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Article ; Online: Tacrolimus-Associated Terminal Ileitis After Kidney Transplantation, Mimicking Crohn Disease: A Case Report.

Collini, Andrea / Ongaro, Alessandra / Favi, Evaldo / Lazzi, Stefano / Micheletti, Giorgio / Ruggieri, Giuliana

2024 Volume 56, Issue 2, Page(s) 459–462

Abstract: The onset of gastroduodenal ulcers is a frequent complication after transplantation, whereas cases of intestinal ulcers are sporadic and poorly described in the literature. A patient on immunosuppressive therapy with tacrolimus and mycophenolate mofetil ... ...

Abstract	The onset of gastroduodenal ulcers is a frequent complication after transplantation, whereas cases of intestinal ulcers are sporadic and poorly described in the literature. A patient on immunosuppressive therapy with tacrolimus and mycophenolate mofetil after kidney transplant for immunoglobulin A-related glomerulonephritis developed symptoms compatible with Crohn disease 7 months after the transplant. The patient was hospitalized for abdominal pain, diarrhea, fever, and weight loss. Imaging and a colonoscopy showed signs of idiopathic inflammatory bowel disease (IBD) affecting the terminal ileum. Behcet's disease, post-transplant lymphoma, cytomegalovirus, Epstein-Barr virus, or mycobacteria infection were excluded. Mycophenolate mofetil was suspended, and steroid therapy was increased without clinical improvement. Eleven units of blood were required for severe anemia. A further colonoscopy revealed ulcerations involving the cecal fundus, ileocecal valve, and distal ileum with bowel stenosis and suspected ischemia. The patient, therefore, underwent an emergency laparoscopic ileocolic resection. The histologic examination did not reveal clear signs of IBD, ischemia, or viral infection of the ileum. The findings seemed indicative of iatrogenic damage from immunosuppressive therapy. The postoperative course was regular, and after 12 months, the patient was asymptomatic, on low-dose tacrolimus and prednisone therapy. During immunosuppressive therapy, the onset of isolated ileal ulcers, which can mimic IBD, may be a sporadic complication.
MeSH term(s)	Humans ; Crohn Disease/diagnosis ; Crohn Disease/drug therapy ; Epstein-Barr Virus Infections ; Herpesvirus 4, Human ; Immunosuppressive Agents/adverse effects ; Inflammatory Bowel Diseases/drug therapy ; Ischemia ; Kidney Transplantation/adverse effects ; Mycophenolic Acid/adverse effects ; Tacrolimus/adverse effects ; Ulcer/chemically induced ; Ulcer/diagnosis
Chemical Substances	Immunosuppressive Agents ; Mycophenolic Acid (HU9DX48N0T) ; Tacrolimus (WM0HAQ4WNM)
Language	English
Publishing date	2024-02-16
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2023.12.015
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Article: Primary versus Salvage Liver Transplantation after Curative-Intent Resection or Radiofrequency Ablation for Hepatocellular Carcinoma: Long-Term Oncological Outcomes.

Anselmo, Alessandro / Siragusa, Leandro / Brigato, Paolo / Riccetti, Camilla / Collini, Andrea / Sensi, Bruno / Tisone, Giuseppe

Cancers

2023 Volume 15, Issue 20

Abstract: Liver transplantation for hepatocellular carcinoma (HCC) may be performed ab initio, primary liver transplantation (PLT), or for HCC recurrence after previous treatments such as liver resection (LR) or radiofrequency ablation (RFA), salvage liver ... ...

Abstract	Liver transplantation for hepatocellular carcinoma (HCC) may be performed ab initio, primary liver transplantation (PLT), or for HCC recurrence after previous treatments such as liver resection (LR) or radiofrequency ablation (RFA), salvage liver transplantation (SLT). The aim of this study was to evaluate the oncological outcomes of SLT vs. PLT. For this, a retrospective study was carried out on patients undergoing liver transplantation for HCC. The outcomes of PLT were compared with those of SLT. The primary outcome was disease-free survival (DFS). The secondary outcomes included overall survival (OS), cancer-specific survival (CSS), and major postoperative complications. A sub-analysis of SLT-LR and SLT-RFA was also performed. In total, 141 patients were included: 96 underwent PLT and 45 SLT. Among the SLT group, 25 patients had undergone previous LR while 20 had had RFA. There were no differences in the major postoperative complications. Unadjusted DFS was significantly longer in the PLT group (
Language	English
Publishing date	2023-10-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers15205030
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Article ; Online: Laparoscopic Nephrectomy for Massive Kidneys in Polycystic Kidney Disease.

