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2. OC.11.1: UNDERDILATION STRATEGY FOR TIPS PLACEMENT REDUCES INCIDENCE OF OVERT HEPATIC ENCEPHALOPATHY WITHOUT AFFECTING CLINICAL EFFICACY AND SURVIVAL: RESULTS OF A MULTICENTER PROSPECTIVE ITALIAN STUDY

Author

Saltini, D., primary, Nardelli, S., additional, Addotti, V., additional, Biribin, L., additional, Guasconi, T., additional, Gioia, S., additional, Caporali, C., additional, Bianchini, M., additional, Rosi, M., additional, Roccarina, D., additional, Ridola, L., additional, Casari, F., additional, Prampolini, F., additional, Indulti, F., additional, Cuffari, B., additional, Ragozzino, L., additional, De Maria, N., additional, Colecchia, A., additional, Senzolo, M., additional, Merli, M., additional, Marra, F., additional, Riggio, O., additional, Vizzutti, F., additional, and Schepis, F., additional

Published
2024
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3. BOC.02.7: UNDERDILATED NEOADJUVANT-TIPS IN PATIENTS WITH CIRRHOSIS AND PORTAL HYPERTENSION CANDIDATES TO OPERATIVE INTERVENTIONS

Author

Saltini, D., primary, Guasconi, T., additional, Ingravallo, A., additional, Indulti, F., additional, Caporali, C., additional, Gitto, S., additional, Falcini, M., additional, Bianchini, M., additional, Cuffari, B., additional, Scoppettuolo, R., additional, Prampolini, F., additional, Casari, F., additional, De Maria, N., additional, Marra, F., additional, Colecchia, A., additional, Vizzutti, F., additional, and Schepis, F., additional

Published
2024
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4. BOC.02.4: EPISODIC OVERT HEPATIC ENCEPHALOPATHY AFTER TRANSJUGULAR INTRAHEPATIC PORTOSYSTEMIC SHUNT DOES NOT INCREASE MORTALITY IN PATIENTS WITH CIRRHOSIS

Author

Nardelli, S., primary, Riggio, O., additional, Marra, F., additional, Gioia, S., additional, Saltini, D., additional, Bellafante, D., additional, Adotti, V., additional, Guasconi, T., additional, Ridola, L., additional, Rosi, M., additional, Caporali, C., additional, Fanelli, F., additional, Roccarina, D., additional, Bianchini, M., additional, Indulti, F., additional, Spagnoli, A., additional, Merli, M., additional, Vizzutti, F., additional, and Schepis, F., additional

Published
2024
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5. OC.05.2: FIRST AND FURTHER LIVER DECOMPENSATION IN PATIENTS WITH METABOLIC-DYSFUNCTION ASSOCIATED STEATOTIC LIVER DISEASE: WHAT CLINICAL IMPACT?

Author

Pennisi, G., primary, Viganò, M., additional, Fracanzani, A.L., additional, Miele, L., additional, Bugianesi, E., additional, D'Ambrosio, R., additional, Ravaioli, F., additional, Schepis, F., additional, Marra, F., additional, Aghemo, A.M.G., additional, Svegliati Baroni, G., additional, Masarone, M., additional, Valenti, L., additional, Armandi, A., additional, Ciccioli, C., additional, Cerini, F., additional, Colecchia, A., additional, Gasbarrini, A., additional, Infantino, G., additional, Liguori, A., additional, Pelusi, S., additional, Saltini, D., additional, Lampertico, P., additional, Persico, M., additional, Pugliese, N., additional, Tulone, A., additional, Di Marco, V., additional, Cammà, C., additional, and Petta, S., additional

Published
2024
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6. Angiopoietin-2 and the Vascular Endothelial Growth Factor Promote Migration and Invasion in Hepatocellular Carcinoma- and Intrahepatic Cholangiocarcinoma-Derived Spheroids

Author

Romanzi, A, Milosa, F, Marcelli, G, Critelli, R, Lasagni, S, Gigante, I, Dituri, F, Schepis, F, Cadamuro, M, Giannelli, G, Fabris, L, Villa, E, Critelli, RM, Romanzi, A, Milosa, F, Marcelli, G, Critelli, R, Lasagni, S, Gigante, I, Dituri, F, Schepis, F, Cadamuro, M, Giannelli, G, Fabris, L, Villa, E, and Critelli, RM

Abstract

Aggressive hepatocellular carcinoma (HCC) overexpressing Angiopoietin-2 (ANG-2) (a protein linked with angiogenesis, proliferation, and epithelial–mesenchymal transition (EMT)), shares 95% of up-regulated genes and a similar poor prognosis with the proliferative subgroup of intrahepatic cholangiocarcinoma (iCCA). We analyzed the pro-invasive effect of ANG-2 and its regulator vascular endothelial growth factor (VEGF) on HCC and CCA spheroids to uncover posUsible common ways of response. Four cell lines were used: Hep3B and HepG2 (HCC), HuCC-T1 (iCCA), and EGI-1 (extrahepatic CCA). We treated the spheroids with recombinant human (rh) ANG-2 and/or VEGF and then observed the changes at the baseline, after 24 h, and again after 48 h. Proangiogenic stimuli increased migration and invasion capability in HCC- and iCCA-derived spheroids and were associated with a modification in EMT phenotypic markers (a decrease in E-cadherin and an increase in N-cadherin and Vimentin), especially at the migration front. Inhibitors targeting ANG-2 (Trebananib) and the VEGF (Bevacizumab) effectively blocked the migration ability of spheroids that had been stimulated with rh-ANG-2 and rh-VEGF. Overall, our findings highlight the critical role played by ANG-2 and the VEGF in enhancing the ability of HCC- and iCCA-derived spheroids to migrate and invade, which are key processes in cancer progression.

