45 results on '"Martina Milana"'
Search Results
2. Moving forward in the treatment of cholangiocarcinoma
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Tommaso M, Manzia, Alessandro, Parente, Ilaria, Lenci, Bruno, Sensi, Martina, Milana, Carlo, Gazia, Alessandro, Signorello, Roberta, Angelico, Giuseppe, Grassi, Giuseppe, Tisone, and Leonardo, Baiocchi
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Cholangiocarcinoma ,Treatment ,Liver transplantation ,Genetic aberration ,Liver resection ,Oncology ,Gastroenterology ,Review ,Immunotherapy ,Settore MED/18 - Abstract
Despite being the second most frequent primary liver tumor in humans, early diagnosis and treatment of cholangiocarcinoma (CCA) are still unsatisfactory. In fact, survival after 5 years is expected in less than one fourth of patients diagnosed with this disease. Rare incidence, late appearance of symptoms and heterogeneous biology are all factors contributing to our limited knowledge of this cancer and determining its poor prognosis in the clinical setting. Several efforts have been made in the last decades in order to achieve an improved classification/understanding with regard to the diverse CCA forms. Location within the biliary tree has helped to distinguish between intrahepatic, perihilar and distal CCA types. Sequence analysis contributed to identifying several characteristic genetic aberrations in CCA that may also serve as possible targets for therapy. Novel findings are expected to significantly improve the management of this malignancy in the near future. In this changing scenario our review focuses on the current and future strategies for CCA treatment. Both systemic and surgical treatments are discussed in detail. The results of the main studies in this field are reported, together with the ongoing trials. The current findings suggest that an integrated multidisciplinary approach to this malignancy would be helpful to improve its outcome.
- Published
- 2021
3. COVID-19 in normal, diseased and transplanted liver
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Giuseppe Grassi, Leonardo Baiocchi, Alessandro Signorello, Ilaria Lenci, and Martina Milana
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Cirrhosis ,Myocarditis ,medicine.medical_treatment ,Peptidyl-Dipeptidase A ,Liver transplantation ,Sepsis ,Settore MED/12 ,03 medical and health sciences ,0302 clinical medicine ,Detoxification ,Non-alcoholic fatty-liver-disease ,Humans ,Medicine ,Respiratory system ,Liver transplant ,medicine.diagnostic_test ,SARS-CoV-2 ,business.industry ,Gastroenterology ,Acute kidney injury ,COVID-19 ,Minireviews ,General Medicine ,Angiotensin-converting enzyme 2 ,medicine.disease ,Liver Transplantation ,Liver ,030220 oncology & carcinogenesis ,Immunology ,030211 gastroenterology & hepatology ,business ,Liver function tests - Abstract
Starting from December 2019 the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has extended in the entire world giving origin to a pandemic. Although the respiratory system is the main apparatus involved by the infection, several other organs may suffer coronavirus disease 2019 (COVID-19)-related injuries. The human tissues expressing angiotensin-converting enzyme 2 (ACE2) are all possible targets of viral damage. In fact myocarditis, meningo-encephalitis, acute kidney injury and other complications have been described with regard to SARS-CoV-2 infection. The liver has a central role in the body homeostasis contributing to detoxification, catabolism and also synthesis of important factor such as plasma proteins. ACE2 is significantly expressed just by cholangiocytes within the liver, however transaminases are increased in more than one third of COVID-19 patients, at hospital admission. The reasons for liver impairment in the course of this infection are not completely clear at present and multiple factors such as: Direct viral effect, release of cytokines, ischemic damage, use of hepatotoxic drugs, sepsis, and others, may contribute to damage. While COVID-19 seems to elicit just a transient alteration of liver function tests in subjects with normal hepatic function, of concern, more severe sequelae are frequently observed in patients with a reduced hepatic reserve. In this review we report data regarding SARS-CoV-2 infection in subjects with normal or diseased liver. In addition the risks of COVID-19 in immunosuppressed patients (either transplanted or suffering for autoimmune liver diseases) are also described.
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- 2021
4. Natremia and liver transplantation: The right amount of salt for a good recipe
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Andrea Aglitti, Ilaria Lenci, Leonardo Baiocchi, Giuseppe Grassi, Martina Milana, and Alessandro Signorello
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medicine.medical_specialty ,Cirrhosis ,Transplant list ,medicine.medical_treatment ,Liver transplantation ,Gastroenterology ,Excretion ,Settore MED/12 ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Internal medicine ,Ascites ,medicine ,Risk of mortality ,Risk factor ,Liver transplant ,Hepatology ,business.industry ,Vaptan ,Sodium imbalance ,Hypervolemic hyponatremia ,Minireviews ,medicine.disease ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,medicine.symptom ,business ,Hyponatremia - Abstract
An adequate balance between electrolytes and clear water is of paramount importance to maintaining physiologic homeostasis. Natremia imbalance and, in particular, hyponatremia is the most frequent electrolyte abnormality observed in hospitalized subjects, involving approximately one-fourth of them. Pathological changes occurring during liver cirrhosis predispose patients to an increased risk of sodium imbalance, and hypervolemic hyponatremia has been reported in nearly 50% of subjects with severe liver disease and ascites. Splanchnic vasodilatation, portal-systemic collaterals’ opening and increased excretion of vasoactive modulators are all factors impairing clear water handling during liver cirrhosis. Of concern, sodium imbalance has been consistently reported to be associated with increased risk of complications and reduced survival in liver disease patients. In the last decades clinical interest in sodium levels has been also extended in the field of liver transplantation. Evidence that [Na+] in blood is an independent risk factor for in-list mortality led to the incorporation of sodium value in prognostic scores employed for transplant priority, such as model for end-stage liver disease-Na and UKELD. On the other hand, severe hyponatremic cirrhotic patients are frequently delisted by transplant centers due to the elevated risk of mortality after grafting. In this review, we describe in detail the relationship between sodium imbalance and liver cirrhosis, focusing on its impact on peritransplant phases. The possible therapeutic approaches, in order to improve transplant outcome, are also discussed.
- Published
- 2020
5. Serum Levels of Granulocyte-Macrophage-colony-stimulating Factor and Stem-cell Factor During Liver Regeneration after Partial Hepatectomy in Humans
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Luca Toti, Laura Tariciotti, Leonardo Baiocchi, Tommaso Maria Manzia, Martina Milana, Carmelo Russo, Ilaria Lenci, Diego Fiume, and Renato Massoud
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Adult ,Male ,stem cell factor ,liver tumor ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Liver tumor ,Stem cell factor ,Gastroenterology ,Metastasis ,Settore MED/12 ,03 medical and health sciences ,symbols.namesake ,Granulocyte-macrophage-cell-stem factor ,0302 clinical medicine ,Internal medicine ,Biomarkers, Tumor ,medicine ,Hepatectomy ,Humans ,Liver neoplasm ,Postoperative Period ,human ,Fisher's exact test ,Aged ,Retrospective Studies ,030304 developmental biology ,Aged, 80 and over ,Pharmacology ,Stem Cell Factor ,0303 health sciences ,business.industry ,Liver Neoplasms ,Granulocyte-Macrophage Colony-Stimulating Factor ,hepatocellular carcinoma ,General Medicine ,Middle Aged ,medicine.disease ,Liver regeneration ,Liver Regeneration ,Granulocyte macrophage colony-stimulating factor ,Hepatocellular carcinoma ,liver resection ,symbols ,Female ,030211 gastroenterology & hepatology ,business ,Follow-Up Studies ,medicine.drug - Abstract
Background: Multiple biological functions have been recognized regarding Granulocyte Macrophage-Colony Stimulating Factor (GM-CSF) and Stem Cell Factor (SCF). Aim: To evaluate the serum changes of GM-CSF and SCF in patients undergoing surgical resection for liver tumor, in the regenerative phase after surgery in order to identify the possible relationship with the patient, tumor or surgical variables. Methods: Thirty-two consecutive patients (50% male, median age 66), undergoing hepatic resection of liver neoplasm, were evaluated. The liver tumor was Hepatocellular Carcinoma (HCC) in 44% of cases. Other tumors were cholangiocarcinoma and metastasis. Serum levels of GM-CSF and SCF were assessed at baseline and 2 days, 7 days and 4 weeks after surgery. Personal and clinical patient data were also recorded. The statistical analysis was carried out using t-test for unpaired data or ANOVA (repeated measure) for continuous variables and Fisher test for discrete variables. Results: GM-CSF levels remained constant after surgery and were compared to baseline values. SCF levels, on the other hand, increased during the time, after surgery. The evaluation of SCF levels (fold increase) according to surgical, patient and tumor variables evidenced some differences. At day 7 and week 4, SCF levels were statistically increased: i) in patients undergoing a large resection in comparison with others (p Conclusions: During liver regeneration in humans, SCF serum levels are increased allowing to hypothesize a possible role of this chemokine during tissue growth and remodeling.
