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2. Improving outcomes of in situ split liver transplantation in Italy over the last 25 years

Author

Lauterio, A, Cillo, U, Spada, M, Trapani, S, De Carlis, R, Bottino, G, Bernasconi, D, Scalamogna, C, Pinelli, D, Cintorino, D, D'Amico, F, Spagnoletti, G, Miggino, M, Romagnoli, R, Centonze, L, Caccamo, L, Baccarani, U, Carraro, A, Cescon, M, Vivarelli, M, Mazaferro, V, Ettorre, G, Rossi, M, Vennarecci, G, De Simone, P, Angelico, R, Agnes, S, Di Benedetto, F, Lupo, L, Zamboni, F, Zefelippo, A, Patrono, D, Diviacco, P, Laureiro, Z, Gringeri, E, Di Francesco, F, Lucianetti, A, Valsecchi, M, Gruttadauria, S, De Feo, T, Cardillo, M, De Carlis, L, Colledan, M, Andorno, E, Lauterio A., Cillo U., Spada M., Trapani S., De Carlis R., Bottino G., Bernasconi D., Scalamogna C., Pinelli D., Cintorino D., D'Amico F. E., Spagnoletti G., Miggino M., Romagnoli R., Centonze L., Caccamo L., Baccarani U., Carraro A., Cescon M., Vivarelli M., Mazaferro V., Ettorre G. M., Rossi M., Vennarecci G., De Simone P., Angelico R., Agnes S., Di Benedetto F., Lupo L. G., Zamboni F., Zefelippo A., Patrono D., Diviacco P., Laureiro Z. L., Gringeri E., Di Francesco F., Lucianetti A., Valsecchi M. G., Gruttadauria S., De Feo T., Cardillo M., De Carlis L., Colledan M., Andorno E., Lauterio, A, Cillo, U, Spada, M, Trapani, S, De Carlis, R, Bottino, G, Bernasconi, D, Scalamogna, C, Pinelli, D, Cintorino, D, D'Amico, F, Spagnoletti, G, Miggino, M, Romagnoli, R, Centonze, L, Caccamo, L, Baccarani, U, Carraro, A, Cescon, M, Vivarelli, M, Mazaferro, V, Ettorre, G, Rossi, M, Vennarecci, G, De Simone, P, Angelico, R, Agnes, S, Di Benedetto, F, Lupo, L, Zamboni, F, Zefelippo, A, Patrono, D, Diviacco, P, Laureiro, Z, Gringeri, E, Di Francesco, F, Lucianetti, A, Valsecchi, M, Gruttadauria, S, De Feo, T, Cardillo, M, De Carlis, L, Colledan, M, Andorno, E, Lauterio A., Cillo U., Spada M., Trapani S., De Carlis R., Bottino G., Bernasconi D., Scalamogna C., Pinelli D., Cintorino D., D'Amico F. E., Spagnoletti G., Miggino M., Romagnoli R., Centonze L., Caccamo L., Baccarani U., Carraro A., Cescon M., Vivarelli M., Mazaferro V., Ettorre G. M., Rossi M., Vennarecci G., De Simone P., Angelico R., Agnes S., Di Benedetto F., Lupo L. G., Zamboni F., Zefelippo A., Patrono D., Diviacco P., Laureiro Z. L., Gringeri E., Di Francesco F., Lucianetti A., Valsecchi M. G., Gruttadauria S., De Feo T., Cardillo M., De Carlis L., Colledan M., and Andorno E.

Abstract

Background & Aims: Split liver transplant(ation) (SLT) is still considered a challenging procedure that is by no means widely accepted. We aimed to present data on 25-year trends in SLT in Italy, and to investigate if, and to what extent, outcomes have improved nationwide during this time. Methods: The study included all consecutive SLTs performed from May 1993 to December 2019, divided into three consecutive periods: 1993–2005, 2006–2014, and 2015–2019, which match changes in national allocation policies. Primary outcomes were patient and graft survival, and the relative impact of each study period. Results: SLT accounted for 8.9% of all liver transplants performed in Italy. A total of 1,715 in situ split liver grafts were included in the analysis: 868 left lateral segments (LLSs) and 847 extended right grafts (ERGs). A significant improvement in patient and graft survival (p <0.001) was observed with ERGs over the three periods. Predictors of graft survival were cold ischaemia time (CIT) <6 h (p = 0.009), UNOS status 2b (p <0.001), UNOS status 3 (p = 0.009), and transplant centre volumes: 25–50 cases vs. <25 cases (p = 0.003). Patient survival was significantly higher with LLS grafts in period 2 vs. period 1 (p = 0.008). No significant improvement in graft survival was seen over the three periods, where predictors of graft survival were CIT <6 h (p = 0.007), CIT <6 h vs. ≥10 h (p = 0.019), UNOS status 2b (p = 0.038), and UNOS status 3 (p = 0.009). Retransplantation was a risk factor in split liver graft recipients, with significantly worse graft and patient survival for both types of graft (p <0.001). Conclusions: Our analysis showed Italian SLT outcomes to have improved over the last 25 years. These results could help to dispel reservations regarding the use of this procedure. Impact and implications: Split liver transplant(ation) (SLT) is still considered a challenging procedure and is by no means widely accepted. This study included all

Published
2023

3. The Italian data on SARS-CoV-2 infection in transplanted patients support an organ specific immune response in liver recipients

