Search

Your search keyword '"Burra, P."' showing total 2,485 results
Start Over Author "Burra, P."
2,485 results on '"Burra, P."'

151. Corrigendum to 'Non-alcoholic fatty liver disease in adults 2021: A clinical practice guideline of the Italian Association for the Study of the Liver (AISF), the Italian Society of Diabetology (SID) and the Italian Society of Obesity (SIO)' Nutrition, Metabolism and Cardiovascular diseases volume 32 issue 1 (2022) 1-16

Author

Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, M., Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., Miele L. (ORCID:0000-0003-3464-0068), Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, M., Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., and Miele L. (ORCID:0000-0003-3464-0068)

Abstract

N/A

Published
2023

152. Corrigendum to 'Non-alcoholic fatty liver disease in adults 2021: A clinical practice guideline of the Italian Association for the Study of the Liver (AISF), the Italian Society of Diabetology (SID) and the Italian Society of Obesity (SIO)' [Dig Liver Dis 54 (2022) 170-182]

Author

Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, M., Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., Miele L. (ORCID:0000-0003-3464-0068), Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, M., Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., and Miele L. (ORCID:0000-0003-3464-0068)

Abstract

N/A

Published
2023

153. The role of antiplatelet therapies on incidence and mortality of hepatocellular carcinoma

Author

Lai, Quirino, De Matthaeis, Nicoletta, Finotti, Michele, Galati, Giovanni, Marrone, Giuseppe, Melandro, Fabio, Morisco, Filomena, Nicolini, Daniele, Pravisani, Riccardo, Giannini, Edoardo G, Aglitti, A, Aliberti, C, Baccarani, U, Bhoori, S, Borzio, M, Brancaccio, G, Burra, P, Cabibbo, G, Casadei Gardini, A, Carrai, P, Cillo, U, Conti, F, Cucchetti, A, D'Ambrosio, R, Dell'Unto, C, Di Costanzi, Gg, Di Sandro, S, Foschi, Fg, Fucilli, F, Gambato, M, Gasbarrini, Antonio, Giuliante, Felice, Ghinolfi, D, Grieco, Antonio, Gruttaduria, S, Guarino, M, Kostandini, A, Iavarone, M, Lenci, I, Levi Sandri, Gb, Losito, F, Lupo, Lg, Manzia, Tm, Mazzocato, S, Mescoli, C, Miele, Luca, Muley, M, Persico, M, Plaz Torres, Mc, Pompili, Maurizio, Ponziani, Francesca Romana, Rapaccini, Gian Ludovico, Rendina, M, Renzulli, M, Rossi, Marco, Rreka, E, Russo, Fp, Sacco, R, Sangiovanni, A, Sessa, A, Simonetti, N, Sposito, C, Tortora, R, Trevisani, F, Viganò, L, Viganò, M, Villa, E, Vincenzi, V, Violi, P, Vitale, A, Gasbarrini, A (ORCID:0000-0002-7278-4823), Giuliante, F (ORCID:0000-0001-9517-8220), Grieco, A (ORCID:0000-0002-0544-8993), Miele, L (ORCID:0000-0003-3464-0068), Pompili, M (ORCID:0000-0001-6699-7980), Ponziani, FR (ORCID:0000-0002-5924-6238), Rapaccini, GL (ORCID:0000-0002-6467-857X), Rossi, M (ORCID:0000-0002-4539-5670), Lai, Quirino, De Matthaeis, Nicoletta, Finotti, Michele, Galati, Giovanni, Marrone, Giuseppe, Melandro, Fabio, Morisco, Filomena, Nicolini, Daniele, Pravisani, Riccardo, Giannini, Edoardo G, Aglitti, A, Aliberti, C, Baccarani, U, Bhoori, S, Borzio, M, Brancaccio, G, Burra, P, Cabibbo, G, Casadei Gardini, A, Carrai, P, Cillo, U, Conti, F, Cucchetti, A, D'Ambrosio, R, Dell'Unto, C, Di Costanzi, Gg, Di Sandro, S, Foschi, Fg, Fucilli, F, Gambato, M, Gasbarrini, Antonio, Giuliante, Felice, Ghinolfi, D, Grieco, Antonio, Gruttaduria, S, Guarino, M, Kostandini, A, Iavarone, M, Lenci, I, Levi Sandri, Gb, Losito, F, Lupo, Lg, Manzia, Tm, Mazzocato, S, Mescoli, C, Miele, Luca, Muley, M, Persico, M, Plaz Torres, Mc, Pompili, Maurizio, Ponziani, Francesca Romana, Rapaccini, Gian Ludovico, Rendina, M, Renzulli, M, Rossi, Marco, Rreka, E, Russo, Fp, Sacco, R, Sangiovanni, A, Sessa, A, Simonetti, N, Sposito, C, Tortora, R, Trevisani, F, Viganò, L, Viganò, M, Villa, E, Vincenzi, V, Violi, P, Vitale, A, Gasbarrini, A (ORCID:0000-0002-7278-4823), Giuliante, F (ORCID:0000-0001-9517-8220), Grieco, A (ORCID:0000-0002-0544-8993), Miele, L (ORCID:0000-0003-3464-0068), Pompili, M (ORCID:0000-0001-6699-7980), Ponziani, FR (ORCID:0000-0002-5924-6238), Rapaccini, GL (ORCID:0000-0002-6467-857X), and Rossi, M (ORCID:0000-0002-4539-5670)

Abstract

Aim To evaluate the impact of antiplatelet therapy (APT)on the incidence of hepatocellular carcinoma (HCC) and mortality following its treatment. Methods A systematic literature search was performed using PubMed and Cochrane Central Register of Controlled Trials Databases. Two HCC clinical settings were explored: (i) incidence, and (ii) death after any HCC treatment. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to compare the pooled data between patients who received or did not receive APT. Results A total of 20 studies were identified, of whom 15 focused on HCC incidence, including 2,685,009 patients, and five on post-treatment death, including 3281 patients. APT was associated with an overall reduced risk of HCC incidence (OR: 0.63; 95%CI = 0.51-0.79; p < 0.001) as well as of post-treatment mortality (OR: 0.54; 95%CI = 0.35-0.83; p = 0.006). Conclusions Current data suggest that APT correlated with higher HCC incidence and poor overall survival following tumour treatment.

Published
2023

155. Somatic copy number alterations in circulating cell-free DNA as a predictive biomarker for hepatocellular carcinoma: insights from a proof-of-concept study.

Author

Pinto, E., Lazzarini, E., Pelizzaro, F., Gambato, M., Santarelli, L., Potente, S., Zanaga, P., Zappitelli, T., Cradin, R., Burra, P., Farinati, F., Romualdi, C., Tosello, V., Indraccolo, S., and Russo, F.P.

Abstract

Despite improvements in hepatocellular carcinoma (HCC) management, its prognosis remains poor. Diagnosis at advanced stages often precludes curative treatment options, and currently available biomarkers (e.g., alpha-fetoprotein (AFP)) offer limited utility in early diagnosis and prognostic stratification. Liquid biopsy has emerged as a promising tool for early HCC detection and prognostic evaluation, and the analysis of circulating cell-free DNA (ccfDNA) hold significant potential as a diagnostic tool. This proof-of-concept study aimed to investigate the potential role of tumor fraction (TF) within ccfDNA as a biomarker in HCC patients. A total of 60 patients were recruited, including 13 with chronic liver disease (CLD), 24 with cirrhosis, and 23 with HCC. Plasma samples were collected, and ccfDNA was extracted for genomic analysis. TF was calculated by focusing on somatic copy number alterations (SCNAs) within the ccfDNA. In patients with CLD and cirrhosis (n = 37), circulating tumor DNA (ctDNA) was undetectable with the exception of one cirrhotic patient, who presented a significant TF (17 %) and displayed HCC shortly after. Conversely, 5 out of 22 HCC patients (21.7 %) exhibited detectable ctDNA, with TF levels ranging from 3.0 % to 32.6 %. Patients with higher TF levels were characterized by more aggressive disease features, including elevated AFP levels, larger tumor sizes, multiple tumor nodules, and advanced-stage disease. Preliminary evidence from this study suggests that the analysis of TF, specifically through the detection of SCNAs, could serve as a promising non-invasive tool for the identification and evaluation of HCC. The innovative approach has the potential to significantly enhance early diagnosis and may also improve prognostic stratification in HCC patients. [ABSTRACT FROM AUTHOR]

Published
2025
Full Text
View/download PDF

156. The early dynamic changes of radiological and biochemical scores help identify a more aggressive PSC phenotype.

Author

Catanzaro, E., Peviani, M., Bonaiuto, E., Pezzato, F., Benatti, M., Gambato, M., Burra, P., Motta, R., and Cazzagon, N.

