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1. Post cholecystectomy bile duct injury: early, intermediate or late repair with hepaticojejunostomy – an E-AHPBA multi-center study

Author

Rystedt, Jenny M.L., Kleeff, Jörg, Salvia, Roberto, Besselink, Mark G., Prasad, Raj, Lesurtel, Mickael, Sturesson, Christian, Abu Hilal, M., Aljaiuossi, A., Antonucci, A., Ardito, F., Ausania, F., Bernon, M., Berrevoet, F., Björnsson, B., Bonsing, B.A., Boonstra, E.A., Bracke, B., Brusadin, R., Burda, L., Caraballo, M., Casellas-Robert, M., Çoker, A., Davide, J., De Gelder, A., De Rose, A.M., Djokic, M., Dudek, K., Ekmekçigil, E., Filauro, M., Fülöp, A., Gallagher, T., Gastaca, M., Gefen, R., Giuliante, F., Habibeh, H., Halle-Smith, J., Haraldsdottir, K.H., Hartman, V., Hauer, A., Hemmingsson, O., Hoskovec, D., Isaksson, B., Jonas, E., Khalaileh, A., Klug, R., Krige, J., Lignier, D., Lindemann, J., López-López, V., Lucidi, V., Mabrut, J.-Y., Månsson, C., Mieog, S., Mirza, D.F., Oldhafer, K.J., Omoshoro-Jones, J.A.O., Ortega-Torrecilla, N., Otto, W., Panaro, F., Pando, E., Paterna-López, S., Pekmezci, S., Pesce, A., Porte, R.J., Poves, I., Prieto Calvo, M., Primavesi, F., Puleo, S., Recordare, A., Rizell, M., Roberts, K., Robles-Campos, R., Sanchiz-Cardenas, E., Sandström, P., Saribeyoglu, K., Schauer, M., Schreuder, M., Siriwardena, A.K., Smith, M.D., Sousa Silva, D., Sparrelid, E., Stättner, S., Stavrou, G.A., Straka, M., Strömberg, C., Sutcliffe, R.P., Szijártó, A., Taflin, H., Trotovšek, B., van Gulik, T., Wallach, N., and Zieniewicz, K.

Published
2019
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4. COVID-19 in liver transplant candidates: Pretransplant and post-transplant outcomes - An ELITA/ELTR multicentre cohort study

Author

Belli, L, Duvoux, C, Cortesi, P, Facchetti, R, Iacob, S, Perricone, G, Radenne, S, Conti, S, Patrono, D, Berlakovich, G, Hann, A, Pasulo, L, Castells, L, Faitot, F, Detry, O, Invernizzi, F, Magini, G, De Simone, P, Kounis, I, Morelli, M, Diaz Fontenla, F, Ericzon, B, Loinaz, C, Johnston, C, Gheorghe, L, Lesurtel, M, Romagnoli, R, Kollmann, D, Perera, M, Fagiuoli, S, Mirza, D, Coilly, A, Toso, C, Zieniewicz, K, Elkrief, L, Karam, V, Adam, R, Den Hoed, C, Merli, M, Puoti, M, De Carlis, L, Oniscu, G, Piano, S, Angeli, P, Fondevila, C, Polak, W, Belli L. S., Duvoux C., Cortesi P. A., Facchetti R., Iacob S., Perricone G., Radenne S., Conti S., Patrono D., Berlakovich G., Hann A., Pasulo L., Castells L., Faitot F., Detry O., Invernizzi F., Magini G., De Simone P., Kounis I., Morelli M. C., Diaz Fontenla F., Ericzon B. -G., Loinaz C., Johnston C., Gheorghe L., Lesurtel M., Romagnoli R., Kollmann D., Perera M. T. P. R., Fagiuoli S., Mirza D., Coilly A., Toso C., Zieniewicz K., Elkrief L., Karam V., Adam R., Den Hoed C., Merli M., Puoti M., De Carlis L., Oniscu G. C., Piano S., Angeli P., Fondevila C., Polak W. G., Belli, L, Duvoux, C, Cortesi, P, Facchetti, R, Iacob, S, Perricone, G, Radenne, S, Conti, S, Patrono, D, Berlakovich, G, Hann, A, Pasulo, L, Castells, L, Faitot, F, Detry, O, Invernizzi, F, Magini, G, De Simone, P, Kounis, I, Morelli, M, Diaz Fontenla, F, Ericzon, B, Loinaz, C, Johnston, C, Gheorghe, L, Lesurtel, M, Romagnoli, R, Kollmann, D, Perera, M, Fagiuoli, S, Mirza, D, Coilly, A, Toso, C, Zieniewicz, K, Elkrief, L, Karam, V, Adam, R, Den Hoed, C, Merli, M, Puoti, M, De Carlis, L, Oniscu, G, Piano, S, Angeli, P, Fondevila, C, Polak, W, Belli L. S., Duvoux C., Cortesi P. A., Facchetti R., Iacob S., Perricone G., Radenne S., Conti S., Patrono D., Berlakovich G., Hann A., Pasulo L., Castells L., Faitot F., Detry O., Invernizzi F., Magini G., De Simone P., Kounis I., Morelli M. C., Diaz Fontenla F., Ericzon B. -G., Loinaz C., Johnston C., Gheorghe L., Lesurtel M., Romagnoli R., Kollmann D., Perera M. T. P. R., Fagiuoli S., Mirza D., Coilly A., Toso C., Zieniewicz K., Elkrief L., Karam V., Adam R., Den Hoed C., Merli M., Puoti M., De Carlis L., Oniscu G. C., Piano S., Angeli P., Fondevila C., and Polak W. G.