Author

Rendina, M, Barone, M, Lillo, C, Trapani, S, Masiero, L, Trerotoli, P, Puoti, F, Lupo, L, Tandoi, F, Agnes, S, Grieco, A, Andorno, E, Marenco, S, Giannini, E, Baccarani, U, Toniutto, P, Carraro, A, Colecchia, A, Cescon, M, Morelli, M, Cillo, U, Burra, P, Angeli, P, Colledan, M, Fagiuoli, S, De Carlis, L, Belli, L, De Simone, P, Carrai, P, Di Benedetto, F, De Maria, N, Ettorre, G, Giannelli, V, Gruttadauria, S, Volpes, R, Corsale, S, Mazzaferro, V, Bhoori, S, Romagnoli, R, Martini, S, Rossi, G, Caccamo, L, Donato, M, Rossi, M, Ginanni Corradini, S, Spada, M, Maggiore, G, Tisone, G, Lenci, I, Vennarecci, G, Tortora, R, Vivarelli, M, Svegliati Baroni, G, Zamboni, F, Mameli, L, Tafuri, S, Simone, S, Gesualdo, L, Cardillo, M, Di Leo, A, Rendina M., Barone M., Lillo C., Trapani S., Masiero L., Trerotoli P., Puoti F., Lupo L. G., Tandoi F., Agnes S., Grieco A., Andorno E., Marenco S., Giannini E. G., Baccarani U., Toniutto P., Carraro A., Colecchia A., Cescon M., Morelli M. C., Cillo U., Burra P., Angeli P., Colledan M., Fagiuoli S., De Carlis L., Belli L., De Simone P., Carrai P., Di Benedetto F., De Maria N., Ettorre G. M., Giannelli V., Gruttadauria S., Volpes R., Corsale S., Mazzaferro V., Bhoori S., Romagnoli R., Martini S., Rossi G., Caccamo L., Donato M. F., Rossi M., Ginanni Corradini S., Spada M., Maggiore G., Tisone G., Lenci I., Vennarecci G., Tortora R., Vivarelli M., Svegliati Baroni G., Zamboni F., Mameli L., Tafuri S., Simone S., Gesualdo L., Cardillo M., Di Leo A., Rendina, M, Barone, M, Lillo, C, Trapani, S, Masiero, L, Trerotoli, P, Puoti, F, Lupo, L, Tandoi, F, Agnes, S, Grieco, A, Andorno, E, Marenco, S, Giannini, E, Baccarani, U, Toniutto, P, Carraro, A, Colecchia, A, Cescon, M, Morelli, M, Cillo, U, Burra, P, Angeli, P, Colledan, M, Fagiuoli, S, De Carlis, L, Belli, L, De Simone, P, Carrai, P, Di Benedetto, F, De Maria, N, Ettorre, G, Giannelli, V, Gruttadauria, S, Volpes, R, Corsale, S, Mazzaferro, V, Bhoori, S, Romagnoli, R, Martini, S, Rossi, G, Caccamo, L, Donato, M, Rossi, M, Ginanni Corradini, S, Spada, M, Maggiore, G, Tisone, G, Lenci, I, Vennarecci, G, Tortora, R, Vivarelli, M, Svegliati Baroni, G, Zamboni, F, Mameli, L, Tafuri, S, Simone, S, Gesualdo, L, Cardillo, M, Di Leo, A, Rendina M., Barone M., Lillo C., Trapani S., Masiero L., Trerotoli P., Puoti F., Lupo L. G., Tandoi F., Agnes S., Grieco A., Andorno E., Marenco S., Giannini E. G., Baccarani U., Toniutto P., Carraro A., Colecchia A., Cescon M., Morelli M. C., Cillo U., Burra P., Angeli P., Colledan M., Fagiuoli S., De Carlis L., Belli L., De Simone P., Carrai P., Di Benedetto F., De Maria N., Ettorre G. M., Giannelli V., Gruttadauria S., Volpes R., Corsale S., Mazzaferro V., Bhoori S., Romagnoli R., Martini S., Rossi G., Caccamo L., Donato M. F., Rossi M., Ginanni Corradini S., Spada M., Maggiore G., Tisone G., Lenci I., Vennarecci G., Tortora R., Vivarelli M., Svegliati Baroni G., Zamboni F., Mameli L., Tafuri S., Simone S., Gesualdo L., Cardillo M., and Di Leo A.

Abstract

Introduction: The study of immune response to SARSCoV-2 infection in different solid organ transplant settings represents an opportunity for clarifying the interplay between SARS-CoV-2 and the immune system. In our nationwide registry study from Italy, we specifically evaluated, during the first wave pandemic, i.e., in non-vaccinated patients, COVID-19 prevalence of infection, mortality, and lethality in liver transplant recipients (LTRs), using non-liver solid transplant recipients (NL-SOTRs) and the Italian general population (GP) as comparators. Methods: Case collection started from February 21 to June 22, 2020, using the data from the National Institute of Health and National Transplant Center, whereas the data analysis was performed on September 30, 2020.To compare the sex- and age-adjusted distribution of infection, mortality, and lethality in LTRs, NL-SOTRs, and Italian GP we applied an indirect standardization method to determine the standardized rate. Results: Among the 43,983 Italian SOTRs with a functioning graft, LTRs accounted for 14,168 patients, of whom 89 were SARS-CoV-2 infected. In the 29,815 NL-SOTRs, 361 cases of SARS-CoV-2 infection were observed. The geographical distribution of the disease was highly variable across the different Italian regions. The standardized rate of infection, mortality, and lethality rates in LTRs resulted lower compared to NL-SOTRs [1.02 (95%CI 0.81-1.23) vs. 2.01 (95%CI 1.8-2.2); 1.0 (95%CI 0.5-1.5) vs. 4.5 (95%CI 3.6-5.3); 1.6 (95%CI 0.7-2.4) vs. 2.8 (95%CI 2.2-3.3), respectively] and comparable to the Italian GP. Discussion: According to the most recent studies on SOTRs and SARS-CoV-2 infection, our data strongly suggest that, in contrast to what was observed in NL-SOTRs receiving a similar immunosuppressive therapy, LTRs have the same risk of SARS-CoV-2 infection, mortality, and lethality observed in the general population. These results suggest an immune response to SARS-CoV-2 infection in LTRS that is different fr

Published
2023

5. Prophylaxis of HBV-recurrence after liver transplantation in patients with HCC: Risk of HCC recurrence from a large, multicentre retrospective study from Italy

