, Christophe, additional, Saliba, Faouzi, additional, McCaughan, Geoff, additional, Fondevila, Constantino, additional, Pomfret, Elizabeth, additional, Rela, Mohamed, additional, Sundaram, Vinay, additional, Claria, Joan, additional, Arroyo, Vicente, additional, Valles, Foix, additional, Martínez, Jorge Carlos, additional, Izquierdo-Bueno, Pedro, additional, Samuel, Didier, additional, Berenguer, Marina, additional, Bosch, Anna, additional, Sanchez, Cristina, additional, Polak, Wojciech, additional, Karvellas, Constantine, additional, Trebicka, Jonel, additional, Moreau, Richard, additional, and Jalan, Rajiv, additional

Published
2024
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12. LBO-004 Excess waitlist mortality and survival benefit of liver transplantation for patients with severe acute-on-chronic liver failure: Interim results of the CHANCE study

Author

Gustot, Thierry, primary, Bernal, William, additional, Fernández, Javier, additional, Diaz, Juan Manuel, additional, de la Peña-Ramirez, Carlos, additional, Farias, Alberto, additional, Zitelli, Patricia Momoyo, additional, Kuo, Alexander, additional, Nissen, Nicholas, additional, Marciano, Sebastián, additional, Gadano, Adrian, additional, Westbrook, Rachel, additional, Bateman, Rebecca, additional, Rammohan, Ashwin, additional, Jothimani, Dinesh, additional, Sudhindran, S, additional, Valsan, Arun, additional, Ruiz, Pablo, additional, Pagano, Giulia, additional, Bagulho, Luis, additional, Marques, Hugo Pinto, additional, Belli, Luca Saverio, additional, Perricone, Giovanni, additional, Selzner, Nazia, additional, Tsien, Cynthia, additional, Gallegos-Orozco, Juan F., additional, Kemmer, Nyingi, additional, Dhanireddy, Kiran, additional, Mendizabal, Manuel, additional, Pages, Josefina, additional, Lindenmeyer, Christina, additional, Eghtesad, Bijan, additional, Putignano, Antonella, additional, Elkrief, Laure, additional, Raszeja-Wyszomirska, Joanna, additional, Anders, Margarita, additional, Nadalin, Silvio, additional, Siniscalchi, Antonio, additional, Tosetti, Giulia, additional, Vinaixa, Carmen, additional, Kriss, Michael, additional, Jalal, Prasun, additional, Michard, Baptiste, additional, Angeli, Paolo, additional, Castro-Narro, Graciela, additional, Boudjema, Karim, additional, Shetty, Kirti, additional, den Hoed, Caroline, additional, Carone, Lívia, additional, Yilmaz, Sezai, additional, Zanotelli, Maria Lúcia, additional, Martin-Mateos, Rosa, additional, Brol, Maximilian Joseph, additional, Yoshizumi, Tomoharu, additional, Durand, Francois, additional, Radenne, Sylvie, additional, Te, Helen, additional, Campos-Varela, Isabel, additional, Laleman, Wim, additional, Ohira, Masahiro, additional, Eguchi, Susumu, additional, Engelmann, Cornelius, additional, Karvellas, Constantine, additional, Braun, Felix, additional, Sinclair, Marie, additional, Bedoya, José Ursic, additional, Loinaz, Carmelo, additional, Perera, Thamara, additional, Soin, Arvinder Singh, additional, Liu, Ken, additional, Raevens, Sarah, additional, Bishop, Rebecca, additional, Simpson, Kenneth J., additional, Akamatsu, Nobuhisa, additional, Chien, Yong Chee, additional, Berlakovich, Gabriela, additional, Zuluaga, Juan Ignacio Marin, additional, Stein, Lance, additional, Hernaez, Ruben, additional, Duvoux, Christophe, additional, Saliba, Faouzi, additional, Fondevila, Constantino, additional, McCaughan, Geoff, additional, Tokat, Yaman, additional, Pomfret, Elizabeth, additional, Rela, Mohamed, additional, Sundaram, Vinay, additional, Claria, Joan, additional, Arroyo, Vicente, additional, Valles, Foix, additional, Martínez, Jorge Carlos, additional, Izquierdo-Bueno, Pedro, additional, Samuel, Didier, additional, Berenguer, Marina, additional, Bosch, Anna, additional, Sanchez, Cristina, additional, Polak, Wojciech, additional, Trebicka, Jonel, additional, Moreau, Richard, additional, and Jalan, Rajiv, additional

