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1. C-reactive protein but not procalcitonin may predict antibiotic response and outcome in infections following major abdominal surgery

Author: Perrella, A., Giuliani, A., De Palma, M., Castriconi, M., Molino, C., Vennarecci, G., Antropoli, C., Esposito, C., Calise, F., and Frangiosa, A.
Published: 2022
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2. Open vs minimally invasive liver surgery for gallbladder cancer, an Italian registry-based analysis

Author: Poletto, E., primary, Conci, S., additional, Ettorre, G.M., additional, Cillo, U., additional, Belli, A., additional, Giuliante, F., additional, Jovine, E., additional, Vennarecci, G., additional, Frena, A., additional, Ferrero, A., additional, Gruttadauria, S., additional, Ercolani, G., additional, Di Benedetto, F., additional, Brolese, A., additional, Dalla Valle, R., additional, Ettore Rossi, G., additional, Barabino, M., additional, Filauro, M., additional, Morelli, L., additional, Massani, M., additional, Vincenti, L., additional, Aldrighetti, L., additional, and Ruzzenente, A., additional
Published: 2024
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3. Tailoring allocation policies and improving access to pediatric liver transplantation over a 16-year period

Author: Spada, Marco, primary, Angelico, Roberta, additional, Trapani, Silvia, additional, Masiero, Lucia, additional, Puoti, Francesca, additional, Colledan, Michele, additional, Cintorino, Davide, additional, Romagnoli, Renato, additional, Cillo, Umberto, additional, Cardillo, Massimo, additional, Agnes, S., additional, Andorno, E., additional, Baccarani, U., additional, Caccamo, L., additional, Rossi, G., additional, Carraro, A., additional, Cescon, M., additional, Simone, P.De, additional, Carlis, L.De, additional, Benedetto, F.Di, additional, Ettorre, G.M., additional, Gruttadauria, S., additional, Lupo, L.G., additional, Tandoi, F., additional, Mazzaferro, V., additional, Rossi, M., additional, Tisone, G., additional, Vennarecci, G., additional, Vivarelli, M., additional, and Zamboni, F., additional
Published: 2023
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4. Improving outcomes of in situ split liver transplantation in Italy over the last 25 years

Author: Lauterio, A, Cillo, U, Spada, M, Trapani, S, De Carlis, R, Bottino, G, Bernasconi, D, Scalamogna, C, Pinelli, D, Cintorino, D, D'Amico, F, Spagnoletti, G, Miggino, M, Romagnoli, R, Centonze, L, Caccamo, L, Baccarani, U, Carraro, A, Cescon, M, Vivarelli, M, Mazaferro, V, Ettorre, G, Rossi, M, Vennarecci, G, De Simone, P, Angelico, R, Agnes, S, Di Benedetto, F, Lupo, L, Zamboni, F, Zefelippo, A, Patrono, D, Diviacco, P, Laureiro, Z, Gringeri, E, Di Francesco, F, Lucianetti, A, Valsecchi, M, Gruttadauria, S, De Feo, T, Cardillo, M, De Carlis, L, Colledan, M, Andorno, E, Lauterio A., Cillo U., Spada M., Trapani S., De Carlis R., Bottino G., Bernasconi D., Scalamogna C., Pinelli D., Cintorino D., D'Amico F. E., Spagnoletti G., Miggino M., Romagnoli R., Centonze L., Caccamo L., Baccarani U., Carraro A., Cescon M., Vivarelli M., Mazaferro V., Ettorre G. M., Rossi M., Vennarecci G., De Simone P., Angelico R., Agnes S., Di Benedetto F., Lupo L. G., Zamboni F., Zefelippo A., Patrono D., Diviacco P., Laureiro Z. L., Gringeri E., Di Francesco F., Lucianetti A., Valsecchi M. G., Gruttadauria S., De Feo T., Cardillo M., De Carlis L., Colledan M., Andorno E., Lauterio, A, Cillo, U, Spada, M, Trapani, S, De Carlis, R, Bottino, G, Bernasconi, D, Scalamogna, C, Pinelli, D, Cintorino, D, D'Amico, F, Spagnoletti, G, Miggino, M, Romagnoli, R, Centonze, L, Caccamo, L, Baccarani, U, Carraro, A, Cescon, M, Vivarelli, M, Mazaferro, V, Ettorre, G, Rossi, M, Vennarecci, G, De Simone, P, Angelico, R, Agnes, S, Di Benedetto, F, Lupo, L, Zamboni, F, Zefelippo, A, Patrono, D, Diviacco, P, Laureiro, Z, Gringeri, E, Di Francesco, F, Lucianetti, A, Valsecchi, M, Gruttadauria, S, De Feo, T, Cardillo, M, De Carlis, L, Colledan, M, Andorno, E, Lauterio A., Cillo U., Spada M., Trapani S., De Carlis R., Bottino G., Bernasconi D., Scalamogna C., Pinelli D., Cintorino D., D'Amico F. E., Spagnoletti G., Miggino M., Romagnoli R., Centonze L., Caccamo L., Baccarani U., Carraro A., Cescon M., Vivarelli M., Mazaferro V., Ettorre G. M., Rossi M., Vennarecci G., De Simone P., Angelico R., Agnes S., Di Benedetto F., Lupo L. G., Zamboni F., Zefelippo A., Patrono D., Diviacco P., Laureiro Z. L., Gringeri E., Di Francesco F., Lucianetti A., Valsecchi M. G., Gruttadauria S., De Feo T., Cardillo M., De Carlis L., Colledan M., and Andorno E.
Abstract: Background & Aims: Split liver transplant(ation) (SLT) is still considered a challenging procedure that is by no means widely accepted. We aimed to present data on 25-year trends in SLT in Italy, and to investigate if, and to what extent, outcomes have improved nationwide during this time. Methods: The study included all consecutive SLTs performed from May 1993 to December 2019, divided into three consecutive periods: 1993–2005, 2006–2014, and 2015–2019, which match changes in national allocation policies. Primary outcomes were patient and graft survival, and the relative impact of each study period. Results: SLT accounted for 8.9% of all liver transplants performed in Italy. A total of 1,715 in situ split liver grafts were included in the analysis: 868 left lateral segments (LLSs) and 847 extended right grafts (ERGs). A significant improvement in patient and graft survival (p <0.001) was observed with ERGs over the three periods. Predictors of graft survival were cold ischaemia time (CIT) <6 h (p = 0.009), UNOS status 2b (p <0.001), UNOS status 3 (p = 0.009), and transplant centre volumes: 25–50 cases vs. <25 cases (p = 0.003). Patient survival was significantly higher with LLS grafts in period 2 vs. period 1 (p = 0.008). No significant improvement in graft survival was seen over the three periods, where predictors of graft survival were CIT <6 h (p = 0.007), CIT <6 h vs. ≥10 h (p = 0.019), UNOS status 2b (p = 0.038), and UNOS status 3 (p = 0.009). Retransplantation was a risk factor in split liver graft recipients, with significantly worse graft and patient survival for both types of graft (p <0.001). Conclusions: Our analysis showed Italian SLT outcomes to have improved over the last 25 years. These results could help to dispel reservations regarding the use of this procedure. Impact and implications: Split liver transplant(ation) (SLT) is still considered a challenging procedure and is by no means widely accepted. This study included all
Published: 2023

5. The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipients

Author: Rendina, M, Barone, M, Lillo, C, Trapani, S, Masiero, L, Trerotoli, P, Puoti, F, Lupo, L, Tandoi, F, Agnes, S, Grieco, A, Andorno, E, Marenco, S, Giannini, E, Baccarani, U, Toniutto, P, Carraro, A, Colecchia, A, Cescon, M, Morelli, M, Cillo, U, Burra, P, Angeli, P, Colledan, M, Fagiuoli, S, De Carlis, L, Belli, L, De Simone, P, Carrai, P, Di Benedetto, F, De Maria, N, Ettorre, G, Giannelli, V, Gruttadauria, S, Volpes, R, Corsale, S, Mazzaferro, V, Bhoori, S, Romagnoli, R, Martini, S, Rossi, G, Caccamo, L, Donato, M, Rossi, M, Ginanni Corradini, S, Spada, M, Maggiore, G, Tisone, G, Lenci, I, Vennarecci, G, Tortora, R, Vivarelli, M, Svegliati Baroni, G, Zamboni, F, Mameli, L, Tafuri, S, Simone, S, Gesualdo, L, Cardillo, M, Di Leo, A, Rendina M., Barone M., Lillo C., Trapani S., Masiero L., Trerotoli P., Puoti F., Lupo L. G., Tandoi F., Agnes S., Grieco A., Andorno E., Marenco S., Giannini E. G., Baccarani U., Toniutto P., Carraro A., Colecchia A., Cescon M., Morelli M. C., Cillo U., Burra P., Angeli P., Colledan M., Fagiuoli S., De Carlis L., Belli L., De Simone P., Carrai P., Di Benedetto F., De Maria N., Ettorre G. M., Giannelli V., Gruttadauria S., Volpes R., Corsale S., Mazzaferro V., Bhoori S., Romagnoli R., Martini S., Rossi G., Caccamo L., Donato M. F., Rossi M., Ginanni Corradini S., Spada M., Maggiore G., Tisone G., Lenci I., Vennarecci G., Tortora R., Vivarelli M., Svegliati Baroni G., Zamboni F., Mameli L., Tafuri S., Simone S., Gesualdo L., Cardillo M., Di Leo A., Rendina, M, Barone, M, Lillo, C, Trapani, S, Masiero, L, Trerotoli, P, Puoti, F, Lupo, L, Tandoi, F, Agnes, S, Grieco, A, Andorno, E, Marenco, S, Giannini, E, Baccarani, U, Toniutto, P, Carraro, A, Colecchia, A, Cescon, M, Morelli, M, Cillo, U, Burra, P, Angeli, P, Colledan, M, Fagiuoli, S, De Carlis, L, Belli, L, De Simone, P, Carrai, P, Di Benedetto, F, De Maria, N, Ettorre, G, Giannelli, V, Gruttadauria, S, Volpes, R, Corsale, S, Mazzaferro, V, Bhoori, S, Romagnoli, R, Martini, S, Rossi, G, Caccamo, L, Donato, M, Rossi, M, Ginanni Corradini, S, Spada, M, Maggiore, G, Tisone, G, Lenci, I, Vennarecci, G, Tortora, R, Vivarelli, M, Svegliati Baroni, G, Zamboni, F, Mameli, L, Tafuri, S, Simone, S, Gesualdo, L, Cardillo, M, Di Leo, A, Rendina M., Barone M., Lillo C., Trapani S., Masiero L., Trerotoli P., Puoti F., Lupo L. G., Tandoi F., Agnes S., Grieco A., Andorno E., Marenco S., Giannini E. G., Baccarani U., Toniutto P., Carraro A., Colecchia A., Cescon M., Morelli M. C., Cillo U., Burra P., Angeli P., Colledan M., Fagiuoli S., De Carlis L., Belli L., De Simone P., Carrai P., Di Benedetto F., De Maria N., Ettorre G. M., Giannelli V., Gruttadauria S., Volpes R., Corsale S., Mazzaferro V., Bhoori S., Romagnoli R., Martini S., Rossi G., Caccamo L., Donato M. F., Rossi M., Ginanni Corradini S., Spada M., Maggiore G., Tisone G., Lenci I., Vennarecci G., Tortora R., Vivarelli M., Svegliati Baroni G., Zamboni F., Mameli L., Tafuri S., Simone S., Gesualdo L., Cardillo M., and Di Leo A.
Abstract: Introduction: The study of immune response to SARSCoV-2 infection in different solid organ transplant settings represents an opportunity for clarifying the interplay between SARS-CoV-2 and the immune system. In our nationwide registry study from Italy, we specifically evaluated, during the first wave pandemic, i.e., in non-vaccinated patients, COVID-19 prevalence of infection, mortality, and lethality in liver transplant recipients (LTRs), using non-liver solid transplant recipients (NL-SOTRs) and the Italian general population (GP) as comparators. Methods: Case collection started from February 21 to June 22, 2020, using the data from the National Institute of Health and National Transplant Center, whereas the data analysis was performed on September 30, 2020.To compare the sex- and age-adjusted distribution of infection, mortality, and lethality in LTRs, NL-SOTRs, and Italian GP we applied an indirect standardization method to determine the standardized rate. Results: Among the 43,983 Italian SOTRs with a functioning graft, LTRs accounted for 14,168 patients, of whom 89 were SARS-CoV-2 infected. In the 29,815 NL-SOTRs, 361 cases of SARS-CoV-2 infection were observed. The geographical distribution of the disease was highly variable across the different Italian regions. The standardized rate of infection, mortality, and lethality rates in LTRs resulted lower compared to NL-SOTRs [1.02 (95%CI 0.81-1.23) vs. 2.01 (95%CI 1.8-2.2); 1.0 (95%CI 0.5-1.5) vs. 4.5 (95%CI 3.6-5.3); 1.6 (95%CI 0.7-2.4) vs. 2.8 (95%CI 2.2-3.3), respectively] and comparable to the Italian GP. Discussion: According to the most recent studies on SOTRs and SARS-CoV-2 infection, our data strongly suggest that, in contrast to what was observed in NL-SOTRs receiving a similar immunosuppressive therapy, LTRs have the same risk of SARS-CoV-2 infection, mortality, and lethality observed in the general population. These results suggest an immune response to SARS-CoV-2 infection in LTRS that is different fr
Published: 2023

