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1. 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

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

Author

Cortesi, P, Vigano, R, Conti, S, Lenci, I, Volpes, R, Martini, S, Angelico, M, Fung, J, Buti, M, Coilly, A, Durand, F, Fondevila, C, Lebray, P, Nevens, F, Polak, W, Rizzetto, M, Zoulim, F, Perricone, G, Berenguer, M, Mantovani, L, Duvoux, C, Belli, L, Cortesi P. A., Vigano R., Conti S., Lenci I., Volpes R., Martini S., Angelico M., Fung J., Buti M., Coilly A., Durand F., Fondevila C., Lebray P., Nevens F., Polak W. G., Rizzetto M., Zoulim F., Perricone G., Berenguer M., Mantovani L. G., Duvoux C., Belli L. S., Cortesi, P, Vigano, R, Conti, S, Lenci, I, Volpes, R, Martini, S, Angelico, M, Fung, J, Buti, M, Coilly, A, Durand, F, Fondevila, C, Lebray, P, Nevens, F, Polak, W, Rizzetto, M, Zoulim, F, Perricone, G, Berenguer, M, Mantovani, L, Duvoux, C, Belli, L, Cortesi P. A., Vigano R., Conti S., Lenci I., Volpes R., Martini S., Angelico M., Fung J., Buti M., Coilly A., Durand F., Fondevila C., Lebray P., Nevens F., Polak W. G., Rizzetto M., Zoulim F., Perricone G., Berenguer M., Mantovani L. G., Duvoux C., and Belli L. S.

Abstract

The European Liver and Intestine Transplant Association, ELITA, promoted a Consensus Conference involving 20 experts across the world which generated updated guidelines on HBV prophylaxis in liver transplant candidates and recipients. This study explores the economic impact associated with the implementation of the new ELITA guidelines. To this aim, a condition-specific cohort simulation model has been developed to compare new and historical prophylaxis, including only pharmaceutical cost and using the European perspective. The target population simulated in the model included both prevalent and incident cases, and consisted of 6,133 patients after the first year, that increased to 7,442 and 8,743 patents after 5 and 10 years from its implementation. The ELITA protocols allowed a cost saving of around € 235.65 million after 5 years and € 540.73 million after 10 years; which was mainly due to early HIBG withdrawal either after the first 4 weeks or after the first year post Liver Transplantation (LT) depending on the virological risk at transplantation. Results were confirmed by sensitivity analyses. The money saved by the implementation of the ELITA guidelines would allow healthcare decision makers and budget holders to understand where costs could be reduced and resources re-allocated to different needs.

Published
2023

3. Individualized HBIG withdrawal in an historical cohort of liver transplant recipients in Italy

Author

Viganò, R., primary, Lenci, I., additional, Carrai, P., additional, Volpes, R., additional, Martini, S., additional, Donato, MF., additional, Mazzarelli, C., additional, Farina, E., additional, Cocchis, D., additional, Perricone, G., additional, Pasulo, L., additional, Becchetti, C., additional, De Simone, P., additional, Romagnoli, R., additional, Fagiuoli, S., additional, Milana, M., additional, Petruccelli, S., additional, Baiocchi, L., additional, Di Benedetto, C., additional, Loglio, A., additional, D'Amico, F., additional, and Belli, L.S., additional

Published
2023
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4. 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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5. 2020 position statement and recommendations of the European Liver and Intestine Transplantation Association (ELITA): management of hepatitis B virus-related infection before and after liver transplantation

Author

Duvoux, C, Belli, L, Fung, J, Angelico, M, Buti, M, Coilly, A, Cortesi, P, Durand, F, Feray, C, Fondevila, C, Lebray, P, Martini, S, Nevens, F, Polak, W, Rizzetto, M, Volpes, R, Zoulim, F, Samuel, D, Berenguer, M, Duvoux C., Belli L. S., Fung J., Angelico M., Buti M., Coilly A., Cortesi P., Durand F., Feray C., Fondevila C., Lebray P., Martini S., Nevens F., Polak W. G., Rizzetto M., Volpes R., Zoulim F., Samuel D., Berenguer M., Duvoux, C, Belli, L, Fung, J, Angelico, M, Buti, M, Coilly, A, Cortesi, P, Durand, F, Feray, C, Fondevila, C, Lebray, P, Martini, S, Nevens, F, Polak, W, Rizzetto, M, Volpes, R, Zoulim, F, Samuel, D, Berenguer, M, Duvoux C., Belli L. S., Fung J., Angelico M., Buti M., Coilly A., Cortesi P., Durand F., Feray C., Fondevila C., Lebray P., Martini S., Nevens F., Polak W. G., Rizzetto M., Volpes R., Zoulim F., Samuel D., and Berenguer M.

Abstract

Background: Prophylaxis of HBV recurrence is critical after liver transplantation in HBV patients. Despite new prophylactic schemes, most European LT centres persist on a conservative approach combining hepatitis B immunoglobulin (HBIG) and nucleos(t)ides analogues (NA). Aim: This setting prompted the European Liver Intestine Transplantation Association (ELITA) to look for a consensus on the prevention of HBV recurrence. Methods: Based on a 4-round Delphi process, ELITA investigated 16 research questions and established 50 recommendations. Results: Prophylaxis should be driven according to 3 simplified risk groups: Low and high virological risk patients, with undetectable and detectable HBV DNA pre-LT, respectively, and special populations (HDV, HCC, poorly adherent patients). In low-risk patients, short-term (4 weeks) combination of third-generation NA+ HBIG, or third generation NA monotherapy can be considered as prophylactic options. In high-risk patients, HBIG can be discontinued once HBV DNA undetectable. Combined therapy for 1 year is advised. HBV-HCC patients should be treated according to their virological risk. In HDV/HBV patients, indefinite dual prophylaxis remains the gold standard. Full withdrawal of HBV prophylaxis following or not HBV vaccination should only be attempted in the setting of clinical trials. Organs from HBsAg+ve donors may be considered after assessment of risks, benefits, and patient consent. They should not be used if HDV is present. In poorly adherent patients, dual long-term prophylaxis is recommended. Budget impact analysis should be taken into account to drive prophylactic regimen. Conclusions: These ELITA recommendations should stimulate a more rational and homogeneous approach to HBV prophylaxis across LT programs.

Published
2021

6. Correction to: Immunosuppressive regimens for adult liver transplant recipients in real-life practice: consensus recommendations from an Italian Working Group (Hepatology International, (2020), 14, 6, (930-943), 10.1007/s12072-020-10091-5)