Abstract

The natural course of Primary Sclerosing Cholangitis (PSC) is generally progressive towards cirrhosis and its complications. Predicting the prognosis in PSC is still a matter of debate. Several prognostic factors associated with transplant-free survival have been identified, including serum markers, composite scores, biliary and parenchymal changes and elastography. The aim of this study was to assess whether the evolution of biochemical and magnetic resonance imaging (MRI) scores is associated with an increased risk of developing clinical outcomes. We conducted a retrospective analysis of patients diagnosed with large ducts, non-cirrhotic PSC, who underwent regular clinical and radiological follow-up with at least two consecutive MRIs closest to the diagnosis, available for review by an expert radiologist. The ANALI scores with and without gadolinium (Gd) were assessed in the two MRIs, and any increase in the ANALI scores was considered as radiological worsening. Demographic data and liver function tests were collected at the same timepoints as the MRI scans, and two scores, the Amsterdam Oxford Model (AOM) and the Mayo Risk Score (MRS), were calculated and stratified into low, intermediate and high-risk categories. The progression of AOM and MRS was defined by the upgrade from one category to a higher one. Clinical outcomes considered included the development of recurrent cholangitis, cirrhosis, liver transplantation (LT), death from liver disease, and the development of hepatobiliary malignancies. A total of 45 patients were included. Median age was 30 (21-38) years at diagnosis and 36 (28-50) years at inclusion. The median interval between the two MRIs was 24 (16–38) months. Twenty-eight (62%) patients were male. The median follow-up after the second MRI was 69 (50-90) months. Thirteen (29%) patients experienced radiological worsening, while 8 (18%) and 7 (16%) patients showed progression of the AOM and the MRS, respectively. The increases in ANALI with and without Gd and the MRS were associated with the risk of development cirrhosis during follow-up (p=0.032, p=0.003 and p=0.001, respectively). Additionally, the increase in ANALI without Gd during follow-up was significantly associated with the need for LT (p=0.001). A trend towards a significant association between the increase in MRS and LT was observed (p=0.085). Finally, patients who developed recurrent cholangitis during follow-up exhibited a progressive increase in ANALI without Gd (p=0.003). The early dynamic changes in radiological and biochemical scores help identify a more aggressive PSC phenotype. These preliminary findings suggest the potential utility of dynamic assessment of radiologic and biochemical scores for prognostic purposes and risk stratification. Further validation in larger cohorts is warranted. [ABSTRACT FROM AUTHOR]

Published
2025
Full Text
View/download PDF

157. Coronary angiography in liver transplant work-up: report from a large multicenter Italian cohort.

Author

Saracco, M., Burra, P., Giannelli, V., Marrone, G., Morelli, MC., Pagano, D., Ponziani, FR., Baroni, G. Svegliati, Toniutto, P., Biolato, M., Cariati, S., D'Arcangelo, F., De Maria, N., Benedetto, C. Di, Donato, FM., Fagiuoli, S., Ferrarese, A., Fumolo, E., Lanza, A. Galeota, and Lenci, I.

Abstract

Evaluating coronary artery disease(CAD) is critical in liver transplant(LT) candidates. Coronary-angiography (CATH) is the invasive gold standard for CAD diagnosis. We aimed to assess CATH role in Italian multicenter pre-LT cohort. 18/21 Italian adult LT centers participated, enrolling cirrhotics who underwent CATH during cardiac work-up between 2018-2022. We evaluated: CATH indications, significant-coronary-stenosis rate (SCS: ≥50% major-vessels or ≥70% moderate-branches), post-LT major cardiovascular events(MACEs), and survival. Between 2018-2022, the 18 centers performed 5336 LTs from deceased donors. 305 pts underwent pre-LT CATH and constituted our study cohort. Median age 62 years; 85% male; BMI 27kg/m²; 68% smokers; 57% diabetes; 55% arterial hypertension; 13% CAD history, 9% peripheral artery disease, 26% CAD family history. Liver etiology was 34% viral, 27% alcohol, 15% MASLD, 12% alcohol+MASLD, MELD 13(IQR 9-18), 61% HCC Indications for CATH were: 31% positive coronary-CT, 25% ≥3 cardiovascular risk factors, 12% cardiac consultation, 11% positive myocardial scintigraphy, 9% positive stress-echocardiography, 8% CAD history, 4% resting echocardiographic abnormalities. CATH complications occurred in 16 pts (5%). SCS was detected in 120(39%) patients, 54% underwent revascularization. At univariate analysis, SCS was associated with male (OR=2.02,CI:1.00-4.09,p=0.049) and smoking history (OR:1.92,CI:1.07-3.47,p=0.029). At multivariable analysis, active smoking (OR2.02,CI:1.07-3.88,p=0.037) and MASLD (OR1.89,CI:1.02-3.55,p=0.044) were independent predictors of SCS. Positive predictive value (PPV) of CCTA and stress-echocardiography was 57% and 35%, respectively. After CATH,259/305 pts were placed on LT waiting list. By 30/06/2023, 230 underwent LT (21% after pre-LT revascularization). 28(12%) MACEs occurred within 2 y after LT with 3 related deaths. 1- and 2-y patient survival 92% and 90%. Cardiac work-up varies across our 18 LT centers. CCTA showed a PPV of 57%. 39% of pts selected for CATH had SCS, 54% requiring revascularization. National efforts should be made to share a unified cardiac work-up protocol tailored for our LT recipients. [ABSTRACT FROM AUTHOR]

Published
2025
Full Text
View/download PDF

158. The role of antiplatelet therapies on incidence and mortality of hepatocellular carcinoma

Author

Lai, Q., De Matthaeis, N., Finotti, M., Galati, G., Marrone, G., Melandro, F., Morisco, F., Nicolini, D., Pravisani, R., Giannini, E. G., Aglitti, A., Aliberti, C., Baccarani, U., Bhoori, S., Borzio, M., Brancaccio, G., Burra, P., Cabibbo, G., Casadei Gardini, A., Carrai, P., Cillo, U., Conti, F., Cucchetti, A., D'Ambrosio, R., Dell'Unto, C., Di Costanzo, G. G., Di Sandro, S., Foschi, F. G., Fucilli, F., Gambato, M., Gasbarrini, A., Giuliante, F., Ghinolfi, D., Grieco, A., Gruttaduria, S., Guarino, M., Kostandini, A., Iavarone, M., Lenci, I., Levi Sandri, G. B., Losito, F., Lupo, L. G., Manzia, T. M., Mazzocato, S., Mescoli, C., Miele, L., Muley, M., Persico, M., Plaz Torres, M. C., Pompili, M., Ponziani, F. R., Rapaccini, G. L., Rendina, M., Renzulli, M., Rossi, M., Rreka, E., Russo, F. P., Sacco, R., Sangiovanni, A., Sessa, A., Simonetti, N., Sposito, C., Tortora, R., Trevisani, F., Vigano, L., Vigano, M., Villa, E., Vincenzi, V., Violi, P., and Vitale, A.

Subjects
clopidogrel, aspirin, Clinical Biochemistry, incidence, occurrence, survival, General Medicine, Biochemistry, Settore MED/18
Abstract

To evaluate the impact of antiplatelet therapy (APT)on the incidence of hepatocellular carcinoma (HCC) and mortality following its treatment.A systematic literature search was performed using PubMed and Cochrane Central Register of Controlled Trials Databases. Two HCC clinical settings were explored: (i) incidence, and (ii) death after any HCC treatment. Odds ratios (OR) and 95% confidence intervals (95%CI) were calculated to compare the pooled data between patients who received or did not receive APT.A total of 20 studies were identified, of whom 15 focused on HCC incidence, including 2,685,009 patients, and five on post-treatment death, including 3281 patients. APT was associated with an overall reduced risk of HCC incidence (OR: 0.63; 95%CI = 0.51-0.79; p 0.001) as well as of post-treatment mortality (OR: 0.54; 95%CI = 0.35-0.83; p = 0.006).Current data suggest that APT correlated with higher HCC incidence and poor overall survival following tumour treatment.

Published
2023

160. Nationwide survey of liver transplantation for Primary Sclerosing Cholangitis in Italy

Author

Morelli, M.C., primary, Gambato, M., additional, Martini, S., additional, Carrai, P., additional, Toniutto, P., additional, Giannelli, V., additional, Donato, F., additional, Lenci, I., additional, Pasulo, L., additional, Mazzarelli, C., additional, Ferrarese, A., additional, Rendina, M., additional, Grieco, A., additional, Lanza, A. Galeota, additional, Svegliati-Baroni, G., additional, De Maria, N., additional, Marenco, S., additional, Mameli, L., additional, and Burra, P., additional

Published
2023
Full Text
View/download PDF

164. Hepatitis D: A still relevant disease

Author

Battistella, S., primary, D'Arcangelo, F., additional, Grasso, M., additional, Zanetto, A., additional, Senzolo, M., additional, Germani, G., additional, Gambato, M., additional, Cillo, U., additional, Gringeri, E., additional, Vitale, A., additional, Burra, P., additional, and Russo, F.P., additional

Published
2023
Full Text
View/download PDF

173. Artificial Intelligence and liver: Opportunities and barriers.

Author

Balsano, Clara, Burra, Patrizia, Duvoux, Christophe, Alisi, Anna, Piscaglia, Fabio, and Gerussi, Alessio

Abstract

Artificial Intelligence (AI) has recently been shown as an excellent tool for the study of the liver; however, many obstacles still have to be overcome for the digitalization of real-world hepatology. The authors present an overview of the current state of the art on the use of innovative technologies in different areas (big data, translational hepatology, imaging, and transplant setting). In clinical practice, physicians must integrate a vast array of data modalities (medical history, clinical data, laboratory tests, imaging, and pathology slides) to achieve a diagnostic or therapeutic decision. Unfortunately, machine learning and deep learning are still far from really supporting clinicians in real life. In fact, the accuracy of any technological support has no value in medicine without the support of clinicians. To make better use of new technologies, it is essential to improve clinicians' knowledge about them. To this end, the authors propose that collaborative networks for multidisciplinary approaches will improve the rapid implementation of AI systems for developing disease-customized AI-powered clinical decision support tools. The authors also discuss ethical, educational, and legal challenges that must be overcome to build robust bridges and deploy potentially effective AI in real-world clinical settings. [ABSTRACT FROM AUTHOR]

Published
2023
Full Text
View/download PDF

175. Understanding the structural basis of the binding specificity of c-di-AMP to M. smegmatisRecA using computational biology approach

