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Article: Living-Donor Uterus Transplantation: A Clinical Review.

Veroux, Massimiliano / Scollo, Paolo / Giambra, Martina Maria / Roscitano, Giuseppe / Giaquinta, Alessia / Setacci, Francesco / Veroux, Pierfrancesco

Journal of clinical medicine

2024 Volume 13, Issue 3

Abstract: Uterus transplantation (UTx) is currently the only available treatment for absolute uterine factor infertility. More than 90 uterus transplantations have been performed worldwide, mostly from living donors. Living-donor (LD) UTx is a challenging surgical ...

Abstract	Uterus transplantation (UTx) is currently the only available treatment for absolute uterine factor infertility. More than 90 uterus transplantations have been performed worldwide, mostly from living donors. Living-donor (LD) UTx is a challenging surgical procedure since it poses ethical issues, and it is a high-risk and invasive surgery with higher hysterectomy-related risks compared to conventional hysterectomy. A total of 59 living-donor hysterectomies have been reported in the literature, including 35 performed with a laparotomic approach, 20 with a robotic approach and 4 with a laparoscopic approach. The mean donor age was 45.6 ± 9.1 years, and 22 were unrelated with the recipients, 34 were emotionally related (27 mothers, 5 sisters, 2 mother's sisters). The mean recipient age was 28.8 ± 4.5 years. Mayer-Rokitansky-Küster-Hauser syndrome was the most common indication for uterus transplant. Robotic living-donor hysterectomy had the longest operative time but resulted in a lower blood loss and postoperative stay compared to laparotomic and laparoscopic approaches. Twenty-nine births from LD-UTx have been reported, four after robotic living-donor hysterectomy and twenty-five after a laparotomic procedure. UTx is now an effective treatment for women with UFI. While living-donor UTx in some cases may be considered an experimental procedure, it offers the extraordinary possibility to give women the opportunity to have a pregnancy. Many efforts should be made to reduce the potential risks for donors, including the use of mini-invasive techniques, and the efficacy of UTx in the recipients, giving the potential harm of immunosuppression in a recipient of a non-life-saving organ.
Language	English
Publishing date	2024-01-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm13030775
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Article: Prevention of Delayed Graft Function in Kidney Transplant Recipients through a Continuous Infusion of the Prostaglandin Analogue Iloprost: A Single-Center Prospective Study.

Veroux, Massimiliano / Sanfilippo, Floriana / Roscitano, Giuseppe / Giambra, Martina / Giaquinta, Alessia / Riccioli, Giordana / Zerbo, Domenico / Corona, Daniela / Sorbello, Massimiliano / Veroux, Pierfrancesco

Biomedicines

2024 Volume 12, Issue 2

Abstract: Background: Delayed graft function (DGF) is common after kidney transplantation from deceased donors and may significantly affect post-transplant outcomes. This study aimed to evaluate whether an innovative approach, based on the administration of the ... ...

Abstract	Background: Delayed graft function (DGF) is common after kidney transplantation from deceased donors and may significantly affect post-transplant outcomes. This study aimed to evaluate whether an innovative approach, based on the administration of the intravenous prostaglandin analogue iloprost, could be beneficial in reducing the incidence of DGF occurring after kidney transplantation from deceased donors. Methods: This prospective, randomized (1:1), placebo-controlled study enrolled all consecutive patients who received a kidney transplant from a deceased donor from January 2000 to December 2012 and who were treated in the peri-transplant period with the prostaglandin analogue iloprost at 0.27 μg/min through an elastomeric pump (treatment group) or with a placebo (control group). Results: A total of 476 patients were included: DGF was reported in 172 (36.1%) patients in the entire cohort. The multivariate analysis showed that the donor's age > 70 years (OR 2.50, 95% confidence interval (CI): 1.40-3.05, Conclusions: This study showed that the use of a continuous infusion of iloprost could safely and effectively reduce the incidence of DGF in recipients of deceased-donor kidneys, allowing a better graft functionality as well as a better graft survival.
Language	English
Publishing date	2024-01-26
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines12020290
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Article ; Online: Attachment and parental bond: impact on psychopathology, mental health and quality of life of hemodialysis patients: a cross-sectional study.

