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1. How useful is the machine perfusion in liver transplantation? An answer from a national survey

Author

Irene Scalera, R. De Carlis, D. Patrono, E. Gringeri, T. Olivieri, D. Pagano, Q. Lai, M. Rossi, S. Gruttadauria, F. Di Benedetto, U. Cillo, R. Romagnoli, L. G. Lupo, and L. De Carlis

Subjects
liver donor, machine perfusion, steatosis, early allograft dysfunction, liver transplantation, Surgery, RD1-811
Abstract

Machine perfusion (MP) has been shown worldwide to offer many advantages in liver transplantation, but it still has some gray areas. The purpose of the study is to evaluate the donor risk factors of grafts, perfused with any MP, that might predict an ineffective MP setting and those would trigger post-transplant early allograft dysfunction (EAD). Data from donors of all MP-perfused grafts at six liver transplant centers have been analyzed, whether implanted or discarded after perfusion. The first endpoint was the negative events after perfusion (NegE), which is the number of grafts discarded plus those that were implanted but lost after the transplant. A risk factor analysis for NegE was performed and marginal grafts for MP were identified. Finally, the risk of EAD was analyzed, considering only implanted grafts. From 2015 to September 2019, 158 grafts were perfused with MP: 151 grafts were implanted and 7 were discarded after the MP phase because they did not reach viability criteria. Of 151, 15 grafts were lost after transplant, so the NegE group consisted of 22 donors. In univariate analysis, the donor risk index >1.7, the presence of hypertension in the medical history, static cold ischemia time, and the moderate or severe macrovesicular steatosis were the significant factors for NegE. Multivariate analysis confirmed that macrosteatosis >30% was an independent risk factor for NegE (odd ratio 5.643, p = 0.023, 95% confidence interval, 1.27–24.98). Of 151 transplanted patients, 34% experienced EAD and had worse 1- and 3-year-survival, compared with those who did not face EAD (NoEAD), 96% and 96% for EAD vs. 89% and 71% for NoEAD, respectively (p = 0.03). None of the donor/graft characteristics was associated with EAD even if the graft was moderately steatotic or fibrotic or from an aged donor. For the first time, this study shows that macrovesicular steatosis >30% might be a warning factor involved in the risk of graft loss or a cause of graft discard after the MP treatment. On the other hand, the MP seems to be useful in reducing the donor and graft weight in the development of EAD.

Published
2022
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2. Decreased apoptosis in fatty livers submitted to subnormothermic machine-perfusion respect to cold storage

Author

E. Boncompagni, E. Gini, A. Ferrigno, G. Milanesi, E. Gringeri, S. Barni, U. Cillo, M. Vairetti, and I. Freitas

Subjects
fatty liver, transplantation, apoptosis, sinusoidal cells, sub-normothermic machine perfusion, cold storage, Biology (General), QH301-705.5
Abstract

Machine perfusion at subnormothermic temperature (20°C), MP20, was developed by Vairetti et al. and showed to afford a better preservation of fatty livers respect to traditional cold storage (CS) in terms of enzyme release into the perfusate and bile, glycogen stores, energy charge and oxidative stress. Here we investigated whether it also caused decreased cell death by apoptosis. Fatty and lean Zucker rats were submitted to MP20 or CS for 6 h and reperfused normothermically for 2 h. Apoptotic cells were revealed by immunohistochemistry of activated caspase-3 and M30 (new epitope on CK18 degraded by caspase-3) and by the TUNEL assay. Portal pressure was also determined. A statistically significant reduction of hepatocyte apoptosis, but especially of sinusoidal cells was determined for fatty livers submitted to MP20 respect to CS. Portal pressure was significantly lower after MP20 respect to CS. The reduction of sinusoidal cell death by apoptosis without need for anti-apoptotic therapies appears particularly positive since apoptotic sinusoidal cells hinder microcirculation in the sinusoids and are thrombogenic. These results further confirm the potential of MP20 for preserving fatty livers that would be otherwise discarded as grafts, and thus for increasing the donor pool for liver transplantation.

Published
2011
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3. Bile detection of squamous cell carcinoma antigen (SCCA) in extrahepatic cholangiocarcinoma

Author

E. Gringeri, A. Biasiolo, M. Di Giunta, C. Mescoli, V. Guzzardo, A. Sartori, G. Cirillo, E. Nieddu, F.E. D'Amico, P. Pontisso, and U. Cillo

Subjects
Hepatology, Gastroenterology
Abstract

Cholangiocarcinoma (CCA) is a rare biliary tract tumor with poor prognosis that often is challenging to diagnose and the majority of patients present with advanced stage. Squamous cell carcinoma antigen 1 (SCCA1) overexpression has been found in different tumors associated with poor prognosis and chemoresistance.To assess the presence and possible prognostic role of SCCA1/2 isoforms in bile and serum of patients with CCA.Forty seven surgical patients (36 with CCA and 11 with benign diseases) were prospectively included in the study. Serum and bile specimens were collected at the time of surgery and free and IgM-complexed SCCA was quantified by ELISA (Xeptagen, srl).Free or IgM linked SCCA was rarely found in serum, while SCCA was detectable in bile samples of patients with CCA, especially in those with extrahepatic form (43% vs 17%, p = 0.008), but not in controls. Despite similar tumor stage, these positive patients presented a trend toward a higher percentage of portal invasion (27% vs 15%) and of tumor recurrence than negative cases (62% vs 40%), although the difference was not statistically significant.These preliminary results indicate that bile testing for SCCA is a specific marker of extrahepatic CCA, with potential prognostic value.