Author

Burra, V. L. S. Prasad, Sahoo, Partha Sarathi, Dhankhar, Amit, Jhajj, Jatinder, Kasamuthu, Prasanna Sudharson, K, S. S. V. Kiran, and Macha, Samuel Krupa Rakshan

Abstract

AbstractMycobacterium tuberculosis RecA (MtRecA), a protein involved in DNA repair, homologous recombination and SOS pathway, contributes to the development of multidrug resistance. ATP binding-site in RecA has been a drug target to disable RecA dependent DNA repair. For the first time, experiments have shown the existence and binding of c-di-AMP to a novel allosteric site in the C-terminal-Domain (CTD) of Mycobacterium smegmatisRecA (MsRecA), a close homolog of MtRecA. In addition, it was observed that the c-di-AMP was not binding to Escherichia coli RecA (EcRecA). This article analyses the possible interactions of the three RecA homologs with the various c-di-AMP conformations to gain insights into the structural basis of the natural preference of c-di-AMP to MsRecA and not to EcRecA, using the structural biology tools. The comparative analysis, based on amino acid composition, homology, motifs, residue types, docking, molecular dynamics simulations and binding free energy calculations, indeed, conclusively indicates strong binding of c-di-AMP to MsRecA. Having very similar results as MsRecA, it is highly plausible for c-di-AMP to strongly bind MtRecA as well. These insights from the in-silico studies adds a new therapeutic approach against TB through design and development of novel allosteric inhibitors for the first time against MtRecA.Communicated by Ramaswamy H. Sarma

Published
2024
Full Text
View/download PDF

176. Workup and management of liver transplantation in alcohol‐related liver disease

Author

Germani, Giacomo, Degré, Delphine, Moreno, Christophe, and Burra, Patrizia

Abstract

Alcohol‐related liver disease (ALD) represents the most common indication for liver transplantation (LT) worldwide. Outcomes of LT for ALD are comparable with those of LT for other etiologies; however, ALD is still considered a controversial indication for LT, mainly because it is considered a self‐inflicted disease with a high risk of return to alcohol use after LT. Pre‐LT evaluation criteria have changed over time, with a progressive re‐evaluation of the required pre‐transplant duration of abstinence. Despite the fact that some transplant programs still require 6 months of abstinence in order to consider a patient suitable for LT, there is increasing evidence that a pre‐transplant abstinence period of <6 months can be considered for well‐selected patients. Early LT for severe alcohol‐related hepatitis that has not responded to medical therapy has been shown to be an effective therapeutic option with high survival benefit when performed within strict and well‐recognized criteria. However, high variability in LT access exists for these patients due to the presence of social and medical stigma. A psycho‐social assessment, together with an evaluation by an addiction specialist, should be mandatory in patients with ALD who are potential candidates for LT in order to assess the risk of post‐transplant return to alcohol use and to ensure good long‐term outcomes. Finally, before LT, attention should be paid to the presence of other potential comorbidities (i.e., cardiovascular and neurological diseases), which could represent a potential contraindication to LT. Similarly, after LT, patients should be adequately monitored for the development of cardiovascular events and screened for “de novo” tumors, although standardized protocols for this monitoring do not exist at this time.

Published
2024
Full Text
View/download PDF

177. The role of an integrated referral program for patients with liver disease: A network between hub and spoke centers

Author

Germani, Giacomo, Ferrarese, Alberto, D’Arcangelo, Francesca, Russo, Francesco Paolo, Senzolo, Marco, Gambato, Martina, Zanetto, Alberto, Cillo, Umberto, Feltracco, Paolo, Persona, Paolo, Serra, Eugenio, Feltrin, Giuseppe, Carretta, Giovanni, Capizzi, Alfio, Donato, Daniele, Tessarin, Michele, and Burra, Patrizia

Abstract

Access to Liver transplantation (LT) can be affected by several barriers, resulting in delayed referral and increased risk of mortality due to complications of the underlying liver disease. To assess the clinical characteristics and outcomes of patients with acute or chronic liver disease referred using an integrated referral program. An integrated referral program was developed in 1 October 2017 based on email addresses and a 24/7 telephone availability. All consecutive adult patients with liver disease referred for the first time using this referral program were prospectively collected until 1 October 2021. Characteristics and outcomes of inpatients were compared with a historical cohort of patients referred without using the integrated referral program (1 October 2015—1 October 2017). Patients were further divided according to pre‐ and post‐Covid‐19 pandemic. Two hundred eighty‐one referred patients were considered. End stage liver disease was the most common underlying condition (79.3%), 50.5% of patients were referred as inpatients and 74.7% were referred for LT evaluation. When inpatient referrals (n= 142) were compared with the historical cohort (n= 86), a significant increase in acute liver injury due to drugs/herbals and supplements was seen (p= 0.01) as well as an increase in End stage liver disease due to alcohol‐related liver disease and NASH, although not statistically significant. A significant increase in referrals for evaluation for Trans‐jugular intrahepatic portosystemic shunt placement was seen over time (5.6% vs. 1%; p= 0.01) as well as for LT evaluation (84.5% vs. 81%; p= 0.01). Transplant‐free survival was similar between the study and control groups (p= 0.3). The Covid‐19 pandemic did not affect trends of referrals and patient survival. The development of an integrated referral program for patients with liver disease can represent the first step to standardize already existing referral networks between hub and spoke centers. Future studies should focus on the timing of referral according to different etiologies to optimize treatment options and outcomes.

Published
2024
Full Text
View/download PDF

178. Homeless and Housed Inpatients with Schizophrenia: Disparities in Service Access upon Discharge from Hospital

Author

Burra, Tara A., Hwang, Stephen W., and Rourke, Sean B.

Abstract

This study examines differences in services available at the time of discharge for homeless and housed psychiatric inpatients. Participants diagnosed with schizophrenia or schizoaffective disorder were recruited from a general hospital psychiatric inpatient unit. Thirty homeless individuals and 21 housed controls (matched for diagnosis, gender, and age) completed a questionnaire and clinical interview. Data on discharge services were extracted from the electronic health record. Factors associated with access to services were examined using logistic regression models. Despite a similar duration of hospitalization to housed participants, homeless participants were significantly less likely to have outpatient follow-up with a family physician, intensive case management, assertive community treatment, income support or prescription drug coverage at the time of discharge from hospital. Although inpatient hospitalization presents an opportunity to reduce homeless people's barriers to accessing health and social services, our results show inequities for homeless people persist at the time of discharge.

Published
2012
Full Text
View/download PDF

179. Overview of Prognostic Systems for Hepatocellular Carcinoma and ITA.LI.CA External Validation of MESH and CNLC Classifications

Author

Vitale, A, Farinati, F, Finotti, M, Di Renzo, C, Brancaccio, G, Piscaglia, F, Cabibbo, G, Caturelli, E, Missale, G, Marra, F, Sacco, R, Giannini, Eg, Trevisani, F, Cillo, U, Bhoori, S, Borzio, M, Burra, P, Casadei Gardini, A, Carrai, P, Conti, F, Cozzolongo, R, Cucchetti, A, D'Ambrosio, R, Dell'Unto, C, De Matthaeis, N, Di Costanzo, Gg, Di Sandro, S, Famularo, S, Foschi, Fg, Fucilli, F, Galati, G, Gambato, M, Gasbarrini, A, Giuliante, F, Ghinolfi, D, Grieco, A, Gruttadauria, S, Guarino, M, Iavarone, M, Kostandini, A, Lai, Q, Lenci, I, Levi Sandri, Gv, Losito, F, Lupo, Lg, Marasco, G, Manzia, Tm, Mazzocato, S, Masarone, M, Melandro, F, Mescoli, C, Miele, L, Morisco, F, Muley, M, Nicolini, D, Pagano, D, Persico, M, Pompili, M, Ponziani, Fr, Pravisani, R, Rapaccini, Gl, Rendina, M, Renzulli, M, Romano, F, Rossi, M, Rreka, E, Russo, Fp, Sangiovanni, A, Sessa, A, Simonetti, N, Sposito, C, Tortora, R, Vigano, L, Vigano, M, Villa, E, Vincenzi, V, Violi, P, Azzaroli, F, Brunetto, Mr, Di Marco, A, Masotto, A, Mega, A, Nardone, G, Oliveri, F, Raimondo, G, Svegliati Baroni, G, Vidili, G, Zoli, M, Vitale A., Farinati F., Finotti M., Di Renzo C., Brancaccio G., Piscaglia F., Cabibbo G., Caturelli E., Missale G., Marra F., Sacco R., Giannini E.G., Trevisani F., Cillo U., Bhoori S., Borzio M., Burra P., Casadei Gardini A., Carrai P., Conti F., Cozzolongo R., Cucchetti A., D'ambrosio R., Dell'unto C., De Matthaeis N., Di Costanzo G.G., Di Sandro S., Famularo S., Foschi F.G., Fucilli F., Galati G., Gambato M., Gasbarrini A., Giuliante F., Ghinolfi D., Grieco A., Gruttadauria S., Guarino M., Iavarone M., Kostandini A., Lai Q., Lenci I., Levi Sandri G.V., Losito F., Lupo L.G., Marasco G., Manzia T.M., Mazzocato S., Masarone M., Melandro F., Mescoli C., Miele L., Morisco F., Muley M., Nicolini D., Pagano D., Persico M., Pompili M., Ponziani F.R., Pravisani R., Rapaccini G.L., Rendina M., Renzulli M., Romano F., Rossi M., Rreka E., Russo F.P., Sangiovanni A., Sessa A., Simonetti N., Sposito C., Tortora R., Vigano L., Vigano M., Villa E., Vincenzi V., Violi P., Azzaroli F., Brunetto M.R., Di Marco A., Masotto A., Mega A., Nardone G., Oliveri F., Raimondo G., Svegliati Baroni G., Vidili G., Zoli M., Vitale, A., Farinati, F., Finotti, M., Di Renzo, C., Brancaccio, G., Piscaglia, F., Cabibbo, G., Caturelli, E., Missale, G., Marra, F., Sacco, R., Giannini, E. G., Trevisani, F., Cillo, U., Bhoori, S., Borzio, M., Burra, P., Casadei Gardini, A., Carrai, P., Conti, F., Cozzolongo, R., Cucchetti, A., D'Ambrosio, R., Dell'Unto, C., De Matthaeis, N., Di Costanzo, G. G., Di Sandro, S., Famularo, S., Foschi, F. G., Fucilli, F., Galati, G., Gambato, M., Gasbarrini, A., Giuliante, F., Ghinolfi, D., Grieco, A., Gruttadauria, S., Guarino, M., Iavarone, M., Kostandini, A., Lai, Q., Lenci, I., Levi Sandri, G. V., Losito, F., Lupo, L. G., Marasco, G., Manzia, T. M., Mazzocato, S., Masarone, M., Melandro, F., Mescoli, C., Miele, L., Morisco, F., Muley, M., Nicolini, D., Pagano, D., Persico, M., Pompili, M., Ponziani, F. R., Pravisani, R., Rapaccini, G. L., Rendina, M., Renzulli, M., Romano, F., Rossi, M., Rreka, E., Russo, F. P., Sangiovanni, A., Sessa, A., Simonetti, N., Sposito, C., Tortora, R., Vigano, L., Vigano, M., Villa, E., Vincenzi, V., Violi, P., Azzaroli, F., Brunetto, M. R., Di Marco, A., Masotto, A., Mega, A., Nardone, G., Oliveri, F., Raimondo, G., Svegliati Baroni, G., Vidili, G., and Zoli, M.