Published
2024

7. Episodic overt hepatic encephalopathy after transjugular intrahepatic portosystemic shunt does not increase mortality in patients with cirrhosis

Author

Nardelli, S., primary, Riggio, O., additional, Marra, F., additional, Gioia, S., additional, Saltini, D., additional, Bellafante, D., additional, Adotti, V., additional, Guasconi, T., additional, Ridola, L., additional, Rosi, M., additional, Caporali, C., additional, Fanelli, F., additional, Roccarina, D., additional, Bianchini, M., additional, Indulti, F., additional, Spagnoli, A., additional, Merli, M., additional, Vizzutti, F., additional, and Schepis, F., additional

Published
2024
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8. Response to “Hepatic encephalopathy and survival after transjugular intra-hepatic portosystemic shunt: do spontaneous portosystemic shunts matter?”

Author

Nardelli, S., primary, Riggio, O., additional, Marra, F., additional, Gioia, S., additional, Saltini, D., additional, Bellafante, D., additional, Adotti, V., additional, Guasconi, T., additional, Ridola, L., additional, Rosi, M., additional, Caporali, C., additional, Fanelli, F., additional, Roccarina, D., additional, Bianchini, M., additional, Indulti, F., additional, Spagnoli, A., additional, Merli, M., additional, Schepis, F., additional, and Vizzutti, F., additional

Published
2024
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9. Hepatic encephalopathy increases the risk for mortality and hospital readmission in decompensated cirrhotic patients: a prospective multicenter study

Author

Riggio, O, Celsa, C, Calvaruso, V, Merli, M, Caraceni, P, Montagnese, S, Mora, V, Milana, M, Saracco, G, Raimondo, G, Benedetti, A, Burra, P, Sacco, R, Persico, M, Schepis, F, Villa, E, Colecchia, A, Fagiuoli, S, Pirisi, M, Barone, M, Azzaroli, F, Soardo, G, Russello, M, Morisco, F, Labanca, S, Fracanzani, A, Pietrangelo, A, Di Maria, G, Nardelli, S, Ridola, L, Gasbarrini, A, Camma, C, Riggio O., Celsa C., Calvaruso V., Merli M., Caraceni P., Montagnese S., Mora V., Milana M., Saracco G. M., Raimondo G., Benedetti A., Burra P., Sacco R., Persico M., Schepis F., Villa E., Colecchia A., Fagiuoli S., Pirisi M., Barone M., Azzaroli F., Soardo G., Russello M., Morisco F., Labanca S., Fracanzani A. L., Pietrangelo A., Di Maria G., Nardelli S., Ridola L., Gasbarrini A., Camma C., Riggio, O, Celsa, C, Calvaruso, V, Merli, M, Caraceni, P, Montagnese, S, Mora, V, Milana, M, Saracco, G, Raimondo, G, Benedetti, A, Burra, P, Sacco, R, Persico, M, Schepis, F, Villa, E, Colecchia, A, Fagiuoli, S, Pirisi, M, Barone, M, Azzaroli, F, Soardo, G, Russello, M, Morisco, F, Labanca, S, Fracanzani, A, Pietrangelo, A, Di Maria, G, Nardelli, S, Ridola, L, Gasbarrini, A, Camma, C, Riggio O., Celsa C., Calvaruso V., Merli M., Caraceni P., Montagnese S., Mora V., Milana M., Saracco G. M., Raimondo G., Benedetti A., Burra P., Sacco R., Persico M., Schepis F., Villa E., Colecchia A., Fagiuoli S., Pirisi M., Barone M., Azzaroli F., Soardo G., Russello M., Morisco F., Labanca S., Fracanzani A. L., Pietrangelo A., Di Maria G., Nardelli S., Ridola L., Gasbarrini A., and Camma C.

Abstract

Introduction: Hepatic encephalopathy (HE) affects the survival and quality of life of patients with cirrhosis. However, longitudinal data on the clinical course after hospitalization for HE are lacking. The aim was to estimate mortality and risk for hospital readmission of cirrhotic patients hospitalized for HE. Methods: We prospectively enrolled 112 consecutive cirrhotic patients hospitalized for HE (HE group) at 25 Italian referral centers. A cohort of 256 patients hospitalized for decompensated cirrhosis without HE served as controls (no HE group). After hospitalization for HE, patients were followed-up for 12 months until death or liver transplant (LT). Results: During follow-up, 34 patients (30.4%) died and 15 patients (13.4%) underwent LT in the HE group, while 60 patients (23.4%) died and 50 patients (19.5%) underwent LT in the no HE group. In the whole cohort, age (HR 1.03, 95% CI 1.01–1.06), HE (HR 1.67, 95% CI 1.08–2.56), ascites (HR 2.56, 95% CI 1.55–4.23), and sodium levels (HR 0.94, 95% CI 0.90–0.99) were significant risk factors for mortality. In the HE group, ascites (HR 5.07, 95% CI 1.39–18.49) and BMI (HR 0.86, 95% CI 0.75–0.98) were risk factors for mortality, and HE recurrence was the first cause of hospital readmission. Conclusion: In patients hospitalized for decompensated cirrhosis, HE is an independent risk factor for mortality and the most common cause of hospital readmission compared with other decompensation events. Patients hospitalized for HE should be evaluated as candidates for LT.

