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Hepatobiliary & Pancreatic Diseases International 2023年第6期22卷 648-649页

作者： Benedetto Ielpo Salvatore Alborino Emmanuel Melloul Fabio Salvatori Quirino Lai massimo rossi Nicolas Demartines Salomone Di Saverio Unidad de Cirugía Hepatobiliopancreática Hospital del MarBarcelonaSpain Interventional Radiology Unit Macerata HospitalMacerataAV4ASUR MarcheItaly HBP and Liver Transplant Surgery Unit Visceral Surgery DeptCHUVUniversity of LausanneLausanneSwitzerland HBP and Liver Transplant Surgery Unit Policlinico Umberto ILa Sapienza University of RomeRomeItaly General Surgery Unit San Benedetto del Tronto HospitalSan Benedetto del TrontoAV5ASUR MarcheItaly

Hilar cholangiocarcinoma is a biliary malignancy arising from the perihilar biliary tree,which is associated with poor oncological outcomes due to its aggressive biology,chemo-resistance and insidious onset[1].As stated by Di Martino et al.,the standard of care is radical resection,and during the last decades,there have been great efforts to improve survival of potentially resectable hilar cholangiocarcinoma,with surgery being the treatment associated with longer survival[2].However,radical resection still represents a challenging operation with high risk of intraoperative and postoperative complications.

关键词： biliary surgery

Survivals after liver transplantation for hepatocellular carcinoma:Granular data for a better allocation process?

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Hepatobiliary & Pancreatic Diseases International 2018年第4期17卷 374-375页

作者： Quirino Lai massimo rossi Hepato-bilio-pancreatic and Liver Transplant Unit Department of SurgerySapienza University of Rome

To the Editor:A large international study has been recently published focusing on the combination of morphological aspects and alpha-fetoprotein(AFP)as predictors of survival in patients with hepatocellular cancer(HCC)treated with liver transplantation(LT)[1].As a matter of fact,morphology and biology represent the two sides of the same

关键词： AFP HCC Survivals after liver transplantation for hepatocellular carcinoma:Granular data for a better allocation process

New insights in the management of the middle hepatic vein dilemma

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Hepatobiliary & Pancreatic Diseases International 2019年第2期18卷 101-102页

作者： Quirino Lai Fabio MelANDro Gianluca Mennini massimo rossi Hepato-Bilio-Pancreatic and Liver Transplant Unit Department of General Surgery and Organ Transplantation Sapienza University of Rome Umberto I Policlinic of Rome

When the first series of adult-to-adult living donor liver transplantation(A2A-LDLT)were performed in Hong Kong[1],it was immediately clear that great technical challenges existed,mainly concerning the middle hepatic ... 详细信息

关键词： New insights middle hepatic vein dilemma

Uncommon indications for associating liver partition and portal vein ligation for staged hepatectomy:a systematic review

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Hepatobiliary Surgery and Nutrition 2021年第2期10卷 210-225页

作者： Quirino Lai Gianluca Mennini Zoe Larghi Laureiro massimo rossi Hepatobiliary Surgery and Organ Transplantation Unit Department of General Surgery and Organ TransplantationSapienza University of RomeRomeItaly

Associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)represents an innovative surgical technique used for the treatment of large hepatic lesions at high risk for post-resection liver failure due to a small future liver remnant.The most significant amount of literature concerns the use of ALPPS for the treatment of hepatocellular carcinoma(HCC),cholangiocarcinoma(CCC),and colorectal liver metastases(CRLM).On the opposite,few is known about the role of ALPPS for the treatment of uncommon liver pathologies.The objective of the present study was to evaluate the current literature on this topic.A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Eligible articles published up to February 2020 were included using the MEDLINE,Scopus,and Cochrane databases.Among the 486 articles screened,45 papers met the inclusion criteria,with 136 described cases of ALPPS for rare indications.These 136 cases were reported in 18 different countries.Only in two countries,namely Germany and Brazil,more than ten cases were observed.As for the ALPPS indications,we reported 41(30.1%)cases of neuroendocrine tumor(NET)metastases,followed by 27(19.9%)cases of gallbladder cancer(GBC),nine(6.6%)pediatric cases,six(4.4%)gastrointestinal stromal tumors,six(4.4%)adult cases of benign primary liver disease,four(2.9%)adult cases of malignant primary liver disease,and 43(31.6%)adult cases of malignant secondary liver disease.According to the International ALPPS Registry data,less than 10%of the ALPPS procedures have been performed for the treatment of uncommon liver *** and GBC are the unique pathologies with acceptable numerosity.ALPPS for NET appears to be a safe procedure,with satisfactory long-term results.On the opposite,the results observed for the treatment of GBC are poor.However,these data should be considered with caution.The rationale for treating benign pathologies with ALPPS appears to be weak.No definitive response should be gi

