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  1. Article ; Online: Age and liver graft: a systematic review with meta-regression.

    Neri, Ilaria / Pascale, Marco Maria / Bianco, Giuseppe / Frongillo, Francesco / Agnes, Salvatore / Giovinazzo, Francesco

    Updates in surgery

    2023  Volume 75, Issue 8, Page(s) 2075–2083

    Abstract: Increasing organ shortage results in extended criteria donors (ECD) being used to face the growing demand for liver grafts. The demographic change leads to greater use of elderly donors for liver transplantation, historically considered marginal donors. ... ...

    Abstract Increasing organ shortage results in extended criteria donors (ECD) being used to face the growing demand for liver grafts. The demographic change leads to greater use of elderly donors for liver transplantation, historically considered marginal donors. Age is still considered amongst ECD in liver transplantation as it could affect transplant outcomes. However, what is the cutoff for donor age is still unclear and debated. A search of PubMed, Scopus and Cochrane Library was performed. The primary outcome was 1-year graft survival (GS). The secondary outcome was overall biliary complications and 3-5 years of graft and overall survival. A meta-regression model was used to analyse the temporal trend relation in the survival outcome. The meta-analysis included 11 studies. Hazard ratios for 1-year (age cutoff of 70 and 80,) and 5-year GS (I2:0%) were similar irrespectively of the age group. The meta-regression analysis showed a significant correlation between the 1-year graft survival and the year of publication. (coef. 0.00027, 95% CI - 0.0001 to - 0.0003 p = 0.0009). Advanced-age donors showed an increased risk of overall biliary complications with an odd ratio (OR) of 1.89 (95% CI 1-3.65). Liver grafts potentially discharged because of high-risk failure show encouraging results, and GS in ECD has progressively improved with a temporal trend. Currently, the criteria of marginality vary amongst centres. Age alone cannot be considered amongst the extended criteria. First of all, because of the positive results in terms of septuagenarian graft survival. Moreover, the potential elderly donor-related adjunctive risk can be balanced by reducing other risk factors. A prospective multicentre study should investigate a multi-factorial model based on donor criteria, recipient features and new functional biomarkers to predict graft outcome, as proper donor-recipient matching seems to be the critical point for good outcomes.
    MeSH term(s) Humans ; Aged ; Liver Transplantation/methods ; Prospective Studies ; Tissue Donors ; Tissue and Organ Procurement ; Graft Survival ; Liver ; Treatment Outcome ; Retrospective Studies ; Age Factors ; Multicenter Studies as Topic
    Language English
    Publishing date 2023-09-11
    Publishing country Italy
    Document type Systematic Review ; Meta-Analysis ; Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-023-01641-1
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    In stock of ZB MED Cologne/Königswinter

    Zs.B 101: Show issues Location:
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  2. Article ; Online: A "cui prodest" evaluation on the development of a minimally invasive liver surgery program: a differential benefit analysis of open and laparoscopic approach for left and right hemihepatectomies.

    Pascale, Marco Maria / Ratti, Francesca / Cipriani, Federica / Marino, Rebecca / Catena, Marco / Clocchiatti, Lucrezia / Buonanno, Silvia / Aldrighetti, Luca

    Surgical endoscopy

    2023  Volume 37, Issue 11, Page(s) 8204–8213

    Abstract: Background: The correlation between technical feasibility and short-term clinical advantage provided by laparoscopic over open technique for major hepatectomies is unclear. This monocentric retrospective study investigates the possible differences in ... ...

