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1. Colonization and infection due to carbapenemase-producing Enterobacteriaceae in liver and lung transplant recipients and donor-derived transmission: a prospective cohort study conducted in Italy

Author

Farina, C., Vailati, F., Gesu, G., Vismara, C., Arghittu, M., Colombo, R., Torresani, E., Rossi, L., Conaldi, P.G., Gona, F., Cambieri, P., Marone, P., Venditti, C., Fernandez, A. Garcia, Mancini, C., Cusi, M., De Angelis, L. Henrici, Fossati, L., Finarelli, A.C., De Cillia, C., Sangiorgi, G., Pinna, A.D., Stella, F., Viale, P., Colledan, M., Platto, M., Bonizzoli, M., Peris, A., Torelli, R., Vesconi, S., Cibelli, E., De Carlis, L., De Gasperi, A., Ravini, M., Carrinola, R., Coluccio, E., Dondossola, D., Rossi, G., Santambrogio, L., Tosi, D., Feltrin, G., Rago, C., Cillo, U., Da Riva, A., Rea, F., Sparacino, V., Bertani, A., Canzonieri, M., Gridelli, B., Mularoni, A., Spada, M., Carrara, E., D’Armini, A. Maria, Paladini, P., Adorno, D., Valeri, M., Caprio, M., Di Ciaccio, P., Puoti, F., Berloco, P., D’Auria, B., Maldarelli, F., Paglialunga, G., Pugliese, F., Rossi, M., Venuta, F., Amoroso, A., Giacometti, R., Rinaldi, M., Salizzoni, M., Errico, G., Gagliotti, C., Monaco, M., Masiero, L., Gaibani, P., Ambretti, S., Landini, M.P., D’Arezzo, S., Di Caro, A., Parisi, S.G., Palù, G., Vespasiano, F., Morsillo, F., Moro, M.L., Procaccio, F., Ricci, A., Grossi, P.A., Pantosti, A., and Nanni Costa, A.

Published
2019
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2. Comments on the scalar propagator in AdS x S and the BMN plane wave

Author

Dorn, H., Salizzoni, M., and Sieg, C.

Subjects
High Energy Physics - Theory
Abstract

We discuss the scalar propagator on generic AdS_{d+1} x S^{d'+1} backgrounds. For the conformally flat situations and masses corresponding to Weyl invariant actions the propagator is powerlike in the sum of the chordal distances with respect to AdS_{d+1} and S^{d'+1}. In all other cases the propagator depends on both chordal distances separately. We discuss the KK mode summation to construct the propagator in brief. For AdS_5 x S^5 we relate our propagator to the expression in the BMN plane wave limit and find a geometric interpretation of the variables occurring in the known explicit construction on the plane wave., Comment: 7 pages, Fortsch.Phys. style, Talk given at 36th International Symposium Ahrenshoop on the Theory of Elementary Particles: Recent Developments in String/M- Theory and Field Theory, Wernsdorf, Germany, 26-30 Aug 2003

Published
2004
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3. Topics in String Field Theory

Author

Bonora, L., Maccaferri, C., Mamone, D., and Salizzoni, M.

Subjects
High Energy Physics - Theory
Abstract

This review of bosonic string field theory is concentrated on two main subjects. In the first part we revisit the construction of the three string vertex and rederive the relevant Neumann coefficients both for the matter and the ghost part following a conformal field theory approach. We use this formulation to solve the VSFT equation of motion for the ghost sector. This part of the paper is based on a new method which allows us to derive known results in a simpler way. In the second part we concentrate on the solution of the VSFT equation of motion for the matter part. We describe the construction of the three strings vertex in the presence of a background B field. We determine a large family of lump solutions, illustrate their interpretation as D-branes and study the low energy limit. We show that in this limit the lump solutions flow toward the so-called GMS solitons., Comment: 47 pages, 1 figure, JHEP, v3: some comments and a footnote added in section 4, comments in section 5.1 modified, 1 reference added

Published
2003

4. Vacuum String Field Theory ancestors of the GMS solitons

Author

Bonora, L., Mamone, D., and Salizzoni, M.

Subjects
High Energy Physics - Theory
Abstract

We define a sequence of VSFT D-branes whose low energy limit leads exactly to a corresponding sequence of GMS solitons. The D-branes are defined by acting on a fixed VSFT lump with operators defined by means of Laguerre polynomials whose argument is quadratic in the string creation operators. The states obtained in this way form an algebra under the SFT star product, which is isomorphic to a corresponding algebra of GMS solitons under the Moyal product. In order to obtain a regularized field theory limit we embed the theory in a constant background B field., Comment: 1+16 pages; v2: typos corrected; v3: two appendices added, final version

Published
2002
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5. Vacuum String Field Theory with B field

Author

Bonora, L., Mamone, D., and Salizzoni, M.

Subjects
High Energy Physics - Theory
Abstract

We continue the analysis of Vacuum String Field Theory in the presence of a constant B field. In particular we give a proof of the ratio of brane tensions is the expected one. On the wake of the recent literature we introduce wedge-like states and orthogonal projections. Finally we show a few examples of the smoothing out effects of the B field on some of the singularities that appear in VSFT., Comment: 20 pages; v2: typos corrected, references added; final version

Published
2002
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6. B field and squeezed states in Vacuum String Field Theory

Author

Bonora, L., Mamone, D., and Salizzoni, M.

Subjects
High Energy Physics - Theory
Abstract

We show that squeezed state solutions for solitonic lumps in Vacuum String Field Theory still exist in the presence of a constant B field. We show in particular that, just as in the B=0 case, we can write down a compact explicit form for such solutions., Comment: 15 pages, Latex, typos corrected, final version

Published
2002
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7. Non-orientable string one-loop corrections in the presence of a B field

Author

Bonora, L. and Salizzoni, M.

Subjects
High Energy Physics - Theory
Abstract

We discuss the problem of noncommutative SO(N) gauge field theories from the string one-loop point of view. To this end we propose an expression for the string propagator on the boundary of the Moebius strip in the presence of a constant B field. We discuss in detail the problems related to its derivation. Then we use it to compute the one-loop corrections to two-, three- and four-gluon amplitudes in an open string theory with orthogonal Chan-Paton factors. We show that these corrections in the field theory limit in 4D are compatible with the one-loop corrections of a renormalizable noncommutative SO(N) gauge field theory., Comment: 29 pages, 1 figure; New version

Published
2001

8. Renormalization of noncommutative U(N) gauge theories

Author

Bonora, L. and Salizzoni, M.

