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| 1 | Editorial statement显示文摘In the following four articles,we will provide an overview of the current clinical work in different areas of liver transplantation.For many decades,this transplantation has been the treatment choice for patients suffering from chronic | Salvatore Gruttadauria Bruno G Gridelli | 2009 | World Journal of Gastroenterology2009，15，6： | 43 |
| 2 | Efficacy of transcatheter embolization/chemoembolization (TAE/TACE) for the treatment of single hepatocellular carcinoma显示文摘AIM:To investigate the efficacy of transcatheter embolization/chemoembolization (TAE/TACE) in cirrhotic patients with single hepatocellular carcinoma (HCC) not suitable for surgical resection and percutaneous ablation therapy. METHODS:A cohort of 176 consecutive cirrhotic patients with single HCC undergoing TAE/TACE was reviewed; 162 patients had at least one image examination (helical CT scan or triphasic contrastenhanced MRI) after treatment and were included into the study. TAE was performed with Lipiodol followed by Gelfoam embolization; TACE was performed with Farmorubicin prepared in sterile drip at a dose of 50 mg/m2,infused over 30 min using a peristaltic pump,and followed by Lipiodol and Gelfoam embolization. RESULTS:Patients characteristics were:mean age,62 years; male/female 117/45; Child-Pugh score 6.2 ± 1.1; MELD 8.7 ± 2.3; mean HCC size,3.6 (range 1.0-12.0) cm. HCC size class was ≤ 2.0 cm,n = 51; 2.1-3.0 cm,n = 35; 3.1-4.0 cm,n = 29; 4.1-5.0 cm,n = 22; 5.1-6.0 cm,n = 11; and > 6.0 cm,n = 14. Patients received a total of 368 TAE/TACE (mean 2.4 ± 1.7). Complete tumor necrosis was obtained in 94 patients (58%),massive (90%-99%) necrosis in 16 patients (10%),partial (50%-89%) necrosis in 18 patients (11%) and poor (< 50%) necrosis in the remaining 34 patients (21%). The rate of complete necrosis according to the HCC size class was:69%,69%,52%,68%,50% and,13% for lesions of ≤ 2.0,2.1-3.0,3.1-4.0,4.1-5.0,5.1-6.0,and > 6.0 cm,respectively. Kaplan-Mayer survival at 24-mo was 88%,68%,59%,59%,45%,and 53% for lesions of ≤ 2.0,2.1-3.0,3.1-4.0,4.1-5.0,5.1-6.0,and > 6.0 cm,respectively. CONCLUSION:Our study showed that in cirrhotic patients with single HCC smaller than 6.0 cm,TAE/TACE produces complete local control of tumor in a significant proportion of patients. TAE/TACE is an effective therapeutic option in patients with single HCC not suitable for surgical resection or percutaneous ablation therapies. Further studies should investigate if the new available embolization agents or drug eluting beads may improve the effect on tumor necrosis. | Roberto Miraglia Giada Pietrosi Luigi Maruzzelli Ioannis Petridis Settimo Caruso Gianluca Marrone Giuseppe Mamone Giovanni Vizzini Angelo Luca Bruno Gridelli | 2007 | World Journal of Gastroenterology2007，13，21： | 38 |
| 3 | Clinical applications of hepatocyte transplantation显示文摘The shortage of organ donors is a problem worldwide, with approximately 15% of adult patients with lifethreatening liver diseases dying while on the waiting list. The use of cell transplantation for liver disease is an attempt to correct metabolic defects, or to support liver function as a bridge to liver transplantation and, as such, has raised a number of expectations. Most of the available studies briefly reported here focus on adult hepatocyte transplantation (HT), and the results are neither reproducible nor comparable, because the means of infusion, amount of injected cells and clinical variability differ among the studies. To better understand the specif ic role of HT in the management of end-stage liver disease, it is important that controlled studies, designed on the principles of evidence-based medicine, be done in order to guarantee the reproducibility of results. | Giada Pietrosi Giovanni Battista Vizzini Salvatore Gruttadauria Bruno Gridelli | 2009 | World Journal of Gastroenterology2009，15，17： | 23 |
