Article
Medicine, General & Internal
Rebecca Panconesi, Mauricio Flores Carvalho, Janina Eden, Marilena Fazi, Fariha Ansari, Leandro Mancina, Nadia Navari, Richard Xavier Sousa Da Silva, Daniele Dondossola, Lucia Bautista Borrego, Matthias Pietzke, Adriano Peris, David Meierhofer, Paolo Muiesan, Alexander Galkin, Fabio Marra, Philipp Dutkowski, Andrea Schlegel
Summary: This study investigated the effects of NRP and HOPE on DCD liver transplantation using an animal model. The results showed that HOPE can reduce mitochondrial injury and inflammation, and improve post-transplant survival.
Article
Surgery
Damiano Patrono, Marinella Zanierato, Marco Vergano, Chiara Magaton, Enrico Diale, Giorgia Rizza, Silvia Catalano, Stefano Mirabella, Donatella Cocchis, Raffaele Potenza, Sergio Livigni, Roberto Balagna, Renato Romagnoli
Summary: The combination of A-NRP and D-HOPE in DCD liver transplantation allows for comparable outcomes to DBD transplantation.
TRANSPLANT INTERNATIONAL
(2022)
Article
Cardiac & Cardiovascular Systems
Deane E. Smith, Zachary N. Kon, Julius A. Carillo, Stacey Chen, Claudia G. Gidea, Greta L. Piper, Alex Reyentovich, Robert A. Montgomery, Aubrey C. Galloway, Nader Moazami
Summary: The feasibility of a donation after circulatory death (DCD) heart transplantation protocol using cardiopulmonary bypass (CPB) for normothermic regional reperfusion (NRP) was evaluated in this pilot study. The study showed excellent outcomes of DCD heart transplantation, indicating the potential for wider adoption of the DCD protocol and increased availability of donor hearts in the United States.
JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
(2022)
Article
Immunology
Riccardo De Carlis, Andrea Schlegel, Samuele Frassoni, Tiziana Olivieri, Matteo Ravaioli, Stefania Camagni, Damiano Patrono, Domenico Bassi, Duilio Pagano, Stefano Di Sandro, Andrea Lauterio, Vincenzo Bagnardi, Salvatore Gruttadauria, Umberto Cillo, Renato Romagnoli, Michele Colledan, Matteo Cescon, Fabrizio Di Benedetto, Paolo Muiesan, Luciano De Carlis
Summary: This study found that NRP and D-HOPE yield good results in DCD livers with prolonged warm ischemia in Italy, reducing the incidence of kidney injury.
Article
Cardiac & Cardiovascular Systems
Alice L. Zhou, Jessica M. Ruck, Alfred J. Casillan, Emily L. Larson, Benjamin L. Shou, Alexander K. Karius, Jinny S. Ha, Pali D. Shah, Christian A. Merlo, Errol L. Bush
Summary: Thoracoabdominal normothermic regional perfusion (TA-NRP) is a method used in the United States to recover cardiothoracic allografts from donors after circulatory death (DCD). Limited data on lung transplants using TA-NRP has prompted a national retrospective review. The study found that recipients of TA-NRP DCD transplants had a lower likelihood of prolonged ventilation and similar outcomes to direct recovery DCD transplants.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Article
Respiratory System
Cristina Baciu, Andrew Sage, Ricardo Zamel, Jason Shin, Xiao-Hui Bai, Olivia Hough, Mamatha Bhat, Jonathan C. Yeung, Marcelo Cypel, Shaf Keshavjee, Mingyao Liu
Summary: Gene expression profiling revealed distinguishable biological transcriptome signatures in DBD and DCD lungs, with DBD lungs showing upregulation of inflammatory pathways and DCD lungs displaying transcriptome signatures associated with cell death. Specific drug targets for rehabilitating DBD lungs were identified, and activation of certain signaling pathways were observed in EVLP-treated DBD lungs.