Subjects
High Energy Physics - Theory
Abstract

We give an explicit proof that the noncommutative U(N) gauge theories are one-loop renormalizable, Comment: 12 pages, Latex. v3: calculations redone, conclusions reversed. v4, v5: minor changes

Published
2000
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15. The SURF (Italian observational study for renal insufficiency evaluation in liver transplant recipients): A post-hoc between-sex analysis

Author

Colombo, D, Zagni, E, Zullo, A, Simoni, L, Fagiuoli, S, De Simone, P, Donati, D, Salizzoni, M, Angeli, P, Burra, P, Cillo, U, Toniutto, P, Rossi, M, Vennarecci, G, De Carlis, L, Donato, F, Cescon, M, Di Leo, A, Di Costanzo, G, Avolio, A, Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G. G., Avolio A., Colombo, D, Zagni, E, Zullo, A, Simoni, L, Fagiuoli, S, De Simone, P, Donati, D, Salizzoni, M, Angeli, P, Burra, P, Cillo, U, Toniutto, P, Rossi, M, Vennarecci, G, De Carlis, L, Donato, F, Cescon, M, Di Leo, A, Di Costanzo, G, Avolio, A, Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G. G., and Avolio A.

Abstract

Background: Female sex has been reported as an independent predictor of severe post-liver transplantation (LT) chronic kidney disease. We performed a by sex post-hoc analysis of the SURF study, that investigated the prevalence of renal impairment following LT, aimed at exploring possible differences between sexes in the prevalence and course of post-LT renal damage. Methods: All patients enrolled in the SURF study were considered evaluable for this sex-based analysis, whose primary objective was to evaluate by sex the proportion of patients with estimated Glomerular Filtration Rate (eGFR) < 60 ml/min/1.73m2 at inclusion and follow-up visit. Results: Seven hundred thirty-eight patients were included in our analysis, 76% males. The proportion of patients with eGFR < 60 mL/min/1.73 m2 was significantly higher in females at initial study visit (33.3 vs 22.8%; p = 0.005), but also before, at time of transplantation (22.9 vs 14.7%; p = 0.0159), as analyzed retrospectively. At follow-up, such proportion increased more in males than in females (33.9 vs 26.0%, p = 0.04). Mean eGFR values decreased over the study in both sexes, with no significant differences. Statistically significant M/F differences in patient distribution by O'Riordan eGFR levels were observed at time of transplant and study initial visit (p = 0.0005 and 0.0299 respectively), but not at follow-up. Conclusions: Though the limitation of being performed post-hoc, this analysis suggests potential sex differences in the prevalence of renal impairment before and after LT, encouraging further clinical research to explore such differences more in depth.

Published
2019

16. Very Early Introduction of Everolimus in De Novo Liver Transplantation: Results of a Multicenter, Prospective, Randomized Trial

Author

Cillo, U, Saracino, L, Vitale, A, Bertacco, A, Salizzoni, M, Lupo, F, Colledan, M, Corno, V, Rossi, G, Reggiani, P, Baccarani, U, Bresadola, V, De Carlis, L, Mangoni, I, Ramirez Morales, R, Agnes, S, Nure, E, Cillo U., Saracino L., Vitale A., Bertacco A., Salizzoni M., Lupo F., Colledan M., Corno V., Rossi G., Reggiani P., Baccarani U., Bresadola V., De Carlis L., Mangoni I., Ramirez Morales R., Agnes S., Nure E., Cillo, U, Saracino, L, Vitale, A, Bertacco, A, Salizzoni, M, Lupo, F, Colledan, M, Corno, V, Rossi, G, Reggiani, P, Baccarani, U, Bresadola, V, De Carlis, L, Mangoni, I, Ramirez Morales, R, Agnes, S, Nure, E, Cillo U., Saracino L., Vitale A., Bertacco A., Salizzoni M., Lupo F., Colledan M., Corno V., Rossi G., Reggiani P., Baccarani U., Bresadola V., De Carlis L., Mangoni I., Ramirez Morales R., Agnes S., and Nure E.

Abstract

Early everolimus (EVR) introduction and tacrolimus (TAC) minimization after liver transplantation may represent a novel immunosuppressant approach. This phase 2, multicenter, randomized, open-label trial evaluated the safety and efficacy of early EVR initiation. Patients treated with corticosteroids, TAC, and basiliximab were randomized (2:1) to receive EVR (1.5 mg twice daily) on day 8 and to gradually minimize or withdraw TAC when EVR was stable at >5 ng/mL or to continue TAC at 6-12 ng/mL. The primary endpoint was the proportion of treated biopsy-proven acute rejection (tBPAR)–free patients at 3 months after transplant. As secondary endpoints, composite tBPAR plus graft/patient loss rate, renal function, TAC discontinuation rate, and adverse events were assessed. A total of 93 patients were treated with EVR, and 47 were controls. After 3 months from transplantation, 87.1% of patients with EVR and 95.7% of controls were tBPAR-free (P = 0.09); composite endpoint-free patients with EVR were 85% (versus 94%; P = 0.15). Also at 3 months, 37.6% patients were in monotherapy with EVR, and the tBPAR rate was 11.4%. Estimated glomerular filtration rate was significantly higher with EVR, as early as 2 weeks after randomization. In the study group, higher rates of dyslipidemia (15% versus 6.4%), wound complication (18.32% versus 0%), and incisional hernia (25.8% versus 6.4%) were observed, whereas neurological disorders were more frequent in the control group (13.9% versus 31.9%; P < 0.05). In conclusion, an early EVR introduction and TAC minimization may represent a suitable approach when immediate preservation of renal function is crucial.

Published
2019

17. A national mandatory-split liver policy: A report from the Italian experience

Author

Angelico, R, Trapani, S, Spada, M, Colledan, M, de Ville de Goyet, J, Salizzoni, M, De Carlis, L, Andorno, E, Gruttadauria, S, Ettorre, G, Cescon, M, Rossi, G, Risaliti, A, Tisone, G, Tedeschi, U, Vivarelli, M, Agnes, S, De Simone, P, Lupo, L, Di Benedetto, F, Santaniello, W, Zamboni, F, Mazzaferro, V, Rossi, M, Puoti, F, Camagni, S, Grimaldi, C, Gringeri, E, Rizzato, L, Nanni Costa, A, Cillo, U, Angelico R., Trapani S., Spada M., Colledan M., de Ville de Goyet J., Salizzoni M., De Carlis L., Andorno E., Gruttadauria S., Ettorre G. M., Cescon M., Rossi G., Risaliti A., Tisone G., Tedeschi U., Vivarelli M., Agnes S., De Simone P., Lupo L. G., Di Benedetto F., Santaniello W., Zamboni F., Mazzaferro V., Rossi M., Puoti F., Camagni S., Grimaldi C., Gringeri E., Rizzato L., Nanni Costa A., Cillo U., Angelico, R, Trapani, S, Spada, M, Colledan, M, de Ville de Goyet, J, Salizzoni, M, De Carlis, L, Andorno, E, Gruttadauria, S, Ettorre, G, Cescon, M, Rossi, G, Risaliti, A, Tisone, G, Tedeschi, U, Vivarelli, M, Agnes, S, De Simone, P, Lupo, L, Di Benedetto, F, Santaniello, W, Zamboni, F, Mazzaferro, V, Rossi, M, Puoti, F, Camagni, S, Grimaldi, C, Gringeri, E, Rizzato, L, Nanni Costa, A, Cillo, U, Angelico R., Trapani S., Spada M., Colledan M., de Ville de Goyet J., Salizzoni M., De Carlis L., Andorno E., Gruttadauria S., Ettorre G. M., Cescon M., Rossi G., Risaliti A., Tisone G., Tedeschi U., Vivarelli M., Agnes S., De Simone P., Lupo L. G., Di Benedetto F., Santaniello W., Zamboni F., Mazzaferro V., Rossi M., Puoti F., Camagni S., Grimaldi C., Gringeri E., Rizzato L., Nanni Costa A., and Cillo U.

