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2. Kidney Transplants From Donors on Extracorporeal Membrane Oxygenation Prior to Death Are Associated With Better Long-Term Renal Function Compared to Donors After Circulatory Death

Author

Gregorini, M, Ticozzelli, E, Abelli, M, Grignano, M, Pattonieri, E, Giacomoni, A, De Carlis, L, Dell'Acqua, A, Caldara, R, Socci, C, Bottazzi, A, Libetta, C, Sepe, V, Malabarba, S, Manzoni, F, Klersy, C, Piccolo, G, Rampino, T, Gregorini M., Ticozzelli E., Abelli M., Grignano M. A., Pattonieri E. F., Giacomoni A., De Carlis L., Dell'Acqua A., Caldara R., Socci C., Bottazzi A., Libetta C., Sepe V., Malabarba S., Manzoni F., Klersy C., Piccolo G., Rampino T., Gregorini, M, Ticozzelli, E, Abelli, M, Grignano, M, Pattonieri, E, Giacomoni, A, De Carlis, L, Dell'Acqua, A, Caldara, R, Socci, C, Bottazzi, A, Libetta, C, Sepe, V, Malabarba, S, Manzoni, F, Klersy, C, Piccolo, G, Rampino, T, Gregorini M., Ticozzelli E., Abelli M., Grignano M. A., Pattonieri E. F., Giacomoni A., De Carlis L., Dell'Acqua A., Caldara R., Socci C., Bottazzi A., Libetta C., Sepe V., Malabarba S., Manzoni F., Klersy C., Piccolo G., and Rampino T.

Abstract

Donation after circulatory death (DCD) allows expansion of the donor pool. We report on 11 years of Italian experience by comparing the outcome of grafts from DCD and extracorporeal membrane oxygenation (ECMO) prior to death donation (EPD), a new donor category. We studied 58 kidney recipients from DCD or EPD and collected donor/recipient clinical characteristics. Primary non function (PNF) and delayed graft function (DGF) rates, dialysis need, hospitalization duration, and patient and graft survival rates were compared. The estimated glomerular filtration rate (eGFR) was measured throughout the follow-up. Better clinical outcomes were achieved with EPD than with DCD despite similar graft and patient survival rates The total warm ischemia time (WIT) was longer in the DCD group than in the EPD group. Pure WIT was the highest in the class II group. The DGF rate was higher in the DCD group than in the EPD group. PNF rate was similar in the groups. Dialysis need was the greatest and hospitalization the longest in the class II DCD group. eGFR was lower in the class II DCD group than in the EPD group. Our results indicate good clinical outcomes of kidney transplants from DCD despite the long “no-touch period” and show that ECMO in the procurement phase improves graft outcome, suggesting EPD as a source for pool expansion.

Published
2022

3. First world consensus conference on pancreas transplantation: Part I—Methods and results of literature search

Author

Boggi, U, Vistoli, F, Marchetti, P, Kandaswamy, R, Berney, T, Andres, A, Arbogast, H, Badet, L, Baronti, W, Bartlett, S, Benedetti, E, Branchereau, J, Burke, G, Buron, F, Caldara, R, Cardillo, M, Casanova, D, Cipriani, F, Cooper, M, Cupisti, A, de Koning, E, Davide, J, Drachenberg, C, Ettorre, G, Fernandez Cruz, L, Fridell, J, Friend, P, Furian, L, Gaber, O, Gruessner, A, Gruessner, R, Gunton, J, Han, D, Iacopi, S, Kauffmann, E, Kaufman, D, Kenmochi, T, Khambalia, H, Lai, Q, Langer, R, Maffi, P, Marselli, L, Menichetti, F, Miccoli, M, Mittal, S, Morelon, E, Napoli, N, Neri, F, Oberholzer, J, Odorico, J, Ollinger, R, Oniscu, G, Orlando, G, Ortenzi, M, Perosa, M, Perrone, V, Redfield, R, Ricci, C, Rigotti, P, Robertson, R, Ross, L, Rossi, M, Saudek, F, Scalea, J, Schenker, P, Secchi, A, Socci, C, Sousa