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9. P.04.19 PREVALENCE OF EXTRAPANCREATIC MALIGNANCIES AMONG PATIENTS WITH INTRADUCTAL PAPILLARY MUCINOUS NEOPLASMS OF PANCREAS (IPMNS)

Author

Panic, N., primary, Bulajic, M., additional, Macchini, F., additional, Solito, S., additional, Berretti, D., additional, Pevere, S., additional, Di Prampero, S.F. Vadalà, additional, Marino, M., additional, Boccia, S., additional, Leoncini, E., additional, Zucchi, E., additional, Pinese, E., additional, Scardino, G., additional, and Zilli, M., additional

Published
2018
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10. Natural leukocyte interferon alfa for the treatment of chronic viral hepatitis in heart transplant recipients. Transplantation

Author

Fagiuoli, S, Pevere, S, Minniti, F, Livi, U, Caforio, A, Naccarato, R, Chiaramonte, M, FAGIUOLI S, PEVERE S, MINNITI F, LIVI U, CAFORIO AL, NACCARATO R, CHIARAMONTE M, Fagiuoli, S, Pevere, S, Minniti, F, Livi, U, Caforio, A, Naccarato, R, Chiaramonte, M, FAGIUOLI S, PEVERE S, MINNITI F, LIVI U, CAFORIO AL, NACCARATO R, and CHIARAMONTE M

Abstract

Background. A more rapid and aggressive course of hepatitis B virus (HBV)-related and hepatitis C virus (HCV)-related infection in organ transplant recipients has been described. Interferon alfa is the most accepted drug for treating HBV and HCV chronic infections. However, the use of interferon alfa-N3 has been contraindicated in heart transplant (HTx) recipients because of the hypothesized greater risk of triggering acute cellular rejection. The aim of this clinical pilot study was to evaluate tolerability, safety, and efficacy of natural leukocyte interferon alfa in the treatment of chronic HBV and HCV in HTx recipients. Methods. Seven HTx recipients were enrolled in the study: two with HBV, four with HCV, and one with combined HBV-HCV chronic infection. The patients had a mean follow-up after heart transplantation of 8.5±3 years, before starting interferon alfa-N3 treatment at a dose of 6 MU three times per week, intramuscularly for 12 months. Results. All patients completed the treatment with no major side effects. No unexpected episodes of acute cellular rejection were observed during the treatment. Mean aminotransferase serum levels were significantly lower than before transplantation at 3 (P<0.03), 6 (P<0.02), and 12 (P<0.02) months of treatment and at the 12-month follow-up (P<0.02). A complete and sustained response was achieved in all subjects with HBV-related chronic hepatitis, whereas sustained virologic response was observed in one of four HCV patients. Conclusions. The preliminary data emerging from our study indicate that natural leukocyte interferon alfa-N3 can be safely administered in HTx recipients with chronic HBV or HCV viral hepatitis. Further studies with larger numbers of patients are needed to assess the efficacy of interferon alfa-N3 on HCV virologic response.

Published
2003

11. HCV in pazienti immunosoppressi

Author

Minniti, F, Pevere, S, Graziotto, A, Fagiuoli, S, MINNITI F, PEVERE S, GRAZIOTTO A, FAGIUOLI S, Minniti, F, Pevere, S, Graziotto, A, Fagiuoli, S, MINNITI F, PEVERE S, GRAZIOTTO A, and FAGIUOLI S

Published
2001

13. HBV and HCV infections in heart transplant recipients

Author

Fagiuoli, S, Minniti, F, Pevere, S, Farinati, F, Burra, P, Livi, U, Naccarato, R, Chiaramonte, M, FAGIUOLI S, MINNITI F, PEVERE S, FARINATI F, BURRA P, LIVI U, NACCARATO R, CHIARAMONTE M, Fagiuoli, S, Minniti, F, Pevere, S, Farinati, F, Burra, P, Livi, U, Naccarato, R, Chiaramonte, M, FAGIUOLI S, MINNITI F, PEVERE S, FARINATI F, BURRA P, LIVI U, NACCARATO R, and CHIARAMONTE M

