G L Grazi

..To review a single-center experience to update the performance indexes of liver resection (LR)...

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..The Internet has led to widespread Web consulting, the proportions of which are not yet known; there is not yet agreement on its management...

..Elderly donors are half of the grafts available in our center for liver transplantation. We retrospectively investigated their characteristics, outcomes, and variables related to graft failure...

..For these situations, a consultation should always be performed by a surgeon experienced in hepatic surgery...

..Great attention should be paid to the pathological conditions of arterial vessels caused by atherosclerosis, i.e. the presence of calcified plaques on the hepatic artery, which might represent the source of severe complications...

..Induction therapy has enabled improvement in graft and patient survival rates...

..We report our experience with intestinal and multivisceral transplantation in Italy...

..The use of the Model for End-stage Liver Disease (MELD) score to prioritize patients on liver waiting lists and to share organs among centers was effective according to US data, but few reports are available in Europe...

..Intestinal transplant surgery is thought to rescue patients in whom complications of total parenteral nutrition (TPN) develop...

..We focused on Sirolimus (Rapamycin) to examine effects on rejection and graft survival following intestinal transplantation...

..Induction therapy has been recently adopted for intestinal transplant...

..73%, p = NS) and disease-free (48% vs. 71%, p = NS) survival rates were obtained for SLT and primary LT for HCC, respectively. LR is a valid treatment for small HCC and in the event of recurrence, SLT is a safe and effective procedure...

..All patients were adults of median age at transplant of 34.7 years and mean weight 59.6 kg. All recipients were on total parenteral nutrition for a mean time of 38.8 months. Mean donor/recipient body weight ratio was 1.1...

..We sought to evaluate liver function recovery after isolated intestinal transplantation in adults with irreversible intestinal failure...

..4% vs. 14.9%, p = n.s.) as was the 1-year patient survival on the list (83% vs. 84%, p = n.s.). The Meld allocation system improved the outcome of patients with or without HCC on the list...

..We evaluated the impact of steroids on survival and post-transplant complications in our experience...

..The actuarial intention-to-treat survival was 27/48 patients (56.3%) in the down-staging and 81/129 cases (62.8%) in the Milan group, p = n.s. The proposed down-staging criteria provide a comparable outcome to the conventional criteria...

..To compare the prognostic efficacy of the 5th and 6th edition of the TNM staging system for HCC...

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..In conclusion, SRL was an effective immunosuppressant even when used in a CNI-sparing regimen. It was beneficial for patients with recently developed renal dysfunction or neurological disorders...

..An increased proportion of HCC candidates and/or an increased median time-to-transplant could lead to a benefit for waiting-list patients that outweighs this harm...

..Mild and moderate vascular alterations in intestinal biopsies after isolated small bowel transplantation (SBT) have uncertain clinical significance...

..The aim of this study was to evaluate the role of surgery in the treatment of non-colorectal, non-neuroendocrine (NCRNNE) liver metastases...

..Quality of life and psychological well-being can be seen as important outcome measures of transplantation surgery...

..We retrospectively reviewed our experience in combined liver-kidney (L-KT) and heart-kidney (H-KT) transplantations...

..Recurrence of hepatitis C after liver transplantation is almost constant and may lead to graft loss. The results of treatment with interferon and/or other agents have been controversial...

..The few reports that deal with isolated resection of section 8 generally describe the use of a deep wedge transparenchymal transection...

..The result suggested that assessment of coping strategies should be explored in intestinal transplant to encourage the use of action-oriented methods and discourage those with possible negative effects...

..Cases with primary graft nonfunction displayed lower survival, because of their compromised clinical status as evidenced by their high MELD scores...

..The impact of the latter on long-term survival in both our groups outlines the importance of surgical technique on the results of hepatectomies...

..In conclusion, for a patient with HCC and portal vein thrombosis, appropriate investigations can establish whether the thrombosis is benign; patients with HCC and benign portal vein thrombosis are candidates for liver transplantation...

..Delaware, Flagstaff, AZ) with an excellent outcome 3 years after the transplant. The prosthesis was necessary because of the impossibility of using the donor iliac arterial grafts due to the presence of widespread atherosclerotic damage...

