|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Veno occlusive disease: Update on clinical management显示文摘Hepatic veno-occlusive disease is a clinical syndrome characterized by hepatomegaly, ascites, weight gain and jaundice, due to sinusoidal congestion which can be caused by alkaloid ingestion, but the most frequent cause is haematopoietic stem cell transplantation (STC) and is also seen after solid organ transplantation. The incidence of veno occlusive disease (VOD) after STC ranges from 0 to 70%, but is decreasing. Survival is good when VOD is a mild form, but when it is severe and associated with an increase of hepatic venous pressure gradient > 20 mmHg, and mortality is about 90%. Prevention remains the best therapeutic strategy, by using non-myeloablative conditioning regimens before STC. Prophylactic administration of ursodeoxycholic acid, being an antioxidant and antiapoptotic agent, can have some benefit in reducing overall mortality. Defibrotide, which has pro-fibrinolytic and antithrombotic properties, is the most effective therapy; decompression of the sinusoids by a transjugular intrahepatic portosystemic shunt (TIPS) can be tried, especially to treat VOD after liver transplantation and when multiorgan failure (MOF) is not present. Liver transplantation can be the last option, but can not be considered a standard rescue therapy, because usually the concomitant presence of multiorgan failure contraindicates this procedure. | M Senzolo G Germani E Cholongitas P Burra AK Burroughs | 2007 | World Journal of Gastroenterology2007，13，29： | 19 |
| 2 | Nonalcoholic fatty liver disease and liver transplantation-Where do we stand?显示文摘Nonalcoholic fatty liver disease/nonalcoholic steatohepatitis(NAFLD/NASH) is a challenging and multisystem disease that has a high socioeconomic impact. NAFLD/NASH is a main cause of macrovesicular steatosis and has multiple impacts on liver transplantation(LT), on patients on the waiting list for transplant, on posttransplant setting as well as on organ donors. Current data indicate new trends in the area of chronic liver disease. Due to the increased incidence of metabolic syndrome(Met S) and its components, NASH cirrhosis and hepatocellular carcinoma caused by NASH will soon become a major indication for LT. Furthermore, due to an increasing incidence of Met S and, consequently, NAFLD, there will be more steatotic donor livers and less high quality organs available for LT, in addition to a lack of available liver allografts. Patients who have NASH and are candidates for LT have multiple comorbidities and are unique LT candidates. Finally, we discuss long-term grafts and patient survival after LT, the recurrence of NASH and NASH appearing de novo after transplantation. In addition, we suggest topics and areas that require more research for improving the health care of this increasing patient population. | Ivana Mikolasevic Tajana Filipec-Kanizaj Maja Mijic Ivan Jakopcic Sandra Milic Irena Hrstic Nikola Sobocan Davor Stimac Patrizia Burra | 2018 | World Journal of Gastroenterology2018，24，14： | 14 |
| 3 | New insights into the coagulopathy of liver disease and liver transplantation显示文摘The liver is an essential player in the pathway of coagulation in both primary and secondary haemostasis. Only von Willebrand factor is not synthetised by the liver, thus liver failure is associated with impairment of coagulation. However, recently it has been shown that the delicate balance between pro and antithrombotic factors synthetised by the liver might be reset to a lower level in patients with chronic liver disease. Therefore, these patients might not be really anticoagulated in stable condition and bleeding may be caused only when additional factors, such as infections, supervene. Portal hypertension plays an important role in coagulopathy in liver disease, reducing the number of circulating platelets, but platelet function and secretion of thrombopoietin have been also shown to be impaired in patients with liver disease. Vitamin K deficiency may coexist, so that abnormal clotting factors are produced due to lack of gamma carboxylation. Moreover during liver failure, there is a reduced capacity to clear activated haemostatic proteins and protein inhibitor complexes from the circulation. Usually therapy for coagulation disorders in liver disease is needed only during bleeding or before invasive procedures. When end stage liver disease occurs, liver transplantation is the only treatment available, which can restore normal haemostasis, and correct genetic clotting defects, such as haemophilia or factor V Leiden mutation. During liver transplantation haemorrage may occur due to the pre-existing hypocoagulable state, the collateral circulation caused by portal hypertension and increased fibrinolysis which occurs during this surgery. | M Senzolo P Burra E Cholongitas AK Burroughs | 2006 | World Journal of Gastroenterology2006，12，48： | 12 |