Abstract

Objective: Explore the impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course. Design: Data from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and were analysed. Results: From 21 February to 20 November 2020, 136 adult cases with laboratory-confirmed SARS-CoV-2 infection from 33 centres in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32.7%) patients died after a median of 18 (10-30) days, with respiratory failure being the major cause (33/37, 89.2%). The 60-day mortality risk did not significantly change between first (35.3%, 95% CI 23.9% to 50.0%) and second (26.0%, 95% CI 16.2% to 40.2%) waves. Multivariable Cox regression analysis showed Laboratory Model for End-stage Liver Disease (Lab-MELD) score of ≥15 (Model for End-stage Liver Disease (MELD) score 15-19, HR 5.46, 95% CI 1.81 to 16.50; MELD score≥20, HR 5.24, 95% CI 1.77 to 15.55) and dyspnoea on presentation (HR 3.89, 95% CI 2.02 to 7.51) being the two negative independent factors for mortality. Twenty-six patients underwent an LT after a median time of 78.5 (IQR 44-102) days, and 25 (96%) were alive after a median follow-up of 118 days (IQR 31-170). Conclusions: Increased mortality in LT candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of ≥15, was observed, with no significant difference between first and second waves of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).

Published
2021

5. Impact of COVID-19 on liver transplantation in Europe: alert from an early survey of European Liver and Intestine Transplantation Association and European Liver Transplant Registry

Author

Polak, W, Fondevila, C, Karam, V, Adam, R, Baumann, U, Germani, G, Nadalin, S, Taimr, P, Toso, C, Troisi, R, Zieniewicz, K, Belli, L, Duvoux, C, Polak W. G., Fondevila C., Karam V., Adam R., Baumann U., Germani G., Nadalin S., Taimr P., Toso C., Troisi R. I., Zieniewicz K., Belli L. S., Duvoux C., Polak, W, Fondevila, C, Karam, V, Adam, R, Baumann, U, Germani, G, Nadalin, S, Taimr, P, Toso, C, Troisi, R, Zieniewicz, K, Belli, L, Duvoux, C, Polak W. G., Fondevila C., Karam V., Adam R., Baumann U., Germani G., Nadalin S., Taimr P., Toso C., Troisi R. I., Zieniewicz K., Belli L. S., and Duvoux C.