Published
2023
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5. More Pronounced Hypercoagulable State and Hypofibrinolysis in Patients With Cirrhosis With Versus Without HCC

Author

E. Campello, Alberto Zanetto, Sabrina Gavasso, Luca Spiezia, Graziella Saggiorato, Fabio Farinati, U. Cillo, Cristiana Bulato, Patrizia Burra, Francesco Paolo Russo, Paolo Simioni, Sarah Shalaby, and Marco Senzolo

Subjects
Liver Cirrhosis, Male, medicine.medical_specialty, Antifibrinolytic, Cirrhosis, Carcinoma, Hepatocellular, medicine.drug_class, medicine.medical_treatment, RC799-869, Chronic liver disease, Gastroenterology, Hemostatics, Liver disease, Predictive Value of Tests, Internal medicine, Fibrinolysis, Medicine, Humans, Thrombophilia, Decompensation, Prospective Studies, Blood Coagulation, Aged, Venous Thrombosis, Hemostasis, Hepatology, business.industry, Portal Vein, Liver Neoplasms, Patient Acuity, Original Articles, Diseases of the digestive system. Gastroenterology, Middle Aged, medicine.disease, Portal vein thrombosis, Hepatocellular carcinoma, Case-Control Studies, Multivariate Analysis, Disease Progression, Original Article, Female, business
Abstract

In patients with cirrhosis, particularly those with hepatocellular carcinoma (HCC), hypercoagulability may be associated with purported increased risks of portal vein thrombosis and cirrhosis progression. In this study, we extensively investigated hemostatic alterations potentially responsible for the thrombotic tendency in HCC, and evaluated whether such alterations were predictive of hepatic decompensation. Patients with cirrhosis at all stages were prospectively recruited and underwent an extensive hemostatic assessment, including all procoagulant factors and inhibitors, thrombin generation with and without thrombomodulin (TG), profibrinolytic and antifibrinolytic factors, and plasmin-antiplasmin complex. In study part 1 (case control), we compared alterations of coagulation and fibrinolysis in patients with cirrhosis with versus without HCC. In study part 2 (prospective), the subgroup of patients with decompensated cirrhosis was followed for development of further decompensation, and predictors of outcome were assessed by multivariate analysis. One-hundred patients were recruited (50 each with and without HCC). Severity of cirrhosis was comparable between groups. Median HCC volume was 9 cm3 (range: 5-16). Compared with controls, patients with HCC demonstrated a significantly more prothrombotic hemostatic profile due to increased TG and reduced activation of fibrinolysis, independent of cirrhosis stage. During a median follow-up of 175 days, 20 patients with decompensated cirrhosis developed further episodes of decompensation that were predicted by low FVII and high plasminogen activator inhibitor-1 levels, independent of Model for End-Stage Liver Disease score. Conclusion: Patients with cirrhosis with HCC have profound hyper-coagulable changes that can account for their increased thrombotic tendency. In contrast, hypercoagulability in patients with decompensated cirrhosis is more likely a consequence of chronic liver disease rather than a driver for cirrhosis progression.

Published
2021

7. Preoperative predictors of recurrence beyond Milan criteria in hepatocellular carcinoma patients treated with frontline liver resection

Author

F. Pelizzaro, F. Trevisani, A. Vitale, U. Cillo, F. Piscaglia, G. Missale, A. Sangiovanni, F.G. Foschi, G. Cabibbo, E. Caturelli, M. Di Marco, F. Azzaroli, M.R. Brunetto, G. Raimondo, G. Vidili, M. Guarino, A. Gasbarrini, C. Campani, G. Svegliati-Baroni, E.G. Giannini, A. Mega, A. Masotto, G.L. Rapaccini, D. Magalotti, R. Sacco, G. Nardone, and F. Farinati

Subjects
Hepatology, Gastroenterology
Published
2023
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13. Hepatitis D: A still relevant disease

Author

S. Battistella, F. D'Arcangelo, M. Grasso, A. Zanetto, M. Senzolo, G. Germani, M. Gambato, U. Cillo, E. Gringeri, A. Vitale, P. Burra, and F.P. Russo

Subjects
Hepatology, Gastroenterology
Published
2023
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15. 413.11: The Improvement Study: Call for a New International Prospective Non-competitive, Observational Study to Validate And Optimize Kinetic Models to Predict Liver Allograft Failure At 3 and 12 Months After Liver Transplantation

Author

A Avolio, V Agopian, Marco Pascale, P Burra, K Croome, M de Santibanes, H Egawa, C Fondevila, Z Guo, Q Lai, P Martins, G Oniscu, W Polak, C Quintini, M Rela, G Sapisochin, J Wielderkeher, G Spoletini, S Agnes, P Pafundi, T Pasciuto, and U Cillo