Abstract

Background. Heart transplant (HTx) recipients risk acquiring hepatotropic viral infections such as hepatitis B virus (HBV) and hepatitis C virus (HCV), and the impact of these infections on post-HTx survival remains unclear. The aim of the present study was to define the prevalence, clinical features, and natural history of HBV and HCV infections in a cohort of HTx recipients. Methods. We retrospectively studied 360 consecutive patients who had undergone HTx. Clinical picture, hepatic injury indexes, and HBV/HCV viral serology were followed post-transplant. Results. During follow-up (average, 8 ± 3.1 years), 49 (16.5%) of the HTx recipients tested positive for at least 1 of the 2 viruses (3.1% HBV, 12% HCV, 0.5% concomitant infection). The prevalence of HCV infection in heart transplant recipients transplanted before and after 1990 was 28% and 4.2%, respectively, the latter being markedly lower (p < 0.001) than in earlier series of HTx recipients and much lower than expected in the age- and sex-matched general population. All HBV-positive and 58% of HCV-positive recipients developed chronic liver disease. Sixteen percent of patients developed cirrhosis during follow-up, and 8% died of end-stage liver disease. Conclusions. The prevalence of HBV and HCV in a large population of HTx recipients is not very different from that reported in the general population. Active viral replication of HBV and an aggressive natural history of both infections are seen in HTx recipients, however. The low prevalence of HBV- and HCV-related infection in recent series probably reflects current viral screening and vaccination policies.

Published
2001

14. Liver transplantation for Wilson's disease: The burden of neurological and psychiatric disorders

Author

Medici V, Mirante VG, Fassati LR, Pompili M, Forti D, Trevisan CP, Cillo U, Sturniolo GC, Fagiuoli S, Andriulli A, Angelico M, Aresu G, Burra P, Caccamo L, Castagneto M, D'Amico DF, Dardano G, Filla A, Gasbarrini A, Gasbarrini G, Gianni S, Grazi GL, Martines D, Marzano A, Melada E, Nardo B, Pevere S, Rapaccini GL, Rizzetto M, Rondinara GF, Salizzoni M, Slim AO, Strazzabosco M, Tisone G, Valente U, Zanus G, Monotematica AISF 2000 OLT Study Group, DEL GAUDIO, MASSIMO, Medici V, Mirante VG, Fassati LR, Pompili M, Forti D, Del Gaudio M, Trevisan CP, Cillo U, Sturniolo GC, Fagiuoli S, Andriulli A, Angelico M, Aresu G, Burra P, Caccamo L, Castagneto M, D'Amico DF, Dardano G, Filla A, Gasbarrini A, Gasbarrini G, Gianni S, Grazi GL, Martines D, Marzano A, Melada E, Nardo B, Pevere S, Rapaccini GL, Rizzetto M, Rondinara GF, Salizzoni M, Slim AO, Strazzabosco M, Tisone G, Valente U, Zanus G, and Monotematica AISF 2000 OLT Study Group.

Subjects
surgical procedures, operative, wilson's disease, LIVER TRANSPLANTATION
Abstract

A retrospective data analysis on liver transplantation for Wilson's disease (WD) was performed among Italian Liver Transplant Centers. Thirty-seven cases were identified. The main indication for liver transplantation was chronic advanced liver disease in 78% of patients. Mixed hepatic and neuropsychiatric symptoms were recorded in 32.3%. Eight patients presented with fulminant liver failure; 44.8% were on medical treatment. Patient and graft survival at 3 months, 12 months, 3 years, 5 years, and 10 years after transplantation were, respectively, 91.8%, 89.1%, 82.9%, 75.6%, and 58.8%, and 85.3%, 83.0%, 77.1%, 70.3%, and 47.2%. Neurological symptoms significantly improved after orthotopic liver transplantation (OLT), but the survival of patients with mixed hepatic and neuropsychiatric involvement was significantly lower than in patients with liver disease alone (P = 0.04). WD characterized by hepatic involvement alone is a rare but good indication for liver transplantation when specific medical therapy fails. Patients with neuropsychiatric signs have a significantly shorter survival even though liver transplantation has a positive impact on neurological symptoms. In conclusion, a combination of hepatic and neuropsychiatric conditions deserves careful neurological evaluation, which should contraindicate OLT in case of severe neurological impairment.