Subjects
Cancer Research, medicine.medical_specialty, Review, lcsh:RC254-282, Prognostic score, 03 medical and health sciences, 0302 clinical medicine, medicine, In patient, Medical physics, Staging system, monotonicity of gradients, Settore MED/12 - Gastroenterologia, discrimination ability, hepatocellular carcinoma, homogeneity, prognostic performance, prognostic system, business.industry, External validation, Mono-tonicity of gradient, medicine.disease, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Settore MED/18, Oncology, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, Population data, 030211 gastroenterology & hepatology, General health, Liver dysfunction, business
Abstract

Simple Summary This review proposes a comprehensive overview of the main prognostic systems for HCC classified as prognostic scores, staging systems, or combined systems. Prognostic systems for HCC are usually compared in terms of homogeneity, monotonicity of gradients, and discrimination ability. However, despite the great number of published studies comparing HCC prognostic systems, it is rather difficult to identify a system that could be universally accepted as the best prognostic scheme for all HCC patients encountered in clinical practice. In order to give a contribute in this topic, we conducted a study aimed at externally validate the MESH score and the CNLC classification using the ITA.LI.CA database. Abstract Prognostic assessment in patients with HCC remains an extremely difficult clinical task due to the complexity of this cancer where tumour characteristics interact with degree of liver dysfunction, patient general health status, and a large span of available treatment options. Several prognostic systems have been proposed in the last three decades, both from the Asian and European/North American countries. Prognostic scores, such as the CLIP score and the recent MESH score, have been generated on a solid statistical basis from real life population data, while staging systems, such as the BCLC scheme and the recent CNLC classification, have been created by experts according to recent HCC prognostic evidences from the literature. A third category includes combined prognostic systems that can be used both as prognostic scores and staging systems. A recent example is the ITA.LI.CA prognostic system including either a prognostic score and a simplified staging system. This review focuses first on an overview of the main prognostic systems for HCC classified according to the above three categories, and, second, on a comprehensive description of the methodology required for a correct comparison between different systems in terms of prognostic performance. In this second section the main studies in the literature comparing different prognostic systems are described in detail. Lastly, a formal comparison between the last prognostic systems proposed for each of the above three categories is performed using a large Italian database including 6882 HCC patients in order to concretely apply the comparison rules previously described.

Published
2021

180. Hepatocellular carcinoma progression during bridging before liver transplantation

Author

Renner, P, Da Silva, T, Schnitzbauer, A, Verloh, N, Schlitt, H, Geissler, E, Zulke, C, Lamby, P, Proneth, A, Duvoux, C, Burra, P, Jauch, K, Rentsch, M, Ganten, T, Schmidt, J, Settmacher, U, Heise, M, Rossi, G, Cillo, U, Kneteman, N, Adam, R, Van Hoek, B, Bachellier, P, Wolf, P, Rostaing, L, Bechstein, W, Rizell, M, Powell, J, Hidalgo, E, Gugenheim, J, Wolters, H, Brockmann, J, Roy, A, Mutzbauer, I, Schlitt, A, Beckebaum, S, Graeb, C, Nadalin, S, Valente, U, Sanchez Turrion, V, Jamieson, N, Scholz, T, Colledan, M, Fandrich, F, Becker, T, Soderdahl, G, Chazouilleres, O, Makisalo, H, Pageaux, G, Steininger, R, Soliman, T, De Jong, K, Pirenne, J, Margreiter, R, Pratschke, J, Pinna, A, Hauss, J, Schreiber, S, Strasser, S, Klempnauer, J, Troisi, R, Bhoori, S, Lerut, J, Bilbao, I, Klein, C, Konigsrainer, A, Otto, G, Mazzaferro, V, Neuhaus, P, Renner P., Da Silva T., Schnitzbauer A. A., Verloh N., Schlitt H. J., Geissler E. K., Zulke C., Lamby P. E., Proneth A., Duvoux C., Burra P., Jauch K. -W., Rentsch M., Ganten T. M., Schmidt J., Settmacher U., Heise M., Rossi G., Cillo U., Kneteman N., Adam R., Van Hoek B., Bachellier P., Wolf P., Rostaing L., Bechstein W. O., Rizell M., Powell J., Hidalgo E., Gugenheim J., Wolters H., Brockmann J., Roy A., Mutzbauer I., Schlitt A., Beckebaum S., Graeb C., Nadalin S., Valente U., Sanchez Turrion V., Jamieson N., Scholz T., Colledan M., Fandrich F., Becker T., Soderdahl G., Chazouilleres O., Makisalo H., Pageaux G. -P., Steininger R., Soliman T., De Jong K. P., Pirenne J., Margreiter R., Pratschke J., Pinna A. D., Hauss J., Schreiber S., Strasser S., Klempnauer J., Troisi R. I., Bhoori S., Lerut J., Bilbao I., Klein C. G., Konigsrainer A., Otto G., Mazzaferro V., Neuhaus P., Renner, P, Da Silva, T, Schnitzbauer, A, Verloh, N, Schlitt, H, Geissler, E, Zulke, C, Lamby, P, Proneth, A, Duvoux, C, Burra, P, Jauch, K, Rentsch, M, Ganten, T, Schmidt, J, Settmacher, U, Heise, M, Rossi, G, Cillo, U, Kneteman, N, Adam, R, Van Hoek, B, Bachellier, P, Wolf, P, Rostaing, L, Bechstein, W, Rizell, M, Powell, J, Hidalgo, E, Gugenheim, J, Wolters, H, Brockmann, J, Roy, A, Mutzbauer, I, Schlitt, A, Beckebaum, S, Graeb, C, Nadalin, S, Valente, U, Sanchez Turrion, V, Jamieson, N, Scholz, T, Colledan, M, Fandrich, F, Becker, T, Soderdahl, G, Chazouilleres, O, Makisalo, H, Pageaux, G, Steininger, R, Soliman, T, De Jong, K, Pirenne, J, Margreiter, R, Pratschke, J, Pinna, A, Hauss, J, Schreiber, S, Strasser, S, Klempnauer, J, Troisi, R, Bhoori, S, Lerut, J, Bilbao, I, Klein, C, Konigsrainer, A, Otto, G, Mazzaferro, V, Neuhaus, P, Renner P., Da Silva T., Schnitzbauer A. A., Verloh N., Schlitt H. J., Geissler E. K., Zulke C., Lamby P. E., Proneth A., Duvoux C., Burra P., Jauch K. -W., Rentsch M., Ganten T. M., Schmidt J., Settmacher U., Heise M., Rossi G., Cillo U., Kneteman N., Adam R., Van Hoek B., Bachellier P., Wolf P., Rostaing L., Bechstein W. O., Rizell M., Powell J., Hidalgo E., Gugenheim J., Wolters H., Brockmann J., Roy A., Mutzbauer I., Schlitt A., Beckebaum S., Graeb C., Nadalin S., Valente U., Sanchez Turrion V., Jamieson N., Scholz T., Colledan M., Fandrich F., Becker T., Soderdahl G., Chazouilleres O., Makisalo H., Pageaux G. -P., Steininger R., Soliman T., De Jong K. P., Pirenne J., Margreiter R., Pratschke J., Pinna A. D., Hauss J., Schreiber S., Strasser S., Klempnauer J., Troisi R. I., Bhoori S., Lerut J., Bilbao I., Klein C. G., Konigsrainer A., Otto G., Mazzaferro V., and Neuhaus P.