| 4 | Neoplastic disease after liver transplantation: focus on de novo neoplasms显示文摘De novo neoplasms account for almost 30% of deaths 10 years after liver transplantation and are the most common cause of mortality in patients surviving at least 1 year after transplant. The risk of malignancy is two to four times higher in transplant recipients than in an age- and sex-matched population, and cancer is expected to surpass cardiovascular complications as the primary cause of death in transplanted patients within the next 2 decades. Since exposure to immunosuppression is associated with an increased frequency of developing neoplasm, long-term immunosuppression should be therefore minimized. Promising results in the prevention of hepatocellular carcinoma(HCC) recurrence have been reported with the use of m TOR inhibitors including everolimus and sirolimus and the ongoing open-label prospective randomized controlled SILVER. Study will provide more information on whether sirolimus-containing vs m TOR-inhibitorfree immunosuppression is more efficacious in reducing HCC recurrence. | Patrizia Burra Kryssia I Rodriguez-Castro | 2015 | World Journal of Gastroenterology2015，21，29： | 9 |
| 5 | Therapeutic approaches for portal biliopathy: A systematic review显示文摘Portal biliopathy(PB) is defined as the presence of biliary abnormalities in patients with non-cirrhotic/nonneoplastic extrahepatic portal vein obstruction(EHPVO) and portal cavernoma(PC). The pathogenesis of PB is due to ab extrinseco compression of bile ducts by PC and/or to ischemic damage secondary to an altered biliary vascularization in EHPVO and PC. Although asymptomatic biliary abnormalities can be frequently seen by magnetic resonance cholangiopancreatography in patients with PC(77%-100%), only a part of these(5%-38%) are symptomatic. Clinical presentation includes jaundice, cholangitis, cholecystitis, abdominal pain, and cholelithiasis. In this subset of patients is required a specific treatment. Different therapeutic approaches aimed to diminish portal hypertension and treat biliary strictures are available. In order to decompress PC, surgical porto-systemic shunt or transjugular intrahepatic porto-systemic shunt can be performed, and treatment on the biliary stenosis includes endoscopic(Endoscopic retrograde cholangiopancreatography with endoscopic sphincterotomy, balloon dilation, stone extraction, stent placement) and surgical(bilioenteric anastomosis, cholecystectomy) approaches. Definitive treatment of PB often requires multiple and combined interventions both on vascular and biliary system. Liver transplantation can be considered in patients with secondary biliary cirrhosis, recurrent cholangitis or unsuccessful control of portal hypertension. | Irene Franceschet Alberto Zanetto Alberto Ferrarese Patrizia Burra Marco Senzolo | 2016 | World Journal of Gastroenterology2016，22，45： | 9 |
| 6 | Is osteoporosis a peculiar association with primary biliary cirrhosis?显示文摘AIM: (1) To compare the prevalence of osteoporosis (t-score ≤-2.5 SD) between stage Ⅳ PBC patients, and two groups of age- and sex-matched controls: one with hepatitis C virus (HCV)-related cirrhosis, and the other one consisting of a group of healthy subjects from the general population; (2) to identify the main risk factors for the development of bone loss.METHODS: Thirty-five stage Ⅳ PBC patients (mean age 52.5±10 years), 49 females with HCV-related cirrhosis (mean age 52.9±5.8 years) and 33 healthy females (mean age 51.8+2.22 years) were enrolled in the study. Bone metabolism was evaluated by measuring serum calcium corrected for serum albumin (Ca corr.), 25-hydroxy vitamin D (25-OH vit D), parathyroid hormone, osteocalcin.Bone mineral density (BMD) was assessed at the lumbar spine by dual-photon X-ray absorptiometry.RESULTS: Osteoporosis was present in 5/35 PBC patients (14.2%) and in 7/49 HCV-related cirrhotic patients (14.3%),without any statistical difference between the two groups.Among healthy control subjects, none had osteoporosis.No difference was found between the three groups in serum parameters of bone metabolism. Univariate analysis showed that menopausal state and low BMI were significantly correlated with osteoporosis. Multivariate regression analysis showed that menopausal status, BMI <23, and old age were independent variables significantly correlated with osteoporosis.CONCLUSION: PBC in itself has no negative influence on BMD. End-stage liver disease patients carry a disease-specific risk for osteoporosis, but have an effective risk of bone loss in relation to individual potential risk for each patient. A practical message should be taken into account, that is, every effort should be made to prevent osteoporosis when a patient has simple osteopenia, or if it is a woman in or near menopausal age. | Annarosa Floreani Andrea Mega Valentina Camozzi Vincenzo Baldo Mario Plebani Patrizia Burra Giovanni Luisetto | 2005 | World Journal of Gastroenterology2005，11，34： | 7 |
| 7 | Liver transplantation for viral hepatitis in 2015显示文摘Liver transplantation(LT) is a life-saving treatment forpatients with end-stage liver disease and for patients with liver cell cancer related to liver disease. Acute and chronic liver diseases related to hepatitis viruses are between the main indications for liver transplantation. The risk of viral reinfection after transplantation is the main limiting factor in these indications. Before the availability of antiviral prophylaxis, hepatitis B virus(HBV) recurrence was universal in patients who were HBV DNA-positive before transplantation. The natural history of recurrent HBV was accelerated by immunosuppression, and it progressed rapidly to graft failure and death. Introduction of post-transplant prophylaxis with immunoglobulin alone first, and associated to antiviral drugs later, drastically reduced HBV recurrence, resulting in excellent long-term outcomes. On the contrary, recurrence of hepatitis C is the main cause of graft loss in most transplant programs. Overall, patient and graft survival after LT for hepatitis C virus(HCV)-associated cirrhosis is inferior compared with other indications. However, successful pretransplant or post transplant antiviral therapy has been associated with increased graft and overall survival. Until recently, the combination of pegylated interferon and ribavirin was the standard of care for the treatment of patients with chronic hepatitis C. Highly active antiviral compounds have been developed over the past decade, thanks to new in vitro systems to study HCV entry, replication, assembly, and release. | alberto ferrarese alberto zanetto martina gambato ilaria bortoluzzi elena nadal giacomo germani marco senzolo patrizia burra francesco paolo russo | 2016 | World Journal of Gastroenterology2016，22，4： | 7 |
| 8 | Markers of acute rejection and graft acceptance in liver transplantation显示文摘The evaluation of the immunosuppression state in liver transplanted patients is crucial for a correct posttransplant management and a major step towards the personalisation of the immunosuppressive therapy. However, current immunological monitoring after liver transplantation relies mainly on clinical judgment and on immunosuppressive drug levels, without a proper assessment of the real suppression of theimmunological system. Various markers have been studied in an attempt to identify a specific indicator of graft rejection and graft acceptance after liver transplantation. Considering acute rejection, the most studied markers are pro-inflammatory and immunoregulatory cytokines and other proteins related to inflammation. However there is considerable overlap with other conditions, and only few of them have been validated. Standard liver tests cannot be used as markers of graft rejection due to their low sensitivity and specificity and the weak correlation with the severity of histopathological findings. Several studies have been performed to identify biomarkers of tolerance in liver transplanted patients. Most of them are based on the analysis of peripheral blood samples and on the use of transcriptional profiling techniques. Amongst these, NK cell-related molecules seem to be the most valid marker of graft acceptance, whereas the role CD4+CD25+Foxp3+ T cells has still to be properly defined. | Giacomo Germani Kryssia Rodriguez-Castro Francesco Paolo Russo Marco Senzolo Alberto Zanetto Alberto Ferrarese Patrizia Burra | 2015 | World Journal of Gastroenterology2015，21，4： | 6 |
