Article
Gastroenterology & Hepatology
Antonio Guerrero, Laura del Campo, Fabio Piscaglia, Bernhard Scheiner, Guohong Han, Francesco Violi, Carlos-Noronha Ferreira, Luis Tellez, Thomas Reiberger, Stefania Basili, Javier Zamora, Agustin Albillos
Summary: This study used an individual patient data meta-analysis to demonstrate the safety and efficacy of anticoagulation in the recanalization of portal vein thrombosis in patients with cirrhosis. Anticoagulation reduces all-cause mortality, but at the expense of increasing non-portal hypertension-related bleeding.
JOURNAL OF HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Shinya Yokoyama, Yoji Ishizu, Takashi Honda, Norihiro Imai, Takanori Ito, Kenta Yamamoto, Tomoyuki Tsuzuki, Masatoshi Ishigami
Summary: Portal vein thrombosis (PVT) in patients with liver cirrhosis may improve spontaneously when large collateral vessels are absent. In these cases, observation without anticoagulation therapy can be considered in expectation of spontaneous reduction of PVT.
HEPATOLOGY RESEARCH
(2022)
Review
Medicine, General & Internal
Swathi Prakash, Jared Bies, Mariam Hassan, Adriana Mares, S. Claudia Didia
Summary: Portal Vein Thrombosis (PVT) is a common complication of advanced liver disease, characterized by the obstruction of the portal vein due to thrombus formation. Recent studies have revealed that decreased blood flow caused by portal hypertension contributes to an increased risk of PVT. Cirrhosis patients with higher MELD and Child Pugh scores have a higher incidence of PVTs. The management of PVTs in cirrhotics remains controversial due to the complex hemostatic profile of these patients.
FRONTIERS IN MEDICINE
(2023)
Review
Medicine, General & Internal
Aitor Odriozola, Angela Puente, Antonio Cuadrado, Coral Rivas, Angela Anton, Francisco Jose Gonzalez, Raul Pellon, Emilio Fabrega, Javier Crespo, Jose Ignacio Fortea
Summary: This article comprehensively reviews the pathophysiology, clinical features, diagnosis, and treatment of portal vein thrombosis in patients with cirrhosis. Despite being a common complication in cirrhotic patients, the impact of portal vein thrombosis on hepatic decompensation and overall mortality is still debated. The lack of large prospective observational studies and randomized trials explain the heterogeneous recommendations in current guidelines.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Hematology
Nicolas Wenger, Tim Sebastian, Jurg H. Beer, Lucia Mazzolai, Drahomir Aujesky, Daniel Hayoz, Rolf P. Engelberger, Wolfgang Korte, Davide Voci, Nils Kucher, Stefano Barco, David Spirk
Summary: The study found differences in demographics, risk factors, and clinical outcomes between PE and DVT alone. Management of anticoagulation duration differs between the two manifestations of VTE in routine clinical practice, contrary to recommendations in the current consensus guidelines.
THROMBOSIS RESEARCH
(2022)
Review
Medicine, Research & Experimental
Raluca S. Costache, Andreea S. Dragomirica, Elena A. Dumitras, Jinga Mariana, Ana Caruntu, Andrada Popescu, Daniel O. Costache
Summary: Portal vein thrombosis (PVT) is a common complication in cirrhotic patients, but can also occur as a primary vascular condition. The pathogenesis of PVT is complex and involves multiple factors, with the JAK2 mutation accepted as a contributing factor.
EXPERIMENTAL AND THERAPEUTIC MEDICINE
(2021)
Article
Gastroenterology & Hepatology
Kylee Martens, Hannah S. McMurry, Steven Koprowski, Justine Hum, Jessica Haraga, Janice H. Jou, Joseph J. Shatzel
Summary: The clinical utility of anticoagulation for patients with cirrhosis and asymptomatic portal vein thrombosis is still debated, with limited data and consensus guidelines. Emerging evidence suggests that prophylactic anticoagulation in cirrhosis patients without PVT may have a lower risk of liver decompensation and mortality without an increased risk of bleeding.