Abstract

To implement split liver transplantation (SLT) a mandatory-split policy has been adopted in Italy since August 2015: donors aged 18-50 years at standard risk are offered for SLT, resulting in a left-lateral segment (LLS) graft for children and an extended-right graft (ERG) for adults. We aim to analyze the impact of the new mandatory-split policy on liver transplantation (LT)-waiting list and SLT outcomes, compared to old allocation policy. Between August 2015 and December 2016 out of 413 potentially “splittable” donors, 252 (61%) were proposed for SLT, of whom 53 (21%) donors were accepted for SLT whereas 101 (40.1%) were excluded because of donor characteristics and 98 (38.9%) for absence of suitable pediatric recipients. The SLT rate augmented from 6% to 8.4%. Children undergoing SLT increased from 49.3% to 65.8% (P =.009) and the pediatric LT-waiting list time dropped (229 [10-2121] vs 80 [12-2503] days [P =.045]). The pediatric (4.5% vs 2.5% [P =.398]) and adult (9.7% to 5.2% [P <.001]) LT-waiting list mortality reduced; SLT outcomes remained stable. Retransplantation (HR = 2.641, P =.035) and recipient weight >20 kg (HR = 5.113, P =.048) in LLS, and ischemic time >8 hours (HR = 2.475, P =.048) in ERG were identified as predictors of graft failure. A national mandatory-split policy maximizes the SLT donor resources, whose selection criteria can be safely expanded, providing favorable impact on the pediatric LT-waiting list and priority for adult sick LT candidates.

Published
2019

18. Endo-therapies for biliary duct-to-duct anastomotic stricture after liver transplantation: Outcomes of a nationwide survey

Author

Cantu, P, Tarantino, I, Baldan, A, Mutignani, M, Tringali, A, Lombardi, G, Cerofolini, A, Di Sario, A, Catalano, G, Bertani, H, Ghinolfi, D, Boarino, V, Masci, E, Bulajic, M, Pisani, A, Fantin, A, Ligresti, D, Barresi, L, Traina, M, Ravelli, P, Forti, E, Barbaro, F, Costamagna, G, Rodella, L, Maroni, L, Salizzoni, M, Conigliaro, R, Filipponi, F, Merighi, A, Staiano, T, Monteleone, M, Mazzaferro, V, Zucchi, E, Zilli, M, Nadal, E, Rosa, R, Santi, G, Parzanese, I, De Carlis, L, Donato, M, Lampertico, P, Maggi, U, Caccamo, L, Rossi, G, Vecchi, M, Penagini, R, Cantu P., Tarantino I., Baldan A., Mutignani M., Tringali A., Lombardi G., Cerofolini A., Di Sario A., Catalano G., Bertani H., Ghinolfi D., Boarino V., Masci E., Bulajic M., Pisani A., Fantin A., Ligresti D., Barresi L., Traina M., Ravelli P., Forti E., Barbaro F., Costamagna G., Rodella L., Maroni L., Salizzoni M., Conigliaro R., Filipponi F., Merighi A., Staiano T., Monteleone M., Mazzaferro V., Zucchi E., Zilli M., Nadal E., Rosa R., Santi G., Parzanese I., De Carlis L., Donato M. F., Lampertico P., Maggi U., Caccamo L., Rossi G., Vecchi M., Penagini R., Cantu, P, Tarantino, I, Baldan, A, Mutignani, M, Tringali, A, Lombardi, G, Cerofolini, A, Di Sario, A, Catalano, G, Bertani, H, Ghinolfi, D, Boarino, V, Masci, E, Bulajic, M, Pisani, A, Fantin, A, Ligresti, D, Barresi, L, Traina, M, Ravelli, P, Forti, E, Barbaro, F, Costamagna, G, Rodella, L, Maroni, L, Salizzoni, M, Conigliaro, R, Filipponi, F, Merighi, A, Staiano, T, Monteleone, M, Mazzaferro, V, Zucchi, E, Zilli, M, Nadal, E, Rosa, R, Santi, G, Parzanese, I, De Carlis, L, Donato, M, Lampertico, P, Maggi, U, Caccamo, L, Rossi, G, Vecchi, M, Penagini, R, Cantu P., Tarantino I., Baldan A., Mutignani M., Tringali A., Lombardi G., Cerofolini A., Di Sario A., Catalano G., Bertani H., Ghinolfi D., Boarino V., Masci E., Bulajic M., Pisani A., Fantin A., Ligresti D., Barresi L., Traina M., Ravelli P., Forti E., Barbaro F., Costamagna G., Rodella L., Maroni L., Salizzoni M., Conigliaro R., Filipponi F., Merighi A., Staiano T., Monteleone M., Mazzaferro V., Zucchi E., Zilli M., Nadal E., Rosa R., Santi G., Parzanese I., De Carlis L., Donato M. F., Lampertico P., Maggi U., Caccamo L., Rossi G., Vecchi M., and Penagini R.

Abstract

Background: The most appropriate endo-therapeutic approach to biliary anastomotic strictures is yet to be defined. Aim: To retrospectively report on the endo-therapy of duct-to-duct anastomotic strictures during 2013 in Italy. Methods: Data were collected from 16 Endoscopy Units at the Italian Liver Transplantation Centers (BASALT study group). Results: Complete endo-therapy and follow-up data are available for 181 patients: 101 treated with plastic multistenting, 26 with fully covered self-expandable metal stenting and 54 with single stenting. Radiological success was achieved for 145 patients (80%), that is, 88% of plastic multistenting, 88% of self-expandable metal stenting and 61% of single stenting (P < 0.001 vs plastic multistenting; P < 0.05 vs self-expandable metal stenting). After first-line endo-therapy failure, the patients underwent a second-line endo-therapy with plastic multistenting for 25%, fully covered self-expandable metal stenting for 53% and single stenting for 22% of cases, and radiological success was achieved for 84%, that is, 100%, 85% and 63% with plastic multistenting, self-expandable metal stenting and single stenting (P < 0.05 vs plastic multistenting or self-expandable metal stenting) respectively. Procedure-related complications occurred in 7.8% of endoscopic retrograde cholangiopancreatographies. Overall, clinical success was achieved in 87% of patients after a median follow-up of 25 months. Conclusion: Plastic multistenting is confirmed as the preferred first-line treatment, while fully covered self-expandable metal stenting as rescue option for biliary anastomotic strictures. Single stenting has sub-optimal results and should be abandoned.

