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Transjugular portosystemic shunt for early-onset refractory ascites after liver transplantation

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Hepatobiliary & Pancreatic Diseases International 2021年第1期20卷 90-93页

作者： Giuseppe Bianco Marco Maria Pascale Francesco Frongillo Erida Nure salvatore agnes Gabriele Spoletini General Surgery and Liver Transplant Unit Fondazione IRCCS-Policlinico Universitario“A.Gemelli”Rome 00168Italy

Liver transplantation(LT)is the most effective treatment for end-stage liver disease and complications of portal hypertension(PHT).However,PHT can relapse as a consequence of viral,alcoholic or metabolic chronic liver disease(CLD)recurrence,rejection,vascular abnormalities,small-for-size syndrome and technical complications(e.g.,portal or hepatic veins stenosis and/or thrombosis)[1].LT recipients with PHT may suffer from com plications similarly to non-transplanted cirrhotic patients(e.g.,refractory ascites,variceal hemorrhages and hydrothorax)although with higher morbidity and mortality due to their postoperative status and concomitant immunosuppressive therapy[2].

关键词： ascites liver mortality

Frequency of and reasons behind non-listing in adult patients referred for liver transplantation: Results from a retrospective study

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World Journal of Transplantation 2024年第2期14卷 99-106页

作者： Marco Biolato Luca Miele Giuseppe Marrone Claudia Tarli Antonio Liguori Rosaria Calia Giovanni Addolorato salvatore agnes Antonio Gasbarrini Maurizio Pompili Antonio Grieco Department of Medical and Surgical Sciences CEMADFondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy Department of Translational Medicine and Surgery Catholic University of Sacred HeartRome 00168Italy

BACKGROUND Few studies have evaluated the frequency of and the reasons behind the refusal of listing liver transplantation *** To assess the ineligibility rate for liver transplantation and its *** A single-center retrospective study was conducted on adult patients which entailed a formal multidisciplinary assessment for liver transplantation *** predictors for listing were evaluated using multivariable logistic *** In our center,314 patients underwent multidisciplinary work-up before liver transplantation enlisting over a three-year *** most frequent reasons for transplant evaluation were decompensated cirrhosis(51.6%)and hepatocellular carcinoma(35.7%).The non-listing rate was 53.8%and the transplant rate was 34.4%for the whole *** hundred and five motivations for ineligibility were *** most common contraindications were psychological(9.3%),cardiovascular(6.8%),and surgical(5.9%).Inappropriate or premature referral accounted for 76(37.1%)*** multivariable analysis,a referral from another hospital(OR:2.113;95%CI:1.259–3.548)served as an independent predictor of *** A non-listing decision occurred in half of our cohort and was based on an inappropriate or premature referral in one case out of *** referral from another hospital was taken as a strong predictor of non-listing.

关键词： Controindication Eligibility Evaluation Referral Personalized medicine

Pediatric T-tube in adult liver transplantation:Technical refinements of insertion and removal

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World Journal of Gastrointestinal Surgery 2021年第12期13卷 1628-1637页

作者： Gabriele Spoletini Giuseppe Bianco Antonio Franco Francesco Frongillo Erida Nure Francesco Giovinazzo Federica Galiandro Andrea Tringali Vincenzo Perri Guido Costamagna Alfonso Wolfango Avolio salvatore agnes General Surgery and Liver Transplantation Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy Digestive Endoscopy Unit Fondazione Policlinico Universitario Agostino Gemelli IRCCSRome 00168Italy