Silva, D, Squifflet, J, Stock, P, Stratta, R, Terrenzio, C, Uva, P, Watson, C, White, S, Boggi U., Vistoli F., Marchetti P., Kandaswamy R., Berney T., Andres A., Arbogast H. P., Badet L., Baronti W., Bartlett S. T., Benedetti E., Branchereau J., Burke G. W. 3., Buron F., Caldara R., Cardillo M., Casanova D., Cipriani F., Cooper M., Cupisti A., de Koning E. J. P., Davide J., Drachenberg C., Ettorre G. M., Fernandez Cruz L., Fridell J. A., Friend P. J., Furian L., Gaber O. A., Gruessner A. C., Gruessner R. W. G., Gunton J. E., Han D. -J., Iacopi S., Kauffmann E. F., Kaufman D., Kenmochi T., Khambalia H. A., Lai Q., Langer R. M., Maffi P., Marselli L., Menichetti F., Miccoli M., Mittal S., Morelon E., Napoli N., Neri F., Oberholzer J., Odorico J. S., Ollinger R., Oniscu G., Orlando G., Ortenzi M., Perosa M., Perrone V. G., Redfield R. R., Ricci C., Rigotti P., Robertson R. P., Ross L. F., Rossi M., Saudek F., Scalea J. R., Schenker P., Secchi A., Socci C., Sousa Silva D., Squifflet J. P., Stock P. G., Stratta R. J., Terrenzio C., Uva P., Watson C. C. E., White S. A., Boggi, U, Vistoli, F, Marchetti, P, Kandaswamy, R, Berney, T, Andres, A, Arbogast, H, Badet, L, Baronti, W, Bartlett, S, Benedetti, E, Branchereau, J, Burke, G, Buron, F, Caldara, R, Cardillo, M, Casanova, D, Cipriani, F, Cooper, M, Cupisti, A, de Koning, E, Davide, J, Drachenberg, C, Ettorre, G, Fernandez Cruz, L, Fridell, J, Friend, P, Furian, L, Gaber, O, Gruessner, A, Gruessner, R, Gunton, J, Han, D, Iacopi, S, Kauffmann, E, Kaufman, D, Kenmochi, T, Khambalia, H, Lai, Q, Langer, R, Maffi, P, Marselli, L, Menichetti, F, Miccoli, M, Mittal, S, Morelon, E, Napoli, N, Neri, F, Oberholzer, J, Odorico, J, Ollinger, R, Oniscu, G, Orlando, G, Ortenzi, M, Perosa, M, Perrone, V, Redfield, R, Ricci, C, Rigotti, P, Robertson, R, Ross, L, Rossi, M, Saudek, F, Scalea, J, Schenker, P, Secchi, A, Socci, C, Sousa Silva, D, Squifflet, J, Stock, P, Stratta, R, Terrenzio, C, Uva, P, Watson, C, White, S, Boggi U., Vistoli F., Marchetti P., Kandaswamy R., Berney T., Andres A., Arbogast H. P., Badet L., Baronti W., Bartlett S. T., Benedetti E., Branchereau J., Burke G. W. 3., Buron F., Caldara R., Cardillo M., Casanova D., Cipriani F., Cooper M., Cupisti A., de Koning E. J. P., Davide J., Drachenberg C., Ettorre G. M., Fernandez Cruz L., Fridell J. A., Friend P. J., Furian L., Gaber O. A., Gruessner A. C., Gruessner R. W. G., Gunton J. E., Han D. -J., Iacopi S., Kauffmann E. F., Kaufman D., Kenmochi T., Khambalia H. A., Lai Q., Langer R. M., Maffi P., Marselli L., Menichetti F., Miccoli M., Mittal S., Morelon E., Napoli N., Neri F., Oberholzer J., Odorico J. S., Ollinger R., Oniscu G., Orlando G., Ortenzi M., Perosa M., Perrone V. G., Redfield R. R., Ricci C., Rigotti P., Robertson R. P., Ross L. F., Rossi M., Saudek F., Scalea J. R., Schenker P., Secchi A., Socci C., Sousa Silva D., Squifflet J. P., Stock P. G., Stratta R. J., Terrenzio C., Uva P., Watson C. C. E., and White S. A.