| 4 | Pediatric liver transplantation显示文摘In previous decades,pediatric liver transplantation has become a state-of-the-art operation with excellent success and limited mortality.Graft and patient survival have continued to improve as a result of improvements in medical,surgical and anesthetic management,organ availability,immunosuppression,and identification and treatment of postoperative complications.The utilization of split-liver grafts and living-related donors has provided more organs for pediatric patients.Newer immunosuppression regimens,including induction therapy,have had a significant impact on graft and patient survival.Future developments of pediatric liver transplantation will deal with long-term followup,with prevention of immunosuppression-related complications and promotion of as normal growth as possible.This review describes the state-of-the-art in pediatric liver transplantation. | Marco Spada Silvia Riva Giuseppe Maggiore Davide Cintorino Bruno Gridelli | 2009 | World Journal of Gastroenterology2009，15，6： | 20 |
| 5 | Small-for-size syndrome in adult-to-adult living-related liver transplantation显示文摘Small-for-size syndrome (SFSS) in adult-to-adult living-related donor liver transplantation (LRLT) remains the greatest limiting factor for the expansion of segmental liver transplantation from either cadaveric or living donors. Portal hyperperfusion, venous pathology, and the arterial buffer response signif icantly contribute to clinical and histopathological manifestations of SFSS. Here, we review the technical aspects of surgical and radiological procedures developed to treat SFSS in LRLT, along with the pathophysiology of this condition. | Salvatore Gruttadauria Duilio Pagano Angelo Luca Bruno Gridelli | 2010 | World Journal of Gastroenterology2010，16，40： | 15 |
| 6 | Interventional radiology procedures in adult patients who underwent liver transplantation显示文摘Interventional radiology has acquired a key role in every liver transplantation(LT)program by treating the majority of vascular and non-vascular post-transplant complications,improving graft and patient survival and avoiding,in the majority of cases,surgical revision and/or re-transplantation.The aim of this paper is to review indications,technical consideration,results achievable and potential complications of interventional radiology procedures after deceased donor LT and living related adult LT. | Roberto Miraglia Luigi Maruzzelli Settimo Caruso Mariapina Milazzo Gianluca Marrone Giuseppe Mamone Vincenzo Carollo Salvatore Gruttadauria Angelo Luca Bruno Gridelli | 2009 | World Journal of Gastroenterology2009，15，6： | 11 |
| 7 | Multidisciplinary imaging of liver hydatidosis显示文摘Liver hydatidosis is a parasitic endemic disease affecting extensive areas in our planet,a significant stigma within medicine to manage because of its incidence,possible complications,and diagnostic involvements.The diagnosis of liver hydatidosis should be as fast as possible because of the relevant complications that may arise with disease progression,involving multiple organs and neighboring structures causing disruption,migration,contamination.The aim of this essay is to illustrate the role of imaging as ultrasonography(US),multi detector row computed tomography,and magnetic resonance imaging(MRI)in the evaluation of liver hydatidosis:the diagnosis,the assessment of extension,the identification of possible complications and the monitoring the response to therapy.US is the screening method of choice.Computed tomography(CT)is indicated in cases in which US is inadequate and has high sensitivity and specificity for calcified hydatid cysts.Magnetic resonance is the best imaging procedure to demonstrate a cystic component and to show a biliary tree involvement.Diagnostic tests such as CT and MRI are mandatory in liver hydatidosis because they allow thorough knowledge regarding lesion size,location,and relations to intrahepatic vascular and biliary structures,providing useful information for effective treatment and decrease in post-operative morbidity.Hydatid disease is classified into four types on the basis of their radiologic appearance. | Gianluca Marrone Francesca Crino' Settimo Caruso Giuseppe Mamone Vincenzo Carollo Mariapina Milazzo Salvatore Gruttadauria Angelo Luca Bruno Gridelli | 2012 | World Journal of Gastroenterology2012，18，13： | 10 |