Published
2024
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13. Transjugular intrahepatic portosystemic shunt in patients with splanchnic vein thrombosis: Prevalence and management of patent foramen ovale.

Author

Becchetti, Chiara, De Nicola, Stella, Gallo, Camilla, Perricone, Giovanni, Annoni, Giuseppe, Solcia, Marco, Musca, Francesco, Alfonsi, Angela, Morelli, Francesco, Barbosa, Fabiane, Brambillasca, Pietro M., Rampoldi, Antonio, Airoldi, Aldo, and Belli, Luca S.

Subjects
TRANSIENT ischemic attack, PATENT foramen ovale, PATIENT portals, PARADOXICAL embolism, PATIENT experience
Abstract

Background and Aims: Transjugular intrahepatic portosystemic shunt (TIPS) is an established procedure for the treatment of several complications of portal hypertension (PH), including non‐neoplastic portal vein thrombosis (PVT). Selection criteria for TIPS in PVT are not yet well established. Despite anecdotal, cases of thromboembolic events from paradoxical embolism due to the presence of patent foramen ovale (PFO) after TIPS placement have been reported in the literature. Therefore, we aimed at describing our experience in patients with non‐neoplastic splanchnic vein thrombosis (SVT) who underwent TIPS following PFO screening. Methods: We conducted a single‐centre retrospective study, including consecutive patients who underwent TIPS for the complications of cirrhotic and non‐cirrhotic portal hypertension (NCPH) and having SVT. Results: Of 100 TIPS placed in patients with SVT, 85 patients were screened for PFO by bubble‐contrast transthoracic echocardiography (TTE) with PFO being detected in 22 (26%) cases. PFO was more frequently detected in patients with non‐cirrhotic portal hypertension (NCPH) (23% in the PFO group vs. 6% in those without PFO, p =.04) and cavernomatosis (46% in the PFO group vs. 19% in those without PFO, p =.008). Percutaneous closure was effectively performed in 11 (50%) after multidisciplinary evaluation of anatomical and clinical features. No major complications were observed following closure. Conclusions: PFO screening and treatment may be considered feasible for patients with SVT who undergo TIPS placement. [ABSTRACT FROM AUTHOR]

Published
2024
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14. 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, 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-Fontenla, 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 G., Polak, Wojciech G., and Duvoux, Christophe

Published
2021
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18. Development and Validation of a Scoring System That Includes Corrected QT Interval for Risk Analysis of Patients With Cirrhosis and Gastrointestinal Bleeding

Author

Biselli, Maurizio, Gramenzi, Annagiulia, Lenzi, Barbara, Dall’Agata, Marco, Pierro, Monica Loreta, Perricone, Giovanni, Tonon, Marta, Bellettato, Luca, D’Amico, Gennaro, Angeli, Paolo, Boffelli, Silvia, Bonavita, Maria Elena, Domenicali, Marco, Caraceni, Paolo, Bernardi, Mauro, and Trevisani, Franco

Published
2019
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19. 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, Luca Saverio, Perricone, Giovanni, Adam, Rene, Cortesi, Paolo A., Strazzabosco, Mario, Facchetti, Rita, Karam, Vincent, Salizzoni, Mauro, Andujar, Rafael Lopez, Fondevila, Costantino, De Simone, Paolo, Morelli, Cristina, Fabregat-Prous, Joan, Samuel, Didier, Agarwaal, Kosh, Moreno Gonzales, Enrique, Charco, Ramon, Zieniewicz, Krzysztof, De Carlis, Luciano, and Duvoux, Christophe