    Abstract Background: The correlation between technical feasibility and short-term clinical advantage provided by laparoscopic over open technique for major hepatectomies is unclear. This monocentric retrospective study investigates the possible differences in the benefit provided by minimally invasive approach between left and right hepatectomy, deepening the concept of differential benefit in the setting of anatomical major resections.
    Methods: All hemihepatectomies performed from January 2004 to December 2021 were identified in the institutional database. A propensity score method was used to match minimal invasive (MILS) and open pairs in the left hemihepatectomies (LH) and right hemihepatectomies (RH) groups with a 1:1 ratio to adjust any potential selection bias. The differential benefit for left and right hepatectomy provided by laparoscopic over open technique was evaluated in a pure analysis (i.e., including cases converted to open) and a risk-adjusted analysis (i.e., after excluding open conversion from the laparoscopic series).
    Results: The analysis of the risk-adjusted differential benefit demonstrated better result of the MILS in the RH group than in the LH group, in terms of blood loss (∆ blood loss - 150 and - 350, respectively; differential benefit: 200 mL, p < 0.05), morbidity (∆ rate of morbidity - 11.3% and - 18.1%, respectively; differential benefit: 6.8%, p < 0.05) and length of stay, LOS (∆ LOS - 1 day and - 3 days, respectively; differential benefit: 2 days, p < 0.05).
    Conclusion: While MILS is associated with improved clinical outcomes both in left and right hepatectomy procedures, the greater advantage provided by laparoscopy was documented in patients undergoing right hepatectomy, i.e. for more technically demanding procedures. A MILS program should include the broadest range of liver resections to ensure the full benefits of the laparoscopic technique.
    MeSH term(s) Humans ; Hepatectomy/methods ; Retrospective Studies ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Postoperative Complications/surgery ; Liver Neoplasms/surgery ; Laparoscopy/methods ; Liver ; Length of Stay ; Treatment Outcome
    Language English
    Publishing date 2023-08-30
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 639039-0
    ISSN 1432-2218 ; 0930-2794
    ISSN (online) 1432-2218
    ISSN 0930-2794
    DOI 10.1007/s00464-023-10382-6
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    Zs.A 2214: Show issues Location:
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  3. Article ; Online: The failure to rescue factor: aftermath analyses on 224 cases of perihilar cholangiocarcinoma.

    Ratti, Francesca / Marino, Rebecca / Catena, Marco / Pascale, Marco Maria / Buonanno, Silvia / De Cobelli, Francesco / Aldrighetti, Luca

    Updates in surgery

    2023  Volume 75, Issue 7, Page(s) 1919–1939

    Abstract: The term "failure to rescue" (FTR) has been recently introduced in the field of hepato-biliary surgery to label cases in which major postoperative complications lead to postoperative fatality. Perihilar cholangiocarcinoma (PHC) surgery has consistently ... ...

    Abstract The term "failure to rescue" (FTR) has been recently introduced in the field of hepato-biliary surgery to label cases in which major postoperative complications lead to postoperative fatality. Perihilar cholangiocarcinoma (PHC) surgery has consistently high postoperative morbidity and mortality rates in which factors associated with FTR are yet to be discovered. The primary endpoint of this study is to compare the Rescue with the FTR cohort referencing patients' characteristics and management protocols applied. A cohort of 224 consecutive patients undergoing surgery for PHC, between 2010 and 2021, was enrolled. Perioperative variables were analyzed according to the severity of major postoperative complications (Clavien ≥ 3a). Kaplan-Meier survival analyses were performed to determine complications' impact on survival. Major complications were reported in 86 cases (38%). Among the major complications' cohort, 72 cases (84%) were graded Clavien 3a-4 (Rescue group), while 14 (16%) cases were graded Clavien 5 (FTR group). Number of lymph-node metastases (OR = 1.33 (1.08-1.63) p = 0.006), poorly differentiated (G3) adenocarcinoma (OR = 7.55 (1.24-45.8) p = 0.028, reintervention (OR = 16.47 (2.76-98.08) p = 0.002), and prognostic nutritional index < 40 (OR = 3.01 (2.265-3.654) p < 0.001) rates were independent predictors of FTR. Right resection side (OR 2.4 (1.33-4.34) p = 0.004) increased the odds of major complications but not of FTR. No difference in overall survival was identified. A distinction of perioperative factors associated with postoperative complications' severity is crucial. Patients developing severe outcomes seem to have different biological and nutritional profiles, showing that efficient preoperative protocols are strategic to identify and avert the risk of FTR.
    MeSH term(s) Humans ; Klatskin Tumor/surgery ; Retrospective Studies ; Postoperative Complications/epidemiology ; Bile Duct Neoplasms/surgery ; Risk Factors ; Hospital Mortality ; Cholangiocarcinoma
    Language English
    Publishing date 2023-07-15
    Publishing country Italy
    Document type Journal Article
    ZDB-ID 2572692-4
    ISSN 2038-3312 ; 2038-131X
    ISSN (online) 2038-3312
    ISSN 2038-131X
    DOI 10.1007/s13304-023-01589-2
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    Zs.B 101: Show issues Location:
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  4. Article ; Online: COVID-19 health restrictions in a transplanted Italian cohort.

