Article
Surgery
Whitney E. Jackson, John S. Malamon, Bruce Kaplan, Jessica L. Saben, Jesse D. Schold, James J. Pomposelli, Elizabeth A. Pomfret
Summary: This study examines the survival benefit of living-donor liver transplant (LDLT) and its association with the Model for End-stage Liver Disease incorporating sodium levels (MELD-Na) score. The findings suggest that LDLT provides a substantial survival benefit to patients with end-stage liver disease, even at lower MELD-Na scores as low as 11. The study challenges current perceptions regarding the timing of LDLT survival benefit.
Article
Immunology
Dor Yoeli, Rashikh A. Choudhury, Hunter B. Moore, Whitney E. Jackson, Trevor L. Nydam, Michael E. Wachs, Elizabeth A. Pomfret, Megan A. Adams
Summary: This study compares the effects of pediatric living donor liver transplantation (LDLT) center volume on waiting list and posttransplant outcomes. The results suggest that high-volume pediatric LDLT centers can improve waiting list survival, while center volume is associated with posttransplant survival. Expertise in all types of pediatric liver transplant options is crucial for optimizing outcomes.
Article
Surgery
Tomoaki Yoh, Satoru Seo, Kojiro Taura, Yuhei Hamaguchi, Satoshi Ogiso, Ken Fukumitsu, Takamichi Ishii, Koichiro Hata, Toshimi Kaido, Yuji Nakamoto, Shinji Uemoto
Summary: LDLT shows better long-term outcomes than LR in patients with HCC, but selected patients with solitary HCC and TLR < 2 may benefit from LR.
WORLD JOURNAL OF SURGERY
(2021)
Review
Oncology
Marcello Di Martino, Alessandro Vitale, Daniele Ferraro, Marilisa Maniscalco, Donatella Pisaniello, Giuseppe Arenga, Federica Falaschi, Alfonso Terrone, Alessandro Iacomino, Alfonso Galeota Lanza, Ciro Esposito, Umberto Cillo, Giovanni Vennarecci
Summary: This systematic review evaluates the effectiveness of downstaging therapies for hepatocellular carcinoma (HCC) patients beyond the listing criteria. The results suggest that patients who are successfully downstaged and transplanted have a longer overall survival compared to those who are not transplanted. However, there are no significant differences in the survival rates between these two groups based on an intention-to-treat analysis.
Review
Gastroenterology & Hepatology
Paul J. Thuluvath, Chau To, Waseem Amjad
Summary: Hepatocellular cancer is a common and deadly cancer worldwide. Liver transplantation is the preferred treatment for unresectable HCC, but due to long waiting periods, locoregional therapies may be needed for some patients.
AMERICAN JOURNAL OF GASTROENTEROLOGY
(2021)
Article
Gastroenterology & Hepatology
Jordyn Silverstein, Francis Y. Yao, Joshua D. Grab, Hillary J. Braun, John Roberts, Jennifer L. Dodge, Neil Mehta
Summary: Living donor liver transplantation (LDLT) is an attractive option for hepatocellular carcinoma (HCC) patients, but its utilization has remained low in recent years. LDLT is an underutilized but valuable option for high-risk patients at risk of waitlist dropout.
LIVER TRANSPLANTATION
(2022)
Article
Cardiac & Cardiovascular Systems
Avik Som, Nicholas J. Reid, John DiCapua, Rory L. Cochran, Thomas An, Raul Uppot, Omar Zurkiya, Eric Wehrenberg-Klee, Sanjeeva Kalva, Ronald S. Arellano
Summary: The study demonstrated the effectiveness of computed tomography-guided percutaneous microwave ablation as a bridging therapy for hepatocellular carcinoma patients awaiting liver transplant, but the completeness of residual disease was not significantly associated with patient survival time.
CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY
(2021)
Article
Oncology
Giacomo Zanus, Giovanni Tagliente, Serena Rossi, Alessandro Bonis, Mattia Zambon, Michele Scopelliti, Marco Brizzolari, Ugo Grossi, Maurizio Romano, Michele Finotti
Summary: This study analyzes the safety and efficacy of pulsed microwave liver ablation as an additional treatment option for HCC patients. The results show that this technique effectively controls tumor progression and recurrence and results in high overall survival rates. It is applicable not only to early-stage patients but also to those with advanced disease.
Article
Surgery
Vikraman Gunabushanam, Swaytha Ganesh, Kyle Soltys, George Mazariegos, Armando Ganoza, Michele Molinari, Amit Tevar, Christopher Hughes, Abhinav Humar
Summary: This study reviewed the application of LPE in Asia and found that it is feasible in high-volume LDLT centers and can overcome ABO incompatibility to increase the number of LDLTs.
JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
(2022)
Article
Surgery
Kate Minoux, Guillaume Lassailly, Massih Ningarhari, Henri Lubret, Medhi El Amrani, Valerie Canva, Stephanie Truant, Philippe Mathurin, Alexandre Louvet, Gilles Lebuffe, Odile Goria, Eric Nguyen-Khac, Emmanuel Boleslawski, Sebastien Dharancy
Summary: This study investigated the trajectory of HCC patients awaiting liver transplantation who were treated with sorafenib. The results suggest that patients treated for HCC progression have high dropout rates and low survival rates, while patients treated for impossibility of loco-regional therapy have acceptable survival rates.
TRANSPLANT INTERNATIONAL
(2022)
Review
Gastroenterology & Hepatology
Marcello Di Martino, Daniele Ferraro, Donatella Pisaniello, Giuseppe Arenga, Federica Falaschi, Alfonso Terrone, Marilisa Maniscalco, Alfonso Galeota Lanza, Ciro Esposito, Giovanni Vennarecci
Summary: This study aimed to evaluate the outcomes of bridging therapies in patients with hepatocellular carcinoma (HCC) considered for liver transplantation (LT). The results showed that patients who received bridging therapies had higher post-LT survival rates despite a longer waiting time.
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
(2023)
Article
Surgery
Lauren Matevish, Madhukar S. Patel, Parsia A. Vagefi
Summary: Downstaging has been shown to be feasible within UNOS-DS criteria, with successful long-term outcomes. Interventional liver-directed therapies have been the standard, but systemic therapies are becoming more effective. Immunotherapy holds promise in downstaging, but further trials are needed to assess feasibility and safety. Individual expertise will continue to guide treatment until more data is available.
SURGICAL CLINICS OF NORTH AMERICA
(2024)
Article
Pharmacology & Pharmacy
Pil Soo Sung, Ji Won Han, Changho Seo, Joseph Ahn, Soon Kyu Lee, Hee Chul Nam, Ho Joong Choi, Young Kyoung You, Jeong Won Jang, Jong Young Choi, Seung Kew Yoon
Summary: This study demonstrated that mTOR inhibitors can help preserve renal function in liver transplantation recipients, especially in patients with renal impairment, without serious adverse events. Regardless of the timing of initiation, a switch to mTOR inhibitors showed significant improvement in kidney function.
FRONTIERS IN PHARMACOLOGY
(2021)
Article
Gastroenterology & Hepatology
Alyson N. Fox, AnnMarie Liapakis, Ramesh Batra, Therese Bittermann, Juliet Emamaullee, Sukru Emre, Yuri Genyk, Hyosun Han, Whitney Jackson, Elizabeth Pomfret, Muhammad Raza, Manuel Rodriguez-Davalos, Susan Rubman Gold, Benjamin Samstein, Akhil Shenoy, Timucin Taner, John P. Roberts
Summary: This article reviews the increasing interest in anonymous nondirected living organ donation in the United States, discusses current transplant policy and emerging data in living donor liver transplantation, and aims to provide consensus guidance for safe evaluation and selection of nondirected living liver donors and just allocation of grafts.
Article
Surgery
Anjana Pillai, Elizabeth. C. C. Verna, Neehar. D. D. Parikh, Matthew Cooper, Carrie Thiessen, Julie Heimbach, Elisa. J. J. Gordon, Gonzalo Sapisochin, Nazia Selzner, Amit Mathur, Emily. R. R. Perito, Michelle Jesse, AnnMarie Liapakis, Vineeta Kumar
Summary: In October 2021, the American Society of Transplantation (AST) held a virtual consensus conference to address barriers preventing the expansion of living donor liver transplantation (LDLT) in the United States. A multidisciplinary group of experts identified financial implications on donors, crisis management, policies and regulations, and ethical considerations as significant barriers. They proposed strategies to overcome these barriers and highlighted the importance of donor safety and the need for appropriate crisis management plans in transplant programs.
CLINICAL TRANSPLANTATION
(2023)
Article
Surgery
Silvia Quaresima, Gianluca Mennini, Tommaso M. Manzia, Alfonso W. Avolio, Roberta Angelico, Gabriele Spoletini, Quirino Lai
Summary: Poor data exist on the influence of holidays and weekdays on the number and the results of liver transplantation in Italy. This study aimed to investigate the impact of holidays and different days of the week on the number of liver transplantations and early graft survival rates. The study found that fewer liver transplantations were performed on holidays and Mondays, but the survival rates were not affected by holidays or the day of transplantation.