Author

Cillo U., Cillo, U, De Carlis, L, Del Gaudio, M, De Simone, P, Fagiuoli, S, Lupo, F, Tisone, G, Volpes, R, Avolio, A, Bitetto, D, Boccagni, P, Carraro, A, Castellaneta, A, Colledan, M, De Maria, N, Di Benedetto, F, Lanza, A, Gardini, I, Guglielmo, N, Invernizzi, F, Laurenzi, A, Leandro, G, Lenci, I, Lorenzin, D, Mameli, L, Manzia, T, Mariani, A, Mennini, G, Mirabella, S, Morelli, M, Nicolini, D, Petruccelli, S, Regalia, E, Reggiani, P, Roselli, S, Zamboni, F, Cillo U., De Carlis L., Del Gaudio M., De Simone P., Fagiuoli S., Lupo F., Tisone G., Volpes R., Avolio A., Bitetto D., Boccagni P., Carraro A., Castellaneta A., Colledan M., De Maria N., Di Benedetto F., Lanza A. G., Gardini I., Guglielmo N., Invernizzi F., Laurenzi A., Leandro G., Lenci I., Lorenzin D., Mameli L., Manzia T. M., Mariani A., Mennini G., Mirabella S., Morelli M. C., Nicolini D., Petruccelli S., Regalia E., Reggiani P., Roselli S., Zamboni F., Cillo U., Cillo, U, De Carlis, L, Del Gaudio, M, De Simone, P, Fagiuoli, S, Lupo, F, Tisone, G, Volpes, R, Avolio, A, Bitetto, D, Boccagni, P, Carraro, A, Castellaneta, A, Colledan, M, De Maria, N, Di Benedetto, F, Lanza, A, Gardini, I, Guglielmo, N, Invernizzi, F, Laurenzi, A, Leandro, G, Lenci, I, Lorenzin, D, Mameli, L, Manzia, T, Mariani, A, Mennini, G, Mirabella, S, Morelli, M, Nicolini, D, Petruccelli, S, Regalia, E, Reggiani, P, Roselli, S, Zamboni, F, Cillo U., De Carlis L., Del Gaudio M., De Simone P., Fagiuoli S., Lupo F., Tisone G., Volpes R., Avolio A., Bitetto D., Boccagni P., Carraro A., Castellaneta A., Colledan M., De Maria N., Di Benedetto F., Lanza A. G., Gardini I., Guglielmo N., Invernizzi F., Laurenzi A., Leandro G., Lenci I., Lorenzin D., Mameli L., Manzia T. M., Mariani A., Mennini G., Mirabella S., Morelli M. C., Nicolini D., Petruccelli S., Regalia E., Reggiani P., Roselli S., and Zamboni F.

Abstract

In the original publication of this article, after the name of the last author, the wording on behalf of the Italian Liver Transplant Working Group is missing.

Published
2021

7. Immunosuppressive regimens for adult liver transplant recipients in real-life practice: consensus recommendations from an Italian Working Group

Author

Cillo, U, De Carlis, L, Del Gaudio, M, De Simone, P, Fagiuoli, S, Lupo, F, Tisone, G, Volpes, R, Cillo U., De Carlis L., Del Gaudio M., De Simone P., Fagiuoli S., Lupo F., Tisone G., Volpes R., Cillo, U, De Carlis, L, Del Gaudio, M, De Simone, P, Fagiuoli, S, Lupo, F, Tisone, G, Volpes, R, Cillo U., De Carlis L., Del Gaudio M., De Simone P., Fagiuoli S., Lupo F., Tisone G., and Volpes R.

Abstract

It is a well-recognized fact that implementing new guidelines in clinical practice may be difficult; therefore the Italian Society for Organ and Tissue Transplantation (SITO) set out to define practical immunosuppression tools for the management of liver transplantation patients. In 2017, an Italian Working Group of liver transplant experts and hepatologists issued a set of consensus statements along with evidence-based recommendations on the use of everolimus after liver transplantation. This article presents the evidence- and consensus-based algorithms developed within the Italian Working Group, which are aimed towards guiding clinicians in the selection of immunosuppressive regimens for the management of adult liver transplant recipients in real-life practice. The liver transplant recipient population, typically managed in clinical practice, was divided into the following categories: (1) standard patients; (2) critically ill patients; (3) patients with a specific etiology; (4) patients with hepatocellular carcinoma; (5) and patients with de novo malignancies. The algorithms are divided into two parts, according to the time from transplantation (0–3 months and > 3 months) and are discussed here along with relevant supporting literature, when available. Ultimately, it is hoped that the evidence- and consensus-based algorithms developed within the Italian Working Group, and presented here, contribute to simplify, personalize, and optimize immunosuppression of liver transplantation recipients in clinical practice.

Published
2020

8. Recent trends and intention-to-treat survival of liver transplantation for nonalcoholic steatohepatitis: an Italian liver transplant registry study

Author

Vitale, A, Trapani, S, Burra, P, Bertacco, A, Romagnoli, R, Martini, S, De Simone, P, Carrai, P, Cescon, M, Morelli, M, De Carlis, L, Belli, L, Gruttadauria, S, Volpes, R, Colledan, M, Fagiuoli, S, Rossi, G, Donato, F, Di Benedetto, F, De Maria, N, Tedeschi, U, Colecchia, A, Ricci, A, Rossi, M, Cardillo, M, Cillo, U, Vitale A, Trapani S, Burra P, Bertacco A, Romagnoli R, Martini S, De Simone P, Carrai P, Cescon M, Morelli MC, De Carlis L, Belli L, Gruttadauria S, Volpes R, Colledan M, Fagiuoli S, Rossi G, Donato F, Di Benedetto F, De Maria N, Tedeschi U, Colecchia A, Ricci A, Rossi M, Cardillo M, Cillo U, Vitale, A, Trapani, S, Burra, P, Bertacco, A, Romagnoli, R, Martini, S, De Simone, P, Carrai, P, Cescon, M, Morelli, M, De Carlis, L, Belli, L, Gruttadauria, S, Volpes, R, Colledan, M, Fagiuoli, S, Rossi, G, Donato, F, Di Benedetto, F, De Maria, N, Tedeschi, U, Colecchia, A, Ricci, A, Rossi, M, Cardillo, M, Cillo, U, Vitale A, Trapani S, Burra P, Bertacco A, Romagnoli R, Martini S, De Simone P, Carrai P, Cescon M, Morelli MC, De Carlis L, Belli L, Gruttadauria S, Volpes R, Colledan M, Fagiuoli S, Rossi G, Donato F, Di Benedetto F, De Maria N, Tedeschi U, Colecchia A, Ricci A, Rossi M, Cardillo M, and Cillo U

Published
2020

9. Location and allocation: inequity of access to liver transplantation for patients with severe acute‐on‐chronic liver failure in Europe

Author

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

Abstract

Background: There is growing evidence that liver transplantation (LT) is the most effective treatment for acute-on-chronic liver failure grade-3 (ACLF-3). This study examines whether and how this evidence translates into practice by analyzing the variability in intensive care unit (ICU) admissions, listing strategies and LT activity for ACLF-3 patients across transplant centers in Europe. Methods: Consecutive patients who were admitted to the ICU with ACLF-3, whether or not they were listed and/or transplanted with ACLF-3 between 2018 and 2019 were included across 20 transplantation centers. Results: 351 patients with ACLF-3 were included: 33 had been listed prior to developing ACLF-3 and 318 had not been listed at the time of admission to the ICU. There was no correlation between the number of unlisted ACLF-3 patients admitted to the ICU and the number listed or transplanted whilst in ACLF-3 across centers. In contrast, there was a correlation between the number of patients listed and the number transplanted whilst in ACLF-3. 21% of patients who were listed whilst in ACLF-3 died on the waiting list or were delisted. The percentage of LT for ACLF-3 patients varied from 0%-29% of patients transplanted with decompensated cirrhosis across centers (average = 8%), with an I2 index of 68% (95% CI: 49%-80%), showing substantial heterogeneity among centers. The one-year survival for all patients with ACLF-3 was significantly higher in centers that listed and transplanted more ACLF-3 patients (>10 patients) than in centers that listed and transplanted fewer: respectively 36% vs. 20%, p = 0.012. Conclusion: Patients with ACLF-3 face inequity of access to LT across Europe. Wait-listing strategies for ACLF-3 patients influence their access to LT and, ultimately, their survival.