Abstract

Comprehensive evidence-based guidelines for the practice of pancreas transplantation are yet to be established. The First World Consensus Conference on Pancreas Transplantation was convened for this purpose. A steering committee selected the participants and defined the questions to be addressed. A group of literature reviewers identified 597 studies to be included in summaries for guidelines production. Expert groups formulated the first draft of recommendations. Two rounds of discussion and voting occurred online, using the Delphi method (agreement rate ≥85%). After each round, critical responses of experts were reviewed, and recommendations were amended accordingly. Recommendations were finalized after live discussions. Each session was preceded by expert presentations and a summary of results of systematic literature review. Up to three voting rounds were allowed for each recommendation. To avoid potential conflicts of interest, deliberations on issues regarding the impact of pancreas transplantation on the management of diabetes were conducted by an independent jury. Recommendations on technical issues were determined by experts and validated using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Quality of evidence was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) methodology. Each recommendation received a GRADE rating (Grading of Recommendations, Assessment, Development and Evaluations).

Published
2021

4. First World Consensus Conference on pancreas transplantation: Part II – recommendations

Author

Boggi, U, Vistoli, F, Andres, A, Arbogast, H, Badet, L, Baronti, W, Bartlett, S, Benedetti, E, Branchereau, J, Burke, G, Buron, F, Caldara, R, Cardillo, M, Casanova, D, Cipriani, F, Cooper, M, Cupisti, A, Davide, J, Drachenberg, C, de Koning, E, Ettorre, G, Fernandez Cruz, L, Fridell, J, Friend, P, Furian, L, Gaber, O, Gruessner, A, Gruessner, R, Gunton, J, Han, D, Iacopi, S, Kauffmann, E, Kaufman, D, Kenmochi, T, Khambalia, H, Lai, Q, Langer, R, Maffi, P, Marselli, L, Menichetti, F, Miccoli, M, Mittal, S, Morelon, E, Napoli, N, Neri, F, Oberholzer, J, Odorico, J, Ollinger, R, Oniscu, G, Orlando, G, Ortenzi, M, Perosa, M, Perrone, V, Pleass, H, Redfield, R, Ricci, C, Rigotti, P, Paul Robertson, R, Ross, L, Rossi, M, Saudek, F, Scalea, J, Schenker, P, Secchi, A, Socci, C, Sousa Silva, D, Squifflet, J, Stock, P, Stratta, R, Terrenzio, C, Uva, P, Watson, C, White, S, Marchetti, P, Kandaswamy, R, Berney, T, Boggi U., Vistoli F., Andres A., Arbogast H. P., Badet L., Baronti W., Bartlett S. T., Benedetti E., Branchereau J., Burke G. W., Buron F., Caldara R., Cardillo M., Casanova D., Cipriani F., Cooper M., Cupisti A., Davide J., Drachenberg C., de Koning E. J. P., Ettorre G. M., Fernandez Cruz L., Fridell J. A., Friend P. J., Furian L., Gaber O. A., Gruessner A. C., Gruessner R. W. G., Gunton J. E., Han D. -J., Iacopi S., Kauffmann E. F., Kaufman D., Kenmochi T., Khambalia H. A., Lai Q., Langer R. M., Maffi P., Marselli L., Menichetti F., Miccoli M., Mittal S., Morelon E., Napoli N., Neri F., Oberholzer J., Odorico J. S., Ollinger R., Oniscu G., Orlando G., Ortenzi M., Perosa M., Perrone V. G., Pleass H., Redfield R. R., Ricci C., Rigotti P., Paul Robertson R., Ross L. F., Rossi M., Saudek F., Scalea J. R., Schenker P., Secchi A., Socci C., Sousa Silva D., Squifflet J. P., Stock P. G., Stratta R. J., Terrenzio C., Uva P., Watson C. C. E., White S. A., Marchetti P., Kandaswamy R., Berney T., Boggi, U, Vistoli, F, Andres, A, Arbogast, H, Badet, L, Baronti, W, Bartlett, S, Benedetti, E, Branchereau, J, Burke, G, Buron, F, Caldara, R, Cardillo, M, Casanova, D, Cipriani, F, Cooper, M, Cupisti, A, Davide, J, Drachenberg, C, de Koning, E, Ettorre, G, Fernandez Cruz, L, Fridell, J, Friend, P, Furian, L, Gaber, O, Gruessner, A, Gruessner, R, Gunton, J, Han, D, Iacopi, S, Kauffmann, E, Kaufman, D, Kenmochi, T, Khambalia, H, Lai, Q, Langer, R, Maffi, P, Marselli, L, Menichetti, F, Miccoli, M, Mittal, S, Morelon, E, Napoli, N, Neri, F, Oberholzer, J, Odorico, J, Ollinger, R, Oniscu, G, Orlando, G, Ortenzi, M, Perosa, M, Perrone, V, Pleass, H, Redfield, R, Ricci, C, Rigotti, P, Paul Robertson, R, Ross, L, Rossi, M, Saudek, F, Scalea, J, Schenker, P, Secchi, A, Socci, C, Sousa Silva, D, Squifflet, J, Stock, P, Stratta, R, Terrenzio, C, Uva, P, Watson, C, White, S, Marchetti, P, Kandaswamy, R, Berney, T, Boggi U., Vistoli F., Andres A., Arbogast H. P., Badet L., Baronti W., Bartlett S. T., Benedetti E., Branchereau J., Burke G. W., Buron F., Caldara R., Cardillo M., Casanova D., Cipriani F., Cooper M., Cupisti A., Davide J., Drachenberg C., de Koning E. J. P., Ettorre G. M., Fernandez Cruz L., Fridell J. A., Friend P. J., Furian L., Gaber O. A., Gruessner A. C., Gruessner R. W. G., Gunton J. E., Han D. -J., Iacopi S., Kauffmann E. F., Kaufman D., Kenmochi T., Khambalia H. A., Lai Q., Langer R. M., Maffi P., Marselli L., Menichetti F., Miccoli M., Mittal S., Morelon E., Napoli N., Neri F., Oberholzer J., Odorico J. S., Ollinger R., Oniscu G., Orlando G., Ortenzi M., Perosa M., Perrone V. G., Pleass H., Redfield R. R., Ricci C., Rigotti P., Paul Robertson R., Ross L. F., Rossi M., Saudek F., Scalea J. R., Schenker P., Secchi A., Socci C., Sousa Silva D., Squifflet J. P., Stock P. G., Stratta R. J., Terrenzio C., Uva P., Watson C. C. E., White S. A., Marchetti P., Kandaswamy R., and Berney T.

Abstract

The First World Consensus Conference on Pancreas Transplantation provided 49 jury deliberations regarding the impact of pancreas transplantation on the treatment of diabetic patients, and 110 experts’ recommendations for the practice of pancreas transplantation. The main message from this consensus conference is that both simultaneous pancreas-kidney transplantation (SPK) and pancreas transplantation alone can improve long-term patient survival, and all types of pancreas transplantation dramatically improve the quality of life of recipients. Pancreas transplantation may also improve the course of chronic complications of diabetes, depending on their severity. Therefore, the advantages of pancreas transplantation appear to clearly surpass potential disadvantages. Pancreas after kidney transplantation increases the risk of mortality only in the early period after transplantation, but is associated with improved life expectancy thereafter. Additionally, preemptive SPK, when compared to SPK performed in patients undergoing dialysis, appears to be associated with improved outcomes. Time on dialysis has negative prognostic implications in SPK recipients. Increased long-term survival, improvement in the course of diabetic complications, and amelioration of quality of life justify preferential allocation of kidney grafts to SPK recipients. Audience discussions and live voting are available online at the following URL address: http://mediaeventi.unipi.it/category/1st-world-consensus-conference-of-pancreas-transplantation/246.

Published
2021

5. Colorectal cancer after bariatric surgery (Cric-Abs 2020): Sicob (Italian society of obesity surgery) endorsed national survey