UPDATES IN SURGERY
(2023)
Letter
Gastroenterology & Hepatology
Silvia Quaresima, Quirino Lai, Vincenzo Pappalardo, Alessandro M. Paganini, Massimo Rossi, Salomone Di Saverio
COLORECTAL DISEASE
(2023)
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
Francesco Ardito, Quirino Lai, Alida Savelli, Simone Grassi, Elena Panettieri, Gennaro Clemente, Gennaro Nuzzo, Antonio Oliva, Felice Giuliante
Summary: The aim of this study was to evaluate the risk factors for malpractice litigation in patients with bile duct injury (BDI) referred to a tertiary care center. The results showed that patients in the late-referral group were more likely to have undergone surgical and endoscopic repair before referral. Prompt referral to experienced tertiary care centers without any attempt at repair may reduce the risk of litigation.
Article
Gastroenterology & Hepatology
Benjamin V. Tran, Dimitrios Moris, Daniela Markovic, Hamed Zaribafzadeh, Ricardo Henao, Quirino Lai, Sander S. Florman, Parissa Tabrizian, Brandy Haydel, Richard M. Ruiz, Goran B. Klintmalm, David D. Lee, C. Burcin Taner, Maarouf Hoteit, Matthew H. Levine, Umberto Cillo, Alessandro Vitale, Elizabeth C. Verna, Karim J. Halazun, Amit D. Tevar, Abhinav Humar, William C. Chapman, Neeta Vachharajani, Federico Aucejo, Jan Lerut, Olga Ciccarelli, Mindie H. Nguyen, Marc L. Melcher, Andre Viveiros, Benedikt Schaefer, Maria Hoppe-Lotichius, Jens Mittler, Trevor L. Nydam, James F. Markmann, Massimo Rossi, Constance Mobley, Mark Ghobrial, Alan N. Langnas, Carol A. Carney, Jennifer Berumen, Gabriel T. Schnickel, Debra L. Sudan, Johnny C. Hong, Abbas Rana, Christopher M. Jones, Thomas M. Fishbein, Ronald W. Busuttil, Andrew S. Barbas, Vatche G. Agopian
Summary: The individual prediction of post-liver transplantation hepatocellular carcinoma (HCC) recurrence risk is important. By analyzing the data of 4981 HCC patients undergoing transplantation, a prediction score was developed to accurately discriminate the risk of HCC recurrence. The score was externally validated in another 1160 patients, showing consistent results in risk discrimination.
LIVER TRANSPLANTATION
(2023)
Article
Nutrition & Dietetics
Simona Parisse, Sara Carnevale, Francesca Di Bartolomeo, Edoardo Poli, Francesca Miceli, Flaminia Ferri, Monica Mischitelli, Bianca Rocco, Quirino Lai, Pierleone Lucatelli, Mario Corona, Gianluca Mennini, Adriano De Santis, Massimo Rossi, Maurizio Muscaritoli, Alfredo Cantafora, Stefano Ginanni Corradini
Summary: This study investigated the impact of dietary simple sugar intake on MELD score changes in cirrhotic liver transplant candidates. The results showed that simple sugar intake was positively correlated with MELD score changes, especially in patients with high visceral adipose tissue index.
Article
Surgery
Fabio Melandro, Quirino Lai, Davide Ghinolfi, Tommaso Maria Manzia, Gabriele Spoletini, Massimo Rossi, Salvatore Agnes, Giuseppe Tisone, Paolo De Simone
Summary: Despite the controversial results of liver transplantation in elderly recipients, this study found that liver transplantation in elderly patients (>= 65 years) provides favorable but inferior results compared to younger patients. Early allograft dysfunction was more frequent in elderly patients, and recipient age >= 65 years was an independent risk factor for patient death and graft loss. Cold ischemia time seems to be a crucial factor for favorable outcomes in elderly patients.
UPDATES IN SURGERY
(2023)
Article
Gastroenterology & Hepatology
Giuseppe Marrone, Valerio Giannelli, Salvatore Agnes, Alfonso Wolfango Avolio, Leonardo Baiocchi, Giammauro Berardi, Giuseppe Maria Ettorre, Flaminia Ferri, Stefano Ginanni Corradini, Antonio Grieco, Nicola Guglielmo, Ilaria Lenci, Raffaella Lionetti, Gianluca Mennini, Martina Milana, Massimo Rossi, Gabriele Spoletini, Giuseppe Tisone, Tommaso Maria Manzia, Quirino Lai
Summary: This study evaluated the accuracy and calibration of different scoring systems in predicting the 90-day dropout of liver transplant candidates in an Italian setting. The results showed that GEMA-Na, MELD 3.0, and sex-adjusted MELDNa had the best predictive performance.
LIVER INTERNATIONAL
(2023)
Article
Gastroenterology & Hepatology
Quirino Lai, Takashi Ito, Samuele Iesari, Toru Ikegami, Daniele Nicolini, Zoe Larghi Laureiro, Massimo Rossi, Marco Vivarelli, Tomoharu Yoshizumi, Etsurou Hatano, Jan Lerut
Summary: This study analyzed the impact of PIVKA-II in HCC patients after liver transplantation. The results found that PIVKA-II and AFP were the most relevant independent risk factors for post-transplantation recurrence, and the adverse effect of PIVKA-II was independent of the AFP status.