De Pasquale, Concetta / Pistorio, Maria Luisa / Veroux, Massimiliano / Sapienza, Gabriella / Florio, Alberto / Hichy, Zira / Ekser, Burcin / Giaquinta, Alessia / Veroux, Pierfrancesco

BMC psychology

2023 Volume 11, Issue 1, Page(s) 210

Abstract: Background: Attachment theory represents a reference model for understanding better how pre-existing personality factors can influence the coping with some chronic conditions. The onset of a chronic disease can represent a "threat" to the relationships ... ...

Abstract	Background: Attachment theory represents a reference model for understanding better how pre-existing personality factors can influence the coping with some chronic conditions. The onset of a chronic disease can represent a "threat" to the relationships between the subject and parental figures according to the type of bond that already exists. The aim of our study was to explore attachment styles in a sample of hemodialysis patients, hypothesizing that a secure attachment bond can constitute a protective factor for the quality of life and mental health in this type of patients. Design: We used a cross-sectional design. Methods: Fifty hemodialysis patients were given the following tests: Attachment Style Questionnaire (ASQ) to assess attachment styles, Parental Bonding Instrument (PBI) to assess parental bonding, Short Form Health Survey-36 (SF-36) for perceived quality of life and Middlesex Hospital Questionnaire (MHQ) to detect key psychological symptoms and relevant traits. Results: The results showed that secure attachment style correlated with good general health (r = 0.339; p < 0.05), good mental health (r = 0.547; p < 0.001) and mental component scale (r = 0.373; p < 0.05) of SF-36. Secure attachment was also significantly associated with mental health (B = 1.104; p = .002) of the SF-36. Conclusions: The results confirmed the positive role of a secure attachment style for adequate psychological health. Early identification of patients with dysfunctional attachment styles will make it possible to offer them targeted interventions to improve their ability to accept, adapt and manage the disease and to maintain adequate psychological well-being.
MeSH term(s)	Humans ; Mental Health ; Cross-Sectional Studies ; Quality of Life ; Parents ; Chronic Disease ; Mental Disorders ; Object Attachment
Language	English
Publishing date	2023-07-15
Publishing country	England
Document type	Journal Article
ZDB-ID	2705921-2
ISSN	2050-7283 ; 2050-7283
ISSN (online)	2050-7283
ISSN	2050-7283
DOI	10.1186/s40359-023-01246-8
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Article: Nonadherence to Immunosuppressants Among Transplant Recipients: Emotional Intelligence as a Predictive Factor During COVID-19 Pandemic.

De Pasquale, Concetta / Barbagallo, Noemi / Veroux, Massimiliano / Pistorio, Maria Luisa / Zerbo, Domenico / Giaquinta, Alessia / Ekser, Burcin / Veroux, Pierfrancesco

Patient preference and adherence

2023 Volume 17, Page(s) 3083–3092

Abstract: Purpose: To evaluate the association between emotional intelligence and fear of COVID-19 on self-reported adherence, based on a cross-sectional design.: Patients and methods: Transplants recipient of both sexes aged 23-75 years old were evaluated at ... ...