Published
2019

19. The SURF (Italian observational study for renal insufficiency evaluation in liver transplant recipients): A post-hoc between-sex analysis

Author

Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G. G., Avolio A., Colombo D., Zagni E., Zullo A., Simoni L., Fagiuoli S., De Simone P., Donati D., Salizzoni M., Angeli P., Burra P., Cillo U., Toniutto P., Rossi M., Vennarecci G., De Carlis L., Donato F., Cescon M., Di Leo A., Di Costanzo G.G., Avolio A., Colombo, D, Zagni, E, Zullo, A, Simoni, L, Fagiuoli, S, De Simone, P, Donati, D, Salizzoni, M, Angeli, P, Burra, P, Cillo, U, Toniutto, P, Rossi, M, Vennarecci, G, De Carlis, L, Donato, F, Cescon, M, Di Leo, A, Di Costanzo, G, and Avolio, A

Subjects
Nephrology, Adult, Male, medicine.medical_specialty, Settore MED/18 - CHIRURGIA GENERALE, Renal function, lcsh:RC870-923, 03 medical and health sciences, 0302 clinical medicine, Calcineurin inhibitors, Calcineurin inhibitor, Internal medicine, Sex differences, Medicine, Humans, Meta-analysi, 030212 general & internal medicine, Longitudinal Studies, Renal insufficiency, Liver transplant, Aged, Retrospective Studies, Sex Characteristics, business.industry, Gender, Middle Aged, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, Transplant Recipients, Liver Transplantation, Calcineurin, Transplantation, Meta-analysis, Clinical research, Cross-Sectional Studies, Italy, 030211 gastroenterology & hepatology, Observational study, Female, business, Research Article, Kidney disease, Follow-Up Studies, Glomerular Filtration Rate
Abstract

Background Female sex has been reported as an independent predictor of severe post-liver transplantation (LT) chronic kidney disease. We performed a by sex post-hoc analysis of the SURF study, that investigated the prevalence of renal impairment following LT, aimed at exploring possible differences between sexes in the prevalence and course of post-LT renal damage. Methods All patients enrolled in the SURF study were considered evaluable for this sex-based analysis, whose primary objective was to evaluate by sex the proportion of patients with estimated Glomerular Filtration Rate (eGFR) 2 at inclusion and follow-up visit. Results Seven hundred thirty-eight patients were included in our analysis, 76% males. The proportion of patients with eGFR 2 was significantly higher in females at initial study visit (33.3 vs 22.8%; p = 0.005), but also before, at time of transplantation (22.9 vs 14.7%; p = 0.0159), as analyzed retrospectively. At follow-up, such proportion increased more in males than in females (33.9 vs 26.0%, p = 0.04). Mean eGFR values decreased over the study in both sexes, with no significant differences. Statistically significant M/F differences in patient distribution by O’Riordan eGFR levels were observed at time of transplant and study initial visit (p = 0.0005 and 0.0299 respectively), but not at follow-up. Conclusions Though the limitation of being performed post-hoc, this analysis suggests potential sex differences in the prevalence of renal impairment before and after LT, encouraging further clinical research to explore such differences more in depth.

Published
2019

25. 2018 Annual Report of the European Liver Transplant Registry (ELTR) – 50-year evolution of liver transplantation

Author

Adam, R, Karam, V, Cailliez, V, O Grady, J, Mirza, D, Cherqui, D, Klempnauer, J, Salizzoni, M, Pratschke, J, Jamieson, N, Hidalgo, E, Paul, A, Andujar, R, Lerut, J, Fisher, L, Boudjema, K, Fondevila, C, Soubrane, O, Bachellier, P, Pinna, A, Berlakovich, G, Bennet, W, Pinzani, M, Schemmer, P, Zieniewicz, K, Romero, C, De Simone, P, Ericzon, B, Schneeberger, S, Wigmore, S, Prous, J, Colledan, M, Porte, R, Yilmaz, S, Azoulay, D, Pirenne, J, Line, P, Trunecka, P, Navarro, F, Lopez, A, De Carlis, L, Pena, S, Kochs, E, Duvoux, C, Adam R., Karam V., Cailliez V., O Grady J. G., Mirza D., Cherqui D., Klempnauer J., Salizzoni M., Pratschke J., Jamieson N., Hidalgo E., Paul A., Andujar R. L., Lerut J., Fisher L., Boudjema K., Fondevila C., Soubrane O., Bachellier P., Pinna A. D., Berlakovich G., Bennet W., Pinzani M., Schemmer P., Zieniewicz K., Romero C. J., De Simone P., Ericzon B. -G., Schneeberger S., Wigmore S. J., Prous J. F., Colledan M., Porte R. J., Yilmaz S., Azoulay D., Pirenne J., Line P. -D., Trunecka P., Navarro F., Lopez A. V., De Carlis L., Pena S. R., Kochs E., Duvoux C., Adam, R, Karam, V, Cailliez, V, O Grady, J, Mirza, D, Cherqui, D, Klempnauer, J, Salizzoni, M, Pratschke, J, Jamieson, N, Hidalgo, E, Paul, A, Andujar, R, Lerut, J, Fisher, L, Boudjema, K, Fondevila, C, Soubrane, O, Bachellier, P, Pinna, A, Berlakovich, G, Bennet, W, Pinzani, M, Schemmer, P, Zieniewicz, K, Romero, C, De Simone, P, Ericzon, B, Schneeberger, S, Wigmore, S, Prous, J, Colledan, M, Porte, R, Yilmaz, S, Azoulay, D, Pirenne, J, Line, P, Trunecka, P, Navarro, F, Lopez, A, De Carlis, L, Pena, S, Kochs, E, Duvoux, C, Adam R., Karam V., Cailliez V., O Grady J. G., Mirza D., Cherqui D., Klempnauer J., Salizzoni M., Pratschke J., Jamieson N., Hidalgo E., Paul A., Andujar R. L., Lerut J., Fisher L., Boudjema K., Fondevila C., Soubrane O., Bachellier P., Pinna A. D., Berlakovich G., Bennet W., Pinzani M., Schemmer P., Zieniewicz K., Romero C. J., De Simone P., Ericzon B. -G., Schneeberger S., Wigmore S. J., Prous J. F., Colledan M., Porte R. J., Yilmaz S., Azoulay D., Pirenne J., Line P. -D., Trunecka P., Navarro F., Lopez A. V., De Carlis L., Pena S. R., Kochs E., and Duvoux C.