Author

Battistella, S., primary, Zanetto, A., additional, Turco, L., additional, Manuli, C., additional, Pasulo, L., additional, Giannelli, V., additional, Mameli, L., additional, Ferrarese, A., additional, Marenco, S., additional, Ferri, F., additional, Lenci, I., additional, Scandali, G., additional, Biolato, M., additional, Fornasiere, E., additional, Ponziani, F.R., additional, Baroni, G. Svegliati, additional, Giannini, E., additional, Toniutto, P., additional, Lanza, A. Galeota, additional, Rendina, M., additional, Donato, F., additional, Fagiuoli, S., additional, De Maria, N., additional, Morelli, M. Cristina, additional, Martini, Silvia, additional, Trapani, S., additional, Grossi, P., additional, Aghemo, A., additional, Russo, F.P., additional, and Burra, P., additional

Published
2023
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12. Temporal trends of waitlistings for liver transplantation in Italy: The ECALITA (Evolution of IndiCAtion in LIver transplantation in ITAly) registry study

Author

Manzia, T, Trapani, S, Nardi, A, Ricci, A, Lenci, I, Milana, M, Angelico, R, De Feo, T, Agnes, S, Andorno, E, Baccarani, U, Carraro, A, Cescon, M, Cillo, U, Colledan, M, De Carlis, L, De Simone, P, Di Benedetto, F, Ettorre, G, Gruttadauria, S, Lupo, L, Mazzaferro, V, Romagnoli, R, Rossi, G, Rossi, M, Spada, M, Vennarecci, G, Vivarelli, M, Zamboni, F, Tisone, G, Cardillo, M, Angelico, M, Manzia T. M., Trapani S., Nardi A., Ricci A., Lenci I., Milana M., Angelico R., De Feo T. M., Agnes S., Andorno E., Baccarani U., Carraro A., Cescon M., Cillo U., Colledan M., De Carlis L., De Simone P., Di Benedetto F., Ettorre G. M., Gruttadauria S., Lupo L. G., Mazzaferro V., Romagnoli R., Rossi G., Rossi M., Spada M., Vennarecci G., Vivarelli M., Zamboni F., Tisone G., Cardillo M., Angelico M., Manzia, T, Trapani, S, Nardi, A, Ricci, A, Lenci, I, Milana, M, Angelico, R, De Feo, T, Agnes, S, Andorno, E, Baccarani, U, Carraro, A, Cescon, M, Cillo, U, Colledan, M, De Carlis, L, De Simone, P, Di Benedetto, F, Ettorre, G, Gruttadauria, S, Lupo, L, Mazzaferro, V, Romagnoli, R, Rossi, G, Rossi, M, Spada, M, Vennarecci, G, Vivarelli, M, Zamboni, F, Tisone, G, Cardillo, M, Angelico, M, Manzia T. M., Trapani S., Nardi A., Ricci A., Lenci I., Milana M., Angelico R., De Feo T. M., Agnes S., Andorno E., Baccarani U., Carraro A., Cescon M., Cillo U., Colledan M., De Carlis L., De Simone P., Di Benedetto F., Ettorre G. M., Gruttadauria S., Lupo L. G., Mazzaferro V., Romagnoli R., Rossi G., Rossi M., Spada M., Vennarecci G., Vivarelli M., Zamboni F., Tisone G., Cardillo M., and Angelico M.

Abstract

Background: Over the last decades relevant epidemiological changes of liver diseases have occurred, together with greatly improved treatment opportunities. Aim: To investigate how the indications for elective adult liver transplantation and the underlying disease etiologies have evolved in Italy. Methods: We recruited from the National Transplant Registry a cohort comprising 17,317 adults patients waitlisted for primary liver transplantation from January-2004 to December-2020. Patients were divided into three Eras:1(2004–2011),2(2012–2014) and 3(2015–2020). Results: Waitlistings for cirrhosis decreased from 65.9% in Era 1 to 46.1% in Era 3, while those for HCC increased from 28.7% to 48.7%. Comparing Eras 1 and 3, waitlistings for HCV-related cirrhosis decreased from 35.9% to 12.1%, yet those for HCV-related HCC increased from 8.5% to 26.7%. Waitlistings for HBV-related cirrhosis remained almost unchanged (13.2% and 12.4%), while those for HBV-related HCC increased from 4.0% to 11.6%. ALD-related cirrhosis decreased from 16.9% to 12.9% while ALD-related HCC increased from 1.9% to 3.9%. Conclusions: A sharp increase in liver transplant waitlisting for HCC and a concomitant decrease of waitlisting for cirrhosis have occurred In Italy. Despite HCV infection has noticeably decreased, still remains the primary etiology of waitlisting for HCC, while ALD and HBV represent the main causes for cirrhosis.

Published
2022

18. Systemic Catheter-Related Venous Thromboembolism in Children: Data From the Italian Registry of Pediatric Thrombosis

Author

Lasagni, D., Nosadini, M., Molinari, A. C., Saracco, P., Pelizza, M. F., Piersigilli, F., Putti, M. C., Gaffuri, M., Giordano, P., Lorenzoni, G., Francavilla, A., Trapani, S., Luciani, M., Suppiej, A., Tufano, A., Tormene, D., Martinato, M., Gregori, D., Sartori, S., Simioni, P., Agostini, M., Bassi, B., Bertoni, E., Casani, A., Farinasso, D., Gallo, E., Gentilomo, C., Grassi, M., Lunetta, F., Magarotto, M., Maschio, F., Palmieri, A., Pettenazzo, A., Sangermani, R., Laverda, A., Lasagni, D, Nosadini, M, Molinari, Ac, Saracco, P, Pelizza, Mf, Piersigilli, F, Putti, Mc, Gaffuri, M, Giordano, P, Lorenzoni, G, Francavilla, A, Trapani, S, Luciani, M, Suppiej, A, Tufano, A, Tormene, D, Martinato, M, Gregori, D, Sartori, S, Simioni, P, Systemic Thromboses Working Group of the Italian Registry of Pediatric Thrombosis (RITI Registro Italiano Trombosi, Infantili)., UCL - SSS/IREC/SLUC - Pôle St.-Luc, and UCL - (SLuc) Service de néonatologie