Published
2005

15. Lymphoproliferative disorders in heart transplant recipients: Role of hepatitis C virus (HCV) and Epstein-Barr virus (EBV) infection

Author

Buda, A, Caforio, A, Calabrese, F, Fagiuoli, S, Pevere, S, Livi, U, Naccarato, R, Burra, P, BUDA A, CAFORIO A, CALABRESE F, FAGIUOLI S, PEVERE S, LIVI U, NACCARATO R, BURRA P., Buda, A, Caforio, A, Calabrese, F, Fagiuoli, S, Pevere, S, Livi, U, Naccarato, R, Burra, P, BUDA A, CAFORIO A, CALABRESE F, FAGIUOLI S, PEVERE S, LIVI U, NACCARATO R, and BURRA P.

Abstract

Post-transplant lymphoproliferative disorders (PTLD) are a well known complication after orthotopic heart transplantation (OHT). Although Epstein-Barr virus (EBV) infection has long been implicated in the pathogenesis of such disorders, other factors may play a part. Because of its lymphotropic properties, hepatitis C virus (HCV) may induce clonal expansion of B-lymphocytes and lead to PTLD. The aim of this study was to evaluate the potential association between HCV and EBV infection and PTLD in OHT patients. The retrospective study considered 404 adult patients screened for HCV. EBV serology, histology, and molecular analysis on tissue biopsies were performed in the PTLD patients (10/404, 2.5 %). HCV positivity was found in 36/404 (8.9 %) patients. The EBV genome was expressed on all neoplastic tissue samples analyzed. A higher proportion of HCV-positive patients developed PTLD than the HCV-negative cases (8 % vs 2 %, P = 0.017). EBV has a demonstrated role in the onset of PTLD, but HCV infection probably has to be considered as well.

Published
2000

16. Natural leukocyte interferon alfa for the treatment of chronic viral hepatitis in heart transplant recipients. Transplantation

Author

FAGIUOLI S, PEVERE S, MINNITI F, LIVI U, CAFORIO AL, NACCARATO R, CHIARAMONTE M, Fagiuoli, S, Pevere, S, Minniti, F, Livi, U, Caforio, A, Naccarato, R, and Chiaramonte, M

Subjects
chronic viral hepatiti, heart transplant recipient, Natural leukocyte interferon alfa
Abstract

Background. A more rapid and aggressive course of hepatitis B virus (HBV)-related and hepatitis C virus (HCV)-related infection in organ transplant recipients has been described. Interferon alfa is the most accepted drug for treating HBV and HCV chronic infections. However, the use of interferon alfa-N3 has been contraindicated in heart transplant (HTx) recipients because of the hypothesized greater risk of triggering acute cellular rejection. The aim of this clinical pilot study was to evaluate tolerability, safety, and efficacy of natural leukocyte interferon alfa in the treatment of chronic HBV and HCV in HTx recipients. Methods. Seven HTx recipients were enrolled in the study: two with HBV, four with HCV, and one with combined HBV-HCV chronic infection. The patients had a mean follow-up after heart transplantation of 8.5±3 years, before starting interferon alfa-N3 treatment at a dose of 6 MU three times per week, intramuscularly for 12 months. Results. All patients completed the treatment with no major side effects. No unexpected episodes of acute cellular rejection were observed during the treatment. Mean aminotransferase serum levels were significantly lower than before transplantation at 3 (P

Published
2003

17. HCV in pazienti immunosoppressi

Author

MINNITI F, PEVERE S, GRAZIOTTO A, FAGIUOLI S, Minniti, F, Pevere, S, Graziotto, A, and Fagiuoli, S

Subjects
HCV Pazienti immunosoppressi
Published
2001

35. Natural alpha-IFN in HCV recurrence after liver transplantation

Author

Targhetta, S, Burra, P, Popovic, A, Silverj, E, Pevere, S, Russo, F, Zanus, G, Cecchetto, A, Naccarato, R, Fagiuoli, S, Russo, FP, Targhetta, S, Burra, P, Popovic, A, Silverj, E, Pevere, S, Russo, F, Zanus, G, Cecchetto, A, Naccarato, R, Fagiuoli, S, and Russo, FP

Published
2001

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