Abstract

There are scarce data on the impact of COVID-19 pandemic on liver transplantation (LT) in Europe. The aim of this study was to obtain a preliminary data on incidence, management, and outcome of COVID-19 in liver transplant recipients and candidates in Europe. An Internet-based survey was sent to the centers affiliated with European Liver Transplant Registry (ELTR). One hundred nine out of 149 (73%) of ELTR centers located in 28 European countries (93%) responded. Ninety-four (86%) of the centers tested all donors, and 75 (69%) centers tested all LT recipients for SARS-CoV-2. Seventy-three (67%) centers selected recipients for LT in the COVID-19 pandemic, whereas 33% did not. Eighty-eight centers reported COVID-19 infection in 57 LT candidates and in 272 LT recipients. Overall crude incidence of COVID-19 among LT candidates and recipients was estimated 1.05% (range 0.5–20%) and 0.34% (range 0.1–4.8%), respectively, and it was significantly higher among candidates (P ' 0.001). Crude rate of death was 18% (10/57) among candidates and 15% (36/244) among recipients. This first large-scale European snapshot study clearly shows that both LT candidates and recipients are at a high risk for COVID-19. These results plead for an early and pro-active screening of COVID-19 symptoms in these populations.

Published
2020

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

Author

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

Abstract

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

Published
2022

7. Long-term outcome after living donor liver transplantation compared to donation after brain death in autoimmune liver diseases: Experience from the European Liver Transplant Registry

Author

Heinemann M, Liwinski T, Adam R, Berenguer M, Mirza D, Malek-Hosseini SA, Heneghan MA, Lodge P, Pratschke J, Boudjema K, Paul A, Zieniewicz K, Fronek J, Mehrabi A, Acarli K, Tokat Y, Coker A, Yilmaz S, Karam V, Duvoux C, Lohse AW, Schramm C, and all the other contributing centers (www.eltr.org) and the European Liver and Int

Subjects
immune/inflammatory, liver transplantation/hepatology, liver transplantation: living donor, patient survival [clinical research/practice, graft survival, liver disease]
Abstract

Knowledge of living donor liver transplantation (LDLT) for autoimmune liver diseases (AILDs) is scarce. This study analyzed survival in LDLT recipients registered in the European Liver Transplant Registry with autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis (PSC) and the non-autoimmune disorder alcohol-related cirrhosis. In total, 29 902 individuals enrolled between 1998 and 2017 were analyzed, including 1003 with LDLT. Survival from >90 days after LDLT for AILDs in adults was 85.5%, 74.2%, and 58.0% after 5, 10, and 15 years. Adjusted for recipient age, sex, and liver transplantation era, adult PSC patients receiving LDLT showed increased mortality compared to donation after brain death (DBD) (hazard ratio [HR] = 1.95, 95% confidence interval [CI] = 1.36-2.80, p 90 days after LDLT compared to DBD (HR = 3.00, 95% CI 1.04-8.70, p = .043). Multivariate analysis identified several risk factors for death in adult PSC patients receiving LDLT including a male donor (HR = 2.49, p = .025). Adult PSC patients with LDLT versus DBD conferred increased mortality from disease recurrence (subdistribution hazard ratio [subHR] = 5.36, p = .001) and biliary complications (subHR = 4.40, p = .006) in multivariate analysis. While long-term outcome following LDLT for AILD is generally favorable, PSC patients with LDLT compared to DBD might be at increased risk of death.

Published
2022

10. The Association of Preoperative Skin Autofluorescence with Development of Acute Kidney Injury after Liver Resection

Author

Krasnodębski, M., primary, Niewiński, G., additional, Grąt, K., additional, Morawski, M., additional, Stypułkowski, J., additional, Borkowski, J., additional, Krawczyk, P., additional, Zhylko, A., additional, Rykowski, P., additional, Skalski, M., additional, Kalinowski, P., additional, Krawczyk, M., additional, Grąt, M., additional, and Zieniewicz, K., additional

Published
2022
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11. Laparoscopic versus Open Right Hemihepatectomy: An Analysis of Data from the Polish National Registry of Minimally Invasive Liver Surgery