6. AFP score and metroticket 2.0 perform similarly and could be used in a “within-ALL” clinical decision tool

Author: Piñero, F, Costentin, C, Degroote, H, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Chagas, A, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Dibenedetto, F, Duque, S, Salame, E, Cillo, U, Marciano, S, Vanlemmens, C, Fagiuoli, S, Carrilho, F, Cherqui, D, Burra, P, Van Vlierberghe, H, Lai, Q, Silva, M, Rubinstein, F, Duvoux, C, Conti, F, Scatton, O, Bernard, P, Francoz, C, Durand, F, Dharancy, S, Woehl, M, Laurent, A, Radenne, S, Dumortier, J, Abergel, A, Barbier, L, Houssel-Debry, P, Pageaux, G, Chiche, L, Deledinghen, V, Hardwigsen, J, Gugenheim, J, Altieri, M, Hilleret, M, Decaens, T, Costa, P, de Ataide, E, Quiñones, E, Anders, M, Varón, A, Zerega, A, Soza, A, Machaca, M, Arufe, D, Menéndez, J, Zapata, R, Vilatoba, M, Muñoz, L, Menéndez, R, Maraschio, M, Podestá, L, Mccormack, L, Mattera, J, Gadano, A, Parente García, J, Magini, G, Miglioresi, L, Gambato, M, D'Ambrosio, C, Vitale, A, Colledan, M, Pinelli, D, Magistri, P, Vennarecci, G, Colasanti, M, Giannelli, V, Pellicelli, A, Eduard, C, Samuele, I, Jeroen, D, Jonas, S, Jacques, P, Chris, V, Dirk, Y, Peter, M, Valerio, L, Christophe, M, Olivier, D, Jean, D, Roberto, T, Paul, L, Piñero F., Costentin C., Degroote H., Notarpaolo A., Boin I. F., Boudjema K., Baccaro C., Chagas A., Bachellier P., Ettorre G. M., Poniachik J., Muscari F., Dibenedetto F., Duque S. H., Salame E., Cillo U., Marciano S., Vanlemmens C., Fagiuoli S., Carrilho F., Cherqui D., Burra P., Van Vlierberghe H., Lai Q., Silva M., Rubinstein F., Duvoux C., Conti F., Scatton O., Bernard P. H., Francoz C., Durand F., Dharancy S., Woehl M. l., Laurent A., Radenne S., Dumortier J., Abergel A., Barbier L., Houssel-Debry P., Pageaux G. P., Chiche L., Deledinghen V., Hardwigsen J., Gugenheim J., altieri M., Hilleret M. N., Decaens T., Costa P., de Ataide E. C., Quiñones E., Anders M., Varón A., Zerega A., Soza A., Machaca M. P., Arufe D., Menéndez J., Zapata R., Vilatoba M., Muñoz L., Menéndez R. C., Maraschio M., Podestá L. G., McCormack L., Mattera J., Gadano A., Parente García J. H., Magini G., Miglioresi L., Gambato M., D'Ambrosio C., Vitale A., Colledan M., Pinelli D., Magistri P., Vennarecci G., Colasanti M., Giannelli V., Pellicelli A., Eduard C., Samuele I., Jeroen D., Jonas S., Jacques P., Chris V., Dirk Y., Peter M., Valerio L., Christophe M., Olivier D., Jean D., Roberto T., Paul L. J., Piñero, F, Costentin, C, Degroote, H, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Chagas, A, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Dibenedetto, F, Duque, S, Salame, E, Cillo, U, Marciano, S, Vanlemmens, C, Fagiuoli, S, Carrilho, F, Cherqui, D, Burra, P, Van Vlierberghe, H, Lai, Q, Silva, M, Rubinstein, F, Duvoux, C, Conti, F, Scatton, O, Bernard, P, Francoz, C, Durand, F, Dharancy, S, Woehl, M, Laurent, A, Radenne, S, Dumortier, J, Abergel, A, Barbier, L, Houssel-Debry, P, Pageaux, G, Chiche, L, Deledinghen, V, Hardwigsen, J, Gugenheim, J, Altieri, M, Hilleret, M, Decaens, T, Costa, P, de Ataide, E, Quiñones, E, Anders, M, Varón, A, Zerega, A, Soza, A, Machaca, M, Arufe, D, Menéndez, J, Zapata, R, Vilatoba, M, Muñoz, L, Menéndez, R, Maraschio, M, Podestá, L, Mccormack, L, Mattera, J, Gadano, A, Parente García, J, Magini, G, Miglioresi, L, Gambato, M, D'Ambrosio, C, Vitale, A, Colledan, M, Pinelli, D, Magistri, P, Vennarecci, G, Colasanti, M, Giannelli, V, Pellicelli, A, Eduard, C, Samuele, I, Jeroen, D, Jonas, S, Jacques, P, Chris, V, Dirk, Y, Peter, M, Valerio, L, Christophe, M, Olivier, D, Jean, D, Roberto, T, Paul, L, Piñero F., Costentin C., Degroote H., Notarpaolo A., Boin I. F., Boudjema K., Baccaro C., Chagas A., Bachellier P., Ettorre G. M., Poniachik J., Muscari F., Dibenedetto F., Duque S. H., Salame E., Cillo U., Marciano S., Vanlemmens C., Fagiuoli S., Carrilho F., Cherqui D., Burra P., Van Vlierberghe H., Lai Q., Silva M., Rubinstein F., Duvoux C., Conti F., Scatton O., Bernard P. H., Francoz C., Durand F., Dharancy S., Woehl M. l., Laurent A., Radenne S., Dumortier J., Abergel A., Barbier L., Houssel-Debry P., Pageaux G. P., Chiche L., Deledinghen V., Hardwigsen J., Gugenheim J., altieri M., Hilleret M. N., Decaens T., Costa P., de Ataide E. C., Quiñones E., Anders M., Varón A., Zerega A., Soza A., Machaca M. P., Arufe D., Menéndez J., Zapata R., Vilatoba M., Muñoz L., Menéndez R. C., Maraschio M., Podestá L. G., McCormack L., Mattera J., Gadano A., Parente García J. H., Magini G., Miglioresi L., Gambato M., D'Ambrosio C., Vitale A., Colledan M., Pinelli D., Magistri P., Vennarecci G., Colasanti M., Giannelli V., Pellicelli A., Eduard C., Samuele I., Jeroen D., Jonas S., Jacques P., Chris V., Dirk Y., Peter M., Valerio L., Christophe M., Olivier D., Jean D., Roberto T., and Paul L. J.
Abstract: Background & Aims: Two recently developed composite models, the alpha-fetoprotein (AFP) score and Metroticket 2.0, could be used to select patients with hepatocellular carcinoma (HCC) who are candidates for liver transplantation (LT). The aim of this study was to compare the predictive performance of both models and to evaluate the net risk reclassification of post-LT recurrence between them using each model's original thresholds. Methods: This multicenter cohort study included 2,444 adult patients who underwent LT for HCC in 47 centers from Europe and Latin America. A competing risk regression analysis estimating sub-distribution hazard ratios (SHRs) and 95% CIs for recurrence was used (Fine and Gray method). Harrell's adapted c-statistics were estimated. The net reclassification index for recurrence was compared based on each model's original thresholds. Results: During a median follow-up of 3.8 years, there were 310 recurrences and 496 competing events (20.3%). Both models predicted recurrence, HCC survival and survival better than Milan criteria (p <0.0001). At last tumor reassessment before LT, c-statistics did not significantly differ between the two composite models, either as original or threshold versions, for recurrence (0.72 vs. 0.68; p = 0.06), HCC survival, and overall survival after LT. We observed predictive gaps and overlaps between the model's thresholds, and no significant gain on reclassification. Patients meeting both models (“within-ALL”) at last tumor reassessment presented the lowest 5-year cumulative incidence of HCC recurrence (7.7%; 95% CI 5.1-11.5) and higher 5-year post-LT survival (70.0%; 95% CI 64.9-74.6). Conclusions: In this multicenter cohort, Metroticket 2.0 and the AFP score demonstrated a similar ability to predict HCC recurrence post-LT. The combination of these composite models might be a promising clinical approach. Impact and implications: Composite models were recently proposed for the selection of liver transplant (LT
Published: 2023

7. Temporal trends of waitlistings for liver transplantation in Italy: The ECALITA (Evolution of IndiCAtion in LIver transplantation in ITAly) registry study

Author: Manzia, T, Trapani, S, Nardi, A, Ricci, A, Lenci, I, Milana, M, Angelico, R, De Feo, T, Agnes, S, Andorno, E, Baccarani, U, Carraro, A, Cescon, M, Cillo, U, Colledan, M, De Carlis, L, De Simone, P, Di Benedetto, F, Ettorre, G, Gruttadauria, S, Lupo, L, Mazzaferro, V, Romagnoli, R, Rossi, G, Rossi, M, Spada, M, Vennarecci, G, Vivarelli, M, Zamboni, F, Tisone, G, Cardillo, M, Angelico, M, Manzia T. M., Trapani S., Nardi A., Ricci A., Lenci I., Milana M., Angelico R., De Feo T. M., Agnes S., Andorno E., Baccarani U., Carraro A., Cescon M., Cillo U., Colledan M., De Carlis L., De Simone P., Di Benedetto F., Ettorre G. M., Gruttadauria S., Lupo L. G., Mazzaferro V., Romagnoli R., Rossi G., Rossi M., Spada M., Vennarecci G., Vivarelli M., Zamboni F., Tisone G., Cardillo M., Angelico M., Manzia, T, Trapani, S, Nardi, A, Ricci, A, Lenci, I, Milana, M, Angelico, R, De Feo, T, Agnes, S, Andorno, E, Baccarani, U, Carraro, A, Cescon, M, Cillo, U, Colledan, M, De Carlis, L, De Simone, P, Di Benedetto, F, Ettorre, G, Gruttadauria, S, Lupo, L, Mazzaferro, V, Romagnoli, R, Rossi, G, Rossi, M, Spada, M, Vennarecci, G, Vivarelli, M, Zamboni, F, Tisone, G, Cardillo, M, Angelico, M, Manzia T. M., Trapani S., Nardi A., Ricci A., Lenci I., Milana M., Angelico R., De Feo T. M., Agnes S., Andorno E., Baccarani U., Carraro A., Cescon M., Cillo U., Colledan M., De Carlis L., De Simone P., Di Benedetto F., Ettorre G. M., Gruttadauria S., Lupo L. G., Mazzaferro V., Romagnoli R., Rossi G., Rossi M., Spada M., Vennarecci G., Vivarelli M., Zamboni F., Tisone G., Cardillo M., and Angelico M.
Abstract: Background: Over the last decades relevant epidemiological changes of liver diseases have occurred, together with greatly improved treatment opportunities. Aim: To investigate how the indications for elective adult liver transplantation and the underlying disease etiologies have evolved in Italy. Methods: We recruited from the National Transplant Registry a cohort comprising 17,317 adults patients waitlisted for primary liver transplantation from January-2004 to December-2020. Patients were divided into three Eras:1(2004–2011),2(2012–2014) and 3(2015–2020). Results: Waitlistings for cirrhosis decreased from 65.9% in Era 1 to 46.1% in Era 3, while those for HCC increased from 28.7% to 48.7%. Comparing Eras 1 and 3, waitlistings for HCV-related cirrhosis decreased from 35.9% to 12.1%, yet those for HCV-related HCC increased from 8.5% to 26.7%. Waitlistings for HBV-related cirrhosis remained almost unchanged (13.2% and 12.4%), while those for HBV-related HCC increased from 4.0% to 11.6%. ALD-related cirrhosis decreased from 16.9% to 12.9% while ALD-related HCC increased from 1.9% to 3.9%. Conclusions: A sharp increase in liver transplant waitlisting for HCC and a concomitant decrease of waitlisting for cirrhosis have occurred In Italy. Despite HCV infection has noticeably decreased, still remains the primary etiology of waitlisting for HCC, while ALD and HBV represent the main causes for cirrhosis.
Published: 2022

8. Current practice of normothermic regional perfusion and machine perfusion in donation after circulatory death liver transplants in Italy

Author: De Carlis, R, Lauterio, A, Centonze, L, Buscemi, V, Schlegel, A, Muiesan, P, De Carlis, L, Carraro, A, Ghinolfi, D, De Simone, P, Ravaioli, M, Cescon, M, Dondossola, D, Bongini, M, Mazzaferro, V, Pagano, D, Gruttadauria, S, Gringeri, E, Cillo, U, Patrono, D, Romagnoli, R, Camagni, S, Colledan, M, Olivieri, T, Di Benedetto, F, Vennarecci, G, Baccarani, U, Lai, Q, Rossi, M, Manzia, T, Tisone, G, Vivarelli, M, Scalera, I, Lupo, L, Andorno, E, Meniconi, R, Ettorre, G, Avolio, A, Agnes, S, Pellegrino, R, Zamboni, F, De Carlis R., Lauterio A., Centonze L., Buscemi V., Schlegel A., Muiesan P., De Carlis L., Carraro A., Ghinolfi D., De Simone P., Ravaioli M., Cescon M., Dondossola D., Bongini M., Mazzaferro V., Pagano D., Gruttadauria S., Gringeri E., Cillo U., Patrono D., Romagnoli R., Camagni S., Colledan M., Olivieri T., Di Benedetto F., Vennarecci G., Baccarani U., Lai Q., Rossi M., Manzia T. M., Tisone G., Vivarelli M., Scalera I., Lupo L. G., Andorno E., Meniconi R. L., Ettorre G. M., Avolio A. W., Agnes S., Pellegrino R. A., Zamboni F., De Carlis, R, Lauterio, A, Centonze, L, Buscemi, V, Schlegel, A, Muiesan, P, De Carlis, L, Carraro, A, Ghinolfi, D, De Simone, P, Ravaioli, M, Cescon, M, Dondossola, D, Bongini, M, Mazzaferro, V, Pagano, D, Gruttadauria, S, Gringeri, E, Cillo, U, Patrono, D, Romagnoli, R, Camagni, S, Colledan, M, Olivieri, T, Di Benedetto, F, Vennarecci, G, Baccarani, U, Lai, Q, Rossi, M, Manzia, T, Tisone, G, Vivarelli, M, Scalera, I, Lupo, L, Andorno, E, Meniconi, R, Ettorre, G, Avolio, A, Agnes, S, Pellegrino, R, Zamboni, F, De Carlis R., Lauterio A., Centonze L., Buscemi V., Schlegel A., Muiesan P., De Carlis L., Carraro A., Ghinolfi D., De Simone P., Ravaioli M., Cescon M., Dondossola D., Bongini M., Mazzaferro V., Pagano D., Gruttadauria S., Gringeri E., Cillo U., Patrono D., Romagnoli R., Camagni S., Colledan M., Olivieri T., Di Benedetto F., Vennarecci G., Baccarani U., Lai Q., Rossi M., Manzia T. M., Tisone G., Vivarelli M., Scalera I., Lupo L. G., Andorno E., Meniconi R. L., Ettorre G. M., Avolio A. W., Agnes S., Pellegrino R. A., and Zamboni F.
Abstract: Background: Normothermic regional perfusion (NRP) and machine perfusion (MP) are variously used in many European centers to improve the outcomes after liver transplantation from donation after circulatory death (DCD). In Italy, a combination of NRP and subsequent MP has been used since the start of the activity. While NRP is mandatory for every DCD recovery, the subsequent use of MP is left to each center. Methods: We have designed a national survey to investigate practices and policies of these techniques. The questionnaire included 46 questions and was distributed to all the 21 Italian centers using an online form between June and July 2021. Results: The overall response rate was 100%. A local NRP program for controlled Maastricht type 3 DCD was active in 11/21 (52.4%) centers. Organization and availability of personnel were perceived as the main difficulties in starting such a program. Between 2015 and 2020, 119 DCD livers were transplanted, with an overall utilization rate of 69.2%. Pump flow and gross aspect were considered the most reliable parameters in liver selection during NRP. Eight (72.7%) centers adopted subsequent hypothermic MP, 1 (9.1%) center normothermic MP, and the remaining 2 (18.2%) used both MP types. Conclusion: This first snapshot survey shows that NRP with subsequent MP is the most used protocol in Italy for DCD livers, although some heterogeneity exists in the type and purpose of MP between centers. Overall, this policy ensures a high utilization rate, considering the high risk of the DCD donor population in Italy. Graphical abstract: [Figure not available: see fulltext.]
Published: 2022

9. The ALPPS procedure for hepatocellular carcinoma

Author: Vennarecci, G., Laurenzi, A., Levi Sandri, G.B., Busi Rizzi, E., Cristofaro, M., Montalbano, M., Piselli, P., Andreoli, A., D'Offizi, G., and Ettorre, G.M.
Published: 2014
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10. A Bayesian methodology to improve prediction of early graft loss after liver transplantation derived from the Liver Match study

