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Article ; Online: Repeat laparoscopic hepatectomy for recurrent tumors is safe and feasible. An invited commentary on: "Perioperative outcomes comparing laparoscopic with open repeat liver resection for post-hepatectomy recurrent liver cancer: A systematic review and meta-analysis" (Int. J. Surg. 2020; Epub ahead of print).

Angelico, Roberta / Gazia, Carlo

International journal of surgery (London, England)

2020 Volume 78, Page(s) 71–72

MeSH term(s)	Hepatectomy ; Humans ; Laparoscopy ; Liver Neoplasms/surgery ; Neoplasm Recurrence, Local/surgery
Language	English
Publishing date	2020-04-21
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	2212038-5
ISSN	1743-9159 ; 1743-9191
ISSN (online)	1743-9159
ISSN	1743-9191
DOI	10.1016/j.ijsu.2020.04.028
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Article ; Online: Prophylactic drains in totally laparoscopic distal gastrectomy: are they always necessary?

Manzia, Tommaso Maria / Parente, Alessandro / Angelico, Roberta

World journal of gastroenterology

2021 Volume 28, Issue 3, Page(s) 399–401

Abstract: Prophylactic drains have always been a useful tool to detect early complications and prevent postoperative fluid collections, particularly in gastrointestinal surgery. Recently, the utilization of such drains has been debated, due to mounting evidence ... ...

Abstract	Prophylactic drains have always been a useful tool to detect early complications and prevent postoperative fluid collections, particularly in gastrointestinal surgery. Recently, the utilization of such drains has been debated, due to mounting evidence that they could be harmful rather than beneficial. Based on recent published articles, Liu
MeSH term(s)	Drainage ; Gastrectomy/adverse effects ; Gastroenterostomy ; Humans ; Laparoscopy/adverse effects ; Stomach Neoplasms/surgery
Language	English
Publishing date	2021-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v28.i3.399
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Article: COVID-19 in a pregnant kidney transplant recipient - what we need to know: A case report.

Angelico, Roberta / Framarino-Dei-Malatesta, Maria Luisa / Iaria, Giuseppe

World journal of transplantation

2022 Volume 12, Issue 10, Page(s) 325–330

Abstract: Background: In the era of the coronavirus disease 2019 (COVID-19) pandemic, kidney tran splant recipients are more susceptible to severe acute respiratory syndrome co ronavirus (SARS-CoV-2) infection, developing severe morbidity and graft im pairment. ... ...

Abstract	Background: In the era of the coronavirus disease 2019 (COVID-19) pandemic, kidney tran splant recipients are more susceptible to severe acute respiratory syndrome co ronavirus (SARS-CoV-2) infection, developing severe morbidity and graft im pairment. Pregnant women are also more likely to develop severe COVID-19 di sease, causing pregnancy complications such as preterm births and acute kidney injury. Case summary: Herein, we report the case of a pregnant woman with a third kidney tran splantation who developed COVID-19 disease. The reduction of immunosuppressive drugs and strict monitoring of trough blood levels were needed to avoid severe SARS-CoV-2-related complications, and permitted to continue a healthy pregnancy and maintain good graft function. In such a complex scenario, the con comitance of COVID-19-related morbidity, the risk of acute rejection in the hype rimmune recipient, graft dysfunction and pregnancy complications make the management of immunosuppression a very difficult task and clinicians must be aware. Conclusion: Tailoring the immunosuppressive regimen is a key factor affecting both the graft outcome and pregnancy safety.
Language	English
Publishing date	2022-10-09
Publishing country	United States
Document type	Case Reports
ISSN	2220-3230
ISSN	2220-3230
DOI	10.5500/wjt.v12.i10.325
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Article ; Online: Rescue liver transplantation after post-hepatectomy acute liver failure: A systematic review and pooled analysis.

Angelico, Roberta / Siragusa, Leandro / Serenari, Matteo / Scalera, Irene / Kauffman, Emanuele / Lai, Quirino / Vitale, Alessandro

Transplantation reviews (Orlando, Fla.)

2023 Volume 37, Issue 3, Page(s) 100773

Abstract: Background: Post-hepatectomy liver failure is a severe complication after major liver resection and is associated with a high mortality rate. Nevertheless, there is no effective treatment for severe liver failure. In such a setting, rescue liver ... ...