BACKGROUND With the increasing use of extended-criteria donor organs,the interest around Ttubes in liver transplantation(LT)was restored whilst concerns regarding T-tuberelated complications *** To describe insertion and removal protocols implemented at our institution to safely use pediatric rubber 5-French T-tubes and subsequent outcomes in a consecutive series of adult *** Data of consecutive adult LT patients from brain-dead donors,treated from March 2017 to December 2019,were collected(i.e.,biliary complications,adverse events,treatment after T-Tube removal).Patients with upfront hepaticojejunostomy,endoscopically removed T-tubes,those who died or received retransplantation before T-tube removal were *** Seventy-two patients were included in this study;T-tubes were removed 158 d(median;IQR 128-206 d)after *** four(5.6%)patients accidental T-tube removal occurred requiring monitoring only;in 68(94.4%)patients Nelaton drain insertion was performed according to our protocol,resulting in 18(25%)patients with a biliary output,subsequently removed after 2 d(median;IQR 1-4 d).Three(4%)patients required endoscopic retrograde cholangiopancreatography(ERCP)due to persistent Nelaton drain ***(4%)patients developed suspected biliary peritonitis,requiring ERCP with sphincterotomy and nasobiliary drain insertion(only one revealing contrast extravasation);no patient required percutaneous drainage or emergency *** The use of pediatric rubber 5-French T-tubes in LT proved safe in our series after insertion and removal procedure refinements.

关键词： Liver transplantation T-tube Kehr Biliary fistula Endoscopic retrograde cholangio-pancreatography Biliary drainage

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

Reverse time-dependent effect of alphafetoprotein and disease control on survival of patients with Barcelona Clinic Liver Cancer stage C hepatocellular carcinoma

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World Journal of Hepatology 2017年第36期9卷 1322-1331页

作者： Francesca Romana Ponziani Irene Spinelli Emanuele Rinninella Lucia Cerrito Antonio Saviano Alfonso Wolfango Avolio Michele Basso Luca Miele Laura Riccardi Maria Assunta Zocco Brigida Eleonora Annicchiarico Matteo Garcovich Marco Biolato Giuseppe Marrone Anna Maria De Gaetano Roberto Iezzi Felice Giuliante Fabio Maria Vecchio salvatore agnes Giovanni Addolorato Massimo Siciliano Gian Lodovico Rapaccini Antonio Grieco Antonio Gasbarrini Maurizio Pompili Department of Internal Medicine Gastroenterology and Hepatology Agostino Gemelli Hospital Department of Liver Transplant Surgery Agostino Gemelli Hospital Department of Oncology Gastroenterology and Hepatology Agostino Gemelli Hospital Department of Bioimaging and Radiological Sciences Agostino Gemelli Hospital Department of Hepatobiliary Surgery Agostino Gemelli Hospital Department of Pathology Agostino Gemelli Hospital

AIM To characterize the survival of cirrhotic patients with Barcelona Clinic Liver Cancer(BCLC) stage C hepatocellular carcinoma(HCC) and to ascertain the factors predicting the achievement of disease control(DC).METHODS The cirrhotic patients with BCLC stage C HCC evaluated by the Hepatocatt multidisciplinary group were subjected to the investigation. Demographic, clinical and tumor features, along with the best tumor response and overall survival were recorded. RESULTS One hundred and ten BCLC stage C patients were included in the analysis; the median overall survival was 13.4 mo(95%CI: 10.6-17.0). Only alphafetoprotein(AFP) serum level > 200 ng/m L and DC could independently predict survival but in a time dependent manner, the former was significantly associated with increased risk of mortality within the first 6 mo of follow-up(HR = 5.073, 95%CI: 2.159-11.916, P = 0.0002), whereas the latter showed a protective effect against death after one year(HR = 0.110, 95%CI: 0.038-0.314, P < 0.0001). Only patients showing microvascular invasion and/or extrahepatic spread recorded lower chances of achieving DC(OR = 0.263, 95%CI: 0.111-0.622, P = 0.002).CONCLUSION The BCLC stage C HCC includes a wide heterogeneous group of cirrhotic patients suitable for potentially curative treatments. The reverse and time dependent effect of AFP serum level and DC on patients' survival confers them as useful predictive tools for treatment management and clinical decisions.

关键词： Hepatocellular carcinoma Cirrhosis Barcelona Clinic Liver Cancer stage C Alphafetoprotein Disease control Performance status Survival