Author: Angelico, M., Cillo, U., Fagiuoli, S., Strazzabosco, M., Caraceni, P., Toniutto, P.L., Nanni Costa, A., Salizzoni, Torino M., Romagnoli, R., Bertolotti, G., Patrono, D., De Carlis, L., Slim, A., Mangoni, J.M.E., Rossi, G., Caccamo, L., Antonelli, B., Mazzaferro, V., Regalia, E., Sposito, C., Colledan, M., Corno, V., Tagliabue, F., Marin, S., Vitale, A., Gringeri, E., Donataccio, M., Donataccio, D., Baccarani, U., Lorenzin, D., Bitetto, D., Valente, U., Gelli, M., Cupo, P., Gerunda, G.E., Rompianesi, G., Pinna, A.D., Grazi, G.L., Cucchetti, A., Zanfi, C., Risaliti, A., Faraci, M.G., Tisone, G., Anselmo, A., Lenci, I., Sforza, D., Agnes, S., Di Mugno, M., Avolio, A.W., Ettorre, G.M., Miglioresi, L., Vennarecci, G., Berloco, P., Rossi, M., Ginanni Corradini, S., Molinaro, A., Calise, F., Scuderi, V., Cuomo, O., Migliaccio, C., Lupo, L., Notarnicola, G., Gridelli, B., Volpes, R., Li Petri, S., Zamboni, F., Carbotta, G., Dedola, S., Nardi, A., Marianelli, T., Gavrila, C., Ricci, A., Vespasiano, F., Angelico, Mario, Nardi, Alessandra, Romagnoli, Renato, Marianelli, Tania, Corradini, Stefano Ginanni, Tandoi, Francesco, Gavrila, Caius, Salizzoni, Mauro, Pinna, Antonio D., Cillo, Umberto, Gridelli, Bruno, De Carlis, Luciano G., Colledan, Michele, Gerunda, Giorgio E., Costa, Alessandro Nanni, and Strazzabosco, Mario
Published: 2014
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11. Current practice of normothermic regional perfusion and machine perfusion in donation after circulatory death liver transplants in Italy

Author: De Carlis, R., Lauterio, A., Centonze, L., Buscemi, V., Schlegel, A., Muiesan, P., De Carlis, L., Carraro, A., Ghinolfi, D., De Simone, P., Ravaioli, M., Cescon, M., Dondossola, D., Bongini, M., Mazzaferro, V., Pagano, D., Gruttadauria, S., Gringeri, E., Cillo, U., Patrono, D., Romagnoli, R., Camagni, S., Colledan, M., Olivieri, T., Di Benedetto, F., Vennarecci, G., Baccarani, U., Lai, Q., Rossi, M., Manzia, T. M., Tisone, G., Vivarelli, M., Scalera, I., Lupo, L. G., Andorno, E., Meniconi, R. L., Ettorre, G. M., Avolio, A. W., Agnes, S., Pellegrino, R. A., Zamboni, F., De Carlis, R, Lauterio, A, Centonze, L, Buscemi, V, Schlegel, A, Muiesan, P, De Carlis, L, Carraro, A, Ghinolfi, D, De Simone, P, Ravaioli, M, Cescon, M, Dondossola, D, Bongini, M, Mazzaferro, V, Pagano, D, Gruttadauria, S, Gringeri, E, Cillo, U, Patrono, D, Romagnoli, R, Camagni, S, Colledan, M, Olivieri, T, Di Benedetto, F, Vennarecci, G, Baccarani, U, Lai, Q, Rossi, M, Manzia, T, Tisone, G, Vivarelli, M, Scalera, I, Lupo, L, Andorno, E, Meniconi, R, Ettorre, G, Avolio, A, Agnes, S, Pellegrino, R, and Zamboni, F
Subjects: Warm ischemia, Hypothermic oxygenated perfusion, Ischemic-type biliary lesions, Liver preservation, Liver utilization, Graft Survival, Organ Preservation, Ischemic-type biliary lesion, Tissue Donors, Settore MED/18, Liver Transplantation, Perfusion, Humans, Surgery
Abstract: Background: Normothermic regional perfusion (NRP) and machine perfusion (MP) are variously used in many European centers to improve the outcomes after liver transplantation from donation after circulatory death (DCD). In Italy, a combination of NRP and subsequent MP has been used since the start of the activity. While NRP is mandatory for every DCD recovery, the subsequent use of MP is left to each center. Methods: We have designed a national survey to investigate practices and policies of these techniques. The questionnaire included 46 questions and was distributed to all the 21 Italian centers using an online form between June and July 2021. Results: The overall response rate was 100%. A local NRP program for controlled Maastricht type 3 DCD was active in 11/21 (52.4%) centers. Organization and availability of personnel were perceived as the main difficulties in starting such a program. Between 2015 and 2020, 119 DCD livers were transplanted, with an overall utilization rate of 69.2%. Pump flow and gross aspect were considered the most reliable parameters in liver selection during NRP. Eight (72.7%) centers adopted subsequent hypothermic MP, 1 (9.1%) center normothermic MP, and the remaining 2 (18.2%) used both MP types. Conclusion: This first snapshot survey shows that NRP with subsequent MP is the most used protocol in Italy for DCD livers, although some heterogeneity exists in the type and purpose of MP between centers. Overall, this policy ensures a high utilization rate, considering the high risk of the DCD donor population in Italy. Graphical abstract: [Figure not available: see fulltext.]
Published: 2022

12. The Italian Consensus on minimally invasive simultaneous resections for synchronous liver metastasis and primary colorectal cancer: A Delphi methodology

Author: Rocca, A, Cipriani, F, Belli, G, Berti, S, Boggi, U, Bottino, V, Cillo, U, Cescon, M, Cimino, M, Corcione, F, De Carlis, L, Degiuli, M, De Paolis, P, De Rose, A, D'Ugo, D, Di Benedetto, F, Elmore, U, Ercolani, G, Ettorre, G, Ferrero, A, Filauro, M, Giuliante, F, Gruttadauria, S, Guglielmi, A, Izzo, F, Jovine, E, Laurenzi, A, Marchegiani, F, Marini, P, Massani, M, Mazzaferro, V, Mineccia, M, Minni, F, Muratore, A, Nicosia, S, Pellicci, R, Rosati, R, Russolillo, N, Spinelli, A, Spolverato, G, Torzilli, G, Vennarecci, G, Vigano, L, Vincenti, L, Delrio, P, Calise, F, Aldrighetti, L, Rocca A., Cipriani F., Belli G., Berti S., Boggi U., Bottino V., Cillo U., Cescon M., Cimino M., Corcione F., De Carlis L., Degiuli M., De Paolis P., De Rose A. M., D'Ugo D., Di Benedetto F., Elmore U., Ercolani G., Ettorre G. M., Ferrero A., Filauro M., Giuliante F., Gruttadauria S., Guglielmi A., Izzo F., Jovine E., Laurenzi A., Marchegiani F., Marini P., Massani M., Mazzaferro V., Mineccia M., Minni F., Muratore A., Nicosia S., Pellicci R., Rosati R., Russolillo N., Spinelli A., Spolverato G., Torzilli G., Vennarecci G., Vigano L., Vincenti L., Delrio P., Calise F., Aldrighetti L., Rocca, A, Cipriani, F, Belli, G, Berti, S, Boggi, U, Bottino, V, Cillo, U, Cescon, M, Cimino, M, Corcione, F, De Carlis, L, Degiuli, M, De Paolis, P, De Rose, A, D'Ugo, D, Di Benedetto, F, Elmore, U, Ercolani, G, Ettorre, G, Ferrero, A, Filauro, M, Giuliante, F, Gruttadauria, S, Guglielmi, A, Izzo, F, Jovine, E, Laurenzi, A, Marchegiani, F, Marini, P, Massani, M, Mazzaferro, V, Mineccia, M, Minni, F, Muratore, A, Nicosia, S, Pellicci, R, Rosati, R, Russolillo, N, Spinelli, A, Spolverato, G, Torzilli, G, Vennarecci, G, Vigano, L, Vincenti, L, Delrio, P, Calise, F, Aldrighetti, L, Rocca A., Cipriani F., Belli G., Berti S., Boggi U., Bottino V., Cillo U., Cescon M., Cimino M., Corcione F., De Carlis L., Degiuli M., De Paolis P., De Rose A. M., D'Ugo D., Di Benedetto F., Elmore U., Ercolani G., Ettorre G. M., Ferrero A., Filauro M., Giuliante F., Gruttadauria S., Guglielmi A., Izzo F., Jovine E., Laurenzi A., Marchegiani F., Marini P., Massani M., Mazzaferro V., Mineccia M., Minni F., Muratore A., Nicosia S., Pellicci R., Rosati R., Russolillo N., Spinelli A., Spolverato G., Torzilli G., Vennarecci G., Vigano L., Vincenti L., Delrio P., Calise F., and Aldrighetti L.
Abstract: At the time of diagnosis synchronous colorectal cancer, liver metastases (SCRLM) account for 15–25% of patients. If primary tumour and synchronous liver metastases are resectable, good results may be achieved performing surgical treatment incorporated into the chemotherapy regimen. So far, the possibility of simultaneous minimally invasive (MI) surgery for SCRLM has not been extensively investigated. The Italian surgical community has captured the need and undertaken the effort to establish a National Consensus on this topic. Four main areas of interest have been analysed: patients’ selection, procedures, techniques, and implementations. To establish consensus, an adapted Delphi method was used through as many reiterative rounds were needed. Systematic literature reviews were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses instructions. The Consensus took place between February 2019 and July 2020. Twenty-six Italian centres participated. Eighteen clinically relevant items were identified. After a total of three Delphi rounds, 30-tree recommendations reached expert consensus establishing the herein presented guidelines. The Italian Consensus on MI surgery for SCRLM indicates possible pathways to optimise the treatment for these patients as consensus papers express a trend that is likely to become shortly a standard procedure for clinical pictures still on debate. As matter of fact, no RCT or relevant case series on simultaneous treatment of SCRLM are available in the literature to suggest guidelines. It remains to be investigated whether the MI technique for the simultaneous treatment of SCRLM maintain the already documented benefit of the two separate surgeries.
Published: 2021

13. An Italian survey on the use of T-tube in liver transplantation: old habits die hard!

Author: Pravisani, R, De Simone, P, Patrono, D, Lauterio, A, Cescon, M, Gringeri, E, Colledan, M, Di Benedetto, F, di Francesco, F, Antonelli, B, Manzia, T, Carraro, A, Vivarelli, M, Regalia, E, Vennarecci, G, Guglielmo, N, Cesaretti, M, Avolio, A, Valentini, M, Lai, Q, Baccarani, U, Pravisani R, De Simone P, Patrono D, Lauterio A, Cescon M, Gringeri E, Colledan M, Di Benedetto F, di Francesco F, Antonelli B, Manzia TM, Carraro A, Vivarelli M, Regalia E, Vennarecci G, Guglielmo N, Cesaretti M, Avolio AW, Valentini MF, Lai QRO, Baccarani U, Pravisani, R, De Simone, P, Patrono, D, Lauterio, A, Cescon, M, Gringeri, E, Colledan, M, Di Benedetto, F, di Francesco, F, Antonelli, B, Manzia, T, Carraro, A, Vivarelli, M, Regalia, E, Vennarecci, G, Guglielmo, N, Cesaretti, M, Avolio, A, Valentini, M, Lai, Q, Baccarani, U, Pravisani R, De Simone P, Patrono D, Lauterio A, Cescon M, Gringeri E, Colledan M, Di Benedetto F, di Francesco F, Antonelli B, Manzia TM, Carraro A, Vivarelli M, Regalia E, Vennarecci G, Guglielmo N, Cesaretti M, Avolio AW, Valentini MF, Lai QRO, and Baccarani U
Abstract: There is enough clinical evidence that a T-tube use in biliary reconstruction at adult liver transplantation (LT) does not significantly modify the risk of biliary stricture/leak, and it may even sustain infective and metabolic complications. Thus, the policy on T-tube use has been globally changing, with progressive application of more restrictive selection criteria. However, there are no currently standardized indications in such change, and many LT Centers rely only on own experience and routine. A nation-wide survey was conducted among all the 20 Italian adult LT Centers to investigate the current policy on T-tube use. It was found that 20% of Centers completely discontinued the T-tube use, while 25% Centers used it routinely in all LT cases. The remaining 55% of Centers applied a selective policy, based on criteria of technical complexity of biliary reconstruction (72.7%), followed by low-quality graft (63.6%) and high-risk recipient (36.4%). A T-tube use > 50% of annual caseload was not associated with high-volume Center status (> 70 LT per year), an active pediatric or living-donor transplant program, or use of DCD grafts. Only 10/20 (50%) Centers identified T-tube as a potential risk factor for complications other than biliary stricture/leak. In these cases, the suspected pathogenic mechanism comprised bacterial colonization (70%), malabsorption (70%), interruption of the entero-hepatic bile-acid cycle (50%), biliary inflammation due to an indwelling catheter (40%) and gut microbiota changes (40%). In conclusion, the prevalence of T-tube use among the Italian LT Centers is still relatively high, compared to the European trend (33%), and the potential detrimental effect of T-tube, beyond biliary stricture/leak, seems to be somehow underestimated.
Published: 2021

14. Perspectives from Italy during the COVID-19 pandemic: nationwide survey-based focus on minimally invasive HPB surgery