Abstract

Background: Recipient selection for liver transplantation in hepatocellular carcinoma (HCC) is based primarily on criteria affecting the chance of long-term success. Here, the relationship between pretransplant bridging therapy and long-term survival was investigated in a subgroup analysis of the SiLVER Study. Methods: Response to bridging, as defined by comparison of imaging at the time of listing and post-transplant pathology report, was categorized into controlled versus progressive disease (more than 20 per cent tumour growth or development of new lesions). Results: Of 525 patients with HCC who had liver transplantation, 350 recipients underwent pretransplant bridging therapy. Tumour progression despite bridging was an independent risk factor affecting overall survival (hazard ratio 1.80; P=0.005). For patients within the Milan criteria (MC) at listing, mean overall survival was longer for those with controlled versus progressive disease (6.8 versus 5.8 years; P<0.001). Importantly, patients with HCCs outside the MC that were downsized to within the MC before liver transplantation had poor outcomes compared with patients who never exceeded the MC (mean overall survival 6.2 versus 6.6 years respectively; P=0.030). Conclusion: Patients with HCCs within the MC that did not show tumour progression under locoregional therapy had the best outcomes after liver transplantation. Downstaging into the limits of the MC did not improve the probability of survival. Prognostic factors determining the long-term success of liver transplantation in patients with hepatocellular carcinoma are still under discussion. A subgroup analysis of the SiLVER trial showed that disease control under bridging therapy is strongly associated with improved prognosis in terms of overall survival. However, in tumours exceeding the limits of the Milan criteria, downstaging did not restore the probability of survival compared with that of patients within the Milan criteria.

Published
2021

181. International study on the outcome of locoregional therapy for liver transplant in hepatocellular carcinoma beyond Milan criteria

Author

Degroote, H, Piñero, F, Costentin, C, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Chagas, A, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Di Benedetto, F, Duque, S, Salame, E, Cillo, U, Gadano, A, Vanlemmens, C, Fagiuoli, S, Rubinstein, F, Burra, P, Cherqui, D, Silva, M, Van Vlierberghe, H, Duvoux, C, Degroote H, Piñero F, Costentin C, Notarpaolo A, Boin IF, Boudjema K, Baccaro C, Chagas AL, Bachellier P, Ettorre GM, Poniachik J, Muscari F, Di Benedetto F, Duque SH, Salame E, Cillo U, Gadano A, Vanlemmens C, Fagiuoli S, Rubinstein F, Burra P, Cherqui D, Silva M, Van Vlierberghe H, Duvoux C, Degroote, H, Piñero, F, Costentin, C, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Chagas, A, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Di Benedetto, F, Duque, S, Salame, E, Cillo, U, Gadano, A, Vanlemmens, C, Fagiuoli, S, Rubinstein, F, Burra, P, Cherqui, D, Silva, M, Van Vlierberghe, H, Duvoux, C, Degroote H, Piñero F, Costentin C, Notarpaolo A, Boin IF, Boudjema K, Baccaro C, Chagas AL, Bachellier P, Ettorre GM, Poniachik J, Muscari F, Di Benedetto F, Duque SH, Salame E, Cillo U, Gadano A, Vanlemmens C, Fagiuoli S, Rubinstein F, Burra P, Cherqui D, Silva M, Van Vlierberghe H, and Duvoux C

Abstract

Background & Aims: Good outcomes after liver transplantation (LT) have been reported after successfully downstaging to Milan criteria in more advanced hepatocellular carcinoma (HCC). We aimed to compare post-LT outcomes in patients receiving locoregional therapies (LRT) before LT according to Milan criteria and University of California San Francisco downstaging (UCSF-DS) protocol and ‘all-comers’. Methods: This multicentre cohort study included patients who received any LRT before LT from Europe and Latin America (2000–2018). We excluded patients with alpha-foetoprotein (AFP) above 1,000 ng/ml. Competing risk regression analysis for HCC recurrence was conducted, estimating subdistribution hazard ratios (SHRs) and corresponding 95% CIs. Results: From 2,441 LT patients, 70.1% received LRT before LT (n = 1,711). Of these, 80.6% were within Milan, 12.0% within UCSF-DS, and 7.4% all-comers. Successful downstaging was achieved in 45.2% (CI 34.8–55.8) and 38.2% (CI 25.4–52.3) of the UCSF-DS group and all-comers, respectively. The risk of recurrence was higher for all-comers (SHR 6.01 [p <0.0001]) and not significantly higher for the UCSF-DS group (SHR 1.60 [p = 0.32]), compared with patients remaining within Milan. The all-comers presented more frequent features of aggressive HCC and higher tumour burden at explant. Among the UCSF-DS group, an AFP value of ≤20 ng/ml at listing was associated with lower recurrence (SHR 2.01 [p = 0.006]) and better survival. However, recurrence was still significantly high irrespective of AFP ≤20 ng/ml in all-comers. Conclusions: Patients within the UCSF-DS protocol at listing have similar post-transplant outcomes compared with those within Milan when successfully downstaged. Meanwhile, all-comers have a higher recurrence and inferior survival irrespective of response to LRT. Additionally, in the UCSF-DS group, an ALP of ≤20 ng/ml might be a novel tool to optimise selection of candidates for LT. Clinical trial number: This study was r

Published
2021

182. Italian association for the study of the liver position statement on SARS-CoV2 vaccination

Author

Russo, F, Piano, S, Bruno, R, Burra, P, Puoti, M, Masarone, M, Montagnese, S, Ponziani, F, Petta, S, Aghemo, A, Russo F. P., Piano S., Bruno R., Burra P., Puoti M., Masarone M., Montagnese S., Ponziani F. R., Petta S., Aghemo A., Russo, F, Piano, S, Bruno, R, Burra, P, Puoti, M, Masarone, M, Montagnese, S, Ponziani, F, Petta, S, Aghemo, A, Russo F. P., Piano S., Bruno R., Burra P., Puoti M., Masarone M., Montagnese S., Ponziani F. R., Petta S., and Aghemo A.

Abstract

The vaccination campaign against Sars-CoV-2 commenced in Italy at the end of December 2020. The first ones to receive the immunization against the virus were the health workers and the residents of nursing homes, following which the vaccine would be available for the entire population, beginning with the most vulnerable individuals. SARS-CoV2 vaccines have been demonstrated to be safe for the general population, although no data for patients with liver diseases or those having undergone liver transplantation are available so far. The present position statement AISF is an attempt to suggest, based on the published data on the impact of Sars-Cov-2 infection in patients with chronic liver disease, a possible priority for vaccination for this category of patients.

Published
2021

184. Risk factors and outcomes associated with recurrent autoimmune hepatitis following liver transplantation

Author

Montano-Loza, A.J., Ronca, V., Ebadi, M., Hansen, B.E., Hirschfield, G., Elwir, S., Alsaed, M., Milkiewicz, P., Janik, M.K., Marschall, H.U., Burza, M.A., Efe, C., Caliskan, A.R., Harputluoglu, M., Kabacam, G., Terrabuio, D., Onofrio, F.D., Selzner, N., Bonder, A., Pares, A., Llovet, L., Akyildiz, M., Arikan, C., Manns, M.P., Taubert, R., Weber, A.L., Schiano, T.D., Haydel, B., Czubkowski, P., Socha, P., Oldak, N., Akamatsu, N., Tanaka, A., Levy, C., Martin, E.F., Goel, A., Sedki, M., Jankowska, I., Ikegami, T., Rodriguez, M., Sterneck, M., Weiler-Normann, C., Schramm, C., Donato, M.F., Lohse, A., Andrade, R.J., Patwardhan, V.R., Hoek, B. van, Biewenga, M., Kremer, A.E., Ueda, Y., Deneau, M., Pedersen, M., Mayo, M.J., Floreani, A., Burra, P., Secchi, M.F., Beretta-Piccoli, B.T., Sciveres, M., Maggiore, G., Jafri, S.M., Debray, D., Girard, M., Lacaille, F., Lytvyak, E., Mason, A.L., Heneghan, M., Oo, Y.H., and Int Autoimmune Hepatitis Grp IAIHG

Subjects
Adult, Male, Hepatology, liver transplantation, recurrent disease, autoimmune liver disease, graft survival, Mycophenolic Acid, survival, Hepatitis, Autoimmune, Recurrence, Risk Factors, Immunoglobulin G, Humans, Female, Immunosuppressive Agents
Abstract

Background & Aims: Autoimmune hepatitis can recur after liver transplantation (LT), though the impact of recurrence on patient and graft survival has not been well characterized. We evaluated a large, international, multicenter cohort to identify the probability and risk factors associated with recurrent AIH and the association between recurrent disease and patient and graft survival.Methods: We included 736 patients (77% female, mean age 42 +/- 1 years) with AIH who underwent LT from January 1987 through June 2020, among 33 centers in North America, South America, Europe and Asia. Clinical data before and after LT, biochemical data within the first 12 months after LT, and immunosuppression after LT were analyzed to identify patients at higher risk of AIH recurrence based on histological diagnosis.Results: AIH recurred in 20% of patients after 5 years and 31% after 10 years. Age at LT

Published
2022

185. A prospective multicentre study of the epidemiology and outcomes of bloodstream infection in cirrhotic patients

Author

Campoli, C., Siccardi, G., Ambretti, S., Stallmach, A., Venditti, M., Lucidi, C., Ludovisi, S., De Cueto, M., Navarro, M.D., Lopez Cortes, E., Bouza, E., Valerio, M., Eworo, A., Losito, R., Senzolo, M., Nadal, E., Ottobrelli, A., Varguvic, M., Badia, C., Borgia, G., Gentile, I., Buonomo, A.R., Boumis, E., Beteta-Lopez, A., Rianda, A., Taliani, G., Grieco, S., Bartoletti, M., Giannella, M., Lewis, R., Caraceni, P., Tedeschi, S., Paul, M., Schramm, C., Bruns, T., Merli, M., Cobos-Trigueros, N., Seminari, E., Retamar, P., Muñoz, P., Tumbarello, M., Burra, P., Torrani Cerenzia, M., Barsic, B., Calbo, E., Maraolo, A.E., Petrosillo, N., Galan-Ladero, M.A., D'Offizi, G., Bar Sinai, N., Rodríguez-Baño, J., Verucchi, G., Bernardi, M., and Viale, P.