Author

Ciccioriccio, Mc, Iossa, A, Boru, Ce, De Angelis, F, Termine, P, Giuffrè, M, Silecchia, G, Luigi, A, Alessandro, B, Fabrizio, B, Vincenzo, B, Marcello, B, Fabio Cesare Campanile, Giovanni, C, Franco, C, Maurizio De Luca, Marco Antonio De Paoli, Mirto, F, Diego, F, Gentileschi, P, Cristiano, G, Alessandro, G, Mario, G, Ezio, L, Marcello, L, Emilio, M, Giuseppe Maria Marinari, Gennaro, M, Bernardo, M, Paolo, M, Roberto, M, Mario, M, Giuseppe, N, Stefano, O, Natale, P, Andrea, P, Nicola, P, Vincenzo, P, Luigi, P, Marco, R, Giuliano, S, Angelo Michele Schettino, Socci, C, Giuseppe, V, Marco Antonio, Z, Ciccioriccio, M. C., Iossa, A., Boru, C. E., De Angelis, F., Termine, P., Giuffre, M., Silecchia, G., Angrisani, L., Balani, A., Bellini, F., Borrelli, V., Boni, M., Campanile, F. C., Cesana, G., Ciampaglia, F., De Luca, M., De Paoli, M. A., Foletto, M., Foschi, D., Gentileschi, P., Giardiello, C., Giovanelli, A., Godina, M., Lattuada, E., Lucchese, M., Manno, E., Marinari, G. M., Martines, G., Marzano, B., Millo, P., Moroni, R., Musella, M., Navarra, G., Olmi, S., Pellicano, N., Peri, A., Perrotta, N., Pilone, V., Piazza, L., Raffaelli, M., Sarro, G., Schettino, A. M., Carlo, S., Vuolo, G., and Zappa, M. A.

Subjects
Adult, medicine.medical_specialty, Referral, Colorectal cancer, bariatric surgery and cancer, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Bariatric Surgery, Medicine (miscellaneous), Colorectal Neoplasm, Surveys and Questionnaires, medicine, Humans, colorectal cancer incidence, gastric bypass and colorectal cancer incidence, Nutrition and Dietetics, business.industry, Incidence (epidemiology), Cancer, Middle Aged, medicine.disease, Confidence interval, Settore MED/18, Surgery, sleeve gastrectomy and colorectal cancer incidence, Standardized mortality ratio, Italy, Cohort, Gastrectomy, Colorectal Neoplasms, business, Human
Abstract

Background: The published colorectal cancer (CRC) outcomes after bariatric surgery (BS) are conflicting, with some anecdotal studies reporting increased risks. The present nationwide survey CRIC-ABS 2020 (Colo-Rectal Cancer Incidence-After Bariatric Surgery-2020), endorsed by the Italian Society of Obesity Surgery (SICOB), aims to report its incidence in Italy after BS, comparing the two commonest laparoscopic procedures—Sleeve Gastrectomy (SG) and Roux-en-Y gastric bypass (GBP). Methods: Two online questionnaires—first having 11 questions on SG/GBP frequency with a follow-up of 5–10 years, and the second containing 15 questions on CRC incidence and management, were administered to 53 referral bariatric, high volume centers. A standardized incidence ratio (SIR—a ratio of the observed number of cases to the expected number) with 95% confidence intervals (CI) was calculated along with CRC incidence risk computation for baseline characteristics. Results: Data for 20,571 patients from 34 (63%) centers between 2010 and 2015 were collected, of which 14,431 had SG (70%) and 6140 GBP (30%). 22 patients (0.10%, mean age = 53 ± 12 years, 13 males), SG: 12 and GBP: 10, developed CRC after 4.3 ± 2.3 years. Overall incidence was higher among males for both groups (SG: 0.15% vs 0.05%; GBP: 0.35% vs 0.09%) and the GBP cohort having slightly older patients. The right colon was most affected (n = 13) and SIR categorized/sex had fewer values < 1, except for GBP males (SIR = 1.07). Conclusion: Low CRC incidence after BS at 10 years (0.10%), and no difference between procedures was seen, suggesting that BS does not trigger the neoplasm development.

Published
2021

6. First world consensus conference on pancreas transplantation: Part I-Methods and results of literature search

Author

Boggi, U., Vistoli, F., Marchetti, P., Kandaswamy, R., Berney, T., Andres, A., Arbogast, H. P., Badet, L., Baronti, W., Bartlett, S. T., Benedetti, E., Branchereau, J., Burke, G. W. 3., Buron, F., Caldara, R., Cardillo, M., Casanova, D., Cipriani, F., Cooper, M., Cupisti, A., de Koning, E. J. P., Davide, J., Drachenberg, C., Ettorre, G. M., Fernandez Cruz, L., Fridell, J. A., Friend, P. J., Furian, L., Gaber, O. A., Gruessner, A. C., Gruessner, R. W. G., Gunton, J. E., Han, D. -J., Iacopi, S., Kauffmann, E. F., Kaufman, D., Kenmochi, T., Khambalia, H. A., Lai, Q., Langer, R. M., Maffi, P., Marselli, L., Menichetti, F., Miccoli, M., Mittal, S., Morelon, E., Napoli, N., Neri, F., Oberholzer, J., Odorico, J. S., Ollinger, R., Oniscu, G., Orlando, G., Ortenzi, M., Perosa, M., Perrone, V. G., Redfield, R. R., Ricci, C., Rigotti, P., Robertson, R. P., Ross, L. F., Rossi, M., Saudek, F., Scalea, J. R., Schenker, P., Secchi, A., Socci, C., Sousa Silva, D., Squifflet, J. P., Stock, P. G., Stratta, R. J., Terrenzio, C., Uva, P., Watson, C. C. E., White, S. A., Boggi U., Vistoli F., Marchetti P., Kandaswamy R., Berney T., Andres A., Arbogast H.P., Badet L., Baronti W., Bartlett S.T., Benedetti E., Branchereau J., Burke G.W., Buron F., Caldara R., Cardillo M., Casanova D., Cipriani F., Cooper M., Cupisti A., de Koning E.J.P., Davide J., Drachenberg C., Ettorre G.M., Fernandez Cruz L., Fridell J.A., Friend P.J., Furian L., Gaber O.A., Gruessner A.C., Gruessner R.W.G., Gunton J.E., Han D.-J., Iacopi S., Kauffmann E.F., Kaufman D., Kenmochi T., Khambalia H.A., Lai Q., Langer R.M., Maffi P., Marselli L., Menichetti F., Miccoli M., Mittal S., Morelon E., Napoli N., Neri F., Oberholzer J., Odorico J.S., Ollinger R., Oniscu G., Orlando G., Ortenzi M., Perosa M., Perrone V.G., Redfield R.R., Ricci C., Rigotti P., Robertson R.P., Ross L.F., Rossi M., Saudek F., Scalea J.R., Schenker P., Secchi A., Socci C., Sousa Silva D., Squifflet J.P., Stock P.G., Stratta R.J., Terrenzio C., Uva P., Watson C.C.E., and White S.A.