Abstract

The purpose of this registry study was to provide an overview of trends and results of liver transplantation (LT) in Europe from 1968 to 2016. These data on LT were collected prospectively from 169 centers from 32 countries, in the European Liver Transplant Registry (ELTR) beginning in 1968. This overview provides epidemiological data, as well as information on evolution of techniques, and outcomes in LT in Europe over more than five decades; something that cannot be obtained from only a single center experience.

Published
2018

26. Survival of children after liver transplantation for hepatocellular carcinoma

Author

Baumann, U, Adam, R, Duvoux, C, Mikolajczyk, R, Karam, V, D'Antiga, L, Chardot, C, Coker, A, Colledan, M, Ericzon, B, Line, P, Hadzic, N, Isoniemi, H, Klempnauer, J, Reding, R, Mckiernan, P, Mclin, V, Paul, A, Salizzoni, M, Furtado, E, Schneeberger, S, Karch, A, Baumann U, Adam R, Duvoux C, Mikolajczyk R, Karam V, D'Antiga L, Chardot C, Coker A, Colledan M, Ericzon BG, Line PD, Hadzic N, Isoniemi H, Klempnauer JL, Reding R, McKiernan PJ, McLin V, Paul A, Salizzoni M, Furtado ES, Schneeberger S, Karch A, Baumann, U, Adam, R, Duvoux, C, Mikolajczyk, R, Karam, V, D'Antiga, L, Chardot, C, Coker, A, Colledan, M, Ericzon, B, Line, P, Hadzic, N, Isoniemi, H, Klempnauer, J, Reding, R, Mckiernan, P, Mclin, V, Paul, A, Salizzoni, M, Furtado, E, Schneeberger, S, Karch, A, Baumann U, Adam R, Duvoux C, Mikolajczyk R, Karam V, D'Antiga L, Chardot C, Coker A, Colledan M, Ericzon BG, Line PD, Hadzic N, Isoniemi H, Klempnauer JL, Reding R, McKiernan PJ, McLin V, Paul A, Salizzoni M, Furtado ES, Schneeberger S, and Karch A

Abstract

Hepatocellular carcinoma (HCC) in childhood differs from adult HCC because it is often associated with inherited liver disease. It is, however, unclear whether liver transplantation (LT) for HCC in childhood with or without associated inherited disease has a comparable outcome to adult HCC. On the basis of data from the European Liver Transplant Registry (ELTR), we aimed to investigate if there are differences in patient and graft survival after LT for HCC between children and adults and between patients with underlying inherited versus noninherited liver disease, respectively. We included all 175 children who underwent LT for HCC and were enrolled in ELTR between 1985 and 2012. Of these, 38 had an associated inherited liver disease. Adult HCC patients with (n=79) and without (n=316, matched by age, sex, and LT date) inherited liver disease served as an adult comparison population. We used multivariable piecewise Cox regression models with shared frailty terms (for LT center) to compare patient and graft survival between the different HCC groups. Survival analyses demonstrated a superior longterm survival of children with inherited liver disease when compared with children with HCC without inherited liver disease (hazard ratio [HR], 0.29; 95% CI, 0.10-0.90; P=0.03) and adults with HCC with inherited liver disease (HR, 0.27; 95% CI, 0.06-1.25; P=0.09). There was no survival difference between adults with and without inherited disease (HR, 1.05; 95% CI, 0.66-1.66; P=0.84). In conclusion, the potential survival advantage of children with an HCC based on inherited disease should be acknowledged when considering transplantation and prioritization for these patients. Further prospective studies accounting for tumor size and extension at LT are necessary to fully interpret our findings. Liver Transplantation 24 246-255 2018 AASLD.

Published
2018

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

Author

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

Abstract

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

Published
2018

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

Author

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

Abstract

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

Published
2020

32. The UN-SUSTAINABLE Match in HCV Recipients. Evidences from the Italian D-MELD Study on Balancing Donor-Recipient Risk Factors.: Abstract# O-162

Author

Avolio, A. W., Agnes, S., Lirosi, M., Salizzoni, M., Pinna, A., Gridelli, B., De Carlis, L., Colledan, M., Gerunda, G., Rossi, G., Ettorre, G., Risaliti, A., Mazzaferro, V., Rossi, M., Tisone, G., Zamboni, F., Lupo, L., Cuomo, O., Calise, F., Donataccio, M., Nicolotti, N., Romagnoli, R., Vitale, A., Cucchetti, A., Gruttadauria, S., Baccarani, U., Caccamo, L., Mangoni, I., Pinelli, D., Montalti, R., Morelli, N., Vennarecci, G., Nicolini, D., Regalia, E., Lai, Q., Anselmo, A., Tondolo, E., Perrella, A., Burra, P., and Cillo, U.

Published
2012

33. Behind D-MELD: The Role of Primary Indication (HCV or HBV) as Significant Covariate in the Outcome Prediction after Liver Transplants.: Abstract# 1672: Poster Board #-Session: P234-IV

Author

Avolio, A. W., Agnes, S., Lirosi, M. C., Salizzoni, M., Pinna, A., Gridelli, B., De Carlis, L., Colledan, M., Gerunda, G., Valente, U., Rossi, G., Ettorre, G., Risaliti, A., Mazzaferro, V., Rossi, M., Tisone, G., Zamboni, F., Lupo, L., Cuomo, O., Calise, F., Nicolotti, N., Vitale, A., Romagnoli, R., Cucchetti, A., Gruttadauria, S., Mangoni, I., Pinelli, D., Montalti, R., Gelli, M., Caccamo, L., Vennarecci, G., Nicolini, D., Regalia, E., Baccarani, U., Lai, Q., Manzia, T., Tondolo, E., Rendina, M., Perrella, A., Scuderi, E., Burra, P., Gasbarrini, A., and Cillo, U.

Published
2012

34. www.D-MELD.com. THE ONLINE PROGNOSTIC CALCULATOR TO OPTIMIZE DONOR-RECIPIENT MATCH: O-123

Author

Avolio, A. W., Agnes, S., Lirosi, M. C., Salizzoni, M., Pinna, A. D., Gridelli, B., De Carlis, L., Colledan, M., Gerunda, G. E., Valente, U., Rossi, G., Ettorre, G. M., Risaliti, A., Mazzaferro, V., Bresadola, F., Rossi, M., Tisone, G., Zamboni, F., Lupo, L., Cuomo, O., Calise, F., Donataccio, M., Nicolotti, N., Vitale, A., Romagnoli, R, Lupo, F., Cucchetti, A., Gruttadauria, S., Mangoni, I., Pinelli, D., Montalti, R, Gelli, M., Caccamo, L., Vennarecci, G., Nicolini, D., Regalia, E., Baccarani, U., Lai, Q., Manzia, T, Tondolo, E., Rendina, M., Perrella, A., Scuderi, E., Antonelli, B., de Waure, C., De Feo, T, Burra, P., Gasbarrini, A., and Cillo, U.