Author

Hołówko, W., primary, Bartkowiak, M., additional, Serednicki, W., additional, Wysocki, M., additional, Morawski, M., additional, Zub-Pokrowiecka, A., additional, Wierdak, M., additional, Grąt, M., additional, Hogendorf, P., additional, Mielko, J., additional, Tarasik, A., additional, Wróblewski, T., additional, Budzyński, A., additional, Pędziwiatr, M., additional, and Zieniewicz, K., additional

Published
2022
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13. Prediction of Incisional Hernia Using Skin Autofluorescence in Patients after Subcostal Laparotomy

Author

Morawski, M., primary, Grąt, M., additional, Krasnodębski, M., additional, Grąt, K., additional, Krawczyk, P., additional, Stypułkowski, J., additional, Borkowski, J., additional, Rykowski, P., additional, Zhylko, A., additional, Skalski, M., additional, Figiel, W., additional, Krawczyk, M., additional, Patkowski, W., additional, and Zieniewicz, K., additional

Published
2022
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15. Improved Survival in Liver Transplant Patients Receiving Prolonged-release Tacrolimus-based Immunosuppression in the European Liver Transplant Registry (ELTR): An Extension Study

Author

Adam, R, Karam, V, Cailliez, V, Trunecka, P, Samuel, D, Tisone, G, Nemec, P, Soubrane, O, Schneeberger, S, Gridelli, B, Bechstein, W, Risaliti, A, Line, P, Vivarelli, M, Rossi, M, Pirenne, J, Klempnauer, J, Rummo, A, Di Benedetto, F, Zieniewicz, K, Troisi, R, Paul, A, Vali, T, Kollmar, O, Boudjema, K, Hoti, E, Colledan, M, Pratschke, J, Lang, H, Popescu, I, Ericzon, B, Strupas, K, De Simone, P, Kochs, E, Heyd, B, Gugenheim, J, Pinna, A, Bennet, W, Kazimi, M, Bachellier, P, Wigmore, S, Rasmussen, A, Clavien, P, Hidalgo, E, O'Grady, J, Zamboni, F, Kilic, M, Duvoux, C, Adam R, Karam V, Cailliez V, Trunecka P, Samuel D, Tisone G, Nemec P, Soubrane O, Schneeberger S, Gridelli B, Bechstein WO, Risaliti A, Line PD, Vivarelli M, Rossi M, Pirenne J, Klempnauer JL, Rummo A, Di Benedetto F, Zieniewicz K, Troisi R, Paul A, Vali T, Kollmar O, Boudjema K, Hoti E, Colledan M, Pratschke J, Lang H, Popescu I, Ericzon BG, Strupas K, De Simone P, Kochs E, Heyd B, Gugenheim J, Pinna AD, Bennet W, Kazimi M, Bachellier P, Wigmore SJ, Rasmussen A, Clavien PA, Hidalgo E, O'Grady JG, Zamboni F, Kilic M, Duvoux C, Adam, R, Karam, V, Cailliez, V, Trunecka, P, Samuel, D, Tisone, G, Nemec, P, Soubrane, O, Schneeberger, S, Gridelli, B, Bechstein, W, Risaliti, A, Line, P, Vivarelli, M, Rossi, M, Pirenne, J, Klempnauer, J, Rummo, A, Di Benedetto, F, Zieniewicz, K, Troisi, R, Paul, A, Vali, T, Kollmar, O, Boudjema, K, Hoti, E, Colledan, M, Pratschke, J, Lang, H, Popescu, I, Ericzon, B, Strupas, K, De Simone, P, Kochs, E, Heyd, B, Gugenheim, J, Pinna, A, Bennet, W, Kazimi, M, Bachellier, P, Wigmore, S, Rasmussen, A, Clavien, P, Hidalgo, E, O'Grady, J, Zamboni, F, Kilic, M, Duvoux, C, Adam R, Karam V, Cailliez V, Trunecka P, Samuel D, Tisone G, Nemec P, Soubrane O, Schneeberger S, Gridelli B, Bechstein WO, Risaliti A, Line PD, Vivarelli M, Rossi M, Pirenne J, Klempnauer JL, Rummo A, Di Benedetto F, Zieniewicz K, Troisi R, Paul A, Vali T, Kollmar O, Boudjema K, Hoti E, Colledan M, Pratschke J, Lang H, Popescu I, Ericzon BG, Strupas K, De Simone P, Kochs E, Heyd B, Gugenheim J, Pinna AD, Bennet W, Kazimi M, Bachellier P, Wigmore SJ, Rasmussen A, Clavien PA, Hidalgo E, O'Grady JG, Zamboni F, Kilic M, and Duvoux C