Subjects
clinical research / practice, diabetes, pancreas / simultaneous pancreas-kidney transplantation, survey, Consensus, Humans, Pancreas Transplantation, medicine.medical_treatment, media_common.quotation_subject, Delphi method, Consensu, Pancreas transplantation, Session (web analytics), Jury, Voting, medicine, Immunology and Allergy, Pharmacology (medical), Grading (education), media_common, Transplantation, Medical education, business.industry, pancreas / simultaneous pancreas‐kidney transplantation, Systematic review, diabete, Special Articles, Original Article, First World, business, Human
Abstract

Comprehensive evidence‐based guidelines for the practice of pancreas transplantation are yet to be established. The First World Consensus Conference on Pancreas Transplantation was convened for this purpose. A steering committee selected the participants and defined the questions to be addressed. A group of literature reviewers identified 597 studies to be included in summaries for guidelines production. Expert groups formulated the first draft of recommendations. Two rounds of discussion and voting occurred online, using the Delphi method (agreement rate ≥85%). After each round, critical responses of experts were reviewed, and recommendations were amended accordingly. Recommendations were finalized after live discussions. Each session was preceded by expert presentations and a summary of results of systematic literature review. Up to three voting rounds were allowed for each recommendation. To avoid potential conflicts of interest, deliberations on issues regarding the impact of pancreas transplantation on the management of diabetes were conducted by an independent jury. Recommendations on technical issues were determined by experts and validated using the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Quality of evidence was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) methodology. Each recommendation received a GRADE rating (Grading of Recommendations, Assessment, Development and Evaluations)., This article presents the results of literature search and the methods used to provide evidence‐based guidelines for the practice of pancreas transplantation at the First World Consensus Conference on Pancreas Transplantation.

Published
2021

9. Toward patient-tailored therapy in agonist opioid treatment: The role of psychopathology, craving behavioural covariates, stress reaction and methadone blood concentration. A case series

Author

Maremmani, Agi, Bacciardi, S, Maremmani, I, Della Rocca, F, Lamanna, F, Socci, C, Cerrai, E, Zallocco, L, Cerniglia, L, Cimino, S, Giusti, L, Lucacchini, A, Protti, M, Mercolini, L, Perugi, G, and Mazzoni, Mr

Subjects
Heroin addiction, Heroin Use Disorder, psychopathology, methadone blood level, craving, treatment, dried blood spot methadone level
Published
2020

20. Health services as a key sector for income and employment change

Author

Socci, C., Ciaschini, M., Pretaroli, R., Severini, F., Ciaschini, M, Pretaroli, R, Severini, F, Socci, C, Socci, C., Ciaschini, M., Pretaroli, R., and Severini, F.

Subjects
SAM, lcsh:Social Sciences, lcsh:H, lcsh:Law, Linkages Analysi, lcsh:H1-99, lcsh:Social sciences (General), Health Structural Change, Linkages Analysis, lcsh:K
Abstract

The analysis of health commodity typically focuses on the efficiency and equity of its market or on the quality of its production and often on the sustainability of its approach to financing. The paper aims to emphasize the importance of health commodity in the process of creation and distribution of income. The methodology is based on the construction of the Social Accounting Matrix with particular attention to health output. We first perform the dispersion analysis in order to evaluate the backward and forward linkages of the health production and then, we simulate different key policies favourable to health commodity aiming to quantify their impacts on the main macroeconomic aggregates.

Published
2010

22. La spesa per anziani in una prospettiva di crescita economica

Author

CIASCHINI M, PRETAROLI R, SEVERINI F, SOCCI C, Ciaschini, M., Pretaroli, R., Severini, F., Socci, C., Ciaschini, M, Pretaroli, R, Severini, F, and Socci, C

Subjects
settore produttivo, Spasa per anziani, Reddito nazionale
Abstract

La spesa per anziani è uno dei comparti della spesa pubblica maggiormente compresso da venti anni a questa parte. Le ragioni che spingono oggi a riconsiderare la spesa per cura e assistenza alla popolazione anziana come volano di crescita e sviluppo poggiano non soltanto su fattori sociali ma anche su considerazioni di tipo squisitamente economico. In questa prospettiva la possibilità di misurare la rilevanza di tale genere di servizi nel determinare le performance del sistema economico diviene cruciale. L’impostazione proposta in questo lavoro fa riferimento alla possibilità di ricondurre il fenomeno della produzione di servizi di cura e assistenza agli anziani all’interno degli schemi tradizionali di contabilità nazionale, in particolare la matrice di contabilità sociale. Una volta implementata, essa permette di utilizzare uno strumento metodologico evoluto, vale a dire il modello multisettoriale biregionale, che consente di quantificare gli effetti sul reddito generati dalla produzione di cura e assistenza agli anziani.