    Pascale, Marco Maria / Bianco, Giuseppe / Ferri, Lorenzo / Agnes, Salvatore

    Transplant international : official journal of the European Society for Organ Transplantation

    2020  Volume 33, Issue 9, Page(s) 1151–1153

    MeSH term(s) COVID-19/epidemiology ; COVID-19/prevention & control ; COVID-19/transmission ; Cohort Studies ; Humans ; Incidence ; Italy/epidemiology ; Liver Transplantation ; Pandemics/prevention & control ; Patient Compliance ; Personal Protective Equipment ; Quarantine ; SARS-CoV-2 ; Transplant Recipients
    Keywords covid19
    Language English
    Publishing date 2020-06-18
    Publishing country Switzerland
    Document type Letter
    ZDB-ID 639435-8
    ISSN 1432-2277 ; 0934-0874
    ISSN (online) 1432-2277
    ISSN 0934-0874
    DOI 10.1111/tri.13661
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    Zs.A 2358: Show issues Location:
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  5. Article: Multidisciplinary Management of Sternal Osteomyelitis Due to

    Pignatti, Marco / Dolci, Giampiero / Zamagni, Elena / Pascale, Renato / Piccin, Ottavio / Ammar, Alessandro / Zeneli, Flavia / Miralles, Maria Elisa Lozano / Mancuso, Katia / Cipriani, Riccardo / Viale, Pierluigi / Pacini, Davide / Martin-Suàrez, Sofia

    Microorganisms

    2023  Volume 11, Issue 11

    Abstract: Sternal wound complications following cardiac surgery, including sternal dehiscence, mediastinitis, and osteomyelitis, pose significant challenges in terms of management and patient outcomes. We present a case report highlighting the complex management ... ...

    Abstract Sternal wound complications following cardiac surgery, including sternal dehiscence, mediastinitis, and osteomyelitis, pose significant challenges in terms of management and patient outcomes. We present a case report highlighting the complex management of a patient who underwent open heart surgery for severe aortic valve stenosis, followed by sternal wound dehiscence and sternum osteomyelitis due to extended spectrum beta lactamase (ESBL) producing
    Language English
    Publishing date 2023-11-03
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2720891-6
    ISSN 2076-2607
    ISSN 2076-2607
    DOI 10.3390/microorganisms11112699
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  6. Article ; Online: Gut microbiome dynamics and Enterobacterales infection in liver transplant recipients: A prospective observational study.

    D'Amico, Federica / Rinaldi, Matteo / Pascale, Renato / Fabbrini, Marco / Morelli, Maria Cristina / Siniscalchi, Antonio / Laici, Cristiana / Coladonato, Simona / Ravaioli, Matteo / Cescon, Matteo / Ambretti, Simone / Viale, Pierluigi / Brigidi, Patrizia / Turroni, Silvia / Giannella, Maddalena

    JHEP reports : innovation in hepatology

    2024  Volume 6, Issue 4, Page(s) 101039

    Abstract: Background & aims: The aim of this study was to investigate gut microbiome (GM) dynamics in relation to carbapenem-resistant Enterobacterales (CRE) colonization, CRE infection, and non-CRE infection development within 2 months after liver transplant (LT) ...

    Abstract Background & aims: The aim of this study was to investigate gut microbiome (GM) dynamics in relation to carbapenem-resistant Enterobacterales (CRE) colonization, CRE infection, and non-CRE infection development within 2 months after liver transplant (LT).
    Methods: A single-center, prospective study was performed in patients undergoing LT from November 2018 to January 2020. The GM was profiled through 16S rRNA amplicon sequencing of a rectal swab taken on the day of transplantation, and fecal samples were collected weekly until 1 month after LT. A subset of samples was subjected to shotgun metagenomics, including resistome dynamics. The primary endpoint was to explore changes in the GM in the following groups: (1) CRE carriers developing CRE infection (CRE_I); (2) CRE carriers not developing infection (CRE_UI); (3) non-CRE carriers developing microbial infection (INF); and (4) non-CRE carriers not developing infection (NEG).
    Results: Overall, 97 patients were enrolled, and 91 provided fecal samples. Of these, five, nine, 22, and 55 patients were classified as CRE_I, CRE_UI, INF, and NEG, respectively. CRE_I patients showed an immediate and sustained post-LT decrease in alpha diversity, with depletion of the GM structure and gradual over-representation of
    Conclusions: GM profiling before LT could improve patient stratification and risk prediction and guide early GM-based intervention strategies to reduce infectious complications and improve overall prognosis.
    Impact and implications: Little is known about the temporal dynamics of gut microbiome (GM) in liver transplant recipients associated with carbapenem-resistant Enterobacterales (CRE) colonization and infection. The GM structure and functionality of patients colonized with CRE and developing infection appeared to be distinct compared with CRE carriers without infection or patients with other microbial infection or no infection and CRE colonization. Higher proportions of antimicrobial-resistant pathogens and poor representation of bacteria and metabolic pathways capable of promoting overall host health were observed in CRE carriers who developed infection, even before liver transplant. Therefore, pretransplant GM profiling could improve patient stratification and risk prediction and guide early GM-based intervention strategies to reduce infectious complications and improve overall prognosis.
    Language English
    Publishing date 2024-02-12
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2589-5559
    ISSN (online) 2589-5559
    DOI 10.1016/j.jhepr.2024.101039
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  8. Article: Transjugular portosystemic shunt for early-onset refractory ascites after liver transplantation.

