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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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12. Daclizumab and Alemtuzumab as Induction Agents in Adult Intestinal and Multivisceral Transplantation: Rejection and Infection Rates in 40 Recipients During the Early Postoperative Period

Author

Zanfi, C., Lauro, A., Cescon, M., Dazzi, A., Ercolani, G., Grazi, G.L., Zanello, M., Vivarelli, M., Del Gaudio, M., Ravaioli, M., Cucchetti, A., Vetrone, G., Tuci, F., Di Gioia, P., Lazzarotto, T., D'Errico, A., Bagni, A., Faenza, S., Siniscalchi, A., Pironi, L., and Pinna, A.D.

Published
2010
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15. Strategies to Restore Adenosine Triphosphate (ATP) Level After More than 20 Hours of Cold Ischemia Time in Human Marginal Kidney Grafts

Author

Ravaioli M, Baldassare M, Vasuri F, Pasquinelli G, Laggetta M, Valente S, De Pace V, Neri F, Siniscalchi A, Zanfi C, Bertuzzo VR, Caraceni P, Trerè D, Longobardi P, Pinna AD., BALDASSARRE, MAURIZIO, Ravaioli, M, Baldassare, M, Vasuri, F, Pasquinelli, G, Laggetta, M, Valente, S, De Pace, V, Neri, F, Siniscalchi, A, Zanfi, C, Bertuzzo, Vr, Caraceni, P, Trerè, D, Longobardi, P, and Pinna, Ad.

Subjects
Organs at Risk, Delayed Graft Function, Cold storage, 030230 surgery, Pharmacology, Kidney, Cold Ischemia Time, 03 medical and health sciences, Adenosine Triphosphate, 0302 clinical medicine, Humans, Medicine, Original Paper, Kidney Transplantation, Organ Preservation, Cold Ischemia, Transplantation, business.industry, Kidney metabolism, General Medicine, Oxygenation, Hypoxia (medical), medicine.anatomical_structure, Pulsatile Flow, 030211 gastroenterology & hepatology, medicine.symptom, business, Perfusion
Abstract

BACKGROUND The persisting organ shortage in the field of transplantation recommends the use of marginal kidneys which poorly tolerate ischemic damage. Adenosine triphosphate (ATP) depletion during cold ischemia time (CIT) is considered crucial for graft function. We tested different strategies of kidney perfusion before transplantation in the attempt to improve the technique. MATERIAL AND METHODS Twenty human discarded kidneys from donors after brain death and with at least 20 hours of CIT were randomized to the following experimental groups (treatment time three-hours at 4°C): a) static cold storage (CS); b) static cold hyperbaric oxygenation (Hyp); c) hypothermic perfusion (PE); d) hypothermic perfusion in hyperbaric oxygenation (PE-Hyp); and e) hypothermic oxygenated perfusion (PE-O2). RESULTS Histological results showed that perfusion with or without oxygen did not produce any endothelial damage. A depletion of ATP content following the preservation procedure was observed in CS, PE, and Hyp, while PE-Hyp and PE-O2 were associated with a net increase of ATP content with respect to baseline level. In addition, PE-Hyp was associated with a significant downregulation of endothelial isoform of nitric oxide synthase (eNOS) gene expression and of hypoxia inducible factor-1α (HIF-1α). CONCLUSIONS Hyperbaric or normobaric oxygenation with perfusion improves organ metabolic preservation compared to other methods. This approach may prevent the onset of delayed graft function, but clinical trials are needed to confirm this.

Published
2018
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19. 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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21. Coping Strategies in Intestinal Transplantation

Author

Golfieri, L., Lauro, A., Tossani, E., Sirri, L., Dazzi, A., Zanfi, C., Vignudelli, A., Amaduzzi, A., Cucchetti, A., La Barba, G., Pezzoli, F., Ercolani, G., Vivarelli, M., Del Gaudio, M., Ravaioli, M., Cescon, M., Grazi, G.L., Grandi, S., and Pinna, A.D.

Published
2007
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31. Steroids in intestinal transplantation

Author

Dazzi, A., Lauro, A., Zanfi, C., Ercolani, G., Vivarelli, M., Grazi, G. L., Cescon, M., Di Simone, M., DʼErrico, A., Lazzarotto, T., Faenza, S., Pironi, L., and Pinna, A. D.