Abstract	Background: Post-hepatectomy liver failure is a severe complication after major liver resection and is associated with a high mortality rate. Nevertheless, there is no effective treatment for severe liver failure. In such a setting, rescue liver transplantation (LT) is used only in extraordinary cases with unclear results. This systematic review aims to define indication of LT in post-hepatectomy liver failure and post-LT outcomes, in terms of patient and disease-free survivals, to assess the procedure's feasibility and effectiveness. Methods: A systematic review of all English language full-text articles published until September 2022 was conducted. Inclusion criteria were articles describing patients undergoing LT for post-hepatectomy liver failure after liver resection, which specified at least one outcome of interest regarding patient/graft survival, postoperative complications, tumour recurrence and cause of death. A pseudo-individual participant data meta-analysis was performed to analyse data. Study quality was assessed with MINORS system. PROSPERO CRD42022349358. Results: Postoperative complication rate was 53.6%. All patients transplanted for benign indications survived. For malignant tumours, 1-, 3- and 5-year overall survival was 94.7%, 82.1% and 74.6%, respectively. The causes of death were tumour recurrence in 83.3% of cases and infection-related in 16.7% of LT recipients. At Cox regression, being transplanted for unconventional malignant indications (colorectal liver metastasis, cholangiocarcinoma) was a risk factor for death HR = 8.93 (95%CI = 1.04-76.63; P-value = 0.046). Disease-free survival differs according to different malignant tumours (P-value = 0.045). Conclusions: Post-hepatectomy liver failure is an emergent indication for rescue LT, but it is not universally accepted. In selected patients, LT can be a life-saving procedure with low short-term risks. However, special attention must be given to long-term oncological prognosis before proceeding with rescue LT in an urgent setting, considering the severity of liver malignancy, organ scarcity, the country's organ allocation policies and the resource of living-related donation.
MeSH term(s)	Humans ; Liver Transplantation/methods ; Neoplasm Recurrence, Local ; Hepatectomy/adverse effects ; Hepatectomy/methods ; Liver Neoplasms/surgery ; Treatment Outcome ; Risk Factors ; Liver Failure, Acute/surgery ; Liver Failure/surgery
Language	English
Publishing date	2023-06-17
Publishing country	United States
Document type	Systematic Review ; Meta-Analysis ; Journal Article ; Review
ZDB-ID	639400-0
ISSN	1557-9816 ; 0955-470X
ISSN (online)	1557-9816
ISSN	0955-470X
DOI	10.1016/j.trre.2023.100773
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Article: Evaluation of Humoral Response following SARS-CoV-2 mRNA-Based Vaccination in Liver Transplant Recipients Receiving Tailored Immunosuppressive Therapy.

Manzia, Tommaso Maria / Sensi, Bruno / Conte, Luigi Eduardo / Siragusa, Leandro / Angelico, Roberta / Frongillo, Francesco / Tisone, Giuseppe

Journal of clinical medicine

2023 Volume 12, Issue 21

Abstract: ... ...

Abstract	Background
Language	English
Publishing date	2023-11-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12216913
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Article ; Online: Machine perfusion organ preservation: Highlights from the American Transplant Congress 2022.

Boteon, Yuri L / Angelico, Roberta / Buchholz, Bettina M / Dabare, Dilan / Martins, Paulo N

Artificial organs

2022

Abstract: The American Transplant Congress 2022, which took place between June 4th and June 8th of 2022, was a hybrid meeting with in-person attendance in Boston-MA and a real-time virtual experience via an online platform. First, we identified abstracts ... ...

Abstract	The American Transplant Congress 2022, which took place between June 4th and June 8th of 2022, was a hybrid meeting with in-person attendance in Boston-MA and a real-time virtual experience via an online platform. First, we identified abstracts discussing machine perfusion preservation for all organs, a hot topic and approach that may develop into the new gold standard of organ preservation in the near future. A total of 39 abstracts on organ machine preservation were presented at the meeting. Next, we selected abstracts which focus on advances including new approaches to organ preservation, promising biomarkers, ex-situ treatment including cellular therapies, and novel research areas. Here, we summarized the latest developments on machine perfusion preservation in both experimental and clinical studies.
Language	English
Publishing date	2022-11-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	441812-8
ISSN	1525-1594 ; 0160-564X
ISSN (online)	1525-1594
ISSN	0160-564X
DOI	10.1111/aor.14448
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Article: What Is the Role of Minimally Invasive Liver Surgery in Treating Patients with Hepatocellular Carcinoma on Cirrhosis?

Vitale, Alessandro / Angelico, Roberta / Sensi, Bruno / Lai, Quirino / Kauffmann, Emanuele / Scalera, Irene / Serenari, Matteo / Ginesini, Michael / Romano, Pierluigi / Furlanetto, Alessandro / D'Amico, Francesco

Cancers

2024 Volume 16, Issue 5

Abstract: Minimally invasive liver surgery (MILS) has been slowly introduced in the past two decades and today represents a major weapon in the fight against HCC, for several reasons. This narrative review conveys the major emerging concepts in the field. The rise ...