Published
2011

37. Infections in liver and lung transplant recipients. A national prospective cohort

Author

Gagliotti, Carlo, Morsillo, Filomena, Moro, Maria Luisa, Masiero, Lucia, Procaccio, Francesco, Vespasiano, Francesca, Pantosti, Annalisa, Monaco, Monica, Errico, Giulia, Ricci, Andrea, Grossi, Paolo, Nanni Costa, Alessandro, Adorno, D., Ambretti, S., Amoroso, A., Arghittu, M., Berloco, P., Bertani, A., Bonizzoli, M., Cambieri, P., Canzonieri, M., Caprio, M., Carrara, E., Carrinola, R., Cibelli, E., Cillo, U., Colledan, M., Colombo, R., Coluccio, E., Conaldi, P. G., Cusi, M., D’Armini, A. M., da Riva, A., D’Auria, B., de Carlis, L., de Cillia, C., de Gasperi, A., Di Caro, A., Di Ciaccio, P., Dondossola, D., Farina, C., Feltrin, G., Finarelli, A. C., Fossati, L., Gaibani, P., Garcia Fernandez, A., Gesu, G., Giacometti, R., Gona, F., Gridelli, B., Henrici de Angelis, L., Landini, M. P., Maldarelli, F., Mancini, C., Marone, P., Mularoni, A., Paglialunga, G., Paladini, P., Palù, G., Parisi, S., Peris, A., Pinna, A. D., Platto, M., Pugliese, F., Puoti, F., Rago, C., Ravini, M., Rea, F., Rinaldi, M., Rossi, G., Rossi, L., Rossi, M., Salizzoni, M., Sangiorgi, G., Santambrogio, L., Spada, M., Sparacino, V., Stella, F., Torelli, R., Torresani, E., Tosi, D., Vailati, F., Valeri, M., Venuta, F., Vesconi, S., Viale, P., Vismara, C., Gagliotti, C, Morsillo, F, Moro, M, Masiero, L, Procaccio, F, Vespasiano, F, Pantosti, A, Monaco, M, Errico, G, Ricci, A, Grossi, P, Nanni Costa, A, Adorno, D, Ambretti, S, Amoroso, A, Arghittu, M, Berloco, P, Bertani, A, Bonizzoli, M, Cambieri, P, Canzonieri, M, Caprio, M, Carrara, E, Carrinola, R, Cibelli, E, Cillo, U, Colledan, M, Colombo, R, Coluccio, E, Conaldi, P, Cusi, M, D’Armini, A, da Riva, A, D’Auria, B, de Carlis, L, de Cillia, C, de Gasperi, A, Di Caro, A, Di Ciaccio, P, Dondossola, D, Farina, C, Feltrin, G, Finarelli, A, Fossati, L, Gaibani, P, Garcia Fernandez, A, Gesu, G, Giacometti, R, Gona, F, Gridelli, B, Henrici de Angelis, L, Landini, M, Maldarelli, F, Mancini, C, Marone, P, Mularoni, A, Paglialunga, G, Paladini, P, Palù, G, Parisi, S, Peris, A, Pinna, A, Platto, M, Pugliese, F, Puoti, F, Rago, C, Ravini, M, Rea, F, Rinaldi, M, Rossi, G, Rossi, L, Rossi, M, Salizzoni, M, Sangiorgi, G, Santambrogio, L, Spada, M, Sparacino, V, Stella, F, Torelli, R, Torresani, E, Tosi, D, Vailati, F, Valeri, M, Venuta, F, Vesconi, S, Viale, P, Vismara, C, Gagliotti, Carlo, Morsillo, Filomena, Moro, Maria Luisa, Masiero, Lucia, Procaccio, Francesco, Vespasiano, Francesca, Pantosti, Annalisa, Monaco, Monica, Errico, Giulia, Ricci, Andrea, Grossi, Paolo, Costa, Alessandro Nanni, Adorno, Domenico, Ambretti, Simone, Amoroso, Antonio, Arghittu, Milena, Berloco, Pasquale, Bertani, Alessandro, Bonizzoli, Manuela, Cambieri, Patrizia, Canzonieri, Marco, Caprio, Mario, Carrara, Elena, Carrinola, Rosaria, Cibelli, Eva, Cillo, Umberto, Colledan, Michele, Colombo, Rosaria, Coluccio, Elena, Conaldi, Pier Giulio, Cusi, Mariagrazia, D’Armini, Andrea Maria, Da Riva, Adelaide, D'Auria, Bianca, De Carlis, Luciano, De Cillia, Carlo, De Gasperi, Andrea, Di Caro, Antonino, Di Ciaccio, Paola, Dondossola, Daniele, Farina, Claudio, Feltrin, Giuseppe, Finarelli, Alba Carola, Fossati, Lucina, Gaibani, Paolo, Fernandez, Aurora Garcia, Gesu, Giovanni, Giacometti, Raffaella, Gona, Floriana, Gridelli, Bruno, De Angelis, Lucia Henrici, Landini, Maria Paola, Maldarelli, Federica, Mancini, Carlo, Marone, Piero, Mularoni, Alessandra, Paglialunga, Giulia, Paladini, Piero, Palù, Giorgio, Parisi, Saverio, Peris, Adriano, Pinna, Antonio Daniele, Platto, Marco, Pugliese, Francesco, Puoti, Francesca, Rago, Claudio, Ravini, Mario, Rea, Federico, Rinaldi, Mauro, Rossi, Giorgio, Rossi, Lucia, Rossi, Massimo, Salizzoni, Mauro, Sangiorgi, Gabriela, Santambrogio, Luigi, Spada, Marco, Sparacino, Vito, Stella, Franco, Torelli, Rosanna, Torresani, Erminio, Tosi, Davide, Vailati, Francesca, Valeri, Maurizio, Venuta, Federico, Vesconi, Sergio, Viale, Pierluigi, and Vismara, Chiara

Subjects
Microbiology (medical), Infectious Diseases, Male, 0301 basic medicine, medicine.medical_treatment, Drug Resistance, Transplant Recipient, 030230 surgery, Liver transplantation, Postoperative Complications, 0302 clinical medicine, Drug Resistance, Multiple, Bacterial, Medicine, Cumulative incidence, Prospective Studies, Prospective cohort study, Incidence, Incidence (epidemiology), Mortality rate, Bacterial, Bacterial Infections, General Medicine, Middle Aged, lung transplant, Anti-Bacterial Agents, infectious, Italy, Female, Multiple, Adult, Bacteria, Humans, Transplant Recipients, Liver Transplantation, Lung Transplantation, Human, medicine.medical_specialty, 030106 microbiology, Bacterial Infection, Infectious Diseases, transplantation, 03 medical and health sciences, Internal medicine, Anti-Bacterial Agent, Lung transplantation, business.industry, lung transplant, liver transplant, infectious, Transplantation, Prospective Studie, liver transplant, Etiology, Postoperative Complication, business, transplantation
Abstract