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- 2020
6. Outcomes of Liver Transplant for Adults With Wilson’s Disease
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Alberto Ferrarese, Salvatore Petta, Matteo Angelo Manini, Silvia Martini, Edoardo G. Giannini, Patrizia Burra, Stefano Fagiuoli, Pierluigi Toniutto, Giovanni Perricone, Mario Angelico, A. Lanza, Maria Cristina Morelli, Antonio Grieco, Giuseppe Marrone, Martina Milana, Sherrie Bhoori, Paola Carrai, Luca S. Belli, Ferrarese A., Morelli M.C., Carrai P., Milana M., Angelico M., Perricone G., Belli L.S., Marrone G., Grieco A., Martini S., Manini M.A., Fagiuoli S., Toniutto P., Galeota Lanza A., Bhoori S., Petta S., Giannini E.G., and Burra P.
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Adult ,Male ,wilson disease, liver transplantation ,medicine.medical_specialty ,medicine.medical_treatment ,wilson disease ,Disease ,030230 surgery ,Liver transplantation ,Severity of Illness Index ,Gastroenterology ,End Stage Liver Disease ,03 medical and health sciences ,Liver disease ,0302 clinical medicine ,Hepatolenticular Degeneration ,Internal medicine ,Acute on chronic liver failure ,medicine ,Humans ,Retrospective Studies ,Transplantation ,Hepatology ,business.industry ,Settore MED/09 - MEDICINA INTERNA ,Wilson ,Genetic disorder ,Patient survival ,medicine.disease ,Long-term outcome ,Liver Transplantation ,Neuropsychiatric symptoms ,Wilson's disease ,Treatment Outcome ,Italy ,Cirrhosis ,Multicenter study ,Female ,030211 gastroenterology & hepatology ,Surgery ,business ,Neurological impairment - Abstract
Wilson's disease (WD) is a rare genetic disorder with protean manifestations. Even if liver transplantation (LT) could represent an effective therapeutic option for patients with end-stage liver disease, it has remained controversial in the presence of neuropsychiatric involvement. This study aimed to examine the frequency of adult LT for WD in Italy, focusing on the disease phenotype at the time of LT. A retrospective, observational, multicenter study was conducted across Italy exploring the frequency and characteristics of adults transplanted for WD between 2006 and 2016. A total of 29 adult WD patients underwent LT during the study period at 11 Italian LT centers (accounting for 0.4% of all LTs performed), and 27 of them were considered in this analysis (male/female, n = 9/18; age at LT, 29 years [19-60 years]; median Model for End-Stage Liver Disease score at LT, 27 [6-49]). Isolated hepatic phenotype was the indication for LT in 17 (63%) patients, whereas 2 (7%) patients underwent LT for neurological impairment on compensated liver disease. Overall 1- and 5-year patient survival was excellent (88% and 83%, respectively). Neuropsychiatric symptoms early after LT completely recovered in only a few patients. In conclusion, WD remains an uncommon, unusual indication for LT in Italy, displaying good post-LT graft and patient survival. Because isolated neuropsychiatric involvement represents a rare indication to LT, more data are needed to properly assess the value of LT for WD in this subset of patients.
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- 2020
7. Gastrointestinal endoscopy in cirrhotic patient: Issues on the table
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Giuseppe Grassi, Martina Milana, Alessandro Signorello, Leonardo Baiocchi, and Ilaria Lenci
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medicine.medical_specialty ,Cirrhosis ,medicine.medical_treatment ,Colon cleansing ,Colonoscopy ,Bowel cleansing ,Disease ,Liver transplantation ,Settore MED/12 ,Gastroesophageal varices ,medicine ,Gastrointestinal endoscopy ,Intensive care medicine ,Hepatic encephalopathy ,medicine.diagnostic_test ,business.industry ,Minireviews ,medicine.disease ,Endoscopy ,Sedation ,Liver function ,business ,Infection - Abstract
Patients with liver cirrhosis are fragile and present specific clinical hallmarks. When undergoing to gastrointestinal (GI) endoscopy, these subjects require an individual pre evaluation, taking into account: Level of haemostasis impairment, the individual risk of infection, the impact of sedation on hepatic encephalopathy and other factors. The overall assessment of liver function, employing common scoring systems, should be also assessed in the preprocedural phase. Beside some common general problems, regarding GI endoscopy in cirrhotic subjects, also specific issues are present for some frequent indications or procedures. For instance, despite an increased incidence of adenomas in cirrhosis, colon cancer screening remains suboptimal in subjects with this disease. Several studies in fact demonstrated liver cirrhosis as a negative factor for an adequate colon cleansing before colonoscopy. On the other hand, also the routine assessment of gastroesophageal varices during upper GI endoscopy presents some concern, since important inter-observer variability or incomplete description of endoscopic findings has been reported in some studies. In this review we discussed in details the most relevant issues that may be considered while performing general GI endoscopic practice, in patient with cirrhosis. For most of these issues there are no guidelines or clear indications. Moreover until now, few studies focused on these aspects. We believe that targeting these issues with corrective measures may be helpful to develop a tailored endoscopic approach for cirrhosis, in the future.
- Published
- 2021
8. De novo malignancies after liver transplantation: The effect of immunosuppressionn-personal data and review of literature
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Ilaria Lenci, Luca Toti, Marco Spada, Roberta Angelico, Martina Milana, Oludamilola T Ademoyero, Domiziana Pedini, Leonardo Baiocchi, Giuseppe Tisone, Carlo Gazia, and Tommaso Maria Manzia
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Adult ,Graft Rejection ,Oncology ,Immunosuppression minimization ,medicine.medical_specialty ,Systematic Reviews ,Immunosuppression weaning ,Pediatric liver transplant ,medicine.medical_treatment ,Liver transplantation ,Settore MED/12 ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Immune system ,Adult liver transplant ,Neoplasms ,Internal medicine ,Immune Tolerance ,medicine ,Humans ,Child ,Cancer ,Clinical operational tolerance ,De novo malignancies ,Graft rejection ,Allografts ,Immunosuppression ,Immunosuppressive Agents ,Incidence ,Liver ,Liver Transplantation ,Withholding Treatment ,Patient Selection ,business.industry ,Gastroenterology ,General Medicine ,medicine.disease ,surgical procedures, operative ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business - Abstract
BACKGROUND Immunosuppression has undoubtedly raised the overall positive outcomes in the post-operative management of solid organ transplantation. However, long-term exposure to immunosuppression is associated with critical systemic morbidities. De novo malignancies following orthotopic liver transplants (OLTs) are a serious threat in pediatric and adult transplant individuals. Data from different experiences were reported and compared to assess the connection between immunosuppression and de novo malignancies in liver transplant patients. AIM To study the role of immunosuppression on the incidence of de novo malignancies in liver transplant recipients. METHODS A systematic literature examination about de novo malignancies and immunosuppression weaning in adult and pediatric OLT recipients was described in the present review. Worldwide data were collected from highly qualified institutions performing OLTs. Patient follow-up, immunosuppression discontinuation and incidence of de novo malignancies were reported. Likewise, the review assesses the differences in adult and pediatric recipients by describing the adopted immunosuppression regimens and the different type of diagnosed solid and blood malignancy. RESULTS Emerging evidence suggests that the liver is an immunologically privileged organ able to support immunosuppression discontinuation in carefully selected recipients. Malignancies are often detected in liver transplant patients undergoing daily immunosuppression regimens. Post-transplant lymphoproliferative diseases and skin tumors are the most detected de novo malignancies in the pediatric and adult OLT population, respectively. To date, immunosuppression withdrawal has been achieved in up to 40% and 60% of well-selected adult and pediatric recipients, respectively. In both populations, a clear benefit of immunosuppression weaning protocols on de novo malignancies is difficult to ascertain because data have not been specified in most of the clinical experiences. CONCLUSION The selected populations of tolerant pediatric and adult liver transplant recipients greatly benefit from immunosuppression weaning. There is still no strong clinical evidence on the usefulness of immunosuppression withdrawal in OLT recipients on malignancies. An interesting focus is represented by the complete reconstitution of the immunological pathways that could help in decreasing the incidence of de novo malignancies and may also help in treating liver transplant patients suffering from cancer.