Collini, Andrea / Benigni, Roberto / Ruggieri, Giuliana / Carmellini, Prof Mario

JSLS : Journal of the Society of Laparoendoscopic Surgeons

2021 Volume 25, Issue 1

Abstract: Background and objectives: Laparoscopic nephrectomy is now considered a feasible surgical approach, even for large kidneys. In the case of massive kidneys, laparoscopy can be problematic, so that some authors suggest an open approach. However, previous ... ...

Abstract	Background and objectives: Laparoscopic nephrectomy is now considered a feasible surgical approach, even for large kidneys. In the case of massive kidneys, laparoscopy can be problematic, so that some authors suggest an open approach. However, previous studies have shown that hand-assisted laparoscopic nephrectomy (HALN) may represent a useful compromise.We describe our hand-assisted laparoscopic technique for nephrectomy of large kidneys (> 2500 g) to encourage the use of laparoscopy for nephrectomy in autosomal dominant polycystic kidney disease. Methods: We retrospectively analyzed data from 26 nephrectomies in 17 patients who underwent HALN for ADPKD and compared them to a group of 22 nephrectomies in 18 patients with open surgical technique. Results: The duration of the procedure was significantly longer in the laparoscopic group, with a median of 180 minutes versus 90 minutes for the unilateral nephrectomies, and 240 minutes versus 122 minutes for the bilateral procedures. The median kidney weight in the open group was 2500 g (range 1300 - 4500 g), while the median weight in the HALN group was 2375 g (range 1000 - 4700 g). The median hospital stay was comparable. No significant differences were recorded in the intra- and postoperative complication rate. Conclusion: Hand-assisted laparoscopic nephrectomy can be considered a technique of choice for patients suffering from ADPKD requiring nephrectomy, also with massive kidneys weighing more than 3500 g. Compared to open nephrectomy, HALN can be performed safely, with reasonably longer operating times and without major complications, and offers a significant reduction in hospitalization time, pain and postoperative discomfort.
MeSH term(s)	Adult ; Aged ; Female ; Humans ; Laparoscopy/adverse effects ; Laparoscopy/methods ; Length of Stay ; Male ; Middle Aged ; Nephrectomy/adverse effects ; Nephrectomy/methods ; Operative Time ; Polycystic Kidney, Autosomal Dominant/pathology ; Polycystic Kidney, Autosomal Dominant/surgery ; Postoperative Complications/epidemiology ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-04-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	2011211-7
ISSN	1938-3797 ; 1086-8089
ISSN (online)	1938-3797
ISSN	1086-8089
DOI	10.4293/JSLS.2020.00107
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Zs.A 5183: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Explant of one graft due to technical complications in dual kidney transplants: analysis of the long-term function of the remaining kidney.

Collini, Andrea / Miccoli, Simone / Piccioni, Stefania / Benigni, Roberto / Ruggieri, Giuliana / Carmellini, Mario

Journal of nephrology

2021 Volume 34, Issue 6, Page(s) 2127–2130

MeSH term(s)	Graft Survival ; Humans ; Kidney ; Kidney Transplantation/adverse effects ; Retrospective Studies ; Tissue Donors ; Treatment Outcome
Language	English
Publishing date	2021-03-11
Publishing country	Italy
Document type	Journal Article
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.1007/s40620-021-01006-0
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Zs.A 3369: Show issues

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Article ; Online: Long-Term Function of Kidneys From an Acute Renal Failure Donor on Continuous Venovenous Hemofiltration: A Case Report.

Collini, Andrea / Piccioni, Stefania / Lorenz, Eva-Maria / Borgogni, Vanessa / Ruggieri, Giuliana / Carmellini, Mario

Transplantation proceedings

2020 Volume 52, Issue 5, Page(s) 1611–1616

Abstract: The organ shortage has induced many transplant centers to use suboptimal grafts, such as those from expanded criteria donors and donors after cardiac death. Acute renal failure donors, sometimes present in intensive therapy units, have been used in a ... ...