Published
2011

23. Are there any relations among transplant centre volume, surgical technique and anatomy for donor graft selection? Ten-year multicentric Italian experience on mini-invasive living donor nephrectomy

Author

Ravaioli, M, Capocasale, E, Furian, L, De Pace, V, Iaria, M, Spagnoletti, G, Salerno, M, Giacomoni, A, De Carlis, L, Di Bella, C, Rostand, N, Boschiero, L, Pasquale, G, Bosio, A, Collini, A, Carmellini, M, Airoldi, A, Bondonno, G, Ditonno, P, Impedovo, S, Beretta, C, Giussani, A, Socci, C, Parolini, D, Abelli, M, Ticozzelli, E, Baccarani, U, Adani, G, Caputo, F, Buscemi, B, Frongia, M, Solinas, A, Gruttadauria, S, Spada, M, Pinna, A, Romagnoli, J, Salerno, MP, Rostand, NM, Impedovo, SV, Parolini, DC, Adani, GL, Pinna, AD, Ravaioli, M, Capocasale, E, Furian, L, De Pace, V, Iaria, M, Spagnoletti, G, Salerno, M, Giacomoni, A, De Carlis, L, Di Bella, C, Rostand, N, Boschiero, L, Pasquale, G, Bosio, A, Collini, A, Carmellini, M, Airoldi, A, Bondonno, G, Ditonno, P, Impedovo, S, Beretta, C, Giussani, A, Socci, C, Parolini, D, Abelli, M, Ticozzelli, E, Baccarani, U, Adani, G, Caputo, F, Buscemi, B, Frongia, M, Solinas, A, Gruttadauria, S, Spada, M, Pinna, A, Romagnoli, J, Salerno, MP, Rostand, NM, Impedovo, SV, Parolini, DC, Adani, GL, and Pinna, AD

Abstract

Background. Selection of the right or left living donor kidney for transplantation is influenced by many variables. In the present multi centric study including 21 Italian transplant centres, we evaluated whether centre volume or surgical technique may influence the selection process. Methods. Intra- and perioperative donor data, donor kidney function, and recipient and graft survival were collected among 693 mini-invasive living donor nephrectomies performed from 2002 to 2014. Centre volume (LOW, 1-50 cases; HIGH,>50 cases) and surgical technique (FULL-LAP, full laparoscopic and robotic; HA-LAP, hand-assisted laparoscopy; MINI-OPEN, mini-lumbotomy) were correlated with selection of right or left donor kidney and with donor and recipient outcome. Results. HIGH-volume centres retrieved a higher rate of donor right kidneys (29.3% versus 17.6%, P<0.01) with single artery (83.1% versus 76.4%, P<0.05) compared with LOW-volume centres. Surgical technique correlated significantly with rate of donor right kidney and presence of multiple arteries: MINIOPEN (53% and 13%) versus HA-LAP (29% and 22%) versus FULL-LAP (11% and 23%), P<0.001 and P<0.05, respectively. All donors had an uneventful outcome; donor bleeding was more frequent in LOW-volume centres (4% versus 0.9%, P<0.05). Conclusions. Centre volume and surgical technique influenced donor kidney side selection. Donor nephrectomy in LOWvolume centres was associated with higher risk of donor bleeding.

Published
2017

24. Are there any relations among transplant centre volume, surgical technique and anatomy for donor graft selection? Ten-year multicentric Italian experience on mini-invasive living donor nephrectomy

Author

Ravaioli, M., Capocasale, E., Furian, L., De Pace, V., Iaria, M., Spagnoletti, Gionata, Salerno, Maria Paola, Giacomoni, A., De Carlis, L., Di Bella, C., Rostand, N. M., Boschiero, L., Pasquale, G., Bosio, A., Collini, A., Carmellini, M., Airoldi, A., Bondonno, G., Ditonno, P., Impedovo, S. V., Beretta, C., Giussani, A., Socci, C., Parolini, D. C., Abelli, M., Ticozzelli, E., Baccarani, U., Adani, G. L., Caputo, F., Buscemi, B., Frongia, M., Solinas, A., Gruttadauria, S., Spada, M., Pinna, A. D., Romagnoli, Jacopo, Spagnoletti G. (ORCID:0000-0003-2626-8147), Salerno M. P., Romagnoli J. (ORCID:0000-0002-7153-0346), Ravaioli, M., Capocasale, E., Furian, L., De Pace, V., Iaria, M., Spagnoletti, Gionata, Salerno, Maria Paola, Giacomoni, A., De Carlis, L., Di Bella, C., Rostand, N. M., Boschiero, L., Pasquale, G., Bosio, A., Collini, A., Carmellini, M., Airoldi, A., Bondonno, G., Ditonno, P., Impedovo, S. V., Beretta, C., Giussani, A., Socci, C., Parolini, D. C., Abelli, M., Ticozzelli, E., Baccarani, U., Adani, G. L., Caputo, F., Buscemi, B., Frongia, M., Solinas, A., Gruttadauria, S., Spada, M., Pinna, A. D., Romagnoli, Jacopo, Spagnoletti G. (ORCID:0000-0003-2626-8147), Salerno M. P., and Romagnoli J. (ORCID:0000-0002-7153-0346)

Abstract

Background. Selection of the right or left living donor kidney for transplantation is influenced by many variables. In the present multi centric study including 21 Italian transplant centres, we evaluated whether centre volume or surgical technique may influence the selection process. Methods. Intra- and perioperative donor data, donor kidney function, and recipient and graft survival were collected among 693 mini-invasive living donor nephrectomies performed from 2002 to 2014. Centre volume (LOW, 1-50 cases; HIGH,>50 cases) and surgical technique (FULL-LAP, full laparoscopic and robotic; HA-LAP, hand-assisted laparoscopy; MINI-OPEN, mini-lumbotomy) were correlated with selection of right or left donor kidney and with donor and recipient outcome. Results. HIGH-volume centres retrieved a higher rate of donor right kidneys (29.3% versus 17.6%, P<0.01) with single artery (83.1% versus 76.4%, P<0.05) compared with LOW-volume centres. Surgical technique correlated significantly with rate of donor right kidney and presence of multiple arteries: MINIOPEN (53% and 13%) versus HA-LAP (29% and 22%) versus FULL-LAP (11% and 23%), P<0.001 and P<0.05, respectively. All donors had an uneventful outcome; donor bleeding was more frequent in LOW-volume centres (4% versus 0.9%, P<0.05). Conclusions. Centre volume and surgical technique influenced donor kidney side selection. Donor nephrectomy in LOWvolume centres was associated with higher risk of donor bleeding.