Published
2023

10. A machine learning enabled score based on large varices predicts 5- and 10-year hepatocellular carcinoma (HCC) development in a 12-year prospective cohort of patients with compensated advanced chronic liver disease

Author

Ascari, S., primary, Sardone, R., additional, Castellana, F., additional, Schepis, F., additional, Baldaccini, V., additional, Semellini, F., additional, Pivetti, A., additional, Di Marco, L., additional, Lei, B., additional, De Maria, N., additional, Dituri, F., additional, Giannelli, G., additional, and Villa, E., additional

Published
2023
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11. Serum procalcitonin predicts mortality independently of the presence of ACLF in patients with cirrhosis and ascites hospitalized for suspicious infection and treated with empiric antibiotic therapy

Author

Bianchini, M., primary, Celsa, C., additional, Magro, B., additional, Cavani, G., additional, Giuffrida, P., additional, Battaglia, S., additional, Saltini, D., additional, Zanetto, A., additional, Indulti, F., additional, Guasconi, T., additional, Girardis, M., additional, Calvaruso, V., additional, Fagiuoli, S., additional, Colecchia, A., additional, Villa, E., additional, Cammà, C., additional, and Schepis, F., additional

Published
2023
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12. Presence and severity of esophageal varices drives portal hypertension-related complications in compensated advanced nonalcoholic fatty liver disease

Author

Pennisi, G., primary, Enea, M., additional, Viganò, M., additional, Schepis, F., additional, de Ledinghen, V., additional, Berzigotti, A., additional, Wong, V., additional, Fracanzani, A.L., additional, Sebastiani, G., additional, Romero-Gomez, M., additional, Bugianesi, E., additional, Svegliati-Baroni, G., additional, Marra, F., additional, Aghemo, A., additional, Valenti, L., additional, Calvaruso, V., additional, Colecchia, A., additional, Di Maria, G., additional, La Mantia, C., additional, Lin, H., additional, Mendoza, Y., additional, Pugliese, N., additional, Ravaioli, F., additional, Lara-Romero, C., additional, Saltini, D., additional, Craxì, A., additional, Di Marco, V., additional, Cammà, C., additional, and Petta, S., additional

Published
2023
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13. TIPS under-dilation strategy with new controlled expansion endoprosthesis: A hemodynamic and imaging confirmation of its feasibility

Author

Saltini, D., primary, Caporali, C., additional, Indulti, F., additional, Casari, F., additional, Prampolini, F., additional, Felaco, D., additional, Battinelli, G., additional, Bianchini, M., additional, Guasconi, T., additional, Cuffari, B., additional, Zanetto, A., additional, Olivieri, T., additional, Assirati, G., additional, Serra, V., additional, Catellani, B., additional, Guidetti, C., additional, Guerrini, G.P., additional, Ballarin, R., additional, Magistri, P., additional, De Maria, N., additional, Di Sandro, S., additional, Torricelli, P., additional, Girardis, M., additional, Villa, E., additional, Colecchia, A., additional, Di Benedetto, F., additional, and Schepis, F., additional

Published
2023
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14. Corrigendum to ‘Baveno VII – Renewing consensus in portal hypertension’ [J Hepatol (2022) 959-974, (S0168827821022996), (10.1016/j.jhep.2021.12.022)]

Author

de Franchis, R., Bosch, J., Garcia-Tsao, G., Reiberger, T., Ripoll, C., Abraldes, J. G., Albillos, A., Baiges, A., Bajaj, J., Banares, R., Barrufet, M., Benajiba, L., Berzigotti, A., Bureau, C., Calvaruso, V., Cardenas, A., D'Amico, G., De Gottardi, A., Dell'Era, A., Escorsell, A., Fallowfield, J., Ferral, H., Francque, S., Gaba, R., Garcia-Pagan, J. C., Genesca, J., Rodrigues, S. G., Gracia-Sanscho, J., Han, G., Hernandez-Gea, V., Jia, J., Kiladjian, J. J., Krag, A., Laleman, W., La Mura, V., Lens, S., Luo, X., Mandorfer, M., Murad, S. D., Paradis, V., Patch, D., Piano, S., Pinzani, M., Plessier, A., Primignani, M., Procopet, B., Rautou, P. E., Rudler, M., Sarin, S. K., Schepis, F., Senzolo, M., Shah, V., Shukla, A., Tandon, P., Tellez, L., Thabut, D., Thiele, M., Trebicka, J., Tripathi, D., Tsochatzis, E., Turco, L., Turon, F., Valla, D., Villanueva, C., Wanless, I., and Yoshiji, H.