Published
2018
Full Text
View/download PDF

187. Long‐term outcomes of direct acting antivirals in post‐transplant advanced hepatitis C virus recurrence and fibrosing cholestatic hepatitis

Author

Vukotic, R., Conti, F., Fagiuoli, S., Morelli, M. C., Pasulo, L., Colpani, M., Foschi, F. G., Berardi, S., Pianta, P., Mangano, M., Donato, M. F., Malinverno, F., Monico, S., Tamè, M., Mazzella, G., Belli, L. S., Viganò, R., Carrai, P., Burra, P., Russo, F. P., Lenci, I., Toniutto, P., Merli, M., Loiacono, L., Iemmolo, R., Degli Antoni, A. M., Romano, A., Picciotto, A., Rendina, M., and Andreone, P.

Published
2017
Full Text
View/download PDF

190. I POSSEDIMENTI DEL MONASTERO BENEDETTINO DI S. NICOLÒ D'OLTRA (1771).

Author

BURRA, Aleksandro

Abstract

Copyright of Annals for Istrian & Mediterranean Studies / Annales: Series Historia et Sociologia is the property of Historical Society of Southern Primorska of Koper and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2023
Full Text
View/download PDF

194. Advancing the global public health agenda for NAFLD: a consensus statement

Author

Lazarus, J.V. Mark, H.E. Anstee, Q.M. Arab, J.P. Batterham, R.L. Castera, L. Cortez-Pinto, H. Crespo, J. Cusi, K. Dirac, M.A. Francque, S. George, J. Hagström, H. Huang, T.T.-K. Ismail, M.H. Kautz, A. Sarin, S.K. Loomba, R. Miller, V. Newsome, P.N. Ninburg, M. Ocama, P. Ratziu, V. Rinella, M. Romero, D. Romero-Gómez, M. Schattenberg, J.M. Tsochatzis, E.A. Valenti, L. Wong, V.W.-S. Yilmaz, Y. Younossi, Z.M. Zelber-Sagi, S. Åberg, F. Adams, L. Khatry, M.S.A. Naamani, K.A. Murillo, O.A. Allen, A.M. Alnaser, F. Alqahtani, S.A. Alswat, K. Alvaro, D. Andrade, R.J. Arrese, M. Awuku, Y.A. Ayesha, M. Baatarkhuu, O. Bakieva, S. Basu, R. Bataller, R. Bedri, S. Bosi, E. Bourliere, M. Bruha, R. Bugianesi, E. Burra, P. Buti, M. Byrne, C.D. Calleja, J.L. Carrieri, P. Carter, F. Fernandez, M.I.C. Castillo-Lopez, G. Castro-Narro, G.E. Chan, H.L.Y. Chan, W.-K. Chang, Y. Colombo, M. Coppell, K.J. Corey, K. Craxi, A. Cryer, D. Dassanayake, A. Martins, A.A.S. de Ledinghen, V. DelPrato, S. Demaio, A. Desalegn, H. Dillon, J. Duseja, A. Dorairaj, P. Ekstedt, M. El Kassas, M. Elsanousi, O.M. Esmat, G. Fan, J.-G. Farpour-Lambert, N. Flisiak, R. Fouad, Y. Fuchs, M. Gani, R.A. Gerber, L. Ghazinyan, H. Gheorghe, L. Goh, G.B.-B. Grønbæk, H. Gulnara, A. Hamid, S. Hebditch, V. Hickman, I.J. Hocking, S.L. Hunyady, B. Idilman, R. Isakov, V.A. Jamal, M.H. Jepsen, P. Iskandar, N.J. Song, M.J. Sudhamshu, K.C. Kakizaki, S. Kalamitsis, G. Kanwal, F. Kao, J.-H. Kaplan, L. Kawaguchi, T. Khader, Y. Kim, S.U. Kodjoh, N. Koek, G. Koike, K. Komas, N.P. Korenjak, M. Kugelmas, M. Labidi, A. Lange, N.F. Lavine, J.E. Lazo, M. Lee, N. Lesmana, C.R.A. Liu, C.-J. Long, M.T. Lopez-Jaramillo, P. Malekzadeh, R. Mahtab, M.A. Marchesini, G. Marinho, R. Vázquez, S.E.M. Mateva, L. Nlombi, C.M. Melin, P. Mikolasevic, I. Milovanovic, T. Musso, C. Nakajima, A. Nava, E. Nersesov, A.V. Nikolova, D. Norris, S. Novak, K. Oben, J. Ong, J.P. Onyekwere, C. Papatheodoridis, G. Paruk, I. Patel, K. Macedo, M.P. Penha-Gonçalves, C. Figue and Lazarus, J.V. Mark, H.E. Anstee, Q.M. Arab, J.P. Batterham, R.L. Castera, L. Cortez-Pinto, H. Crespo, J. Cusi, K. Dirac, M.A. Francque, S. George, J. Hagström, H. Huang, T.T.-K. Ismail, M.H. Kautz, A. Sarin, S.K. Loomba, R. Miller, V. Newsome, P.N. Ninburg, M. Ocama, P. Ratziu, V. Rinella, M. Romero, D. Romero-Gómez, M. Schattenberg, J.M. Tsochatzis, E.A. Valenti, L. Wong, V.W.-S. Yilmaz, Y. Younossi, Z.M. Zelber-Sagi, S. Åberg, F. Adams, L. Khatry, M.S.A. Naamani, K.A. Murillo, O.A. Allen, A.M. Alnaser, F. Alqahtani, S.A. Alswat, K. Alvaro, D. Andrade, R.J. Arrese, M. Awuku, Y.A. Ayesha, M. Baatarkhuu, O. Bakieva, S. Basu, R. Bataller, R. Bedri, S. Bosi, E. Bourliere, M. Bruha, R. Bugianesi, E. Burra, P. Buti, M. Byrne, C.D. Calleja, J.L. Carrieri, P. Carter, F. Fernandez, M.I.C. Castillo-Lopez, G. Castro-Narro, G.E. Chan, H.L.Y. Chan, W.-K. Chang, Y. Colombo, M. Coppell, K.J. Corey, K. Craxi, A. Cryer, D. Dassanayake, A. Martins, A.A.S. de Ledinghen, V. DelPrato, S. Demaio, A. Desalegn, H. Dillon, J. Duseja, A. Dorairaj, P. Ekstedt, M. El Kassas, M. Elsanousi, O.M. Esmat, G. Fan, J.-G. Farpour-Lambert, N. Flisiak, R. Fouad, Y. Fuchs, M. Gani, R.A. Gerber, L. Ghazinyan, H. Gheorghe, L. Goh, G.B.-B. Grønbæk, H. Gulnara, A. Hamid, S. Hebditch, V. Hickman, I.J. Hocking, S.L. Hunyady, B. Idilman, R. Isakov, V.A. Jamal, M.H. Jepsen, P. Iskandar, N.J. Song, M.J. Sudhamshu, K.C. Kakizaki, S. Kalamitsis, G. Kanwal, F. Kao, J.-H. Kaplan, L. Kawaguchi, T. Khader, Y. Kim, S.U. Kodjoh, N. Koek, G. Koike, K. Komas, N.P. Korenjak, M. Kugelmas, M. Labidi, A. Lange, N.F. Lavine, J.E. Lazo, M. Lee, N. Lesmana, C.R.A. Liu, C.-J. Long, M.T. Lopez-Jaramillo, P. Malekzadeh, R. Mahtab, M.A. Marchesini, G. Marinho, R. Vázquez, S.E.M. Mateva, L. Nlombi, C.M. Melin, P. Mikolasevic, I. Milovanovic, T. Musso, C. Nakajima, A. Nava, E. Nersesov, A.V. Nikolova, D. Norris, S. Novak, K. Oben, J. Ong, J.P. Onyekwere, C. Papatheodoridis, G. Paruk, I. Patel, K. Macedo, M.P. Penha-Gonçalves, C. Figue

Abstract

Non-alcoholic fatty liver disease (NAFLD) is a potentially serious liver disease that affects approximately one-quarter of the global adult population, causing a substantial burden of ill health with wide-ranging social and economic implications. It is a multisystem disease and is considered the hepatic component of metabolic syndrome. Unlike other highly prevalent conditions, NAFLD has received little attention from the global public health community. Health system and public health responses to NAFLD have been weak and fragmented, and, despite its pervasiveness, NAFLD is largely unknown outside hepatology and gastroenterology. There is only a nascent global public health movement addressing NAFLD, and the disease is absent from nearly all national and international strategies and policies for non-communicable diseases, including obesity. In this global Delphi study, a multidisciplinary group of experts developed consensus statements and recommendations, which a larger group of collaborators reviewed over three rounds until consensus was achieved. The resulting consensus statements and recommendations address a broad range of topics — from epidemiology, awareness, care and treatment to public health policies and leadership — that have general relevance for policy-makers, health-care practitioners, civil society groups, research institutions and affected populations. These recommendations should provide a strong foundation for a comprehensive public health response to NAFLD. © 2021, Springer Nature Limited.