Subjects
central venous catheter (CVC), pediatric, children, Pediatrics, Perinatology and Child Health, catheter-complications, heparin, registry, thrombosis, Socio-culturale, equipment and supplies
Abstract

BackgroundCentral venous catheters (CVCs) represent one of the main risk factors for venous thrombotic events (VTEs) in children.MethodsWe studied the Italian Registry of Pediatric Thrombosis (RITI) with regard to systemic radiologically confirmed CVC-related VTEs (CVC-VTEs) occurred during 6.5 years in children aged 29 days to 18 years.ResultsA total of 78 CVC-VTEs were included, which occurred in 76 patients (40/76, 53% males). CVC-VTEs comprised 67 non-cardiac VTEs (86%) and 11 intracardiac thrombotic events (ICTEs) (14%); the median age at onset was 19 and 17 months, respectively. The most frequent reason for CVC insertion was supportive therapy. The catheters were placed percutaneously in 85% of cases (56/66) and surgically in the remaining 15% (10/66). Peripherally inserted central catheters (PICCs) were used in 47% (31/66) cases, partially implanted catheters in 42% (28/66), non-implantable catheters in 7% (5/66), and totally implanted catheters (Port) in 2% (1/66). CVC-VTEs were symptomatic in 77% of cases (60/78), while in the remaining 23%, they were incidentally detected on the imaging performed for the underlying condition. The median time between CVC insertion and the onset of symptoms was 10 days in non-cardiac VTEs and 39 days in ICTEs. Doppler ultrasound was the diagnostic technique most frequently used. The venous compartment most frequently affected was the veins of the lower extremities (52%, 43/73). Anti-thrombotic treatment was administered in 96% of CVC-VTEs (75/78). About 2.6% (2/76) of patients experienced a second thrombotic event. At discharge, post-thrombotic syndrome was reported in 13.5% (5/37) events with available data, CVC replacement in 10.8% (4/47), and ischemic necrosis with toe finger amputation in 2.7% (1/37). Three patients died due to an underlying condition; no CVC-VTE-related deaths were reported.ConclusionsWe have carried out a registry-based study on CVC-VTEs in the children in Italy, providing the data that may help improve the detection and management of this CVC-related complication.

Published
2022

19. Liver transplantation from active COVID-19 donors: A lifesaving opportunity worth grasping?

Author

Romagnoli, R, Gruttadauria, S, Tisone, G, Maria Ettorre, G, De Carlis, L, Martini, S, Tandoi, F, Trapani, S, Saracco, M, Luca, A, Manzia, T, Visco Comandini, U, De Carlis, R, Ghisetti, V, Cavallo, R, Cardillo, M, Grossi, P, Romagnoli R., Gruttadauria S., Tisone G., Maria Ettorre G., De Carlis L., Martini S., Tandoi F., Trapani S., Saracco M., Luca A., Manzia T. M., Visco Comandini U., De Carlis R., Ghisetti V., Cavallo R., Cardillo M., Grossi P. A., Romagnoli, R, Gruttadauria, S, Tisone, G, Maria Ettorre, G, De Carlis, L, Martini, S, Tandoi, F, Trapani, S, Saracco, M, Luca, A, Manzia, T, Visco Comandini, U, De Carlis, R, Ghisetti, V, Cavallo, R, Cardillo, M, Grossi, P, Romagnoli R., Gruttadauria S., Tisone G., Maria Ettorre G., De Carlis L., Martini S., Tandoi F., Trapani S., Saracco M., Luca A., Manzia T. M., Visco Comandini U., De Carlis R., Ghisetti V., Cavallo R., Cardillo M., and Grossi P. A.

Abstract

COVID-19 pandemic dramatically impacted transplantation landscape. Scientific societies recommend against the use of donors with active SARS-CoV-2 infection. Italian Transplant Authority recommended to test recipients/donors for SARS-CoV-2-RNA immediately before liver transplant (LT) and, starting from November 2020, grafts from deceased donors with active SARS-CoV-2 infection were allowed to be considered for urgent-need transplant candidates with active/resolved COVID-19. We present the results of the first 10 LTs with active COVID-19 donors within an Italian multicenter series. Only two recipients had a positive molecular test at LT and one of them remained positive up to 21 days post-LT. None of the other eight recipients was found to be SARS-CoV-2 positive during follow-up. IgG against SARS-CoV-2 at LT were positive in 80% (8/10) of recipients, and 71% (5/7) showed neutralizing antibodies, expression of protective immunity related to recent COVID-19. In addition, testing for SARS-CoV-2 RNA on donors’ liver biopsy at transplantation was negative in 100% (9/9), suggesting a very low risk of transmission with LT. Immunosuppression regimen remained unchanged, according to standard protocol. Despite the small number of cases, these data suggest that transplanting livers from donors with active COVID-19 in informed candidates with SARS-CoV-2 immunity, might contribute to safely increase the donor pool.

