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| 1 | Perioperative thrombotic complications in liver transplantation显示文摘Although the perioperative bleeding complications and the major side effects of blood transfusion have always been the primary concern in liver transplantation(OLT),the possible cohesion of an underestimated intrinsic hypercoagulative state during and after the transplant procedure may pose a major threat to both patient and graft survival.Thromboembolism during OLT is characterized not only by a complex aetiology,but also by unpredictable onset and evolution of the disease.The initiation of a procoagulant process may be triggered by various factors,such as inflammation,venous stasis,ischemia-reperfusion injury,vascular clamping,anatomical and technical abnormalities,genetic factors,deficiency of profibrinolytic activity,and platelet activation.The involvement of the arterial system,intracardiac thrombosis,pulmonary emboli,portal vein thrombosis,and deep vein thrombosis,are among the most serious thrombotic events in the perioperative period.The rapid detection of occlusive vascular events is of paramount importance as it heavily influences the prognosis,particularly when these events occur intraoperatively or early after OLT.Regardless of the lack of studies and guidelines on anticoagulant prophylaxis in this setting,many institutions recommend such an approach especially in the subset of patients at high risk.However,the decision of when,how and in what doses to use the various chemical anticoagulants is still a difficult task,since there is no common consensus,even for highrisk cases.The risk of postoperative thromboembolism causing severe hemodynamic events,or even loss of graft function,must be weighed and compared with the risk of an important bleeding.In this article we briefly review the risk factors and the possible predictors of major thrombotic complications occurringin the perioperative period,as well as their incidence and clinical features.Moreover,the indications to pharmacological prophylaxis and the current treatment strategies are also summarized. | Paolo Feltracco Stefania Barbieri Umberto Cillo Giacomo Zanus Marco Senzolo Carlo Ori | 2015 | World Journal of Gastroenterology2015，21，26： | 13 |
| 2 | Role of blood AFP mRNA and tumor grade in the preoperative prognostic evaluation of patients with hepatoceiluiar carcinoma显示文摘AIM: To explore the potential prognostic role of preoperative tumor grade and blood AFP mRNA in a cohort of patients with hepatocellular carcinoma (HCC)eligible for radical therapies according to a well-defined treatment algorithm not including nodule size and number as absolute selection criteria.METHODS: Fifty patients with a diagnosis of HCC were prospectively enrolled in the study. Inclusion criteria were: (1) histological assessment of tumor grade by means of percutaneous biopsies; (2) determination of AFP mRNA status in the blood; (3) patient's eligibility for radical therapies.RESULTS: At preoperative evaluation, 54% of the study group had a well-differentiated HCC, 42% had AFP mRNA in the blood, 40% had a tumor larger than 5 cm and 56% had more than one nodule. Surgery (resection or liver transplantation) was performed in 29 patients,while 21 had percutaneous ablation procedures. After a median follow-up of 28 mo, 12-, 24-, and 36-mo survival rates were 78%, 58%, and 51%, respectively. Surgical therapy, performance status and three tumor-related variables (AFP mRNA, HCC grade and gross vascular invasion) resulted as significant survival predictors at univariate analysis. Nodule size and number did not perform as significant prognosticators. Multivariate study selected only surgical therapy and a biologically early HCC profile (AFP mRNA negative and well-differentiated tumor without gross vascular invasion) as independent survival variables.CONCLUSION: The preoperative determination of tumor grade and blood AFP mRNA status may potentially refine the prognostic evaluation of HCC patients and improve the selection process for radical therapies. | Umberto Cillo Alessandro Vitale Filippo Navaglia Daniela Basso Umberto Montin Marco Bassanello Francesco D'Amico Francesco Antonio Ciarleglio Alberto Brolese Giacomo Zanus Vito De Pascale Mario Plebani Davide Francesco D'Amico | 2005 | World Journal of Gastroenterology2005，11，44： | 12 |
| 3 | Prediction of hepatocellular carcinoma biological behaviorin patient selection for liver transplantation显示文摘Morphological criteria have always been considered the benchmark for selecting hepatocellular carcinoma(HCC)patients for liver transplantation(LT).These criteria,which are often inappropriate to express the tumor’s biological behavior and aggressiveness,offer only a static view of the disease burden and are frequently unable to correctly stratify the tumor recurrence risk after LT.Alpha-fetoprotein(AFP)and its progression as well as AFP-m RNA,AFP-L3%,des-γ-carboxyprothrombin,inflammatory markers and other serological tests appear to be correlated with post-transplant outcomes.Several other markers for patient selection including functional imaging studies such as18F-FDG-PET imaging,histological evaluation of tumor grade,tissue-specific biomarkers,and molecular signatures have been outlined in the literature.HCC growth rate and response to pre-transplant therapies can further contribute to the transplant evaluation process of HCC patients.While AFP,its progression,and HCC response to pretransplant therapy have already been used as a part of an integrated prognostic model for selecting patients,the utility of other markers in the transplant setting is still under investigation.This article intends to review the data in the literature concerning predictors that could be included in an integrated LT selection model and to evaluate the importance of biological aggressiveness in the evaluation process of these patients. | Umberto Cillo Tommaso Giuliani Marina Polacco Luz Maria Herrero Manley Gino Crivellari Alessandro Vitale | 2016 | World Journal of Gastroenterology2016，22，1： | 7 |