JOURNAL OF CLINICAL GASTROENTEROLOGY
(2022)
Review
Gastroenterology & Hepatology
Jin Hean Koh, Zi Hui Liew, Gin Kee Ng, Hui Ting Liu, Yew Chong Tam, Andrea De Gottardi, Yu Jun Wong
Summary: This study aimed to compare the efficacy and safety of DOAC versus VKA in treating non-tumoral PVT in cirrhotic patients. The results showed that DOAC were associated with higher PVT recanalization rate, but had similar bleeding risk compared to VKA.
DIGESTIVE AND LIVER DISEASE
(2022)
Review
Hematology
Nicolas Wenger, Tim Sebastian, Rolf Peter Engelberger, Nils Kucher, David Spirk
Summary: PE and DVT, two clinical manifestations of VTE, have substantial differences in patient characteristics, risk factors, clinical manifestations, and outcomes. However, current guidelines for the management of DVT and PE have strikingly similar recommendations for diagnosis and treatment, with the main difference being the indication for advanced reperfusion therapies. More data is needed to propose evidence-based adjustments in diagnostic and therapeutic strategies to improve prognosis and outcomes for patients with VTE.
THROMBOSIS RESEARCH
(2021)
Article
Multidisciplinary Sciences
Nicola Mumoli, Francesco Dentali, Giulia Conte, Alessandra Colombo, Riccardo Capra, Cesare Porta, Giuseppe Rotiroti, Francesca Zuretti, Marco Cei, Flavio Tangianu, Isabella Evangelista, Jose Vitale, Antonino Mazzone, Igor Giarretta
Summary: This study investigated the incidence of upper extremity deep vein thrombosis (UEDVT) in patients with moderate to severe COVID-19 infection and found that patients requiring helmet continuous positive airway pressure (CPAP) ventilation were at higher risk of developing UEDVT, which was associated with increased mortality.
Article
Medicine, General & Internal
Alvaro Dubois-Silva, Cristina Barbagelata-Lopez, Patricia Pineiro-Parga, Luciano Lopez-Jimenez, Antoni Riera-Mestre, Sebastian Schellong, Judith Catella, Marijan Bosevski, Mireia Roca Toledo, Manuel Monreal
Summary: Among patients with acute symptomatic pulmonary embolism (PE) and concomitant lower-limb deep vein thrombosis (DVT), the presence of DVT symptoms is associated with higher all-cause and PE-related mortality within 30 days. Assessing DVT symptoms can help with risk stratification of these patients.
EUROPEAN JOURNAL OF INTERNAL MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Leonard Naymagon, Douglas Tremblay, Nicole Zubizarreta, Erin Moshier, John Mascarenhas, Thomas Schiano
Summary: Anticoagulation therapy appears to be safe and effective in cirrhotic patients with portal vein thrombosis, leading to higher rates of complete radiographic resolution and recanalization of occlusive PVT without increasing major bleeding rates. Additional prospective studies are needed to confirm these findings and evaluate other outcomes.
DIGESTIVE DISEASES AND SCIENCES
(2021)
Review
Gastroenterology & Hepatology
Marco Senzolo, Guadalupe Garcia-Tsao, Juan Carlos Garcia-Pagan
Summary: Portal vein thrombosis (PVT) is a complication of cirrhosis with increasing incidence related to the severity of cirrhosis. Various risk factors contribute to PVT occurrence and progression. While the impact of complete PVT on liver transplant outcomes is clear, its effect on cirrhosis progression remains uncertain. Treatment options vary based on individual patient characteristics and thrombus features.
