10 results on '"Angelico, M"'
Search Results
2. The acquisition of positively charged amino acids in HBsAg C-terminus correlates with HBV-induced liver cancer in vivo, impairs HBsAg secretion and affects its structural stability in vitro
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Piermatteo, L, Carioti, L, Duca, L, Saccomandi, P, Cappiello, G, Trimoulet, P, Fleury, H, Francioso, S, Lenci, I, Andreoni, M, Angelico, M, Minutolo, A, Matteucci, C, Sarmati, L, Svicher, V, and R. Salpini.
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Settore MED/07 - Published
- 2022
3. Economic Impact of European Liver and Intestine Transplantation Association (ELITA) Recommendations for Hepatitis B Prophylaxis After Liver Transplantation
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Cortesi, Paolo Angelo, Viganò, Raffaella, Conti, Sara, Lenci, Ilaria, Volpes, Riccardo, Martini, Silvia, Angelico, Mario, Fung, James, Buti, Maria, Coilly, Audrey, Durand, Francois, Fondevila, Constantino, Lebray, Pascal, Nevens, Frederik, Polak, Wojciech G., Rizzetto, Mario, Zoulim, Fabien, Perricone, Giovanni, Berenguer, Marina, Mantovani, Lorenzo Giovanni, Duvoux, Christophe, Belli, Luca Saverio, 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, and Surgery
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liver transplant ,Transplantation ,economic ,SDG 3 - Good Health and Well-being ,prophylaxi ,Humans ,Drug Therapy, Combination ,economics ,prophylaxis ,hepatitis B ,immunoglobulin (IgG) ,Antiviral Agents ,Liver Transplantation - 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. ispartof: TRANSPLANT INTERNATIONAL vol:36 ispartof: location:Switzerland status: published
- Published
- 2023
4. Temporal trends of waitlistings for liver transplantation in Italy: The ECALITA (Evolution of IndiCAtion in LIver transplantation in ITAly) registry study
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Tommaso Maria Manzia, Silvia Trapani, Alessandra Nardi, Andrea Ricci, Ilaria Lenci, Martina Milana, Roberta Angelico, Tullia Maria De Feo, Salvatore Agnes, Enzo Andorno, Umberto Baccarani, Amedeo Carraro, Matteo Cescon, Umberto Cillo, Michele Colledan, Luciano De Carlis, Paolo De Simone, Fabrizio Di Benedetto, Giuseppe Maria Ettorre, Salvatore Gruttadauria, Luigi Giovanni Lupo, Vincenzo Mazzaferro, Renato Romagnoli, Giorgio Rossi, Massimo Rossi, Marco Spada, Giovanni Vennarecci, Marco Vivarelli, Fausto Zamboni, Giuseppe Tisone, Massimo Cardillo, Mario Angelico, Manzia, T, Trapani, S, Nardi, A, Ricci, A, Lenci, I, Milana, M, Angelico, R, De Feo, T, Agnes, S, Andorno, E, Baccarani, U, Carraro, A, Cescon, M, Cillo, U, Colledan, M, De Carlis, L, De Simone, P, Di Benedetto, F, Ettorre, G, Gruttadauria, S, Lupo, L, Mazzaferro, V, Romagnoli, R, Rossi, G, Rossi, M, Spada, M, Vennarecci, G, Vivarelli, M, Zamboni, F, Tisone, G, Cardillo, M, and Angelico, M
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Adult ,Liver Cirrhosis ,Carcinoma, Hepatocellular ,Hepatology ,Liver Neoplasms ,Gastroenterology ,End-stage liver disease ,Epidemiology of liver disease ,Hepatitis C ,Settore MED/18 ,Liver Transplantation ,Settore MED/18 - Chirurgia Generale ,Humans ,Liver disease etiology ,Registries - Abstract
Background: Over the last decades relevant epidemiological changes of liver diseases have occurred, together with greatly improved treatment opportunities. Aim: To investigate how the indications for elective adult liver transplantation and the underlying disease etiologies have evolved in Italy. Methods: We recruited from the National Transplant Registry a cohort comprising 17,317 adults patients waitlisted for primary liver transplantation from January-2004 to December-2020. Patients were divided into three Eras:1(2004–2011),2(2012–2014) and 3(2015–2020). Results: Waitlistings for cirrhosis decreased from 65.9% in Era 1 to 46.1% in Era 3, while those for HCC increased from 28.7% to 48.7%. Comparing Eras 1 and 3, waitlistings for HCV-related cirrhosis decreased from 35.9% to 12.1%, yet those for HCV-related HCC increased from 8.5% to 26.7%. Waitlistings for HBV-related cirrhosis remained almost unchanged (13.2% and 12.4%), while those for HBV-related HCC increased from 4.0% to 11.6%. ALD-related cirrhosis decreased from 16.9% to 12.9% while ALD-related HCC increased from 1.9% to 3.9%. Conclusions: A sharp increase in liver transplant waitlisting for HCC and a concomitant decrease of waitlisting for cirrhosis have occurred In Italy. Despite HCV infection has noticeably decreased, still remains the primary etiology of waitlisting for HCC, while ALD and HBV represent the main causes for cirrhosis.