Published
2017

26. Effetti macroeconomica dei ussidi alla produzione di cultura nelle Marche

Author

Ciaschini, M., Pretaroli, R., Severini, F, Socci, C., Ciaschini, M., Pretaroli, R., Severini, F, and Socci, C.

Subjects
Cultura, Investimenti in Cultura, Regione Marche, SAM, CGE
Abstract

The economic value of culture production depends on the territory and the social structure of the economy. The cultural district imposes the transition from the single-chain to the multi-chain system of production in order to evaluate the relations with the sectors of the culture production process and with all the other traditional sectors. In this prospective economic models and accounting schemes able to describe the economic/social/environmental relations between the agents are required. As in the tourism, using open multisectoral models and disaggregated accounting schemes, allows to respond to this exigency. Indeed such instruments provide a full detailed description of production processes and an accurate disaggregation of economic agents according to spatial and social characteristics. This allows developing a general analysis with the possibility to identify the direct and indirect interrelations between the economic activities and institutional sectors connected to culture. In this paper we provide an ex-ante and ex-post evaluation of public programs to support the production of culture in order to quantify the socio-economic effects of such expenditure and suggest alternative destinations for public resources.

Published
2014

27. Problemi chirurgici nel trapianto di rene e di pancreas - Position paper [Surgical overview on kidney and pancreas transplantation]

Author

Capocasale, E., Berardinelli, L., Beretta, C., Berloco, P., Boggi, U., Boschiero, L., Bretto, P., Carmellini, M., Citterio, F., Concone, G., De Carlis, L., De Rosa, P., Del Gaudio, M., Di Sandro, S., Di Tonno, P., Faenza, A., Famulari, A., Giacomoni, A., Giovannoni, M., Iaria, M., Lauterio, A., Lasaponara, F., Mazzoni, M. P., Nicita, G., Orsenigo, E., Parolini, D. C., Pietrabissa, A., Pinna, A. D., Pisani, F., Ravaioli, M., Rigotti, P., Romagnoli, J., Rossetti, O., Secchi, A., Socci, C., and Vistoli, F.

Subjects
failed allograft, kidney and pancreas transplantation, kidney preservation, living donation, recipient selection, failed allograft, living donation, kidney and pancreas transplantation, recipient selection, kidney preservation
Published
2016

30. Surgical overview on kidney and pancreas transplantation

Author

Capocasale, E, Berardinelli, L, Beretta, C, Berloco, P, Boggi, U, Boschiero, L, Bretto, P, Carmellini, M, Citterio, F, Concone, G, De Carlis, L, De Rosa, P, Del Gaudio, M, Di Sandro, S, Di Tonno, P, Faenza, A, Famulari, A, Giacomoni, A, Giovannoni, M, Iaria, M, Lauterio, A, Lasaponara, F, Mazzoni, M, Nicita, G, Orsenigo, E, Parolini, D, Pietrabissa, A, Pinna, A, Pisani, F, Ravaioli, M, Rigotti, P, Romagnoli, J, Rossetti, O, Secchi, A, Socci, C, Vistoli, F, Capocasale, Enzo, Berardinelli, Luisa, Beretta, Claudio, Berloco, Pasquale, Boggi, Ugo, Boschiero, Luigino, Bretto, Piero, Carmellini, Mario, Citterio, Franco, Concone, Giacomo, De Carlis, Luciano, De Rosa, Paride, Del Gaudio, Massimo, Di Sandro, Stefano, Di Tonno, Pasquale, Faenza, Alessandro, Famulari, Antonio, Giacomoni, Alessandro, Giovannoni, Massimo, Iaria, Maurizio, Lauterio, Andrea, Lasaponara, Fedele, Mazzoni, Maria Patrizia, Nicita, Giulio, Orsenigo, Elena, Parolini, Danilo Carlo, Pietrabissa, Andrea, Pinna, Antonio Daniele, Pisani, Franco, Ravaioli, Matteo, Rigotti, Paolo, Romagnoli, Jacopo, Rossetti, Ornella, Secchi, Antonio, Socci, Carlo, Vistoli, Fabio, Capocasale, E, Berardinelli, L, Beretta, C, Berloco, P, Boggi, U, Boschiero, L, Bretto, P, Carmellini, M, Citterio, F, Concone, G, De Carlis, L, De Rosa, P, Del Gaudio, M, Di Sandro, S, Di Tonno, P, Faenza, A, Famulari, A, Giacomoni, A, Giovannoni, M, Iaria, M, Lauterio, A, Lasaponara, F, Mazzoni, M, Nicita, G, Orsenigo, E, Parolini, D, Pietrabissa, A, Pinna, A, Pisani, F, Ravaioli, M, Rigotti, P, Romagnoli, J, Rossetti, O, Secchi, A, Socci, C, Vistoli, F, Capocasale, Enzo, Berardinelli, Luisa, Beretta, Claudio, Berloco, Pasquale, Boggi, Ugo, Boschiero, Luigino, Bretto, Piero, Carmellini, Mario, Citterio, Franco, Concone, Giacomo, De Carlis, Luciano, De Rosa, Paride, Del Gaudio, Massimo, Di Sandro, Stefano, Di Tonno, Pasquale, Faenza, Alessandro, Famulari, Antonio, Giacomoni, Alessandro, Giovannoni, Massimo, Iaria, Maurizio, Lauterio, Andrea, Lasaponara, Fedele, Mazzoni, Maria Patrizia, Nicita, Giulio, Orsenigo, Elena, Parolini, Danilo Carlo, Pietrabissa, Andrea, Pinna, Antonio Daniele, Pisani, Franco, Ravaioli, Matteo, Rigotti, Paolo, Romagnoli, Jacopo, Rossetti, Ornella, Secchi, Antonio, Socci, Carlo, and Vistoli, Fabio