JOURNAL OF HEPATOLOGY
(2021)
Article
Hematology
Hannah McMurry, Jean M. G. Sabile, Benjamin Elstrott, Boris Chobrutskiy, Ajay Mohinani, Sarah Patel, Sonia Gowda, Kylee Martens, Joseph Shatzel
Summary: Splanchnic vein thrombosis (SVT) occurs in a heterogenous group of patients secondary to a variety of risk factors including liver disease. Minimal data exists regarding natural history and outcomes of SVT, making it difficult to inform management decisions. This study aimed to identify clinical factors predictive of new or progressive thrombosis in a cohort of untreated SVT patients.
THROMBOSIS RESEARCH
(2022)
Article
Gastroenterology & Hepatology
Wei Fen Xie, Ji Yao Wang, Yu Lan Liu, Xing Shun Qi, Ling Yang
Summary: This expert consensus systematically reviews the epidemiology, risk factors, imaging examinations, diagnosis, assessment of disease severity, and treatment strategy of portal vein thrombosis in liver cirrhosis, based on the most recent evidence and expert opinions, to further standardize the diagnosis and treatment of the disease in clinical practice.
JOURNAL OF DIGESTIVE DISEASES
(2021)
Article
Gastroenterology & Hepatology
Alberto Zanetto, Filippo Pelizzaro, Elena Campello, Cristiana Bulato, Lorenz Balcar, Wenyi Gu, Sabrina Gavasso, Graziella Saggiorato, Stefan Zeuzem, Francesco Paolo Russo, Mattias Mandorfer, Thomas Reiberger, Jonel Trebicka, Patrizia Burra, Paolo Simioni, Marco Senzolo
Summary: This study found that acutely decompensated cirrhosis is associated with abnormal coagulation function and that the severity of inflammation is the most important predictor of acute-on-chronic liver failure and bleeding. A predictive model was proposed to accurately identify individuals at higher risk of acute-on-chronic liver failure in acutely decompensated cirrhosis.
JOURNAL OF HEPATOLOGY
(2023)
Article
Gastroenterology & Hepatology
Alberto Zanetto, Elena Campello, Patrizia Burra, Marco Senzolo, Paolo Simioni
Summary: Alterations in platelet aggregation may predict portal vein thrombosis (PVT) in patients with decompensated cirrhosis. The PLT ratio obtained from whole-blood aggregometry is a promising thrombotic biomarker.
LIVER INTERNATIONAL
(2023)
Review
Gastroenterology & Hepatology
Sara Battistella, Francesca D'Arcangelo, Marco Grasso, Alberto Zanetto, Martina Gambato, Giacomo Germani, Marco Senzolo, Francesco Paolo Russo, Patrizia Burra
Summary: Non-alcoholic fatty liver disease (NAFLD) is the fastest growing indication for liver transplantation (LT) in Western countries. NAFLD/NASH patients require a multidisciplinary approach for proper pre-surgical evaluation and are at higher risk of post-transplant complications. Lifestyle modifications, immunosuppressive regimens, and development of new drugs are important for improving outcomes in these patients.
CLINICAL AND MOLECULAR HEPATOLOGY
(2023)
Review
Surgery
Evangelos Cholongitas, Patrizia Burra, Georgia Vourli, George V. Papatheodoridis
Summary: The use of initial/early everolimus appears to be effective and has a satisfactory safety profile, making it a reasonable therapeutic option in liver transplantation.