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- 2019
9. Clinical Operational Tolerance and Immunosuppression Minimization in Kidney Transplantation: Where Do We Stand?
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Ilaria Lenci, Tommaso Maria Manzia, Martina Milana, Roberta Angelico, Giuseppe Tisone, Leonardo Baiocchi, Francesco Santopaolo, and Carlo Gazia
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medicine.medical_specialty ,medicine.medical_treatment ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,immunosuppression minimization ,medicine ,Humans ,Practice Patterns, Physicians' ,Intensive care medicine ,Kidney transplantation ,030304 developmental biology ,Renal biomarkers ,Immunosuppression Therapy ,Pharmacology ,0303 health sciences ,business.industry ,renal biomarker ,Immunosuppression ,General Medicine ,medicine.disease ,Kidney Transplantation ,Transplantation ,clinical operational tolerance ,immune system ,kidney transplantation ,rejection ,Settore MED/18 - Chirurgia Generale ,Transplantation Tolerance ,business ,Identical twins - Abstract
Background: The 20th century represents a breakthrough in the transplantation era, since the first kidney transplantation between identical twins was performed. This was the first case of tolerance, since the recipient did not need immunosuppression. However, as transplantation became possible, an immunosuppression-free status became the ultimate goal, since the first tolerance case was a clear exception from the hard reality nowadays represented by rejection. Methods: A plethora of studies was described over the past decades to understand the molecular mechanisms responsible for rejection. This review focuses on the most relevant studies found in the literature where renal tolerance cases are claimed. Contrasting, and at the same time, encouraging outcomes are herein discussed and a glimpse on the main renal biomarkers analyzed in this field is provided. Results: The activation of the immune system has been shown to play a central role in organ failure, but also it seems to induce a tolerance status when an allograft is performed, despite tolerance is still rare to register. Although there are still overwhelming challenges to overcome and various immune pathways remain arcane; the immunosuppression minimization might be more attainable than previously believed. Conclusion: Multiple biomarkers and tolerance mechanisms suspected to be involved in renal transplantation have been investigated to understand their real role, with still no clear answers on the topic. Thus, the actual knowledge provided necessarily leads to more in-depth investigations, although many questions in the past have been answered, there are still many issues on renal tolerance that need to be addressed.
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- 2019
10. Domino Liver Transplantation: Where are we Now?
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Ilaria Lenci, A. Bosa, Martina Milana, Mario Angelico, Francesco Santopaolo, and Leonardo Baiocchi
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Pharmacology ,medicine.medical_specialty ,business.industry ,Patient Selection ,medicine.medical_treatment ,Liver Neoplasms ,General Medicine ,030230 surgery ,Liver transplantation ,Amyloidosis transthyretin ,Domino ,Liver Transplantation ,Surgery ,Transplantation ,Settore MED/12 ,03 medical and health sciences ,0302 clinical medicine ,Cardiothoracic surgery ,Liver donors ,Humans ,Medicine ,Metabolic disease ,business ,Metabolism, Inborn Errors ,030217 neurology & neurosurgery - Abstract
Background:Domino transplant occurs when a recipient explanted graft is used for a second recipient.Introduction:The first experience came from thoracic surgery by the observation that many patients during heart-lung transplantation actually showed a functional heart that could be employed in other subjects with a good result.Results:This concept was then extended to the field of liver transplantation. At present, some patients transplanted for an inborn metabolic disease may be considered as excellent domino liver donors.Conclusion:The results, limitations, clinical challenges and the donor and recipient features of domino liver transplantation are discussed in this manuscript.
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- 2019
11. Liver transplantation for hepatocellular carcinoma: Where do we stand?
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Francesco Santopaolo, Tommaso Maria Manzia, Leonardo Baiocchi, Martina Milana, and Ilaria Lenci
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Oncology ,Time Factors ,Hepatocellular carcinoma ,medicine.medical_treatment ,Tumor burden ,Economic shortage ,Disease ,Liver transplantation ,Medical Oncology ,0302 clinical medicine ,Risk Factors ,Settore MED/12 - Gastroenterologia ,Health Care Rationing ,Liver Neoplasms ,Gastroenterology ,Minireviews ,General Medicine ,Allografts ,Embolization, Therapeutic ,Neoadjuvant Therapy ,Observational Studies as Topic ,Liver ,Local ,030220 oncology & carcinogenesis ,Practice Guidelines as Topic ,Disease Progression ,030211 gastroenterology & hepatology ,Therapeutic ,medicine.medical_specialty ,Carcinoma, Hepatocellular ,Waiting Lists ,Milan Criteria ,Down-staging ,Milan criteria ,Bridging ,Disease-Free Survival ,Embolization ,03 medical and health sciences ,Internal medicine ,medicine ,Humans ,Liver Transplantation ,Neoplasm Recurrence, Local ,Neoplasm Staging ,Patient Selection ,business.industry ,Carcinoma ,Disease progression ,Hepatocellular ,medicine.disease ,Neoplasm Recurrence ,Survival benefit ,business - Abstract
Hepatocellular carcinoma represents an important cause of morbidity and mortality worldwide. It is the sixth most common cancer and the fourth leading cause of cancer death. Liver transplantation is a key tool for the treatment of this disease in human therefore hepatocellular carcinoma is increasing as primary indication for grafting. Although liver transplantation represents an outstanding therapy for hepatocellular carcinoma, due to organ shortage, the careful selection and management of patients who may have a major survival benefit after grafting remains a fundamental question. In fact, only some stages of the disease seem amenable of this therapeutic option, stimulating the debate on the appropriate criteria to select candidates. In this review we focused on current criteria to select patients with hepatocellular carcinoma for liver transplantation as well as on the strategies (bridging) to avoid disease progression and exclusion from grafting during the stay on wait list. The treatments used to bring patients within acceptable criteria (down-staging), when their tumor burden exceeds the standard criteria for transplant, are also reported. Finally, we examined tumor reappearance following liver transplantation. This occurrence is estimated to be approximately 8%-20% in different studies. The possible approaches to prevent this outcome after transplant are reported with the corresponding results.
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- 2019
12. Molecular Mechanisms Linking Risk Factors to Cholangiocarcinoma Development
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Ludovica Ceci, Tianhao Zhou, Ilaria Lenci, Vik Meadows, Lindsey Kennedy, Ping Li, Burcin Ekser, Martina Milana, Wenjun Zhang, Chaodong Wu, Keisaku Sato, Sanjukta Chakraborty, Shannon S. Glaser, Heather Francis, Gianfranco Alpini, and Leonardo Baiocchi
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Settore MED/12 ,Cancer Research ,liver fluke ,risk factor ,Oncology ,cirrhosis ,primary sclerosing cholangitis ,bile duct cysts ,cholangiocarcinoma - Abstract
The poor prognosis of cholangiocarcinoma in humans is related to several factors, such as (i) the heterogeneity of the disease, (ii) the late onset of symptoms and (iii) the limited comprehension of the carcinogenic pathways determining neoplastic changes, which all limit the pursuit of appropriate treatment. Several risk factors have been recognized, including different infective, immune-mediated, and dysmorphogenic disorders of the biliary tree. In this review, we report the details of possible mechanisms that lead a specific premalignant pathological condition to become cholangiocarcinoma. For instance, during liver fluke infection, factors secreted from the worms may play a major role in pathogenesis. In primary sclerosing cholangitis, deregulation of histamine and bile-acid signaling may determine important changes in cellular pathways. The study of these molecular events may also shed some light on the pathogenesis of sporadic (unrelated to risk factors) forms of cholangiocarcinoma, which represent the majority (nearly 75%) of cases.
