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Hypothermic oxygenated perfusion for a steatotic liver graft

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Hepatobiliary & Pancreatic Diseases International 2020年第1期19卷 88-90页

作者： Quirino Lai Franco Ruberto fabio melandro Zoe Larghi Laureiro Massimo Rossi Gianluca Mennini Department of General Surgery and Organ Transplantation Sapienza University of RomeRomeItaly Department of Anaesthesiology Critical Care Medicine and Pain TherapySapienza University of RomeRomeItaly

To the Editor:Donor steatosis represents a well-known risk factor for primary non-function,early allograft dysfunction,and biliary complications after liver transplantation(LT)[1,2].Recently,machine perfusion(MP)technology has been implemented in the clinical practice,with the primary intent to assess the graft quality and to optimize the organ selection process[3].A limited number of articles has been published specifically investigated the role of MP in steatotic livers[4–10],with few of them looking at the role of hypothermic MP.

关键词： perfusion liver graft

Donor-to-recipient gender match in liver transplantation: A systematic review and meta-analysis

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World Journal of Gastroenterology 2018年第20期24卷 2203-2210页

作者： Quirino Lai Francesco Giovanardi fabio melandro Zoe Larghi Laureiro Manuela Merli Barbara Lattanzi Redan Hassan Massimo Rossi Gianluca Mennini Hepato-bilio-pancreatic and Liver Transplant Unit Department of Surgery Sapienza University of Rome Division of Gastroenterology Department of Clinical Medicine Sapienza University of Rome

AIM To perform a systematic review and meta-analysis on donor-to-recipient gender mismatch as a risk factor for post-transplant graft loss. METHODS A systematic literature search was performed using PubM ed, Cochrane Library database and EMBASE. The primary outcome was graft loss after liver transplantation. Odds ratios and 95% confidence intervals were calculated to compare the pooled data between groups with different donor-to-recipient gender matches. Three analyses were done considering(1) gender mismatches(F-M and M-F) vs matches(M-M and F-F);(2) Femaleto-Male mismatch vs other matches; and(3) Male-toFemale mismatch vs other matches.RESULTS A total of 7 articles were analysed. Gender mismatch(M-F and F-M) was associated with a significant increase of graft loss respect to match(M-M and F-F)(OR: 1.30; 95%CI: 1.13-1.50; P < 0.001). When F-M mismatch was specifically investigated, it confirmed its detrimental role in terms of graft survival(OR: 1.83; 95%CI: 1.20-2.80; P = 0.005). M-F mismatch failed to present a significant role(OR: 1.09; 95%CI: 0.73-1.62; P = 0.68).CONCLUSION Gender mismatch is a risk factor for poor graft survival after liver transplantation. Female-to-male mismatch represents the worst combination. More studies are needed with the intent to better clarify the reasons for these results.

关键词： Graft survival Female-to-male mismatch Liver transplantation Donor-to-recipient match Gender

Platelet-to-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer: A systematic review and meta-analysis

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World Journal of Gastroenterology 2018年第15期24卷 1658-1665页

作者： Quirino Lai fabio melandro Zoe Larghi Laureiro Francesco Giovanardi Stefano Ginanni Corradini Flaminia Ferri Redan Hassan Massimo Rossi Gianluca Mennini Hepato-bilio-pancreatic and Liver Transplant Unit Department of Surgery Sapienza University of Rome Division of Gastroenterology Department of Clinical Medicine Sapienza University of Rome

AIM To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio(PLR) as a risk factor for post-transplant hepatocellular cancer(HCC) recurrence. METHODS A systematic literature search was performed using PubM ed. Participants of any age and sex, who underwent liver transplantation for HCC were considered following these criteria:(1) studies comparing pre-transplant low vs high PLR values;(2) studies reporting post-transplant recurrence rates; and(3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measure was set for HCC recurrence after transplantation. RESULTS A total of 5 articles, published between 2014 and 2017, fulfilled the selection criteria. As for the quality of the reported studies, all the investigated articles presented an overall high quality. A total of 899 cases were investigated: 718 cases(80.0%) were males. Three studies coming from European countries and one from Japan presented HCV as the main cause of cirrhosis. On the opposite, one Chinese study presented a greater incidence of HBV-related cirrhotic cases. In all the studies apart one, the PLR cut-off value of 150 was reported. At meta-analysis, high PLR value was associated with a significant increase in recurrence after transplantation(OR = 3.33; 95%CI: 1.78-6.25; P < 0.001). A moderate heterogeneity was observed among the identified studies according to the Higgins I^2 statistic value.CONCLUSION Pre-transplant high PLR values are connected with an increased risk of post-operative recurrence of hepatocellular cancer. More studies are needed for better clarify the biological mechanisms of this results.