Published
2022

11. 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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13. Development of a model based on case-mix analysis to predict 6-month patient survival after liver transplantation: a multicenter Italian study

Author

Avolio, A, Lai, Q, Franco, A, Bianco, G, Calia, R, Spoletini, G, Agnes, S, Grieco, A, Rossi, M, Corradini, S, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Donato, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Di Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carraro, A, Burra, P, Cillo, U, Avolio A, Lai Q, Franco A, Bianco G, Calia R, Spoletini G, Agnes S, Grieco A, Rossi M, Corradini SG, Vivarelli M, Benedetti A, Lupo L, Rendina M, Colledan M, Fagiuoli S, Cescon M, Donato C, Zamboni F, Mameli L, De Carlis L, Belli L, Rossi G, Donato F, Mazzaferro V, Bhoori S, Di Benedetto F, De Maria N, Santaniello W, Di Costanzo G, Gruttadauria S, Volpes R, De Simone P, Carrai P, Spada M, Nobile V, Ettorre G, Giannelli V, Tisone G, Lenci I, Romagnoli R, Martini S, Risaliti A, Toniutto P, Tedeschi U, Carraro A, Burra P, Cillo U, Avolio, A, Lai, Q, Franco, A, Bianco, G, Calia, R, Spoletini, G, Agnes, S, Grieco, A, Rossi, M, Corradini, S, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Donato, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Di Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carraro, A, Burra, P, Cillo, U, Avolio A, Lai Q, Franco A, Bianco G, Calia R, Spoletini G, Agnes S, Grieco A, Rossi M, Corradini SG, Vivarelli M, Benedetti A, Lupo L, Rendina M, Colledan M, Fagiuoli S, Cescon M, Donato C, Zamboni F, Mameli L, De Carlis L, Belli L, Rossi G, Donato F, Mazzaferro V, Bhoori S, Di Benedetto F, De Maria N, Santaniello W, Di Costanzo G, Gruttadauria S, Volpes R, De Simone P, Carrai P, Spada M, Nobile V, Ettorre G, Giannelli V, Tisone G, Lenci I, Romagnoli R, Martini S, Risaliti A, Toniutto P, Tedeschi U, Carraro A, Burra P, and Cillo U

Published
2019

14. Different perceptions of sustainable case-mix for liver transplantation between surgeons and hepatologists: an Italian multicenter study

Author

Calia, R, Avolio, A, Luciani, M, Franco, A, Lai, Q, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Morelli, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Agnes, S, Grieco, A, Spoletini, G, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Rossi, M, Corradini, S, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carrao, A, Burra, P, Cillo, U, Calia R, Avolio A, Luciani M, Franco A, Lai Q, Vivarelli M, Benedetti A, Lupo L, Rendina M, Colledan M, Fagiuoli S, Cescon M, Morelli C, Zamboni F, Mameli L, De Carlis L, Belli L, Rossi G, Donato F, Mazzaferro V, Bhoori S, Di Benedetto F, De Maria N, Santaniello W, Costanzo G, Gruttadauria S, Volpes R, De Simone P, Carrai P, Spada M, Nobile V, Agnes S, Grieco A, Spoletini G, Ettorre G, Giannelli V, Tisone G, Lenci I, Rossi M, Corradini SG, Romagnoli R, Martini S, Risaliti A, Toniutto P, Tedeschi U, Carrao A, Burra P, Cillo U, Calia, R, Avolio, A, Luciani, M, Franco, A, Lai, Q, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Morelli, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Agnes, S, Grieco, A, Spoletini, G, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Rossi, M, Corradini, S, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carrao, A, Burra, P, Cillo, U, Calia R, Avolio A, Luciani M, Franco A, Lai Q, Vivarelli M, Benedetti A, Lupo L, Rendina M, Colledan M, Fagiuoli S, Cescon M, Morelli C, Zamboni F, Mameli L, De Carlis L, Belli L, Rossi G, Donato F, Mazzaferro V, Bhoori S, Di Benedetto F, De Maria N, Santaniello W, Costanzo G, Gruttadauria S, Volpes R, De Simone P, Carrai P, Spada M, Nobile V, Agnes S, Grieco A, Spoletini G, Ettorre G, Giannelli V, Tisone G, Lenci I, Rossi M, Corradini SG, Romagnoli R, Martini S, Risaliti A, Toniutto P, Tedeschi U, Carrao A, Burra P, and Cillo U

Published
2019

15. THE CASE-MIX IN LIVER TRANSPLANTATION. DIFFERENT PERCEPTIONS (TRANSPLANT SURGEONS AND TRANSPLANT HEPATOLOGISTS) AND DIFFERENT CONCORDANCE LEVELS WITHIN CENTERS

Author

Calia, R, Avolio, A, Luciani, M, Franco, A, Lai, Q, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Morelli, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Di Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Agnes, S, Grieco, A, Spoletini, G, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Rossi, M, Corradini, S, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carraro, A, Burra, P, Cillo, U, Calia R, Avolio A, Luciani M, Franco A, Lai Q, Vivarelli M, Benedetti A, Lupo L, Rendina M, Colledan M, Fagiuoli S, Cescon M, Morelli C, Zamboni F, Mameli L, De Carlis L, Belli LS, Rossi G, Donato F, Mazzaferro V, Bhoori S, Di Benedetto F, De Maria N, Santaniello W, Di Costanzo G, Gruttadauria S, Volpes R, De Simone P, Carrai P, Spada M, Nobile V, Agnes S, Grieco A, Spoletini G, Ettorre G, Giannelli V, Tisone G, Lenci I, Rossi M, Corradini SG, Romagnoli R, Martini S, Risaliti A, Toniutto P, Tedeschi U, Carraro A, Burra P, Cillo U, Calia, R, Avolio, A, Luciani, M, Franco, A, Lai, Q, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Morelli, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Di Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Agnes, S, Grieco, A, Spoletini, G, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Rossi, M, Corradini, S, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carraro, A, Burra, P, Cillo, U, Calia R, Avolio A, Luciani M, Franco A, Lai Q, Vivarelli M, Benedetti A, Lupo L, Rendina M, Colledan M, Fagiuoli S, Cescon M, Morelli C, Zamboni F, Mameli L, De Carlis L, Belli LS, Rossi G, Donato F, Mazzaferro V, Bhoori S, Di Benedetto F, De Maria N, Santaniello W, Di Costanzo G, Gruttadauria S, Volpes R, De Simone P, Carrai P, Spada M, Nobile V, Agnes S, Grieco A, Spoletini G, Ettorre G, Giannelli V, Tisone G, Lenci I, Rossi M, Corradini SG, Romagnoli R, Martini S, Risaliti A, Toniutto P, Tedeschi U, Carraro A, Burra P, and Cillo U

Published
2019

17. Correction to: Immunosuppressive regimens for adult liver transplant recipients in real-life practice: consensus recommendations from an Italian Working Group (Hepatology International, (2020), 14, 6, (930-943), 10.1007/s12072-020-10091-5)

Author

Cillo, U, De Carlis, L, Del Gaudio, M, De Simone, P, Fagiuoli, S, Lupo, F, Tisone, G, Volpes, R, Avolio, A, Bitetto, D, Boccagni, P, Carraro, A, Castellaneta, A, Colledan, M, De Maria, N, Di Benedetto, F, Lanza, Ag, Gardini, I, Guglielmo, N, Invernizzi, F, Laurenzi, A, Leandro, G, Lenci, I, Lorenzin, D, Mameli, L, Manzia, Tm, Mariani, A, Mennini, G, Mirabella, S, Morelli, Mc, Nicolini, D, Petruccelli, S, Regalia, E, Reggiani, P, Roselli, S, and Zamboni, F

Subjects
Settore MED/18
Published
2021

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

Author

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

Abstract

Although discrimination of the model for end stage liver disease (MELD) is generally considered acceptable, its calibration is still unclear. In a validation study, we assessed the discrimination and calibration performance of 3 versions of the model: original MELD-TIPS, used to predict survival after transjugular intra-hepatic portosystemic shunt (TIPS); classic MELD-Mayo; MELD-UNOS, used by United Network for Organ Sharing (UNOS). Recalibration and model updating were also explored.