Published
2021

20. Efficacy of Sofosbuvir/Ledipasvir in Adolescents with Chronic Hepatitis C Genotypes 1, 3, and 4: A Real-world Study

Author

Serranti, D, Nebbia, G, Cananzi, M, Nicastro, E, Dato, F, Nuti, F, Garazzino, S, Silvestro, E, Giacomet, V, Forlanini, F, Pinon, M, Calvo, P, Riva, S, Dodi, I, Cangelosi, A, Antonucci, R, Ricci, S, Bartolini, E, Mastrangelo, G, Trapani, S, Lenge, M, Gaio, P, Vajro, P, Iorio, R, D'Antiga, L, Indolfi, G, Serranti D., Nebbia G., Cananzi M., Nicastro E., Dato F. D., Nuti F., Garazzino S., Silvestro E., Giacomet V., Forlanini F., Pinon M., Calvo P. L., Riva S., Dodi I., Cangelosi A. M., Antonucci R., Ricci S., Bartolini E., Mastrangelo G., Trapani S., Lenge M., Gaio P., Vajro P., Iorio R., D'Antiga L., Indolfi G., Serranti, D, Nebbia, G, Cananzi, M, Nicastro, E, Dato, F, Nuti, F, Garazzino, S, Silvestro, E, Giacomet, V, Forlanini, F, Pinon, M, Calvo, P, Riva, S, Dodi, I, Cangelosi, A, Antonucci, R, Ricci, S, Bartolini, E, Mastrangelo, G, Trapani, S, Lenge, M, Gaio, P, Vajro, P, Iorio, R, D'Antiga, L, Indolfi, G, Serranti D., Nebbia G., Cananzi M., Nicastro E., Dato F. D., Nuti F., Garazzino S., Silvestro E., Giacomet V., Forlanini F., Pinon M., Calvo P. L., Riva S., Dodi I., Cangelosi A. M., Antonucci R., Ricci S., Bartolini E., Mastrangelo G., Trapani S., Lenge M., Gaio P., Vajro P., Iorio R., D'Antiga L., and Indolfi G.

Abstract

Objectives: Sofosbuvir/Ledipasvir (SOF/LDV) has been approved by the European Medicine Agency (EMA)for the treatment of children and adolescents (at least 3 years of age) with chronic hepatitis C (CHC) genotype 1, 3, and 4 infection. The aim of this study was to evaluate the efficacy and safety of SOF/LDV in adolescents (12 to <18 years old) with CHC in the real-world setting. Methods: Prospective, open-label, multicentre study involving 12 Italian centres. Patients received the fixed-dose combination of SOF/LDV (400/90 mg) once daily-ribavirin as per EMA approval and recommendations. The key efficacy endpoint was sustained virological response 12 weeks after the end of treatment (SVR12) as per intention-to-treat analysis. Safety was assessed by adverse events and clinical/laboratory data. Results: Seventy-eight consecutive adolescents (median age 15.2 years, range 12-17.9; girls 53.8%) were enrolled and treated between June 2018 and December 2019. Genotype distribution was as follows: Genotype 1 (82.1%), 3 (2.5%), and 4 (15.4%). Seventy-six (97.4%) patients completed treatment and follow-up. Overall, SVR12 was 98.7%. One patient was lost to follow-up after 4 weeks of treatment; 1 patient completed treatment and missed the follow-up visit. No virological breakthrough or relapse were observed. No patient experienced grade 3 to 4 adverse event or serious adverse event. Conclusions: The results of this real-world study confirmed the high efficacy and the optimal safety profile of SOF/LDV for treatment of CHC in adolescents.

Published
2021

23. Recent trends and intention-to-treat survival of liver transplantation for nonalcoholic steatohepatitis: an Italian liver transplant registry study

Author

Vitale, A, Trapani, S, Burra, P, Bertacco, A, Romagnoli, R, Martini, S, De Simone, P, Carrai, P, Cescon, M, Morelli, M, De Carlis, L, Belli, L, Gruttadauria, S, Volpes, R, Colledan, M, Fagiuoli, S, Rossi, G, Donato, F, Di Benedetto, F, De Maria, N, Tedeschi, U, Colecchia, A, Ricci, A, Rossi, M, Cardillo, M, Cillo, U, Vitale A, Trapani S, Burra P, Bertacco A, Romagnoli R, Martini S, De Simone P, Carrai P, Cescon M, Morelli MC, De Carlis L, Belli L, Gruttadauria S, Volpes R, Colledan M, Fagiuoli S, Rossi G, Donato F, Di Benedetto F, De Maria N, Tedeschi U, Colecchia A, Ricci A, Rossi M, Cardillo M, Cillo U, Vitale, A, Trapani, S, Burra, P, Bertacco, A, Romagnoli, R, Martini, S, De Simone, P, Carrai, P, Cescon, M, Morelli, M, De Carlis, L, Belli, L, Gruttadauria, S, Volpes, R, Colledan, M, Fagiuoli, S, Rossi, G, Donato, F, Di Benedetto, F, De Maria, N, Tedeschi, U, Colecchia, A, Ricci, A, Rossi, M, Cardillo, M, Cillo, U, Vitale A, Trapani S, Burra P, Bertacco A, Romagnoli R, Martini S, De Simone P, Carrai P, Cescon M, Morelli MC, De Carlis L, Belli L, Gruttadauria S, Volpes R, Colledan M, Fagiuoli S, Rossi G, Donato F, Di Benedetto F, De Maria N, Tedeschi U, Colecchia A, Ricci A, Rossi M, Cardillo M, and Cillo U

Published
2020

25. Kawasaki syndrome: the Florentine experience

Author

Falcini, F., Ermini, M., Trapani, S., Taccetti, G., Bartolozzi, G., Simone, L. De, Manetti, A., Turchini, S., Farsi, A., Lombardi, A., Matucci-Cerinic, M., Keser, G., Khamashta, M., Direskeneli, H., Hughes, G. R. V., Ansell, B. M., editor, Bacon, P. A., editor, Lie, J. T., editor, and Yazici, H., editor

Published
1996
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26. SARS-CoV-2 infection in liver transplantation is associated with favorable outcomes: an Italian transplant registry study