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- 2022
5. Fairness and pitfalls of the Italian waiting list for elective liver transplantation: The ECALITA registry study.
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Manzia TM, Trapani S, Nardi A, Ricci A, Lenci I, Sensi B, Angelico R, De Feo TM, Agnes S, Andorno E, Baccarani U, Carraro A, Cescon M, Cillo U, Colledan M, Pinelli D, De Carlis L, De Simone P, Ghinolfi D, Benedetto FD, Ettorre GM, Gruttadauria S, Lupo LG, Tandoi F, Mazzaferro V, Romagnoli R, Rossi G, Caccamo L, Rossi M, Spada M, Vennarecci G, Vivarelli M, Zamboni F, Tisone G, Cardillo M, and Angelico M
- Abstract
Background: The challenge of transplant waiting-lists is to provide organs for all candidates while maintaining efficiency and equity., Aims: We investigated the probability of being transplanted or of waiting-list dropout in Italy., Methods: Data from 12,749 adult patients waitlisted for primary liver-transplantation from January 2012 to December 2022 were collected from the National Transplant-Registry.The cohort was divided into Eras:1 (2012-2014);2 (2015-2018);and 3 (2019-2022)., Results: The one-year probability of undergoing transplant increased (67.6 % in Era 1vs73.8 % in Era 3,p < 0001) with a complementary 46 % decrease in waiting-list failures. Patients with hepatocellular-carcinoma were transplanted more often than cirrhotics[at model for end-stage liver-disease (MELD)-15:HR = 1.28,95 %CI:1.21-1.35;at MELD-25:HR = 1.04,95 %CI:0.92-1.19) and those with other indications (at MELD-15:HR = 1.27,95 %CI:1.11-1.46) across all eras. Candidates with Hepatitis-B-virus (HBV)related disease had a greater probability of transplant than those with Hepatitis-C virus-related (HR = 1.13,95 %CI:1.07-1.20), alcohol-related (HR = 1.13,95 %CI:1.05-1.21), and metabolic-related (HR = 1.18,95 %CI:1.09-1.28)disease. Waiting-list failures increased by 27 % every 5 MELD-points and by 14 % for every 5-year increase in recipient-age and decreased by 10 % with each 10-cm increase in stature. Blood-group O patients showed the highest probability of waiting-list failure (HR = 1.28,95 %CI:1.15-1.43)., Conclusions: Liver-transplantation waiting-list success-rates have significantly improved in Italy, with patients with hepatocellular-carcinoma and/or HBV-related diseases being favored. High MELD-score, old-age, short-stature, and blood-group O were significant risk-factors for waiting-list failure. Efforts to improve organ-allocation and prioritization-policies are underway., Competing Interests: Conflict of interest The authors of this manuscript have no conflicts of interest to disclose., (Copyright © 2024. Published by Elsevier Ltd.)
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- 2024
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6. Successful clinical and virological outcomes of liver transplantation for HDV/HBV-related disease after long-term discontinuation of hepatitis B immunoglobulins.