LIVER TRANSPLANTATION
(2023)
Article
Nutrition & Dietetics
Simona Parisse, Alessandra Gianoncelli, Gloria Isani, Francesco Luigi Gambaro, Giulia Andreani, Emil Malucelli, Giuliana Aquilanti, Ilaria Carlomagno, Raffaella Carletti, Monica Mischitelli, Flaminia Ferri, Veronica Paterna, Quirino Lai, Gianluca Mennini, Fabio Melandro, Cira Di Gioia, Massimo Rossi, Stefano Iotti, Michela Fratini, Stefano Ginanni Corradini
Summary: This study aimed to evaluate the magnesium content in human cirrhotic liver and its correlation with serum AST levels, expression of hepatocellular injury, and MELDNa prognostic score. The results showed that patients with cirrhosis had lower hepatic magnesium content and higher percentage of TRPM7-positive hepatocytes. The increase in hepatic magnesium content and TRPM7 expression were associated with worsening of MELDNa score. These findings suggest that severity of hepatocyte injury and prognosis in cirrhosis are closely related to magnesium depletion and overexpression of TRPM7.
Article
Medicine, General & Internal
Quirino Lai, Fabio Melandro, Tommaso M. Manzia, Gabriele Spoletini, Anna Crovetto, Gaetano Gallo, Redan Hassan, Gianluca Mennini, Roberta Angelico, Alfonso W. Avolio, Frederik Berrevoet, Luis Abreu de Carvalho, Salvatore Agnes, Giuseppe Tisone, Massimo Rossi
Summary: This study aims to demonstrate the adverse effect of donor gamma-glutamyl transferase (GGT) on graft loss in a large European liver transplant cohort. Donor GGT is found to be an independent predictor of graft loss and its inclusion in traditional prediction models improves the accuracy. However, the exact mechanisms linking GGT and poor transplant outcomes need further investigation.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Medicine, General & Internal
Simona Parisse, Quirino Lai, Francesca Martini, Alice Martini, Flaminia Ferri, Monica Mischitelli, Fabio Melandro, Gianluca Mennini, Massimo Rossi, Domenico Alvaro, Stefano Ginanni Corradini
Summary: In cirrhotic patients with a history of hepatic encephalopathy, rifaximin treatment reduces hospitalizations and lowers the risk of all-cause hospitalization and hepatic encephalopathy-related hospitalization in patients on the liver transplantation waiting list.
JOURNAL OF CLINICAL MEDICINE
(2023)
Article
Surgery
Quirino Lai, Gianluca Mennini, Stefano Ginanni Corradini, Flaminia Ferri, Stefano Fonte, Francesco Pugliese, Manuela Merli, Massimo Rossi
Summary: This study aims to analyze the monocentric liver transplantation experience to identify the pre-operatively available parameters limiting a 10-year post-transplant survival. The study found that there were differences in initial liver function, surgical techniques, and immunosuppression between the short surviving group (< 10 years) and the long surviving group (& GE; 10 years). Age, transplantation era, and UNOS status 1-2A were identified as independent risk factors for not reaching at least 10 years of follow-up.
UPDATES IN SURGERY
(2023)
Review
Medicine, General & Internal
Silvia Quaresima, Fabio Melandro, Francesco Giovanardi, Kejal Shah, Valerio De Peppo, Gianluca Mennini, Davide Ghinolfi, Ashley Limkemann, Timothy M. M. Pawlik, Quirino Lai
Summary: This paper reviews the recent developments in liver transplantation (LT) for unresectable colorectal liver metastases (CRLM) and cholangiocellular carcinoma (CCA), and suggests that integration of LT with (neo)-adjuvant chemotherapy, radiotherapy, or locoregional treatments can effectively cure selected patients. However, further advances in diagnosis, treatment protocols, and donor-to-recipient matching are needed to better define the oncological indications for transplantation. Prospective, multicenter trials are still required to study these advances and their impact on outcomes.
MEDICINA-LITHUANIA
(2023)
Review
Gastroenterology & Hepatology
Fabio Melandro, Davide Ghinolfi, Gaetano Gallo, Silvia Quaresima, Riccardo Aurelio Nasto, Massimo Rossi, Gianluca Mennini, Quirino Lai
Summary: This article reviews the various challenges in the diagnosis and treatment of intrahepatic cholangiocarcinoma (iCCA) and discusses the latest advancements in surgical strategies and systemic treatment for this disease.
GASTROENTEROLOGY INSIGHTS
(2023)