Abstract	Purpose: To evaluate the association between emotional intelligence and fear of COVID-19 on self-reported adherence, based on a cross-sectional design. Patients and methods: Transplants recipient of both sexes aged 23-75 years old were evaluated at the Organ Transplant Unit, University Hospital of Catania, Italy. Data were analyzed using frequency, descriptives, Spearman and Pearson correlations, Chi-square goodness of fit test, and linear regression. Self-reported adherence was estimated with the Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS). Emotional intelligence and fear of COVID were, respectively, measured with the Emotional Intelligence Scale (EIS) and Multidimensional Assessment of COVID-19 Related Fears Scale (MAC-RF). This was a cross-sectional study of kidney transplant recipients. In reporting this study the authors followed the STROBE guidelines. Results: A correlation was found between EIS and MAC and between EIS and adherence but there was no correlation between MAC and adherence. A linear regression model was also conducted using a stepwise method, which indicated that EIS was a significant predictor of adherence ( Conclusion: This study was found that EIS is a predictor of adherence to treatment in transplant patients. Fear of COVID, while positively correlated to EIS, is not correlated to the adherence's outcome, possibly due to the proper follow-up performed to the patients. Indeed, according to these results, we suggest to provide good follow-ups with recipients, with interviews also based on self-regulation and awareness.
Language	English
Publishing date	2023-11-27
Publishing country	New Zealand
Document type	Journal Article
ZDB-ID	2455848-5
ISSN	1177-889X
ISSN	1177-889X
DOI	10.2147/PPA.S426358
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Article ; Online: Percutaneous Endovascular Repair of the Abdominal Aorta Iatrogenic Injury Using a Custom-Modified Fenestrated Stent Graft.

Giambra, Martina Maria / Iovino, Flavia / Barbanti, Marco / Cavallo, Matteo / Virgilio, Carla / Roscitano, Giuseppe / Costa, Giuliano / Veroux, Pierfrancesco

JACC. Cardiovascular interventions

2023 Volume 16, Issue 10, Page(s) 1297–1298

MeSH term(s)	Humans ; Aorta, Abdominal/diagnostic imaging ; Aorta, Abdominal/surgery ; Treatment Outcome ; Endovascular Procedures/adverse effects ; Iatrogenic Disease ; Stents
Language	English
Publishing date	2023-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	2452157-7
ISSN	1876-7605 ; 1936-8798
ISSN (online)	1876-7605
ISSN	1936-8798
DOI	10.1016/j.jcin.2023.02.020
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Article: Obesity and bariatric surgery in kidney transplantation: A clinical review.

Veroux, Massimiliano / Mattone, Edoardo / Cavallo, Matteo / Gioco, Rossella / Corona, Daniela / Volpicelli, Alessio / Veroux, Pierfrancesco

World journal of diabetes

2021 Volume 12, Issue 9, Page(s) 1563–1575

Abstract: Obesity is increasing worldwide, and this has major implications in the setting of kidney transplantation. Patients with obesity may have limited access to transplantation and increased posttransplant morbidity and mortality. Most transplant centers ... ...

Abstract	Obesity is increasing worldwide, and this has major implications in the setting of kidney transplantation. Patients with obesity may have limited access to transplantation and increased posttransplant morbidity and mortality. Most transplant centers incorporate interventions aiming to target obesity in kidney transplant candidates, including dietary education and lifestyle modifications. For those failing nutritional restriction and medical therapy, the use of bariatric surgery may increase the transplant candidacy of patients with obesity and end-stage renal disease (ESRD) and may potentially improve the immediate and late outcomes. Bariatric surgery in ESRD patients is associated with weight loss ranging from 29.8% to 72.8% excess weight loss, with reported mortality and morbidity rates of 2% and 7%, respectively. The most commonly performed bariatric surgical procedures in patients with ESRD and in transplant patients are laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass. However, the correct timing of bariatric surgery and the ideal type of surgery have yet to be determined, although pretransplant LSG seems to be associated with an acceptable risk-benefit profile. We review the impact of obesity on kidney transplant candidates and recipients and in potential living kidney donors, exploring the potential impact of bariatric surgery in addressing obesity in these populations, thereby potentially improving posttransplant outcomes.
Language	English
Publishing date	2021-06-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2583471-X
ISSN	1948-9358
ISSN	1948-9358
DOI	10.4239/wjd.v12.i9.1563
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Article: Quality of Life and Mental Health in Kidney Transplant Recipients During the COVID-19 Pandemic.

De Pasquale, Concetta / Pistorio, Maria Luisa / Veroux, Pierfrancesco / Gioco, Rossella / Giaquinta, Alessia / Privitera, Francesca / Veroux, Massimiliano

Frontiers in psychiatry

2021 Volume 12, Page(s) 645549

Abstract: Introduction: ...