Subjects
Transplantation
Published
2022
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16. STUDIO RETROSPETTIVO MULTICENTRICO SULL'UTILIZZO DELLA PERFUSIONE NORMOTERMICA REGIONALE E DELLA MACCHINA DA PERFUSIONE NEL TRAPIANTO DI FEGATO DA DONATORE IN MORTE CIRCOLATORIA

Author

R. De Carlis, A. Schlegel, S. Frassoni, T. Olivieri, M. Ravaioli, S. Camagni, D. Patrono, D. Bassi, D. Pagano, S. Di Sandro, A. Lauterio, V. Bagnardi, S. Gruttadauria, U. Cillo, R. Romagnoli, M. Colledan, M. Cescon, F. Di Benedetto, P. Muiesan, L. De Carlis, and R. De Carlis, A. Schlegel, S. Frassoni, T. Olivieri, M. Ravaioli, S. Camagni, D. Patrono, D. Bassi, D. Pagano, S. Di Sandro, A. Lauterio, V. Bagnardi, S. Gruttadauria, U. Cillo, R. Romagnoli, M. Colledan, M. Cescon, F. Di Benedetto, P. Muiesan, L. De Carlis

Subjects
perfusione normotermica
Published
2021

18. Efficacy and safety of Niuliva® immune globulin to prevent hepatitis B reinfection in de novo orthotopic liver transplant

Author

F. Di Benedetto, M Barcelò, U. Cillo, Mauro Salizzoni, P De Simone, Antonio Páez, and Mk Woodward

Subjects
recurrence, biology, business.industry, Orthotopic Liver Transplant, anhepatic phase, ®, Hepatitis B, medicine.disease, HBIG, hepatitis B virus, intravenous, Niuliva, orthotopic liver transplantation, reinfection, Virology, Immunology, biology.protein, Medicine, Antibody, business
Abstract

Aims: To determine efficacy and safety of intravenous hepatitis B immune globulin (Niuliva®, Grifols) to prevent reinfection in de novo orthotopic liver transplantation. Patients & methods: In a nonrandomized, noncontrolled and Phase III clinical trial, 15 adult patients (12 men) were treated with Niuliva from the anhepatic phase (10,000 IU/daily 1 week postsurgery) up to 6 or 12 months (5000 IU/weekly 1 month; 5000 IU/monthly thereafter). Results: No patients showed reinfection throughout the study. Niuliva was effective in maintaining antibody titers above the thresholds recommended by the European Medicines Agency (EMA) to prevent reinfection (100–150 IU/l). Four serious adverse events were reported in three patients (none related to the study product). There were no seroconversions and no deaths. Conclusion: Long-term, high-dose Niuliva administration was safe and effective to prevent graft reinfection in the tested patients.

Published
2019
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19. Evolution of Techniques and Surgical Outcomes of Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy in Italy: A Comprehensive Trend Analysis over 9 Years

Author

M. Serenari, F. Ratti, M. Zanello, N. Guglielmo, F. Mocchegiani, F. Di Benedetto, M. Colledan, V. Mazzaferro, M. Cescon, A. Ferrero, E. Gringeri, M. Massani, R. Dalla Valle, G. Grazi, B. Nardo, G. Zanus, F. Romano, M. Masetti, U. Cillo, M. Vivarelli, G.M. Ettorre, L. Aldrighetti, and E. Jovine

Subjects
Hepatology, Gastroenterology
Published
2022
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20. Bile Leakage after Laparoscopic and Open Liver Resection; Incidence and Clinical Impact: An International Multicenter Propensity Score-Matched Study of 13,379 Patients

Author

Nadia Russolillo, M. Abu Hilal, F. Cipriani, Davit L. Aghayan, Bjørn Edwin, Ra’ed Al-jarrah, John N. Primrose, Fernando Rotellar, M. D'Hondt, Francesca Ratti, L. Aldrighetti, Annamaria Ferrero, M.G. Besselink, Marco Vivarelli, J. Lanari, A. Benedetti Cacciaguerra, David Fuks, Santiago López-Ben, U. Cillo, Felice Giuliante, and B. Görgec

Subjects
medicine.medical_specialty, Open liver resection, Hepatology, business.industry, Incidence (epidemiology), Propensity score matching, medicine, Gastroenterology, Bile leakage, business, Surgery
Abstract

Despite many developments, postoperative bile leakage (POBL) remains a relatively common postoperative complication after laparoscopic liver resection (LLR) and open liver resection (OLR). Previous studies regarding the incidence and clinical impact of POBL have mainly focused on patients undergoing OLR. The aim of this study is to compare the incidence and clinical impact of POBL between patients undergoing LLR and OLR in a large international multicenter cohort using a propensity score matched analysis.