| 9 | Invasive fungal infection before and after liver transplantation显示文摘Invasive infections are a major complication before liver transplantation(LT)and in the early phase after surgery.There has been an increasing prevalence of invasive fungal disease(IFD),especially among the sickest patients with decompensated cirrhosis and acute-on-chronic liver failure,who suffer from a profound state of immune dysfunction and receive intensive care management.In such patients,who are listed for LT,development of an IFD often worsens hepatic and extra-hepatic organ dysfunction,requiring a careful evaluation before surgery.In the post-transplant setting,the burden of IFD has been reduced after the clinical advent of antifungal prophylaxis,even if several major issues still remain,such as duration,target population and drug type(s).Nevertheless,the development of IFD in the early phase after surgery significantly impairs graft and patient survival.This review outlines presentation,prophylactic and therapeutic strategies,and outcomes of IFD in LT candidates and recipients,providing specific considerations for clinical practice. | Alberto Ferrarese Annamaria Cattelan Umberto Cillo Enrico Gringeri Francesco Paolo Russo Giacomo Germani Martina Gambato Patrizia Burra Marco Senzolo | 2020 | World Journal of Gastroenterology2020，26，47： | 6 |
| 10 | Acute alcoholic hepatitis, end stage alcoholic liver disease and liver transplantation: An Italian position statement显示文摘Alcoholic liver disease encompasses a broad spectrum of diseases ranging from steatosis steatohepatitis,fibrosis,and cirrhosis to hepatocellular carcinoma.Forty-four per cent of all deaths from cirrhosis are attributed to alcohol.Alcoholic liver disease is the second most common diagnosis among patients undergoing liver transplantation(LT).The vast majority of transplant programmes(85%)require 6 mo of abstinence prior to transplantation;commonly referred to as the'6-mo rule'.Both in the case of progressive end-stage liver disease(ESLD)and in the case of severe acute alcoholic hepatitis(AAH),not responding to medical therapy,there is a lack of evidence to support a 6-mo sobriety period.It is necessary to identify other risk factors that could be associated with the resumption of alcohol drinking.The'Group of Italian Regions'suggests that:in a case of ESLD with model for end-stage liver disease<19 a 6-mo abstinence period is required;in a case of ESLD,a 3-mo sober period before LT may be more ideal than a 6-mo period,in selected patients;and in a case of severe AAH,not respond-ing to medical therapies(up to 70%of patients die within 6 mo),LT is mandatory,even without achieving abstinence.The multidisciplinary transplant team must include an addiction specialist/hepato-alcohologist.Patients have to participate in self-help groups. | Gianni Testino Patrizia Burra Ferruccio Bonino Francesco Piani Alessandro Sumberaz Roberto Peressutti Andrea Giannelli Castiglione Valentino Patussi Tiziana Fanucchi Ornella Ancarani Giovanna De Cerce Anna Teresa Iannini Giovanni Greco Antonio Mosti Marilena Durante Paola Babocci Mariano Quartini Davide Mioni Sarino Aricò Aniello Baselice Silvia Leone Fabiola Lozer Emanuele Scafato Paolo Borro | 2014 | World Journal of Gastroenterology2014，20，40： | 5 |
| 11 | Hepatitis C virus related cirrhosis decreased as indication to liver transplantation since the introduction of direct-acting antivirals: A single-center study显示文摘AIM To evaluate waiting list(WL) registration and liver transplantation(LT) rates in patients with hepatitis C virus(HCV)-related cirrhosis since the introduction of direct-acting antivirals(DAAs).METHODS All adult patients with cirrhosis listed for LT at Padua University Hospital between 2006-2017 were retrospectively collected using a prospectivelyupdated database; patients with HCV-related cirrhosis were divided by indication for LT [dec-HCV vs HCV/hepatocellular carcinoma(HCC)] and into two interval times(2006-2013 and 2014-2017) according to the introduction of DAAs. For each patient, indications to LT, severity of liver dysfunction and the outcome in the WL were assessed and compared between the two different time periods. For patients receiving DAA-based regimens, the achievement of viral eradication