Published
2018
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22. Location and allocation

Author

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, Surgery, Gastroenterology & Hepatology, Intensive Care, Biomatériaux et Bioingénierie (BB), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS), Laboratoire des sciences de l'ingénieur, de l'informatique et de l'imagerie (ICube), École Nationale du Génie de l'Eau et de l'Environnement de Strasbourg (ENGEES)-Université de Strasbourg (UNISTRA)-Institut National des Sciences Appliquées - Strasbourg (INSA Strasbourg), Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de Recherche en Informatique et en Automatique (Inria)-Les Hôpitaux Universitaires de Strasbourg (HUS)-Centre National de la Recherche Scientifique (CNRS)-Matériaux et Nanosciences Grand-Est (MNGE), Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut de Chimie du CNRS (INC)-Centre National de la Recherche Scientifique (CNRS)-Réseau nanophotonique et optique, Université de Strasbourg (UNISTRA)-Université de Haute-Alsace (UHA) Mulhouse - Colmar (Université de Haute-Alsace (UHA))-Centre National de la Recherche Scientifique (CNRS)-Université de Strasbourg (UNISTRA)-Centre National de la Recherche Scientifique (CNRS), Interface de Recherche Fondamentale et Appliquée en Cancérologie (IRFAC - Inserm U1113), Université de Strasbourg (UNISTRA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Centre Paul Strauss : Centre Régional de Lutte contre le Cancer (CRLCC)-Fédération de Médecine Translationelle de Strasbourg (FMTS), Mitochondrie, stress oxydant et protection musculaire (MSP), Université de Strasbourg (UNISTRA), the ELITA/EF-CLIF Working Group, 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, and Agarwal, B

Subjects
Transplantation, ILL CIRRHOTIC-PATIENTS, Liver transplantation, Hepatology, Intensive care, Waiting list, Surgery, Acute-on-Chronic Liver Failure, [SDV.MHEP]Life Sciences [q-bio]/Human health and pathology
Abstract

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 patients with ACLF-3 across transplantation centers in Europe. 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. A total of 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 patients with ACLF-3 admitted to the ICU and the number listed or transplanted while in ACLF-3 across centers. By contrast, there was a correlation between the number of patients listed and the number transplanted while in ACLF-3. About 21% of patients who were listed while in ACLF-3 died on the waiting list or were delisted. The percentage of LT for patients with ACLF-3 varied from 0% to 29% for those transplanted with decompensated cirrhosis across centers (average = 8%), with an I(2) index of 68% (95% confidence interval, 49%-80%), showing substantial heterogeneity among centers. The 1-year survival for all patients with ACLF-3 was significantly higher in centers that listed and transplanted more patients with ACLF-3 (>10 patients) than in centers that listed and transplanted fewer: 36% versus 20%, respectively (p = 0.012). Patients with ACLF-3 face inequity of access to LT across Europe. Waitlisting strategies for patients with ACLF-3 influence their access to LT and, ultimately, their survival.

Published
2022

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

Author

Cortesi, Paolo Angelo, Viganò, Raffaella, Conti, Sara, Lenci, Ilaria, Volpes, Riccardo, Martini, Silvia, Angelico, Mario, Fung, James, Buti, Maria, Coilly, Audrey, Durand, Francois, Fondevila, Constantino, Lebray, Pascal, Nevens, Frederik, Polak, Wojciech G., Rizzetto, Mario, Zoulim, Fabien, Perricone, Giovanni, Berenguer, Marina, Mantovani, Lorenzo Giovanni, Duvoux, Christophe, Belli, Luca Saverio, Cortesi, Paolo Angelo, Viganò, Raffaella, Conti, Sara, Lenci, Ilaria, Volpes, Riccardo, Martini, Silvia, Angelico, Mario, Fung, James, Buti, Maria, Coilly, Audrey, Durand, Francois, Fondevila, Constantino, Lebray, Pascal, Nevens, Frederik, Polak, Wojciech G., Rizzetto, Mario, Zoulim, Fabien, Perricone, Giovanni, Berenguer, Marina, Mantovani, Lorenzo Giovanni, Duvoux, Christophe, and Belli, Luca Saverio