Infections are a major complication of solid organ transplants (SOTs). This study aimed to describe recipients’ characteristics, and the frequency and etiology of infections and transplant outcome in liver and lung SOTs, and to investigate exposures associated to infection and death in liver transplant recipients. The study population included recipients of SOTs performed in Italy during a 1-year period in ten Italian lung transplant units and eight liver transplant units. Data on comorbidities, infections, retransplantation, and death were prospectively collected using a web-based system, with a 6-month follow-up. The cumulative incidence of infection was 31.7% and 47.8% in liver and lung transplants, respectively, with most infections occurring within the first month after transplantation. Gram-negatives, which were primarily multidrug-resistant, were the most frequent cause of infection. Death rates were 0.42 per 1000 recipient-days in liver transplants and 1.41 per 1000 recipient-days in lung transplants. Infection after SOT in adult liver recipients is associated to an increased risk of death (OR = 13.25; p-value < 0.001). Given the frequency of infection caused by multidrug-resistant microorganisms in SOT recipients in Italy and the heavy impact of infections on the transplant outcome, the reinforcement of surveillance and control activities to prevent the transmission of multidrug-resistant microorganisms in SOT recipients represents a priority. The implementation of the study protocol in liver and lung transplant units and the sharing of results have increased the awareness about the threat due to antimicrobial resistance in the country.

Published
2018

42. AISF position paper on HCV in immunocompromised patients

Author

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

Abstract

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

Published
2019

43. The SURF (Italian observational study for renal insufficiency evaluation in liver transplant recipients): A post-hoc between-sex analysis

Author

Colombo, D., Zagni, E., Zullo, A., Simoni, L., Fagiuoli, S., De Simone, P., Donati, D., Salizzoni, M., Angeli, P., Burra, P., Cillo, U., Toniutto, P., Rossi, M., Vennarecci, G., De Carlis, L., Donato, F., Cescon, M., Di Leo, A., Di Costanzo, G. G., Avolio, Alfonso Wolfango, Avolio A. (ORCID:0000-0003-2491-7625), Colombo, D., Zagni, E., Zullo, A., Simoni, L., Fagiuoli, S., De Simone, P., Donati, D., Salizzoni, M., Angeli, P., Burra, P., Cillo, U., Toniutto, P., Rossi, M., Vennarecci, G., De Carlis, L., Donato, F., Cescon, M., Di Leo, A., Di Costanzo, G. G., Avolio, Alfonso Wolfango, and Avolio A. (ORCID:0000-0003-2491-7625)

Abstract

Background: Female sex has been reported as an independent predictor of severe post-liver transplantation (LT) chronic kidney disease. We performed a by sex post-hoc analysis of the SURF study, that investigated the prevalence of renal impairment following LT, aimed at exploring possible differences between sexes in the prevalence and course of post-LT renal damage. Methods: All patients enrolled in the SURF study were considered evaluable for this sex-based analysis, whose primary objective was to evaluate by sex the proportion of patients with estimated Glomerular Filtration Rate (eGFR) < 60 ml/min/1.73m2 at inclusion and follow-up visit. Results: Seven hundred thirty-eight patients were included in our analysis, 76% males. The proportion of patients with eGFR < 60 mL/min/1.73 m2 was significantly higher in females at initial study visit (33.3 vs 22.8%; p = 0.005), but also before, at time of transplantation (22.9 vs 14.7%; p = 0.0159), as analyzed retrospectively. At follow-up, such proportion increased more in males than in females (33.9 vs 26.0%, p = 0.04). Mean eGFR values decreased over the study in both sexes, with no significant differences. Statistically significant M/F differences in patient distribution by O'Riordan eGFR levels were observed at time of transplant and study initial visit (p = 0.0005 and 0.0299 respectively), but not at follow-up. Conclusions: Though the limitation of being performed post-hoc, this analysis suggests potential sex differences in the prevalence of renal impairment before and after LT, encouraging further clinical research to explore such differences more in depth.

Published
2019

46. Prevention of hepatitis C recurrence by bridging sofosbuvir/ribavirin from pre- to post-liver transplant: A real-life strategy

Author

Donato, M. F., Morelli, C., Romagnoli, R., Invernizzi, F., Mazzarelli, C., Iemmolo, R. M., Montalbano, M., Lenci, I., Bhoori, S., Pieri, G., Berardi, S., Caraceni, P., Martini, S., Angeli, P., Belli, L. S., Bernabucci, V., Malinverno, F., Monico, S., Ottobrelli, A., Romano, A., Strona, S., Tame, M. R., Visco-Comandini, U., Cavenago, M., De Carlis, L., Di Benedetto, F., Dondossola, D., Ettorre, G. M., Mazzaferro, V., Montin, U., Pinna, A. D., Rossi, G., Salizzoni, M., Tisone, G., Donato, Maria Francesca, Morelli, Cristina, Romagnoli, Renato, Invernizzi, Federica, Mazzarelli, Chiara, Iemmolo, Rosa Maria, Montalbano, Marzia, Lenci, Ilaria, Bhoori, Sherrie, Pieri, Giulia, Berardi, Sonia, Caraceni, Paolo, Martini, Silvia, Donato, M, Morelli, C, Romagnoli, R, Invernizzi, F, Mazzarelli, C, Iemmolo, R, Montalbano, M, Lenci, I, Bhoori, S, Pieri, G, Berardi, S, Caraceni, P, Martini, S, Angeli, P, Belli, L, Bernabucci, V, Malinverno, F, Monico, S, Ottobrelli, A, Romano, A, Strona, S, Tamè, M, Visco-Comandini, U, Cavenago, M, De Carlis, L, Di Benedetto, F, Dondossola, D, Ettorre, G, Mazzaferro, V, Montin, U, Pinna, A, Rossi, G, Salizzoni, M, and Tisone, G