EUROPEAN RESPIRATORY JOURNAL
(2021)
Article
Cardiac & Cardiovascular Systems
Katrien Vandendriessche, Vincent Tchana-Sato, Didier Ledoux, Karlien Degezelle, Steffen Rex, Arne Neyrinck, Ina Jochmans, Diethard Monbaliu, Christophe Vandenbriele, Johan Van Cleemput, Bart Meyns, Filip Rega
Summary: This study investigates the safety and feasibility of heart transplantation after circulatory death using thoraco-abdominal normothermic regional perfusion and subsequent cold storage. The results show a 100% survival rate and good cardiac function in four procedures.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
Article
Surgery
Ivo J. Schurink, Femke H. C. de Goeij, Lex J. M. Habets, Fenna E. M. van de Leemkolk, Christian A. A. van Dun, Gabriel C. Oniscu, Ian P. J. Alwayn, Wojciech G. Polak, Volkert A. L. Huurman, Jeroen de Jonge
Summary: This study demonstrates that declined liver grafts donated after circulatory death (DCD) can be salvaged with abdominal normothermic regional perfusion (aNRP), avoiding primary nonfunction and reducing the occurrence of ischemic cholangiopathy.
Article
Cardiac & Cardiovascular Systems
Jennifer A. Frontera, Ariane Lewis, Les James, Kara Melmed, Brendan Parent, Eytan Raz, Syed T. Hussain, Deane E. Smith, Nader Moazami
Summary: The use of thoracoabdominal normothermic regional perfusion (TA-NRP) in donation after circulatory death (DCD) is an important development in organ donation. However, there have been concerns about the restoration of brain blood flow. In this study, the authors used intraoperative transcranial Doppler (TCD) to assess brain blood flow in two DCD TA-NRP cases and found no evidence of restored blood flow.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Article
Cardiac & Cardiovascular Systems
Shin Tanaka, Jose Luis Campo-Canaveral de la Cruz, Silvana Crowley Carrasco, Alejandra Romero Roman, Lucas Hoyos Mejia, Jose Manuel NaranjoGomez, Mar Cordoba Pelaez, Alvaro Sanchez Calle, Mariana Gil Barturen, Marina Perez Redondo, Christian Garcia Fadul, Andres Varela de Ugarte, David Gomez-de-Antonio
Summary: This study compared lung transplantation outcomes using lungs procured from cDCD donors using the A-NRP and abdominal RR techniques, and found no significant differences in terms of primary graft dysfunction, hospital mortality, and 1-year survival rate between the two groups.
EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
(2021)
Article
Surgery
Maria Padilla, Elisabeth Coll, Cristina Fernandez-Perez, Teresa Pont, Angel Ruiz, Marina Perez-Redondo, Eva Oliver, Lander Atutxa, Jose M. Mancino, Domingo Daga, Eduardo Minambres, Jose Moya, Barbara Vidal, Jose M. Duenas-Jurado, Fernando Mosteiro, Alberto Rodriguez-Salgado, Esperanza Fernandez-Garcia, Ramon Lara, Domingo Hernandez-Marrero, Belen Estebanez, Maria Luisa Rodriguez-Ferrero, Maria Barber, Fernando Garcia-Lopez, Amado Andres, Carlos Santiago, Ana Zapatero, Rafael Badenes, Francisco Carrizosa, Jose J. Blanco, Jose L. Bernal, Francisco J. Elola, Cristina Vidal, Christel Terron, Pablo Castro, Jordi Comas, Beatriz Dominguez-Gil
Summary: NRP in controlled DCDD kidney transplants shows better short-term outcomes compared to RR, with a lower risk of delayed graft function and 1-year graft loss in the NRP group.
AMERICAN JOURNAL OF TRANSPLANTATION
(2021)
Article
Cardiac & Cardiovascular Systems
Jad Malas, Qiudong Chen, Jason Thomas, Dominic Emerson, Dominick Megna, Fardad Esmailian, Michael E. Bowdish, Joanna Chikwe, Pedro Catarino
Summary: Thoracoabdominal normothermic regional perfusion is an alternative method for procuring hearts from donation after circulatory death (DCD) donors, but its impact on concomitantly procured lung allografts is still uncertain.