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

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

Author

Cortesi, Paolo Angelo, primary, Viganò, Raffaella, additional, Conti, Sara, additional, Lenci, Ilaria, additional, Volpes, Riccardo, additional, Martini, Silvia, additional, Angelico, Mario, additional, Fung, James, additional, Buti, Maria, additional, Coilly, Audrey, additional, Durand, Francois, additional, Fondevila, Constantino, additional, Lebray, Pascal, additional, Nevens, Frederik, additional, Polak, Wojciech G., additional, Rizzetto, Mario, additional, Zoulim, Fabien, additional, Perricone, Giovanni, additional, Berenguer, Marina, additional, Mantovani, Lorenzo Giovanni, additional, Duvoux, Christophe, additional, and Belli, Luca Saverio, additional

Published
2023
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27. COVID-19 in liver transplant candidates

Author

Belli, Luca Saverio, Duvoux, Christophe, Cortesi, Paolo Angelo, Facchetti, Rita, Iacob, Speranta, Perricone, Giovanni, Radenne, Sylvie, Conti, Sara, Patrono, Damiano, Berlakovich, Gabriela, Hann, Angus, Pasulo, Luisa, Castells, Lluis, Faitot, Francois, Detry, Olivier, Invernizzi, Federica, Magini, Giulia, De Simone, Paolo, Kounis, Ilias, Morelli, Maria Cristina, Díaz Fontenla, Fernando, Ericzon, Bo-Göran, Loinaz, Carmelo, Johnston, Chris, Gheorghe, Liliana, Lesurtel, Mickael, Romagnoli, Renato, Kollmann, Dagmar, Perera, M Thamara Pr, Fagiuoli, Stefano, Mirza, Darius, Coilly, Audrey, Toso, Christian, Zieniewicz, Krzysztof, Elkrief, Laure, Karam, Vincent, Adam, Rene, den Hoed, Caroline, Merli, Marco, Puoti, Massimo, De Carlis, Luciano, Oniscu, Gabriel C, Piano, Salvatore, Angeli, Paolo, Fondevila, Constantino, Polak, Wojciech G, ELITA-ELTR COVID-19 Registry, Gastroenterology & Hepatology, Surgery, 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, and Polak, W

Subjects
0301 basic medicine, Male, medicine.medical_specialty, Waiting Lists, medicine.medical_treatment, liver cirrhosis, Pneumonia, Viral, Population, Liver transplantation, 03 medical and health sciences, Liver disease, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Risk Factors, Internal medicine, Cause of Death, Medicine, Humans, Viral, Registries, education, Cause of death, education.field_of_study, ddc:617, liver transplantation, liver cirrhosi, Proportional hazards model, business.industry, SARS-CoV-2, Gastroenterology, COVID-19, Pneumonia, Middle Aged, medicine.disease, Transplant Recipients, Transplantation, Europe, 030104 developmental biology, Respiratory failure, Liver cirrhosis, 030211 gastroenterology & hepatology, Female, Liver Transplantation, business, Cohort study
Abstract

ObjectiveExplore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course.DesignData from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed.ResultsFrom 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).ConclusionsIncreased 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

28. Delisting of Liver Transplant Candidates with Chronic HCV Infection after Viral Erradication: Outcome 2 Years after Delisting. A European Study