| 4 | Transplant benefit for patients with hepatocellular carcinoma显示文摘Although liver transplantation is theoretically the best treatment for hepatocellular carcinoma(HCC),it is limited by the realities of perioperative complications,and the shortage of donor organs.Furthermore,in many cases there are available alternative treatments such as resection or locoregional therapy.Deciding upon the best option for a patient with HCC is complicated,involving numerous ethical principles including:urgency,utility,intention-to-treat survival,transplant benefit,harm to candidates on waiting list,and harm to living donors.The potential contrast between different principles is particularly relevant for patients with HCC for several reasons:(1)HCC candidates to liver transplantation are increasing;(2)the great prognostic heterogeneity within the HCC population;(3)in HCC patients tumor progression before liver transplantation may significantly impair post transplant outcome;and(4)effective alternative therapies are often available for HCC candidates to liver transplantation.In this paper we suggest that allocating organs by transplant benefit could help balance these competing principles,and also introduce equity between patients with HCC and nonmalignant liver disease.We also propose a triangular equipoise model to help decide between deceased donor liver transplantation,living donor liver transplantation,or alternative therapies. | Alessandro Vitale Michael Volk Umberto Cillo | 2013 | World Journal of Gastroenterology2013，19，48： | 6 |
| 5 | 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 |
| 6 | Covert hepatic encephalopathy: Agreement and predictive validity of different indices显示文摘AIM:To investigate the agreement and prognosticvalue of different measures of covert hepatic encephalopathy(CHE).METHODS:One-hundred-and-thirty-two cirrhotic outpatients underwent electroencephalography(EEG),paper-and-pencil psychometry(PHES)and critical flicker frequency,scored on the original/modified(CFFo/CFFm)thresholds.Eighty-four patients underwent Dopplerultrasound to diagnose/exclude portal-systemic shunt.Seventy-nine were followed-up for 11±7 mo in relation to the occurrence of hepatic encephalopathy(HE)-related hospitalisations.RESULTS:On the day of study,36%had gradeⅠHE,42%abnormal EEG,33%abnormal PHES and 31/21%abnormal CFFo/CFFm.Significant associations were observed between combinations of test abnormalities;however,agreement was poor(Cohen’sκ<0.4).The prevalence of EEG,PHES and CFFo/CFFm abnormalities was significantly higher in patients with gradeⅠovert HE.The prevalence of EEG and CFFm abnormalities was higher in patients with shunt.The prevalence of EEG abnormalities was significantly higher in patients with a history of HE.During follow-up,10 patients died,10were transplanted and 29 had HE-related hospitalisations.GradeⅠHE(P=0.004),abnormal EEG(P=0.008)and abnormal PHES(P=0.04)at baseline all predicted the subsequent occurrence of HE;CFF did not.CONCLUSION:CHE diagnosis probably requires a combination of clinical,neurophysiological and neuropsychological indices. | Sara Montagnese Esmeralda Balistreri Sami Schiff Michele De Rui Paolo Angeli Giacomo Zanus Umberto Cillo Giancarlo Bombonato Massimo Bolognesi David Sacerdoti Angelo Gatta Carlo Merkel Piero Amodio | 2014 | World Journal of Gastroenterology2014，20，42： | 6 |
| 7 | 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 |
| 8 | 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 |
| 9 | 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 |
| 10 | Laparoscopic treatment of simple hepatic cysts and polycystic liver disease显示文摘 | P. Fiamingo U. Tedeschi M. Veroux U. Cillo A. Brolese A. Da Rold C. Madia G. Zanus D.F. D'Amico | 2003 | Surgical Endoscopy2003，，4： | 2 |
| 11 | 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 |
| 12 | Prospective validation of the Barcelona Clinic Liver Cancer staging system显示文摘 | Umberto Cillo Alessandro Vitale Francesco Grigoletto Fabio Farinati Alberto Brolese Giacomo Zanus Daniele Neri Patrizia Boccagni Nela Srsen Francesco D’Amico Francesco Antonio Ciarleglio Alessio Bridda Davide Francesco D’Amico | 2006 | Journal of Hepatology2006，，4： | 2 |
| 13 | Prospective evaluation of anticoagulation and transjugular intrahepatic portosistemic shunt for the management of portal vein thrombosis in cirrhosis显示文摘 | Marco Senzolo Teresa M. Sartori Valeria Rossetto Patrizia Burra Umberto Cillo Patrizia Boccagni Daniele Gasparini Diego Miotto Paolo Simioni Emmanuel Tsochatzis Kenneth A. Burroughs | 2012 | Liver Int2012，，6： | 2 |
| 14 | Propofol anesthesia for outpatient oral and maxillofacialsurgery显示文摘 | Cillo JE Jr | | 0，，05： | 1 |
| 15 | Homeobox genes in normal and malignant cells 显示文摘 | Cillo C Cantile M Faiella A | 2001 | J Cell Physiol2001，188，2： | 1 |
| 16 | Growth factor and cytokine gene expression in mechanically strained human osteoblast-like cells: implications for distraction osteogenesis 显示文摘 | Gassner R Koepsel RR | 2000 | Oral Surg Oral Med Oral Pathol Oral Radiol Endod2000，90，2： | 1 |
| 17 | Homeobox genes in normal and malignant cells 显示文摘 | Cantile M faiella A | 2001 | Jcell Physiol2001，188，： | 1 |
| 18 | Clinical significance of alphafetoproteinmRNA in blood of patients with hepatocellular carcinoma显示文摘 | Cillo U Navaglia F Vitale A | 2004 | Clin Chim Acta2004，347，12： | 1 |
| 19 | Differential patterns of Hox gene expression are associated with specific integrin and ICAM profiles in clonal populations isolated from a single human melanoma 显示文摘 | Cillo C Cantile M Mortarini R | 1996 | Int J Cancer1996，66，5： | 1 |
| 20 | Homeobox genes in normal and malignant cells 显示文摘 | Cillo C Cantile M Faiella A | 2001 | J Cell Physiol2001，188，： | 1 |
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