Author

Rendina, M., primary, Barone, M., additional, Trapani, S., additional, Masiero, L., additional, Trerotoli, P., additional, Puoti, F., additional, Lupo, L.G., additional, Agnes, S., additional, Grieco, A., additional, Andorno, E., additional, Marenco, S., additional, Baccarani, U., additional, Toniutto, P., additional, Carraro, A., additional, Colecchia, A., additional, Cescon, M., additional, Morelli, M.C., additional, Cillo, U., additional, Burra, P., additional, Angeli, P., additional, Colledan, M., additional, Fagiuoli, S., additional, De Carlis, L., additional, Belli, L., additional, De Simone, P., additional, Carrai, P., additional, Di Benedetto, F., additional, De Maria, N., additional, Ettorre, G.M., additional, Giannelli, V., additional, Gruttadauria, S., additional, Volpes, R., additional, Mazzaferro, V., additional, Bhoori, S., additional, Romagnoli, R., additional, Martini, S., additional, Rossi, G., additional, Donato, F., additional, Rossi, M., additional, Ginanni Corradini, S., additional, Spada, M., additional, Maggiore, G., additional, Tisone, G., additional, Lenci, I., additional, Vennarecci, G., additional, Di Costanzo, G.G., additional, Vivarelli, M., additional, Svegliati Baroni, G., additional, Zamboni, F. o, additional, Mameli, L., additional, Tafuri, S., additional, Simone, S., additional, Gesualdo, L., additional, Cardillo, M., additional, and Di Leo, A., additional

Published
2022
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28. Treatment and monitoring of children with chronic hepatitis C in the Pre-DAA era: A European survey of 38 paediatric specialists

Author

Indolfi, G, Bailey, H, Serranti, D, Giaquinto, C, Thorne, C, Sokal, E, Debray, D, Girard, M, Feiterna-Sperling, C, Wirth, S, Guidi, R, Verucchi, G, D'Antiga, L, Nicastro, E, Maggiore, G, Trapani, S, Ricci, S, Resti, M, Giacomet, V, Benincaso, A, Nebbia, G, Iorio, R, Cananzi, M, Riva, S, Bossi, G, Dodi, I, Nobili, V, Comparcola, D, Garazzino, S, Calvo, P, Pokorska-Spiewak, M, Pawlowska, M, Goncalves, C, Goncalves, I, Bals, M, Tudor, A, Noguera-Julian, A, Ramos, J, Fischler, B, Mclin, V, Brown, M, Kelly, D, Davison, S, Turkova, A, Bamford, A, Indolfi G., Bailey H., Serranti D., Giaquinto C., Thorne C., Sokal E., Debray D., Girard M., Feiterna-Sperling C., Wirth S., Guidi R., Verucchi G., D'Antiga L., Nicastro E., Maggiore G., Trapani S., Ricci S., Resti M., Giacomet V., Benincaso A. R., Nebbia G., Iorio R., Cananzi M., Riva S., Bossi G., Dodi I., Nobili V., Comparcola D., Garazzino S., Calvo P. L., Pokorska-Spiewak M., Pawlowska M., Goncalves C., Goncalves I., Bals M., Tudor A. M., Noguera-Julian A., Ramos J. T., Fischler B., McLin V., Brown M., Kelly D., Davison S., Turkova A., Bamford A., Indolfi, G, Bailey, H, Serranti, D, Giaquinto, C, Thorne, C, Sokal, E, Debray, D, Girard, M, Feiterna-Sperling, C, Wirth, S, Guidi, R, Verucchi, G, D'Antiga, L, Nicastro, E, Maggiore, G, Trapani, S, Ricci, S, Resti, M, Giacomet, V, Benincaso, A, Nebbia, G, Iorio, R, Cananzi, M, Riva, S, Bossi, G, Dodi, I, Nobili, V, Comparcola, D, Garazzino, S, Calvo, P, Pokorska-Spiewak, M, Pawlowska, M, Goncalves, C, Goncalves, I, Bals, M, Tudor, A, Noguera-Julian, A, Ramos, J, Fischler, B, Mclin, V, Brown, M, Kelly, D, Davison, S, Turkova, A, Bamford, A, Indolfi G., Bailey H., Serranti D., Giaquinto C., Thorne C., Sokal E., Debray D., Girard M., Feiterna-Sperling C., Wirth S., Guidi R., Verucchi G., D'Antiga L., Nicastro E., Maggiore G., Trapani S., Ricci S., Resti M., Giacomet V., Benincaso A. R., Nebbia G., Iorio R., Cananzi M., Riva S., Bossi G., Dodi I., Nobili V., Comparcola D., Garazzino S., Calvo P. L., Pokorska-Spiewak M., Pawlowska M., Goncalves C., Goncalves I., Bals M., Tudor A. M., Noguera-Julian A., Ramos J. T., Fischler B., McLin V., Brown M., Kelly D., Davison S., Turkova A., and Bamford A.

Abstract

The burden of paediatric Hepatitis C virus (HCV) infection across Europe is unknown, as are current policies regarding monitoring and treatment. This collaborative study aimed to collect aggregate data to characterise the population of ≤18-year-olds with HCV infection in specialist follow up in a 12-month period (2016) across the PENTAHep European consortium, and investigate current policies around monitoring and treatment. A cross-sectional, web-based survey was distributed in April 2017 to 50 paediatricians in 19 European countries, covering patients' profile, and monitoring and treatment practices. Responses were received from 38/50 clinicians collectively caring for 663 children with chronic HCV infection of whom three-quarters were aged ≥6 years and 90% vertically infected. HCV genotype 1 was the most common (n 380; 57.3%), followed by genotype 3, 4 and 2. Seventeen children (3%) with chronic HCV infection were diagnosed with cirrhosis, and six were reported to have received liver transplantation for HCV-related liver disease. The majority (n 425; 64.1%) of the European children with HCV infection remained treatment-naive in 2016. Age affected clinicians' attitudes towards treatment; 94% reported being willing to use direct-acting antivirals, if available, in adolescents (aged ≥11 years), 78% in children aged 6-10 and 42% in those 3-5 years of age (Pearson correlation coefficient −0.98; P 0.0001). This survey provides the largest characterisation of the population of children in clinical follow-up for chronic HCV infection in Europe, alongside important contextual information on their management and treatment. Discussion is needed around strategies and criteria for use of direct-acting antivirals in these children.