Author

Vinaixa, Carmen, Belli, Luca Saverio, Berenguer, Marina, Cortesi, Pablo, Strazzabosco, Mario, Faccheti, Rita, Rockenschaub, Susanne-Rasoul, Martini, Silvia, Morelli, Cristina, Donato, Francesca, Volpes, Ricardo, Pasulo, Luisa, Pageaux, Georges-Philippe, Coilly, Audrey, Perricone, Giovanni, Mazzarelli, Chiara, Di Nicola, Stella, Berlakovich, Gabriela, and Duvuox, Christophe

Published
2018
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29. TOP-064-YI Impact of bacterial infections on kidney function and survival in patients with decompensated cirrhosis and acute kidney injury worldwide-analysis of the ICA-GLOBAL AKI study

Author

Juanola, Adrià, Patidar, Kavish, Thu Ma, Ann, Barone, Anna, Incicco, Simone, Kulkarni, Anand, Luis Pérez-Hernández, José, Wentworth, Brian, Asrani, Sumeet, Alessandria, Carlo, Abdelaaty Abdelkader, Nadia, Jun Wong, Yu, Xie, Qing, Pyrsopoulos, Nikolaos T., Kim, Sung-Eun, Fouad, Yasser, Torre, Aldo, Cerda Reyes, Eira, Diaz-Ferrer, Javier, Maiwall, Rakhi, Simonetto, Douglas, Papp, Maria, Orman, Eric, Perricone, Giovanni, Sole, Cristina, Lange, Christian M., Farias, Alberto, Pereira, Gustavo, Gadano, Adrian, Caraceni, Paolo, Weil-Verhoeven, Delphine, Verma, Nipun, Han Kim, Jeong, Vorobioff, Julio D., Cordova-Gallardo, Jacqueline, Ivashkin, Vladimir, Pablo Roblero, Juan, Maan, Raoel, Toledo, Claudio, Riggio, Oliviero, Fassio, Eduardo, Marino, Mónica, Nabilou, Puria, Vargas, Victor, Merli, Manuela, Lofego Goncalves, Luciana, Rabinowich, Liane, Krag, Aleksander, Balcar, Lorenz, Montes, Pedro, Mattos, Angelo Z., Bruns, Tony, Mohammed Nur, Abdulsemed, Laleman, Wim, Carrera Estupiñan, Enrique, Cecilia Cabrera, Maria, Girala, Marcos, Samant, Hrishikesh, Raevens, Sarah, Madaleno, Joao, Ray Kim, W., Pablo Arab, Juan, Presa, José, Noronha Ferreira, Carlos, Galante, Antonio, Francoz, Claire, Allegretti, Andrew S., Bart Takkenberg, R., Harputluoglu, Murat, Marciano, Sebastián, Kumar Sarin, Shiv, Ginès, Pere, Angeli, Paolo, Sola, Elsa, and Piano, Salvatore

Published
2024
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30. TOP-062 Global epidemiology of acute kidney injury in hospitalized patients with cirrhosis: the ICA-GLOBAL AKI study