Abstract

Background. We compared, through the European Liver Transplant Registry, long-term liver transplantation outcomes with prolonged-release tacrolimus (PR-T) versus immediate-release tacrolimus (IR-T)-based immunosuppression. This retrospective analysis comprises up to 8-year data collected between 2008 and 2016, in an extension of our previously published study. Methods. Patients with <1 month follow-up were excluded; patients were propensity score matched for baseline characteristics. Efficacy measures included: univariate/multivariate analyses of risk factors influencing graft/patient survival up to 8 years posttransplantation, and graft/patient survival up to 4 years with PR-T versus IR-T. Overall, 13 088 patients were included from 44 European centers; propensity score-matched analyses comprised 3006 patients (PR-T: n = 1002; IR-T: n = 2004). Results. In multivariate analyses, IR-T-based immunosuppression was associated with reduced graft survival (risk ratio, 1.49; P = 0.0038) and patient survival (risk ratio, 1.40; P = 0.0215). There was improvement with PR-T versus IR-T in graft survival (83% versus 77% at 4 y, respectively; P = 0.005) and patient survival (85% versus 80%; P = 0.017). Patients converted from IR-T to PR-T after 1 month had a higher graft survival rate than patients receiving IR-T at last follow-up (P < 0.001), or started and maintained on PR-T (P = 0.019). One graft loss in 4 years was avoided for every 14.3 patients treated with PR-T versus IR-T. Conclusions. PR-T-based immunosuppression might improve long-term outcomes in liver transplant recipients than IR-T-based immunosuppression.

Published
2019

22. COVID-19 in Liver Transplant Candidates: Pre- and Post-Transplant Outcome

Author

Giovanni P, Hann A, Invernzzi F, lesurtel m, G. Magini, François Faitot, C. Morelli, Stefano Fagiuoli, Karam, Damiano Patrono, Renato Romagnoli, Diaz-Fontenla F, Kounis I, C. Fondevila, zieniewicz k, Rita Facchetti, Paolo Cortesi, Paolo De Simone, Elkrief L, Mirza D, Iacob S, Caroline M. den Hoed, Gheorghe L, Sylvie Radenne, Bo Göran Ericzon, Marco Merli, Lluis Castells, Carmelo Loinaz, Christophe Duvoux, Roberto Fumagalli, Berlakovic G, Sara Conti, Christian Toso, Perera T, Luca S. Belli, Wojciech G. Polak, Massimo Puoti, Luciano Dc, Kollmann D, Detry O, Luisa Pasulo, and Audrey Coilly

Subjects
medicine.medical_specialty, education.field_of_study, Cirrhosis, business.industry, Proportional hazards model, medicine.medical_treatment, Population, Liver transplantation, medicine.disease, Vaccination, Respiratory failure, Internal medicine, medicine, media_common.cataloged_instance, European union, business, education, media_common, Cause of death
Abstract