- Published
- 2022
13. Cumulative incidence of solid and hematological De novo malignancy after liver transplantation in a multicentre cohort
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Cristina Lucidi, Marco Biolato, Antonio Liguori, Manuela Merli, Alfonso Wolfango Avolio, Antonio Grieco, Ilaria Lenci, Raffaella Lionetti, Barbara Lattanzi, Massimo Rossi, Giuseppe Tisone, Mario Angelico, Salvatore Agnes, Martina Milana, and Quirino Lai
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Specialties of internal medicine ,Lymphoproliferative disorders ,Kaplan-Meier Estimate ,Liver transplantation ,Gastroenterology ,Young Adult ,03 medical and health sciences ,Postoperative Complications ,0302 clinical medicine ,Neoplasms ,Internal medicine ,cancer ,complication ,liver transplant ,neoplasms ,medicine ,Humans ,Cumulative incidence ,Liver transplant ,Cancer ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Hepatology ,business.industry ,Incidence ,Liver Diseases ,Retrospective cohort study ,General Medicine ,Middle Aged ,medicine.disease ,Liver Transplantation ,RC581-951 ,Italy ,030220 oncology & carcinogenesis ,Cohort ,Female ,030211 gastroenterology & hepatology ,business ,Complication ,Cohort study - Abstract
Background Recent innovations in the field of liver transplantation have led to a wealth of new treatment regimes, with potential impact on the onset of de novo malignancies (DNM). The aim of this multicenter cohort study was to provide contemporary figures for the cumulative incidences of solid and hematological DNM after liver transplantation. Methods We designed a retrospective cohort study including patients undergoing LT between 2000 and 2015 in three Italian transplant centers. Cumulative incidence was calculated by Kaplan–Meyer analysis. Results The study included 789 LT patients with a median follow-up of 81 months (IQR: 38–124). The cumulative incidence of non-cutaneous DNM was 6.2% at 5-years, 11.6% at 10-years and 16.3% at 15-years. Post-Transplant Lymphoproliferative Disorders (PTLD) were demonstrated to have a cumulative incidence of 1.0% at 5-years, 1.6% at 10-years and 2.2% at 15-years. Solid Organ Tumors (SOT) demonstrated higher cumulative incidences – 5.3% at 5-years, 10.3% at 10-years and 14.4% at 15-years. The most frequently observed classifications of SOT were lung (rate 1.0% at 5-years, 2.5% at 10-years) and head & neck tumors (rate 1.3% at 5-years, 1.9% at 10-years). Conclusions Lung tumors and head & neck tumors are the most frequently observed SOT after LT.
- Published
- 2021
14. Sustained virological response with DAAs decreases glucose level but do not improve renal function, lipid metabolism and blood pressure in liver transplanted patients: a 3-year, long-term follow up
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Raffaella Lionetti, Manuela Merli, Ilaria Lenci, Giampiero D’Offizi, Mauro Zaccarelli, Marco Biolato, Martina Milana, Chiara Taibi, Francesca Di Sario, Maria Grazia de Palo, Antonio Grieco, and Ubaldo Visco Comandini
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Hepatology - Published
- 2020
15. Analysis of resistance and phylogenetic clusters in HCV-2c infected patients within the Italian network Vironet C
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Anna Claudia Pellicelli, Alessandro Pieri, Enzo Boeri, V. Pace Palitti, Roberto Gulminetti, V. Di Marco, Stefania Paolucci, Simona Landonio, F. Di Lorenzo, Laura Monno, L. Sarmati, Stefano Novati, Annapaola Callegaro, Simona Marenco, G. Raimondo, Lavinia Fabeni, Maurizio Zazzi, Silvia Barbaliscia, Nicola Coppola, P. Andreone, L. Carioti, Claudio Maria Mastroianni, Anna Licata, Fausto Baldanti, M. Andreoni, M. Quartini, M. Lichtner, Gloria Taliani, Laura Ambra Nicolini, Francesca Ceccherini-Silberstein, C.F. Perno, Luca Foroghi, Giustino Parruti, Bianca Bruzzone, Caterina Pasquazzi, C. Paternoster, Martina Milana, Sergio Babudieri, K. Yu La Rosa, M. Puoti, Hamid Hasson, Teresa Pollicino, N. Iapadre, C. Minichini, Raffaele Cozzolongo, Valeria Micheli, Barbara Rossetti, Aldo Bertoli, Elisabetta Teti, Marianna Aragri, Antonio Craxì, Filomena Morisco, V.C. Di Maio, Vincenzo Sangiovanni, Leonardo Baiocchi, and Mario Angelico
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Genetics ,Hepatology ,Resistance (ecology) ,Phylogenetic tree ,business.industry ,Gastroenterology ,Medicine ,business - Published
- 2020
16. Possible application of melatonin treatment in human diseases of the biliary tract
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Shannon Glaser, Zhihong Yang, Lenci Ilaria, Lindsey Kennedy, Suthat Liangpunsakul, Praveen Kusumanchi, Leonardo Baiocchi, Ludovica Ceci, Heather Francis, Gianfranco Alpini, Fanyin Meng, Martina Milana, and Tianhao Zhou
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0301 basic medicine ,medicine.medical_specialty ,endocrine system ,Physiology ,Biliary Tract Diseases ,Review ,Antioxidants ,Melatonin ,03 medical and health sciences ,0302 clinical medicine ,Physiology (medical) ,Internal medicine ,Medicine ,Animals ,Humans ,Settore MED/12 - Gastroenterologia ,Hepatology ,business.industry ,Liver Diseases ,Gastroenterology ,Central Nervous System Depressants ,Melatonin treatment ,Melatonin metabolism ,030104 developmental biology ,Endocrinology ,Biliary tract ,business ,030217 neurology & neurosurgery ,hormones, hormone substitutes, and hormone antagonists ,medicine.drug - Abstract
Melatonin was discovered in 1958 by Aaron Lerner. Its name comes from the ability of melatonin to change the shape of amphibian melanophores from stellate to roundish. Starting from the 1980s, the role of melatonin in the regulation of mammalian circadian and seasonal clocks has been elucidated. Presently, several other effects have been identified in different organs. For example, the beneficial effects of melatonin in models of liver damage have been described. This review gives first a general background on experimental and clinical data on the use of melatonin in liver damage. The second part of the review focuses on the findings related to the role of melatonin in biliary functions, suggesting a possible use of melatonin therapy in human diseases of the biliary tree.
- Published
- 2019
17. Complete hepatitis B virus prophylaxis withdrawal in hepatitis B surface antigen–positive liver transplant recipients after longterm minimal immunosuppression
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Valentina Svicher, Giuseppe Tisone, Daniele Di Paolo, Luca Toti, Laura Tariciotti, Tommaso Maria Manzia, Carlo Federico Perno, Francesco Santopaolo, Ilaria Lenci, Mario Angelico, Martina Milana, and Leonardo Baiocchi
- Subjects
Adult ,Male ,Hepatitis B virus ,HBsAg ,Hepatitis C virus ,Immunoglobulins ,030230 surgery ,medicine.disease_cause ,Antiviral Agents ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Recurrence ,medicine ,Humans ,Serologic Tests ,Hepatitis B e Antigens ,Hepatitis B Antibodies ,Seroconversion ,Aged ,Immunosuppression Therapy ,Transplantation ,Hepatitis B Surface Antigens ,Hepatitis B immune globulin ,Hepatology ,business.industry ,virus diseases ,Nucleosides ,Middle Aged ,Hepatitis B ,medicine.disease ,Virology ,Transplant Recipients ,digestive system diseases ,Liver Transplantation ,Withholding Treatment ,DNA, Viral ,Coinfection ,Female ,030211 gastroenterology & hepatology ,Surgery ,Hepatitis D virus ,business ,Follow-Up Studies ,medicine.drug - Abstract
Tailored approaches have been attempted to prevent hepatitis B virus (HBV) reinfection in antibodies against hepatitis B surface antigen (HBsAg)-positive liver transplantation (LT) recipients in order to minimize the use of hepatitis B immune globulin (HBIG) and nucleoside analogues (NAs). We report the results of complete HBV prophylaxis withdrawal after a follow-up of at least 6 years in LT recipients with undetectable serum HBV DNA and intrahepatic total HBV DNA and covalently closed circular DNA at LT. We included 30 HBsAg positive, hepatitis B e antigen-negative recipients, 6 with hepatitis C virus and 7 with hepatitis D virus coinfection, who had received HBIG plus NA for at least 5 years after LT. Stepwise HBIG and NA withdrawal was performed in two 6-month periods under strict monitoring of HBV virology. All patients underwent a clinical, biochemical, and virological follow-up at 3-6 month intervals. HBV recurrence (HBsAg seroreversion ± detectable HBV DNA) occurred in 6 patients: in 1 patient after HBIG interruption and in 5 after both HBIG and NA cessation. Only 3 patients required reinstitution of HBV prophylaxis because of persistent HBV replication, and all achieved optimal control of HBV infection and did not experience clinical events. The other who recurred showed only short-lasting HBsAg positivity, with undetectable HBV DNA, followed by spontaneous anti-HBs seroconversion. An additional 15 patients mounted an anti-HBs titer, without previous serum HBsAg detectability. At the end of follow-up, 90% of patients were still prophylaxis-free, 93.3% were HBsAg negative, and 100% were HBV DNA negative; 60% had anti-HBs titers >10 IU/L (median, 143; range, 13-1000). This small series shows that complete prophylaxis withdrawal is safe in patients transplanted for HBV-related disease at low risk of recurrence and is often followed by spontaneous anti-HBs seroconversion. Further studies are needed to confirm this finding. Liver Transplantation 22 1205-1213 2016 AASLD.