Author

Patidar, Kavish, Thu Ma, Ann, Juanola, Adrià, Barone, Anna, Incicco, Simone, Kulkarni, Anand, Luis Pérez-Hernàndez, José, Wentworth, Brian, Asrani, Sumeet, Alessandria, Carlo, Abdelaaty Abdelkader, Nadia, Jun Wong, Yu, Xie, Qing, Pyrsopoulos, Nikolaos T., Kim, Sung-Eun, Fouad, Yasser, Torre, Aldo, Cerda Reyes, Eira, Diaz-Ferrer, Javier, Maiwall, Rakhi, Simonetto, Douglas, Papp, Maria, Orman, Eric, Perricone, Giovanni, Sole, Cristina, Lange, Christian M., Farias, Alberto, Pereira, Gustavo, Gadano, Adrian, Caraceni, Paolo, Thevenot, Thierry, Verma, Nipun, Han Kim, Jeong, Vorobioff, Julio D., Cordova-Gallardo, Jacqueline, Ivashkin, Vladimir, Pablo Roblero, Juan, Maan, Raoel, Toledo, Claudio, Riggio, Oliviero, Fassio, Eduardo, Marino, Monica, Nabilou, Puria, Vargas, Victor, Merli, Manuela, Lofego Goncalves, Luciana, Rabinowich, Liane, Krag, Aleksander, Balcar, Lorenz, Montes, Pedro, Mattos, Angelo Z., Bruns, Tony, Mohammed Nur, Abdulsemed, Laleman, Wim, Carrera Estupiñan, Enrique, Cecilia Cabrera, Maria, Girala, Marcos, Samant, Hrishikesh, Raevens, Sarah, Madaleno, Joao, Ray Kim, W., Pablo Arab, Juan, Presa, José, Noronha Ferreira, Carlos, Galante, Antonio, Allegretti, Andrew S., Bart Takkenberg, R., Harputluoglu, Murat, Marciano, Sebastián, Kumar Sarin, Shiv, Ginès, Pere, Durand, François, Angeli, Paolo, Solà, Elsa, and Piano, Salvatore

Published
2024
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31. 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

32. The impact of infection by multidrug‐resistant agents in patients with cirrhosis. A multicenter prospective study

Author

Salerno, Francesco, Borzio, Mauro, Pedicino, Claudia, Simonetti, Rosa, Rossini, Angelo, Boccia, Sergio, Cacciola, Irene, Burroughs, Andrew K., Manini, Matteo A., La Mura, Vincenzo, Angeli, Paolo, Bernardi, Mauro, Dalla Gasperina, Daniela, Dionigi, Elena, Dibenedetto, Clara, Arghittu, Milena, Francavilla, Antonio, Trevisani, Franco, Salmi, Andrea, Fatuzzo, Filippo, Arvaniti, Vassiliki, Cambieri, Patrizia, Raguzzi, Ivana, Aghemo, Alessio, Trotta, Elisa, Cottone, Mario, Perricone, Giovanni, Giusti, Massimo, Cazzaniga, Massimo, Gobbo, Giulia, Monti, Valentina, Tejada, Milvana, Costa, Elena, Andriulli, Angelo, and Grossi, Paolo

Published
2017
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34. Successful recovery from severe inverted Takotsubo cardiomyopathy after liver transplantation: the efficacy of extracorporeal membrane oxygenation (ECMO)

Author

LAUTERIO, Andrea, primary, BOTTIROLI, Maurizio, additional, CANNATA, Aldo, additional, DE CARLIS, Riccardo, additional, VALSECCHI, Mila, additional, PERRICONE, Giovanni, additional, COLOMBO, Stefania, additional, BUSCEMI, Vincenzo, additional, ZANIBONI, Matteo, additional, PEDRAZZINI, Giovanna, additional, MONDINO, Michele, additional, RUSSO, Claudio, additional, FUMAGALLI, Roberto, additional, and DE CARLIS, Luciano, additional

Published
2022
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36. Performance of the model for end-stage liver disease score for mortality prediction and the potential role of etiology

Author

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

Published
2021
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37. Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: Results of the ELITA/EF-CLIF collaborative study (ECLIS)

Author

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

Published
2021
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41. Location and allocation: Inequity of access to liver transplantation for patients with severe acute‐on‐chronic liver failure in Europe.

Author

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, and Iegri, Claudia

Published
2022
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43. 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

44. 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

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

Author

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, François, 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, 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, François, 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, and Jalan, Rajiv