| 8 | Imaging in liver transplantation显示文摘The aim of this study was to illustrate the role of noninvasive imaging tools such as ultrasonography,multidetector row computed tomography,and magnetic resonance imaging in the evaluation of pediatric and adult liver recipients and potential liver donors,and in the detection of potential complications arising from liver transplantation. | Settimo Caruso Roberto Miraglia Luigi Maruzzelli Salvatore Gruttadauria Angelo Luca Bruno Gridelli | 2009 | World Journal of Gastroenterology2009，15，6： | 8 |
| 9 | Analysis of surgical and perioperative complications in seventy-five right hepatectomies for living donor liver transplantation显示文摘AIM: To present an analysis of the surgical and perioperative complications in a series of seventy- five right hepatectomies for living-donation (RHLD) performed in our center. METHODS: From January 2002 to September 2007, we performed 75 RHLD, defined as removal of a portion of the liver corresponding to Couinaud segments 5-8, in order to obtain a graft for adult to adult living-related liver transplantation (ALRLT). Surgical complications were stratified according to the most recent version of the Clavien classification of postoperative surgical complications. The perioperative period was defined as within 90 d of surgery. RESULTS: No living donor mortality was present in this series, no donor operation was aborted and no donors received any blood transfusion. Twenty- three (30.6%) living donors presented one or more episodes of complication in the perioperative period. Seven patients (9.33%) out of 75 developed biliary complications, which were the most common complications in our series.CONCLUSION: The need to define, categorize and record complications when healthy individuals, such as living donors, undergo a major surgical procedure, such as a right hepatectomy, reflects the need for prompt and detailed reports of complications arising in this particular category of patient. Perioperative complications and post resection liver regeneration are not influenced by anatomic variations or patient demographic. | Salvatore Gruttadauria James Wallis Marsh Giovan Battista Vizzini Fabrizio di Francesco Angelo Luca Riccardo Volpes Amadeo Marcos Bruno Gridelli | 2008 | World Journal of Gastroenterology2008，14，20： | 7 |
| 10 | Endoscopic treatment of biliary complications after liver transplantation显示文摘AIM:To evaluate the efficacy of endoscopic treatment in patients who undergo OLTx or LRLTx and develop biliary complications. METHODS:This is a prospective, observational study of patients who developed biliary complications, after OLTx and LRLTx, with duct-to-duct anastomosis performed between June 2003 and June 2007. Endoscopic Retrograde Cholangiopancreatography (ERCP) was considered unsuccessful when there was evidence of continuous bile leakage despite endoscopic stent placement, or persistence of stenosis after 1 year, despite multiple dilatation and stent placement. When the ERCP failed, a percutaneous trans-hepatic approach (PTC) or surgery was adopted. RESULTS: From June 2003 to June 2007, 261 adult patients were transplanted in our institute, 68 from living donors and 193 from cadaveric donors. In the OLTx group the rate of complications was 37.3%, while in the LRLTx group was 64.7%. The rate of ERCP failure was 19.4% in the OLTx group and 38.6% in LRLTx group. In OLTx group, 1 patient was re- transplanted and 8 patients died. In the LRLTx group, 2 patients underwent OLTx and 8 patients died. The follow-up was 23.3 ± 13.13 mo and 21.02 ± 14.10 mo, respectively.CONCLUSION: Although ERCP is quite an effective mode of managing post-transplant bile duct complications, a significant number of patients need other types of approach. Further prospective studies are necessary in order to establish whether other endoscopic protocols or new devices, could improve the current results. | Ilaria Tarantino Luca Barresi Ioannis Petridis Riccardo Volpes Mario Traina Bruno Gridelli | 2008 | World Journal of Gastroenterology2008，14，26： | 6 |