Author: Aldrighetti, L, Boggi, U, Falconi, M, Giuliante, F, Cipriani, F, Ratti, F, Torzilli, G, Abu Hilal, M, Andrianello, S, Anselmo, A, Ardito, F, Gian, L, Banchini, F, Barabino, M, Barberis, A, Bassi, C, Batignani, G, Battiston, C, Belli, A, Berti, S, Bianco, P, Brolese, A, Brozzetti, S, Butturini, G, Calise, F, Carabott, K, Capretti, G, Casadei, R, Cescon, M, Cesaretti, M, Cillo, U, Cinardi, N, Colledan, M, Coppola, A, Cotsoglou, C, Crippa, S, Bona, E, Valle, R, De Angelis, M, De Carlis, L, Di Benedetto, F, Di Sebastiano, P, Dova, L, Ercolani, G, Esposito, A, Giuseppe, M, Fabris, A, Ferrero, A, Frena, A, Frigerio, I, Gianotti, L, Giuliani, A, Grazi, G, Gringeri, E, Griseri, G, Gruttadauria, S, Guglielmi, A, Izzo, F, Jovine, E, Lanza, E, Malleo, G, Manzini, L, Massani, M, Mazzaferro, V, Memeo, R, Minni, F, Morelli, L, Nappo, G, Nardo, B, Orlando, F, Partelli, S, Patriti, A, Patrone, R, Percivale, A, Piccolo, G, Ravaioli, M, Reggiani, P, Risaliti, M, Rocca, A, Romagnoli, R, Romano, F, Russolillo, N, Ruzzenente, A, Saladino, E, Salvia, R, Santambrogio, R, Tarchi, P, Troci, A, Troisi, R, Urbani, L, Veneroni, L, Vennarecci, G, Vigano, L, Viola, M, Vistoli, F, Vivarelli, M, Zanello, M, Zanus, G, Zerbi, A, Aldrighetti L., Boggi U., Falconi M., Giuliante F., Cipriani F., Ratti F., Torzilli G., Abu Hilal M., Andrianello S., Anselmo A., Ardito F., Gian L. B., Banchini F., Barabino M., Barberis A., Bassi C., Batignani G., Battiston C., Belli A., Berti S., Bianco P., Brolese A., Brozzetti S., Butturini G., Calise F., Carabott K., Capretti G., Casadei R., Cescon M., Cesaretti M., Cillo U., Cinardi N., Colledan M., Coppola A., Cotsoglou C., Crippa S., Bona E. D., Valle R. D., De Angelis M., De Carlis L., Di Benedetto F., Di Sebastiano P., Dova L., Ercolani G., Esposito A., Giuseppe M. E., Fabris A., Ferrero A., Frena A., Frigerio I., Gianotti L., Giuliani A., Grazi G., Gringeri E., Griseri G., Gruttadauria S., Guglielmi A., Izzo F., Jovine E., Lanza E., Malleo G., Manzini L., Massani M., Mazzaferro V., Memeo R., Minni F., Morelli L., Nappo G., Nardo B., Orlando F., Partelli S., Patriti A., Patrone R., Percivale A., Piccolo G., Ravaioli M., Reggiani P., Risaliti M., Rocca A., Romagnoli R., Romano F., Russolillo N., Ruzzenente A., Saladino E., Salvia R., Santambrogio R., Tarchi P., Troci A., Troisi R., Urbani L., Veneroni L., Vennarecci G., Vigano L., Viola M., Vistoli F., Vivarelli M., Zanello M., Zanus G., Zerbi A., Aldrighetti, L, Boggi, U, Falconi, M, Giuliante, F, Cipriani, F, Ratti, F, Torzilli, G, Abu Hilal, M, Andrianello, S, Anselmo, A, Ardito, F, Gian, L, Banchini, F, Barabino, M, Barberis, A, Bassi, C, Batignani, G, Battiston, C, Belli, A, Berti, S, Bianco, P, Brolese, A, Brozzetti, S, Butturini, G, Calise, F, Carabott, K, Capretti, G, Casadei, R, Cescon, M, Cesaretti, M, Cillo, U, Cinardi, N, Colledan, M, Coppola, A, Cotsoglou, C, Crippa, S, Bona, E, Valle, R, De Angelis, M, De Carlis, L, Di Benedetto, F, Di Sebastiano, P, Dova, L, Ercolani, G, Esposito, A, Giuseppe, M, Fabris, A, Ferrero, A, Frena, A, Frigerio, I, Gianotti, L, Giuliani, A, Grazi, G, Gringeri, E, Griseri, G, Gruttadauria, S, Guglielmi, A, Izzo, F, Jovine, E, Lanza, E, Malleo, G, Manzini, L, Massani, M, Mazzaferro, V, Memeo, R, Minni, F, Morelli, L, Nappo, G, Nardo, B, Orlando, F, Partelli, S, Patriti, A, Patrone, R, Percivale, A, Piccolo, G, Ravaioli, M, Reggiani, P, Risaliti, M, Rocca, A, Romagnoli, R, Romano, F, Russolillo, N, Ruzzenente, A, Saladino, E, Salvia, R, Santambrogio, R, Tarchi, P, Troci, A, Troisi, R, Urbani, L, Veneroni, L, Vennarecci, G, Vigano, L, Viola, M, Vistoli, F, Vivarelli, M, Zanello, M, Zanus, G, Zerbi, A, Aldrighetti L., Boggi U., Falconi M., Giuliante F., Cipriani F., Ratti F., Torzilli G., Abu Hilal M., Andrianello S., Anselmo A., Ardito F., Gian L. B., Banchini F., Barabino M., Barberis A., Bassi C., Batignani G., Battiston C., Belli A., Berti S., Bianco P., Brolese A., Brozzetti S., Butturini G., Calise F., Carabott K., Capretti G., Casadei R., Cescon M., Cesaretti M., Cillo U., Cinardi N., Colledan M., Coppola A., Cotsoglou C., Crippa S., Bona E. D., Valle R. D., De Angelis M., De Carlis L., Di Benedetto F., Di Sebastiano P., Dova L., Ercolani G., Esposito A., Giuseppe M. E., Fabris A., Ferrero A., Frena A., Frigerio I., Gianotti L., Giuliani A., Grazi G., Gringeri E., Griseri G., Gruttadauria S., Guglielmi A., Izzo F., Jovine E., Lanza E., Malleo G., Manzini L., Massani M., Mazzaferro V., Memeo R., Minni F., Morelli L., Nappo G., Nardo B., Orlando F., Partelli S., Patriti A., Patrone R., Percivale A., Piccolo G., Ravaioli M., Reggiani P., Risaliti M., Rocca A., Romagnoli R., Romano F., Russolillo N., Ruzzenente A., Saladino E., Salvia R., Santambrogio R., Tarchi P., Troci A., Troisi R., Urbani L., Veneroni L., Vennarecci G., Vigano L., Viola M., Vistoli F., Vivarelli M., Zanello M., Zanus G., and Zerbi A.
Abstract: The safety of minimally invasive procedures during COVID pandemic remains hotly debated, especially in a country, like Italy, where minimally invasive techniques have progressively and pervasively entered clinical practice, in both the hepatobiliary and pancreatic community. A nationwide snapshot of the management of HPB minimally invasive surgery activity during COVID-19 pandemic is provided: a survey was developed and conducted within AICEP (Italian Association of HepatoBilioPancreatic Surgeons) with the final aim of conveying the experience, knowledge, and opinions into a unitary report enabling more efficient crisis management. Results from the survey (81 respondents) show that, in Italian hospitals, minimally invasive surgery maintains its role despite the COVID-19 pandemic, with the registered reduction of cases being proportional to the overall reduction of the HPB surgical activity. Respondents agree that the switch from minimally invasive to open technique can be considered as a valid option for cases with a high technical complexity. Several issues merit specific attention: screening for virus positivity should be universally performed; only expert surgical teams should operate on positive patients and specific technical measures to lower the biological risk of contamination during surgery must be followed. Future studies specifically designed to establish the true risks in minimally invasive surgery are suggested. Furthermore, a standard and univocal process of prioritization of patients from Regional Healthcare Systems is advisable.
Published: 2020

15. Preliminary Analysis of the Impact of COVID-19 Outbreak on Italian Liver Transplant Programs

Author: Agnes, S, Andorno, E, Avolio, A, Baccarani, U, Carraro, A, Cescon, M, Cillo, U, Colledan, M, De Carlis, L, De Simone, P, De Ville De Goyet, J, Di Benedetto, F, Ettorre, G, Gringeri, E, Gruttadauria, S, Lupo, L, Mazzaferro, V, Regalia, E, Romagnoli, R, Rossi, G, Rossi, M, Spada, M, Tisone, G, Vennarecci, G, Vivarelli, M, Zamboni, F, Boggi, U, Agnes S., Andorno E., Avolio A. W., Baccarani U., Carraro A., Cescon M., Cillo U., Colledan M., De Carlis L., De Simone P., De Ville De Goyet J., Di Benedetto F., Ettorre G. M., Gringeri E., Gruttadauria S., Lupo L. G., Mazzaferro V., Regalia E., Romagnoli R., Rossi G. E., Rossi M., Spada M., Tisone G., Vennarecci G., Vivarelli M., Zamboni F., Boggi U., Agnes, S, Andorno, E, Avolio, A, Baccarani, U, Carraro, A, Cescon, M, Cillo, U, Colledan, M, De Carlis, L, De Simone, P, De Ville De Goyet, J, Di Benedetto, F, Ettorre, G, Gringeri, E, Gruttadauria, S, Lupo, L, Mazzaferro, V, Regalia, E, Romagnoli, R, Rossi, G, Rossi, M, Spada, M, Tisone, G, Vennarecci, G, Vivarelli, M, Zamboni, F, Boggi, U, Agnes S., Andorno E., Avolio A. W., Baccarani U., Carraro A., Cescon M., Cillo U., Colledan M., De Carlis L., De Simone P., De Ville De Goyet J., Di Benedetto F., Ettorre G. M., Gringeri E., Gruttadauria S., Lupo L. G., Mazzaferro V., Regalia E., Romagnoli R., Rossi G. E., Rossi M., Spada M., Tisone G., Vennarecci G., Vivarelli M., Zamboni F., and Boggi U.
Abstract: Liver Transplant Programs in Italy have faced a sequela of management and clinical decision-making problems due to the high incidence in some regions of the country of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The Italian Society for Organ Transplantation (SITO) and the Board of Liver Transplant Program Directors issued a survey to assess the initial impact of this pandemic event on the routine activity of 22 Italian Liver Transplant Programs. One hundred percent of participants completed the survey within a few days. The analysis is presented dividing the centers in two macro-areas: north-central Italy and south-central Italy. The reason for this is that the two areas had a different incidence of the infection and because they have distinctive rates of cadaveric donation. Overall, all centers remained open although a reduction in the activity was noted. Transplant Programs reduced their outpatient activity both in terms of pre-transplant evaluation (68% of the centers) and transplant recipient follow-up (100%); a reduction in transplant activity was observed in the first two weeks of March only in the north-central macro area (23 LTs vs 39 in 2018 and 60 in 2019); overall, SARS-CoV-2 infection was registered for 24 liver transplant recipients and 37 health care providers in liver transplant units. In the perspective of the increasing magnitude of the epidemic, more data will be required to define appropriate strategies for the increasingly complex management of liver transplant patients.
Published: 2020

16. R3-AFP score is a new composite tool to refine prediction of hepatocellular carcinoma recurrence after liver transplantation