- Published
- 2016
18. Pitfalls in the reporting of upper endoscopy features in cirrhotic patients
- Author
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Antonietta Lamazza, Leonardo Baiocchi, Ilaria Lenci, S. Cucchiarelli, Raffaella Lionetti, Martina Milana, Francesco Santopaolo, Mario Angelico, and Tommaso Maria Manzia
- Subjects
Liver Cirrhosis ,medicine.medical_specialty ,Stomach Diseases ,Portal hypertensive gastropathy ,Esophageal varices ,Esophageal and Gastric Varices ,Endoscopy, Gastrointestinal ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Hypertension, Portal ,medicine ,Humans ,Portal hypertension ,Survey ,Retrospective Studies ,Hepatology ,business.industry ,General surgery ,Upper endoscopy ,Gastroenterology ,Gastric varices ,medicine.disease ,Endoscopic Procedure ,Data Accuracy ,Clinical Practice ,Settore MED/18 - Chirurgia Generale ,030220 oncology & carcinogenesis ,030211 gastroenterology & hepatology ,business ,Gastrointestinal Hemorrhage - Abstract
Background Upper endoscopy is the main tool for the accurate assessment of the risk of bleeding in cirrhotic patients. Aim To evaluate the diagnostic accuracy of upper endoscopy, in cirrhotic subjects, during common clinical practice. Methods 120 endoscopic reports produced in different hospitals in our region were retrospectively and randomly selected. After a general evaluation, aimed at assessing the description of various endoscopic features, reports were evaluated by four expert endoscopists and four expert hepatologists. Experts were asked to fill in a questionnaire for each single endoscopic procedure, regarding the diagnostic accuracy of the report. Results Endoscopic reports lacked descriptions of the size of esophageal varices and red signs in 14% and 29% of cases respectively. Presence (or absence) of gastric varices or portal hypertensive gastropathy were not reported in 62% and 34% of cases respectively. According to expert endoscopists 41% of the reports were incomplete, while, according to hepatologists, reports were incomplete and inadequate for clinical purposes in 36% of cases. Conclusion Our study clearly evidenced a significant lack of information in reports on upper endoscopy in cirrhotic patients, and supports the prompt adoption of corrective strategies.
- Published
- 2018
19. SAT-433-Portal venous velocity and platelet count as a simple non-invasive tool to rule out the presence of varices needing treatment in patients with compensated cirrhosis
- Author
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Angelico Mario, Simona Francioso, C. Masetti, Martina Milana, A. Bosa, Francesco Santopaolo, A. Pecchioli, Piera Rossi, Ilaria Lenci, A. Brega, Leonardo Baiocchi, Francesca Antenucci, and B. Neri
- Subjects
medicine.medical_specialty ,Cirrhosis ,Hepatology ,business.industry ,Non invasive ,medicine.disease ,Venous velocity ,Internal medicine ,medicine ,Cardiology ,Platelet ,In patient ,business ,Varices - Published
- 2019
20. The evolving scenario of HBV infection and disease: A never-ending story
- Author
-
Martina Milana and Mario Angelico
- Subjects
Hepatitis B virus ,Pediatrics ,medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,MEDLINE ,Disease ,Hepatitis B ,medicine.disease_cause ,medicine.disease ,Settore MED/05 ,Cohort Studies ,Hepatitis B, Chronic ,Humans ,Medicine ,business ,Cohort study - Published
- 2019
21. Characterization of baseline factors associated with treatment outcome in HCV-infected patients naive to direct acting antivirals: particular focus on natural resistance
- Author
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M. Siciliano, Giulia Morsica, Anna Claudia Pellicelli, Silvia Galli, F. Ceccherini-Silberstein, Fausto Baldanti, Bianca Bruzzone, R. Campoli, Giuliano Rizzardini, Vincenza Calvaruso, Gloria Taliani, V. Pace Palitti, C. Masetti, P Paba, Antonio Craxì, Filomena Morisco, Ennio Polilli, V.C. Di Maio, Martina Milana, William Gennari, C.F. Perno, Rossana Scutari, Aldo Bertoli, Valeria Cento, M. Andreoni, V. Boccaccio, Marianna Aragri, G.B. Gaeta, M. Lichtner, Caterina Pasquazzi, Vanni Borghi, Laura Ambra Nicolini, Renato Maserati, G. Fiorentino, Sergio Babudieri, Elisabetta Degasperi, Giustino Parruti, Mario Angelico, L. Foroghi, Valeria Ghisetti, Silvia Barbaliscia, Carlo Magni, Valeria Micheli, Elisabetta Teti, Nicola Coppola, Stefania Paolucci, L. Sarmati, R. D’Ambrosio, Pietro Lampertico, M. Puoti, N. Iapadre, Stefano Bonora, and V. Guarneri
- Subjects
Natural resistance ,Oncology ,Focus (computing) ,medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Treatment outcome ,Gastroenterology ,medicine ,Baseline (configuration management) ,DIRECT ACTING ANTIVIRALS ,business - Published
- 2019
22. HCV-RNA quantification in liver bioptic samples and extrahepatic compartments, using the abbott RealTime HCV assay
- Author
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F.P. Antonucci, Carlo Federico Perno, Mario Angelico, Ilaria Lenci, Tommaso Maria Manzia, Francesca Ceccherini-Silberstein, Domenico Di Carlo, Daniele Sforza, M.C. Sorbo, M. Manuelli, Martina Milana, Giuseppe Tisone, and Valeria Cento
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Biopsy ,Total rna ,Hepacivirus ,030230 surgery ,DIRECT ACTING ANTIVIRALS ,Real-Time Polymerase Chain Reaction ,Antiviral Agents ,Resection ,03 medical and health sciences ,0302 clinical medicine ,Virology ,Medicine ,Ascitic Fluid ,Humans ,Aged ,Ascitic fluid ,medicine.diagnostic_test ,business.industry ,virus diseases ,Reproducibility of Results ,Hepatitis C, Chronic ,Middle Aged ,Viral Load ,Settore MED/07 - Microbiologia e Microbiologia Clinica ,Hepatitis C ,digestive system diseases ,Real-time polymerase chain reaction ,Liver ,Liver biopsy ,RNA, Viral ,030211 gastroenterology & hepatology ,Female ,Lymph ,Lymph Nodes ,Reagent Kits, Diagnostic ,business - Abstract
Background & aims We evaluated the performance of a rapid method to quantify HCV-RNA in the hepatic and extrahepatic compartments, by using for the first time the Abbott RealTime HCV-assay. Methods Non-tumoral (NT), tumoral (TT) liver samples, lymph nodes and ascitic fluid from patients undergoing orthotopic-liver-transplantation (N = 18) or liver resection (N = 4) were used for the HCV-RNA quantification; 5/22 patients were tested after or during direct acting antivirals (DAA) treatment. Total RNA and DNA quantification from tissue-biopsies allowed normalization of HCV-RNA concentrations in IU/μg of total RNA and IU/106 liver-cells, respectively. Results HCV-RNA was successfully quantified with high reliability in liver biopsies, lymph nodes and ascitic fluid samples. Among the 17 untreated patients, a positive and significant HCV-RNA correlation between serum and NT liver-samples was observed (Pearson: rho = 0.544, p = 0.024). Three DAA-treated patients were HCV-RNA “undetectable” in serum, but still “detectable” in all tested liver-tissues. Differently, only one DAA-treated patient, tested after sustained-virological-response, showed HCV-RNA “undetectability” in liver-tissue. Conclusions HCV-RNA was successfully quantified with high reliability in liver bioptic samples and extrahepatic compartments, even when HCV-RNA was “undetectable” in serum. Abbott RealTime HCV-assay is a good diagnostic tool for HCV quantification in intra- and extra-hepatic compartments, whenever a bioptic sample is available