Abstract	Introduction:
Language	English
Publishing date	2021-06-09
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2564218-2
ISSN	1664-0640
ISSN	1664-0640
DOI	10.3389/fpsyt.2021.645549
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Article ; Online: Live Birth from Cryopreserved Oocyte After Uterus Transplantation: A Case Report.

Scollo, Paolo / Scibilia, Giuseppe / Vento, Maria Elena / Borzì, Placido / Veroux, Pierfrancesco / Mereu, Liliana / Pecorino, Basilio

The American journal of case reports

2023 Volume 24, Page(s) e940960

Abstract: BACKGROUND Important legal and ethical issues must be addressed in the practice of uterus transplantation, because it is a non-life-saving intervention. In all cases reported in the literature so far, uterus transplantation is preceded by oocyte ... ...

Abstract	BACKGROUND Important legal and ethical issues must be addressed in the practice of uterus transplantation, because it is a non-life-saving intervention. In all cases reported in the literature so far, uterus transplantation is preceded by oocyte retrieval, fertilization of the collected oocytes, and subsequent freezing of the embryos produced. This element should be considered because of the potential ethical, legal, and moral implications related to the existence and fate of supernumerary embryos in the event of transplantation failure. CASE REPORT The Italian Research Project for Uterus Transplantation from a brain-dead donor was approved in 2018 (No. 1438/CNT2018). A 28-year-old patient with Mayer-Rokitansky-Küster-Hauser syndrome, ectopic ovaries, and good ovarian reserve received uterus transplantation in 2020 after oocyte retrieval with laparoscopic assistance. Metaphase oocytes were cryopreserved and thawed after the successful transplantation to perform in vitro fertilization followed by embryo transfer. The pregnancy course was regular, without symptoms until week 30, when PCR positivity for SARS-CoV-2 was recorded. The patient underwent an emergency cesarean delivery at 34 weeks' gestation because of fever and the appearance of regular uterine contractions. An infant was born alive and vital at 34 weeks of pregnancy and weighed 1725 g. The newborn was discharged in good condition and with a body weight of 2740 g. CONCLUSIONS This case report shows that cryopreservation of oocytes can overcome the ethical issue related to embryo retrieval before a successful uterus transplantation can be demonstrated. Our result supports the possibility of bypassing embryo freezing before ascertaining the success of uterus transplantation.
MeSH term(s)	Infant, Newborn ; Female ; Pregnancy ; Humans ; Adult ; Live Birth ; COVID-19 ; SARS-CoV-2 ; Uterus/transplantation ; Cryopreservation ; Oocytes
Language	English
Publishing date	2023-09-29
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2517183-5
ISSN	1941-5923 ; 1941-5923
ISSN (online)	1941-5923
ISSN	1941-5923
DOI	10.12659/AJCR.940960
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Article ; Online: Post-transplant colitis after kidney transplantation: clinical, endoscopic and histological features.

Gioco, Rossella / Puzzo, Lidia / Patanè, Marco / Corona, Daniela / Trama, Giuseppe / Veroux, Pierfrancesco / Veroux, Massimiliano

Aging

2020 Volume 12, Issue 24, Page(s) 24709–24720

Abstract: Chronic immunosuppression may increase the risk of post-transplant infection and medication-related injury and may also be responsible for the increased risk of gastrointestinal complications in kidney transplant recipients. Differentiating the various ... ...