Author: Costentin, C, Piñero, F, Degroote, H, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Podestá, L, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Dibenedetto, F, Hoyos Duque, S, Salame, E, Cillo, U, Marciano, S, Vanlemmens, C, Fagiuoli, S, Burra, P, Van Vlierberghe, H, Cherqui, D, Lai, Q, Silva, M, Rubinstein, F, Duvoux, C, Conti, F, Scatton, O, Bernard, P, Francoz, C, Durand, F, Dharancy, S, Woehl, M, Laurent, A, Radenne, S, Dumortier, J, Abergel, A, Barbier, L, Houssel-Debry, P, Pageaux, G, Chiche, L, Deledinghen, V, Hardwigsen, J, Gugenheim, J, Altieri, M, Hilleret, M, Decaens, T, Chagas, A, Costa, P, Cristina de Ataide, E, Quiñones, E, Duque, S, Anders, M, Varón, A, Zerega, A, Soza, A, Machaca, M, Arufe, D, Menéndez, J, Zapata, R, Vilatoba, M, Muñoz, L, Menéndez, R, Maraschio, M, Mccormack, L, Mattera, J, Gadano, A, Fatima Boin, I, Parente García, J, Carrilho, F, Magini, G, Miglioresi, L, Gambato, M, Benedetto, F, D’Ambrosio, C, Vitale, A, Colledan, M, Pinelli, D, Magistri, P, Vennarecci, G, Colasanti, M, Giannelli, V, Pellicelli, A, Vlierberghe, H, Eduard, C, Samuele, I, Jeroen, D, Jonas, S, Jacques, P, Chris, V, Dirk, Y, Peter, M, Valerio, L, Christophe, M, Olivier, D, Jean, D, Roberto, T, Paul, L, Costentin, Charlotte, Piñero, Federico, Degroote, Helena, Notarpaolo, Andrea, Boin, Ilka F., Boudjema, Karim, Baccaro, Cinzia, Podestá, Luis G., Bachellier, Philippe, Ettorre, Giuseppe Maria, Poniachik, Jaime, Muscari, Fabrice, Dibenedetto, Fabrizio, Hoyos Duque, Sergio, Salame, Ephrem, Cillo, Umberto, Marciano, Sebastian, Vanlemmens, Claire, Fagiuoli, Stefano, Burra, Patrizia, Van Vlierberghe, Hans, Cherqui, Daniel, Lai, Quirino, Silva, Marcelo, Rubinstein, Fernando, Duvoux, Christophe, Conti, Filomena, Scatton, Olivier, Bernard, Pierre Henri, Francoz, Claire, Durand, Francois, Dharancy, Sébastien, Woehl, Marie-lorraine., Laurent, Alexis, Radenne, Sylvie, Dumortier, Jérôme, Abergel, Armand, Barbier, Louise, Houssel-Debry, Pauline, Pageaux, Georges Philippe, Chiche, Laurence, Deledinghen, Victor, Hardwigsen, Jean, Gugenheim, J., altieri, M., Hilleret, Marie Noelle, Decaens, Thomas, Chagas, Aline, Costa, Paulo, Cristina de Ataide, Elaine, Quiñones, Emilio, Duque, Sergio Hoyos, Marciano, Sebastián, Anders, Margarita, Varón, Adriana, Zerega, Alina, Soza, Alejandro, Machaca, Martín Padilla, Arufe, Diego, Menéndez, Josemaría, Zapata, Rodrigo, Vilatoba, Mario, Muñoz, Linda, Menéndez, Ricardo Chong, Maraschio, Martín, McCormack, Lucas, Mattera, Juan, Gadano, Adrian, Fatima Boin, Ilka SF., Parente García, Jose Huygens, Carrilho, Flair, Magini, Giulia, Miglioresi, Lucia, Gambato, Martina, Benedetto, Fabrizio Di, D’Ambrosio, Cecilia, Vitale, Alessandro, Colledan, Michele, Pinelli, Domenico, Magistri, Paolo, Vennarecci, Giovanni, Colasanti, Marco, Giannelli, Valerio, Pellicelli, Adriano, Baccaro, Cizia, Vlierberghe, Hans Van, Eduard, Callebout, Samuele, Iesari, Jeroen, Dekervel, Jonas, Schreiber, Jacques, Pirenne, Chris, Verslype, Dirk, Ysebaert, Peter, Michielsen, Valerio, Lucidi, Christophe, Moreno, Olivier, Detry, Jean, Delwaide, Roberto, Troisi, Paul, Lerut Jan, Costentin, C, Piñero, F, Degroote, H, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Podestá, L, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Dibenedetto, F, Hoyos Duque, S, Salame, E, Cillo, U, Marciano, S, Vanlemmens, C, Fagiuoli, S, Burra, P, Van Vlierberghe, H, Cherqui, D, Lai, Q, Silva, M, Rubinstein, F, Duvoux, C, Conti, F, Scatton, O, Bernard, P, Francoz, C, Durand, F, Dharancy, S, Woehl, M, Laurent, A, Radenne, S, Dumortier, J, Abergel, A, Barbier, L, Houssel-Debry, P, Pageaux, G, Chiche, L, Deledinghen, V, Hardwigsen, J, Gugenheim, J, Altieri, M, Hilleret, M, Decaens, T, Chagas, A, Costa, P, Cristina de Ataide, E, Quiñones, E, Duque, S, Anders, M, Varón, A, Zerega, A, Soza, A, Machaca, M, Arufe, D, Menéndez, J, Zapata, R, Vilatoba, M, Muñoz, L, Menéndez, R, Maraschio, M, Mccormack, L, Mattera, J, Gadano, A, Fatima Boin, I, Parente García, J, Carrilho, F, Magini, G, Miglioresi, L, Gambato, M, Benedetto, F, D’Ambrosio, C, Vitale, A, Colledan, M, Pinelli, D, Magistri, P, Vennarecci, G, Colasanti, M, Giannelli, V, Pellicelli, A, Vlierberghe, H, Eduard, C, Samuele, I, Jeroen, D, Jonas, S, Jacques, P, Chris, V, Dirk, Y, Peter, M, Valerio, L, Christophe, M, Olivier, D, Jean, D, Roberto, T, Paul, L, Costentin, Charlotte, Piñero, Federico, Degroote, Helena, Notarpaolo, Andrea, Boin, Ilka F., Boudjema, Karim, Baccaro, Cinzia, Podestá, Luis G., Bachellier, Philippe, Ettorre, Giuseppe Maria, Poniachik, Jaime, Muscari, Fabrice, Dibenedetto, Fabrizio, Hoyos Duque, Sergio, Salame, Ephrem, Cillo, Umberto, Marciano, Sebastian, Vanlemmens, Claire, Fagiuoli, Stefano, Burra, Patrizia, Van Vlierberghe, Hans, Cherqui, Daniel, Lai, Quirino, Silva, Marcelo, Rubinstein, Fernando, Duvoux, Christophe, Conti, Filomena, Scatton, Olivier, Bernard, Pierre Henri, Francoz, Claire, Durand, Francois, Dharancy, Sébastien, Woehl, Marie-lorraine., Laurent, Alexis, Radenne, Sylvie, Dumortier, Jérôme, Abergel, Armand, Barbier, Louise, Houssel-Debry, Pauline, Pageaux, Georges Philippe, Chiche, Laurence, Deledinghen, Victor, Hardwigsen, Jean, Gugenheim, J., altieri, M., Hilleret, Marie Noelle, Decaens, Thomas, Chagas, Aline, Costa, Paulo, Cristina de Ataide, Elaine, Quiñones, Emilio, Duque, Sergio Hoyos, Marciano, Sebastián, Anders, Margarita, Varón, Adriana, Zerega, Alina, Soza, Alejandro, Machaca, Martín Padilla, Arufe, Diego, Menéndez, Josemaría, Zapata, Rodrigo, Vilatoba, Mario, Muñoz, Linda, Menéndez, Ricardo Chong, Maraschio, Martín, McCormack, Lucas, Mattera, Juan, Gadano, Adrian, Fatima Boin, Ilka SF., Parente García, Jose Huygens, Carrilho, Flair, Magini, Giulia, Miglioresi, Lucia, Gambato, Martina, Benedetto, Fabrizio Di, D’Ambrosio, Cecilia, Vitale, Alessandro, Colledan, Michele, Pinelli, Domenico, Magistri, Paolo, Vennarecci, Giovanni, Colasanti, Marco, Giannelli, Valerio, Pellicelli, Adriano, Baccaro, Cizia, Vlierberghe, Hans Van, Eduard, Callebout, Samuele, Iesari, Jeroen, Dekervel, Jonas, Schreiber, Jacques, Pirenne, Chris, Verslype, Dirk, Ysebaert, Peter, Michielsen, Valerio, Lucidi, Christophe, Moreno, Olivier, Detry, Jean, Delwaide, Roberto, Troisi, and Paul, Lerut Jan
Abstract: Background & Aims: Patients with hepatocellular carcinoma (HCC) are selected for liver transplantation (LT) based on pre-LT imaging ± alpha-foetoprotein (AFP) level, but discrepancies between pre-LT tumour assessment and explant are frequent. Our aim was to design an explant-based recurrence risk reassessment score to refine prediction of recurrence after LT and provide a framework to guide post-LT management. Methods: Adult patients who underwent transplantation between 2000 and 2018 for HCC in 47 centres were included. A prediction model for recurrence was developed using competing-risk regression analysis in a European training cohort (TC; n = 1,359) and tested in a Latin American validation cohort (VC; n=1,085). Results: In the TC, 76.4% of patients with HCC met the Milan criteria, and 89.9% had an AFP score of ≤2 points. The recurrence risk reassessment (R3)-AFP model was designed based on variables independently associated with recurrence in the TC (with associated weights): ≥4 nodules (sub-distribution of hazard ratio [SHR] = 1.88, 1 point), size of largest nodule (3–6 cm: SHR = 1.83, 1 point; >6 cm: SHR = 5.82, 5 points), presence of microvascular invasion (MVI; SHR = 2.69, 2 points), nuclear grade >II (SHR = 1.20, 1 point), and last pre-LT AFP value (101–1,000 ng/ml: SHR = 1.57, 1 point; >1,000 ng/ml: SHR = 2.83, 2 points). Wolber's c-index was 0.76 (95% CI 0.72–0.80), significantly superior to an R3 model without AFP (0.75; 95% CI 0.72–0.79; p = 0.01). Four 5-year recurrence risk categories were identified: very low (score = 0; 5.5%), low (1–2 points; 15.1%), high (3–6 points; 39.1%), and very high (>6 points; 73.9%). The R3-AFP score performed well in the VC (Wolber's c-index of 0.78; 95% CI 0.73–0.83). Conclusions: The R3 score including the last pre-LT AFP value (R3-AFP score) provides a user-friendly, standardised framework to design post-LT surveillance strategies, protocols, or adjuvant therapy trials for HCC not limited to the Milan
Published: 2022

17. Bridging and downstaging to transplantation in HCC

Author: Ettorre, G.M., Vennarecci, G., Santoro, R., Lepiane, P., Laurenzi, A., Colasanti, M., Carpanese, L., Sciuto, R., Antonini, M., and Doffizi, G.
Published: 2012
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18. SARS-CoV-2 infection in liver transplantation is associated with favorable outcomes: an Italian transplant registry study

Author: Rendina, M., primary, Barone, M., additional, Trapani, S., additional, Masiero, L., additional, Trerotoli, P., additional, Puoti, F., additional, Lupo, L.G., additional, Agnes, S., additional, Grieco, A., additional, Andorno, E., additional, Marenco, S., additional, Baccarani, U., additional, Toniutto, P., additional, Carraro, A., additional, Colecchia, A., additional, Cescon, M., additional, Morelli, M.C., additional, Cillo, U., additional, Burra, P., additional, Angeli, P., additional, Colledan, M., additional, Fagiuoli, S., additional, De Carlis, L., additional, Belli, L., additional, De Simone, P., additional, Carrai, P., additional, Di Benedetto, F., additional, De Maria, N., additional, Ettorre, G.M., additional, Giannelli, V., additional, Gruttadauria, S., additional, Volpes, R., additional, Mazzaferro, V., additional, Bhoori, S., additional, Romagnoli, R., additional, Martini, S., additional, Rossi, G., additional, Donato, F., additional, Rossi, M., additional, Ginanni Corradini, S., additional, Spada, M., additional, Maggiore, G., additional, Tisone, G., additional, Lenci, I., additional, Vennarecci, G., additional, Di Costanzo, G.G., additional, Vivarelli, M., additional, Svegliati Baroni, G., additional, Zamboni, F. o, additional, Mameli, L., additional, Tafuri, S., additional, Simone, S., additional, Gesualdo, L., additional, Cardillo, M., additional, and Di Leo, A., additional
Published: 2022
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19. Correction to: Ostomy closure rate during COVID-19 pandemic: an Italian multicentre observational study (Updates in Surgery, (2022), 74, 3, (1017-1025), 10.1007/s13304-022-01274-w)

Author: Balla, A., Saraceno, F., Di Saverio, S., Di Lorenzo, N., Lepiane, P., Guerrieri, M., Sileri, P., Agostinelli, L., Agresta, F., Anania, G., Antolino, L., Anoldo, P., Botteri, E., Bracale, U., Carbone, F., Carlini, M., Carrano, F. M., Casadei, G., Coletta, D., Crafa, F., De'Angelis, N., Delrio, P., De Palma, G. D., Di Martino, M., Elmore, U., Gozzini, L., Grieco, M., Levi Sandri, G. B., Licitra, E., Lucchi, A., Massani, M., Memeo, R., Milone, M., Oppici, D., Ortenzi, M., Patriti, A., Pecchini, F., Peltrini, R., Piccoli, M., Pisanu, A., Podda, M., Poggioli, G., Ranucci, M. C., Rega, D., Rosati, R., Roscio, F., Rottoli, M., Santoro, R., Sartori, A., Spinelli, A., Vanella, S., Vennarecci, G., and Vettoretto, N.
Published: 2022

20. The SURF (Italian observational study for renal insufficiency evaluation in liver transplant recipients): A post-hoc between-sex analysis

Author: Colombo, D, Zagni, E, Zullo, A, Simoni, L, Fagiuoli, S, De Simone, P, Donati, D, Salizzoni, M, Angeli, P, Burra, P, Cillo, U, Toniutto, P, Rossi, M, Vennarecci, G, De Carlis, L, Donato, F, Cescon, M, Di Leo, A, Di Costanzo, G, Avolio, A, Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G. G., Avolio A., Colombo, D, Zagni, E, Zullo, A, Simoni, L, Fagiuoli, S, De Simone, P, Donati, D, Salizzoni, M, Angeli, P, Burra, P, Cillo, U, Toniutto, P, Rossi, M, Vennarecci, G, De Carlis, L, Donato, F, Cescon, M, Di Leo, A, Di Costanzo, G, Avolio, A, Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G. G., and Avolio A.
Abstract: Background: Female sex has been reported as an independent predictor of severe post-liver transplantation (LT) chronic kidney disease. We performed a by sex post-hoc analysis of the SURF study, that investigated the prevalence of renal impairment following LT, aimed at exploring possible differences between sexes in the prevalence and course of post-LT renal damage. Methods: All patients enrolled in the SURF study were considered evaluable for this sex-based analysis, whose primary objective was to evaluate by sex the proportion of patients with estimated Glomerular Filtration Rate (eGFR) < 60 ml/min/1.73m2 at inclusion and follow-up visit. Results: Seven hundred thirty-eight patients were included in our analysis, 76% males. The proportion of patients with eGFR < 60 mL/min/1.73 m2 was significantly higher in females at initial study visit (33.3 vs 22.8%; p = 0.005), but also before, at time of transplantation (22.9 vs 14.7%; p = 0.0159), as analyzed retrospectively. At follow-up, such proportion increased more in males than in females (33.9 vs 26.0%, p = 0.04). Mean eGFR values decreased over the study in both sexes, with no significant differences. Statistically significant M/F differences in patient distribution by O'Riordan eGFR levels were observed at time of transplant and study initial visit (p = 0.0005 and 0.0299 respectively), but not at follow-up. Conclusions: Though the limitation of being performed post-hoc, this analysis suggests potential sex differences in the prevalence of renal impairment before and after LT, encouraging further clinical research to explore such differences more in depth.
Published: 2019

21. Laparoscopic liver resection of hepatocellular carcinoma located in unfavorable segments: a propensity score-matched analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry

Author: Levi Sandri, G, Ettorre, G, Aldrighetti, L, Cillo, U, Dalla Valle, R, Guglielmi, A, Mazzaferro, V, Ferrero, A, Di Benedetto, F, Gruttadauria, S, De Carlis, L, Vennarecci, G, Antonucci, A, Belli, G, Berti, S, Boggi, U, Bonsignore, P, Brolese, A, Calise, F, Ceccarelli, G, Colledan, M, Coratti, A, Ferla, F, Floridi, A, Frena, A, Giuliani, A, Giuliante, F, Grazi, G, Gringeri, E, Griseri, G, Iaria, M, Jovine, E, Magistri, P, Maida, P, Mezzatesta, P, Russolillo, N, Navarra, G, Parisi, A, Pinna, A, Ratti, F, Rossi, G, Ruzzenente, A, Santambrogio, R, Scotti, A, Sgroi, G, Slim, A, Torzilli, G, Vincenti, L, Virdis, M, Zamboni, F, Levi Sandri G. B., Ettorre G. M., Aldrighetti L., Cillo U., Dalla Valle R., Guglielmi A., Mazzaferro V., Ferrero A., Di Benedetto F., Gruttadauria S., De Carlis L., Vennarecci G., Antonucci A., Belli G., Berti S., Boggi U., Bonsignore P., Brolese A., Calise F., Ceccarelli G., Colledan M., Coratti A., Ferla F., Floridi A., Frena A., Giuliani A., Giuliante F., Grazi G. L., Gringeri E., Griseri G., Iaria M., Jovine E., Magistri P., Maida P., Mezzatesta P., Russolillo N., Navarra G., Parisi A., Pinna A. D., Ratti F., Rossi G. E., Ruzzenente A., Santambrogio R., Scotti A., Sgroi G., Slim A., Torzilli G., Vincenti L., Virdis M., Zamboni F., Levi Sandri, G, Ettorre, G, Aldrighetti, L, Cillo, U, Dalla Valle, R, Guglielmi, A, Mazzaferro, V, Ferrero, A, Di Benedetto, F, Gruttadauria, S, De Carlis, L, Vennarecci, G, Antonucci, A, Belli, G, Berti, S, Boggi, U, Bonsignore, P, Brolese, A, Calise, F, Ceccarelli, G, Colledan, M, Coratti, A, Ferla, F, Floridi, A, Frena, A, Giuliani, A, Giuliante, F, Grazi, G, Gringeri, E, Griseri, G, Iaria, M, Jovine, E, Magistri, P, Maida, P, Mezzatesta, P, Russolillo, N, Navarra, G, Parisi, A, Pinna, A, Ratti, F, Rossi, G, Ruzzenente, A, Santambrogio, R, Scotti, A, Sgroi, G, Slim, A, Torzilli, G, Vincenti, L, Virdis, M, Zamboni, F, Levi Sandri G. B., Ettorre G. M., Aldrighetti L., Cillo U., Dalla Valle R., Guglielmi A., Mazzaferro V., Ferrero A., Di Benedetto F., Gruttadauria S., De Carlis L., Vennarecci G., Antonucci A., Belli G., Berti S., Boggi U., Bonsignore P., Brolese A., Calise F., Ceccarelli G., Colledan M., Coratti A., Ferla F., Floridi A., Frena A., Giuliani A., Giuliante F., Grazi G. L., Gringeri E., Griseri G., Iaria M., Jovine E., Magistri P., Maida P., Mezzatesta P., Russolillo N., Navarra G., Parisi A., Pinna A. D., Ratti F., Rossi G. E., Ruzzenente A., Santambrogio R., Scotti A., Sgroi G., Slim A., Torzilli G., Vincenti L., Virdis M., and Zamboni F.
Abstract: Objective: Laparoscopic liver resection (LLR) for Hepatocellular Carcinoma (HCC) is one of the most important indications for the minimally invasive approach. Our study aims to analyze the experience of the Italian Group of Minimally Invasive Liver Surgery with laparoscopic surgical treatment of HCC, with a focus on tumor location and how it affects morbidity and mortality. Methods: 38 centers participated in this study; 372 cases of LLR for HCC were prospectively enrolled. Patients were divided into two groups according to the HCC nodule location. Group 1 favorable location and group 2 unfavorable location. Perioperative outcomes were compared between the two groups before and after a propensity score match (PS) 1:1. Results: Before PS in group 2 surgical time was longer; conversion rate was higher; postoperative transfusion and comprehensive complication index were also higher. PS was performed with a cohort of 298 patients (from 18 centers), with 66 and 232 patients with HCC in unfavorable and favorable locations, respectively. After PS matching, 62 patients from group 1 and group 2 each were compared. Operative and postoperative course were similar in patients with HCC in favorable and unfavorable LLR locations. Surgical margins were found to be identical before and after PS. Conclusions: These results show that LLR in patients with HCC can be safely performed in all segments because of the extensive experience of all surgeons from multiple centers in performing traditional open liver surgery as well as laparoscopic surgery.
Published: 2019