and the outcome were also evaluated. RESULTS One thousand one hundred and ninty-four [male(M)/female(F): 925/269] patients were included. Considering the whole cohort, HCV-related cirrhosis was the main etiology at the time of WL registration(490/1194 patients, 41%). HCV-related cirrhosis significantly decreased as indication to WL registration after DAA introduction(from 43.3% in 2006-2013 to 37.2% in 2014-2017, P = 0.05), especially amongst decHCV(from 24.2% in 2006-2013 to 15.9% in 2014-2017, P = 0.007). Even HCV remained the most common indication to LT over time(289/666, 43.4%), there was a trend towards a decrease after DAAs introduction(from 46.3% in 2006-2013 to 39% in 2014-2017, P = 0.06). HCV patients(M/F: 43/11, mean age: 57.7 ± 8 years) who achieved viral eradication in the WL had better transplant-free survival(log-rank test P = 0.02) and delisting rate(P = 0.002) than untreated HCV patients. CONCLUSION Introduction of DAAs significantly reduced WL registrations for HCV related cirrhosis, especially in the setting of decompensated cirrhosis. | Alberto Ferrarese Giacomo Germani Martina Gambato Francesco Paolo Russo Marco Senzolo Alberto Zanetto Sarah Shalaby Umberto Cillo Giacomo Zanus Paolo Angeli Patrizia Burra | 2018 | World Journal of Gastroenterology2018，24，38： | 5 |
| 12 | Long term follow-up and outcome of liver transplantation from hepatitis B surface antigen positive donors显示文摘Liver transplant for hepatitis B virus(HBV) currently yields excellent outcomes: it allows to rescue patients with an HBV-related advanced liver disease, resulting in a demographical modification of the waiting list for liver transplant. In an age of patient-tailored treatments, in liver transplantation as well the aim is to offer the best suitable graft to the patient who can benefit from it, also expanding the criteria for organ acceptance and allocation. With the intent of developing strategies to increase the donor pool, we set-up a multicenter study involving 3 Liver Transplant Centers in Italy: patients undergoing liver transplantation between March 03, 2004, and May 21, 2010, were retrospectively evaluated. 1408 patients underwent liver transplantation during the study period, 28(2%) received the graft from hepatitis B surface antigen positive(HBs Ag)-positive deceased donors. The average follow-up after liver transplantation was 63.7 mo [range: 0.1-119.4; SD ± 35.8]. None Primary nonfunction, re-liver transplantation, early or late hepatic artery thrombosis occurred. The 1-, 3-and 5-year graft and patient survival resulted of 85.7%, 82.1%, 78.4%. Our results suggest that the use of HBs Agpositive donors liver grafts is feasible, since HBV can be controlled without affecting graft stability. However, the selection of grafts and the postoperative antiviral therapy should be managed appropriately. | Roberto Ballarin Alessandro Cucchetti Francesco Paolo Russo Paolo Magistri Matteo Cescon Umberto Cillo Patrizia Burra Antonio Daniele Pinna Fabrizio Di Benedetto | 2017 | World Journal of Gastroenterology2017，23，12： | 4 |
| 13 | Management of bacterial infection in the liver transplant candidate显示文摘Bacterial infection(BI) is a common cause of impairment of liver function in patients with cirrhosis, especially in the liver transplant candidates. These patients share an immunocompromised state and increased susceptibility to develop community and hospital-acquired infections. The changing epidemiology of BI, with an increase of multidrug resistant strains, especially in healthcareassociated settings, represents a critical issue both in the waiting list and in the post-operative management. This review focused on the role played by BI in patients awaiting liver transplantation, evaluating the risk of drop-out from the waiting list, the possibility to undergo liver transplantation after recovery from infection or during a controlled infection. | Alberto Ferrarese Alberto Zanetto Chiara Becchetti Salvatore Stefano Sciarrone Sarah Shalaby Giacomo Germani Martina Gambato Francesco Paolo Russo Patrizia Burra Marco Senzolo | 2018 | World Journal of Hepatology2018，10，2： | 3 |