Background: The impact of COVID-19 on patients on the waiting list for liver transplantation (LT) and on their post-LT course is presently unknown. Methods: Data from consecutive adult LT candidates with COVID-19 were collected across Europe in a dedicated registry and analyzed. Findings: From February 21st to November 20th, 2020, 136 adult cases with laboratory confirmed SARS-CoV-2 infection from 33 centers in 11 European countries were collected, with 113 having COVID-19. Thirty-seven (37/113, 32·7%) patients died after a median of 18 (10-30) days, respiratory failure being the major cause (33/37, 89·2%). The 60-day mortality risk did not significantly change between first (35·3%, 95% CI 23·9-50·0) and second wave (26·0%, 95% CI 16·2-40·2). Multivariable Cox regression analysis showed lab-MELD score ≥15 (MELD 15-19 HR 6·09, 95% CI 2·01-18·45; MELD ≥20 HR 5·21, 95% CI 1·76-15·45) and dyspnea on presentation (HR 4·10, 95% CI 2·09-8·06) being the two negative independent factors for mortality. The mortality risk reached 49·2% (31/63) in patients with decompensated cirrhosis and lab-MELD score ≥15. Twenty-six patient received a LT after a median time of 78.5 (IQR 44-102) days and 25 (96%) are alive after median follow-up of 118 days (IQR 31-170). Interpretation: Increased mortality in LT candidates with COVID-19 (32·7%), reaching 49·2% in those with decompensated cirrhosis and lab-MELD score ≥15, with no significant difference between first and second wave of the pandemic. Respiratory failure was the major cause of death. The dismal prognosis of patients with decompensated cirrhosis supports the adoption of strict preventative measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%). Funding: No funding source. Declaration of Interests: None to declare. Ethics Approval Statement: Data was collected in accordance with General Data Protection Regulation (GDPR), the European Union legislation and the ELTR privacy policy. Reg. HCB/2020/0479 released by CLINICAL RESEARCH ETHICS COMMITTEE from Hospital Clinic Barcelona

Published
2021
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23. Characteristics, Trends, and Outcomes of Liver Transplantation for Primary Sclerosing Cholangitis in Female Versus Male Patients: An Analysis From the European Liver Transplant Registry

Author

Berenguer M, Di Maira T, Baumann U, Mirza DF, Heneghan MA, Klempnauer JL, Bennet W, Ericzon BG, Line PD, Lodge PA, Zieniewicz K, Watson, CJE, Metselaar HJ, Adam R, Karam V, Aguilera V, and European Liver Intestine Transplan

Subjects
PRIMARY BILIARY-CIRRHOSIS, AGE, IMPACT, RISK-FACTORS, SURVIVAL, SEX, GENDER, RECURRENCE, PHENOTYPE, DISEASE
Abstract

Background. The influence of sex on primary sclerosing cholangitis (PSC), pre- and postliver transplantation (LT) is unclear. Aims are to assess whether there have been changes in incidence, profile, and outcome in LT-PSC patients in Europe with specific emphasis on sex. Methods. Analysis of the European Liver Transplant Registry database (PSC patients registered before 2018), including baseline demographics, donor, biochemical, and clinical data at LT, immunosuppression, and outcome. Results. European Liver Transplant Registry analysis (n = 6463, 32% female individuals) demonstrated an increasing number by cohort (1980-1989, n = 159; 1990-1999, n = 1282; 2000-2009, n = 2316; 2010-2017, n = 2549) representing on average 4% of all transplant indications. This increase was more pronounced in women (from 1.8% in the first cohort to 4.3% in the last cohort). Graft survival rate at 1, 5, 10, 15, 20, and 30 y was 83.6%, 70.8%, 57.7%, 44.9%, 30.8%, and 11.6%, respectively. Variables independently associated with worse survival were male sex, donor and recipient age, cholangiocarcinoma at LT, nondonation after brain death donor, and reduced size of the graft. These findings were confirmed using a more recent LT population closer to the current standard of care (LT after the y 2000). Conclusions. An increasing number of PSC patients, particularly women, are being transplanted in European countries with better graft outcomes in female recipients. Other variables impacting outcome include donor and recipient age, cholangiocarcinoma, nondonation after brain death donor, and reduced graft size.

Published
2021

24. Liver transplantation for patients with acute-on-chronic liver failure (ACLF) in Europe: results of the ELITA/EF-CLIF collaborative study (ECLIS)