关键词： Recurrence inflammation hepatocellular cancer liver transplantation platelet-to-lymphocyte ratio

From portal to splanchnic venous thrombosis:What surgeons should bear in mind

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World Journal of Hepatology 2014年第8期6卷 549-558页

作者： Quirino Lai Gabriele Spoletini Rafael S Pinheiro fabio melandro Nicola Guglielmo Jan Lerut Starzl Unit of Abdominal Transplantation University Hospitals Saint-LucUniversitéCatholique Lou-vainB-1200 BrusselsBelgium Oxford Transplant Centre Churchill HospitalOxford University Hospitals NHS TrustOxford OX3 7LEUnited Kingdom Department of Gastroenterology University of Sao Paulo Medical School05508-070 Sao PauloBrazil Department of General Surgery and Organ Transplantation University SapienzaUmberto I Hospital00186 RomeItaly

The present study aims to review the evolution of surgical management of portal(PVT) and splanch-nic venous thrombosis(SVT) in the context of liver transplantation over the last 5 decades. PVT is more commonly managed by endovenous thrombectomy, while SVT requires more complex technical expedients. Several surgical techniques have been proposed, such as extensive eversion thrombectomy, anastomosis to collateral veins, reno-portal anastomosis, cavo-portal hemi-transposition, portal arterialization and combined liver-intestinal transplantation. In order to achieve satisfactory outcomes, careful planning of the surgical strategy is mandatory. The excellent results that are ob-tained nowadays confirm that, even extended, splanch-nic thrombosis is no longer an absolute contraindication for liver transplantation. Patients with advanced portal thrombosis may preferentially be referred to specialized centres, in which complex vascular approaches and even multivisceral transplantation are performed.

关键词： Liver transplantation Portal vein thrombosis Splanchnic vein thrombosis Thrombectomy Vascular graft Spleno-renal shunt Cavo-portal hemi-transposition Portal vein arterialization Intestinal transplantation Multi-visceral transplant

Mitochondrial DNA methylation and mitochondria-related epigenetics in neurodegeneration

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Neural Regeneration Research 2024年第2期19卷 405-406页

作者： fabio Coppedè Department of Translational Research and of New Surgical and Medical Technologies Laboratory of Medical GeneticsUniversity of PisaPisaItaly、Interdepartmental Research Center of Biology and Pathology of AgingUniversity of PisaPisaItaly

Mitochondria are cytoplasmic organelles referred to as the powerhouse of the cell because they are primarily involved in oxidative phosphorylation and energy production.They are particularly abundant in tissues with high energy demands,including muscle,liver,and brain,and mitochondrial dysfunction,oxidative mitochondrial DNA(mtDNA)damage,and impaired mitochondrial dynamics have often been associated with neurodegeneration.

关键词： impaired neurodegeneration oxidative

A quantitative analysis of the US materials flow methodology and comparison to the EU methodology for MSW statistics

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Waste Disposal and Sustainable Energy 2024年第1期6卷 85-94页

作者： Demetra Tsiamis fabio Poretti Stefano Consonni Marco J.Castaldi Earth Engineering Center Department of Chemical EngineeringThe City College of New YorkNew YorkNYUSA Dipartimento Di Energetica Politecnico Di MilanoPiazza Leonardo da Vinci 3220133MilanItaly

The European Union(EU)and the United States(US)determine municipal solid waste(MSW)statistics differently.The EU applies a site-specific methodology that directly measures waste whereas the US employs a materials flow methodology that estimates MSW statistics indirectly based on production and recovery data from industries.This study dissects the materials flow methodology and presents quantitative materials flow Sankey diagrams for the primary MSW materials to highlight data gaps that can be addressed to improve the methodology’s accuracy.Private industry plastics data were applied to the materials flow methodology,and the results were within 10%of the plastics statistics reported by the US Environmental Protection Agency(US EPA).Drawbacks to the methodologies include EU measurement inaccuracies due to double-counting and not accounting for residual waste in the US.The latter may partially explain why landfilling tonnages reported by the US EPA were approximately 60%less than the tonnages reported by the Waste to Energy Research and Technology Council(WTERT)in its national MSW survey that applied the EU methodology in the US.Unlike the EU,there is no US national policy that requires states to measure and report state-level waste data to the US EPA.Future improvements in US MSW statistics rely heavily on the implementation of national policies to homogenize the measurement and collection of waste data from states.

关键词： Materials flow methodology Site-specific methodology United States European Union Municipal solid waste Discrepancy

Physical exercise and synaptic protection in human and pre-clinical models of multiple sclerosis

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Neural Regeneration Research 2024年第8期19卷 1768-1771页

作者： Federica Azzolini Ettore Dolcetti Antonio Bruno Valentina Rovella Diego Centonze fabio Buttari Unit of Neurology IRCCS NeuromedPozzilliItaly Department of System Medicine University of Tor VergataRomeItaly Synaptic Immunopathology Lab Department of Systems MedicineTor Vergata UniversityRomeItaly

In multiple sclerosis,only immunomodulato ry and immunosuppressive drugs are recognized as disease-modifying therapies.Howeve r,in recent years,several data from pre-clinical and clinical studies suggested a possible role of physical exe rcise as disease-modifying therapy in multiple sclerosis.Current evidence is sparse and often conflicting,and the mechanisms underlying the neuroprotective and antinflammatory role of exercise in multiple sclerosis have not been fully elucidated.Data,mainly derived from pre-clinical studies,suggest that exe rcise could enhance longterm potentiation and thus neuroplasticity,could reduce neuroinflammation and synaptopathy,and dampen astrogliosis and microgliosis.In humans,most trials focused on direct clinical and MRI outcomes,as investigating synaptic,neuroinflammato ry,and pathological changes is not straightfo rward compared to animal models.The present review analyzed current evidence and limitations in research concerning the potential disease-modifying therapy effects of exercise in multiple sclerosis in animal models and human studies.