Published
2022

15. Quality of life in liver transplant recipients during the Corona virus disease 19 pandemic: A multicentre study

Author

Gitto, S., Golfieri, L., Mannelli, N., Tame, M. R., Lopez, I., Ceccato, R., Montanari, S., Falcini, M., Vitale, G., De Maria, N., Presti, D. L., Marzi, L., Mega, A., Valente, G., Borghi, A., Foschi, F. G., Grandi, S., Forte, P., Cescon, M., Di Benedetto, F., Andreone, P., Arcangeli, G., De Simone, P., Bonacchi, A., Sofi, F., Morelli, M. C., Petranelli, M., Lau, C., Marra, F., Chiesi, F., Vizzutti, F., Vero, V., Di Donato, R., Berardi, S., Pianta, P., D'Anzi, S., Schepis, F., Gualandi, N., Miceli, F., Villa, E., Piai, G., Valente, M., Campani, C., Lynch, E., Magistri, P., Cursaro, C., Chiarelli, A., Carrai, P., Petruccelli, S., Dinu, M., and Pagliai, G.

Subjects
liver transplant, Hepatology, quality of life, COVID-19
Published
2022

16. The impact of first and further decompensation in patients with metabolic-dysfunction associated compensated advanced chronic liver disease.

Author

Pennisi, G., Maria, G. Di, Wong, V. Wai-Sun, de Ledinghen, V., Sebastiani, G., Viganò, M., Fracanzani, A.L., Miele, L., Bugianesi, E., Ekstedt, M., D'Ambrosio, R., Schepis, F., Marra, F., Aghemo, A.M., Svegliati-Baroni, G., Persico, M., Valenti, L., Berzigotti, A., George, J., and Ravaioli, F.

Abstract

The first and further decompensation mark the natural history and the risk of mortality in patients with cirrhosis. We assessed the cumulative incidence of first and further (acute and non-acute) decompensation and evaluated their impact on both liver-related death (LR-D) in patients with compensated advanced chronic liver disease (cACLD) due to metabolic dysfunction-associated steatotic liver disease (MASLD). Consecutive patients with clinical (LSM>10 kPa) or biopsy-proven (F3-F4 fibrosis) diagnosis of cACLD due to MASLD were included. First and further decompensation were defined according to Baveno VII criteria. The acute (AD) and non-acute (NAD)[MOU1] [VW(2] presentation of the decompensation was also evaluated. Competing risk analysis and cumulative incidence functions (CIF) [MOU3] were assessed by Fine and Gray. Cause-specific Cox models with baseline and time-dependent variables were applied. Multistate model was built to better assess the clinical course of cACLD due to MASLD. The cumulative incidence of the first decompensation was 3.5% at 5 years, increasing 20-times the risk of LR-D at cause-specific Cox analysis; the cumulative incidence of further decompensation was 44% at 5 years among patients with first decompensation, additionally increasing 1.6-times the risk of LR-D. Ascites, followed by variceal bleeding, were the most common events in both first and further decompensation. The impact of AD and NAD as both first or further event on LR-D was similar[MOU4]. Hepatocellular carcinoma (HCC) further independently increased the risk of LR-D of 3.2-times and 1.6-times, respectively, in the whole cohort of cACLD due to MASLD and in those who experienced first decompensation. The first and further decompensations (AD and NAD) represent tipping points in the clinical course of patients with cACLD due to MASLD, increasing 20-times and additionally 1.6-times the risk of LR-D. HCC is an independent predictor of LR-D in patients with cACLD due to MASLD, resulting in an additional risk of LR-D when associated with both first and further decompensation. [ABSTRACT FROM AUTHOR]

Published
2024
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17. Transjugular intra-hepatic portosystemic shunt (TIPS) in elderly patients: preliminary analysis of a multicenter retrospective cohort.

Author

Roccarina, D., primary, Turco, L., additional, Campani, C., additional, Saltini, D., additional, Aspite, S., additional, Calvaruso, V., additional, Arena, U., additional, Senzolo, M., additional, Fanelli, F., additional, Caporali, C., additional, Gitto, S., additional, Citone, M., additional, Di Bonaventura, C., additional, Schepis, F., additional, Vizzutti, F., additional, Riggio, O., additional, Burra, P., additional, Villa, E., additional, Cammà, C., additional, Marra, F., additional, and Bianchini, M., additional

Published
2022
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20. First and further liver decompensation in patients with metabolic-dysfunction associated steatotic liver disease: what clinical impact?

Author

Pennisi, G., Viganò, M., Fracanzani, A.L., Miele, L., Bugianesi, E., D'Ambrosio, R., Ravaioli, F., Schepis, F., Marra, F., Aghemo, A., Svegliati-Baroni, G., Masarone, M., Valenti, L., Armandi, A., Ciccioli, C., Cerini, F., Colecchia, A., Gasbarrini, A., Infantino, G., Liguori, A., Pelusi, S., Saltini, D., Lampertico, P., Persico, M., Pugliese, N., Tulone, A., Marco, V. Di, Cammà, C., and Petta, S.

Published
2024
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21. Underdilation strategy for TIPS placement reduces incidence of overt hepatic encephalopathy without affecting clinical efficacy and survival: results of a multicenter prospective Italian study

Author

Saltini, D., Nardelli, S., Addotti, V., Biribin, L., Guasconi, T., Gioia, S., Caporali, C., Bianchini, M., Rosi, M., Roccarina, D., Ridola, L., Casari, F., Prampolini, F., Indulti, F., Cuffari, B., Ragozzino, L., De Maria, N., Colecchia, A., Senzolo, M., Merli, M., Marra, F., Riggio, O., Vizzutti, F., and Schepis, F.