| 14 | Rethinking the role of non-selective beta blockers in patients with cirrhosis and portal hypertension显示文摘Non-selective beta blockers(NSBB) are commonly used to prevent portal hypertensive bleeding in cirrhotics.Nevertheless, in the last years, the use of NSBB in critically decompensated patients, especially in those with refractory ascites, has been questioned, mainly for an increased risk of mortality and worsening of systemic hemodynamics. Moreover, even if NSBB have been reported to correlate with a higher risk of renal failure and severe infection in patients with advanced liver disease and hypotension, their use has been associated with a reduction of risk of spontaneous bacterial peritonitis, modification of gut permeability and reduction of bacterial translocation. This manuscript systematically reviews the published evidences about harms and benefits of the use of NSBB in patients with decompensated cirrhosis. | Alberto Ferrarese Alberto Zanetto Giacomo Germani Patrizia Burra Marco Senzolo | 2016 | World Journal of Hepatology2016，8，24： | 3 |
| 15 | A Prospective Policy Development to Increase Split-Liver Transplantation for 2 Adult Recipients: Results of a 12-Year Multicenter Collaborative Study显示文摘 | Paolo Aseni Tullia Maria De Feo Luciano De Carlis Umberto Valente Michele Colledan Umberto Cillo Giorgio Rossi Vincenzo Mazzaferro Matteo Donataccio Nicola De Fazio Enzo Andorno Patrizia Burra | 2014 | Annals of Surgery2014，，1： | 3 |
| 16 | Survival benefit of liver resection for patients with hepatocellular carcinoma across different Barcelona Clinic Liver Cancer stages: a multicentre study显示文摘 | Alessandro Vitale Patrizia Burra Anna Chiara Frigo Franco Trevisani Fabio Farinati Gaya Spolverato Michael Volk Edoardo G. Giannini Francesca Ciccarese Fabio Piscaglia Gian Lodovico Rapaccini Mariella Di Marco Eugenio Caturelli Marco Zoli Franco Borzio Gi | 2014 | Journal of Hepatology2014，，： | 2 |
| 17 | Liver transplantation for HBV-related cirrhosis in Europe: An ELTR study on evolution and outcomes显示文摘 | Patrizia Burra Giacomo Germani Renè Adam Vincent Karam Alfredo Marzano Pietro Lampertico Mauro Salizzoni Franco Filipponi Jurgen L. Klempnauer Denis Castaing Murat Kilic Luciano De Carlis Peter Neuhaus Sezai Yilmaz Andreas Paul Antonio D. Pinna Andrew K. | 2012 | Journal of Hepatology2012，，： | 2 |
| 18 | De Novo Autoimmune Hepatitis after Liver Transplantation显示文摘 | Maria Guido Patrizia Burra | 2011 | Semin Liver Dis2011，，： | 2 |
| 19 | Female gender in the setting of liver transplantation显示文摘The evolution of liver diseases to end-stage liver disease or to acute hepatic failure, the evaluation process for liver transplantation, the organ allocation decisionmaking, as well as the post-transplant outcomes are different between female and male genders. Women's access to liver transplantation is hampered by the use of model for end-stage liver disease(MELD) score, in which creatinine values exert a systematic bias against women due to their lower values even in the presence of variable degrees of renal dysfunction. Furthermore, even when correcting MELD score for gender-appropriate creatinine determination, a quantifiable uneven access to transplant prevails, demonstrating that other factors are also involved. While some of the differences can be explained from the epidemiological point of view, hormonal status plays an important role. Moreover, the pre-menopausal and post-menopausal stages imply profound differences in a woman's physiology, including not only the passage from the fertile age to the non-fertile stage, but also the loss of estrogens and their potentially protective role in delaying liver fibrosis progression, amongst others. With menopause, the tendency to gain weight may contribute to the development of or worsening of pre-existing metabolic syndrome. As an increasing number of patients are transplanted for non-alcoholic steatohepatitis, and as the average age at transplant increases, clinicians must be prepared for the management of this particular condition, especially in post-menopausal women, who are at particular risk of developing metabolic complications after menopause. | Kryssia Isabel Rodríguez-Castro Eleonora De Martin Martina Gambato Silvia Lazzaro Erica Villa Patrizia Burra | 2014 | World Journal of Transplantation2014，4，4： | 2 |
| 20 | Comparison of de novo tumours after liver transplantation with incidence rates from Italian cancer registries显示文摘 | U. Baccarani P. Piselli D. Serraino G.L. Adani D. Lorenzin M. Gambato A. Buda G. Zanus A. Vitale A. De Paoli C. Cimaglia V. Bresadola P. Toniutto A. Risaliti U. Cillo F. Bresadola P. Burra | 2009 | Digestive and Liver Disease2009，，1： | 2 |
您所在的机构暂未开通此部分的功能，请联系管理员