| 11 | Cystic echinococcosis of the liver and lung treated by radiofrequency thermal ablation:An ex-vivo pilot experimental study in animal models显示文摘AIM:To evaluate radiofrequency thermal ablation (RTA) for treatment of cystic echinococcosis in animal models (explanted organs).METHODS:Infected livers and lungs from slaughtered animals,10 bovine and two ovine,were collected.Cysts were photographed,and their volume,cyst content,germinal layer adhesion status,wall calcification and presence of daughter or adjacent cysts were evaluated by ultrasound.Some cysts were treated with RTA at 150 W,80℃,7 min.Temperature was monitored inside and outside the cyst.A second needle was placed inside the cyst for pressure stabilization.After treatment,all cysts were sectioned and examined by histology.Cysts were defined as alive if a preserved germinal layer at histology was evident,and as successfully treated if the germinal layer was necrotic.RESULTS:The subjects of the study were 17 cysts (nine hepatic and eight pulmonary),who were treated with RTA.Pathology showed 100% success rate in both hepatic (9/9) and lung cysts (8/8);immediate volume reduction of at least 65%;layer of host tissue necrosis outside the cyst,with average extension of 0.64 cm for liver and 1.57 cm for lung;and endocyst attached to the pericystium both in hepatic and lung cysts with small and focal de novo endocyst detachment in just 3/9 hepatic cysts.CONCLUSION:RTA appears to be very effective in killing hydatid cysts of explanted liver and lung.Bile duct and bronchial wall necrosis,persistence of endocyst attached to pericystium,should help avoid or greatly decrease in vivo post-treatment fistula occurrence and consequent overlapping complications that are common after surgery or percutaneous aspiration,injection and reaspiration.In vivo studies are required to confirm and validate this new therapeutic approach. | Vincenzo Lamonaca Antonino Virga Marta Ida Minervini Roberta Di Stefano Alessio Provenzani Pietro Tagliareni Giovanna Fleres Angelo Luca Giovanni Vizzini Ugo Palazzo Bruno Gridelli | 2009 | World Journal of Gastroenterology2009，15，26： | 6 |
| 12 | Liver transplantation for polycystic liver and massive hepatomegaly显示文摘Liver tumor and other benign liver diseases such as polycystic liver disease can cause massive hepatomegaly and may represent an indication for liver transplantation(LT)in some instances.In this setting,LT can be extremely difficult and challenging due to its decreased mobility and access to vascular supply.Benefit from either a right or a left partial liver resection during the transplant procedure has been advocated to safely accomplish the hepatectomy of the native liver.Although we believe that partial hepatectomy adds some risk to intra-operative bleeding,we alternatively advise a different approach.We have a successful experience with LT in 6 massive hepatomegaly patients due to giant liver lesions.All the transplant procedures were performed without intermediate partial liver resection,showing that selective use of veno-venous bypass can play a significant role in the treatment of massive hepatomegaly. | Salvatore Gruttadauria Fabrizio di Francesco Bruno Gridelli | 2010 | World Journal of Gastroenterology2010，16，11： | 4 |
| 13 | Huge extrahepatic portal vein aneurysm as a late complication of liver transplantation显示文摘A 60-year-old male underwent orthotopic liver trans- plantation because of hepatitis C virus related cirrhosis. After 12 d,the patient underwent re-transplantation due to primary graft non function.One year later the patient developed a thrombosis of the main portal vein needing a surgical revision.After 11 years the patient was operated on because of a clinical picture of intestinal occlusion.As an incidental finding,a large aneurysm of the main portal vein was diagnosed.The incidence of intra-and extrahepatic Portal vein aneurysms(PVAs) is not clear.To the best of our knowledge,only one case of intrahepatic PVA in a liver transplant has been reported in the literature.In addition,we have found no documented cases of extrahepatic PVAs in liver transplanted patients. | Fabrizio di Francesco Salvatore Gruttadauria Settimo Caruso Bruno Gridelli | 2010 | World Journal of Hepatology2010，2，5： | 3 |