Published
2024
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24. Under-dilated TIPS Associate With Efficacy and Reduced Encephalopathy in a Prospective, Non-randomized Study of Patients With Cirrhosis

Author

Schepis, F, Vizzutti, F, Garcia-Tsao, G, Marzocchi, G, Rega, L, De Maria, N, Di Maira, T, Gitto, S, Caporali, C, Colopi, S, De Santis, M, Arena, U, Rampoldi, A, Airoldi, A, Cannavale, A, Fanelli, F, Mosconi, C, Renzulli, M, Agazzi, R, Nani, R, Quaretti, P, Fiorina, I, Moramarco, L, Miraglia, R, Luca, A, Bruno, R, Fagiuoli, S, Golfieri, R, Torricelli, P, Di Benedetto, F, Belli, L, Banchelli, F, Laffi, G, Marra, F, Villa, E, Schepis F., Vizzutti F., Garcia-Tsao G., Marzocchi G., Rega L., De Maria N., Di Maira T., Gitto S., Caporali C., Colopi S., De Santis M., Arena U., Rampoldi A., Airoldi A., Cannavale A., Fanelli F., Mosconi C., Renzulli M., Agazzi R., Nani R., Quaretti P., Fiorina I., Moramarco L., Miraglia R., Luca A., Bruno R., Fagiuoli S., Golfieri R., Torricelli P., Di Benedetto F., Belli L. S., Banchelli F., Laffi G., Marra F., Villa E., Schepis, F, Vizzutti, F, Garcia-Tsao, G, Marzocchi, G, Rega, L, De Maria, N, Di Maira, T, Gitto, S, Caporali, C, Colopi, S, De Santis, M, Arena, U, Rampoldi, A, Airoldi, A, Cannavale, A, Fanelli, F, Mosconi, C, Renzulli, M, Agazzi, R, Nani, R, Quaretti, P, Fiorina, I, Moramarco, L, Miraglia, R, Luca, A, Bruno, R, Fagiuoli, S, Golfieri, R, Torricelli, P, Di Benedetto, F, Belli, L, Banchelli, F, Laffi, G, Marra, F, Villa, E, Schepis F., Vizzutti F., Garcia-Tsao G., Marzocchi G., Rega L., De Maria N., Di Maira T., Gitto S., Caporali C., Colopi S., De Santis M., Arena U., Rampoldi A., Airoldi A., Cannavale A., Fanelli F., Mosconi C., Renzulli M., Agazzi R., Nani R., Quaretti P., Fiorina I., Moramarco L., Miraglia R., Luca A., Bruno R., Fagiuoli S., Golfieri R., Torricelli P., Di Benedetto F., Belli L. S., Banchelli F., Laffi G., Marra F., and Villa E.

Abstract

Background & Aims: Portosystemic encephalopathy (PSE) is a major complication of trans-jugular intrahepatic porto-systemic shunt (TIPS) placement. Most devices are self-expandable polytetrafluoroethylene-covered stent grafts (PTFE-SGs) that are dilated to their nominal diameter (8 or 10 mm). We investigated whether PTFE-SGs dilated to a smaller caliber (under-dilated TIPS) reduce PSE yet maintain clinical and hemodynamic efficacy. We also studied whether under-dilated TIPS self-expand to nominal diameter over time. Methods: We performed a prospective, non-randomized study of 42 unselected patients with cirrhosis who received under-dilated TIPS (7 and 6 mm) and 53 patients who received PTFE-SGs of 8 mm or more (controls) at referral centers in Italy. After completion of this study, dilation to 6 mm became the standard and 47 patients were included in a validation study. All patients were followed for 6 months; Doppler ultrasonography was performed 2 weeks and 3 months after TIPS placement and every 6 months thereafter. Stability of PTFE-SG diameter was evaluated by computed tomography analysis of 226 patients with cirrhosis whose stent grafts increased to 6, 7, 8, 9, or 10 mm. The primary outcomes were incidence of at least 1 episode of PSE grade 2 or higher during follow up, incidence of recurrent variceal hemorrhage or ascites, incidence of shunt dysfunction requiring TIPS recanalization, and reduction in porto-caval pressure gradient. Results: PSE developed in a significantly lower proportion of patients with under-dilated TIPS (27%) than controls (54%) during the first year after the procedure (P =.015), but the proportions of patients with recurrent variceal hemorrhage or ascites did not differ significantly between groups. No TIPS occlusions were observed. These results were confirmed in the validation cohort. In an analysis of self-expansion of stent grafts, during a mean follow-up period of 252 days after placement, none of the PTFE-SGs self-expanded to t

Published
2018

28. Preoperative Chemoradiotherapy of oesophageal cancer: A Systematic Review and Meta-analysis

Author

Fiorica, F., Di Bona, D., Schepis, F., Licata, A., Shahied, L, and Venturi, A.

Subjects
Chemotherapy -- Usage, Chemotherapy -- Health aspects, Chemotherapy -- Research, Esophageal cancer -- Care and treatment, Esophageal cancer -- Health aspects, Cancer -- Chemotherapy, Cancer -- Usage, Cancer -- Health aspects, Cancer -- Research, Health
Published
2004

29. Assessment of sarcopenia improves the prediction of post-TIPS mortality in older adult patients with cirrhosis.

Author

Saltini, D., Nardelli, S., Vizzutti, F., Miraglia, R., Bellafante, D., Banchelli, F., Caporali, C., Maruzzelli, L., Falcone, G., Bianchini, M., Guasconi, T., Ingravallo, A., Casari, F., Prampolini, F., Colecchia, A., Marra, F., Cammà, C., Senzolo, M., Riggio, O., and Schepis, F.

Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) has been demonstrated to be feasible in older adult patients (age ≥70 years), yet the selection criteria remain suboptimal. Sarcopenia, highly prevalent in elderly population, may be significantly associated with post-TIPS outcome. This study aimed at evaluating the impact of baseline sarcopenia on post-TIPS survival in older adults with cirrhosis. A retrospective analysis of the prospective Italian TIPS-Registry was conducted to identify patients ≥70 years who received TIPS from June 2015 to March 2023. The availability of baseline abdominal CT scan was a mandatory inclusion criterion. Skeletal muscle index (SMI) was evaluated at the L3-L4 level. Sarcopenia was defined as SMI <50 cm2/m2 for men and <39 cm2/m2 for women. Probability of liver-related death was evaluated by competing risks analysis. A prediction model for liver-related mortality was created. One-hundred and fifteen patients were included: median age 74 years (IQR 3.1), 62% male, median dry-BMI 25.7 (IQR 4.7), 60% prevalence of sarcopenia. The main etiologies were viral (40%), alcohol-associated cirrhosis (23%), and metabolic dysfunction-associated steatohepatitis (20%). Refractory ascites (57%) was the main indications for TIPS. During a mean follow up of 20 months (IQR 20), 40 (34.8%) patients died for liver-related causes and 16 (13.9%) for extrahepatic causes. Liver-related mortality was significantly higher in patients with sarcopenia than in those without (6-months: 25.0% vs. 2.2%; 1-year: 43.0% vs. 4.8%, respectively; p value <0.001). A predictive model including INR, creatinine, and sarcopenia was developed to estimate liver-related mortality. The model achieved good predictive performances with AUCs of 0.826, 0.788, and 0.712 at 6-month, 1-year, and 2-years, respectively. Due to its significant impact on survival, the evaluation of sarcopenia may improve the selection of older adults candidate to TIPS. The new predictive model for post-TIPS liver-related mortality deserves external validation. [ABSTRACT FROM AUTHOR]

Published
2024
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30. Predicting post-TIPS hepatic encephalopathy risk in patients with cirrhosis and refractory ascites: a proof-of-concept study using a 4D MRI perfusional model.

Author

Saltini, D., Piscopo, A., Nocetti, L., Colopi, S., Caporali, C., Bianchini, M., Guasconi, T., Casari, F., Scoppettuolo, M., Prampolini, F., Giglio, C., Mayorga, A.S. Velasco, Ascari, F., Colecchia, A., and Schepis, F.

Abstract

Transjugular intrahepatic portosystemic shunt (TIPS) is a well-established treatment for refractory ascites (RA) in patients with cirrhosis. However, a major drawback is the development of post-procedural hepatic encephalopathy (HE), which results from the diversion of blood from the portal vein. According to the first-pass effect, this diversion reduces the liver's capacity to metabolize substances from the gut, leading to an accumulation of toxic compounds in the brain. Given that liver perfusion relies on arterial compensation (hepatic arterial buffer), it is plausible that effective compensation, which also depends on cardiac function, may reduce the risk of encephalopathy by detoxifying the blood during the second-pass metabolism. To evaluate by Dynamic Contrast Enhanced-Magnetic Resonance Imaging (DCE-MRI) the changes in liver perfusion induced by TIPS in patients with RA and their relationship with the risk of HE. Twenty-nine consecutive patients underwent DCE-MRI, cardiac and hepatic hemodynamic evaluation before and after TIPS. MRI images were processed by a homemade software using the Dual Input Dual Compartment (DIDC) model, focusing on perfusion parameters. The DIDC model showed that total hepatic perfusion decreased by 24% after TIPS (248 ml/min/100ml vs 189 ml/min/100ml, p 0.095). As expected, a significant reduction in portal perfusion (decreased by 67%; 128.6 ml/min/100ml vs 42.4 ml/min/100ml, p 0.004) and an increase in hepatic arterial fraction post-TIPS (48% vs 77%, p 0.001) was observed. Post-TIPS residual total hepatic perfusion inversely correlated with one-year HE risk: patients with perfusion ≤ 130 ml/min/100ml had a HE risk of 67.6% vs 36.4% for those > 130 ml/min/100ml (HR: 2.1, p 0.039). Perfusion MRI is able to elucidate the impact of TIPS on liver perfusion, quantifying the extent of hepatic perfusion and its correlation with the development of post-TIPS HE. [ABSTRACT FROM AUTHOR]

Published
2024
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31. Retreatment with interferon plus ribavirin of chronic hepatitis C non-responders to interferon monotherapy: a meta-analysis of individual patient data. (Liver Disease)

Author

Camma, C., Bruno, S., Schepis, F., Iacono, O. Lo, Andreone, P., Gramenzi, A.G., Mangia, A., Andriulli, A., Puoti, M., Spadaro, A., Freni, M., Marco, V. Di, Cino, L., Saracco, G., Chiesa, A., Crosignani, A., Caporaso, N., Morisco, F., Rumi, M.G., and Craxi, A.

Subjects
Interferon -- Evaluation, Ribavirin -- Evaluation, Hepatitis C -- Drug therapy, Health
Abstract

Background and aims: Retreatment with a combination of α interferon (IFN) plus ribavirin of patients with chronic hepatitis C who did not respond to IFN monotherapy has not been assessed [...]