Abstract	The organ shortage has induced many transplant centers to use suboptimal grafts, such as those from expanded criteria donors and donors after cardiac death. Acute renal failure donors, sometimes present in intensive therapy units, have been used in a very low number of cases due to the fear of primary nonfunction of this type of graft. There are few published studies about the utilization of donors with severe acute renal failure and there is no general consensus identifying unequivocal criteria for their use by different transplant centers. We transplanted 2 kidneys from a 67-year-old donor who suffered from acute renal failure as a consequence of extracorporeal circulation in cardiac surgery and died of a massive cerebral edema with cistern obliteration. The kidneys were discarded by other transplant centers due to the patient's acute renal failure, treated by continuous venovenous hemofiltration. Both transplants were successful and both grafts showed very good renal function after 6 months. One recipient suffered from delayed graft function and renal drug toxicity, which resolved 1 month post transplant. The long-term graft function at 10 years is acceptable, with very low proteinuria. As a growing gap between the inadequate supply and constantly high demand for kidney transplantation has led doctors to explore novel policies to increase the number of available organs over the last 2 decades, acute renal failure treated by continuous venovenous hemofiltration does not seem to be a contraindication for the utilization of grafts.
MeSH term(s)	Acute Kidney Injury/therapy ; Aged ; Continuous Renal Replacement Therapy ; Delayed Graft Function ; Donor Selection ; Graft Survival ; Humans ; Kidney Transplantation/methods ; Male ; Middle Aged
Language	English
Publishing date	2020-04-04
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	82046-5
ISSN	1873-2623 ; 0041-1345
ISSN (online)	1873-2623
ISSN	0041-1345
DOI	10.1016/j.transproceed.2020.02.054
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Article ; Online: Human cytomegalovirus-related gastrointestinal disease after kidney transplantation: A systematic review.

Zais, Ilaria Elena / Sirotti, Alessandro / Iesari, Samuele / Campioli, Edoardo / Costantino, Andrea / Delbue, Serena / Collini, Andrea / Guarneri, Andrea / Ambrogi, Federico / Cacciola, Roberto / Ferraresso, Mariano / Favi, Evaldo

Clinical transplantation

2023 Volume 38, Issue 1, Page(s) e15218

Abstract: Background: Human-cytomegalovirus (hCMV) infection involving the gastrointestinal tract represents a leading cause of morbidity and mortality among kidney transplant (KT) recipients (KTRs). Signs and symptoms of the disease are extremely variable. ... ...

Abstract	Background: Human-cytomegalovirus (hCMV) infection involving the gastrointestinal tract represents a leading cause of morbidity and mortality among kidney transplant (KT) recipients (KTRs). Signs and symptoms of the disease are extremely variable. Prompt anti-viral therapy administration and immunosuppression modification are key factors for optimizing management. However, complex work-up strategies are generally required to confirm the preliminary diagnosis. Unfortunately, solid evidence and guidelines on this specific topic are not available. We consequently aimed to summarize current knowledge on post-KT hCMV-related gastrointestinal disease (hCMV-GID). Methods: We conducted a systematic review (PROSPERO ID: CRD42023399363) about hCMV-GID in KTRs. Results: Our systematic review includes 52 case-reports and ten case-series, published between 1985 and 2022, collectively reporting 311 cases. The most frequently reported signs and symptoms of hCMV-GID were abdominal pain, diarrhea, epigastric pain, vomiting, fever, and GI bleeding. Esophagogastroduodenoscopy and colonoscopy were the primary diagnostic techniques. In most cases, the preliminary diagnosis was confirmed by histology. Information on anti-viral prophylaxis were extremely limited as much as data on induction or maintenance immunosuppression. Treatment included ganciclovir and/or valganciclovir administration. Immunosuppression modification mainly consisted of mycophenolate mofetil or calcineurin inhibitor minimization and withdrawal. In total, 21 deaths were recorded. Renal allograft-related outcomes were described for 26 patients only. Specifically, reported events were acute kidney injury (n = 17), transplant failure (n = 5), allograft rejection (n = 4), and irreversible allograft dysfunction (n = 3). Conclusions: The development of local and national registries is strongly recommended to improve our understanding of hCMV-GID. Future clinical guidelines should consider the implementation of dedicated diagnostic and treatment strategies.
MeSH term(s)	Humans ; Kidney Transplantation/adverse effects ; Kidney Transplantation/methods ; Cytomegalovirus ; Antiviral Agents/therapeutic use ; Cytomegalovirus Infections/diagnosis ; Cytomegalovirus Infections/drug therapy ; Cytomegalovirus Infections/etiology ; Ganciclovir/therapeutic use ; Gastrointestinal Diseases/diagnosis ; Gastrointestinal Diseases/drug therapy ; Gastrointestinal Diseases/etiology
Chemical Substances	Antiviral Agents ; Ganciclovir (P9G3CKZ4P5)
Language	English
Publishing date	2023-12-08
Publishing country	Denmark
Document type	Systematic Review ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	639001-8
ISSN	1399-0012 ; 0902-0063
ISSN (online)	1399-0012
ISSN	0902-0063
DOI	10.1111/ctr.15218
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Article ; Online: When a Diuretic Causes Pulmonary Oedema.