关键词： disease-modifying behaviour endocannabinoid system long-term potentiation multiple sclerosis neuroplasticity neuroprotection physical exercise synaptopathy

Venous Doppler flow patterns,venous congestion,heart disease and renal dysfunction:A complex liaison

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World Journal of Cardiology 2024年第1期16卷 5-9页

作者： Alessio Di Maria Rossella Siligato Marta Bondanelli fabio Fabbian Specialized Medicines Renal UnitUniversity Hospital St.Anna of FerraraFerrara I-44124Italy Department of Biomedical DentalMorphological and Functional Imaging SciencesUniversity of MessinaMessina I-98121Italy Department of Medical Sciences University of FerraraFerrara I-44124Italy Department of Medical Sciences University of FerraraFerrara 44124Italy

The World Journal of Cardiology published an article written by Kuwahara et al that we take the pleasure to comment on.We focused our attention on venous congestion.In intensive care settings,it is now widely accepted that venous congestion is an important clinical feature worthy of investigation.Evaluating venous Doppler profile abnormalities at multiple sites could suggest adequate treatment and monitor its efficacy.Renal dysfunction could trigger or worsen fluid overload in heart disease,and cardio-renal syndrome is a well-characterized spectrum of disorders describing the complex interactions between heart and kidney diseases.Fluid overload and venous congestion,including renal venous hypertension,are major determinants of acute and chronic renal dysfunction arising in heart disease.Organ congestion from venous hypertension could be involved in the development of organ injury in several clinical situations,such as critical diseases,congestive heart failure,and chronic kidney disease.Ultrasonography and abnormal Doppler flow patterns diagnose clinically significant systemic venous congestion.Cardiologists and nephrologists might use this valuable,noninvasive,bedside diagnostic tool to establish fluid status and guide clinical choices.

关键词： Cardio-renal syndrome Fluid overload Venous congestion Acute kidney injury Ultrasound Doppler flow patterns

Lower limb suspension induces threshold-specific alterations of motor units properties that are reversed by active recovery

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Journal of Sport and Health Science 2024年第2期13卷 264-276页

作者： Giacomo Valli fabio Sarto Andrea Casolo Alessandro Del Vecchio Martino V.Franchi Marco V.Narici Giuseppe De Vito Department of Biomedical Sciences University of PadovaPadova 35131Italy Department Artificial Intelligence in Biomedical Engineering Friedrich-Alexander UniversityErlangen-Nurnberg 91052Germany

Purpose:This study aimed to non-invasively test the hypothesis that(a) short-term lower limb unloading would induce changes in the neural control of force production(based on motor units(MUs) properties) in the vastus lateralis muscle and(b) possible changes are reversed by active recovery(AR).Methods:Ten young males underwent 10 days of unilateral lower limb suspension(ULLS) followed by 21 days of AR.During ULLS,participants walked exclusively on crutches with the dominant leg suspended in a slightly flexed position(15°-20°) and with the contralateral foot raised by an elevated shoe.The AR was based on resistance exercise(leg press and leg extension) and executed at 70% of each participant’s 1repetition maximum,3 times/week.Maximal voluntary isometric contraction(MVC) of knee extensors and MUs properties of the vastus lateralis muscle were measured at baseline,after ULLS,and after AR.MUs were identified using high-density electromyography during trapezoidal isometric contractions at 10%,25%,and 50% of the current MVC,and individual MUs were tracked across the 3 data collection points.Results:We identified 1428 unique MUs,and 270 of them(18.9%) were accurately tracked.After ULLS,MVC decreased by 29.77%,MUs absolute recruitment/derecruitment thresholds were reduced at all contraction intensities(with changes between the 2 variables strongly correlated),while discharge rate was reduced at 10% and 25% but not at 50% MVC.Impaired MVC and MUs properties fully recovered to baseline levels after AR.Similar changes were observed in the pool of total as well as tracked MUs.Conclusion:Our novel results demonstrate,non-invasively,that 10 days of ULLS affected neural control predominantly by altering the discharge rate of lower-threshold but not of higher-threshold MUs,suggesting a preferential impact of disuse on motoneurons with a lower depolarization threshold.However,after 21 days of AR,the impaired MUs properties were fully restored to baseline levels,highlighting the plasticity of the components involved in neural cont

关键词： Disuse High-density EMG Muscle disuse Neural impairment Neuromuscular degeneration