Subjects
Liver Cirrhosis, Male, Sofosbuvir, Sustained Virologic Response, Hepatocellular carcinoma, medicine.medical_treatment, Hepacivirus, Liver transplantation, medicine.disease_cause, hepatitis C, hepatocellular carcinoma, liver transplant, sofosbuvir therapy, virological response, Adult, Aged, Antiviral Agents, Carcinoma, Hepatocellular, Drug Therapy, Combination, Female, Hepatitis C, Humans, Italy, Liver Neoplasms, Middle Aged, Postoperative Period, Preoperative Period, Recurrence, Retrospective Studies, Ribavirin, Liver Transplantation, Gastroenterology, chemistry.chemical_compound, 0302 clinical medicine, Sofosbuvir therapy, Retrospective Studie, Liver transplant, Virological response, Liver Neoplasm, 030220 oncology & carcinogenesis, Combination, 030211 gastroenterology & hepatology, Viral hepatitis, Human, medicine.drug, medicine.medical_specialty, Liver Cirrhosi, Hepatitis C virus, 03 medical and health sciences, Hepatology, Drug Therapy, Internal medicine, medicine, Antiviral Agent, Hepaciviru, business.industry, Carcinoma, Hepatocellular, medicine.disease, Settore MED/18, Surgery, Regimen, chemistry, business
Abstract

Background and aims Hepatitis C virus (HCV) reinfection following liver transplant (LT) is associated with reduced graft and patients survival. Before transplant, Sofosbuvir/Ribavirin (SOF/R) treatment prevents recurrent HCV in 96% of those patients achieving viral suppression for at least 4 weeks before transplant. We evaluated whether a bridging SOF-regimen from pre to post-transplant is safe and effective to prevent HCV recurrence in those patients with less than 4 week HCV-RNA undetectability at the time of transplant. Material and Methods From July 2014 SOF/R was given in 233 waitlisted HCV cirrhotics with/without hepatocellular carcinoma (HCC) within an Italian Compassionate Program. One-hundred were transplanted and 31 patients (31%) treated by SOF/R bridging therapy were studied Results LT indication in bridge subgroup was HCC in 22 and decompensated cirrhosis in 9. HCV-genotype was 1/4 in 18 patients. SOF 400 mg/day and R (median dosage 800 mg/day) were given for a median of 35 days before LT. At transplant time, 19 patients were still HCV-RNA positive (median HCV-RNA 58 IU/ml). One recipient had a virological breakthrough at week 4 post-transplant; one died, on treatment, 1-month post-transplant for sepsis and 29/31 achieved a 12-week sustained virological response (94%). Acute cellular rejection occurred in 4 recipients. On September 2016, 30 recipients (97%) are alive with a median follow-up of 18 months (range 13-25). Conclusions In patients with suboptimal virological response at LT a bridging SOF/R regimen helps avoiding post-transplant graft reinfection. This article is protected by copyright. All rights reserved.

Published
2017

49. Liver Transplantation for Hepatic Trauma: A Study From the European Liver Transplant Registry

Author

Krawczyk, M, Grat, M, Adam, R, Polak, W, Klempnauer, J, Pinna, A, Di Benedetto, F, Filipponi, F, Senninger, N, Foss, A, Rufian-Pena, S, Bennet, W, Pratschke, J, Paul, A, Settmacher, U, Rossi, G, Salizzoni, M, Fernandez-Selles, C, de Rituerto, S, Gomez-Bravo, M, Pirenne, J, Detry, O, Majno, P, Nemec, P, Bechstein, W, Bartels, M, Nadalin, S, Pruvot, F, Mirza, D, Lupo, L, Colledan, M, Tisone, G, Ringers, J, Daniel, J, Torra, R, Gonzalez, E, Canizares, R, Martinez, V, Rodriguez, F, Yilmaz, S, Remiszewski, P, Krawczyk M, Grat M, Adam R, Polak WG, Klempnauer J, Pinna A, Di Benedetto F, Filipponi F, Senninger N, Foss A, Rufian-Pena S, Bennet W, Pratschke J, Paul A, Settmacher U, Rossi G, Salizzoni M, Fernandez-Selles C, de Rituerto STM, Gomez-Bravo MA, Pirenne J, Detry O, Majno PE, Nemec P, Bechstein WO, Bartels M, Nadalin S, Pruvot FR, Mirza DF, Lupo L, Colledan M, Tisone G, Ringers J, Daniel J, Torra RC, Gonzalez EM, Canizares RB, Martinez VCM, Rodriguez FSJ, Yilmaz S, Remiszewski P, Krawczyk, M, Grat, M, Adam, R, Polak, W, Klempnauer, J, Pinna, A, Di Benedetto, F, Filipponi, F, Senninger, N, Foss, A, Rufian-Pena, S, Bennet, W, Pratschke, J, Paul, A, Settmacher, U, Rossi, G, Salizzoni, M, Fernandez-Selles, C, de Rituerto, S, Gomez-Bravo, M, Pirenne, J, Detry, O, Majno, P, Nemec, P, Bechstein, W, Bartels, M, Nadalin, S, Pruvot, F, Mirza, D, Lupo, L, Colledan, M, Tisone, G, Ringers, J, Daniel, J, Torra, R, Gonzalez, E, Canizares, R, Martinez, V, Rodriguez, F, Yilmaz, S, Remiszewski, P, Krawczyk M, Grat M, Adam R, Polak WG, Klempnauer J, Pinna A, Di Benedetto F, Filipponi F, Senninger N, Foss A, Rufian-Pena S, Bennet W, Pratschke J, Paul A, Settmacher U, Rossi G, Salizzoni M, Fernandez-Selles C, de Rituerto STM, Gomez-Bravo MA, Pirenne J, Detry O, Majno PE, Nemec P, Bechstein WO, Bartels M, Nadalin S, Pruvot FR, Mirza DF, Lupo L, Colledan M, Tisone G, Ringers J, Daniel J, Torra RC, Gonzalez EM, Canizares RB, Martinez VCM, Rodriguez FSJ, Yilmaz S, and Remiszewski P

Abstract

Background. Liver transplantation is the most extreme form of surgical management of patients with hepatic trauma, with very limited literature data supporting its use. The aim of this study was to assess the results of liver transplantation for hepatic trauma. Methods. This retrospective analysis based on European Liver Transplant Registry comprised data of 73 recipients of liver transplantation for hepatic trauma performed in 37 centers in the period between 1987 and 2013. Mortality and graft loss rates at 90 days were set as primary and secondary outcome measures, respectively. Results. Mortality and graft loss rates at 90 days were 42.5% and 46.6%, respectively. Regarding general variables, cross-clamping without extracorporeal veno-venous bypass was the only independent risk factor for both mortality (P = 0.031) and graft loss (P = 0.034). Regarding more detailed factors, grade of liver trauma exceeding IV increased the risk of mortality (P = 0.005) and graft loss (P = 0.018). Moreover, a tendency above the level of significance was observed for the negative impact of injury severity score (ISS) on mortality (P = 0.071). The optimal cutoff for ISS was 33, with sensitivity of 60.0%, specificity of 80.0%, positive predictive value of 75.0%, and negative predictive value of 66.7%. Conclusions. Liver transplantation seems to be justified in selected patients with otherwise fatal severe liver injuries, particularly in whom cross-clamping without extracorporeal bypass can be omitted. The ISS cutoff less than 33 may be useful in the selection process.

Published
2016

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