Published
2002

33. Long-term prospective study of development of hepatocellular carcinoma in compensated cirrhosis

Author

Pivetti, A., primary, Todesca, P., additional, Bernabucci, V., additional, Lei, B., additional, Buono, M. Del, additional, Turco, L., additional, Schepis, F., additional, Bianchini, M., additional, De Maria, N., additional, Romagnoli, D., additional, Carulli, L., additional, Casari, F., additional, Caporali, C., additional, Felaco, D., additional, and Villa, E., additional

Published
2020
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34. Systemic inflammation is associated with hyperdynamic circulation and predicts acute-on-chronic liver failure

Author

Praktiknjo, M, additional, Monteiro, S, additional, Grandt, J, additional, Kimer, N, additional, Madsen, JL, additional, Werge, MP, additional, Illiam, PW, additional, Brol, M, additional, Turco, L, additional, Schierwagen, R, additional, Chang, J, additional, Klein, S, additional, Jansen, C, additional, Uschner, F, additional, Welsch, C, additional, Moreau, R, additional, Schepis, F, additional, Bendtsen, F, additional, Gluud, LL, additional, Møller, S, additional, and Trebicka, J, additional

Published
2020
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35. Consensus conference on TIPS management: Techniques, indications, contraindications

Author

Fagiuoli, S, Bruno, R, Debernardi Venon, W, Schepis, F, Vizzutti, F, Toniutto, P, Senzolo, M, Caraceni, P, Salerno, F, Angeli, P, Cioni, R, Vitale, A, Grosso, M, De Gasperi, A, D'Amico, G, Marzano, A, Fagiuoli S., Bruno R., Debernardi Venon W., Schepis F., Vizzutti F., Toniutto P., Senzolo M., Caraceni P., Salerno F., Angeli P., Cioni R., Vitale A., Grosso M., De Gasperi A., D'Amico G., Marzano A., Fagiuoli, S, Bruno, R, Debernardi Venon, W, Schepis, F, Vizzutti, F, Toniutto, P, Senzolo, M, Caraceni, P, Salerno, F, Angeli, P, Cioni, R, Vitale, A, Grosso, M, De Gasperi, A, D'Amico, G, Marzano, A, Fagiuoli S., Bruno R., Debernardi Venon W., Schepis F., Vizzutti F., Toniutto P., Senzolo M., Caraceni P., Salerno F., Angeli P., Cioni R., Vitale A., Grosso M., De Gasperi A., D'Amico G., and Marzano A.

Abstract

The trans jugular intrahepatic Porto systemic shunt (TIPS) is no longer viewed as a salvage therapy or a bridge to liver transplantation and is currently indicated for a number of conditions related to portal hypertension with positive results in survival. Moreover, the availability of self-expandable polytetrafluoroethylene (PTFE)-covered endoprostheses has dramatically improved the long-term patency of TIPS. However, since the last updated International guidelines have been published (year 2009) new evidence have come, which have open the field to new indications and solved areas of uncertainty. On this basis, the Italian Association of the Study of the Liver (AISF), the Italian College of Interventional Radiology—Italian Society of Medical Radiology (ICIR-SIRM), and the Italian Society of Anesthesia, Analgesia and Intensive Care (SIAARTI) promoted a Consensus Conference on TIPS. Under the auspices of the three scientific societies, the consensus process started with the review of the literature by a scientific board of experts and ended with a formal consensus meeting in Bergamo on June 4th and 5th, 2015. The final statements presented here were graded according to quality of evidence and strength of recommendations and were approved by an independent jury. By highlighting strengths and weaknesses of current indications to TIPS, the recommendations of AISF-ICIR-SIRM-SIAARTI may represent the starting point for further studies.

Published
2017

37. Transient Elastography and Ultrasonography: Optimal Evaluation of Liver Fibrosis and Cirrhosis in Patients with Chronic Hepatitis B Concurrent with Nonalcoholic Fatty Liver Disease

Author

Zhang, G. -L., Zhao, Q. -Y., Lin, C. -S., Z. -X., Hu, Zhang, T., Gao, Z. -L., and Schepis, F.

Subjects
0301 basic medicine, Adult, Liver Cirrhosis, Male, medicine.medical_specialty, Cirrhosis, Article Subject, Biopsy, lcsh:Medicine, Area Under Curve, Body Mass Index, Female, Hepatitis B, Chronic, Humans, Middle Aged, Non-alcoholic Fatty Liver Disease, ROC Curve, Elasticity Imaging Techniques, Ultrasonography, Gastroenterology, General Biochemistry, Genetics and Molecular Biology, 03 medical and health sciences, 0302 clinical medicine, Fibrosis, Internal medicine, Nonalcoholic fatty liver disease, medicine, Chronic, General Immunology and Microbiology, medicine.diagnostic_test, Receiver operating characteristic, business.industry, lcsh:R, General Medicine, Hepatitis B, medicine.disease, 030104 developmental biology, Liver biopsy, 030211 gastroenterology & hepatology, Hepatic fibrosis, business, Transient elastography, Research Article
Abstract