关键词： Neuroendocrine tumor(NET) gastrointestinal stromal tumors(GIST) gallbladder cancer(GBC) hepatoblastoma,metastases

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

Prognostic role of artificial intelligence among patients with hepatocellular cancer:A systematic review

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World Journal of Gastroenterology 2020年第42期26卷 6679-6688页

作者： Quirino Lai Gabriele Spoletini Gianluca Mennini Zoe Larghi Laureiro Diamantis I Tsilimigras TimothyMichael Pawlik massimo rossi Hepato-biliary and Organ Transplant Unit Department of SurgerySapienza University of RomeRome 00161Italy General Surgery and Liver Transplantation Unit Fondazione Policlinico Universitario A Gemelli IRCCSRome 00100Italy Wexner Medical Center The Ohio State UniversityColumbusOH 43210United States

BACKGROUND Prediction of survival after the treatment of hepatocellular carcinoma(HCC)has been widely investigated,yet remains inadequate.The application of artificial intelligence(AI)is emerging as a valid adjunct to traditional statistics due to the ability to process vast amounts of data and find hidden interconnections between variables.AI and deep learning are increasingly employed in several topics of liver cancer research,including diagnosis,pathology,and prognosis.AIM To assess the role of AI in the prediction of survival following HCC treatment.METHODS A web-based literature search was performed according to the Preferred Reporting Items for Systemic Reviews and Meta-Analysis guidelines using the keywords“artificial intelligence”,“deep learning”and“hepatocellular carcinoma”(and synonyms).The specific research question was formulated following the patient(patients with HCC),intervention(evaluation of HCC treatment using AI),comparison(evaluation without using AI),and outcome(patient death and/or tumor recurrence)structure.English language articles were retrieved,screened,and reviewed by the authors.The quality of the papers was assessed using the Risk of Bias In Non-randomized Studies of Interventions tool.Data were extracted and collected in a database.RESULTS Among the 598 articles screened,nine papers met the inclusion criteria,six of which had low-risk rates of bias.Eight articles were published in the last decade;all came from eastern countries.Patient sample size was extremely heterogenous(n=11-22926).AI methodologies employed included artificial neural networks(ANN)in six studies,as well as support vector machine,artificial plant optimization,and peritumoral radiomics in the remaining three studies.All the studies testing the role of ANN compared the performance of ANN with traditional statistics.Training cohorts were used to train the neural networks that were then applied to validation cohorts.In all cases,the AI models demonstrated superior predictive performance compared with traditional statis

关键词： Deep learning Artificial neuronal network Recurrence Liver transplantation Resection Hepatocellular cancer

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

Liver transplantation in adults:Choosing the appropriate timing

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2012年第4期3卷 49-61页

作者： Maria Siciliano Lucia Parlati Federica Maldarelli massimo rossi Stefano Ginanni Corradini Department of Clinical Medicine Division of GastroenterologySapienza University of Rome00185 RomeItaly Department of General Surgery and Organ Transplantation "Paride Stefanini" Sapienza University of Rome00185 RomeItaly