Traversa, Matteo / Collini, Andrea / Villois, Paola / Elia, Fabrizio / Verhovez, Andrea / Aprà, Franco

European journal of case reports in internal medicine

2018 Volume 5, Issue 6, Page(s) 864

Abstract: Background: Hydrochlorothiazide (HCTZ) is one of the most popular drugs for the treatment of hypertension and heart failure. Most of its side effects are harmless and predictable, but some studies report a few life-threatening reactions to this drug, ... ...

Abstract	Background: Hydrochlorothiazide (HCTZ) is one of the most popular drugs for the treatment of hypertension and heart failure. Most of its side effects are harmless and predictable, but some studies report a few life-threatening reactions to this drug, one of the most dangerous being acute pulmonary oedema. Case report: A 73-year-old woman was admitted to the Emergency Department with acute respiratory failure due to pulmonary oedema. Her past medical history included long-lasting hypertension with permanent atrial fibrillation and mitral stenosis. Her blood pressure control had been suboptimal, so her cardiologist had changed amlodipine to combination therapy with ramipril and HCTZ. However, 20 min after taking the new drug, the patient experienced fever, vomiting and diarrhoea immediately followed by acute onset of dyspnoea. Conclusion: Since HCTZ is one of the most popular drugs for hypertension treatment and millions of patients take it every day, it is important to keep in mind both the common adverse reactions as well as the dangerous, although rare, ones. Learning points: Pulmonary oedema is a very unusual adverse reaction to hydrochlorothiazide, and a rare presentation of a common condition.Pulmonary oedema is not always due to heart problems.It is important to keep in mind that hypersensitivity reactions may have many different presentations.
Language	English
Publishing date	2018-06-26
Publishing country	Italy
Document type	Journal Article
ISSN	2284-2594
ISSN (online)	2284-2594
DOI	10.12890/2018_000864
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Article ; Online: Renal transplant from very old donors: how far can we go?

Collini, Andrea / Kalmar, Peter / Dhamo, Armando / Ruggieri, Giuliana / Carmellini, Mario

Transplantation

2009 Volume 87, Issue 12, Page(s) 1830–1836

Abstract: Background: The organ shortage has led many transplant centers to accept kidneys from old, suboptimal deceased donors, and make increasing use of old-for-old allocation systems. We report the experience of an Italian transplant center in the utilization ...

Abstract	Background: The organ shortage has led many transplant centers to accept kidneys from old, suboptimal deceased donors, and make increasing use of old-for-old allocation systems. We report the experience of an Italian transplant center in the utilization of "ultra-old" (>75 years old) donors. Methods: Sixty grafts from donors aged 75 years or older (mean age 79.1 years, range 75-90 years) were used for 38 patients: 16 as single and 22 as double transplants. Results: The actuarial graft survival rate was 73.7% for year 1, 69.8% for year 2, and 64.0% for year 3. The patient survival rate was 81.2% and remained stable for years 1, 2, and 3. The delayed graft function rate was 57.9%. Acute rejection and chronic allograft nephropathy rates were comparable with our other expanded criteria donors. The majority of the patients had stable creatinine levels, between 2 and 3 mg/mL after the second month, with sufficient creatinine clearance. Conclusions: Our results seems encouraging with patient and graft survival rates, complication rates, and renal function parameters being slightly worse than in expanded criteria donors, but still generally acceptable. The use of old kidneys in old recipients, bearing in mind their usual life expectancy, gives them a properly functioning kidney and improved quality of life.
MeSH term(s)	Age Factors ; Aged ; Aged, 80 and over ; Female ; Graft Survival/physiology ; Humans ; Immunosuppressive Agents/therapeutic use ; Italy ; Kidney Transplantation/immunology ; Kidney Transplantation/mortality ; Kidney Transplantation/physiology ; Life Expectancy ; Male ; Retrospective Studies ; Survival Analysis ; Survivors/statistics & numerical data ; Tissue Donors/statistics & numerical data
Chemical Substances	Immunosuppressive Agents
Language	English
Publishing date	2009-06-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	208424-7
ISSN	1534-6080 ; 0041-1337
ISSN (online)	1534-6080
ISSN	0041-1337
DOI	10.1097/TP.0b013e3181a6b4ff
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Zs.A 488: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 509: Show issues

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Article: Massive hemothorax after removal of subclavian vein catheter: a very unusual complication.