    Bianco, Giuseppe / Pascale, Marco Maria / Frongillo, Francesco / Nure, Erida / Agnes, Salvatore / Spoletini, Gabriele

    Hepatobiliary & pancreatic diseases international : HBPD INT

    2020  Volume 20, Issue 1, Page(s) 90–93

    MeSH term(s) Adult ; Ascites/etiology ; Follow-Up Studies ; Humans ; Liver Failure/surgery ; Liver Transplantation/adverse effects ; Liver Transplantation/methods ; Male ; Middle Aged ; Portasystemic Shunt, Transjugular Intrahepatic/adverse effects ; Postoperative Complications/etiology ; Time Factors
    Language English
    Publishing date 2020-09-13
    Publishing country Singapore
    Document type Case Reports ; Journal Article
    ZDB-ID 2241386-8
    ISSN 1499-3872
    ISSN 1499-3872
    DOI 10.1016/j.hbpd.2020.09.005
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    Zs.A 6313: Show issues Location:
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  9. Article: Effect of a Fourth Dose of mRNA Vaccine and of Immunosuppression in Preventing SARS-CoV-2 Breakthrough Infections in Heart Transplant Patients.

    Masetti, Marco / Scuppa, Maria Francesca / Aloisio, Alessio / Giovannini, Laura / Borgese, Laura / Manno, Stefania / Tazza, Beatrice / Pascale, Renato / Bonazzetti, Cecilia / Caroccia, Natascia / Sabatino, Mario / Spitaleri, Giosafat / Viale, Pierluigi / Giannella, Maddalena / Potena, Luciano

    Microorganisms

    2023  Volume 11, Issue 3

    Abstract: Patients with heart transplantation (HT) have an increased risk of COVID-19 disease and the efficacy of vaccines on antibody induction is lower, even after three or four doses. The aim of our study was to assess the efficacy of four doses on infections ... ...

    Abstract Patients with heart transplantation (HT) have an increased risk of COVID-19 disease and the efficacy of vaccines on antibody induction is lower, even after three or four doses. The aim of our study was to assess the efficacy of four doses on infections and their interplay with immunosuppression. We included in this retrospective study all adult HT patients (12/21-11/22) without prior infection receiving a third or fourth dose of mRNA vaccine. The endpoints were infections and the combined incidence of ICU hospitalizations/death after the last dose (6-month survival rate). Among 268 patients, 62 had an infection, and 27.3% received four doses. Following multivariate analysis, three vs. four doses, mycophenolate (MMF) therapy, and HT < 5 years were associated with an increased risk of infection. MMF ≥ 2000 mg/day independently predicted infection, together with the other variables, and was associated with ICU hospitalization/death. Patients on MMF had lower levels of anti-RBD antibodies, and a positive antibody response after the third dose was associated with a lower probability of infection. In HT patients, a fourth dose of vaccine against SARS-CoV-2 reduces the risk of infection at six months. Mycophenolate, particularly at high doses, reduces the clinical effectiveness of the fourth dose and the antibody response to the vaccine.
    Language English
    Publishing date 2023-03-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2720891-6
    ISSN 2076-2607
    ISSN 2076-2607
    DOI 10.3390/microorganisms11030755
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  10. Article ; Online: COVID‐19 health restrictions in a transplanted Italian cohort

    Pascale, Marco Maria / Bianco, Giuseppe / Ferri, Lorenzo / Agnes, Salvatore

    Transplant International

    2020  Volume 33, Issue 9, Page(s) 1151–1153

    Keywords Transplantation ; covid19
    Language English
    Publisher Wiley
    Publishing country us
    Document type Article ; Online
    ZDB-ID 639435-8
    ISSN 1432-2277 ; 0934-0874
    ISSN (online) 1432-2277
    ISSN 0934-0874
    DOI 10.1111/tri.13661
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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