Published
2021

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

Author

Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Belli, Luca S, Duvoux, Christophe, Artzner, Thierry, Bernal, William, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie-Caroline, Pageaux, George-Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, Francoise, Rabinovich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Fondevila, Costantino, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Jalan, Rajiv, FAGIUOLI, STEFANO, Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Belli, Luca S, Duvoux, Christophe, Artzner, Thierry, Bernal, William, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie-Caroline, Pageaux, George-Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, Francoise, Rabinovich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Fondevila, Costantino, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Jalan, Rajiv, and FAGIUOLI, STEFANO

Abstract

Background and aims: Liver transplantation (LT) has been proposed to be an effective salvage therapy even for the sickest patients with acute-on-chronic liver failure (ACLF). This large collaborative study was designed to address the current clinical practice and outcomes of ACLF patients wait listed (WL) for LT in Europe. Methods: Retrospective study including 308 consecutive ACLF patients, listed in 20 centres across 8 European countries, from January 2018 to June 2019. Results: 2677 patients received a LT, 1216 (45.4%) for decompensated cirrhosis (DC). Of these, 234 (19.2%) had ACLF at LT: ACLF-1, 58 (4.8%); ACLF-2, 78 (6.4%); and ACLF-3, 98 (8.1%). Wide variations were observed amongst countries: France and Germany had high rates of ACLF-2/3 (27-41%); Italy, Switzerland, Poland and Netherlands had medium rates (9-15%); and United Kingdom and Spain had low rates (3-5%) (p <.0001). One-year probability of survival after LT for patients with ACLF was 81% (95% CI 74-87). Pre-LT arterial lactate levels >4 mmol/L (HR 3.14, 95% CI 1.37-7.19), recent infection from multi-drug resistant organisms (HR 3.67, 95% CI 1.63-8.28), and renal replacement therapy (HR 2.74, 95% CI 1.37-5.51) were independent predictors of post-LT mortality. During the same period, 74 patients with ACLF died on the WL. In an intention-to-treat analysis, one-year survival of ACLF patients on the LT WL was 73% for ACLF-1 or -2 and 50% for ACLF-3. Conclusion: The results reveal wide variations in listing patients with ACLF in Europe despite favorable post-LT survival. Risk factors for mortality were identified, allowing a more precise prognostic assessment of ACLF patients for potential LT. Lay summary: Acute on chronic liver failure (ACLF) is a severe clinical condition for which liver transplantation is an effective therapeutic option. This study has demonstrated that in Europe, referral and access to liver transplantation (LT) for patients with ACLF needs to be harmonized to avoid inequities.

Published
2021

22. THE CASE-MIX IN LIVER TRANSPLANTATION. DIFFERENT PERCEPTIONS (TRANSPLANT SURGEONS AND TRANSPLANT HEPATOLOGISTS) AND DIFFERENT CONCORDANCE LEVELS WITHIN CENTERS

Author

Calia, R., Avolio, A., Luciani, M., Franco, Antonio, Lai, Q., Vivarelli, M., Benedetti, A., Lupo, L., Rendina, M., Colledan, Michele, Fagiuoli, S., Cescon, M., Morelli, C., Zamboni, F., Mameli, L., Carlis, Luciano, Belli, Luca Saverio, Rossi, G., Donato, F., Mazzaferro, V., Bhoori, S., Di Benedetto, Fabrizio, Maria, N., Santaniello, W., Di Costanzo, G., Gruttadauria, Salvatore, Volpes, R., Paolo De Simone, Carrai, Paola, Spada, M., Nobile, V., Agnes, S., Grieco, Antonio, Spoletini, G., Ettorre, G., Giannelli, Valerio, Tisone, G., Lenci, I., Rossi, M., Corradini, S. Ginanni, Romagnoli, R., Martini, S., Risaliti, A., Toniutto, P., Tedeschi, U., Carraro, A., Burra, Patrizia, Cillo, Umberto, Calia, R, Avolio, A, Luciani, M, Franco, A, Lai, Q, Vivarelli, M, Benedetti, A, Lupo, L, Rendina, M, Colledan, M, Fagiuoli, S, Cescon, M, Morelli, C, Zamboni, F, Mameli, L, De Carlis, L, Belli, L, Rossi, G, Donato, F, Mazzaferro, V, Bhoori, S, Di Benedetto, F, De Maria, N, Santaniello, W, Di Costanzo, G, Gruttadauria, S, Volpes, R, De Simone, P, Carrai, P, Spada, M, Nobile, V, Agnes, S, Grieco, A, Spoletini, G, Ettorre, G, Giannelli, V, Tisone, G, Lenci, I, Rossi, M, Corradini, S, Romagnoli, R, Martini, S, Risaliti, A, Toniutto, P, Tedeschi, U, Carraro, A, Burra, P, and Cillo, U

Subjects
LIVER TRANSPLANTATION
Published
2019

23. Delisting HCV-infected liver transplant candidates who improved after viral eradication: Outcome 2 years after delisting

Author

Perricone, G, Duvoux, C, Berenguer, M, Cortesi, P, Vinaixa, C, Facchetti, R, Mazzarelli, C, Rockenschaub, S, Martini, S, Morelli, C, Monico, S, Volpes, R, Pageaux, G, Fagiuoli, S, Belli, L, Perricone G., Duvoux C., Berenguer M., Cortesi P. A., Vinaixa C., Facchetti R., Mazzarelli C., Rockenschaub S. -R., Martini S., Morelli C., Monico S., Volpes R., Pageaux G. -P., Fagiuoli S., Belli L. S., Perricone, G, Duvoux, C, Berenguer, M, Cortesi, P, Vinaixa, C, Facchetti, R, Mazzarelli, C, Rockenschaub, S, Martini, S, Morelli, C, Monico, S, Volpes, R, Pageaux, G, Fagiuoli, S, Belli, L, Perricone G., Duvoux C., Berenguer M., Cortesi P. A., Vinaixa C., Facchetti R., Mazzarelli C., Rockenschaub S. -R., Martini S., Morelli C., Monico S., Volpes R., Pageaux G. -P., Fagiuoli S., and Belli L. S.

Abstract

Backgrounds & Aims: Treating patients with decompensated cirrhosis with direct-acting antiviral (DAA) therapy while on the waiting list for liver transplantation results in substantial improvement of liver function allowing 1 in 4 patients to be removed from the waiting list or delisted, as reported in a previous study promoted by the European Liver and Intestine Transplant Association (ELITA). The aim of this study was to report on clinical outcomes of delisted patients, including mortality risk, hepatocellular carcinoma development and clinical decompensation requiring relisting. Methods: One hundred and forty-two HCV-positive patients on the liver transplant waiting list for decompensated cirrhosis, negative for hepatocellular carcinoma, between February 2014 and June 2015 were treated with DAA therapy and were prospectively followed up. Results: Forty-four patients (30.9%) were delisted following clinical improvement. This percentage was higher than in the original study because of a number of patients being delisted long after starting DAAs. The median Child-Pugh and MELD score of delisted patients was 5.5 and 9 respectively. Four patients were relisted, because of HCC diagnosis in 1 case and 3 patients developed ascites. One further patient died (2.4%) because of rapidly progressing hepatocellular carcinoma twenty-two months after delisting. Of the 70 patients who received a liver graft, 9 died (13%). Conclusions: Antiviral therapy allows for a long-term improvement of liver function and the delisting of one-third of treated patients with risk of liver-related complications after delisting being very low.