Published
2022
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21. A Model to Predict Outcomes Following Liver Resection for Hepatocellular Carcinoma on Metabolic Syndrome: A Western Perspective on a Rising Disease

Author

G. Berardi, L. Aldrighetti, C. Ferrone, V. Mazzaferro, P. Serrano, D. Cherqui, D. Geller, U. Cillo, G. Ettorre, A. Ferrero, D. Kwon, M. Cescon, G. Sapisochin, F. Rotellar, G. Torzilli, M. Abu-Hilal, C. Corvera, S. Helton, E. Onkendi, S. Lopez Ben, R. Troisi, K. Simo, C. Conrad, and P. Kingham

Subjects
Hepatology, Gastroenterology
Published
2022
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22. OC.04.6 CIRCULATING PROSTAGLANDIN E2: A NOVEL POTENTIAL PROGNOSTIC BIOMARKER IN PATIENTS WITH HEPATOCELLULAR CARCINOMA

Author

G. Businello, A. Ponzoni, M.P. Kitenge, G. Munari, U. Cillo, Romilda Cardin, Fabio Farinati, Alessandro Vitale, Matteo Fassan, Filippo Pelizzaro, and B. Penzo

Subjects
Hepatology, business.industry, Hepatocellular carcinoma, Gastroenterology, Cancer research, Medicine, Prognostic biomarker, In patient, Prostaglandin E2, business, medicine.disease, medicine.drug
Published
2021
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23. Liver transplantation as last-resort treatment for patients with bile duct injuries following cholecystectomy: A multicenter analysis

Author

Tsaparas, P. Machairas, N. Ardiles, V. Krawczyk, M. Patrono, D. Baccarani, U. Cillo, U. Aandahl, E.M. Cotsoglou, C. Espinoza, J.L. Claría, R.S. Kostakis, I.D. Foss, A. Mazzaferro, V. De Santibañes, E. Sotiropoulos, G.C.

Subjects
education
Abstract

Background Liver transplantation (LT) has been used as a last resort in patients with end-stage liver disease due to bile duct injuries (BDI) following cholecystectomy. Our study aimed to identify and evaluate factors that cause or contribute to an extended liver disease that requires LT as ultimate solution, after BDI during cholecystectomy. Methods Data from 8 high-volume LT centers relating to patients who underwent LT after suffering BDI during cholecystectomy were prospectively collected and retrospectively analyzed. Results Thirty-four patients (16 men, 18 women) with a median age of 45 (range 22-69) years were included in this study. Thirty of them (88.2%) underwent LT because of liver failure, most commonly as a result of secondary biliary cirrhosis. The median time interval between BDI and LT was 63 (range 0-336) months. There were 23 cases (67.6%) of postoperative morbidity, 6 cases (17.6%) of post-transplant 30-day mortality, and 10 deaths (29.4%) in total after LT. There was a higher probability that patients with concomitant vascular injury (hazard ratio 10.69, P=0.039) would be referred sooner for LT. Overall survival following LT at 1, 3, 5 and 10 years was 82.4%, 76.5%, 73.5% and 70.6%, respectively. Conclusion LT for selected patients with otherwise unmanageable BDI following cholecystectomy yields acceptable long-term outcomes. © 2021 Hellenic Society of Gastroenterology.

Published
2021

27. SARS-CoV-2 infection in liver transplantation is associated with favorable outcomes: an Italian transplant registry study

Author

M. Rendina, M. Barone, S. Trapani, L. Masiero, P. Trerotoli, F. Puoti, L.G. Lupo, S. Agnes, A. Grieco, E. Andorno, S. Marenco, U. Baccarani, P. Toniutto, A. Carraro, A. Colecchia, M. Cescon, M.C. Morelli, U. Cillo, P. Burra, P. Angeli, M. Colledan, S. Fagiuoli, L. De Carlis, L. Belli, P. De Simone, P. Carrai, F. Di Benedetto, N. De Maria, G.M. Ettorre, V. Giannelli, S. Gruttadauria, R. Volpes, V. Mazzaferro, S. Bhoori, R. Romagnoli, S. Martini, G. Rossi, F. Donato, M. Rossi, S. Ginanni Corradini, M. Spada, G. Maggiore, G. Tisone, I. Lenci, G. Vennarecci, G.G. Di Costanzo, M. Vivarelli, G. Svegliati Baroni, F. o Zamboni, L. Mameli, S. Tafuri, S. Simone, L. Gesualdo, M. Cardillo, and A. Di Leo

Subjects
Hepatology, Gastroenterology
Published
2022
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28. Prognostic Models predicting allograft failure at 90 and 365 days after liver transplantation. Call for an international Est to West prospective observational study to guide re-transplantation

Author

A. Avolio, V. Agopian, P. Burra, P. Martins, G. Oniscu, M. Rela, G. Sapisochin, C. Quintini, H. Egawa, W. Polak, X. He, C. Fondevila, C.M. Lo, M. De Santibanes, Z. Guo, Q. Lai, A.J. Hessheimer, G. Spoletini, G. Bianco, G. Moschetta, L. Miele, A. Grieco, S. Agnes, S. Gruttadauria, R. Romagnoli, and U. Cillo

Subjects
Hepatology, Gastroenterology
Published
2022
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29. Minimally Invasive Liver Resections for Hepatocelullar Carcinoma on Metabolic Syndrome: A Western Perspective on a Rising Disease