Abstract	Minimally invasive liver surgery (MILS) has been slowly introduced in the past two decades and today represents a major weapon in the fight against HCC, for several reasons. This narrative review conveys the major emerging concepts in the field. The rise in metabolic-associated steatotic liver disease (MASLD)-related HCC means that patients with significant cardiovascular risk will benefit more profoundly from MILS. The advent of efficacious therapy is leading to conversion from non-resectable to resectable cases, and therefore more patients will be able to undergo MILS. In fact, resection outcomes with MILS are superior compared to open surgery both in the short and long term. Furthermore, indications to surgery may be further expanded by its use in Child B7 patients and by the use of laparoscopic ablation, a curative technique, instead of trans-arterial approaches in cases not amenable to radiofrequency. Therefore, in a promising new approach, multi-parametric treatment hierarchy, MILS is hierarchically superior to open surgery and comes second only to liver transplantation.
Language	English
Publishing date	2024-02-28
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16050966
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Article ; Online: How future surgery will benefit from SARS-COV-2-related measures: a SPIGC survey conveying the perspective of Italian surgeons.

Siragusa, Leandro / Angelico, Roberta / Angrisani, Marco / Zampogna, Biagio / Materazzo, Marco / Sorge, Roberto / Giordano, Luca / Meniconi, Roberto / Coppola, Alessandro

Updates in surgery

2023 Volume 75, Issue 6, Page(s) 1711–1727

Abstract: COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective ... ...

Abstract	COVID-19 negatively affected surgical activity, but the potential benefits resulting from adopted measures remain unclear. The aim of this study was to evaluate the change in surgical activity and potential benefit from COVID-19 measures in perspective of Italian surgeons on behalf of SPIGC. A nationwide online survey on surgical practice before, during, and after COVID-19 pandemic was conducted in March-April 2022 (NCT:05323851). Effects of COVID-19 hospital-related measures on surgical patients' management and personal professional development across surgical specialties were explored. Data on demographics, pre-operative/peri-operative/post-operative management, and professional development were collected. Outcomes were matched with the corresponding volume. Four hundred and seventy-three respondents were included in final analysis across 14 surgical specialties. Since SARS-CoV-2 pandemic, application of telematic consultations (4.1% vs. 21.6%; p < 0.0001) and diagnostic evaluations (16.4% vs. 42.2%; p < 0.0001) increased. Elective surgical activities significantly reduced and surgeons opted more frequently for conservative management with a possible indication for elective (26.3% vs. 35.7%; p < 0.0001) or urgent (20.4% vs. 38.5%; p < 0.0001) surgery. All new COVID-related measures are perceived to be maintained in the future. Surgeons' personal education online increased from 12.6% (pre-COVID) to 86.6% (post-COVID; p < 0.0001). Online educational activities are considered a beneficial effect from COVID pandemic (56.4%). COVID-19 had a great impact on surgical specialties, with significant reduction of operation volume. However, some forced changes turned out to be benefits. Isolation measures pushed the use of telemedicine and telemetric devices for outpatient practice and favored communication for educational purposes and surgeon-patient/family communication. From the Italian surgeons' perspective, COVID-related measures will continue to influence future surgical clinical practice.
MeSH term(s)	Humans ; SARS-CoV-2 ; COVID-19 ; Pandemics ; Surgeons ; Surveys and Questionnaires
Language	English
Publishing date	2023-08-14
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/s13304-023-01613-5
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Article ; Online: Successful clinical and virological outcomes of liver transplantation for HDV/HBV-related disease after long-term discontinuation of hepatitis B immunoglobulins.

Lenci, Ilaria / Tariciotti, Laura / Angelico, Roberta / Milana, Martina / Signorello, Alessandro / Manzia, Tommaso Maria / Toti, Luca / Tisone, Giuseppe / Angelico, Mario / Baiocchi, Leonardo

Clinical transplantation

2023 Volume 37, Issue 6, Page(s) e14971

Abstract: Background: Indefinite, long-term administration of hepatitis B immunoglobulins (HBIg), together with a third generation nucleos(t)ide analog (NA), is the currently recommended prophylactic strategy to prevent viral recurrence after liver ... ...