Abstract

Background & Aims: Liver transplantation (LT) has been proposed as an effective salvage therapy even for the sickest patients with acute-on-chronic liver failure (ACLF). This large collaborative study was designed to assess the current clinical practice and outcomes of patients with ACLF who are wait-listed for LT in Europe. Methods: This was a retrospective study including 308 consecutive patients with ACLF, listed in 20 centres across 8 European countries, from January 2018 to June 2019. Results: A total of 2,677 patients received a LT: 1,216 (45.4%) for decompensated cirrhosis. Of these, 234 (19.2%) had ACLF at LT: 58 (4.8%) had ACLF-1, 78 (6.4%) had ACLF-2, and 98 (8.1%) had ACLF-3. Wide variations were observed amongst countries: France and Germany had high rates of ACLF-2/3 (27–41%); Italy, Switzerland, Poland and the Netherlands had medium rates (9–15%); and the United Kingdom and Spain had low rates (3–5%) (p <0.0001). The 1-year probability of survival after LT for patients with ACLF was 81% (95% CI 74–87). Pre-LT arterial lactate levels >4 mmol/L (hazard ratio [HR] 3.14; 95% CI 1.37–7.19), recent infection from multidrug 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 waiting list. In an intention-to-treat analysis, 1-year survival of patients with ACLF on the LT waiting list was 73% for ACLF-1 or -2 and 50% for ACLF-3. Conclusion: The results reveal wide variations in the listing of patients with ACLF in Europe despite favourable post-LT survival. Risk factors for mortality were identified, enabling a more precise prognostic assessment of patients with ACLF. 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 t

Published
2021

46. 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

47. 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, 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-Fontenla, 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 G., Polak, Wojciech G., Duvoux, Christophe, 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-Fontenla, 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 G., 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 1 and June 27, 2020, 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 of 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 percent 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

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

Author

Belli, Luca Saverio, Duvoux, Christophe, Cortesi, Paolo Angelo, Facchetti, Rita, Iacob, Speranta, Perricone, Giovanni, Radenne, Sylvie, Conti, Sara, Patrono, Damiano, Berlakovich, Gabriela, Hann, Angus, Pasulo, Luisa, Castells, Lluis, Faitot, Francois, Detry, Olivier, Invernizzi, Federica, Magini, Giulia, De Simone, Paolo, Kounis, Ilias, Morelli, Maria Cristina, Diáz Fontenla, Fernando, Ericzon, Bo Göran, Loinaz, Carmelo, Johnston, Chris, Gheorghe, Liliana, Lesurtel, Mickael, Romagnoli, Renato, Kollmann, Dagmar, Perera, M. Thamara P.R., Fagiuoli, Stefano, Mirza, Darius, Coilly, Audrey, Toso, Christian, Zieniewicz, Krzysztof, Elkrief, Laure, Karam, Vincent, Adam, Rene, Den Hoed, Caroline, Merli, Marco, Puoti, Massimo, De Carlis, Luciano, Oniscu, Gabriel C., Piano, Salvatore, Angeli, Paolo, Fondevila, Constantino, Polak, Wojciech G., Belli, Luca Saverio, Duvoux, Christophe, Cortesi, Paolo Angelo, Facchetti, Rita, Iacob, Speranta, Perricone, Giovanni, Radenne, Sylvie, Conti, Sara, Patrono, Damiano, Berlakovich, Gabriela, Hann, Angus, Pasulo, Luisa, Castells, Lluis, Faitot, Francois, Detry, Olivier, Invernizzi, Federica, Magini, Giulia, De Simone, Paolo, Kounis, Ilias, Morelli, Maria Cristina, Diáz Fontenla, Fernando, Ericzon, Bo Göran, Loinaz, Carmelo, Johnston, Chris, Gheorghe, Liliana, Lesurtel, Mickael, Romagnoli, Renato, Kollmann, Dagmar, Perera, M. Thamara P.R., Fagiuoli, Stefano, Mirza, Darius, Coilly, Audrey, Toso, Christian, Zieniewicz, Krzysztof, Elkrief, Laure, Karam, Vincent, Adam, Rene, Den Hoed, Caroline, Merli, Marco, Puoti, Massimo, De Carlis, Luciano, Oniscu, Gabriel C., Piano, Salvatore, Angeli, Paolo, Fondevila, Constantino, and Polak, Wojciech 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

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