Author

G. Berardi, L. Aldrighetti, C. Ferrone, V. Mazzaferro, P. Serrano, D. Cherqui, D. Geller, U. Cillo, G. Ettorre, A. Ferrero, D. Kwon, M. Cescon, G. Sapisochin, F. Rotellar, G. Torzilli, M. Abu-Hilal, C. Corvera, S. Helton, E. Onkendi, S. Lopez Ben, R. Troisi, K. Simo, C. Conrad, and P. Kingham

Subjects
Hepatology, Gastroenterology
Published
2022
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31. Pregnancy after liver transplantation: a survey from Italian liver transplants centres

Author

Simona Marenco, Lucia Lapenna, Manuela Merli, Erica Villa, Francesco Russo, L. Trespidi, P. Burra, Sofia Volpato, A.Galeota Lanza, N. De Maria, I.G. Ramezzana, Erida Nure, U. Cillo, Luisa Pasulo, Maria Francesca Donato, P. Bo, Alberto Ferrarese, Patrizia Boccagni, A.W. Avolio, S.S. Sciarrone, Erich Cosmi, L. Mameli, Marco Maria Pascale, Federica Invernizzi, Sherrie Bhoori, Pierluigi Toniutto, Stefano Fagiuoli, Ilaria Lenci, and R. Di Donato

Subjects
medicine.medical_specialty, Pregnancy, Hepatology, business.industry, medicine.medical_treatment, Gastroenterology, Medicine, Liver transplantation, Liver transplants, business, medicine.disease, Surgery
Published
2021
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32. Increased platelet aggregation in patients with cirrhosis and hepatocellular carcinoma: A new potential therapeutic target?

Author

Alberto Zanetto, E. Campello, Martina Gambato, P. Burra, Marco Senzolo, U. Cillo, Paolo Simioni, Francesco Russo, Fabio Farinati, Alessandro Vitale, and Sarah Shalaby

Subjects
medicine.medical_specialty, Cirrhosis, Hepatology, business.industry, Internal medicine, Hepatocellular carcinoma, Gastroenterology, medicine, In patient, medicine.disease, business, Increased Platelet Aggregation
Published
2021
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35. AF.79 EPIDEMIOLOGICAL TRENDS OF HEPATOCELLULAR CARCINOMA IN PATIENTS WITH METABOLIC-DYSFUNCTION-ASSOCIATED FATTY LIVER DISEASE (MAFLD) IN ITALY

Author

U. Cillo, Alessandro Vitale, Giulio Marchesini, Fabio Farinati, G. Svegliati Baroni, M. Cucco, Luca Miele, and Franco Trevisani

Subjects
medicine.medical_specialty, Hepatology, business.industry, Fatty liver, Gastroenterology, Disease, medicine.disease, Hepatocellular carcinoma, Internal medicine, Epidemiology, medicine, In patient, business
Published
2021
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36. OC.04.8 IMPACT OF COVID-19 PANDEMIC ON REFERRAL OF PATIENTS WITH LIVER DISEASE TO A LIVER TRANSPLANT CENTER

Author

P. Persona, E. Serra, Alberto Zanetto, G. Carretta, Daniele Donato, U. Cillo, Francesco Russo, Marco Senzolo, Monica Pellone, Sarah Shalaby, Martina Gambato, Giacomo Germani, Alberto Ferrarese, P. Burra, and Paolo Feltracco

Subjects
medicine.medical_specialty, Hepatology, Coronavirus disease 2019 (COVID-19), Referral, business.industry, Gastroenterology, medicine.disease, Oc.04 Liver, Liver disease, Oral Communications, Emergency medicine, Pandemic, Medicine, Center (algebra and category theory), business
Published
2021

39. Minimally-invasive Stage 1 to Protect against the Risk of Liver Failure in ALPPS for Hepatocellular Carcinoma

Author

U. Cillo, Bruno Nardo, M. Zanello, Matteo Serenari, R. Dalla Valle, Marco Massani, F. Di Benedetto, L. Aldrighetti, Giuseppe Maria Ettorre, Marco Vivarelli, Matteo Cescon, Michele Colledan, Vincenzo Mazzaferro, Federico Mocchegiani, Francesca Ratti, Elio Jovine, and Nicola Guglielmo

Subjects
medicine.medical_specialty, Hepatology, business.industry, Hepatocellular carcinoma, Internal medicine, Gastroenterology, medicine, Liver failure, Stage (cooking), medicine.disease, business
Published
2021
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40. Laparoscopic and percutaneous microwave ablation to treat liver metastasis from colon cancer. A tool for long-term iterative strategy: results from a high volume center

Author

Domenico Bassi, Michele Finotti, F.E. D'Amico, Riccardo Boetto, U. Cillo, Enrico Gringeri, R. Alessandris, and Alessandro Vitale

Subjects
medicine.medical_specialty, Percutaneous, Hepatology, Colorectal cancer, business.industry, Microwave ablation, Gastroenterology, medicine.disease, Iterative strategy, Term (time), Metastasis, medicine, Center (algebra and category theory), Radiology, business, Volume (compression)
Published
2021
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41. Benefits of Laparoscopy for Major Liver Resection in Cirrhotic Patients: Time for Pushing Indications Beyond the Limits? A Propensity Score Matched Analysis