Abstract	Background: Indefinite, long-term administration of hepatitis B immunoglobulins (HBIg), together with a third generation nucleos(t)ide analog (NA), is the currently recommended prophylactic strategy to prevent viral recurrence after liver transplantation (LT) for Hepatitis Delta virus (HDV)/Hepatitis B virus (HBV)-related disease. Methods: We retrospectively analyzed the safety and long-term clinical and virological outcomes of a consecutive cohort of 16 patients (10 males, median age 64.5, range 41-75) transplanted for HDV/HBV-related cirrhosis at our Institution, who discontinued HBIg after a median of 24.5 months (range 15-116) after transplant. All patients continued prophylaxis with same NA used before LT. Recurrence of HDV/HBV infection was defined as reappearance of serum HDV-RNA with detectable serum HBsAg and/or HBV-DNA. Results: The median follow-up after LT was 138 months (range 73-316) and 110 months (range 52-200) after HBIg withdrawal. All patients were HBsAg-positive, HBV-DNA negative, and anti-HDV positive at the time of LT and without coinfections with HCV or HIV. Patients were followed with biochemical and virological tests every 3-6 months after HBIg withdrawal. No recurrences of HDV/HBV infection or disease were observed during monoprophylaxis with NA. In addition, eight patients (50%) spontaneously developed anti-HBs titers above 10 IU/L at a median of 74 months (range 58-140) following HBIG discontinuation. Conclusions: HBIg withdrawal after LT is a safe and efficacious strategy in patients transplanted for HDV/HBV disease and is frequently associated with the spontaneous development of serological immunity against HBV. These data call for a revision of current prophylactic recommendations in this setting.
MeSH term(s)	Male ; Humans ; Child, Preschool ; Child ; Liver Transplantation/adverse effects ; Hepatitis B virus/genetics ; Hepatitis B/complications ; Antiviral Agents/therapeutic use ; Hepatitis B Surface Antigens ; Retrospective Studies ; DNA, Viral/genetics ; Treatment Outcome ; Immunoglobulins/therapeutic use ; Hepatitis B Antibodies
Chemical Substances	hepatitis B hyperimmune globulin (XII270YC6M) ; Antiviral Agents ; Hepatitis B Surface Antigens ; DNA, Viral ; Immunoglobulins ; Hepatitis B Antibodies
Language	English
Publishing date	2023-03-17
Publishing country	Denmark
Document type	Journal Article
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.14971
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Article ; Online: The impact of center volume on the utilization and outcomes of machine perfusion technology in liver transplantation: An international survey.

Angelico, Roberta / Sensi, Bruno / Quaranta, Claudia / Orsi, Michela / Parente, Alessandro / Schlegel, Andrea / Tisone, Giuseppe / Manzia, Tommaso M

Artificial organs

2023 Volume 47, Issue 11, Page(s) 1773–1785

Abstract: Introduction: Machine perfusion (MP) was developed to expand the donor pool and improve liver transplantation (LT) outcomes. Despite optimal results in clinical trials, the real-world MP benefit in centers with low-/mid-volume activity (LVCs) is still ... ...

Abstract	Introduction: Machine perfusion (MP) was developed to expand the donor pool and improve liver transplantation (LT) outcomes. Despite optimal results in clinical trials, the real-world MP benefit in centers with low-/mid-volume activity (LVCs) is still being determined. Methods: Online survey on MP for LT, distributed to worldwide LT-centers representatives. Variables of interest included logistics, technicalities, and outcomes. Responders were grouped into high-volume centers (HVCs) (>60 LTs/year) and LVCs and results compared. Results: Sixty-seven centers were included, 36 HVCs and 31 LVCs. Significant differences in MP regarded: (I) existence of an established program (80.6% vs. 41.9%; p = 0.02), (II) presence of a dedicated perfusionist (58.3% vs. 22.6%; p = 0.006), (III) duration (>4 h: 47.2% vs. 16.1%; p = 0.01), (IV) routine use (20%-40% vs. 5%-20%; p = 0.002), (V) graft utilization (>50%: 75% vs. 51.6%; p = 0.009), (VI) 90-day patient-survival (90%-100% vs. 50%-90%; p = 0.001) and (VII) subjectively perceived benefit (always vs. only in selected ECD; p = 0.009). Concordance was found for indications, type, viability tests, graft-salvage, 90-day graft-loss, and major-complications. Conclusions: This study captured a picture of MP in real-world LT-practice. Significant disparities have surfaced between LVCs and HVCs regarding logistics, utilization, and results. To close this gap, efforts should be made to more efficiently deliver dedicated support, training and mentoring to LVC teams adopting MP technology.
MeSH term(s)	Humans ; Liver Transplantation ; Perfusion ; Technology ; Organ Preservation
Language	English
Publishing date	2023-08-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	441812-8
ISSN	1525-1594 ; 0160-564X
ISSN (online)	1525-1594
ISSN	0160-564X
DOI	10.1111/aor.14635
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