| 14 | Early graft dysfunction following adult-to-adult livingrelated liver transplantation:Predictive factors and outcomes显示文摘AIM:To describe a condition that we define as early graft dysfunction(EGD)which can be identified preoperatively. METHODS:Small-for-size graft dysfunction following living-related liver transplantation(LRLT)is characterized by EGD when the graft-to-recipient body weight ratio(GRBWR)is below 0.8%.However, patients transplanted with GRBWR above 0.8%can develop dysfunction of the graft.In 73 recipients of LRLT(GRBWR>0.8%),we identified 10 patients who developed EGD.The main measures of outcomes analyzed were overall mortality,number of re-transplants and length of stay in days(LOS).Furthermore we analyzed other clinical pre-transplant variables,intraoperative parameters and post transplant data.RESULTS:A trend in favor of the non-EGD group(3-mo actuarial survival 98%vs 88%,P=0.09;3-mo graft mortality 4.7%vs 20%,P=0.07)was observed as well as shorter LOS(13 d vs 41.5 d;P=0.001)and smaller requirement of peri-operative Units of Plasma (4 vs 14;P=0.036).Univariate analysis of pre- transplant variables identified platelet count,serum bilirubin,INR and Meld-Na score as predictors of EGD. In the multivariate analysis transplant Meld-Na score (P=0.025,OR:1.175)and pretransplant platelet count(P=0.043,OR:0.956)were independently associated with EGD. CONCLUSION:EGD can be identified preoperatively and is associated with increased morbidity after LRLT. A prompt recognition of EGD can trigger a timely treatment. | Salvatore Gruttadauria Fabrizio di Francesco Giovanni Battista Vizzini Angelo Luca Marco Spada Davide Cintorino Sergio Li Petri Giada Pietrosi Duilio Pagano Bruno Gridelli | 2009 | World Journal of Gastroenterology2009，15，36： | 2 |
| 15 | Chemotherapy-induced neutropenia and treatment efficacy in advanced non-small-cell lung cancer: a pooled analysis of three randomised trials显示文摘 | Massimo Di Maio Cesare Gridelli Ciro Gallo Frances Shepherd Franco Vito Piantedosi Silvio Cigolari Luigi Manzione Alfonso Illiano Santi Barbera Sergio Federico Robbiati Luciano Frontini Elena Piazza Giovanni Pietro Ianniello Enzo Veltri Federico Castiglio | 2005 | Lancet Oncology2005，，9： | 2 |
| 16 | Liver regeneration after liver resection: Clinical aspects and correlation with infective complications显示文摘AIM:To investigate whether early liver regeneration after resection in patients with hepatic tumors might be influenced by post-operative infective complications.METHODS:A retrospective analysis of 27 liver resections for tumors performed in a single referral center from November 2004 to January 2010.Regeneration was evaluated by multidetector computed tomographyat a mean follow-up of 43.85 d.The Clavien-Dindo classification was used to evaluate postoperative events in the first 6 mo after transplantation,and Centers for Disease Control and Prevention definitions were used for healthcare associated infections data.Generalized linear regression models with Gaussian family distribution and log link function were used to reveal the principal promoters of early liver regeneration.RESULTS:Ten of the 27 patients(37%)underwent chemotherapy prior to surgery,with a statistically significant prevalence of patients with metastasis(P=0.007).Eight patients(30%)underwent embolization,3 with primary tumors,and 5 with secondary tumors.Twenty patients(74%)experienced complications,with 12(60%)experiencing Clavien-Dindo Grade 3a to 5 complications.Regeneration≥100%occurred in 10(37%)patients.The predictors were smaller future remnant liver volume(-0.002;P<0.001),and a greater spleen volume/future remnant liver volume ratio(0.499;P=0.01).Patients with a resection of≥5 Couinaud segments experienced greater early regeneration(P=0.04).Nine patients experienced surgical site infections,and in 7 cases Clavien-Dindo Grade 3a to 4 complications were detected(P=0.016).There were no significant differences between patients with primary or secondary tumors,and either onset or infections or severity of surgical complications.CONCLUSION:Regardless of the onset of infective complications,future remnant liver and spleen volumes may be reliable predictors of early liver regeneration after hepatic resection on an otherwise healthy liver. | Duilio Pagano Marco Spada Vishal Parikh Fabio Tuzzolino Davide Cintorino Luigi Maruzzelli Giovanni Vizzini Angelo Luca Alessandra Mularoni Paolo Grossi Bruno Gridelli Salvatore Gruttadauria | 2014 | World Journal of Gastroenterology2014，20，22： | 2 |