Published
2018

24. Recurrence of Hepatitis B Infection in Liver Transplant Patients Receiving Long-Term Hepatitis B Immunoglobulin Prophylaxis

Author

Beckebaum, S, Herzer, K, Bauhofer, A, Gelson, W, De Simone, P, de Man, R, Engelmann, C, Mullhaupt, B, Vionnet, J, Salizzoni, M, Volpes, R, Ercolani, G, De Carlis, L, Angeli, P, Burra, P, Dufour, J, Rossi, M, Cillo, U, Neumann, U, Fischer, L, Niemann, G, Toti, L, Tisone, G, Beckebaum S., Herzer K., Bauhofer A., Gelson W., De Simone P., de Man R., Engelmann C., Mullhaupt B., Vionnet J., Salizzoni M., Volpes R., Ercolani G., De Carlis L., Angeli P., Burra P., Dufour J. -F., Rossi M., Cillo U., Neumann U., Fischer L., Niemann G., Toti L., Tisone G., Beckebaum, S, Herzer, K, Bauhofer, A, Gelson, W, De Simone, P, de Man, R, Engelmann, C, Mullhaupt, B, Vionnet, J, Salizzoni, M, Volpes, R, Ercolani, G, De Carlis, L, Angeli, P, Burra, P, Dufour, J, Rossi, M, Cillo, U, Neumann, U, Fischer, L, Niemann, G, Toti, L, Tisone, G, Beckebaum S., Herzer K., Bauhofer A., Gelson W., De Simone P., de Man R., Engelmann C., Mullhaupt B., Vionnet J., Salizzoni M., Volpes R., Ercolani G., De Carlis L., Angeli P., Burra P., Dufour J. -F., Rossi M., Cillo U., Neumann U., Fischer L., Niemann G., Toti L., and Tisone G.

Abstract

BACKGROUND Long-term real-world data are relatively sparse regarding recurrence of chronic hepatitis B virus (HBV) infection after liver transplantation using hepatitis B immunoglobulin (HBIg) and nucleos(t)ide analogue (NUC) prophylaxis. MATERIAL AND METHODS Data from 371 adults transplanted for HBV-related disease at 20 European centers and given HBIg for 312 months ± NUC therapy were analyzed retrospectively. RESULTS HBIg comprised Hepatect® (iv HBIgB; n=299), subcutaneous Zutectra® (sc HBIg, n=236), and other HBIg preparations (n=130); 93.5% received NUC therapy. Mean follow-up was 6.8±3.5 years. The primary efficacy variable, freedom from HBV recurrence, occurred in 95.7% of patients (95% CI [93.1%, 97.5%]). The observed incidence of recurrence was 16/371 (4.3%) (annual rate 0.65%); 5/16 patients with recurrence had discontinued HBIg and 7/16 had anti-HBs <100 IU/l. Excluding these 7 patients, the HBV recurrence rate was 2.4%. The recurrence rate while on HBIg therapy was 1 per 2069 months. In patients who discontinued HBIg, risk of HBV recurrence versus sc HBIg users was increased by 5.2-fold (1 per 1 603 versus 1 per 8379 treatment months). The annual rate of HBV-related hepatocellular carcinoma (HCC) recurrence was 1.7%. CONCLUSIONS These results support the long-term use of HBIg with NUC therapy as an effective management strategy to minimize risk of HBV recurrence and virus-related complications after liver transplantation.

Published
2018

25. Liver transplantation in hepatocellular carcinoma after tumour downstaging (XXL): a randomised, controlled, phase 2b/3 trial

Author

Mazzaferro, V, Citterio, D, Bhoori, S, Bongini, M, Miceli, R, De Carlis, L, Colledan, M, Salizzoni, M, Romagnoli, R, Antonelli, B, Vivarelli, M, Tisone, G, Rossi, M, Gruttadauria, S, Di Sandro, S, De Carlis, R, Lucà, M, De Giorgio, M, Mirabella, S, Belli, L, Fagiuoli, S, Martini, S, Iavarone, M, Svegliati Baroni, G, Angelico, M, Ginanni Corradini, S, Volpes, R, Mariani, L, Regalia, E, Flores, M, Droz Dit Busset, M, Sposito, C, Mazzaferro, Vincenzo, Citterio, Davide, Bhoori, Sherrie, Bongini, Marco, Miceli, Rosalba, De Carlis, Luciano, Colledan, Michele, Salizzoni, Mauro, Romagnoli, Renato, Antonelli, Barbara, Vivarelli, Marco, Tisone, Giuseppe, Rossi, Massimo, Gruttadauria, Salvatore, Di Sandro, Stefano, De Carlis, Riccardo, Lucà, Maria Grazia, De Giorgio, Massimo, Mirabella, Stefano, Belli, Luca, Fagiuoli, Stefano, Martini, Silvia, Iavarone, Massimo, Svegliati Baroni, Gianluca, Angelico, Mario, Ginanni Corradini, Stefano, Volpes, Riccardo, Mariani, Luigi, Regalia, Enrico, Flores, Maria, Droz Dit Busset, Michele, Sposito, Carlo, Mazzaferro, V, Citterio, D, Bhoori, S, Bongini, M, Miceli, R, De Carlis, L, Colledan, M, Salizzoni, M, Romagnoli, R, Antonelli, B, Vivarelli, M, Tisone, G, Rossi, M, Gruttadauria, S, Di Sandro, S, De Carlis, R, Lucà, M, De Giorgio, M, Mirabella, S, Belli, L, Fagiuoli, S, Martini, S, Iavarone, M, Svegliati Baroni, G, Angelico, M, Ginanni Corradini, S, Volpes, R, Mariani, L, Regalia, E, Flores, M, Droz Dit Busset, M, Sposito, C, Mazzaferro, Vincenzo, Citterio, Davide, Bhoori, Sherrie, Bongini, Marco, Miceli, Rosalba, De Carlis, Luciano, Colledan, Michele, Salizzoni, Mauro, Romagnoli, Renato, Antonelli, Barbara, Vivarelli, Marco, Tisone, Giuseppe, Rossi, Massimo, Gruttadauria, Salvatore, Di Sandro, Stefano, De Carlis, Riccardo, Lucà, Maria Grazia, De Giorgio, Massimo, Mirabella, Stefano, Belli, Luca, Fagiuoli, Stefano, Martini, Silvia, Iavarone, Massimo, Svegliati Baroni, Gianluca, Angelico, Mario, Ginanni Corradini, Stefano, Volpes, Riccardo, Mariani, Luigi, Regalia, Enrico, Flores, Maria, Droz Dit Busset, Michele, and Sposito, Carlo

Abstract

Background: Indications for liver transplantation for hepatocellular carcinoma are evolving and so-called expanded criteria remain debated. Locoregional therapies are able to downstage hepatocellular carcinoma from beyond to within the Milan criteria. We aimed to investigate the efficacy of liver transplantation after successful hepatocellular carcinoma downstaging. Methods: We did an open-label, multicentre, randomised, controlled trial designed in two phases, 2b and 3, at nine Italian tertiary care and transplantation centres. Patients aged 18–65 years with hepatocellular carcinoma beyond the Milan criteria, absence of macrovascular invasion or extrahepatic spread, 5-year estimated post-transplantation survival of at least 50%, and good liver function (Child-Pugh A-B7) were recruited and underwent tumour downstaging with locoregional, surgical, or systemic therapies according to multidisciplinary decision. After an observation period of 3 months, during which sorafenib was allowed, patients with partial or complete responses according to modified Response Evaluation Criteria in Solid Tumors were randomly assigned (1:1) by an interactive web-response system to liver transplantation or non-transplantation therapies (control group). A block randomisation (block size of 2), stratified by centre and compliance to sorafenib treatment, was applied. Liver transplantation was done with whole or split organs procured from brain-dead donors. The control group received sequences of locoregional and systemic treatment at the time of demonstrated tumour progression. The primary outcomes were 5-year tumour event-free survival for phase 2b and overall survival for phase 3. Analyses were by intention to treat. Organ allocation policy changed during the course of the study and restricted patient accrual to 4 years. This trial is registered with ClinicalTrials.gov, NCT01387503. Findings: Between March 1, 2011, and March 31, 2015, 74 patients were enrolled. Median duration of downsta