Published
2019

29. Shortened 8-Week Course of Sofosbuvir/Ledipasvir Therapy in Adolescents With Chronic Hepatitis C Infection

Author

Serranti, D, Dodi, I, Nicastro, E, Cangelosi, A, Riva, S, Ricci, S, Bartolini, E, Trapani, S, Mastrangelo, G, Vajro, P, D'Antiga, L, Resti, M, Indolfi, G, Serranti D., Dodi I., Nicastro E., Cangelosi A. M., Riva S., Ricci S., Bartolini E., Trapani S., Mastrangelo G., Vajro P., D'Antiga L., Resti M., Indolfi G., Serranti, D, Dodi, I, Nicastro, E, Cangelosi, A, Riva, S, Ricci, S, Bartolini, E, Trapani, S, Mastrangelo, G, Vajro, P, D'Antiga, L, Resti, M, Indolfi, G, Serranti D., Dodi I., Nicastro E., Cangelosi A. M., Riva S., Ricci S., Bartolini E., Trapani S., Mastrangelo G., Vajro P., D'Antiga L., Resti M., and Indolfi G.

Abstract

Treatment-naïve, noncirrhotic adults with chronic hepatitis C virus genotype 1 infection and with viremia levels <6 million IU/mL could be effectively treated with sofosbuvir/ledipasvir for 8 weeks. The aim of this pilot, prospective, open-label, multicenter study was to evaluate the efficacy and safety of this shortened treatment course in adolescents (≥12 years). The efficacy endpoint was sustained virological response 12 weeks after the end of treatment. Safety was assessed by adverse events and clinical/laboratory data. Fourteen consecutive adolescents (median age 16.5 years, Q1 14.1-Q3 17.4; female 57.1%), vertically infected, were enrolled and treated (June 2018-January 2019). Overall, the end of treatment response and sustained virological response 12 weeks after the end of treatment were 100%. No grade 3 to 4 adverse event or a serious adverse event was observed. Further studies are needed to confirm the optimal efficacy of the shortened 8-week treatment with sofosbuvir/ledipasvir for treatment-naïve, noncirrhotic adolescents with chronic hepatitis C virus genotype 1 infection and pretreatment viremia level < 6 million IU/mL.

Published
2019

30. 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

32. The decrease of Kawasaki syndrome during the second COVID-19 wave: a potential, unexpected effect of social distancing

Author

Mastrolia, Mv, Agostiniani, R, Azzari, C, Bernardini, R, Bottone, U, Calabri, Gb, Civitelli, F, Consolini, R, Danieli, R, Di Silvio, R, Falorni, S, Gagliardi, L, Grosso, S, Indolfi, G, L'Erario, M, Martini, M, Memmini, G, Peroni, D, Pezzati, M, Suriano, G, Tafi, L, Trapani, S, Vaccaro, A, Vasarri, Pl, and Gabriele, S

Subjects
Rheumatology, SARS-CoV-2, Immunology, Physical Distancing, Immunology and Allergy, COVID-19, Humans, Mucocutaneous Lymph Node Syndrome
Published
2021

34. Impact of SARS-CoV-2 Pandemic and Strategies for Resumption of Activities During the Second Wave of the Pandemic: A Report From Eight Paediatric Hospitals From the ECHO Network

Author

Indolfi G, Stivala M, Lenge M, Díaz-Naderi R, McIntosh J, Ricard Casadevall Llandrich, Gannon J, McGreevy KS, Trapani S, Miettinen P, Lahdenne P, Desborough L, Pavare J, van Rossum A, Zyska D, Resti M, and Zanobini A

Subjects
children, SARS-CoV-2, COVID-19, restart, preparedness
Abstract

The Severe Acute Respiratory Syndrome CoronaVirus type 2 (SARS-CoV-2) pandemic impacted the organization of paediatric hospitals. This study aimed to evaluate the preparedness for the pandemic among a European network of children's hospitals and to explore the strategies to restart health care services. A cross-sectional, web-based survey was distributed in May 2020 to the 13 children's tertiary care hospitals belonging to the European Children's Hospitals Organisation. Responses were obtained from eight hospitals (62%). Significant reductions were observed in accesses to the emergency departments (41.7%), outpatient visits (35.7%), intensive and non-intensive care unit inpatient admissions (16.4 and 13%, respectively) between February 1 and April 30, 2020 as compared with the same period of 2019. Overall, 93 children with SARS CoV-2 infection were admitted to inpatient wards. All the hospitals created SARS-CoV-2 preparedness plans for the diagnosis and management of infected patients. Routine activities were re-scheduled. Four hospitals shared their own staff with adult units, two designated bed spaces for adults and only one admitted adults to inpatient wards. The three main components for the resumption of clinical activities were testing, source control, and reorganization of spaces and flows. Telemedicine and telehealth services were used before the SARS-CoV-2 pandemic by three hospitals and by all the hospitals during it. Conclusion: The present study provides a perspective on preparedness to SARS-CoV-2 pandemic among eight large European children's hospitals, on the impact of the pandemic on the hospital activities and on the strategies adopted to restart clinical activities.

Published
2021

35. Characteristics and risk factors for SARS-CoV-2 in children tested in the early phase of the pandemic: a cross-sectional study, Italy, 23 February to 24 May 2020