Abstract	Chronic immunosuppression may increase the risk of post-transplant infection and medication-related injury and may also be responsible for the increased risk of gastrointestinal complications in kidney transplant recipients. Differentiating the various forms of post-transplant colitis is challenging, since most have similar clinical and histological features. This study evaluated the incidence of post-transplant gastrointestinal complications during screening colonoscopy. Kidney transplant recipients undergoing a colonoscopy for any reasons in the period 2014-2018 were included. Among the 134 patients completing the colonoscopy, 74 patients (56%) had an abnormal finding: an adenoma was found in 25 patients (18.6%), while 19 patients (14.1%) had colitis. Mycophenolic acid/related colitis was the most common colitis (6%), while 7 patients (5.2%) developed a
MeSH term(s)	Adenoma/diagnosis ; Adenoma/epidemiology ; Age Distribution ; Aged ; Anemia ; Colitis/chemically induced ; Colitis/diagnosis ; Colitis/epidemiology ; Colonoscopy ; Colorectal Neoplasms/diagnosis ; Colorectal Neoplasms/epidemiology ; Diarrhea ; Diverticulosis, Colonic/diagnosis ; Diverticulosis, Colonic/epidemiology ; Early Detection of Cancer ; Female ; Gastrointestinal Hemorrhage ; Graft Rejection/prevention & control ; Humans ; Immunosuppressive Agents/adverse effects ; Incidence ; Inflammatory Bowel Diseases/diagnosis ; Inflammatory Bowel Diseases/epidemiology ; Kidney Failure, Chronic/surgery ; Kidney Transplantation ; Male ; Middle Aged ; Mycophenolic Acid/adverse effects ; Tacrolimus/adverse effects ; Time Factors
Chemical Substances	Immunosuppressive Agents ; Mycophenolic Acid (HU9DX48N0T) ; Tacrolimus (WM0HAQ4WNM)
Language	English
Publishing date	2020-12-22
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, U.S. Gov't, Non-P.H.S.
ISSN	1945-4589
ISSN (online)	1945-4589
DOI	10.18632/aging.202345
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Article ; Online: Study of Defense Mechanisms in Kidney Transplanted Subjects.

De Pasquale, Concetta / Pistorio, Maria Luisa / Veroux, Massimiliano / Martinelli, Valentina / Giaquinta, Alessia / Veroux, Pierfrancesco

Transplantation proceedings

2020 Volume 52, Issue 5, Page(s) 1570–1576

Abstract: Defenses mechanisms are defined as the tools an individual uses to manage instincts, drives, and affects. Transplantation is a stressful event that requires the body to mobilize its internal and external defenses and implement coping and adaptation ... ...

Abstract	Defenses mechanisms are defined as the tools an individual uses to manage instincts, drives, and affects. Transplantation is a stressful event that requires the body to mobilize its internal and external defenses and implement coping and adaptation strategies, which can be essential for overcoming the painful and potentially dangerous environmental, existential, and relational situations that may occur after transplantation. The aim of our study was to analyze the defense styles in 50 kidney transplanted subjects and to correlate the latter with any psychopathology and the quality of life subjectively perceived. The Defense Style Questionnaire was administered to evaluate the defense mechanisms. The Symptom Checklist-90-R (SCL-90-R) was used for the evaluation of any psychopathology. Quality of life was studied using the Complete Form Health Survey (SF-36). The "somatization" (SOM) and "anxiety" (ANX) dimensions of the SCL-90 R correlated significantly with the "reaction formation" (RF) neurotic defense (RF/SOM r = .893; RF/ANX r = .966; P < .05). A good perception of one's "general health" (GH) correlated significantly with the "humor" (HU) and "sublimation" (SU) mature defenses (HU/GH r = .681; SU/GH r = .524; P < .05). Kidney transplanted subjects are exposed to persistent physical and psychosocial stress and each transplanted subject uses their own defense mechanisms to contain the mental pain and reduce the emotional stress derived from the transplantation experience. Identifying the different kinds of defenses (mature, immature, or neurotic) can be an effective way to search for predictive indices of a good quality of life and adherence to treatments.
MeSH term(s)	Adaptation, Psychological ; Adult ; Anxiety ; Defense Mechanisms ; Emotions ; Female ; Humans ; Kidney Transplantation/psychology ; Male ; Middle Aged ; Quality of Life ; Self Concept ; Surveys and Questionnaires
Language	English
Publishing date	2020-03-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2020.02.076
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