CLINICAL TRANSPLANTATION
(2023)
Article
Gastroenterology & Hepatology
Sarah Shalaby, Sara Battistella, Alberto Zanetto, Debora Bizzaro, Giacomo Germani, Francesco Paolo Russo, Patrizia Burra
CLINICS IN LIVER DISEASE
(2023)
Article
Biochemistry & Molecular Biology
Massimiliano Cadamuro, Samantha Sarcognato, Riccardo Camerotto, Noemi Girardi, Alberto Lasagni, Giacomo Zanus, Umberto Cillo, Enrico Gringeri, Giovanni Morana, Mario Strazzabosco, Elena Campello, Paolo Simioni, Maria Guido, Luca Fabris
Summary: Metabolic syndrome (MetS) is associated with the development of intrahepatic cholangiocarcinoma (iCCA), a liver tumor. MetS iCCAs have increased deposition of osteopontin (OPN), tenascin C (TnC), and periostin (POSTN) in the extracellular matrix (ECM), which stimulates cell motility and cancer-stem-cell-like phenotype. OPN overexpression may serve as a predictive biomarker and therapeutic target for MetS iCCA.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Medicine, General & Internal
Oliviero Riggio, Ciro Celsa, Vincenza Calvaruso, Manuela Merli, Paolo Caraceni, Sara Montagnese, Vincenzina Mora, Martina Milana, Giorgio Maria Saracco, Giovanni Raimondo, Antonio Benedetti, Patrizia Burra, Rodolfo Sacco, Marcello Persico, Filippo Schepis, Erica Villa, Antonio Colecchia, Stefano Fagiuoli, Mario Pirisi, Michele Barone, Francesco Azzaroli, Giorgio Soardo, Maurizio Russello, Filomena Morisco, Sara Labanca, Anna Ludovica Fracanzani, Antonello Pietrangelo, Gabriele Di Maria, Silvia Nardelli, Lorenzo Ridola, Antonio Gasbarrini, Calogero Camma
Summary: In patients hospitalized for decompensated cirrhosis, hepatic encephalopathy (HE) is an independent risk factor for mortality and the most common cause of hospital readmission. Therefore, patients with HE should be evaluated as candidates for liver transplantation.
FRONTIERS IN MEDICINE
(2023)
Article
Gastroenterology & Hepatology
Marco Senzolo, Sarah Shalaby, Marco Grasso, Alessandro Vitale, Enrico Pizzirani, Giulio Barbiero, Alberto Zanetto, Paolo Feltracco, Paolo Simioni, Patrizia Burra, Umberto Cillo
Summary: This study found that HCC is an independent risk factor for the occurrence and progression of PVT in cirrhosis. The presence of PVT is associated with lower overall survival, especially when it is progressive or occlusive. This study emphasizes the importance of screening and prompt treatment for PVT.
Article
Immunology
Maria Rendina, Michele Barone, Chiara Lillo, Silvia Trapani, Lucia Masiero, Paolo Trerotoli, Francesca Puoti, Luigi Giovanni Lupo, Francesco Tandoi, Salvatore Agnes, Antonio Grieco, Enzo Andorno, Simona Marenco, Edoardo Giovanni Giannini, Umberto Baccarani, Pierluigi Toniutto, Amedeo Carraro, Antonio Colecchia, Matteo Cescon, Maria Cristina Morelli, Umberto Cillo, Patrizia Burra, Paolo Angeli, Michele Colledan, Stefano Fagiuoli, Luciano De Carlis, Luca Belli, Paolo De Simone, Paola Carrai, Fabrizio Di Benedetto, Nicola De Maria, Giuseppe Maria Ettorre, Valerio Giannelli, Salvatore Gruttadauria, Riccardo Volpes, Sveva Corsale, Vincenzo Mazzaferro, Sherrie Bhoori, Renato Romagnoli, Silvia Martini, Giorgio Rossi, Lucio Caccamo, Maria Francesca Donato, Massimo Rossi, Stefano Ginanni Corradini, Marco Spada, Giuseppe Maggiore, Giuseppe Tisone, Ilaria Lenci, Giovanni Vennarecci, Raffaella Tortora, Marco Vivarelli, Gianluca Svegliati Baroni, Fausto Zamboni, Laura Mameli, Silvio Tafuri, Simona Simone, Loreto Gesualdo, Massimo Cardillo, Alfredo Di Leo
Summary: This study evaluated the prevalence, mortality, and lethality of COVID-19 infection in liver transplant recipients (LTRs) compared to non-liver solid transplant recipients (NL-SOTRs) and the general population (GP) in Italy. The results showed that the infection, mortality, and lethality rates in LTRs were lower than NL-SOTRs and comparable to the Italian GP. The discussion suggests that LTRs may have a different immune response to SARS-CoV-2 infection compared to NL-SOTRs, possibly due to the immunotolerance induced by the grafted liver.