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Lenci I, Tariciotti L, Angelico R, Milana M, Signorello A, Manzia TM, Toti L, Tisone G, Angelico M, and Baiocchi L
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- Male, Humans, Child, Preschool, Child, Hepatitis B virus genetics, Antiviral Agents therapeutic use, Hepatitis B Surface Antigens, Retrospective Studies, DNA, Viral genetics, Treatment Outcome, Immunoglobulins therapeutic use, Hepatitis B Antibodies, Liver Transplantation adverse effects, Hepatitis B complications
- Abstract
Background: Indefinite, long-term administration of hepatitis B immunoglobulins (HBIg), together with a third generation nucleos(t)ide analog (NA), is the currently recommended prophylactic strategy to prevent viral recurrence after liver transplantation (LT) for Hepatitis Delta virus (HDV)/Hepatitis B virus (HBV)-related disease., Methods: We retrospectively analyzed the safety and long-term clinical and virological outcomes of a consecutive cohort of 16 patients (10 males, median age 64.5, range 41-75) transplanted for HDV/HBV-related cirrhosis at our Institution, who discontinued HBIg after a median of 24.5 months (range 15-116) after transplant. All patients continued prophylaxis with same NA used before LT. Recurrence of HDV/HBV infection was defined as reappearance of serum HDV-RNA with detectable serum HBsAg and/or HBV-DNA., Results: The median follow-up after LT was 138 months (range 73-316) and 110 months (range 52-200) after HBIg withdrawal. All patients were HBsAg-positive, HBV-DNA negative, and anti-HDV positive at the time of LT and without coinfections with HCV or HIV. Patients were followed with biochemical and virological tests every 3-6 months after HBIg withdrawal. No recurrences of HDV/HBV infection or disease were observed during monoprophylaxis with NA. In addition, eight patients (50%) spontaneously developed anti-HBs titers above 10 IU/L at a median of 74 months (range 58-140) following HBIG discontinuation., Conclusions: HBIg withdrawal after LT is a safe and efficacious strategy in patients transplanted for HDV/HBV disease and is frequently associated with the spontaneous development of serological immunity against HBV. These data call for a revision of current prophylactic recommendations in this setting., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- 2023
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7. Temporal trends of waitlistings for liver transplantation in Italy: The ECALITA (Evolution of IndiCAtion in LIver transplantation in ITAly) registry study.
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Manzia TM, Trapani S, Nardi A, Ricci A, Lenci I, Milana M, Angelico R, De Feo TM, Agnes S, Andorno E, Baccarani U, Carraro A, Cescon M, Cillo U, Colledan M, De Carlis L, De Simone P, Di Benedetto F, Ettorre GM, Gruttadauria S, Lupo LG, Mazzaferro V, Romagnoli R, Rossi G, Rossi M, Spada M, Vennarecci G, Vivarelli M, Zamboni F, Tisone G, Cardillo M, and Angelico M
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- Adult, Humans, Liver Cirrhosis epidemiology, Liver Cirrhosis surgery, Registries, Liver Transplantation, Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular surgery, Liver Neoplasms epidemiology, Liver Neoplasms surgery, Hepatitis C complications, Hepatitis C epidemiology
- Abstract
Background: Over the last decades relevant epidemiological changes of liver diseases have occurred, together with greatly improved treatment opportunities., Aim: To investigate how the indications for elective adult liver transplantation and the underlying disease etiologies have evolved in Italy., Methods: We recruited from the National Transplant Registry a cohort comprising 17,317 adults patients waitlisted for primary liver transplantation from January-2004 to December-2020. Patients were divided into three Eras:1(2004-2011),2(2012-2014) and 3(2015-2020)., Results: Waitlistings for cirrhosis decreased from 65.9% in Era 1 to 46.1% in Era 3, while those for HCC increased from 28.7% to 48.7%. Comparing Eras 1 and 3, waitlistings for HCV-related cirrhosis decreased from 35.9% to 12.1%, yet those for HCV-related HCC increased from 8.5% to 26.7%. Waitlistings for HBV-related cirrhosis remained almost unchanged (13.2% and 12.4%), while those for HBV-related HCC increased from 4.0% to 11.6%. ALD-related cirrhosis decreased from 16.9% to 12.9% while ALD-related HCC increased from 1.9% to 3.9%., Conclusions: A sharp increase in liver transplant waitlisting for HCC and a concomitant decrease of waitlisting for cirrhosis have occurred In Italy. Despite HCV infection has noticeably decreased, still remains the primary etiology of waitlisting for HCC, while ALD and HBV represent the main causes for cirrhosis., (Copyright © 2022. Published by Elsevier Ltd.)