22. The SURF (Italian observational study for renal insufficiency evaluation in liver transplant recipients): A post-hoc between-sex analysis

Author: Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G. G., Avolio A., Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G.G., Avolio A., Colombo, D, Zagni, E, Zullo, A, Simoni, L, Fagiuoli, S, De Simone, P, Donati, D, Salizzoni, M, Angeli, P, Burra, P, Cillo, U, Toniutto, P, Rossi, M, Vennarecci, G, De Carlis, L, Donato, F, Cescon, M, Di Leo, A, Di Costanzo, G, and Avolio, A
Subjects: Nephrology, Adult, Male, medicine.medical_specialty, Settore MED/18 - CHIRURGIA GENERALE, Renal function, lcsh:RC870-923, 03 medical and health sciences, 0302 clinical medicine, Calcineurin inhibitors, Calcineurin inhibitor, Internal medicine, Sex differences, Medicine, Humans, Meta-analysi, 030212 general & internal medicine, Longitudinal Studies, Renal insufficiency, Liver transplant, Aged, Retrospective Studies, Sex Characteristics, business.industry, Gender, Middle Aged, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Transplant Recipients, Liver Transplantation, Calcineurin, Transplantation, Meta-analysis, Clinical research, Cross-Sectional Studies, Italy, 030211 gastroenterology & hepatology, Observational study, Female, business, Research Article, Kidney disease, Follow-Up Studies, Glomerular Filtration Rate
Abstract: Background Female sex has been reported as an independent predictor of severe post-liver transplantation (LT) chronic kidney disease. We performed a by sex post-hoc analysis of the SURF study, that investigated the prevalence of renal impairment following LT, aimed at exploring possible differences between sexes in the prevalence and course of post-LT renal damage. Methods All patients enrolled in the SURF study were considered evaluable for this sex-based analysis, whose primary objective was to evaluate by sex the proportion of patients with estimated Glomerular Filtration Rate (eGFR) 2 at inclusion and follow-up visit. Results Seven hundred thirty-eight patients were included in our analysis, 76% males. The proportion of patients with eGFR 2 was significantly higher in females at initial study visit (33.3 vs 22.8%; p = 0.005), but also before, at time of transplantation (22.9 vs 14.7%; p = 0.0159), as analyzed retrospectively. At follow-up, such proportion increased more in males than in females (33.9 vs 26.0%, p = 0.04). Mean eGFR values decreased over the study in both sexes, with no significant differences. Statistically significant M/F differences in patient distribution by O’Riordan eGFR levels were observed at time of transplant and study initial visit (p = 0.0005 and 0.0299 respectively), but not at follow-up. Conclusions Though the limitation of being performed post-hoc, this analysis suggests potential sex differences in the prevalence of renal impairment before and after LT, encouraging further clinical research to explore such differences more in depth.
Published: 2019

23. PREDICTION OF RECURRENCE AFTER LIVER TRANSPLANTATION FOR HCC: VALIDATION OF THE AFP MODEL IN AN ITALIAN COHORT: 61

Author: Notarpaolo, Bizouard, G., Gambato, M., Montalti, R., Magini, G., Miglioresi, L., Vitale, A., Vennarecci, G., Dʼambrosio, C., Burra, P., Manenti, F., Fagiuoli, S., Ettorre, G. M., Andreoli, A., Cillo, U., Katsahian, S., Roudot-Thoraval, F., and Duvoux, C.
Published: 2015

24. Successful Use of Extended Criteria Donor Grafts With Low to Moderate Steatosis in Patients With Model for End-Stage Liver Disease Scores Below 27

Author: Avolio, A.W., Frongillo, F., Nicolotti, N., Mulè, A., Vennarecci, G., De Simone, P., and Agnes, S.
Published: 2009
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25. Hepatocellular carcinoma and the risk of de novo malignancies after liver transplantation

Author: Shalaby, S, Taborelli, M, Zanetto, A, Ferrarese, A, D'Arcangelo, F, Gambato, M, Senzolo, M, Russo, F P, Germani, G, Boccagni, P, Ettorre, G M, Baccarani, U, Lauro, A, Galatioto, L, Rendina, M, Petrara, R, De Rossi, A, Nudo, F, Toti, L, Fantola, G, Vennarecci, G, Risaliti, A, Pinna, A D, Gruttadauria, S, Di Leo, A, Rossi, M, Tisone, G, Zamboni, F, Cillo, U, Piselli, P, Serraino, D, and Burra, P
Subjects: liver transplant, post-transplant neoplastic screening, post-transplant survival, solid tumors, de novo malignancies
Published: 2021

26. Renal Function Deterioration Is Higher Within The First Year After Liver Transplantation: Results of The Italian Cross-Sectional, Multicenter Study (SURF).: Abstract# C2000

Author: De Simone, P., Donato, F., Mennini, G., Cillo, U., Dissegna, D., Rosi, S., Burra, P., Vennarecci, G., Donati, D., Brusa, R., and Fagiuoli, S.
Published: 2014

27. Psychological profiles and risk of relapse in cirrhosis due to alcohol abuse

Author: Galeota Lanza, A., primary, Mazzarone, G., additional, Moreas, V.G.M., additional, Cangiano, A., additional, Giordano, F., additional, Aragiusto, G., additional, Arenga, G., additional, Campanella, L., additional, Ceriello, A., additional, Ferraro, D., additional, Migliaccio, C., additional, Pisaniello, D., additional, Esposito, I., additional, Picciotto, F., additional, Di Costanzo, G., additional, Chierego, C., additional, Esposito, C., additional, and Vennarecci, G., additional
Published: 2021
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28. Renal Safety of Liposomal Amphotericin B After Liver Transplantation

Author: Perrella, A., Esposito, C., Giuliani, Antonio, Migliaccio, C., Granato, G., Santaniello, W., Vennarecci, G., Giuliani A. (ORCID:0000-0002-0773-2162), Perrella, A., Esposito, C., Giuliani, Antonio, Migliaccio, C., Granato, G., Santaniello, W., Vennarecci, G., and Giuliani A. (ORCID:0000-0002-0773-2162)
Abstract: N/A
Published: 2020

29. Perspectives from Italy during the COVID-19 pandemic: nationwide survey-based focus on minimally invasive HPB surgery

Author: Aldrighetti, L., Boggi, U., Falconi, M., Giuliante, F., Cipriani, F., Ratti, F., Torzilli, G., Abu Hilal, M., Andrianello, S., Anselmo, A., Ardito, F., Gian, L. B., Banchini, F., Barabino, M., Barberis, A., Bassi, C., Batignani, G., Battiston, C., Belli, A., Berti, S., Bianco, P., Brolese, A., Brozzetti, S., Butturini, G., Calise, F., Carabott, K., Capretti, G., Casadei, R., Cescon, M., Cesaretti, M., Cillo, U., Cinardi, N., Colledan, M., Coppola, A., Cotsoglou, C., Crippa, S., Bona, E. D., Valle, R. D., De Angelis, M., De Carlis, L., Di Benedetto, F., Di Sebastiano, P., Dova, L., Ercolani, G., Esposito, A., Giuseppe, M. E., Fabris, A., Ferrero, A., Frena, A., Frigerio, I., Gianotti, L., Giuliani, A., Grazi, G., Gringeri, E., Griseri, G., Gruttadauria, S., Guglielmi, A., Izzo, F., Jovine, E., Lanza, E., Malleo, G., Manzini, L., Massani, M., Mazzaferro, V., Memeo, R., Minni, F., Morelli, L., Nappo, G., Nardo, B., Orlando, F., Partelli, S., Patriti, A., Patrone, R., Percivale, A., Piccolo, G., Ravaioli, M., Reggiani, P., Risaliti, M., Rocca, A., Romagnoli, R., Romano, F., Russolillo, N., Ruzzenente, A., Saladino, E., Salvia, R., Santambrogio, R., Tarchi, P., Troci, A., Troisi, R., Urbani, L., Veneroni, L., Vennarecci, G., Vigano, L., Viola, M., Vistoli, F., Vivarelli, M., Zanello, M., Zanus, G., Zerbi, A., Giuliante F. (ORCID:0000-0001-9517-8220), Ardito F. (ORCID:0000-0003-1596-2862), Aldrighetti, L., Boggi, U., Falconi, M., Giuliante, F., Cipriani, F., Ratti, F., Torzilli, G., Abu Hilal, M., Andrianello, S., Anselmo, A., Ardito, F., Gian, L. B., Banchini, F., Barabino, M., Barberis, A., Bassi, C., Batignani, G., Battiston, C., Belli, A., Berti, S., Bianco, P., Brolese, A., Brozzetti, S., Butturini, G., Calise, F., Carabott, K., Capretti, G., Casadei, R., Cescon, M., Cesaretti, M., Cillo, U., Cinardi, N., Colledan, M., Coppola, A., Cotsoglou, C., Crippa, S., Bona, E. D., Valle, R. D., De Angelis, M., De Carlis, L., Di Benedetto, F., Di Sebastiano, P., Dova, L., Ercolani, G., Esposito, A., Giuseppe, M. E., Fabris, A., Ferrero, A., Frena, A., Frigerio, I., Gianotti, L., Giuliani, A., Grazi, G., Gringeri, E., Griseri, G., Gruttadauria, S., Guglielmi, A., Izzo, F., Jovine, E., Lanza, E., Malleo, G., Manzini, L., Massani, M., Mazzaferro, V., Memeo, R., Minni, F., Morelli, L., Nappo, G., Nardo, B., Orlando, F., Partelli, S., Patriti, A., Patrone, R., Percivale, A., Piccolo, G., Ravaioli, M., Reggiani, P., Risaliti, M., Rocca, A., Romagnoli, R., Romano, F., Russolillo, N., Ruzzenente, A., Saladino, E., Salvia, R., Santambrogio, R., Tarchi, P., Troci, A., Troisi, R., Urbani, L., Veneroni, L., Vennarecci, G., Vigano, L., Viola, M., Vistoli, F., Vivarelli, M., Zanello, M., Zanus, G., Zerbi, A., Giuliante F. (ORCID:0000-0001-9517-8220), and Ardito F. (ORCID:0000-0003-1596-2862)
Abstract: The safety of minimally invasive procedures during COVID pandemic remains hotly debated, especially in a country, like Italy, where minimally invasive techniques have progressively and pervasively entered clinical practice, in both the hepatobiliary and pancreatic community. A nationwide snapshot of the management of HPB minimally invasive surgery activity during COVID-19 pandemic is provided: a survey was developed and conducted within AICEP (Italian Association of HepatoBilioPancreatic Surgeons) with the final aim of conveying the experience, knowledge, and opinions into a unitary report enabling more efficient crisis management. Results from the survey (81 respondents) show that, in Italian hospitals, minimally invasive surgery maintains its role despite the COVID-19 pandemic, with the registered reduction of cases being proportional to the overall reduction of the HPB surgical activity. Respondents agree that the switch from minimally invasive to open technique can be considered as a valid option for cases with a high technical complexity. Several issues merit specific attention: screening for virus positivity should be universally performed; only expert surgical teams should operate on positive patients and specific technical measures to lower the biological risk of contamination during surgery must be followed. Future studies specifically designed to establish the true risks in minimally invasive surgery are suggested. Furthermore, a standard and univocal process of prioritization of patients from Regional Healthcare Systems is advisable.
Published: 2020

30. Preliminary Analysis of the Impact of COVID-19 Outbreak on Italian Liver Transplant Programs.

Author: Agnes, Salvatore, Andorno, E, Avolio, Alfonso Wolfango, Baccarani, U, Carraro, A, Cescon, M, Cillo, U, Colledan, M, De Carlis, L, De Simone, P, De Ville De Goyet, J, Di Benedetto, F, Ettorre, Gm, Gringeri, E, Gruttadauria, S, Lupo, Lg, Mazzaferro, V, Regalia, E, Romagnoli, R, Rossi, Ge, Rossi, M, Spada, M, Tisone, G, Vennarecci, G, Vivarelli, M, Zamboni, F, Boggi, U., Agnes S (ORCID:0000-0002-3341-4221), Avolio AW (ORCID:0000-0003-2491-7625), Agnes, Salvatore, Andorno, E, Avolio, Alfonso Wolfango, Baccarani, U, Carraro, A, Cescon, M, Cillo, U, Colledan, M, De Carlis, L, De Simone, P, De Ville De Goyet, J, Di Benedetto, F, Ettorre, Gm, Gringeri, E, Gruttadauria, S, Lupo, Lg, Mazzaferro, V, Regalia, E, Romagnoli, R, Rossi, Ge, Rossi, M, Spada, M, Tisone, G, Vennarecci, G, Vivarelli, M, Zamboni, F, Boggi, U., Agnes S (ORCID:0000-0002-3341-4221), and Avolio AW (ORCID:0000-0003-2491-7625)
Abstract: Liver Transplant Programs in Italy have faced a sequela of management and clinical decisionmaking problems due to the high incidence in some regions of the country of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). The Italian Society for Organ Transplantation (SITO) and the Board of Liver Transplant Program Directors issued a survey to assess the initial impact of this pandemic event on the routine activity of 22 Italian Liver Transplant Programs. One hundred percent of participants completed the survey within a few days. The analysis is presented dividing the centers in two macro-areas: north-central Italy and south-central Italy. The reason for this is that the two areas had a different incidence of the infection and because they have distinctive rates of cadaveric donation. Overall, all centers remained open although a reduction in the activity was noted. Transplant Programs reduced their outpatient activity both in terms of pre-transplant evaluation (68% of the centers) and transplant recipient follow-up (100%); a reduction in transplant activity was observed in the first two weeks of March only in the north-central macro area (23 LTs vs 39 in 2018 and 60 in 2019); overall, SARS-CoV-2 infection was registered for 24 liver transplant recipients and 37 health care providers in liver transplant units. In the perspective of the increasing magnitude of the epidemic, more data will be required to define appropriate strategies for the increasingly complex management of liver transplant patients.
Published: 2020

31. Liver Transplantation in HIV-Positive Patients

Author: Vennarecci, G., Ettorre, G.M., Antonini, M., Santoro, R., Perracchio, L., Visco, G., and Santoro, E.
Published: 2007
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32. First-Line Liver Resection and Salvage Liver Transplantation Are Increasing Therapeutic Strategies for Patients With Hepatocellular Carcinoma and Child A Cirrhosis