- Published
- 2017
23. On treatment HCV-RNA evaluation in real-life: Still a role in the era of direct acting antiviral agents?
- Author
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Angelico Mario, Ilaria Lenci, Valeria Micheli, L. Sarmati, Giuliano Rizzardini, C.F. Perno, M. Andreoni, Guido Gubertini, Elisabetta Teti, Simona Francioso, Francesca Ceccherini Silberstein, Valeria Cento, Monica Schiavini, Marco Ciotti, C. Masetti, Simone Passerini, Carlo Magni, Marianna Aragri, V.C. Di Maio, Aldo Bertoli, and Martina Milana
- Subjects
Hepatology ,business.industry ,In real life ,Medicine ,business ,Virology ,Direct acting - Published
- 2018
24. SAT-246-Overall survival and incidence of liver-related events in a cohort of cirrhotic patients treated with direct antiviral agents: Results from a multicenter study
- Author
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C. Masetti, Francesco Santopaolo, Massimo Marignani, Giovanni Galati, Angelico Mario, Giampiero D’offizi, Paola Begini, Martina Milana, Ubaldo Visco Comandini, Umberto Vespasiani Gentilucci, Raffaella Lionetti, and Chiara Taibi
- Subjects
medicine.medical_specialty ,Hepatology ,Multicenter study ,business.industry ,Incidence (epidemiology) ,Internal medicine ,Cohort ,Overall survival ,Medicine ,business - Published
- 2019
25. Liver stiffness and portal hypertension predict failure to DAA treatment in a real-life cohort of HCV-infected patients treated with recommended regimens
- Author
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S. Di Nardi, D. Di Paolo, A. Pecchioli, C. Masetti, A. Brega, Francesco Santopaolo, Ilaria Lenci, F. De Leonardis, Martina Milana, T. Marianelli, F. Antenucci, Mario Angelico, A. Bosa, Leonardo Baiocchi, Plinio Rossi, and Simona Francioso
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Cohort ,Gastroenterology ,medicine ,Portal hypertension ,medicine.disease ,business ,Surgery - Published
- 2017
26. Results of a fast-track referral system for urgent outpatient hepatology visits
- Author
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Ilaria Lenci, Leonardo Baiocchi, Simona Francioso, Francesco Santopaolo, and Martina Milana
- Subjects
Liver Cirrhosis ,Male ,medicine.medical_specialty ,Referral ,Patient referral ,Liver Function Tests ,Internal medicine ,Liver enzyme ,Ambulatory Care ,medicine ,Humans ,Referral and Consultation ,Retrospective Studies ,business.industry ,Liver Diseases ,Health Policy ,Liver Neoplasms ,Public Health, Environmental and Occupational Health ,Outcome measures ,Retrospective cohort study ,General Medicine ,Middle Aged ,Hepatology ,Emergency medicine ,Referral system ,Female ,Fast track ,business ,Program Evaluation - Abstract
In 2011, our regional district adopted an experimental system for fast referral (within 72 h) by general practitioners to several outpatient specialist evaluations including hepatology. The aim of this study was to assess the characteristics and appropriateness of urgent hepatology visits.Retrospective study.Hospital-based study in Italy.A total of 192 subjects referred to our outpatient hepatology clinic classified as 'urgent' were compared with 397 patients evaluated with standard referral. A comparison with 200 patients visited just before the adoption of the new system was also included.Patients' features and appropriateness of referral in urgent and non-urgent groups using the new system.Increase in liver enzymes was the main factor that leads to specialist hepatology consultation and was more frequent in the urgent group (37% vs. 27.1%, P0.001). Liver malignancies were identified in 2.6% of patients in the urgent group, whereas this percentage was 10 times lower in the non-urgent group (P = 0.01). Urgent patients required inpatient admission more frequently compared with non-urgent patients (4.2% vs. 0.5%; P = 0.003). Inappropriate referral was recorded in 41% of cases in the urgent group (no reason for urgency 27%; condition not attributable to liver 13.5%). In the non-urgent group, consultations were inappropriate in 20.1% of cases (condition not attributable to liver). In comparison with the old system, the new one allocated85% of patients with serious illness to urgent group.This strategy is helpful in selecting patients with more serious hepatic conditions. Appropriateness of referral represents a crucial issue.
- Published
- 2015
27. Crusted scabies in a liver transplant patient mimicking rupioid psoriasis
- Author
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Luca Bianchi, Virginia Garofalo, Ilaria Lenci, Augusto Orlandi, Martina Milana, Rosita Saraceno, and Mario Angelico
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Dermatology ,Sarcoptes scabiei ,Liver transplantation ,Diagnosis, Differential ,Scabies ,030207 dermatology & venereal diseases ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Psoriasis ,medicine ,Humans ,030212 general & internal medicine ,skin and connective tissue diseases ,Aged ,Immunosuppression Therapy ,Settore MED/35 - Malattie Cutanee e Veneree ,integumentary system ,biology ,business.industry ,food and beverages ,Immunosuppression ,medicine.disease ,biology.organism_classification ,Liver Transplantation ,Immunology ,Female ,Transplant patient ,Differential diagnosis ,business - Abstract
Crusted scabies is a rare, highly contagious infection caused by massive infestation of Sarcoptes scabiei var. hominis. Patients with a weakened immune system are particularly affected by crusted scabies, as an inadequate host response and subsequent unrestrained growth of parasitic mites play a key pathogenetic role. Clinical presentation of crusted scabies typically features psoriasiform, warty skin plaques. We hereby report the case of a liver transplant patient with a peculiar presentation of [...]
- Published
- 2016
28. Treatment failure to first-line direct antiviral (DAA) in HCV-related advanced liver disease: An Italian real-life urban setting
- Author
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C.F. Perno, F. Chiesara, D. Di Paolo, V. Gerardi, Alessandra Moretti, Francesca Ceccherini-Silberstein, Anna Claudia Pellicelli, Valeria Cento, C. Masetti, Paolo Rossi, Francesco Santopaolo, M. Siciliano, Mario Angelico, L. Fondacaro, Martina Milana, Raffaella Lionetti, Ilaria Lenci, and Gianpiero D’Offizi
- Subjects
Liver disease ,medicine.medical_specialty ,Hepatology ,business.industry ,First line ,Internal medicine ,Gastroenterology ,medicine ,medicine.disease ,business ,Virology ,Treatment failure - Published
- 2016
29. Clinical relevance of accurate HCV genotype and subtype assignment by NS3/NS5A/NS5B direct sequencing in the era of new direct acting antiviral agents
- Author
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Carlo Magni, Francesca Ceccherini-Silberstein, M. Puoti, Claudio Maria Mastroianni, A. Di Biagio, Marco Romano, Filomena Morisco, Giustino Parruti, Antonio Gasbarrini, Gloria Taliani, M. Siciliano, Simona Landonio, V.C. Di Maio, Martina Milana, Laura Gianserra, F. Deodati, Caterina Pasquazzi, M. Andreoni, J. Vecchiet, Valeria Cento, L. Lambiase, Marianna Aragri, Simona Francioso, E. D’Amico, Gabriella d'Ettorre, Giuliano Rizzardini, D. Di Paolo, Antonio Grieco, F. De Leonardis, A. Manunta, Ivana Maida, Anna Claudia Pellicelli, Mario Angelico, K. Yu La Rosa, Miriam Lichtner, P. Cacciatore, Cesare Sarrecchia, F.P. Antonucci, Aldo Bertoli, Valeria Micheli, Antonio Picciotto, Dante Romagnoli, Savino Bruno, Laura Ambra Nicolini, Ilaria Lenci, C.F. Perno, Marco Ciotti, Lorenzo Nosotti, Simona Marenco, Elisabetta Teti, M. Tontodonati, Maria Stella Mura, R. Campoli, Nicola Caporaso, S. Grieco, Sergio Babudieri, and Umberto Vespasiani-Gentilucci
- Subjects
Genetics ,chemistry.chemical_compound ,NS3 ,Hepatology ,chemistry ,Direct sequencing ,Genotype ,Gastroenterology ,Clinical significance ,Biology ,NS5A ,NS5B ,Direct acting - Published
- 2016
30. Clinical and Functional Changes Associated with the Achievement of Sustained Response in HCV Genotype-1 Infected Liver Transplant Recipients: Does Sofosbuvir Differ from Peg-Interferon Therapy?