Published
2022

195. The EASL–Lancet Liver Commission: protecting the next generation of Europeans against liver disease complications and premature mortality

Author

Karlsen, TH, Sheron, N, Zelber-Sagi, S, Carrieri, P, Dusheiko, G, Bugianesi, E, Pryke, R, Hutchinson, SJ, Sangro, B, Martin, NK, Cecchini, M, Dirac, MA, Belloni, A, Serra-Burriel, M, Ponsioen, CY, Sheena, B, Lerouge, A, Devaux, M, Scott, N, Hellard, M, Verkade, HJ, Sturm, E, Marchesini, G, Yki-Järvinen, H, Byrne, CD, Targher, G, Tur-Sinai, A, Barrett, D, Ninburg, M, Reic, T, Taylor, A, Rhodes, T ; https://orcid.org/0000-0003-2400-9838, Treloar, C ; https://orcid.org/0000-0002-8230-0386, Petersen, C, Schramm, C, Flisiak, R, Simonova, MY, Pares, A, Johnson, P, Cucchetti, A, Graupera, I, Lionis, C, Pose, E, Fabrellas, N, Ma, AT, Mendive, JM, Mazzaferro, V, Rutter, H, Cortez-Pinto, H, Kelly, D, Burton, R, Lazarus, JV, Ginès, P, Buti, M, Newsome, PN, Burra, P, Manns, MP, Karlsen, TH, Sheron, N, Zelber-Sagi, S, Carrieri, P, Dusheiko, G, Bugianesi, E, Pryke, R, Hutchinson, SJ, Sangro, B, Martin, NK, Cecchini, M, Dirac, MA, Belloni, A, Serra-Burriel, M, Ponsioen, CY, Sheena, B, Lerouge, A, Devaux, M, Scott, N, Hellard, M, Verkade, HJ, Sturm, E, Marchesini, G, Yki-Järvinen, H, Byrne, CD, Targher, G, Tur-Sinai, A, Barrett, D, Ninburg, M, Reic, T, Taylor, A, Rhodes, T ; https://orcid.org/0000-0003-2400-9838, Treloar, C ; https://orcid.org/0000-0002-8230-0386, Petersen, C, Schramm, C, Flisiak, R, Simonova, MY, Pares, A, Johnson, P, Cucchetti, A, Graupera, I, Lionis, C, Pose, E, Fabrellas, N, Ma, AT, Mendive, JM, Mazzaferro, V, Rutter, H, Cortez-Pinto, H, Kelly, D, Burton, R, Lazarus, JV, Ginès, P, Buti, M, Newsome, PN, Burra, P, and Manns, MP

Published
2022

196. Immune Activation, Exhaustion and Senescence Profiles as Possible Predictors of Cancer in Liver Transplanted Patients

Author

Petrara, MR, Shalaby, S, Ruffoni, E, Taborelli, M, Carmona, F, Giunco, S, Del Bianco, P, Piselli, P, Serraino, D, Cillo, U, Dolcetti, R, Burra, P, De Rossi, A, Petrara, MR, Shalaby, S, Ruffoni, E, Taborelli, M, Carmona, F, Giunco, S, Del Bianco, P, Piselli, P, Serraino, D, Cillo, U, Dolcetti, R, Burra, P, and De Rossi, A

Abstract

Liver transplanted (LT) patients for hepatocellular carcinoma (LT-HCC) or for other causes (LT-no-HCC) may develop post-transplantation malignancies. Although immune activation and senescence are frequently implicated in cancer development, no data is available on their possible role as biomarkers predictive of tumor onset in this setting. A total of 116 patients were investigated: the 45 LT-HCC patients were older than the 71 LT-non-HCC (p=0.011), but comparable for sex, HCV, HBV infection and immunosuppressive treatment. At baseline, the numbers of activated and senescent-like circulating cells were significantly higher in LT-HCC patients than in LT-no-HCC ones. After a median follow-up of 26.8 months, 6 post-transplant malignancies (PTM) occurred: 4 in LT-HCC (8.9%) and 2 in LT-no-HCC (2.8%) patients. Overall, subjects with high percentages of activated and exhausted T and B cells at baseline were at higher risk of PTM. Notably, within the LT-HCC group, a higher percentage of senescence-like T cells was also associated with cancer development. Moreover, patients with PTM had higher telomere erosion and higher levels of circulating PAMPs (16S rDNA) and DAMPs (mtDNA) when compared with matched patients without PTM. Overall, these findings suggest that immune activation and exhaustion may be useful to predict the risk of PTM occurrence, regardless of the cause of transplantation. In LT-HCC, T-cell senescence represents an additional risk factor for tumor onset.

Published
2022

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

Author

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

Abstract

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

Published
2022

198. Non-alcoholic fatty liver disease in adults 2021: A clinical practice guideline of the Italian Association for the Study of the Liver (AISF), the Italian Society of Diabetology (SID) and the Italian Society of Obesity (SIO)

Author

Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, Marco, Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., Miele L. (ORCID:0000-0003-3464-0068), Federici M., Marchesini, G., Bugianesi, E., Burra, P., Marra, F., Miele, Luca, Alisi, A., Vajro, P., Masarone, M., Petta, S., Persico, M., Svegliati-Baroni, G., Valenti, L., Federici, Marco, Purrello, F., Sasso, F. C., Targher, G., Busetto, L., Petroni, M. L., Santini, F., Camma, C., Colli, A., Miele L. (ORCID:0000-0003-3464-0068), and Federici M.

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a common and emerging liver disease in adults, paralleling the epidemic of obesity and diabetes, and leading to worrisome events (hepatocellular carcinoma and end-stage liver disease). In the last years, mounting evidence added insights about epidemiology, natural history, diagnosis and lifestyle-based or drug treatment of NAFLD. In this rapidly evolving scenario, members of the Associazione Italiana per lo Studio del Fegato (AISF), the Società Italiana di Diabetologia (SID) and the Società Italiana dell'Obesità (SIO) reviewed current knowledge on NAFLD. The quality of the published evidence is graded, and practical recommendations are made following the rules and the methodology suggested in Italy by the Centro Nazionale per l'Eccellenza delle cure (CNEC) and Istituto Superiore di Sanità (ISS). Whenever possible, recommendations are placed within the context the Italian Healthcare system, with reference to specific experience and local diagnostic and management resources. Level of evidence: Level of evidence of recommendations for each PICO question were reported according to available evidence.