Author: Vennarecci, G., Ettorre, G.M., Antonini, M., Santoro, R., Maritti, M., Tacconi, G., Spoletini, D., Tessitore, L., Perracchio, L., Visco, G., Puoti, C., and Santoro, E.
Published: 2007
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33. Incidence and Timing of Infections After Liver Transplant in Italy

Author: Piselli, P., Zanfi, C., Corazza, V., Ferretti, S., Scuderi, M., Arana, M. Gabriel, Secchia, S. Barzoni, Lauro, A., Dazzi, A., Pinna, A., Ettorre, G.M., Vennarecci, G., Santoro, R., Ferretti, G., Gusman, N., Berloco, P.B., Grossi, P., Angeletti, C., Bellelli, S., Costa, A. Nanni, Ippolito, G., Girardi, E., and Serraino, D.
Published: 2007
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34. USE OF HEPATIC INTRA-ARTERIAL INFUSION OF YTTRIUM-90 MICROSPHERE AS DOWNSTAGING AND BRIDGE TO LIVER TRANSPLANTATION IN PATIENTS WITH HEPATOCELLULAR CARCINOMA: FOS218

Author: Vennarecci, G., Santoro, R., Lepiane, P., Laurenzi, A., Colace, L., Moroni, E., Colasanti, M., and Ettorre, G. M.
Published: 2012

35. The UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factors.: Abstract# O-162

Author: Avolio, A. W., Agnes, S., Lirosi, M., Salizzoni, M., Pinna, A., Gridelli, B., De Carlis, L., Colledan, M., Gerunda, G., Rossi, G., Ettorre, G., Risaliti, A., Mazzaferro, V., Rossi, M., Tisone, G., Zamboni, F., Lupo, L., Cuomo, O., Calise, F., Donataccio, M., Nicolotti, N., Romagnoli, R., Vitale, A., Cucchetti, A., Gruttadauria, S., Baccarani, U., Caccamo, L., Mangoni, I., Pinelli, D., Montalti, R., Morelli, N., Vennarecci, G., Nicolini, D., Regalia, E., Lai, Q., Anselmo, A., Tondolo, E., Perrella, A., Burra, P., and Cillo, U.
Published: 2012

36. Behind D-MELD: The Role of Primary Indication (HCV or HBV) as Significant Covariate in the Outcome Prediction after Liver Transplants.: Abstract# 1672: Poster Board #-Session: P234-IV

Author: Avolio, A. W., Agnes, S., Lirosi, M. C., Salizzoni, M., Pinna, A., Gridelli, B., De Carlis, L., Colledan, M., Gerunda, G., Valente, U., Rossi, G., Ettorre, G., Risaliti, A., Mazzaferro, V., Rossi, M., Tisone, G., Zamboni, F., Lupo, L., Cuomo, O., Calise, F., Nicolotti, N., Vitale, A., Romagnoli, R., Cucchetti, A., Gruttadauria, S., Mangoni, I., Pinelli, D., Montalti, R., Gelli, M., Caccamo, L., Vennarecci, G., Nicolini, D., Regalia, E., Baccarani, U., Lai, Q., Manzia, T., Tondolo, E., Rendina, M., Perrella, A., Scuderi, E., Burra, P., Gasbarrini, A., and Cillo, U.
Published: 2012

37. www.D-MELD.com. THE ONLINE PROGNOSTIC CALCULATOR TO OPTIMIZE DONOR-RECIPIENT MATCH: O-123

Author: Avolio, A. W., Agnes, S., Lirosi, M. C., Salizzoni, M., Pinna, A. D., Gridelli, B., De Carlis, L., Colledan, M., Gerunda, G. E., Valente, U., Rossi, G., Ettorre, G. M., Risaliti, A., Mazzaferro, V., Bresadola, F., Rossi, M., Tisone, G., Zamboni, F., Lupo, L., Cuomo, O., Calise, F., Donataccio, M., Nicolotti, N., Vitale, A., Romagnoli, R, Lupo, F., Cucchetti, A., Gruttadauria, S., Mangoni, I., Pinelli, D., Montalti, R, Gelli, M., Caccamo, L., Vennarecci, G., Nicolini, D., Regalia, E., Baccarani, U., Lai, Q., Manzia, T, Tondolo, E., Rendina, M., Perrella, A., Scuderi, E., Antonelli, B., de Waure, C., De Feo, T, Burra, P., Gasbarrini, A., and Cillo, U.
Published: 2011

38. Laparoscopic liver resection of hepatocellular carcinoma located in unfavorable segments: a propensity score-matched analysis from the I Go MILS (Italian Group of Minimally Invasive Liver Surgery) Registry

Author: Levi Sandri, G. B., Ettorre, G. M., Aldrighetti, L., Cillo, U., Dalla Valle, R., Guglielmi, A., Mazzaferro, V., Ferrero, A., Di Benedetto, F., Gruttadauria, S., De Carlis, L., Vennarecci, G., Antonucci, Anna Maria, Belli, G., Berti, S., Boggi, U., Bonsignore, P., Brolese, A., Calise, F., Ceccarelli, G., Colledan, M., Coratti, A., Ferla, F., Floridi, A., Frena, A., Giuliani, Antonio, Giuliante, Felice, Grazi, G. L., Gringeri, E., Griseri, G., Iaria, M., Jovine, E., Magistri, P., Maida, P., Mezzatesta, P., Russolillo, N., Navarra, G., Parisi, Carmelo Maria Antonio, Pinna, A. D., Ratti, F., Rossi, G. E., Ruzzenente, A., Santambrogio, R., Scotti, A., Sgroi, G., Slim, A., Torzilli, Guido, Vincenti, L., Virdis, M., Zamboni, F., Antonucci A., Giuliani A. (ORCID:0000-0002-0773-2162), Giuliante F. (ORCID:0000-0001-9517-8220), Parisi A., Torzilli G., Levi Sandri, G. B., Ettorre, G. M., Aldrighetti, L., Cillo, U., Dalla Valle, R., Guglielmi, A., Mazzaferro, V., Ferrero, A., Di Benedetto, F., Gruttadauria, S., De Carlis, L., Vennarecci, G., Antonucci, Anna Maria, Belli, G., Berti, S., Boggi, U., Bonsignore, P., Brolese, A., Calise, F., Ceccarelli, G., Colledan, M., Coratti, A., Ferla, F., Floridi, A., Frena, A., Giuliani, Antonio, Giuliante, Felice, Grazi, G. L., Gringeri, E., Griseri, G., Iaria, M., Jovine, E., Magistri, P., Maida, P., Mezzatesta, P., Russolillo, N., Navarra, G., Parisi, Carmelo Maria Antonio, Pinna, A. D., Ratti, F., Rossi, G. E., Ruzzenente, A., Santambrogio, R., Scotti, A., Sgroi, G., Slim, A., Torzilli, Guido, Vincenti, L., Virdis, M., Zamboni, F., Antonucci A., Giuliani A. (ORCID:0000-0002-0773-2162), Giuliante F. (ORCID:0000-0001-9517-8220), Parisi A., and Torzilli G.
Abstract: Objective: Laparoscopic liver resection (LLR) for Hepatocellular Carcinoma (HCC) is one of the most important indications for the minimally invasive approach. Our study aims to analyze the experience of the Italian Group of Minimally Invasive Liver Surgery with laparoscopic surgical treatment of HCC, with a focus on tumor location and how it affects morbidity and mortality. Methods: 38 centers participated in this study; 372 cases of LLR for HCC were prospectively enrolled. Patients were divided into two groups according to the HCC nodule location. Group 1 favorable location and group 2 unfavorable location. Perioperative outcomes were compared between the two groups before and after a propensity score match (PS) 1:1. Results: Before PS in group 2 surgical time was longer; conversion rate was higher; postoperative transfusion and comprehensive complication index were also higher. PS was performed with a cohort of 298 patients (from 18 centers), with 66 and 232 patients with HCC in unfavorable and favorable locations, respectively. After PS matching, 62 patients from group 1 and group 2 each were compared. Operative and postoperative course were similar in patients with HCC in favorable and unfavorable LLR locations. Surgical margins were found to be identical before and after PS. Conclusions: These results show that LLR in patients with HCC can be safely performed in all segments because of the extensive experience of all surgeons from multiple centers in performing traditional open liver surgery as well as laparoscopic surgery.
Published: 2019

39. The SURF (Italian observational study for renal insufficiency evaluation in liver transplant recipients): A post-hoc between-sex analysis

Author: Colombo, D., Zagni, E., Zullo, A., Simoni, L., Fagiuoli, S., De Simone, P., Donati, D., Salizzoni, M., Angeli, P., Burra, P., Cillo, U., Toniutto, P., Rossi, M., Vennarecci, G., De Carlis, L., Donato, F., Cescon, M., Di Leo, A., Di Costanzo, G. G., Avolio, Alfonso Wolfango, Avolio A. (ORCID:0000-0003-2491-7625), Colombo, D., Zagni, E., Zullo, A., Simoni, L., Fagiuoli, S., De Simone, P., Donati, D., Salizzoni, M., Angeli, P., Burra, P., Cillo, U., Toniutto, P., Rossi, M., Vennarecci, G., De Carlis, L., Donato, F., Cescon, M., Di Leo, A., Di Costanzo, G. G., Avolio, Alfonso Wolfango, and Avolio A. (ORCID:0000-0003-2491-7625)
Abstract: Background: Female sex has been reported as an independent predictor of severe post-liver transplantation (LT) chronic kidney disease. We performed a by sex post-hoc analysis of the SURF study, that investigated the prevalence of renal impairment following LT, aimed at exploring possible differences between sexes in the prevalence and course of post-LT renal damage. Methods: All patients enrolled in the SURF study were considered evaluable for this sex-based analysis, whose primary objective was to evaluate by sex the proportion of patients with estimated Glomerular Filtration Rate (eGFR) < 60 ml/min/1.73m2 at inclusion and follow-up visit. Results: Seven hundred thirty-eight patients were included in our analysis, 76% males. The proportion of patients with eGFR < 60 mL/min/1.73 m2 was significantly higher in females at initial study visit (33.3 vs 22.8%; p = 0.005), but also before, at time of transplantation (22.9 vs 14.7%; p = 0.0159), as analyzed retrospectively. At follow-up, such proportion increased more in males than in females (33.9 vs 26.0%, p = 0.04). Mean eGFR values decreased over the study in both sexes, with no significant differences. Statistically significant M/F differences in patient distribution by O'Riordan eGFR levels were observed at time of transplant and study initial visit (p = 0.0005 and 0.0299 respectively), but not at follow-up. Conclusions: Though the limitation of being performed post-hoc, this analysis suggests potential sex differences in the prevalence of renal impairment before and after LT, encouraging further clinical research to explore such differences more in depth.
Published: 2019

40. Increased cancer risk in patients undergoing dialysis: A population-based cohort study in North-Eastern Italy

Author: Taborelli, M., Toffolutti, F., Del Zotto, S., Clagnan, E., Furian, L., Piselli, P., Citterio, Franco, Zanier, L., Boscutti, G., Serraino, D., Shalaby, S., Petrara, R., Burra, P., Zanus, G., Zanini, S., Rigotti, P., Rendina, M., Di Leo, A., Schena, F. P., Grandaliano, Giuseppe, Fiorentino, M., Lauro, A., Pinna, A. D., Di Gioia, P., Pellegrini, S., Zanfi, C., Scolari, M. P., Stefoni, S., Todeschini, P., Panicali, L., Valentini, C., Baccarani, U., Risaliti, A., Adani, G. L., Lorenzin, D., Ettorre, G. M., Vennarecci, G., Colasanti, M., Coco, M., Ettorre, F., Santoro, R., Miglioresi, L., Nudo, F., Rossi, M., Mennini, G., Toti, L., Tisone, G., Casella, A., Fazzolari, L., Sforza, D., Iaria, G., Gazia, C., Belardi, C., Cimaglia, C., Agresta, A., D'Offizi, G., Comandini, U. V., Lionetti, R., Montalbano, M., Taibi, C., Fantola, G., Zamboni, F., Piredda, G. B., Michittu, M. B., Murgia, M. G., Onano, B., Fratino, L., Maso, L. D., De Paoli, P., Verdirosi, D., Vaccher, E., Pisani, F., Famulari, A., Delreno, F., Iesari, S., De Luca, L., Iaria, M., Capocasale, E., Cremaschi, E., Sandrini, S., Valerio, F., Mazzucotelli, V., Bossini, N., Setti, G., Veroux, M., Veroux, P., Giaquinta, A., Zerbo, D., Busnach, G., Di Leo, L., Perrino, M. L., Querques, M., Colombo, V., Sghirlanzoni, M. C., Messa, P., Leoni, A., Galatioto, L., Gruttadauria, S., Sparacino, V., Caputo, F., Buscemi, B., Spagnoletti, Gionata, Salerno, Maria Paola, Favi, E., Segoloni, G. P., Biancone, L., Lavacca, A., Maresca, M. C., Cascone, C., Virgilio, B., Donati, D., Dossi, F., Fontanella, A., Ambrosini, A., Di Cicco, M., Citterio F. (ORCID:0000-0003-0489-6337), Grandaliano G. (ORCID:0000-0003-1213-2177), Spagnoletti G. (ORCID:0000-0003-2626-8147), Salerno M. P., Taborelli, M., Toffolutti, F., Del Zotto, S., Clagnan, E., Furian, L., Piselli, P., Citterio, Franco, Zanier, L., Boscutti, G., Serraino, D., Shalaby, S., Petrara, R., Burra, P., Zanus, G., Zanini, S., Rigotti, P., Rendina, M., Di Leo, A., Schena, F. P., Grandaliano, Giuseppe, Fiorentino, M., Lauro, A., Pinna, A. D., Di Gioia, P., Pellegrini, S., Zanfi, C., Scolari, M. P., Stefoni, S., Todeschini, P., Panicali, L., Valentini, C., Baccarani, U., Risaliti, A., Adani, G. L., Lorenzin, D., Ettorre, G. M., Vennarecci, G., Colasanti, M., Coco, M., Ettorre, F., Santoro, R., Miglioresi, L., Nudo, F., Rossi, M., Mennini, G., Toti, L., Tisone, G., Casella, A., Fazzolari, L., Sforza, D., Iaria, G., Gazia, C., Belardi, C., Cimaglia, C., Agresta, A., D'Offizi, G., Comandini, U. V., Lionetti, R., Montalbano, M., Taibi, C., Fantola, G., Zamboni, F., Piredda, G. B., Michittu, M. B., Murgia, M. G., Onano, B., Fratino, L., Maso, L. D., De Paoli, P., Verdirosi, D., Vaccher, E., Pisani, F., Famulari, A., Delreno, F., Iesari, S., De Luca, L., Iaria, M., Capocasale, E., Cremaschi, E., Sandrini, S., Valerio, F., Mazzucotelli, V., Bossini, N., Setti, G., Veroux, M., Veroux, P., Giaquinta, A., Zerbo, D., Busnach, G., Di Leo, L., Perrino, M. L., Querques, M., Colombo, V., Sghirlanzoni, M. C., Messa, P., Leoni, A., Galatioto, L., Gruttadauria, S., Sparacino, V., Caputo, F., Buscemi, B., Spagnoletti, Gionata, Salerno, Maria Paola, Favi, E., Segoloni, G. P., Biancone, L., Lavacca, A., Maresca, M. C., Cascone, C., Virgilio, B., Donati, D., Dossi, F., Fontanella, A., Ambrosini, A., Di Cicco, M., Citterio F. (ORCID:0000-0003-0489-6337), Grandaliano G. (ORCID:0000-0003-1213-2177), Spagnoletti G. (ORCID:0000-0003-2626-8147), and Salerno M. P.
Abstract: Background: In southern Europe, the risk of cancer in patients with end-stage kidney disease receiving dialysis has not been well quantified. The aim of this study was to assess the overall pattern of risk for de novo malignancies (DNMs) among dialysis patients in the Friuli Venezia Giulia region, north-eastern Italy. Methods: A population-based cohort study among 3407 dialysis patients was conducted through a record linkage between local healthcare databases and the cancer registry (1998-2013). Person-years (PYs) were calculated from 30 days after the date of first dialysis to the date of DNM diagnosis, kidney transplant, death, last follow-up or December 31, 2013, whichever came first. The risk of DNM, as compared to the general population, was estimated using standardized incidence ratios (SIRs) and 95% confidence intervals (CIs). Results: During 10,798 PYs, 357 DNMs were diagnosed in 330 dialysis patients. A higher than expected risk of 1.3-fold was found for all DNMs combined (95% CI: 1.15-1.43). The risk was particularly high in younger dialysis patients (SIR = 1.88, 95% CI: 1.42-2.45 for age 40-59 years), and it decreased with age. Moreover, significantly increased DNM risks emerged during the first 3 years since dialysis initiation, especially within the first year (SIR = 8.52, 95% CI: 6.89-10.41). Elevated excess risks were observed for kidney (SIR = 3.18; 95% CI: 2.06-4.69), skin non-melanoma (SIR = 1.81, 95% CI: 1.46-2.22), oral cavity (SIR = 2.42, 95% CI: 1.36-4.00), and Kaposi's sarcoma (SIR = 10.29, 95% CI: 1.25-37.16). Conclusions: The elevated risk for DNM herein documented suggest the need to implement a targeted approach to cancer prevention and control in dialysis patients.
Published: 2019