FRONTIERS IN IMMUNOLOGY
(2023)
Review
Oncology
Elisa Catanzaro, Enrico Gringeri, Patrizia Burra, Martina Gambato
Summary: Cholangiocarcinoma in patients with primary sclerosing cholangitis is a major concern and has a high mortality rate. Recent data have shown differences between primary sclerosing cholangitis-associated cholangiocarcinoma and de novo cholangiocarcinoma, raising questions about the disease mechanisms and optimal clinical approaches. This review highlights the latest updates in primary sclerosing cholangitis-associated cholangiocarcinoma and potential future strategies for diagnosis and surveillance.
Review
Biology
Giacomo Germani, Francesca D'Arcangelo, Marco Grasso, Patrizia Burra
Summary: Treatment options for acute alcohol-related hepatitis range from medical therapy to liver transplantation, and LT is effective for selected patients. However, due to the inability to ensure abstinence, LT is controversial in terms of organ scarcity and the risk of relapse. Careful patient selection and comprehensive support are essential.
Review
Gastroenterology & Hepatology
Pierluigi Toniutto, Sarah Shalaby, Laura Mameli, Filomena Morisco, Martina Gambato, Valentina Cossiga, Maria Guarino, Fabio Marra, Maurizia R. Brunetto, Patrizia Burra, Erica Villa, Special Interest Grp Gender Hepatol, Italian Assoc Study Liver AISF
Summary: Clinical research has shown that liver diseases can develop, progress, and respond to treatment differently in men and women due to the presence of estrogen and androgen receptors, which result in disparities in gene expression patterns, immune responses, and liver damage progression. Hormones and certain lifestyle factors like obesity, alcohol consumption, and smoking can interact with hormone-related mechanisms to affect liver diseases. The impact of sex hormones and gender differences on liver tumor occurrence and clinical outcomes remains uncertain. In this review, we critically examine gender-based differences in molecular mechanisms associated with liver carcinogenesis and the prevalence, prognosis, and treatment of liver tumors.
Review
Gastroenterology & Hepatology
Joerg M. Pollok, Pascale Tinguely, Marina Berenguer, Claus U. Niemann, Dimitri A. Raptis, Michael Spiro
Summary: There is significant controversy surrounding enhanced recovery for liver-transplant recipients, and this review aimed to summarize current knowledge, identify key components, and create internationally accepted guidelines. A collaborative effort by the ERAS4OLT.org partnership and specialists from around the world resulted in 80 final recommendations covering various aspects of enhanced recovery for liver transplantation. These guidelines provide a comprehensive overview and can guide the development of enhanced recovery programs globally.
LANCET GASTROENTEROLOGY & HEPATOLOGY
(2023)
Article
Geriatrics & Gerontology
Edoardo Vogliotti, Chiara Ceolin, Matteo Valenti, Jessica Vanin, Carlotta Campodall'Orto, Marta Tonon, Bruno Micael Zanforlini, Chiara Curreri, Maria Devita, Marina De Rui, Alessandra Coin, Umberto Cillo, Patrizia Burra, Paolo Angeli, Giuseppe Sergi
Summary: The purpose of this study was to compare the accuracy of the Liver Frailty Index (LFI) and the Multidimensional Prognostic Index (MPI) as predictors of mortality in a cohort of older adult candidates for liver transplantation. The findings showed that both MPI and LFI were good predictors of mortality in older people patients listed for liver transplantation.
EUROPEAN GERIATRIC MEDICINE
(2023)