Liver transplantation is indicated in patients with acute liver failure,decompensated cirrhosis,hepatocellular carcinoma and rare liver-based genetic defects that trigger damage of other organs.Early referral to a transplant center is crucial in acute liver failure due to the high mortality with medical therapy and its unpredictable evolution.Referral to a transplant center should be considered when at least one complication of cirrhosis occurs during its natural history.However,because of the shortage of organ donors and the short-term mortality after liver transplantation on one hand and the possibility of managing the complications of cirrhosis with other treatments on the other,patients are carefully selected by the transplant center to ensure that transplantation is indicated and that there are no medical,surgical and psychological contraindications.Patients approved for transplantation are placed on the transplant waiting list and prioritized according to disease severity.Thus,the appropriate timing of transplantation depends on recipient disease severity and,although this is still a matter of debate,also on donor quality.These two variables are known to determine the "transplant benefit"(i.e.,when the expected patient survival is better with,than without,transplantation) and should guide donor allocation.

关键词： Liver transplantation Referral Waiting list Prioritization Allocation Timing Cirrhosis Hepatocellular carcinoma Indications Contraindications

Development and validation of an artificial intelligence model for predicting post-transplant hepatocellular cancer recurrence

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Cancer Communications 2023年第12期43卷 1381-1385页

作者： Quirino Lai Carmine De Stefano Jean Emond Prashant Bhangui Toru Ikegami Benedikt Schaefer Maria Hoppe-Lotichius Anna Mrzljak Takashi Ito Marco Vivarelli Giuseppe Tisone Salvatore Agnes Giuseppe Maria Ettorre massimo rossi Emmanuel Tsochatzis Chung Mau Lo Chao-Long Chen Umberto Cillo Matteo Ravaioli Jan Paul Lerut the EurHeCaLT and the West-East LT Study Group General Surgery and Organ Transplantation Unit AOU Policlinico Umberto I Sapienza University of Rome Rome Italy Data Science and Engineering Polytechnic of Turin Turin Italy Division of Liver Transplantation and Hepatobiliary Surgery Department of Surgery Weill Cornell Medicine-Columbia University New York US Medanta Institute of Liver Transplantation and Regenerative Medicine Medanta-The Medicity Gurgaon India Department of Surgery and Science Kyushu University Fukuoka Japan Department of Medicine I Gastroenterology Hepatology and Endocrinology Medical University of Innsbruck Innsbruck Austria Klinik für Allgemein- Viszeral- und Transplantationschirurgie Universitätsmedizin Mainz Mainz Germany Liver Transplant Centre Merkur University of Zagreb Zagreb Croatia Division of Hepato-Biliary-Pancreatic and Transplant Surgery Department of Surgery Graduate School of Medicine Kyoto Japan Unit of Hepatobiliary Surgery and Transplantation AOU Ospedali Riuniti Polytechnic University of Marche Ancona Italy Department of Surgical Sciences and Medical Sciences University of Rome-Tor Vergata Rome Italy Liver Unit Department of Surgery Catholic University-Fondazione Policlinico Universitario Agostino Gemelli IRCCS Rome Italy Department of Transplantation and General Surgery San Camillo Hospital Rome Italy UCL Institute for Liver and Digestive Health and Royal Free Sheila Sherlock Liver Centre Royal Free Hospital London UK Hong Kong University–Department of Surgery Queen Mary Hospital University of Hong Kong Hong Kong P. R. China Department of Surgery Kaohsiung Chang Gung Memorial Hospital Chang Gung University College of Medicine Kaohsiung Taiwan P. R. China Department of Surgery Oncology and Gastroenterology University of Padua Padua Italy Department of General Surgery and Transplantation IRCCS Azienda Ospedaliero-Universitaria di Bologna Bologna University Bologna Italy Institut de Recherche Clinique Université catholique de Louvain Brussels Belgium 不详

Dear Editor,In recent years,criteria based on the combinationof morphology and biology have been proposed forimproving the selection of hepatocellular cancer(HCC)patients waiting for liver transplantation(LT)[1,2].Since all the proposed models showed suboptimalresults in predicting the risk of postLT recurrence,aprediction model constructed using artificial intelligence(Al)could be an attractive way to surpass this limit[3,4].Therefore,the Time_Radiological-response_Alpha-fetoproteIN_Artificial-Intelligence(TRAIN-AI)modelwas developed,combining morphology and biology tumorvariables.

关键词： hepatocellular cancer artificial