41. Charting the Path Forward for Risk Prediction in Liver Transplant for Hepatocellular Carcinoma: International Validation of HALTHCC Among 4,089 Patients

Author: Firl, D. J., Sasaki, K., Agopian, V. G., Gorgen, A., Kimura, S., Dumronggittigule, W., Mcvey, J. C., Iesari, S., Mennini, G., Vitale, A., Finkenstedt, A., Onali, S., Hoppe-Lotichius, M., Vennarecci, G., Manzia, T. M., Nicolini, D., Avolio, Alfonso Wolfango, Agnes, Salvatore, Vivarelli, M., Tisone, G., Ettorre, G. M., Otto, G., Tsochatzis, E., Rossi, M., Viveiros, A., Cillo, U., Markmann, J. F., Ikegami, T., Kaido, T., Lai, Q., Sapisochin, G., Lerut, J., Aucejo, F. N., Avolio A. W. (ORCID:0000-0003-2491-7625), Agnes S. (ORCID:0000-0002-3341-4221), Firl, D. J., Sasaki, K., Agopian, V. G., Gorgen, A., Kimura, S., Dumronggittigule, W., Mcvey, J. C., Iesari, S., Mennini, G., Vitale, A., Finkenstedt, A., Onali, S., Hoppe-Lotichius, M., Vennarecci, G., Manzia, T. M., Nicolini, D., Avolio, Alfonso Wolfango, Agnes, Salvatore, Vivarelli, M., Tisone, G., Ettorre, G. M., Otto, G., Tsochatzis, E., Rossi, M., Viveiros, A., Cillo, U., Markmann, J. F., Ikegami, T., Kaido, T., Lai, Q., Sapisochin, G., Lerut, J., Aucejo, F. N., Avolio A. W. (ORCID:0000-0003-2491-7625), and Agnes S. (ORCID:0000-0002-3341-4221)
Abstract: Prognosticating outcomes in liver transplant (LT) for hepatocellular carcinoma (HCC) continues to challenge the field. Although Milan Criteria (MC) generalized the practice of LT for HCC and improved outcomes, its predictive character has degraded with increasing candidate and oncological heterogeneity. We sought to validate and recalibrate a previously developed, preoperatively calculated, continuous risk score, the Hazard Associated with Liver Transplantation for Hepatocellular Carcinoma (HALTHCC), in an international cohort. From 2002 to 2014, 4,089 patients (both MC in and out [25.2%]) across 16 centers in North America, Europe, and Asia were included. A continuous risk score using pre-LT levels of alpha-fetoprotein, Model for End-Stage Liver Disease Sodium score, and tumor burden score was recalibrated among a randomly selected cohort (n = 1,021) and validated in the remainder (n = 3,068). This study demonstrated significant heterogeneity by site and year, reflecting practice trends over the last decade. On explant pathology, both vascular invasion (VI) and poorly differentiated component (PDC) increased with increasing HALTHCC score. The lowest-risk patients (HALTHCC 0-5) had lower rates of VI and PDC than the highest-risk patients (HALTHCC > 35) (VI, 7.7%[ 1.2-14.2] vs. 70.6% [48.3-92.9] and PDC:4.6% [0.1%-9.8%] vs. 47.1% [22.6-71.5]; P < 0.0001 for both). This trend was robust to MC status. This international study was used to adjust the coefficients in the HALTHCC score. Before recalibration, HALTHCC had the greatest discriminatory ability for overall survival (OS; C-index = 0.61) compared to all previously reported scores. Following recalibration, the prognostic utility increased for both recurrence (C-index = 0.71) and OS (C-index = 0.63). Conclusion: This large international trial validated and refined the role for the continuous risk metric, HALTHCC, in establishing pre-LT risk among candidates with HCC worldwide. Prospective trials introducing HA
Published: 2019

42. FIXED DOSE-RATE GEMCITABINE (GEM) INFUSION IN ADVANCED PANCREATIC (P) AND BILIARY TREE (B) CARCINOMA

Author: Milella, M., Gelibter, A., Di Cosimo, S., Carlini, P., Ruggeri, E. M., Ceribelli, A., Daddiego, G., Lifrieri, M., Carboni, F., Vennarecci, G., Ettorre, G. M., and Cognetti, F.
Published: 2003

43. Immunosuppression without prednisone after liver transplantion is safe and associated with normal early graft function: preliminary results of a randomized study

Author: Tisone, G., Angelico, M., Palmieri, G., Pisani, F., Baiocchi, L., Vennarecci, G., Anselmo, A., Orlando, G., Negrini, S., and Casciani, C. U.
Published: 1998
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44. De novo neoplasms after liver transplantation: donor gender and age influence

Author: Shalaby, S., primary, Taborelli, M., additional, Ruzzarin, A., additional, Zanetto, A., additional, Ferrarese, A., additional, Becchetti, C., additional, Sciarrone, S.S., additional, Zeni, N., additional, Gambato, M., additional, Germani, G., additional, Senzolo, M., additional, Russo, F.P., additional, Boccagni, P., additional, Zanus, G., additional, Ettorre, G.M., additional, Baccarani, U., additional, Lauro, A., additional, Galatioto, L., additional, Rendina, M., additional, Petrara, R., additional, Nudo, F., additional, Toti, L., additional, Fantola, G., additional, Vennarecci, G., additional, Pinna, A.D., additional, Gruttadauria, S., additional, Risaliti, A., additional, Di Leo, A., additional, Rossi, M., additional, Tisone, G., additional, Zamboni, F., additional, Cillo, U., additional, Piselli, P., additional, Serraino, D., additional, and Burra, P., additional
Published: 2019
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45. Laparoscopic liver resection for hepatocellular carcinoma: a Single Center experience of more than 100 cases

Author: Levi Sandri, G.B., primary, Colasanti, M., additional, Lepiane, P., additional, Vennarecci, G., additional, and Ettorre, G.M., additional
Published: 2019
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46. ALPPS procedure for hepatocellular carcinoma with macrovascular tumoral thrombosis: the San Camillo Experience

Author: Sandri, G.B. Levi, primary, Vennarecci, G., additional, Lepiane, P., additional, Colasanti, M., additional, and Ettorre, G.M., additional
Published: 2019
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47. ALPPS for bleeding HCC in HBV cirrhosis: a safety strategy

Author: Sandri, G.B. Levi, primary, Colasanti, M., additional, Lepiane, P., additional, Vennarecci, G., additional, and Ettorre, G.M., additional
Published: 2019
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48. ALPPS procedure for hepatocellular carcinoma with macrovascular tumoral thrombosis: the San Camillo Experience

Author: Levi Sandri, G.B., primary, Vennarecci, G., additional, Lepiane, P., additional, Colasanti, M., additional, and Ettorre, G.M., additional
Published: 2019
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49. PREDNISONE IS UNNECESSARY AS ROUTINE TREATMENT AFTER LIVER TRANSPLANTATION(OLT)

Author: Tisone, G., Angelico, M., Palmieri, G., Pisani, F., Baiocchi, L., Anselmo, A., Negrini, S., Orlando, G., Vennarecci, G., and Casciani, C. U.
Published: 1998

50. Prevalent use of Combined Prophylaxis of Hepatitis B after liver transplantation in Italy: Results of a national survey in a large cohort

Author: Marzano, A, Andreone, P, Boccagni, P, Burra, P, Caneschi, F, Conoscitore, P, Coppola, C, De Carlis, L, Fagiuoli, S, Forte, P, Gaeta, G, Iemmolo, R, Suffredini, A, Mazzola, M, Merli, M, Parrilli, G, Piai, G, Piras, M, Salizzoni, M, Tamè, M, Tisone, G, Toniutto, P, Vennarecci, G, Volpes, R, Zamboni, F, Caccamo, L, Bertuzzo, V, Bongiovanni, A, Brin-Dicci, G, Cocchis, D, Ettorre, G, Gianni, E, Giusto, M, Lenisa, I, Lucà, M, Mameli, L, Mangoni, I, Manini, M, Paoli, S, Russo, F, Staiano, L, Stornaiuolo, G, Toti, L, Valente, G, Vukotic, R, Marzano, Alfredo, Andreone, Pietro, Boccagni, Patrizia, Burra, Patrizia, Caneschi, Francesco, Conoscitore, Pasquale F., Coppola, Carmine, De Carlis, Luciano, Fagiuoli, Stefano, Forte, Paolo, Gaeta, Giovanni B., Iemmolo, Rosa M., Suffredini, Anna Lotti, Mazzola, Michele, Merli, Manuela, Parrilli, Gianpaolo, Piai, Guido, Piras, Maria R., Salizzoni, Mauro, Tamè, Mariarosa, Tisone, Giuseppe, Toniutto, Pierluigi, Vennarecci, Giovanni, Volpes, Riccardo, Zamboni, Fausto, Caccamo, Lucio, Bertuzzo, Valentina R., Bongiovanni, Assunta S., Brin-Dicci, Gaetano, Cocchis, Donatella, Ettorre, Giuseppe M., Gianni, Elena, Giusto, Michela, Lenisa, Ilaria, Lucà, Maria G., Mameli, Laura, Mangoni, Iacopo, Manini, Matteo A., Paoli, Serena, Russo, Francesco P., Staiano, Laura, Stornaiuolo, Gianfranca, Toti, Luca, Valente, Giovanna, Vukotic, Ranka, Marzano, A, Andreone, P, Boccagni, P, Burra, P, Caneschi, F, Conoscitore, P, Coppola, C, De Carlis, L, Fagiuoli, S, Forte, P, Gaeta, G, Iemmolo, R, Suffredini, A, Mazzola, M, Merli, M, Parrilli, G, Piai, G, Piras, M, Salizzoni, M, Tamè, M, Tisone, G, Toniutto, P, Vennarecci, G, Volpes, R, Zamboni, F, Caccamo, L, Bertuzzo, V, Bongiovanni, A, Brin-Dicci, G, Cocchis, D, Ettorre, G, Gianni, E, Giusto, M, Lenisa, I, Lucà, M, Mameli, L, Mangoni, I, Manini, M, Paoli, S, Russo, F, Staiano, L, Stornaiuolo, G, Toti, L, Valente, G, Vukotic, R, Marzano, Alfredo, Andreone, Pietro, Boccagni, Patrizia, Burra, Patrizia, Caneschi, Francesco, Conoscitore, Pasquale F., Coppola, Carmine, De Carlis, Luciano, Fagiuoli, Stefano, Forte, Paolo, Gaeta, Giovanni B., Iemmolo, Rosa M., Suffredini, Anna Lotti, Mazzola, Michele, Merli, Manuela, Parrilli, Gianpaolo, Piai, Guido, Piras, Maria R., Salizzoni, Mauro, Tamè, Mariarosa, Tisone, Giuseppe, Toniutto, Pierluigi, Vennarecci, Giovanni, Volpes, Riccardo, Zamboni, Fausto, Caccamo, Lucio, Bertuzzo, Valentina R., Bongiovanni, Assunta S., Brin-Dicci, Gaetano, Cocchis, Donatella, Ettorre, Giuseppe M., Gianni, Elena, Giusto, Michela, Lenisa, Ilaria, Lucà, Maria G., Mameli, Laura, Mangoni, Iacopo, Manini, Matteo A., Paoli, Serena, Russo, Francesco P., Staiano, Laura, Stornaiuolo, Gianfranca, Toti, Luca, Valente, Giovanna, and Vukotic, Ranka
Abstract: BACKGROUND: Prophylaxis of hepatitis B after liver transplantation with antiviral(s) and immunoglobulins effciently protect the majority of recipients; however recent experiences suggest a decline of HBsag-positive candidates and the use of hepatitis B immunoglobulin-free schedules. MetHoDs: this national survey evaluated the epidemiology and clinical results of hepatitis B prophylaxis among 10,365 liver transplants performed in 25 years in 13 italian centers. RESULTS: With a percentage of 22, 2260 procedures were performed in HBsAg-positive recipients and 714 out of 1080 anti-HBc-positive grafts were used in HBsag-negative recipients; a total of 2974 patients (29%) were considered at risk of hepatitis B after liver transplantation. similar rates (18% of HBsag-positive candidates and 15% of anti-HBc-positive grafts) were registered in the last collected year. combined prophylaxis with Hepatitis B immunoglobulins remained prevalent among centers and was effective in 96% of HBsag-positive recipients and in 94% of HBsag-negative recipients of anti-HBc-positive grafts. CONCLUSIONS: Data from this survey confrm: the excellent results of combined prophylaxis; the past and persistent use of Hepatitis B immunoglobulin-on and only rare-off prophylactic regimens, in contrast with the newest reports; the increasing use of anti-HBc-positive grafts; the past and present high prevalence of HBsag-positive recipients, due to an increase in candidates with either hepatocellular carcinoma and Hepatitis Delta Virus coinfection in the last years
Published: 2018

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