- Author
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C. Masetti, Francesco Santopaolo, Mario Angelico, Plinio Rossi, F. De Leonardis, D. Di Paolo, Leonardo Baiocchi, Simona Francioso, Martina Milana, Ilaria Lenci, and S. Cucchiarelli
- Subjects
Peg interferon ,Hepatology ,Hcv genotype 1 ,Sofosbuvir ,business.industry ,Sustained response ,Medicine ,business ,Virology ,medicine.drug - Published
- 2016
31. Different Prevalence of HCV Resistance and HCV RNA Quantification Within Tumoral and Non Tumoral Liver Tissues in HCC/Transplanted Patients
- Author
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Mario Angelico, Martina Milana, V. Cento, Daniele Sforza, Ilaria Lenci, Tommaso Maria Manzia, D. Di Paolo, F.P. Antonucci, G. Tisone, M.C. Sorbo, F. Ceccherini-Silberstein, F. De Leonardis, C.F. Perno, L. Carioti, Maria Concetta Bellocchi, and M. Manuelli
- Subjects
0301 basic medicine ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Hepatology ,business.industry ,Medicine ,030211 gastroenterology & hepatology ,business ,Virology - Published
- 2016
32. Natural HCV resistance is common in Italy and differently associated to genotypes
- Author
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Simona Landonio, Barbara Menzaghi, Giustino Parruti, T. Ruggiero, Valeria Cento, Francesca Ceccherini-Silberstein, Ilaria Lenci, M. Melis, Giuliano Rizzardini, Antonio Gasbarrini, P. Cacciatore, V. Pace Palitti, M.C. Sorbo, Ennio Polilli, Martina Milana, Alessandro Pieri, Laura Gianserra, Anna Claudia Pellicelli, P. Andreone, C. Masetti, Bianca Bruzzone, Simona Marenco, Elisabetta Teti, M. Andreoni, Gloria Taliani, Aldo Bertoli, Elisa Biliotti, Miriam Lichtner, Nicola Coppola, Vincenza Calvaruso, Fausto Baldanti, Stefania Paolucci, C.F. Perno, Carlo Magni, Sergio Babudieri, Valeria Micheli, Antonio Craxì, Filomena Morisco, V.C. Di Maio, Dante Romagnoli, Laura Ambra Nicolini, Mario Angelico, Loredana Sarmati, M. Siciliano, M. Puoti, N. Iapadre, Marianna Aragri, Vincenzo Vullo, Caterina Pasquazzi, and F. De Leonardis
- Subjects
0301 basic medicine ,Genetics ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Hepatology ,Resistance (ecology) ,business.industry ,Genotype ,Gastroenterology ,Medicine ,030211 gastroenterology & hepatology ,business - Published
- 2017
33. Treatment with direct-acting antiviral agents is associated with improvement of renal function in a cohort of HCV-infected patients with chronic kidney disease
- Author
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A. Brega, T. Marianelli, Ilaria Lenci, C. Masetti, Francesco Santopaolo, F. Antenucci, F. De Leonardis, D. Di Paolo, Plinio Rossi, A. Pecchioli, Leonardo Baiocchi, Mario Angelico, S. Di Nardi, Simona Francioso, Martina Milana, and A. Bosa
- Subjects
Nephrology ,medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Cohort ,Gastroenterology ,medicine ,Renal function ,medicine.disease ,business ,Direct acting ,Kidney disease - Published
- 2017
34. Decreased alpha-fetoprotein levels in HCV cirrhotic patients after direct-acting antiviral agents therapy. Does this indicate a reduced risk of hepatocellular carcinoma?
- Author
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F. Antenucci, C. Masetti, Plinio Rossi, Francesco Santopaolo, A. Brega, D. Di Paolo, A. Pecchioli, Ilaria Lenci, S. Cucchiarelli, Simona Francioso, T. Marianelli, F. De Leonardis, S. Di Nardi, A. Bosa, Mario Angelico, Martina Milana, and Leonardo Baiocchi
- Subjects
Alpha fetoprotein levels ,medicine.medical_specialty ,Reduced risk ,Hepatology ,business.industry ,Internal medicine ,Hepatocellular carcinoma ,Gastroenterology ,medicine ,medicine.disease ,business ,Direct acting - Published
- 2017
35. Liver stiffness and portal hypertension predict failure to DAA treatment in a real-life cohort of hepatitis C virus-infected patients treated with recommended regimens
- Author
-
C. Masetti, Francesco Santopaolo, F. Antenucci, T. Marianelli, A. Brega, D. Di Paolo, A. Bosa, S. Di Nardi, A. Pecchioli, F. De Leonardis, Plinio Rossi, Simona Francioso, Mario Angelico, Ilaria Lenci, Martina Milana, and Leonardo Baiocchi
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Hepatitis C virus ,medicine.disease ,medicine.disease_cause ,Gastroenterology ,Surgery ,Liver stiffness ,Internal medicine ,Cohort ,medicine ,Portal hypertension ,business - Published
- 2017
36. Treatment with direct-acting antiviral agents is associated with improvement of renal function in a cohort of hepatitis C virus infected patients with chronic kidney disease
- Author
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Simona Francioso, A. Bosa, S. Di Nardi, F. De Leonardis, Piera Rossi, A. Brega, Leonardo Baiocchi, Martina Milana, D. Di Paolo, C. Masetti, Francesco Santopaolo, Mario Angelico, T. Marianelli, Ilaria Lenci, A. Pecchioli, and F. Antenucci
- Subjects
0301 basic medicine ,Hepatology ,business.industry ,Hepatitis C virus ,Renal function ,medicine.disease_cause ,medicine.disease ,03 medical and health sciences ,030104 developmental biology ,0302 clinical medicine ,Immunology ,Cohort ,Medicine ,030211 gastroenterology & hepatology ,business ,Direct acting ,Kidney disease - Published
- 2017
37. Improved virological outcomes and excellent safety profile in genotype 3 HCV-infected cirrhotic patients after an extended 24-weeks course of daclatasvir, sofosbuvir + ribavirin: insights from a real-life multicenter study
- Author
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Chiara Taibi, Raffaella Lionetti, Maurizio Pompili, Ubaldo Visco Comandini, Anna Rosa Garbuglia, Mario Angelico, Gianpiero D’Offizi, Paola Begini, Martina Milana, B. Imperatrice, Marzia Montalbano, M. Siciliano, and Ilaria Lenci
- Subjects
medicine.medical_specialty ,Daclatasvir ,Hepatology ,Sofosbuvir ,business.industry ,Ribavirin ,010102 general mathematics ,01 natural sciences ,Gastroenterology ,03 medical and health sciences ,chemistry.chemical_compound ,Safety profile ,0302 clinical medicine ,chemistry ,Multicenter study ,Internal medicine ,Genotype ,medicine ,030212 general & internal medicine ,0101 mathematics ,business ,medicine.drug - Published
- 2017
38. Different prevalence of HCV resistance and HCV quantification within blood and liver samples (tumoral and non tumoral tissues) of HCC/transplanted patients
- Author
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Francesca Ceccherini-Silberstein, L. Carioti, V. Cento, Maria Concetta Bellocchi, Ilaria Lenci, Tommaso Maria Manzia, M. Manuelli, Martina Milana, G. Tisone, Daniele Sforza, F. De Leonardis, D. Di Paolo, F.P. Antonucci, Mario Angelico, M.C. Sorbo, and C.F. Perno
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Internal medicine ,Gastroenterology ,Medicine ,business - Published
- 2016
39. Clinical and functional changes associated with the sustained virological response after treatment of genotype-1 HCV recurrence in liver transplant recipients: Does sofosbuvir differ from peg-interferon based therapy?