JOURNAL OF HEART AND LUNG TRANSPLANTATION
(2023)
Article
Biochemistry & Molecular Biology
Joris Blondeel, Nicholas Gilbo, Veerle Heedfeld, Tine Wylin, Louis Libbrecht, Ina Jochmans, Jacques Pirenne, Hannelie Korf, Diethard Monbaliu
Summary: During normothermic machine perfusion (NMP), livers procured after warm ischemia (WI) exhibit a distinct innate immune response compared to directly procured (DP) livers. The cytokine profile in WI livers shifts towards an anti-inflammatory phenotype during NMP and whole blood (WB) reperfusion, while pro-apoptotic signaling is stronger during NMP. WB reperfusion results in a blunted cytokine release in livers, suggesting a reconditioning effect of NMP, regardless of ischemic damage.
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
(2023)
Article
Surgery
Vincent Tchana-Sato, Gregory Hans, Janne Brouckaert, Olivier Detry, Johan Van Cleemput, Steffen Rex, Oceane Jaquet, Erwin De Troy, Mai-Linh Nguyen Trung, Arnaud Ancion, Raf Van den Eynde, Isabelle Lievens, Marc Gilbert Lagny, Marie-Helene Delbouille, Jean Olivier Defraigne, Didier Ledoux, Filip Rega
Summary: This study reports the first case of heart donation after euthanasia, demonstrating the feasibility of using specific repair measures and preservation methods to successfully perform a heart transplant.
AMERICAN JOURNAL OF TRANSPLANTATION
(2022)
Article
Surgery
Jose Luis Campo-Canaveral de la Cruz, Eduardo Minambres, Elisabeth Coll, Maria Padilla, Gloria Sanchez Antolin, Gloria de la Rosa, Joel Rosado, Francisco Javier Gonzalez Garcia, Silvana Crowley Carrasco, Gabriel Sales Badia, Eva Maria Fieria Costa, Jose Alberto Garcia Salcedo, Victor Mora, Carlos de la Torre, Rafael Badenes, Lander Atutxa Bizkarguenaga, Beatriz Dominguez-Gil
Summary: This study aimed to investigate the outcomes of lung and liver transplantation using NRP in cDCD donors and compare them with transplants using DBD grafts. The results showed that simultaneous transplantation of lungs and livers from cDCD donors using NRP offers similar outcomes to transplants using DBD grafts.
AMERICAN JOURNAL OF TRANSPLANTATION
(2023)
Article
Engineering, Biomedical
Damiano Patrono, Davide Cussa, Federica Rigo, Renato Romagnoli
Summary: This survey reveals significant heterogeneity in indications, techniques, and timing of machine perfusion (MP) in liver transplantation among experts, highlighting the importance of identifying optimal scenarios for each technique. Additionally, viability assessment is emphasized as a fundamental need for transplant professionals when considering the use of MP.
Letter
Gastroenterology & Hepatology
Mila Valsecchi, Andrea Lauterio, Roberto Crocchiolo, Riccardo De Carlis, Mariateresa Pugliano, Leonardo Centonze, Fabio Ferla, Matteo Zaniboni, Silvio Veronese, Gian Marco Podda, Luca Belli, Silvano Rossini, Luciano De Carlis, Roberto Fumagalli
LIVER TRANSPLANTATION
(2022)
Article
Gastroenterology & Hepatology
Roberto Rossotti, Marco Merli, Chiara Mazzarelli, Riccardo Maria De Carlis, Giovanna Travi, Marta Vecchi, Raffaella Vigano, Andrea Lauterio, Alessandro Raimondi, Luca Saverio Belli, Luciano Gregorio De Carlis, Massimo Puoti
Summary: This study retrospectively evaluated the overall survival rate, the impact of anti-HCV direct-acting agents (DAA), and the rate of HCC recurrence in HBV/HCV-infected patients who underwent liver transplantation (LT). The results showed improved post-LT survival after DAA availability and no impact of HIV on mortality. However, co-infected individuals had a higher and delayed rate of HCC recurrence.