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..At a 2-year mean follow-up, deaths occurred only in the transplant population. Therefore, intestinal surgical rescue, if successful, is optimal in adult patients...

..However, the most compromised patients are more likely to display intraoperative risks, postoperative complications, and worsening of extracardiac, extrahepatic symptoms...

..However, the overall efficacy of this approach will be established only in some years...

..Treatment of hepatitis C virus (HCV) recurrence after liver transplantation (LT) is difficult with low response rates...

..This condition can be successfully treated with early diagnosis and a combination of aggressive surgery and antifungal therapy...

..46; P =.013). Even closer correlations were found with vagal score. AD (mainly VD) may be involved in the pathogenesis of the hyperdynamic circulatory syndrome of patients with advanced cirrhosis...

..The last patient had mesh as a bridge for a subsequent myocutaneous flap from the thigh. All patients are in good health with well-functioning grafts and no need for parenteral nutrition. No enterocutaneous fistulae were detected...

..In cases such as ours with extensive fibrosis and inflamed tissue mimicking cholangiocarcinoma or gallbladder carcinoma, a wide hepaticojejunostomy is required to establish adequate biliary drainage...

..We report the elevation of serum XOR during the three weeks following LT for the first time, as well as the influence of the graft reperfusion technique on XOR serum levels...

..These findings establish a basis toward the development of therapeutic strategies aimed at blocking miR-221 in HCC...

..Patients with Arg47 or other aggressive TTR amyloidoses should be considered high priority patients for orthotopic liver transplantation...

..They are often the result of Epstein-Barr virus (EBV)-induced proliferation of B-lymphocytes in the setting of immunosuppression...

..Bile duct strictures may be malignant or benign. In the absence of previous biliary surgery a precise preoperative diagnosis is often difficult, in particular when a tumor mass is absent in the preoperative radiologic findings...

..The incidence of adverse events is comparable except for a significantly higher incidence of diabetes mellitus and diarrhea in the tacrolimus group. Both agents are effective primary immunosuppressants in liver transplant recipients...

..This model allows the timely transplantation of patients with HCC without severely affecting the outcome of patients without HCC...

..To examine modifications of acid-base balance of cirrhotic patients undergoing hepatectomy for hepatocellular carcinoma (HCC)...

..The use of the Model for End-Stage Liver Disease (MELD) score to prioritize patients on liver waiting lists must take the bias of different laboratories into account...

..A case of long-term survival after two-stage hepatectomy for colorectal metastases is reported. Considerations on technical aspects, interval between the two liver resections, role of adjuvant chemotherapy and indications are discussed...

..In conclusion, the efficacy of tumor selection criteria must be analyzed with the use of preoperative data, to avoid bias of the postoperative evaluation. Tumor volume and alfa-fetoprotein level may improve the selection of patients...

..Hepatitis C virus (HCV) recurrence in HCV+ liver transplant recipients is almost inevitable and may be promoted by immunosuppression. We compared the amount of liver damage with regard to usage of steroids and basiliximab...

..When access to liver transplantation is limited, this benefit is restricted to patients with a good cirrhosis-related prognosis...

..04; group 2 versus group 3, P = 0.03). In conclusion, older donor grafts managed with routine graft biopsy and short ischemia time may work effectively, regardless of the severity of the recipient's liver disease...

..The percentage of oxidase activity seems to be correlated with tissue damage and consequent liver impairment. The low XOR activity observed in HCC is consistent with reported experimental pathology...

..HCV-positive patients with AST levels above 2N have the highest risk for intrahepatic recurrence and should be monitored carefully or offered alternative treatments...

..However, the most compromised patients are more exposed to intraoperative risks, postoperative complications, and worsening of extracardiac and extrahepatic symptoms. The need for VVB remains to be evaluated...

..We assessed the effect of tacrolimus on recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) and compared it with that of the other calcineurin inhibitor, cyclosporine...

..A preoperative MEGX value lower than 25 ng/dL in cirrhotic patients was related to a significantly higher risk of liver insufficiency and postoperative complications after hepatic resection...

..Long-term patient and graft survival seem to be achievable, but the high rate and rapidity of HCV reinfection remain a major concern for HCV(+) patients...

..A careful evaluation of node status is nevertheless advisable also in patients with hepatocellular carcinoma on cirrhosis...