- Author
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A. Bosa, D. Di Paolo, Ilaria Lenci, Simona Francioso, S. Cucchiarelli, C. Masetti, Francesco Santopaolo, Martina Milana, Leonardo Baiocchi, F. De Leonardis, Mario Angelico, and Paolo Rossi
- Subjects
medicine.medical_specialty ,Hepatology ,Sofosbuvir ,business.industry ,Gastroenterology ,Hcv recurrence ,Virology ,Virological response ,Peg interferon ,Internal medicine ,Genotype ,Medicine ,business ,After treatment ,medicine.drug - Published
- 2016
40. Failure to First-Line Direct Antiviral (DAA) Treatment of HCV Infection in an Italian Real-Life Urban Setting
- Author
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C. Masetti, F. Ceccherini-Silberstain, L. Fondacaro, Francesco Santopaolo, Gianpiero D’Offizi, D. Di Paolo, Valeria Cento, A. Moretti, Ilaria Lenci, Raffaella Lionetti, Mario Angelico, Anna Claudia Pellicelli, Martina Milana, Plinio Rossi, C.F. Perno, F. Chiesara, Annalisa Tortora, and M. Siciliano
- Subjects
Hepatology ,business.industry ,First line ,Medicine ,business ,Virology - Published
- 2016
41. P0903 : Slow HCV kinetics following sofosbuvir + ribavirin administration in real-life setting of liver transplant recipients with severe recurrent hepatitis C
- Author
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C. Chialà, R. Canu, Maria Chiara Colombo, Giuseppe Tisone, Francesca Ceccherini-Silberstein, Fausto Zamboni, V.C. Di Maio, Antonio Picciotto, Luciano Milanesi, M. Manuelli, Giorgio Rossi, Ilaria Lenci, A. Di Leo, L. Mameli, M.C. Sorbo, M. Rendina, Daniele Sforza, Roberta Alfieri, Simona Marenco, A. Abedrabbo, Maria Francesca Donato, M.L. Ponti, Martina Milana, R. Ganga, Federica Malinverno, Valeria Cento, C.F. Perno, Marianna Aragri, S. Monico, and Mario Angelico
- Subjects
medicine.medical_specialty ,Hepatology ,Sofosbuvir ,business.industry ,Ribavirin ,Gastroenterology ,chemistry.chemical_compound ,chemistry ,Internal medicine ,medicine ,In real life ,Recurrent hepatitis ,business ,medicine.drug - Published
- 2015
42. Transarterial Chemoocclusion (Taco) With Degradable-Starch-Microsphere In Unresecable Hepatocellular Carcinoma: A Prospective Pilot-Study
- Author
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A. Brega, Francesco Santopaolo, Ilaria Lenci, Simona Francioso, Martina Milana, Fabrizio Chegai, Mario Angelico, and Antonio Orlacchio
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,Gastroenterology ,medicine.disease ,Medical care ,Microsphere ,Stable Disease ,Internal medicine ,Hepatocellular carcinoma ,Cholecystitis ,medicine ,Doxorubicin ,Liver function ,Artery occlusion ,business ,medicine.drug - Abstract
Background: According to BCLC algorithm, Transarterial Chemoembolization is recommended for unresecable hepatocellular carcinoma (HCC) in patients with preserved liver function. The intraarterial chemotherapy with transient artery occlusion could be a valid treatment alternative in patients with high-risk of liver failure. Aim of the present study was to evaluate efficacy and safety of TACO using Degradable-Starch-Microspheres (DSM) in patients with unresecable HCC. Methods We prospectively enrolled 24 cirrhotic patients (21/3M/F, mean age 66.3±10.5 years) with unresecable HCC, to be treated with three consecutives DSM-TACO at 5-week intervals. Chemotherapy drug was Doxorubicin Chloridrate (50mg/m2) mixed with 275mg DSM (Embocept®S, PharmaCept). Liver function before and after treatmentswas evaluatedwith Child Pugh and MELD scores. Treatment responsewas assessed by CT-scan 4weeks after procedures according to mRECIST criteria. Results: Overall, Complete Response (CR) was observed in 5/24 (20.8%), 9/24 (37.5%) and14/24 (58.3%)pts after thefirst, the second and the third procedure, respectively. No patient showed Stable Disease or Disease Progression at the end of the study. Patients withmonolobar disease (14/24: 58.3%) showed significant CR after the 1st procedure compared with bilobar HCC localization (5/14 vs 0/10; p=0.017). At the end, CR did not differ between mono or bilobar disease (9/14: 64.2% vs 5/10: 50%; p=ns). Drop-outs occurred in 8 patients (33.3%): 4 after the 1st treatment (3 worsened liver function, 1 liver transplanted), 4 after the 2nd treatment (2worsened liver function, 1 liver transplanted, 1 non compliance). Postembolization syndromewas observed in 9 (37.5%), in 4 (16.6%) requiring extended hospitalization. One patient had cholecystitis resolved with medical care. Conclusions: DSM-TACO offers a valid TACE alternative in patients with unresecable HCC. Careful patients selection is required to avoid liver failure in patients with border-line liver compensation. Further investigation to define DSM-TACO effects on survival is warranted.
- Published
- 2015
43. T-09 Correlation between NS5A variants and fibrosis progression in patients with HCV recurrence after liver transplantation
- Author
-
G. Tisone, Ilaria Lenci, S. Cucchiarelli, D. Di Paolo, Mario Angelico, Valeria Cento, F.P. Antonucci, Martina Milana, F. Ceccherini Silberstein, V.C. Di Maio, Emiliano Giardina, F. De Luca, and C.F. Perno
- Subjects
medicine.medical_specialty ,Hepatology ,business.industry ,medicine.medical_treatment ,Gastroenterology ,Hcv recurrence ,Liver transplantation ,medicine.disease ,Fibrosis ,Internal medicine ,medicine ,In patient ,business ,NS5A - Published
- 2013
44. 166 HCV DIVERSITY AND FIBROSIS PROGRESSION: NS5A AND CORE VARIANTS CORRELATE WITH SEVERITY OF HCV RECURRENCE AFTER LIVER TRANSPLANTATION
- Author
-
Ilaria Lenci, G. Tisone, S. Cucchiarelli, C.F. Perno, Martina Milana, D. Di Paolo, F.P. Antonucci, F. Ceccherini-Silberstein, V.C. Di Maio, Emiliano Giardina, Mario Angelico, F. De Luca, and Valeria Cento
- Subjects
Core (anatomy) ,medicine.medical_specialty ,Framingham Risk Score ,Hepatology ,business.industry ,medicine.medical_treatment ,Hcv recurrence ,Liver transplantation ,medicine.disease ,Virology ,Gastroenterology ,Obesity ,Fibrosis ,Internal medicine ,medicine ,Risk factor ,NS5A ,business - Abstract
Results: The overall 1-, 5and 10-year posttransplant survival rates, stratified by the composite risk score are presented in table 1. More than half (53.6%) of patients had at least one of the risk factors (obesity, renal dysfunction or advanced age). Patients with two or more risk factors (score ≥2) experienced a significantly higher covariate-adjusted risk of death compared to patients with zero (HR: 5.9, 95%CI: 2.3–14.3; p < 0.001) or one (HR: 2.6, 95%CI: 1.3–5.6; p = 0.009) risk factor.
- Published
- 2013
45. P.11.22 HCV GENOME VARIANTS CORRELATE WITH SEVERITY OF HCV RECURRENCE AFTER LIVER TRANSPLANTATION: DOES THE VIRAL DIVERSITY PLAY A ROLE ON FIBROSIS PROGRESSION?
- Author
-
Valeria Cento, C.F. Perno, Ilaria Lenci, Mario Angelico, S. Cucchiarelli, F.P. Antonucci, D. Di Paolo, Martina Milana, F. Ceccherini-Silberstein, V.C. Di Maio, F. De Luca, and Emiliano Giardina
- Subjects
Hepatology ,business.industry ,media_common.quotation_subject ,medicine.medical_treatment ,Gastroenterology ,Hcv recurrence ,Liver transplantation ,medicine.disease ,Virology ,Genome ,Fibrosis ,Immunology ,Medicine ,business ,Diversity (politics) ,media_common - Published
- 2013
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