Published
2007

35. Survival after the diagnosis of de novo malignancy in liver transplant recipients

Author

Taborelli, M, Piselli, P, Ettorre, Gm, Baccarani, U, Burra, P, Lauro, A, Galatioto, L, Rendina, M, Shalaby, S, Petrara, R, Nudo, F, Toti, L, Fantola, G, Cimaglia, C, Agresta, A, Vennarecci, G, Pinna, Ad, Gruttadauria, S, Risaliti, A, Di Leo, A, Rossi, M, Tisone, G, Zamboni, F, Serraino, D, Zanus, G, Zanini, S, Rigotti, P, Schena, Fp, Grandaliano, G, Fiorentino, M, Di Gioia, P, Pellegrini, S, Zanfi, C, Scolari, Mp, Stefoni, S, Todeschini, P, Panicali, L, Valentini, C, Adani, Gl, Lorenzin, D, Colasanti, M, Coco, M, Ettorre, F, Santoro, R, Miglioresi, L, Mennini, G, Casella, A, Fazzolari, L, Sforza, D, Iaria, G, Gazia, C, Belardi, C, D'Offizi, G, Comandini, Uv, Lionetti, R, Montalbano, M, Taibi, C, Piredda, Gb, Michittu, Mb, Murgia, Mg, Onano, B, Fratino, L, Maso, Ld, 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, Giuffrida, G, Giaquinta, A, Zerbo, D, Busnach, G, Di Leo, L, Perrino, Ml, Querques, M, Colombo, V, Sghirlanzoni, Mc, Messa, P, Leoni, A, Sparacino, V, Caputo, F, Buscemi, B, Citterio, F, Spagnoletti, G, Salerno, Mp, Favi, E, Segoloni, Gp, Biancone, L, Lavacca, A, Maresca, Mc, Cascone, C, Virgilio, B, Donati, D, Dossi, F, Fontanella, A, Ambrosini, A, and Di Cicco, M.

Published
2019

38. HCV and Kidney Transplantation: Pushing the Limits for Living Donation. Case Report and Mini Review

Author

Rossetto, A, primary, Comai, G, additional, Cuna, V, additional, Morelli, MC, additional, Siniscalchi, A, additional, Corradetti, V, additional, Del Gaudio, M, additional, Zanfi, C, additional, Bertuzzo, V, additional, Maroni, L, additional, Odaldi, F, additional, Frascaroli, G, additional, La Manna, G, additional, D’Errico, A, additional, and Ravaioli, M, additional

Published
2019
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39. 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. Technical aspects of intestinal transplantation

Author

Colledan, M, Zanfi, C, Pinna, A, Colledan M, Zanfi C, Pinna AD, Colledan, M, Zanfi, C, Pinna, A, Colledan M, Zanfi C, and Pinna AD

Abstract

Purpose of review: Intestinal transplantation includes an heterogeneous group of procedures in which different compositions of organs are transplanted. The current classification includes four groups according to the inclusion of the liver and/or the stomach in the graft: isolated intestinal transplantation, liver-intestinal transplantation, multivisceral transplantation, and modified multivisceral transplantation. Variants exist, the technical evolution having been slow, yet constant over years. Recent findings: The most relevant early technical improvements were aimed at achieving better feasibility and safety of the most difficult aspects of the different procedures, such as removal of the recipient's diseased organs, performing of vascular reconstructions and prevention of complications as with retention of the donor's duodenum and pancreas in liver-intestine transplantation. More recently, apart from a clear definition of the classification of the procedures, progress has been more directed in a conservative direction such as the preservation of the native spleen with and without the pancreas in multivisceral transplants. Summary: After achieving consistent satisfactory short-term results, the technical interest in intestinal transplantation is now moved to solutions that, in spite of a possible increased difficulty, may offer better opportunities of mid-term and long-term successes, both in terms of survival and quality of life.

Published
2013

42. Long Term Follow-Up of Patients with De Novo Tumors after 1300 Liver Transplantations: A Case-Control Study

Author

Del Gaudio, M, Tame, Mr, Bianchi, G, Zanfi, C, Ercolani, G, Cescon, M, Lauro, A, Cucchetti, A, Zanello, M, Vetrone, G, Morelli, C, Grazi, Gl, Pinna, Ad, Del Gaudio, M, Tame, MR, Bianchi, G, Zanfi, C, Ercolani, G, Cescon, M, Lauro, A, Cucchetti, A, Zanello, M, Vetrone, G, Morelli, C, Grazi, GL, and Pinna, AD

Subjects
liver transplantation, liver transplantation de novo tumors long-term follow-up, de novo tumors, liver transplantation, de novo tumors, long-term follow-up, liver transplant de novo tumors, long-term follow-up, NO
Abstract