Author

Lazzerini, M., Sforzi, I., Trapani, S., Biban, P., Silvagni, D., Villa, G., Tibaldi, J., Bertacca, L., Felici, E., Perricone, G., Parrino, R., Gioe, C., Lega, S., Conte, Fabrizio Paolo Massimo, Marchetti, Fabio, Magista, A., Berlese, P., Martelossi, S., Vaienti, F., Valletta, E., Mauro, Michele, Dall'Amico, R., Fasoli, S., Gatto, Antonio, Chiaretti, Antonio, Dragovic, D., Pascolo, P., Pilotto, C., Liguoro, I., Miorin, E., Saretta, F., Trobia, G. L., Di Stefano, A., Orlandi, Armando, Cardinale, F., Lubrano, R., Testa, A., Binotti, M., Moressa, V., Barbi, E., Armocida, B., Mariani, I., Conte M., Marchetti F., Mauro M., Gatto A., Chiaretti A. (ORCID:0000-0002-9971-1640), Orlandi A. (ORCID:0000-0001-5253-4678), Lazzerini, M., Sforzi, I., Trapani, S., Biban, P., Silvagni, D., Villa, G., Tibaldi, J., Bertacca, L., Felici, E., Perricone, G., Parrino, R., Gioe, C., Lega, S., Conte, Fabrizio Paolo Massimo, Marchetti, Fabio, Magista, A., Berlese, P., Martelossi, S., Vaienti, F., Valletta, E., Mauro, Michele, Dall'Amico, R., Fasoli, S., Gatto, Antonio, Chiaretti, Antonio, Dragovic, D., Pascolo, P., Pilotto, C., Liguoro, I., Miorin, E., Saretta, F., Trobia, G. L., Di Stefano, A., Orlandi, Armando, Cardinale, F., Lubrano, R., Testa, A., Binotti, M., Moressa, V., Barbi, E., Armocida, B., Mariani, I., Conte M., Marchetti F., Mauro M., Gatto A., Chiaretti A. (ORCID:0000-0002-9971-1640), and Orlandi A. (ORCID:0000-0001-5253-4678)

Abstract

BackgroundVery few studies describe factors associated with COVID-19 diagnosis in children.AimWe here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy.MethodsWe included cases aged 0-18 years tested between 23 February and 24 May 2020. Our primary analysis focused on children tested because of symptoms/signs suggestive of COVID-19.ResultsAmong 2,494 children tested, 2,148 (86.1%) had symptoms suggestive of COVID-19. Clinical presentation of confirmed COVID-19 cases included besides fever (82.4%) and respiratory signs or symptoms (60.4%) also gastrointestinal (18.2%), neurological (18.9%), cutaneous (3.8%) and other unspecific influenza-like presentations (17.8%). In multivariate analysis, factors significantly associated with SARS-CoV-2 positivity were: exposure history (adjusted odds ratio (AOR): 39.83; 95% confidence interval (CI): 17.52-90.55; p < 0.0001), cardiac disease (AOR: 3.10; 95% CI: 1.19-5.02; p < 0.0001), fever (AOR: 3.05%; 95% CI: 1.67-5.58; p = 0.0003) and anosmia/ageusia (AOR: 4.08; 95% CI: 1.69-9.84; p = 0.002). Among 190 (7.6%) children positive for SARS-CoV-2, only four (2.1%) required respiratory support and two (1.1%) were admitted to intensive care; all recovered.ConclusionRecommendations for SARS-CoV-2 testing in children should consider the evidence of broader clinical features. Exposure history, fever and anosmia/ageusia are strong risk factors in children for positive SARS-CoV-2 testing, while other symptoms did not help discriminate positive from negative individuals. This study confirms that COVID-19 was a mild disease in the general paediatric population in Italy. Further studies are needed to understand risk, clinical spectrum and outcomes of COVID-19 in children with pre-existing conditions.

Published
2021

41. A Narrative Review on Pediatric Scurvy: The Last Twenty Years

Author

Trapani, S., Rubino, C., Giuseppe Indolfi, and Paolo Lionetti

Subjects
Delayed Diagnosis, Nutrition and Dietetics, Nutrition. Foods and food supply, Ascorbic Acid, limp, Diagnosis, Differential, children, Ascorbic Acid Deficiency, Humans, TX341-641, Scurvy, hemorrhage, Child, musculoskeletal pain, Food Science
Abstract

Scurvy is a well-known clinical condition caused by vitamin C deficiency. Although considered a rare disease in high-income countries, it has been recently increasingly reported in children, especially in those with abnormal dietary habits, mental or physical disabilities. We performed an extensive review of the literature analyzing studies published in the last 20 years focusing on clinical features, differential diagnosis and diagnostic delay. Fifteen articles were selected, collectively reporting a total of 166 children. Because of the wide clinical spectrum (musculoskeletal complaints and/or mucocutaneous lesions or systemic symptoms), scurvy can mimic several conditions, including autoimmune diseases, infections, and neoplasia. In addition, frequent findings such as normal nutritional status, anemia or elevated inflammatory markers may guide clinicians towards the abovementioned misdiagnoses. Scurvy should be considered in patients presenting with musculoskeletal complaints, not only in those with risk factors but also in healthy children. A focused dietary history and a careful physical examination, assessing other signs of vitamin C deficiency, are mandatory in these patients. When suspected, the dosage of serum vitamin C is the diagnostic gold standard; furthermore, imaging studies, performed by an expert radiologist, can reveal the typical features of scurvy. Only early diagnosis can avoid unnecessary investigations and potentially fatal complications of the disease.

Published
2022
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42. Liver Transplantation during the COVID-19 pandemic: A quantitative model balancing individual patient benefit against population healthcare needs

Author

Cillo, U., primary, Vitale, A., additional, Volk, M.L., additional, Frigo, A.C., additional, Feltracco, P., additional, Cattelan, A., additional, Brancaccio, G., additional, Feltrin, G., additional, Angeli, P., additional, Burra, P., additional, Lonardi, S., additional, Trapani, S., additional, and Cardillo, M., additional

Published
2021
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45. Recent trends and intention-to-treat survival of liver transplantation for nonalcoholic steatohepatitis: an Italian liver transplant registry study

Author

Vitale, A., primary, Trapani, S., additional, Burra, P., additional, Bertacco, A., additional, Romagnoli, R., additional, Martini, S., additional, De Simone, P., additional, Carrai, P., additional, Cescon, M., additional, Morelli, M.C., additional, De Carlis, L., additional, Belli, L., additional, Gruttadauria, S., additional, Volpes, R., additional, Colledan, M., additional, Fagiuoli, S., additional, Rossi, G., additional, Donato, F., additional, Di Benedetto, F., additional, De Maria, N., additional, Tedeschi, U., additional, Colecchia, A., additional, Ricci, A., additional, Rossi, M., additional, Cardillo, M., additional, and Cillo, U., additional

Published
2020
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