Collini, Andrea / Nepi, Stefano / Ruggieri, Giuliana / Carmellini, Mario

Critical care medicine

2002 Volume 30, Issue 3, Page(s) 697–698

Abstract: A case of massive hemothorax developing a few minutes after removal of a central venous catheter is described in a 51-yr-old woman, who had undergone a renal transplant. The patient had an arteriovenous fistula for hemodialysis on the same side as the ... ...

Abstract	A case of massive hemothorax developing a few minutes after removal of a central venous catheter is described in a 51-yr-old woman, who had undergone a renal transplant. The patient had an arteriovenous fistula for hemodialysis on the same side as the central catheter. The mechanism of the onset of this complication is discussed. We recommend avoiding positioning a central catheter on the same side as an arm arteriovenous fistula. Furthermore, we think it is necessary to monitor patients after removal, as is usually done after positioning, to detect this potentially fatal complication.
MeSH term(s)	Arteriovenous Shunt, Surgical ; Catheterization, Central Venous/adverse effects ; Female ; Hemothorax/diagnostic imaging ; Hemothorax/etiology ; Humans ; Kidney Transplantation ; Middle Aged ; Postoperative Complications ; Radiography ; Subclavian Vein
Language	English
Publishing date	2002-03
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	197890-1
ISSN	1530-0293 ; 0090-3493
ISSN (online)	1530-0293
ISSN	0090-3493
DOI	10.1097/00003246-200203000-00034
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Article ; Online: Changes of liver enzymes and bilirubin during ischemic stroke: mechanisms and possible significance.

Muscari, Antonio / Collini, Andrea / Fabbri, Elisa / Giovagnoli, Marco / Napoli, Chiara / Rossi, Valentina / Vizioli, Luca / Bonfiglioli, Andrea / Magalotti, Donatella / Puddu, Giovanni M / Zoli, Marco

BMC neurology

2014 Volume 14, Page(s) 122

Abstract: Background: Small changes of bilirubin and liver enzymes are often detected during the acute phase of stroke, but their origin and significance are still poorly understood.: Methods: On days 0, 3, 7, and 14 after admission, 180 patients with ischemic ...

Abstract	Background: Small changes of bilirubin and liver enzymes are often detected during the acute phase of stroke, but their origin and significance are still poorly understood. Methods: On days 0, 3, 7, and 14 after admission, 180 patients with ischemic stroke underwent serial determinations of bilirubin, GOT, GPT, γGT, alkaline phosphatase, C-reactive protein (CRP) and complete blood count. On days 0 and 7 common bile duct diameter was measured by ultrasound, and on day 3 cerebral infarct volume (IV) was calculated from CT scan slices. Results: During the first week GOT, GPT, γGT (P < 0.001) and CRP (P = 0.03) increased with subsequent plateau, while significant decrements (P < 0.001) concerned unconjugated bilirubin, erythrocytes and haemoglobin. Alkaline phosphatase, direct bilirubin and common bile duct diameter remained stable. IV correlated with CRP, leukocytes, GOT, γGT (r > 0.3, P < 0.001 for all) and direct bilirubin (r = 0.23, P = 0.008). In multivariate analysis only CRP and GOT remained independently associated with IV (P < =0.001). The correlation of IV with GOT increased progressively from admission to day 14. GOT independently correlated with GPT which, in turn, correlated with γGT. γGT was also highly correlated with leukocytes. Unconjugated bilirubin correlated with haemoglobin, which was inversely correlated with CRP. Conclusions: The changes of bilirubin and liver enzymes during ischemic stroke reflect two phenomena, which are both related to IV: 1) inflammation, with consequent increment of CRP, leukocytes and γGT, and decrease of haemoglobin and unconjugated bilirubin and 2) an unknown signal, independent from inflammation, leading to increasing GOT and GPT levels.
MeSH term(s)	Aged ; Aged, 80 and over ; Aspartate Aminotransferases/blood ; Bilirubin/blood ; Brain Ischemia/blood ; Brain Ischemia/complications ; Brain Ischemia/enzymology ; Female ; Humans ; Liver/enzymology ; Liver Function Tests ; Male ; Middle Aged ; Nervous System Diseases/epidemiology ; Nervous System Diseases/etiology ; Neurologic Examination ; Stroke/blood ; Stroke/complications ; Stroke/enzymology ; gamma-Glutamyltransferase/blood
Chemical Substances	gamma-Glutamyltransferase (EC 2.3.2.2) ; Aspartate Aminotransferases (EC 2.6.1.1) ; Bilirubin (RFM9X3LJ49)
Language	English
Publishing date	2014-06-06
Publishing country	England
Document type	Journal Article
ISSN	1471-2377
ISSN (online)	1471-2377
DOI	10.1186/1471-2377-14-122
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