Author

Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Belli, Luca S, Duvoux, Christophe, Artzner, Thierry, Bernal, William, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie-Caroline, Pageaux, George-Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, Francoise, Rabinovich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Fondevila, Costantino, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Jalan, Rajiv, FAGIUOLI, STEFANO, Belli, L, Duvoux, C, Artzner, T, Bernal, W, Conti, S, Cortesi, P, Sacleux, S, Pageaux, G, Radenne, S, Trebicka, J, Fernandez, J, Perricone, G, Piano, S, Nadalin, S, Morelli, M, Martini, S, Polak, W, Zieniewicz, K, Toso, C, Berenguer, M, Iegri, C, Invernizzi, F, Volpes, R, Karam, V, Adam, R, Faitot, F, Rabinovich, L, Saliba, F, Meunier, L, Lesurtel, M, Uschner, F, Fondevila, C, Michard, B, Coilly, A, Meszaros, M, Poinsot, D, Schnitzbauer, A, De Carlis, L, Fumagalli, R, Angeli, P, Arroyo, V, Jalan, R, Fagiuoli, S, Belli, Luca S, Duvoux, Christophe, Artzner, Thierry, Bernal, William, Conti, Sara, Cortesi, Paolo A, Sacleux, Sophie-Caroline, Pageaux, George-Philippe, Radenne, Sylvie, Trebicka, Jonel, Fernandez, Javier, Perricone, Giovanni, Piano, Salvatore, Nadalin, Silvio, Morelli, Maria C, Martini, Silvia, Polak, Wojciech G, Zieniewicz, Krzysztof, Toso, Christian, Berenguer, Marina, Iegri, Claudia, Invernizzi, Federica, Volpes, Riccardo, Karam, Vincent, Adam, René, Faitot, Francoise, Rabinovich, Liane, Saliba, Faouzi, Meunier, Lucy, Lesurtel, Mickael, Uschner, Frank E, Fondevila, Costantino, Michard, Baptiste, Coilly, Audrey, Meszaros, Magdalena, Poinsot, Domitille, Schnitzbauer, Andreas, De Carlis, Luciano G, Fumagalli, Roberto, Angeli, Paolo, Arroyo, Vincente, Jalan, Rajiv, and FAGIUOLI, STEFANO

Abstract

Background and aims: Liver transplantation (LT) has been proposed to be an effective salvage therapy even for the sickest patients with acute-on-chronic liver failure (ACLF). This large collaborative study was designed to address the current clinical practice and outcomes of ACLF patients wait listed (WL) for LT in Europe. Methods: Retrospective study including 308 consecutive ACLF patients, listed in 20 centres across 8 European countries, from January 2018 to June 2019. Results: 2677 patients received a LT, 1216 (45.4%) for decompensated cirrhosis (DC). Of these, 234 (19.2%) had ACLF at LT: ACLF-1, 58 (4.8%); ACLF-2, 78 (6.4%); and ACLF-3, 98 (8.1%). Wide variations were observed amongst countries: France and Germany had high rates of ACLF-2/3 (27-41%); Italy, Switzerland, Poland and Netherlands had medium rates (9-15%); and United Kingdom and Spain had low rates (3-5%) (p <.0001). One-year probability of survival after LT for patients with ACLF was 81% (95% CI 74-87). Pre-LT arterial lactate levels >4 mmol/L (HR 3.14, 95% CI 1.37-7.19), recent infection from multi-drug resistant organisms (HR 3.67, 95% CI 1.63-8.28), and renal replacement therapy (HR 2.74, 95% CI 1.37-5.51) were independent predictors of post-LT mortality. During the same period, 74 patients with ACLF died on the WL. In an intention-to-treat analysis, one-year survival of ACLF patients on the LT WL was 73% for ACLF-1 or -2 and 50% for ACLF-3. Conclusion: The results reveal wide variations in listing patients with ACLF in Europe despite favorable post-LT survival. Risk factors for mortality were identified, allowing a more precise prognostic assessment of ACLF patients for potential LT. Lay summary: Acute on chronic liver failure (ACLF) is a severe clinical condition for which liver transplantation is an effective therapeutic option. This study has demonstrated that in Europe, referral and access to liver transplantation (LT) for patients with ACLF needs to be harmonized to avoid inequities.