Abstract

The main purpose of this paper, written by a group of Italian expert transplant surgeons, is to provide clinical support and to help through the decision-making process over pre-transplant surgical procedures in potential kidney recipients, as well as selection of pancreas transplant candidates and perioperative management of kidney recipient. Current topics such as different approaches in minimally invasive donor nephrectomy, methods of graft preservation and treatment of failed allograft were addressed.

Published
2016

34. L’impatto della spesa per gli anziani sull’occupazione attraverso un modello computazionale

Author

Ciaschini, M., Pretaroli, R., Severini, F., Socci, C., Ciaschini, M., Pretaroli, R., Severini, F., and Socci, C.

Subjects
spesa in assistenza per anziani non autosufficienti, politche di spesa, CGE
Abstract

Una differente allocazione tra i soggetti istituzionali della spesa in assistenza per anziani non autosufficienti può rappresentare una opportunità di crescita per sistema economico se è in grado di attivare processi produttivi che stimolano la produzione complessiva o l’occupazione. La possibilità di rivedere la spesa sanitaria come spesa produttiva all’interno del sistema economico ci spinge dunque ad analizzare gli impatti di diversi scenari di politica sanitaria all’interno del flusso circolare del reddito attraverso del modello computazionale di equilibrio economico generale (CGE), adattato alla matrice bi regionale di contabilità sociale (SAM) per l’Italia. In particolare, l’esigenza di testare gli impatti delle politiche di spesa sanitaria sull’occupazione impone di inserire all’interno del modello CGE l’ipotesi di disoccupazione involontaria ed identificare all’interno della SAM i flussi relativi alle prestazioni sanitarie di assistenza considerate di rilievo. Tre sono le categorie di spesa individuate: l’assistenza domiciliare integrata (ADI), l’assistenza residenziale in strutture private accreditate (ARA) e l’assistenza residenziale in strutture pubbliche (ARP). In quest’ottica, dato il quadro economico italiano disaggregato in due macro-regioni (Nord-Centro/Sud-Isole), l’ampio dettaglio sulla spesa sanitaria ed un mercato del lavoro con disoccupazione, il modello consente di analizzare gli effetti diretti ed indiretti di una politica di riduzione della spesa ADI a favore di una maggiore spesa in ARA, operata secondo due diverse modalità. Nel primo scenario proposto la riallocazione della spesa è in capo alle regioni, che riducono il finanziamento di ADI in favore di ARA; nel secondo scenario le regioni trasferiscono le risorse liberate dalla riduzione della spesa in ADI, alle famiglie per finanziare la domanda di servizi ARA. Entrambe le manovre sono a parità di bilancio.

Published
2011

47. Kidney Function after Islet Transplant Alone in Type 1 Diabetes: Impact of immunosuppressive therapy on progression of diabetic nephropathy

Author

Maffi, P, Bertuzzi, F, De Taddeo, F, Magistretti, P, Nano, R, Fiorina, P, Caumo, A, Pozzi, P, Socci, C, Venturini, M, Del Maschio, A, Secchi, A, Maffi, P, Bertuzzi, F, De Taddeo, F, Magistretti, P, Nano, R, Fiorina, P, Caumo, A, Pozzi, P, Socci, C, Venturini, M, DEL MASCHIO, Alessandro, and Secchi, Antonio

Abstract

OBJECTIVE— Islet transplantation alone is an alternative for the replacement of pancreatic endocrine function in patients with type 1 diabetes. The aim of our study was to assess the impact of the Edmonton immunosuppressive protocol (tacrolimus-sirolimus association) on kidney function. RESEARCH DESIGN AND METHODS— Nineteen patients with type 1 diabetes and metabolic instability received islet transplantation alone and immunosuppressive therapy according to the Edmonton protocol. Serum creatinine (sCr), creatinine clearance (CrCl), and 24-h urinary protein excretion (UPE) were assessed at baseline and during a follow-up of 339 patientmonths. RESULTS— After islet transplantation we observed 1) sCr within the normal range in all but two patients in whom sCr increased immediately after islet transplantation, and despite withdrawal of immunosuppression, patients progressed to end-stage renal disease (ESRD); 2) CrCl remained within the normal range for those patients who had normal baseline values and decreased, progressing to ESRD in two patients with a decreased baseline CrCl; and 3) 24-h UPE worsened (300 mg/24 h) in four patients. In the two patients who progressed to ESRD, the worsening of 24-h UPE occurred immediately after islet transplantation. In one patient 24-h UPE worsening occurred at 18 months, and, after withdrawal of immunosuppression, it returned to the normal range. In another patient 24-h UPE increased at 24 months and remained stable while immunosuppression was continued. CONCLUSIONS— In type 1 diabetic patients receiving islet transplantation alone, the association of tacrolimus and sirolimus should be used only in patients with normal kidney function. Alternative options for immunosuppressive treatment should be considered for patients with even a mild decrease of kidney function.

Published
2007

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