| 17 | A case of biliary stones and anastomotic biliary stricture after liver transplant treated with the rendez-vous technique and electrokinetic lithotritor显示文摘The paper studies the combined radiologic and endoscopic approach (rendez vous technique) to the treatment of the biliary complications following liver transplant. The 'rendez-vous' technique was used with an electrokinetic lithotripter, in the treatment of a biliary anastomotic stricture with multiple biliary stones in a patient who underwent orthotopic liver transplant. In this patient, endoscopic or percutaneous transhepatic management of the biliary complication failed. The combined approach, percutaneous transhepatic and endoscopic treatment (rendez-vous technique) with the use of an electrokinetic lithotritor, was used to solve the biliary stenosis and to remove the stones. Technical success, defined as disappearance of the biliary stenosis and stone removal, was obtained in just one session, which definitively solved the complications. The combined approach of percutaneous transhepatic and endoscopic (rendez-vous technique) treatment, in association with an electrokinetic lithotritor, is a safe and feasible alternative treatment, especially after the failure of endoscopic and/or percutaneous trans-hepatic isolated procedures. | Marta Di Pisa Mario Traina Roberto Miraglia Luigi Maruzzelli Riccardo Volpes Salvatore Piazza Angelo Luca Bruno Gridelli | 2008 | World Journal of Gastroenterology2008，14，18： | 2 |
| 18 | Right hepatic lobe living donation: A 12 years single Italian center experience显示文摘Mini invasive techniques are taking over conventional open liver resections in the setting of left lateral segmentectomy for living liver donation,and hydride procedure are being implemented for the living related right hepatectomy.Our center routinely performs laparoscopic left lateral segmentectomy for pediatric recipient and has been the first in the Europe performing an entirely robotic right hepatectomy.Great emphasis is posed on living donor safety which is the first priority during the entire operation,then the most majority of our procedures are still conventional open right hepatectomy(RHLD),defined as removal of a portion of liver corresponding to Couinaud segments 5-8,in order to obtain a graft for adult to adult living related liver transplant.During this 10 years period some changes,herein highlighted,have occurred to our surgical techniques.This study reports the largest Italian experience with RHLD,focused on surgical technique evolution over a 10 years period.Donor safety must be the first priority in right-lobe living-related donation:the categorization of complications of living donors,specially,after this'highly sensitive'procedure,reflects the need for prompt and detailed reports. | Salvatore Gruttadauria Duilio Pagano Davide Cintorino Antonio Arcadipane Mario Traina Riccardo Volpes Angelo Luca Giovanni Vizzini Bruno Gridelli Marco Spada | 2013 | World Journal of Gastroenterology2013，19，38： | 2 |
| 19 | Gefitinib as first-line treatment for patients with advanced non-small-cell lung cancer with activating epidermal growth factor receptor mutation: Review of the evidence显示文摘 | C. Gridelli F. De Marinis M. Di Maio D. Cortinovis F. Cappuzzo T. Mok | 2010 | Lung Cancer2010，，3： | 2 |
| 20 | Activity and toxicity of gemcitabine and gemcitabine+vinorelbine in advanced non-small-cell lung cancer elderly patients phase Ⅱ data from the muhicenter Italian lung cancer in the elderly study (MILES) randomized trial显示文摘 | Gridelli C Cigolari S Gallo C | 2001 | Lung Cancer2001，31，23： | 1 |
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