Author

Nadia Russolillo, F. Cipriani, Andrea Ruzzenente, M.G. Besselink, M. Abu Hilal, Marco Vivarelli, U. Cillo, David Fuks, Federico Mocchegiani, Felice Giuliante, Adnan Alseidi, J. Lanari, A. Benedetti Cacciaguerra, M. D'Hondt, Giuseppe Zimmitti, Fernando Rotellar, Bjørn Edwin, L. Aldrighetti, Santiago López-Ben, Annamaria Ferrero, and B. Görgec

Subjects
medicine.medical_specialty, Hepatology, medicine.diagnostic_test, business.industry, Propensity score matching, Gastroenterology, Medicine, business, Laparoscopy, Resection, Surgery
Published
2021
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42. OC.05.6 GENDER-RELATED DIFFERENCES IN SCCA-IGM LEVELS IN HEPATOCELLULAR CARCINOMA PATIENTS TREATED WITH TRANSARTERIAL CHEMOEMBOLIZATION

Author

Filippo Pelizzaro, F. Soldà, U. Cillo, Camillo Aliberti, A. Imondi, Alessandro Vitale, Fabio Farinati, A. Sammarco, Romilda Cardin, A. Sartori, and B. Penzo

Subjects
medicine.medical_specialty, Hepatology, business.industry, Internal medicine, Hepatocellular carcinoma, Gastroenterology, medicine, medicine.disease, Gender related, business
Published
2020
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44. Role of a dedicated referral system for patients with liver disease and potential indication for liver transplantation: prospective data from a single centre experience

Author

Giacomo Germani, Alberto Ferrarese, Monica Pellone, P. Burra, P. Persona, Martina Gambato, U. Cillo, Francesco Russo, G. Carretta, Paolo Feltracco, S.S. Sciarrone, Daniele Donato, Sarah Shalaby, and Marco Senzolo

Subjects
medicine.medical_specialty, Hepatology, business.industry, General surgery, medicine.medical_treatment, Gastroenterology, Prospective data, Liver transplantation, medicine.disease, Single centre, Liver disease, Medicine, Referral system, business
Published
2020
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45. Recent trends and intention-to-treat survival of liver transplantation for nonalcoholic steatohepatitis: an Italian liver transplant registry study

Author

N. De Maria, S. Trapani, M.C. Morelli, Renato Romagnoli, L. De Carlis, Stefano Fagiuoli, Riccardo Volpes, Paola Carrai, Silvia Martini, Francesco Donato, Massimo Cardillo, Michele Colledan, U Tedeschi, Lino Belli, Alessandra Bertacco, P. De Simone, Salvatore Gruttadauria, Marcos A. Rossi, Matteo Cescon, Alessandro Vitale, Antonio Colecchia, P. Burra, U. Cillo, Gemma Rossi, A. Ricci, F. Di Benedetto, Vitale, A, Trapani, S, Burra, P, Bertacco, A, Romagnoli, R, Martini, S, De Simone, P, Carrai, P, Cescon, M, Morelli, M, De Carlis, L, Belli, L, Gruttadauria, S, Volpes, R, Colledan, M, Fagiuoli, S, Rossi, G, Donato, F, Di Benedetto, F, De Maria, N, Tedeschi, U, Colecchia, A, Ricci, A, Rossi, M, Cardillo, M, and Cillo, U

Subjects
Nonalcoholic steatohepatitis, medicine.medical_specialty, Intention-to-treat analysis, liver transplantation, Hepatology, business.industry, Registry study, Internal medicine, medicine.medical_treatment, Gastroenterology, medicine, Liver transplantation, business
Published
2020
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46. Adherence to Surviving Sepsis campaign 3-hour bundles improves survival in non-critically ill patients with cirrhosis and sepsis

Author

L. Torresan, Salvatore Piano, P. Angeli, Marta Tonon, U. Cillo, Carmine Gambino, P. Burra, S. Incicco, and Silvano Fasolato

Subjects
Sepsis, medicine.medical_specialty, Cirrhosis, Surviving Sepsis Campaign, Hepatology, business.industry, Critically ill, Gastroenterology, medicine, Intensive care medicine, medicine.disease, business
Published
2020
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47. Multicentre evaluation of case volume in minimally invasive hepatectomy