Published
2020

29. Use of Everolimus in Liver Transplantation: Recommendations from a Working Group

Author

De Simone P, Fagiuoli S, Cescon M, De Carlis L, Tisone G, Volpes R, Cillo U, Avolio AW, Burra P, Calise F, Di Benedetto F, Ettorre GM, Galeota Lanza A, Lupo L, Montin U, Reggiani P, Rendina M, Torre G, Bozzoli M, Ippoliti G, Sacchini D, Venturini F, De Simone, P, Fagiuoli, S, Cescon, M, De Carlis, L, Tisone, G, Volpes, R, Cillo, U, and De Simone P, Fagiuoli S, Cescon M, De Carlis L, Tisone G, Volpes R, Cillo U, Avolio AW, Burra P, Calise F, Di Benedetto F, Ettorre GM, Galeota Lanza A, Lupo L, Montin U, Reggiani P, Rendina M, Torre G, Bozzoli M, Ippoliti G, Sacchini D, Venturini F

Subjects
Graft Rejection, medicine.medical_specialty, Consensus, Time Factors, Time Factor, Delphi Technique, medicine.medical_treatment, Protein Kinase Inhibitor, Consensu, 030230 surgery, Liver transplantation, Nephrotoxicity, 03 medical and health sciences, Immunosuppressive Agent, 0302 clinical medicine, Internal medicine, medicine, Humans, Everolimus, Cooperative Behavior, Adverse effect, Protein Kinase Inhibitors, Transplantation, TOR Serine-Threonine Kinase, business.industry, TOR Serine-Threonine Kinases, Graft Survival, Immunosuppression, Evidence-based medicine, Surgery, Liver Transplantation, Settore MED/18, Calcineurin, Immunosuppressive Agents, Interdisciplinary Communication, Signal Transduction, Treatment Outcome, Everolimu, 030211 gastroenterology & hepatology, business, medicine.drug, Human
Abstract

Immunosuppression after liver transplantation (LT) is presently based on use of calcineurin inhibitors (CNI), although they are associated with an increased incidence of renal dysfunction, cardiovascular complications, and de novo and recurrent malignancies. Over the past decade, mammalian target of rapamycin inhibitors have received considerable attention as immunosuppressants because they are associated with a more favorable renal profile versus CNI, as well as antiproliferative activity in clinical studies. Comprehensive guidelines on use of everolimus (EVR) in LT are still lacking. In Italy, a project, named Everolimus: the road to long-term functioning, was initiated to collect the experience on EVR after LT with the aim of providing guidance for transplant clinicians. Herein, recommendations by this national consensus group, based on Delphi methodology, are presented. Consensus was reached on 20 of the 23 statements proposed, and their level of evidence, grade of recommendation, and percent of agreement are reported. Statements are grouped into 4 areas: (A) renal function; (B) time of EVR introduction, CNI reduction and elimination, and risk for graft rejection; (C) antiproliferative effects of EVR; and (D) management of EVR-related adverse events. The high level of consensus shows that there is good agreement on the routine use of EVR in predefined clinical scenarios, especially in light of posttransplant nephrotoxicity and other adverse events associated with long-term administration of CNIs.

Published
2017

31. Recent trends and intention-to-treat survival of liver transplantation for nonalcoholic steatohepatitis: an Italian liver transplant registry study

Author

Vitale, A., primary, Trapani, S., additional, Burra, P., additional, Bertacco, A., additional, Romagnoli, R., additional, Martini, S., additional, De Simone, P., additional, Carrai, P., additional, Cescon, M., additional, Morelli, M.C., additional, De Carlis, L., additional, Belli, L., additional, Gruttadauria, S., additional, Volpes, R., additional, Colledan, M., additional, Fagiuoli, S., additional, Rossi, G., additional, Donato, F., additional, Di Benedetto, F., additional, De Maria, N., additional, Tedeschi, U., additional, Colecchia, A., additional, Ricci, A., additional, Rossi, M., additional, Cardillo, M., additional, and Cillo, U., additional

Published
2020
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35. Common issues in the management of patients in the waiting list and after liver transplantation

Author

Burra, P, Belli, L, Ginanni, Corradini, S, Volpes, R, Marzioni, M, Giannini, E, Toniutto, P, Carrai, P, Donato, F, Lanza-Galeota, A, Martini, S, Pasulo, L, Ponziani, F, Russo, F, Coppola, C, Forte, P, Mazzarelli, C, Merli, M, Montalbano, M, Picciotto, F, Rendina, M, Zanetto, A, Angeli, P, Foschi, F, Manini, M, Marzano, A, Perricone, G, Pianta, P, Tamè, M, De Maria, N, Domenicali, M, Ottobrelli, A, Picciotto, A, Ponti, L, Vizzini, G, Corradini, S, Bhoori, S, Ferri, F, Gaffuri, G, Lenci, I, Mameli, L, Morelli, M, and Piras, M. R.

Subjects
medicine.medical_specialty, Alcoholic liver disease, DAAs, HBV recurrence, Immunosuppression, Liver transplantation, Antiviral Agents, Hepatitis C, Chronic, Humans, Italy, Liver Diseases, Alcoholic, Recurrence, Societies, Medical, Disease Management, Liver Transplantation, Waiting Lists, Hepatology, Gastroenterology, medicine.medical_treatment, 030230 surgery, 03 medical and health sciences, 0302 clinical medicine, Medical, Internal medicine, medicine, In patient, Chronic, Disease management (health), business.industry, Liver Diseases, General surgery, Hcv recurrence, Evidence-based medicine, Alcoholic, medicine.disease, Hepatitis C, surgical procedures, operative, Waiting list, 030211 gastroenterology & hepatology, Societies, business
Abstract

The present document contains the recommendations of an expert panel of transplant hepatologists, appointed by the Italian Association for the Study of the Liver (AISF), on how to manage the most common aspects of liver transplantation: the topics covered include: new treatments for HCV in patients on the waiting list for liver transplantation; antiviral treatments in patients with HCV recurrence after liver transplantation; prophylaxis for HBV recurrence after liver transplantation; indications for liver transplantation in alcoholic liver disease; and Immunosuppressive therapy. The statements on each topic were approved by participants at the AISF Transplant Hepatologist Expert Meeting (organized by the Permanent Committee on Liver Transplantation in Mondello on 4–5 October 2015), and are graded according to the Oxford classification of levels of evidence.