DIGESTIVE AND LIVER DISEASE
(2023)
Review
Oncology
Gian Piero Guerrini, Giuseppe Esposito, Tiziana Olivieri, Paolo Magistri, Roberto Ballarin, Stefano Di Sandro, Fabrizio Di Benedetto
Summary: This article compares the surgical and long-term outcomes of Salvage Liver Transplantation (SLT) and Primary Liver Transplantation (PLT) for HCC through a meta-analysis. The results show that SLT has comparable surgical outcomes but slightly poorer long-term survival compared to PLT.
Article
Medicine, General & Internal
Quirino Lai, Nicoletta De Matthaeis, Michele Finotti, Giovanni Galati, Giuseppe Marrone, Fabio Melandro, Filomena Morisco, Daniele Nicolini, Riccardo Pravisani, Edoardo G. Giannini
Summary: This study evaluates the impact of antiplatelet therapy on the incidence and mortality of hepatocellular carcinoma. The results suggest that antiplatelet therapy is associated with a reduced risk of HCC incidence and post-treatment mortality.
EUROPEAN JOURNAL OF CLINICAL INVESTIGATION
(2023)
Article
Gastroenterology & Hepatology
Damiano Patrono, Riccardo De Carlis, Alessandro Gambella, Francesca Farnesi, Alice Podesta, Andrea Lauterio, Francesco Tandoi, Luciano De Carlis, Renato Romagnoli
Summary: The viability of liver grafts with significant MaS (>= 30%) has not been specifically assessed in end-ischemic NMP. Our study found that NMP allowed successful transplantation of 57% of livers with moderate-to-severe MaS. Prolonged observation and stable lactate clearance are important for the use of steatotic livers.
LIVER TRANSPLANTATION
(2023)
Article
Gastroenterology & Hepatology
Janina Eden, Richard Xavier Sousa Da Silva, Miriam Cortes-Cerisuelo, Kristopher Croome, Riccardo De Carlis, Amelia J. Hessheimer, Xavier Muller, Femke de Goeij, Vanessa Banz, Giulia Magini, Philippe Compagnon, Andreas Elmer, Andrea Lauterio, Rebecca Panconesi, Jeannette Widmer, Daniele Dondossola, Paolo Muiesan, Diethard Monbaliu, Marieke de Rosner van van Rosmalen, Olivier Detry, Constantino Fondevila, Ina Jochmans, Jacques Pirenne, Franz Immer, Gabriel C. Oniscu, Jeroen de Jonge, Mickael Lesurtel, Luciano G. De Carlis, C. Burcin Taner, Nigel Heaton, Andrea Schlegel, Philipp Dutkowski
Summary: Liver graft utilization rates and discard rates vary across countries, with machine perfusion strategies contributing to better DCD utilization rates. Risk factors and use of various machine perfusion techniques vary between countries, but this does not significantly impact 5-year graft survival rates. Overall, countries with routine use of machine perfusion strategies have higher DCD utilization rates without compromised outcomes.
JOURNAL OF HEPATOLOGY
(2023)
Letter
Immunology
Andrea Lauterio, Riccardo De Carlis, Leonardo Centonze, Marco Merli, Mila Valsecchi, Gianpaola Monti, Massimo Puoti, Roberto Fumagalli, Luciano De Carlis
TRANSPLANT INFECTIOUS DISEASE
(2023)
Article
Immunology
Leonardo Centonze, Giovanna Gorga, Riccardo De Carlis, Davide Bernasconi, Andrea Lauterio, Luca Carbonaro, Ivan Vella, Cristiano Sgrazzutti, Niccolo Incarbone, Francesco Rizzetto, Maria Grazia Valsecchi, Angelo Vanzulli, Luciano De Carlis
Summary: The study found that spontaneous portosystemic shunts (SPSSs) have a significant impact on the natural history of cirrhotic patients and postoperative outcomes following liver transplantation (LT). A higher total shunt area (TSA) is associated with lower patient survival and increased risks of early allograft dysfunction, acute kidney injury, and clinically relevant complications. Therefore, careful hemodynamic assessment and management are crucial for patients with multiple or larger shunts.