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- 2022
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8. Electronic Outpatient Referral System for Liver Transplant Improves Appropriateness and Allows First Visit Triage.
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Ferri F, Milana M, Abbatecola A, Pintore A, Lenci I, Parisse S, Vitale A, Di Croce G, Mennini G, Lai Q, Rossi M, Angelico R, Tisone G, Anselmo A, Angelico M, and Corradini SG
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- Electronics, Humans, Outpatients, Referral and Consultation, Liver Transplantation, Triage methods
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Background & Aims: Missed or inappropriate referrals of potential candidates for liver transplantation (LT) are common and traditional referral methods (tRs) do not allow for efficient triage. We investigated the effects of a website developed for electronic outpatient referral to LT (eRW-LT) on these issues., Methods: We prospectively collected data on all consecutive outpatient referrals to 2 Italian LT centers from January 2015 to December 2019. In the second half of the study, starting from July 2017, referring physicians had the option of using eRW-LT, quickly obtaining the judgment on the appropriateness and urgency of the visit from a transplant hepatologist., Results: In the second half of the study, there were 99 eRW-LTs and 96 traditional referrals (new tRs), representing a 17.4% increase over the 161 traditional referrals (old tRs) of the first half. With eRW-LT, 11.1% of referrals were judged inappropriate online without booking a visit. Appropriateness, judged at the time of the first visit, was 59.6%, 56.2%, and 94.3% with old tRs, new tRs, and eRW-LT, respectively. Considering the appropriate visits, the median waiting time in days between referral date and first visit appointment was significantly shorter for urgent visits referred with eRW-LT (5.0; 95% CI, 4.8-9.3) compared with nonurgent visits sent with the same system (17.0; 95% CI, 11.5-25.0; P < .0001), those referred with old tRs (14.0; 95% CI, 8.0-23.0; P < .001) and with new tRs (16.0; 95% CI, 10.0-23.0; P < .001)., Conclusions: eRW-LT allows an increase in the number of referrals for LT, ensuring effective triage and better appropriateness of visits., (Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
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- 2022
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9. 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.
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Duvoux C, Belli LS, Fung J, Angelico M, Buti M, Coilly A, Cortesi P, Durand F, Féray C, Fondevila C, Lebray P, Martini S, Nevens F, Polak WG, Rizzetto M, Volpes R, Zoulim F, Samuel D, and Berenguer M
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- Antiviral Agents therapeutic use, Hepatitis B virus, Humans, Immunoglobulins therapeutic use, Neoplasm Recurrence, Local drug therapy, Recurrence, Treatment Outcome, Carcinoma, Hepatocellular drug therapy, Hepatitis B drug therapy, Hepatitis B prevention & control, Liver Neoplasms drug therapy, Liver Transplantation adverse effects
- 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., (© 2021 John Wiley & Sons Ltd.)
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- 2021
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10. Cumulative incidence of solid and hematological De novo malignancy after liver transplantation in a multicentre cohort.
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Lucidi C, Biolato M, Lai Q, Lattanzi B, Lenci I, Milana M, Lionetti R, Liguori A, Angelico M, Tisone G, Avolio AW, Agnes S, Rossi M, Grieco A, and Merli M
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- Adolescent, Adult, Aged, Female, Humans, Incidence, Italy, Kaplan-Meier Estimate, Liver Diseases etiology, Liver Diseases pathology, Male, Middle Aged, Neoplasms diagnosis, Postoperative Complications diagnosis, Proportional Hazards Models, Retrospective Studies, Young Adult, Liver Diseases surgery, Liver Transplantation, Neoplasms epidemiology, Postoperative Complications epidemiology
- 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., (Copyright © 2021 Fundación Clínica Médica Sur, A.C. Published by Elsevier España, S.L.U. All rights reserved.)
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- 2021
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