Published
2022

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

Author

Costentin, C, Piñero, F, Degroote, H, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Podestá, L, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Dibenedetto, F, Hoyos Duque, S, Salame, E, Cillo, U, Marciano, S, Vanlemmens, C, Fagiuoli, S, Burra, P, Van Vlierberghe, H, Cherqui, D, Lai, Q, Silva, M, Rubinstein, F, Duvoux, C, Conti, F, Scatton, O, Bernard, P, Francoz, C, Durand, F, Dharancy, S, Woehl, M, Laurent, A, Radenne, S, Dumortier, J, Abergel, A, Barbier, L, Houssel-Debry, P, Pageaux, G, Chiche, L, Deledinghen, V, Hardwigsen, J, Gugenheim, J, Altieri, M, Hilleret, M, Decaens, T, Chagas, A, Costa, P, Cristina de Ataide, E, Quiñones, E, Duque, S, Anders, M, Varón, A, Zerega, A, Soza, A, Machaca, M, Arufe, D, Menéndez, J, Zapata, R, Vilatoba, M, Muñoz, L, Menéndez, R, Maraschio, M, Mccormack, L, Mattera, J, Gadano, A, Fatima Boin, I, Parente García, J, Carrilho, F, Magini, G, Miglioresi, L, Gambato, M, Benedetto, F, D’Ambrosio, C, Vitale, A, Colledan, M, Pinelli, D, Magistri, P, Vennarecci, G, Colasanti, M, Giannelli, V, Pellicelli, A, Vlierberghe, H, Eduard, C, Samuele, I, Jeroen, D, Jonas, S, Jacques, P, Chris, V, Dirk, Y, Peter, M, Valerio, L, Christophe, M, Olivier, D, Jean, D, Roberto, T, Paul, L, Costentin, Charlotte, Piñero, Federico, Degroote, Helena, Notarpaolo, Andrea, Boin, Ilka F., Boudjema, Karim, Baccaro, Cinzia, Podestá, Luis G., Bachellier, Philippe, Ettorre, Giuseppe Maria, Poniachik, Jaime, Muscari, Fabrice, Dibenedetto, Fabrizio, Hoyos Duque, Sergio, Salame, Ephrem, Cillo, Umberto, Marciano, Sebastian, Vanlemmens, Claire, Fagiuoli, Stefano, Burra, Patrizia, Van Vlierberghe, Hans, Cherqui, Daniel, Lai, Quirino, Silva, Marcelo, Rubinstein, Fernando, Duvoux, Christophe, Conti, Filomena, Scatton, Olivier, Bernard, Pierre Henri, Francoz, Claire, Durand, Francois, Dharancy, Sébastien, Woehl, Marie-lorraine., Laurent, Alexis, Radenne, Sylvie, Dumortier, Jérôme, Abergel, Armand, Barbier, Louise, Houssel-Debry, Pauline, Pageaux, Georges Philippe, Chiche, Laurence, Deledinghen, Victor, Hardwigsen, Jean, Gugenheim, J., altieri, M., Hilleret, Marie Noelle, Decaens, Thomas, Chagas, Aline, Costa, Paulo, Cristina de Ataide, Elaine, Quiñones, Emilio, Duque, Sergio Hoyos, Marciano, Sebastián, Anders, Margarita, Varón, Adriana, Zerega, Alina, Soza, Alejandro, Machaca, Martín Padilla, Arufe, Diego, Menéndez, Josemaría, Zapata, Rodrigo, Vilatoba, Mario, Muñoz, Linda, Menéndez, Ricardo Chong, Maraschio, Martín, McCormack, Lucas, Mattera, Juan, Gadano, Adrian, Fatima Boin, Ilka SF., Parente García, Jose Huygens, Carrilho, Flair, Magini, Giulia, Miglioresi, Lucia, Gambato, Martina, Benedetto, Fabrizio Di, D’Ambrosio, Cecilia, Vitale, Alessandro, Colledan, Michele, Pinelli, Domenico, Magistri, Paolo, Vennarecci, Giovanni, Colasanti, Marco, Giannelli, Valerio, Pellicelli, Adriano, Baccaro, Cizia, Vlierberghe, Hans Van, Eduard, Callebout, Samuele, Iesari, Jeroen, Dekervel, Jonas, Schreiber, Jacques, Pirenne, Chris, Verslype, Dirk, Ysebaert, Peter, Michielsen, Valerio, Lucidi, Christophe, Moreno, Olivier, Detry, Jean, Delwaide, Roberto, Troisi, Paul, Lerut Jan, Costentin, C, Piñero, F, Degroote, H, Notarpaolo, A, Boin, I, Boudjema, K, Baccaro, C, Podestá, L, Bachellier, P, Ettorre, G, Poniachik, J, Muscari, F, Dibenedetto, F, Hoyos Duque, S, Salame, E, Cillo, U, Marciano, S, Vanlemmens, C, Fagiuoli, S, Burra, P, Van Vlierberghe, H, Cherqui, D, Lai, Q, Silva, M, Rubinstein, F, Duvoux, C, Conti, F, Scatton, O, Bernard, P, Francoz, C, Durand, F, Dharancy, S, Woehl, M, Laurent, A, Radenne, S, Dumortier, J, Abergel, A, Barbier, L, Houssel-Debry, P, Pageaux, G, Chiche, L, Deledinghen, V, Hardwigsen, J, Gugenheim, J, Altieri, M, Hilleret, M, Decaens, T, Chagas, A, Costa, P, Cristina de Ataide, E, Quiñones, E, Duque, S, Anders, M, Varón, A, Zerega, A, Soza, A, Machaca, M, Arufe, D, Menéndez, J, Zapata, R, Vilatoba, M, Muñoz, L, Menéndez, R, Maraschio, M, Mccormack, L, Mattera, J, Gadano, A, Fatima Boin, I, Parente García, J, Carrilho, F, Magini, G, Miglioresi, L, Gambato, M, Benedetto, F, D’Ambrosio, C, Vitale, A, Colledan, M, Pinelli, D, Magistri, P, Vennarecci, G, Colasanti, M, Giannelli, V, Pellicelli, A, Vlierberghe, H, Eduard, C, Samuele, I, Jeroen, D, Jonas, S, Jacques, P, Chris, V, Dirk, Y, Peter, M, Valerio, L, Christophe, M, Olivier, D, Jean, D, Roberto, T, Paul, L, Costentin, Charlotte, Piñero, Federico, Degroote, Helena, Notarpaolo, Andrea, Boin, Ilka F., Boudjema, Karim, Baccaro, Cinzia, Podestá, Luis G., Bachellier, Philippe, Ettorre, Giuseppe Maria, Poniachik, Jaime, Muscari, Fabrice, Dibenedetto, Fabrizio, Hoyos Duque, Sergio, Salame, Ephrem, Cillo, Umberto, Marciano, Sebastian, Vanlemmens, Claire, Fagiuoli, Stefano, Burra, Patrizia, Van Vlierberghe, Hans, Cherqui, Daniel, Lai, Quirino, Silva, Marcelo, Rubinstein, Fernando, Duvoux, Christophe, Conti, Filomena, Scatton, Olivier, Bernard, Pierre Henri, Francoz, Claire, Durand, Francois, Dharancy, Sébastien, Woehl, Marie-lorraine., Laurent, Alexis, Radenne, Sylvie, Dumortier, Jérôme, Abergel, Armand, Barbier, Louise, Houssel-Debry, Pauline, Pageaux, Georges Philippe, Chiche, Laurence, Deledinghen, Victor, Hardwigsen, Jean, Gugenheim, J., altieri, M., Hilleret, Marie Noelle, Decaens, Thomas, Chagas, Aline, Costa, Paulo, Cristina de Ataide, Elaine, Quiñones, Emilio, Duque, Sergio Hoyos, Marciano, Sebastián, Anders, Margarita, Varón, Adriana, Zerega, Alina, Soza, Alejandro, Machaca, Martín Padilla, Arufe, Diego, Menéndez, Josemaría, Zapata, Rodrigo, Vilatoba, Mario, Muñoz, Linda, Menéndez, Ricardo Chong, Maraschio, Martín, McCormack, Lucas, Mattera, Juan, Gadano, Adrian, Fatima Boin, Ilka SF., Parente García, Jose Huygens, Carrilho, Flair, Magini, Giulia, Miglioresi, Lucia, Gambato, Martina, Benedetto, Fabrizio Di, D’Ambrosio, Cecilia, Vitale, Alessandro, Colledan, Michele, Pinelli, Domenico, Magistri, Paolo, Vennarecci, Giovanni, Colasanti, Marco, Giannelli, Valerio, Pellicelli, Adriano, Baccaro, Cizia, Vlierberghe, Hans Van, Eduard, Callebout, Samuele, Iesari, Jeroen, Dekervel, Jonas, Schreiber, Jacques, Pirenne, Chris, Verslype, Dirk, Ysebaert, Peter, Michielsen, Valerio, Lucidi, Christophe, Moreno, Olivier, Detry, Jean, Delwaide, Roberto, Troisi, and Paul, Lerut Jan

Abstract

Background & Aims: Patients with hepatocellular carcinoma (HCC) are selected for liver transplantation (LT) based on pre-LT imaging ± alpha-foetoprotein (AFP) level, but discrepancies between pre-LT tumour assessment and explant are frequent. Our aim was to design an explant-based recurrence risk reassessment score to refine prediction of recurrence after LT and provide a framework to guide post-LT management. Methods: Adult patients who underwent transplantation between 2000 and 2018 for HCC in 47 centres were included. A prediction model for recurrence was developed using competing-risk regression analysis in a European training cohort (TC; n = 1,359) and tested in a Latin American validation cohort (VC; n=1,085). Results: In the TC, 76.4% of patients with HCC met the Milan criteria, and 89.9% had an AFP score of ≤2 points. The recurrence risk reassessment (R3)-AFP model was designed based on variables independently associated with recurrence in the TC (with associated weights): ≥4 nodules (sub-distribution of hazard ratio [SHR] = 1.88, 1 point), size of largest nodule (3–6 cm: SHR = 1.83, 1 point; >6 cm: SHR = 5.82, 5 points), presence of microvascular invasion (MVI; SHR = 2.69, 2 points), nuclear grade >II (SHR = 1.20, 1 point), and last pre-LT AFP value (101–1,000 ng/ml: SHR = 1.57, 1 point; >1,000 ng/ml: SHR = 2.83, 2 points). Wolber's c-index was 0.76 (95% CI 0.72–0.80), significantly superior to an R3 model without AFP (0.75; 95% CI 0.72–0.79; p = 0.01). Four 5-year recurrence risk categories were identified: very low (score = 0; 5.5%), low (1–2 points; 15.1%), high (3–6 points; 39.1%), and very high (>6 points; 73.9%). The R3-AFP score performed well in the VC (Wolber's c-index of 0.78; 95% CI 0.73–0.83). Conclusions: The R3 score including the last pre-LT AFP value (R3-AFP score) provides a user-friendly, standardised framework to design post-LT surveillance strategies, protocols, or adjuvant therapy trials for HCC not limited to the Milan

Published
2022

200. Toward a more precise prognostic stratification in acute decompensation of cirrhosis: The Padua model 2.0

Author

Zanetto, Alberto, Pelizzaro, Filippo, Mion, Monica Maria, Bucci, Marco, Ferrarese, Alberto, Simioni, Paolo, Basso, Daniela, Burra, Patrizia, and Senzolo, Marco

Abstract

The clinical course of acutely decompensated cirrhosis (AD) is heterogeneous. Presepsin (PSP) is a plasmatic biomarker that reflects Toll‐like receptor activity and systemic inflammation. We conducted a prospective study to: (1) measure PSP in AD and (2) assess whether PSP in AD can predict the development of acute‐on‐chronic liver failure (ACLF). Patients with AD were prospectively recruited at admission and underwent determination of PSP. In study part 1, we compared PSP in AD versus controls (stable decompensated and compensated cirrhosis). In study part 2, we prospectively followed patients with AD for 1 year and evaluated predictors of ACLF. One hundred and seventy three patients with AD were included (median MELD: 18; CLIF‐C AD score: 54). Compared with controls, patients with AD had higher levels of PSP (674 ng/L vs. 310 ng/L vs. 157 ng/L; p< 0.001). In patients with AD, Child–Pugh C and acute kidney injury were associated with higher levels of PSP. During the follow‐up, 52 patients developed ACLF (median time from recruitment: 66 days). PSP, CLIF‐C AD score, and Child–Pugh stage were independently associated with ACLF. A predictive model combining these variables (Padua model 2.0) accurately identified patients at higher risk of ACLF (AUROC 0.864; 95% CI 0.780–0.947; sensitivity 82.9%, specificity 76.7%). In patients at lower risk of ACLF based on a CLIF‐C AD <50, a PSP >674 ng/L could discriminate between two groups at significantly different risk of ACLF. Finally, in patients who did not develop ACLF, baseline PSP was significantly higher in those who progressed toward unstable versus stable decompensated cirrhosis. The Padua model 2.0 can be used to identify patients with AD at high risk of ACLF. If these results are validated by external cohorts, PSP could become a new biomarker to improve risk stratification in AD.

Published
2023
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results