Background and Aims. Concordance between transient elastography (TE) and ultrasonography (US) in assessing liver fibrosis in patients with chronic hepatitis B (CHB) and concurrent nonalcoholic fatty liver disease (NAFLD) has been rarely studied. This study aimed to evaluate the individual and combined performances of TE and US in assessing liver fibrosis and cirrhosis. Patients and Methods. Consecutive CHB patients with NAFLD were prospectively enrolled. TE and US examinations were performed, with liver biopsy as a reference standard. Receiver operating characteristic (ROC) curves were obtained to evaluate the diagnostic performance. Differences between the areas under the ROC curves (AUCs) were compared using DeLong’s test. Results. TE and US scores correlated significantly with the histological fibrosis staging scores. TE was significantly superior to US in the diagnosis of significant fibrosis (AUC, 0.84 vs 0.73; P=0.02), advanced fibrosis (AUC, 0.95 vs 0.76; P Conclusions. TE is useful for predicting hepatic fibrosis and excluding cirrhosis in CHB patients with NAFLD. A combination of TE and US does not improve the accuracy in assessing liver fibrosis or cirrhosis.

Published
2019

39. Clinical presentation and etiological spectrum of idiopathic non-cirrhotic portal hypertension (INCPH): data from the Italian Registry

Author

Primignani, M., primary, Tosetti, G., additional, La Mura, V., additional, Bitto, N., additional, Turco, L., additional, Bianchini, M., additional, Gioia, S., additional, Maggioni, M., additional, Senzolo, M., additional, Ferrarese, A., additional, Angeli, P., additional, Colloredo, G., additional, Airoldi, A., additional, Angrisani, D., additional, De Nicola, S., additional, Sarcognato, S., additional, Lampertico, P., additional, Schepis, F., additional, Riggio, O., additional, and Guido, M., additional

Published
2019
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43. VIATORR stent grafts do not self-expand to their nominal diameters in cirrhotic livers: good news from a computed tomography-based Italian multicentric study

Author

Schepis F, Vizzutti F, Marzocchi G, Quaretti P, Rampoldi A, Agazzi R, Golfieri R, Luca A, Fanelli F, Caporali C, Colopi S, De Santis M, Rega L, Arena U, Fiorina I, Moramarco L. P, Airoldi A, Nani R, Renzulli M, Mosconi C, Bruno R, Fagiuoli S, Cannavale A, Di Maira T, Villa E, and Schepis F, Vizzutti F, Marzocchi G, Quaretti P, Rampoldi A, Agazzi R, Golfieri R, Luca A, Fanelli F, Caporali C, Colopi S, De Santis M, Rega L, Arena U, Fiorina I, Moramarco L.P, Airoldi A, Nani R, Renzulli M, Mosconi C, Bruno R, Fagiuoli S, Cannavale A, Di Maira T, Villa E

Subjects
cirrhotic liver, computed tomography, VIATORR stent graft
Published
2014

49. Loss of tumour suppressor gene PTEN marks the transition from intratubular germ cell neoplasias (ITGCN) to invasive germ cell tumors

Author

DI VIZIO D., CITO L., BOCCIA A., INSABATO L., PETTINATO G., MOTTI M. L., SCHEPIS F., D, AMICO W., FABIANI F., TAVERNISE B., VENUTA S., FUSCO A., VIGLIETTO G., CHIEFFI, Paolo, DI VIZIO, D., Cito, L., Boccia, A., Chieffi, Paolo, Insabato, L., Pettinato, G., Motti, M. L., Schepis, F., D, Amico, W., Fabiani, F., Tavernise, B., Venuta, S., Fusco, A., and Viglietto, G.

Published
2005

50. The cl2/dro1/ccdc80 null mice develop thyroid and ovarian neoplasias

Author

Leone, V, Ferraro, A, Schepis, F, Federico, A, Sepe, R, Arra, C, Langella, C, Palma, G, De Lorenzo, C, Troncone, G, Masciullo, V, Scambia, Giovanni, Fusco, A, Pallante, P., Scambia, Giovanni (ORCID:0000-0003-2758-1063), Leone, V, Ferraro, A, Schepis, F, Federico, A, Sepe, R, Arra, C, Langella, C, Palma, G, De Lorenzo, C, Troncone, G, Masciullo, V, Scambia, Giovanni, Fusco, A, Pallante, P., and Scambia, Giovanni (ORCID:0000-0003-2758-1063)

Abstract

We have previously reported that the expression of the CL2/CCDC80 gene is downregulated in human papillary thyroid carcinomas, particularly in follicular variants. We have also reported that the restoration of CL2/CCDC80 expression reverted the malignant phenotype of thyroid carcinoma cell lines and that CL2/CCDC80 positively regulated E-cadherin expression, an ability that likely accounts for the role of the CL2/CCDC80 gene in thyroid cancer progression. In order to validate the tumour suppressor role of the CL2/CCDC80 gene in thyroid carcinogenesis we generated cl2/ccdc80 knock-out mice. We found that embryonic fibroblasts from cl2/ccdc80(-/-) mice showed higher proliferation rate and lower susceptibility to apoptosis. Furthermore, cl2/ccdc80(-/-) mice developed thyroid adenomas and ovarian carcinomas. Finally, ret/PTC1 transgenic mice crossed with the cl2/ccdc80 knock-out mice developed more aggressive thyroid carcinomas compared with those observed in the single ret/PTC1 transgenic mice. Together, these results indicate CL2/CCDC80 as a putative tumour suppressor gene in human thyroid carcinogenesis.

Published
2015

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