Article
Immunology
Stefano Di Sandro, Barbara Catellani, Cristiano Guidetti, Paolo Magistri, Roberto Ballarin, Annarita Pecchi, Daniela Caracciolo, Giovanni Guaraldi, Gian Piero Guerrini, Fabrizio Di Benedetto
Summary: HIV and HCV infections cause millions of deaths worldwide annually. With the introduction of effective therapies, these previously untreatable infections are now fully controlled. This study presents a successful living donor liver transplantation from a donor with both previous HIV and HCV infections, demonstrating that individuals with well-controlled HIV/HCV infections and without risk factors may be suitable donors.
Editorial Material
Oncology
Fabrizio Di Benedetto, Paolo Magistri, Stefano Di Sandro
ANNALS OF SURGICAL ONCOLOGY
(2023)
Article
Infectious Diseases
Erica Franceschini, Giovanni Dolci, Antonella Santoro, Marianna Meschiari, Alice Ricco, Marianna Menozzi, Giulia Jole Burastero, Biagio Cuffari, Nicola De Maria, Lucia Serio, Emanuela Biagioni, Barbara Catellani, Stefano Di Sandro, Antonio Colecchia, Massimo Girardis, Fabrizio Di Benedetto, Cristina Mussini
Summary: This study aims to describe a case series of patients with decompensated liver cirrhosis and Pneumocystis jirovecii pneumonia (PCP). The results show that liver cirrhosis can be an independent risk factor for PCP, especially in patients with severe alcoholic hepatitis who are on corticosteroid treatment for decompensated cirrhosis. Primary prophylaxis for PCP should be considered in these patients.
INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES
(2023)
Review
Gastroenterology & Hepatology
Riccardo De Carlis, Paolo Muiesan, Burcin Taner
Summary: DCD grafts pose risks of complications and graft loss after liver transplantation due to prolonged functional donor warm ischaemia time. Improved outcomes have been achieved through stringent donor selection criteria and utilization of organ perfusion technologies. These technologies also enable liver function assessment and precise graft-recipient selection.
JOURNAL OF HEPATOLOGY
(2023)
Review
Surgery
Cristiano Guidetti, Ning Q. Pang, Barbara Catellani, Paolo Magistri, Daniela Caracciolo, Gian P. Guerrini, Annarita Pecchi, Stefano Di Sandro, Fabrizio Di Benedetto
Summary: Iatrogenic injury to the liver hilum during cholecystectomy is a severe complication that may require liver transplantation. This study reviewed the experience of our center and analyzed the outcomes of liver transplantation in this setting. The results showed high mortality and incidence of severe complications after liver transplantation, but long-term survival rates were still promising.
INTERNATIONAL JOURNAL OF SURGERY
(2023)
Review
Nutrition & Dietetics
Federico Ravaioli, Nicola De Maria, Lorenza Di Marco, Alessandra Pivetti, Riccardo Casciola, Carlo Ceraso, Gabriella Frassanito, Martina Pambianco, Maddalena Pecchini, Chiara Sicuro, Laura Leoni, Stefano Di Sandro, Paolo Magistri, Renata Menozzi, Fabrizio Di Benedetto, Antonio Colecchia
Summary: Liver transplantation (LT) is a complex surgical procedure that requires careful planning and care to ensure the nutritional status of the patient. This review examines the assessment and management of nutritional status before, during, and after LT, specifically for patients who have undergone bariatric surgery. Key factors influencing nutritional status in liver transplant patients, such as pre-existing malnutrition, liver disease severity, comorbidities, and immunosuppressive medications, are identified. The review emphasizes the importance of pre-operative nutritional assessment and intervention, close monitoring of nutritional status, individualized nutrition care plans, and ongoing support after LT. It also evaluates the impact of bariatric surgery on the nutritional status of liver transplant recipients, providing valuable insights for optimizing nutritional status during the transplant process.