Published
2017

36. AISF position paper on HCV in immunocompromised patients

Author

Angelucci, E, Astegiano, M, Baratelli, C, Biancone, L, Bironzo, P, Brancaccio, G, Brunetto, M, Bruno, R, Burra, P, Cabras, M, l Caraceni, P, Chialà, C, Clemente, M, Colli, A, Daniele, B, De Gasperi, E, Di Marco, V, Ditto, M, Fagiuoli, S, Ferri, C, Gaeta, G, Grossi, P, Imperatrice, B, Lampertico, P, Macaluso, F, Madonia, S, Marignani, M, Mazzarelli, C, Mella, A, Missale, G, Parisi, S, Pasulo, L, Puoti, M, Rendina, M, Ribaldone, D, Rossi, G, Toniutto, P, Tucci, A, Vajro, P, Viganò, M, Volpes, R, Zignego, A, Giannini, E, Miele, L, Russo, F, Petta, S, Bonora, S, Brignardello, E, Busca, A, Cariti, G, Cavallo, F, Conforti, M, Coscia, M, Craxì, A, Curci, D, Cusinato, S, Di Maio, M, Valle, R, Fusaro, E, Giacardi, A, Giaccone, L, Lagget, M, Libertucci, D, Minutolo, R, Montrucchio, G, Orlando, A, Orsucci, L, Pasquina, C, Pera, A, Peroni, C, Pirisi, M, Racca, P, Riccardini, F, Rizzetto, M, Salizzoni, M, Salomone, M, Saracco, G, Scaglione, L, Torre, G, Tozzi, R, Vitolo, U, Verme, G, Brunetto, MR, Cabras, MG, Clemente, MG, Ditto, MC, Gaeta, GB, Grossi, PA, Macaluso, FS, Zignego, AL, Giannini, EG, Russo, FP, Valle, RD, Peroni, CL, Saracco, GM, Angelucci, E, Astegiano, M, Baratelli, C, Biancone, L, Bironzo, P, Brancaccio, G, Brunetto, M, Bruno, R, Burra, P, Cabras, M, l Caraceni, P, Chialà, C, Clemente, M, Colli, A, Daniele, B, De Gasperi, E, Di Marco, V, Ditto, M, Fagiuoli, S, Ferri, C, Gaeta, G, Grossi, P, Imperatrice, B, Lampertico, P, Macaluso, F, Madonia, S, Marignani, M, Mazzarelli, C, Mella, A, Missale, G, Parisi, S, Pasulo, L, Puoti, M, Rendina, M, Ribaldone, D, Rossi, G, Toniutto, P, Tucci, A, Vajro, P, Viganò, M, Volpes, R, Zignego, A, Giannini, E, Miele, L, Russo, F, Petta, S, Bonora, S, Brignardello, E, Busca, A, Cariti, G, Cavallo, F, Conforti, M, Coscia, M, Craxì, A, Curci, D, Cusinato, S, Di Maio, M, Valle, R, Fusaro, E, Giacardi, A, Giaccone, L, Lagget, M, Libertucci, D, Minutolo, R, Montrucchio, G, Orlando, A, Orsucci, L, Pasquina, C, Pera, A, Peroni, C, Pirisi, M, Racca, P, Riccardini, F, Rizzetto, M, Salizzoni, M, Salomone, M, Saracco, G, Scaglione, L, Torre, G, Tozzi, R, Vitolo, U, Verme, G, Brunetto, MR, Cabras, MG, Clemente, MG, Ditto, MC, Gaeta, GB, Grossi, PA, Macaluso, FS, Zignego, AL, Giannini, EG, Russo, FP, Valle, RD, Peroni, CL, and Saracco, GM

Abstract

This report summarizes the clinical features and the indications for treating HCV infection in immunocompromised and transplanted patients in the Direct Acting Antiviral drugs era.

Published
2019

39. Development of a model based on case-mix analysis to predict 6-month patient survival after liver transplantation: a multicenter Italian study

Author

Avolio, A., primary, Lai, Q., additional, Franco, A., additional, Bianco, G., additional, Calia, R., additional, Spoletini, G., additional, Agnes, S., additional, Grieco, A., additional, Rossi, M., additional, Corradini, S. Ginanni, additional, Vivarelli, M., additional, Benedetti, A., additional, Lupo, L., additional, Rendina, M., additional, Colledan, M., additional, Fagiuoli, S., additional, Cescon, M., additional, Donato, C., additional, Zamboni, F., additional, Mameli, L., additional, De Carlis, L., additional, Belli, L., additional, Rossi, G., additional, Donato, F., additional, Mazzaferro, V., additional, Bhoori, S., additional, Di Benedetto, F., additional, De Maria, N., additional, Santaniello, W., additional, Di Costanzo, G., additional, Gruttadauria, S., additional, Volpes, R., additional, De Simone, P., additional, Carrai, P., additional, Spada, M., additional, Nobile, V., additional, Ettorre, G., additional, Giannelli, V., additional, Tisone, G., additional, Lenci, I., additional, Romagnoli, R., additional, Martini, S., additional, Risaliti, A., additional, Toniutto, P., additional, Tedeschi, U., additional, Carraro, A., additional, Burra, P., additional, and Cillo, U., additional

Published
2019
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44. Recurrence of Hepatitis B Infection in Liver Transplant Patients Receiving Long-Term Hepatitis B Immunoglobulin Prophylaxis

Author

Beckebaum, S., Herzer, K. (Kerstin), Bauhofer, A. (Artur), Gelson, W. (William), De Simone, P. (Paolo), Man, R.A. (Robert) de, Engelmann, C. (Cornelius), Müllhaupt, B. (Beat), Vionnet, J. (Julien), Salizzoni, M. (Mauro), Volpes, R. (Riccardo), Ercolani, G. (Giorgio), Carlis, L. (Luciano) de, Angeli, V., Burra, P. (Patrizia), Dufour, J.-F. (Jean-François), Rossi, M. (Massimo), Cillo, U. (Umberto), Neumann, U., Fischer, L. (Lutz), Niemann, G. (Gabriele), Toti, L. (Luca), Tisone, G. (Guiseppe), Beckebaum, S., Herzer, K. (Kerstin), Bauhofer, A. (Artur), Gelson, W. (William), De Simone, P. (Paolo), Man, R.A. (Robert) de, Engelmann, C. (Cornelius), Müllhaupt, B. (Beat), Vionnet, J. (Julien), Salizzoni, M. (Mauro), Volpes, R. (Riccardo), Ercolani, G. (Giorgio), Carlis, L. (Luciano) de, Angeli, V., Burra, P. (Patrizia), Dufour, J.-F. (Jean-François), Rossi, M. (Massimo), Cillo, U. (Umberto), Neumann, U., Fischer, L. (Lutz), Niemann, G. (Gabriele), Toti, L. (Luca), and Tisone, G. (Guiseppe)

Abstract

BACKGROUND Long-term real-world data are relatively sparse regarding recurrence of chronic hepatitis B virus (HBV) infection after liver transplantation using hepatitis B immunoglobulin (HBIg) and nucleos(t)ide analogue (NUC) prophylaxis. MATERIAL AND METHODS Data from 371 adults transplanted for HBV-related disease at 20 European centers and given HBIg for ³12 months ± NUC therapy were analyzed retrospectively. RESULTS HBIg comprised Hepatect® (iv HBIgB; n=299), subcutaneous Zutectra® (sc HBIg, n=236), and other HBIg preparations (n=130); 93.5% received NUC therapy. Mean follow-up was 6.8±3.5 years. The primary efficacy variable, freedom from HBV recurrence, occurred in 95.7% of patients (95% CI [93.1%, 97.5%]). The observed incidence of recurrence was 16/371 (4.3%) (annual rate 0.65%); 5/16 patients with recurrence had discontinued HBIg and 7/16 had anti-HBs <100 IU/l. Excluding these 7 patients, the HBV recurrence rate was 2.4%. The recurrence rate while on HBIg therapy was 1 per 2069 months. In patients who discontinued HBIg, risk of HBV recurrence versus sc HBIg users was increased by 5.2-fold (1 per 1 603 versus 1 per 8379 treatment months). The annual rate of HBV-related hepatocellular carcinoma (HCC) recurrence was 1.7%. CONCLUSIONS These results support the long-term use of HBIg with NUC therapy as an effective management strategy to minimize risk of HBV recurrence and virus-related complications after liver transplantation.