Author

L Viganò, M Cimino, L Aldrighetti, A Ferrero, U Cillo, A Guglielmi, G M Ettorre, F Giuliante, R Dalla Valle, V Mazzaferro, E Jovine, L De Carlis, F Calise, G Torzilli, F Ratti, E Gringeri, N Russolillo, G B Levi Sandri, F Ardito, U Boggi, S Gruttadauria, F Di Benedetto, G E Rossi, S Berti, G Ceccarelli, L Vincenti, G Belli, F Zamboni, A Coratti, P Mezzatesta, R Santambrogio, G Navarra, A Giuliani, A D Pinna, A Parisi, M Colledan, A Slim, A Antonucci, G L Grazi, A Frena, G Sgroi, A Brolese, L Morelli, A Floridi, A Patriti, L Veneroni, L Boni, P Maida, G Griseri, M Filauro, S Guerriero, G Tisone, R Romito, U Tedeschi, G Zimmitti, Vigano L., Cimino M., Aldrighetti L., Ferrero A., Cillo U., Guglielmi A., Ettorre G.M., Giuliante F., Dalla Valle R., Mazzaferro V., Jovine E., De Carlis L., Calise F., Torzilli G., Ratti F., Gringeri E., Russolillo N., Levi Sandri G.B., Ardito F., Boggi U., Gruttadauria S., Di Benedetto F., Rossi G.E., Berti S., Ceccarelli G., Vincenti L., Belli G., Zamboni F., Coratti A., Mezzatesta P., Santambrogio R., Navarra G., Giuliani A., Pinna A.D., Parisi A., Colledan M., Slim A., Antonucci A., Grazi G.L., Frena A., Sgroi G., Brolese A., Morelli L., Floridi A., Patriti A., Veneroni L., Boni L., Maida P., Griseri G., Filauro M., Guerriero S., Tisone G., Romito R., Tedeschi U., Zimmitti G., Vigano, L, Cimino, M, Aldrighetti, L, Ferrero, A, Cillo, U, Guglielmi, A, Ettorre, G, Giuliante, F, Dalla Valle, R, Mazzaferro, V, Jovine, E, De Carlis, L, Calise, F, Torzilli, G, Ratti, F, Gringeri, E, Russolillo, N, Levi Sandri, G, Ardito, F, Boggi, U, Gruttadauria, S, Di Benedetto, F, Rossi, G, Berti, S, Ceccarelli, G, Vincenti, L, Belli, G, Zamboni, F, Coratti, A, Mezzatesta, P, Santambrogio, R, Navarra, G, Giuliani, A, Pinna, A, Parisi, A, Colledan, M, Slim, A, Antonucci, A, Grazi, G, Frena, A, Sgroi, G, Brolese, A, Morelli, L, Floridi, A, Patriti, A, Veneroni, L, Boni, L, Maida, P, Griseri, G, Filauro, M, Guerriero, S, Tisone, G, Romito, R, Tedeschi, U, Zimmitti, G, Vigano, L., Cimino, M., Aldrighetti, L., Ferrero, A., Cillo, U., Guglielmi, A., Ettorre, G. M., Giuliante, F., Dalla Valle, R., Mazzaferro, V., Jovine, E., De Carlis, L., Calise, F., Torzilli, G., Ratti, F., Gringeri, E., Russolillo, N., Levi Sandri, G. B., Ardito, F., Boggi, U., Gruttadauria, S., Di Benedetto, F., Rossi, G. E., Berti, S., Ceccarelli, G., Vincenti, L., Belli, G., Zamboni, F., Coratti, A., Mezzatesta, P., Santambrogio, R., Navarra, G., Giuliani, A., Pinna, A. D., Parisi, A., Colledan, M., Slim, A., Antonucci, A., Grazi, G. L., Frena, A., Sgroi, G., Brolese, A., Morelli, L., Floridi, A., Patriti, A., Veneroni, L., Boni, L., Maida, P., Griseri, G., Filauro, M., Guerriero, S., Tisone, G., Romito, R., Tedeschi, U., and Zimmitti, G.

Subjects
Aged, Female, Hepatectomy, Humans, Italy, Liver Neoplasms, Male, Minimally Invasive Surgical Procedures, Registries, Retrospective Studies, Treatment Outcome, Liver surgery, Hepatic resection, Settore MED/18 - CHIRURGIA GENERALE, medicine.medical_treatment, Proposal, laparoscopy, Metastases, Liver resections, 0302 clinical medicine, minimally invasive liver surgery, case volume, Case volume, Laparascopic Liver Resection, minimally invasive hepatectomy, liver resections, 030220 oncology & carcinogenesis, high-volume centres, 030211 gastroenterology & hepatology, hepatectomy, laparoscopy, liver resections, Hepatocellular-Carcinome, medicine.medical_specialty, Outcomes, NO, 03 medical and health sciences, Hospital volume, medicine, minimally invasive, hepatectomy, LS7_4, business.industry, Retrospective cohort study, Laparascopic Liver Resection, Hepatocellular-Carcinome, Surgery, Outcomes, Metastases, Difficulty, Proposal, hepatectomy, Surgery, Severe morbidity, business, Difficulty
Abstract