..The purpose of this study is to select the best candidates for liver transplantation considering several prognostic factors that are related to tumor characteristics...

..Evaluation of the short- and long-term outcome of liver resections for HCC in cirrhotic patients...

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..In this cohort of patients, the use of sirolimus appeared safe and provided an adequate prophylaxis against rejection, even though the drug was administered in the immediate postoperative period after LT...

..The similar incidence of arterial complications among patients receiving LLS or ERG suggests that maintenance of the celiac trunk with LLS is not detrimental for right-sided grafts...

..CONCLUSION: By allocating donors >60 years mainly to HCC patients, we controlled dropout without affecting their survival and the outcome of non-HCC patients...

..In conclusion, high Hcy may be involved in the pathogenesis of cardiovascular events in OLT patients. The usefulness of Hcy-lowering therapy remains to be verified...

..CONCLUSION: Partial necrosis was a risk factor for tumor recurrence after liver transplantation. Patients and procedures should be selected while also bearing in mind the side-effect of incomplete necrosis of the nodules...

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..More patients required antidiabetic therapy with tacrolimus regardless of diabetic status at baseline...

..Nevertheless, a better understanding of the clinical situations and changes in treatment strategies have led to significant improvements in terms of graft and patient survival rates, now close to the survival rate of EAGF-free patients...

..007), undifferentiation (P=0.003) and high alpha-fetoprotein levels (P=0.011). CONCLUSIONS: DT is easy to estimate and indicates the prognosis of single HCCs prior to liver resection...

..The maintenance of the celiac trunk with LLS does not seem detrimental for right-sided grafts, whereas the use of interposition grafts for arterial reconstruction should be avoided...

..53). CONCLUSION: Being older than 70 years should not be a contraindication for major hepatectomies, provided that liver cirrhosis and severe associated medical conditions are ruled out during the preoperative evaluation...

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..1%). In conclusion, the MELD score can accurately predict postoperative liver failure and morbidity of cirrhotic patients referred for resection of HCC and should be used to select the best candidates for hepatectomy...

..007; IPC-, P = 0.003). Prereperfusion and postreperfusion apoptosis was minimal in both groups. In conclusion, IPC reduced ischemia/reperfusion injury through a decrease of hepatocellular necrosis, but it showed no clinical benefits...

..GADD45-alpha protein levels were higher in HCCs with DNA-bound CDKN1A and PCNA, suggesting a possible role in DNA repair...

..Nevertheless, attention and surgical refinement can lead to a significant reduction of the biliary complication rate, improving graft and patient survival...

..The total volume of metastases, not number and location, seems to be the strongest predictor of survival...

..Complete control of tumor growth was achieved, while no alterations of graft function were observed throughout the treatment period...

..This rapid and straightforward procedure, which allows identification of a wide range of IgH rearrangements, could facilitate molecular analysis of PTLD in routine practice, while limiting consumption of valuable diagnostic material...

..CONCLUSIONS: Surgical therapy is a safe and effective management for hepatolithiasis. The possibility of developing cholangiocarcinoma in inveterate hepatolithiasis is real, and hepatic resection removes this risk...

..Outcome is quite dismal in patients with early HCV recurrence requiring retransplantation within 1 yr of first OLT...

..To evaluate the role of liver resection for noncolorectal, nonneuroendocrine metastases, indications and results were retrospectively reviewed in 142 observed patients...

..Engraftment by R epithelial cells seems to be less important than previously reported...

..We assessed the usefulness of immunotherapy with tumor infiltrating lymphocytes (TIL) plus Interleukin-2 (IL-2) as adjuvant treatment...

..These results indicate that cyclin G1 is a target of miR-122a and expand our knowledge of the molecular alterations involved in HCC pathogenesis and of the role of miRNAs in human cancer...

..There were no hemorrhagic complications associated with the use of aspirin. In conclusion,antiplatelet prophylaxis can effectively reduce the incidence of late HAT after LT, particularly in those patients at risk for this complication...

..Notch signalling is altered in several solid tumours and it plays a role in growth inhibition and apoptosis of hepatocellular carcinoma (HCC)-derived cell lines, bile duct development and hepatocyte regeneration...