Published
2018
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45. 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

49. Balancing donor and recipient risk factors in liver transplantation: the value of D-MELD with particular reference to HCV recipients

Author

Avolio, A, Cillo, U, Salizzoni, M, DE CARLIS, LUCIANO GREGORIO, Colledan, M, Gerunda, G, Mazzaferro, V, Tisone, G, Romagnoli, R, Caccamo, L, Rossi, M, Vitale, A, Cucchetti, A, Lupo, L, Gruttadauria, S, Nicolotti, N, Burra, P, Gasbarrini, A, Agnes, S, Lirosi, M, Miele, L, Pompili, M, Siciliano, M, Perilli, V, Gaspari, R, Castagneto, M, Lupo, F, Tandoi, F, De Carlis, L, Mangoni, I, Belli, L, Pinna, A, Cescon, M, Gridelli, B, Li Petri, S, Volpes, R, Pinelli, D, Fagiuoli, S, Montalti, R, Regalia, E, Rossi, G, Antonelli, B, Berloco, P, Lai, Q, Risaliti, A, Nicolini, D, Valente, U, Gelli, M, Morelli, N, Zamboni, F, Tondolo, V, Ettorre, G, Vennarecci, G, Bresadola, F, Baccarani, U, Toniutto, P, Manzia, T, Anselmo, A, Angelico, M, Calise, F, Scuderi, V, Romano, M, Rendina, M, Barone, M, Cuomo, O, Perrella, A, Santaniello, W, Donataccio, M, Dalle Ore, G, De Ville De Goyet, J, Monti, L, De Waure, C., Avolio A.W., Cillo U., Salizzoni M., De Carlis L., Colledan M., Gerunda G.E., Mazzaferro V., Tisone G., Romagnoli R., Caccamo L., Rossi M., Vitale A., Cucchetti A., Lupo L., Gruttadauria S., Nicolotti N., Burra P., Gasbarrini A., Agnes S., Lirosi M.C., Miele L., Pompili M., Siciliano M., Perilli V., Gaspari R., Castagneto M., Tandoi F., Mangoni I., Belli L., Pinna A.D., Cescon M., Gridelli B., Li Petri S., Volpes R., Pinelli D., Fagiuoli S., Montalti R., Regalia E., Rossi G., Antonelli B., Berloco P., Lai Q., Risaliti A., Nicolini D., Valente U., Gelli M., Morelli N., Zamboni F., Tondolo V., Brotzu G., Ettorre G.M., Vennarecci G., Bresadola F., Baccarani U., Toniutto P.L., Manzia T., Anselmo A., Angelico M., Calise F., Scuderi V., Romano M., Rendina M., Barone M., Cuomo O., Perrella A., Santaniello W., Donataccio M., Dalle Ore G., de Ville de J., Monti L., Avolio, A W, Cillo, U, Salizzoni, M, De Carlis, L, Colledan, M, Gerunda, G E, Mazzaferro, Mariapia, Tisone, G, Romagnoli, R, Caccamo, L, Rossi, M, Vitale, A, Cucchetti, A, Lupo, L, Gruttadauria, S, Nicolotti, N, Burra, P, Gasbarrini, A, Agnes, S, Montalti, Roberto, Avolio, A, DE CARLIS, L, Gerunda, G, Mazzaferro, V, Lirosi, M, Miele, L, Pompili, M, Siciliano, M, Perilli, V, Gaspari, R, Castagneto, M, Lupo, F, Tandoi, F, Mangoni, I, Belli, L, Pinna, A, Cescon, M, Gridelli, B, Li Petri, S, Volpes, R, Pinelli, D, Fagiuoli, S, Montalti, R, Regalia, E, Rossi, G, Antonelli, B, Berloco, P, Lai, Q, Risaliti, A, Nicolini, D, Valente, U, Gelli, M, Morelli, N, Zamboni, F, Tondolo, V, Ettorre, G, Vennarecci, G, Bresadola, F, Baccarani, U, Toniutto, P, Manzia, T, Anselmo, A, Angelico, M, Calise, F, Scuderi, V, Romano, M, Rendina, M, Barone, M, Cuomo, O, Perrella, A, Santaniello, W, Donataccio, M, Dalle Ore, G, De Ville De Goyet, J, Monti, L, and De Waure, C

Subjects
Graft Rejection, Male, medicine.medical_treatment, Settore MED/18 - CHIRURGIA GENERALE, Hepacivirus, Liver transplantation, Gastroenterology, Liver disease, Postoperative Complications, Retrospective Studie, UNSUSTAINABLE MATCH, Models, Risk Factors, Immunology and Allergy, Health Status Indicators, Age Factor, PROGNOSTIC INDICES, Pharmacology (medical), Health Status Indicator, D-MELD, Liver Transplantation, liver transplantation, Hazard ratio, Graft Survival, donor-recipient match, outcome, prognosis, risk factors, Age Factors, Trapianto epatico, Hepatitis C, Hepatitis B, Statistical, Middle Aged, Prognosis, Tissue Donors, Survival Rate, Italy, HCV, Female, Human, Adult, medicine.medical_specialty, Prognosi, Donor Selection, End Stage Liver Disease, Young Adult, Internal medicine, medicine, Humans, fattori di rischio, Aged, Retrospective Studies, Transplantation, Hepaciviru, Models, Statistical, business.industry, Donor selection, Risk Factor, Settore MED/09 - MEDICINA INTERNA, Odds ratio, medicine.disease, Settore MED/18, Surgery, body regions, Postoperative Complication, business
Abstract

Donor-recipient match is a matter of debate in liver transplantation. D-MELD (donor age × recipient biochemical model for end-stage liver disease [MELD]) and other factors were analyzed on a national Italian database recording 5946 liver transplants. Primary endpoint was to determine factors predictive of 3-year patient survival. D-MELD cutoff predictive of 5-year patient survival 1628). At 3 years, the odds ratio (OR) for death was 2.03 (95% confidence interval [CI], 1.44-2.85) in D-MELD class C versus B. The OR was 0.40 (95% CI, 0.24-0.66) in class A versus class B. Other predictors were hepatitis C virus (HCV; OR = 1.42; 95% CI, 1.11-1.81), hepatitis B virus (HBV; OR = 0.69; 95% CI, 0.51-0.93), retransplant (OR = 1.82; 95% CI, 1.16-2.87) and low-volume center (OR = 1.48; 95% CI, 1.11-1.99). Cox regressions up to 90 months confirmed results. The hazard ratio was 1.97 (95% CI, 1.59-2.43) for D-MELD class C versus class B and 0.42 (95% CI, 0.29-0.60) for D-MELD class A versus class B. Recipient age, HCV, HBV and retransplant were also significant. The 5yrsPS

Published
2011

50. Use of Everolimus in Liver Transplantation: Recommendations from a Working Group

Author

De Simone, P, Fagiuoli, S, Cescon, M, De Carlis, L, Tisone, G, Volpes, R, Cillo, U, De Simone, P, Fagiuoli, S, Cescon, M, De Carlis, L, Tisone, G, Volpes, R, and Cillo, U

Abstract

Immunosuppression after liver transplantation (LT) is presently based on use of calcineurin inhibitors (CNI), although they are associated with an increased incidence of renal dysfunction, cardiovascular complications, and de novo and recurrent malignancies. Over the past decade, mammalian target of rapamycin inhibitors have received considerable attention as immunosuppressants because they are associated with a more favorable renal profile versus CNI, as well as antiproliferative activity in clinical studies. Comprehensive guidelines on use of everolimus (EVR) in LT are still lacking. In Italy, a project, named Everolimus: the road to long-term functioning, was initiated to collect the experience on EVR after LT with the aim of providing guidance for transplant clinicians. Herein, recommendations by this national consensus group, based on Delphi methodology, are presented. Consensus was reached on 20 of the 23 statements proposed, and their level of evidence, grade of recommendation, and percent of agreement are reported. Statements are grouped into 4 areas: (A) renal function; (B) time of EVR introduction, CNI reduction and elimination, and risk for graft rejection; (C) antiproliferative effects of EVR; and (D) management of EVR-related adverse events. The high level of consensus shows that there is good agreement on the routine use of EVR in predefined clinical scenarios, especially in light of posttransplant nephrotoxicity and other adverse events associated with long-term administration of CNIs

Published
2017

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