Surgical outcomes may be associated with hospital volume and the influence of volume on minimally invasive liver surgery (MILS) is not known.Patients entered into the prospective registry of the Italian Group of MILS from 2014 to 2018 were considered. Only centres with an accrual period of at least 12 months and stable MILS activity during the enrolment period were included. Case volume was defined by the mean number of minimally invasive liver resections performed per month (MILS/month).A total of 2225 MILS operations were undertaken by 46 centres; nine centres performed more than two MILS/month (1376 patients) and 37 centres carried out two or fewer MILS/month (849 patients). The proportion of resections of anterolateral segments decreased with case volume, whereas that of major hepatectomies increased. Left lateral sectionectomies and resections of anterolateral segments had similar outcome in the two groups. Resections of posterosuperior segments and major hepatectomies had higher overall and severe morbidity rates in centres performing two or fewer MILS/month than in those undertaking a larger number (posterosuperior segments resections: overall morbidity 30·4 versus 18·7 per cent respectively, and severe morbidity 9·9 versus 4·0 per cent; left hepatectomy: 46 versus 22 per cent, and 19 versus 5 per cent; right hepatectomy: 42 versus 34 per cent, and 25 versus 15 per cent).A volume-outcome association existed for minimally invasive hepatectomy. Complex and major resections may be best managed in high-volume centres.Los resultados quirúrgicos pueden estar relacionados con el volumen de casos del hospital, pero no se conoce la influencia en la cirugía mínimamente invasiva del hígado (minimally‐invasive liver surgery, MILS). MÉTODOS: Se incluyeron los pacientes registrados en el registro prospectivo del grupo italiano de MILS desde 2014 a 2018. Solo se consideraron centros con extensión de ≥ 12 meses y actividad estable de MILS durante el periodo de reclutamiento. El volumen de casos se definió como el número de MILS efectuado por mes.Se llevaron a cabo un total de 2.225 MILS en 46 centros, 9 de ellos con 2 MILS/mes (n = 1.376 pacientes) y 37 centros con ≤ 2 MILS/mes (n = 849). La proporción de resecciones de segmentos anterolaterales disminuyó con el volumen de casos, mientras que la proporción de hepatectomías mayores aumentó. Los resultados para ambos grupos fueron similares en las seccionectomías lateral izquierda y en las resecciones del segmento anterolateral. Las resecciones del segmento posterosuperior y las hepatectomías mayores presentaron tasas más altas de morbilidad global y morbilidad grave en centros que realizaban ≤ 2 MILS/mes que en los que realizaban 2 MILS/mes (resecciones del segmento posterosuperior, morbilidad global 30,4 versus 18,7%, morbilidad grave 9,9 versus 4,0%; hepatectomía izquierda, 46,2 versus 22,0%, 19,2 versus 5,5%; hepatectomía derecha, 41,7 versus 33,8%, 25,0 versus 14.9%). CONCLUSIÓN: Se observó una asociación volumen‐resultado para la resección hepática mínimamente invasiva. Las resecciones complejas y mayores se pueden manejar mejor en centros de gran volumen.

Published
2020

48. Liver Transplantation and Hepatobiliary Surgery

Author

U. Cillo, Domenico Bassi, Enrico Gringeri, F.E. D'Amico, and Riccardo Boetto

Subjects
Hepatobiliary surgery, medicine.medical_specialty, business.industry, medicine.medical_treatment, medicine, Liver transplantation, business, Surgery
Published
2020
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49. Severe acute alcoholic hepatitis: can we offer early liver transplantation?

Author

Giacomo Germani, Biancarosa Volpe, Giuseppe Feltrin, G. Carretta, Debora Bizzaro, Alessandra Feltrin, Giovanni Forza, Andrea Ronzan, Patrizia Burra, U. Cillo, and F.E. D'Amico

Subjects
medicine.medical_specialty, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, media_common.quotation_subject, Liver transplantation, Severity of Illness Index, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Early Medical Intervention, Internal Medicine, medicine, Humans, Decompensation, Intensive care medicine, media_common, First episode, Hepatitis, Alcoholic, business.industry, Gastroenterology, Abstinence, medicine.disease, Liver Transplantation, Transplantation, surgical procedures, operative, 030220 oncology & carcinogenesis, Acute Disease, 030211 gastroenterology & hepatology, Transplant surgeon, Acute Alcoholic Hepatitis, business
Abstract

Alcohol-related liver disease is one of the most prevalent liver diseases worldwide and is the second most common indication for liver transplantation. Most transplant programs require 6 months of abstinence prior to transplantation; commonly referred to as the "six-month rule." According to this rule, the patients admitted for severe acute alcoholic hepatitis are not eligible for liver transplantation in most transplant centers. However, there is increasing evidence that if liver transplantation is performed in selected patients after the first episode of severe decompensation with no response to steroid therapy, it represents an effective treatment. In such selected patients, the post-transplant outcomes are good with survival rates that are significantly higher when compared with patients not responding to medical therapy and not transplanted. A multidisciplinary assessment, involving several stakeholders such as a transplant hepatologist, transplant surgeon, psychologist and psychiatrist is becoming mandatory to properly evaluate the candidate to liver transplantation for alcoholic liver diseases and severe acute alcoholic hepatitis. In the clinical setting of severe acute alcoholic hepatitis, further studies are needed for the identification of accepted selection clinical and psychosocial criteria that can provide the best long-term results. The early liver transplantation option should therefore be explored within strict criteria for this setting.

Published
2020

50. Analysis of clinical course of portal vein thrombosis in cirrhosis with hepatocellular carcinoma

Author

E. Pizzirani, P. Burra, Alberto Zanetto, Enrico Gringeri, M. Grasso, F.E. D'Amico, U. Cillo, Martina Gambato, Marco Senzolo, and Alessandro Vitale

Subjects
medicine.medical_specialty, Cirrhosis, Hepatology, business.industry, Internal medicine, Hepatocellular carcinoma, Gastroenterology, medicine, Clinical course, medicine.disease, business, Portal vein thrombosis
Published
2021
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