Published
2021

26. 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

27. Improved survival in liver transplant patients receiving prolonged-release Tacrolimus in the European Liver Transplant Registry (ELTR): long-term follow-up, extension study

Author

Adam, R, Karam, V, Caillez, V, Trunecka, P, Samuel, D, Tisone, G, Nemec, P, Soubrane, O, Schneeberger, S, Gridelli, B, Bechstein, W, Risaliti, A, Line, P, Vivarelli, M, Rossi, M, Pirenne, J, Klempnauer, J, Rumo, O, Di Benedetto, F, Zieniewicz, K, Troisi, R, Paul, A, Vali, T, Kollmar, O, Boudjema, K, Hoti, E, Colledan, M, Pratschke, J, Lang, H, Popescu, I, Ericzon, B, Strupas, K, De Simone, P, Kochs, E, Heyd, B, Gugenheim, J, Pinna, A, Bennet, W, Kazimi, M, Bachellier, P, Wigmore, S, Rasmussen, A, Clavien, P, Hidalgo, E, O'Grady, J, Zamboni, F, Kilic, M, Duvoux, C, Adam R, Karam V, Caillez V, Trunecka P, Samuel D, Tisone G, Nemec P, Soubrane O, Schneeberger S, Gridelli B, Bechstein W, Risaliti A, Line P, Vivarelli M, Rossi M, Pirenne J, Klempnauer J, Rumo O, Di Benedetto F, Zieniewicz K, Troisi R, Paul A, Vali T, Kollmar O, Boudjema K, Hoti E, Colledan M, Pratschke J, Lang H, Popescu I, Ericzon BG, Strupas K, De Simone P, Kochs E, Heyd B, Gugenheim J, Pinna AD, Bennet W, Kazimi M, Bachellier P, Wigmore SJ, Rasmussen A, Clavien PA, Hidalgo E, O'Grady JG, Zamboni F, Kilic M, Duvoux C, Adam, R, Karam, V, Caillez, V, Trunecka, P, Samuel, D, Tisone, G, Nemec, P, Soubrane, O, Schneeberger, S, Gridelli, B, Bechstein, W, Risaliti, A, Line, P, Vivarelli, M, Rossi, M, Pirenne, J, Klempnauer, J, Rumo, O, Di Benedetto, F, Zieniewicz, K, Troisi, R, Paul, A, Vali, T, Kollmar, O, Boudjema, K, Hoti, E, Colledan, M, Pratschke, J, Lang, H, Popescu, I, Ericzon, B, Strupas, K, De Simone, P, Kochs, E, Heyd, B, Gugenheim, J, Pinna, A, Bennet, W, Kazimi, M, Bachellier, P, Wigmore, S, Rasmussen, A, Clavien, P, Hidalgo, E, O'Grady, J, Zamboni, F, Kilic, M, Duvoux, C, Adam R, Karam V, Caillez V, Trunecka P, Samuel D, Tisone G, Nemec P, Soubrane O, Schneeberger S, Gridelli B, Bechstein W, Risaliti A, Line P, Vivarelli M, Rossi M, Pirenne J, Klempnauer J, Rumo O, Di Benedetto F, Zieniewicz K, Troisi R, Paul A, Vali T, Kollmar O, Boudjema K, Hoti E, Colledan M, Pratschke J, Lang H, Popescu I, Ericzon BG, Strupas K, De Simone P, Kochs E, Heyd B, Gugenheim J, Pinna AD, Bennet W, Kazimi M, Bachellier P, Wigmore SJ, Rasmussen A, Clavien PA, Hidalgo E, O'Grady JG, Zamboni F, Kilic M, and Duvoux C

Published
2018

28. Long-term survival after liver transplantation for autoimmune hepatitis - results from the European Liver Transplant Registry

Author

Heinemann M, Adam R, Berenguer M, Mirza D, Malek-Hosseini SA, O'Grady JG, Lodge P, Pratschke J, Boudjema K, Paul A, Zieniewicz K, Fronek J, Weiss KH, Karam V, Duvoux C, Lohse A, and Schramm C

Subjects
surgical procedures, operative, ELTR database, autoimmune liver diseases, graft survival, long-term follow-up, patient survival
Abstract

The aim of this study was to analyse long-term patient and graft survival after liver transplantation for autoimmune hepatitis (AIH-LT) from the prospective multicentre European Liver Transplant Registry.

Published
2020

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