Long-term survival data on de novo malignancy are limited following orthotopic liver transplantation (OLT) when compared with controls without malignancies. Methods: Over a 23 yr period at our institution, 86 of 1300 patients (6.6%) who underwent OLT were identifi ed to have 86 de novo malignancies. The clinical characteristics and survival of these patients were retrospectively reviewed and compared with a control cohort of 86 OLT recipients without malignancy matched with the incidence cases by age, year of OLT, sex, and type of liver disease. Results: Chronic hepatitis C (49%) and B virus (20%), alcohol (18.4%) were the three leading causes of liver disease. Skin cancer was the most common malignancy (26%) including 5 cases of Kaposi disease, followed by gastrointestinal (24.6%) and hematological malignancies (PTLD) (17%), eye and rhynopharinx cancers (12.3%), lung cancers (7.6%), breast cancer (6.1%) and urinary cancers (4.6%). The cases and controls were not signifi cantly different in the immunosuppressive regimen (66% vs 74% Neoral and 34% vs 26% Prograf, p=0.42), the number of rejection episodes (15 vs 16,p=0.92), the gender (71% vs 69% male and 29% vs 31% female, p=0.67) the median recipient age (53 vs 51, p=0.63) and donor age (48.89 ± 20.3 vs 44.27 ± 17.3, p=0.52). The median time of the diagnosis of de novo tumor after OLT was 4.17 ± 3.77 years (0.4-16.2). The 5- and 10-year Kaplan–Meier survival rates for the cases were 84% and 62%, respectively, vs. 79% and 72%, respectively, for the controls (p=NS by log-rank test). Patients with skin cancers had 10- year survival similar to the controls (88% vs 72%,p=NS), but signifi cantly better than non-skin cancers (88% vs 56%, p=0.0001). The prognosis for patients with gastrointestinal tumors was poor, with a median survival of 8.6 months after the diagnosis. Conclusion: In this single institutional study, de novo malignancies after OLT were uncommon. Patients with non-skin cancer after OLT had diminished long-term survival compared with the controls. Following the poor prognosis of gastrointestinal cancers, it is mandatory an yearly surveillance after OLT to treat eventually this kind of tumors at an early stage.

Published
2010

43. Assessment psicologico nel trapianto di intestino

Author

GRANDI, SILVANA, GOLFIERI, LUCIA, TOSSANI, ELIANA, SIRRI, LAURA, Lauro A., Venturoli A., Dazzi A., Zanfi C., Cescon M., PINNA, ANTONIO DANIELE, Grandi S., Golfieri L., Lauro A., Venturoli A., Tossani E., Sirri L., Dazzi A., Zanfi C., Cescon M., and Pinna A.D.

Published
2008

44. Strategie di coping nel trapianto di intestino

Author

GRANDI, SILVANA, GOLFIERI, LUCIA, TOSSANI, ELIANA, SIRRI, LAURA, Venturoli A., Lauro A., Dazzi A., Zanfi C., Cescon M., PINNA, ANTONIO DANIELE, Grandi S., Golfieri L., Venturoli A., Lauro A., Tossani E., Sirri L., Dazzi A., Zanfi C., Cescon M., and Pinna A.D.

Published
2008

45. Medication compliance after liver transplantation: the importance of family support

Author

GOLFIERI, LUCIA, TOSSANI, ELIANA, Lauro A., ERCOLANI, GIORGIO, Zanfi C., Amaduzzi A., Vivarelli M., Ravaioli M., Sirri L., GRANDI, SILVANA, DAZZI, ALESSANDRO, GRAZI, GIAN LUCA, CESCON, MATTEO, VAROTTI, GIOVANNI, DEL GAUDIO, MASSIMO, FAENZA, STEFANO, PINNA, ANTONIO DANIELE, Golfieri L., Tossani E., Lauro A., Dazzi A., Ercolani G., Zanfi C., Amaduzzi A., Grazi GL, Vivarelli M., Cescon M., Varotti G., Del Gaudio M., Ravaioli M., Sirri L., Faenza S., Grandi S., and Pinna AD.

Published
2006

46. Alemtuzumab Plus Cyclosporine Treatment of the Autoimmune Hemolytic Anemia in an Adult Bowel Transplant

Author

Lauro, A., Stanzani, M., Finelli, C., Zanfi, C., Morelli, M. C., Pasqualini, E., Dazzi, A., Ravaioli, M., Di Simone, M., Giudice, V., Pironi, L., and Pinna, A. D.

Subjects
Article Subject, hemic and lymphatic diseases
Abstract

An adult male underwent a bowel transplant for tufting enteropathy, receiving alemtuzumab, tacrolimus, and steroids as immunosuppressants. Five years later, he developed an autoimmune hemolytic anemia (AIHA), anti-IgG positive, with reduced reticulocyte count, leukopenia, and thrombocytopenia with antiplatelet antibodies. After an unsuccessful initial treatment with high dose steroids, reduction in tacrolimus dose, and intravenous immunoglobulin (IVIG), a bone marrow biopsy revealed absence of erythroid maturation with precursor hyperplasia. The patient was switched to sirolimus and received four doses of rituximab plus two courses of plasmapheresis, which decreased his transfusion requirements. After a febrile episode one month later, the AIHA relapsed with corresponding decreases in platelet and leukocyte count: cyclosporine A (CsA) was started with a second course of rituximab and IVIG without response, even though repeat bone marrow biopsy did not reveal morphology correlated to an acquired pure red cell aplasia (APRCA). Considering the similarity in his clinical and laboratory findings to APRCA, alemtuzumab was added (three doses over a week) with CsA followed by steroids. The patient was eventually discharged transfusion-independent, with increasing hemoglobin (Hb) levels and normal platelet and leukocyte count. One year later he is still disease-free with functioning graft.

Published
2014
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