Liver hypertrophy techniques: a position paper from the Italian Group of Regenerative and Occlusive Worldwide-used techniques of hepatic Hypertrophy (I GROWtoH).

In candidates for hepatectomy, different techniques to induce liver hypertrophy and modulate the future liver remnant are available. However, their use in specific clinical scenarios is highly heterogeneous and there is no consensus about minimal safety standards needed to incorporate these strategies into routine clinical practice. The aim of this position paper was to summarize newly available evidence in the field and compare medical practice among different hepatobiliary surgical units to evaluate the transformative potential of liver hypertrophy techniques in surgical oncology.

Life Expectancy of Transplanted Livers - HOPE Against Aging?

Objective: To investigate the impact of cumulative liver age on graft survival in liver transplant recipients.

Summary Of Background Data: Organ shortage has led to increased use of elderly donor livers for an ageing group of recipients, particularly in Europe. We hypothesized that hypothermic oxygenated perfusion (HOPE) enhances graft resilience against aging in livers from elderly donors.

HHV8-related diseases in solid organ transplantation: a case series and systematic literature review.

Background: The true burden of HHV-8 in solid organ transplant (SOT) setting remains difficult to quantify and there are several uncertainties about the best prevention and management of HHV-8 related complications.

Objectives: To describe epidemiology and impact on outcome of HHV-8 related diseases in patients undergoing SOT, we reviewed all episodes diagnosed at our hospital over 8-year period and performed a narrative systematic literature review.

Sources: A search on PubMed, Scopus and Cochrane Library, according to Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, was done.

Liver Transplantation for Colorectal Metastases: Impact of a Standardised Protocol for Patient Selection on Transplant Outcomes.

Colorectal liver metastases (CRLM) occur in up to 50% of colorectal cancer with a significant impact on patient survival, of whom only 20-30% will be considered suitable for surgical treatment. Despite the progress in systemic therapies, palliative chemotherapy alone results in a 5-year overall survival (OS) < 10%. Recently, liver transplantation (LT) has been reconsidered as an option and demonstrates improved survival in highly selected patients.

Impact of intraoperative goal-directed therapy on perioperative outcomes in kidney transplantation: a multicenter randomized controlled trial.

Appropriate fluid management is crucial in anesthesiologic management during kidney transplantation (KT). Traditional parameters such as blood pressure and central venous pressure are unreliable and weakly supported by guidelines. Goal-directed fluid therapy (GDT) has emerged as a technique for administering fluids and vasoactive drugs based on algorithms to ensure adequate tissue perfusion.

Risk Factors of Acute Rejection: Impact on Graft Outcomes in a Cohort of Kidney Transplant Recipients.

: Acute rejection (AR) in kidney transplant (KT) recipients remains a significant challenge for short- and long-term graft survival even in the most recent years characterized by extended criteria donors and older and more comorbid recipients. : We analyzed risk factors and outcomes of AR in 339 KT recipients treated at St. Orsola-Malpighi Hospital, Bologna (Italy), between 1 January 2019 and 31 December 2021.

The Italian Score for Organ Allocation: A Ten-Year Monocentric Retrospective Analysis in Liver Transplantation for Hepatocellular Carcinoma.

Background: The Italian Score for Organ Allocation (ISO), a transplant benefit oriented allocation system, was introduced in Italy in 2016. The main objective of this study is to identify risk factors for Drop-Out in hepatocellular (HCC) patients enlisted for LT before (Pre-ISO Era) and after ISO (ISO Era) introduction, while the secondary objective is to evaluate the survival results.

Methods: CIFs for liver transplantation and Drop-Out were estimated and compared between eras.

MiR-22/GLUT1 Axis Induces Metabolic Reprogramming and Sorafenib Resistance in Hepatocellular Carcinoma.

The approval of immunotherapy has revolutionized the management of hepatocellular carcinoma (HCC) patients. However, sorafenib remains a first-line therapeutic option for advanced patients and, in particular, for patients not eligible for immune checkpoint inhibitors, but its efficacy is limited by the onset of acquired resistance, highlighting the urgent need for predictive biomarkers. This study investigates the role of miR-22 in metabolic reprogramming and its potential as a biomarker in HCC.

Hypothermic Oxygenated Perfusion in Extended Criteria Donor Kidney Transplantation-A Randomized Clinical Trial.

Background: The role of machine perfusion after kidney transplantation (KT) in extended criteria donors (ECD) is unclear, and the current evidence in the literature remains controversial.

Methods: We present an open-label single center randomized trial where 109 patients undergoing KT with ECD grafts between January 2019 and December 2022 were randomized to receive kidneys treated with either hypothermic oxygenated perfusion (HOPE, n = 54) or static cold storage (SCS, n = 55) alone. The primary endpoint was the incidence of delayed graft function (DGF).

Exploring parvovirus B19 pathogenesis and therapy among kidney transplant recipients: case report and review of literature.

We report the case of a 34-year-old male recipient of an ABO-incompatible living donor kidney transplant who was repeatedly hospitalised for anaemia. Acute kidney injury in a patient with severe and recurrent anaemia related to parvovirus B19 infection was diagnosed through viral and histopathological analysis. In view of the patient's impaired immune response due to the immunosuppressive regimen, clinical stabilisation was reached by repeated intravenous immunoglobulin administration as a maintenance therapy in a prolonged course, although viral clearance did not occur.

Risk factors for IgA nephropathy recurrence and impact on graft survival in a cohort of kidney transplanted patients.

Recurrence of IgA nephropathy (IgAN) after kidney transplant (KT) appears associated with worse graft survival; thus, the identification of risk factors is worthwhile to improve pre-transplant evaluation of KT recipients and to identify the optimal treatment strategy. The aim of this study was to determine incidence, risk factors and impact on renal function and graft survival of IgAN recurrence after KT. We performed a retrospective study including 110 patients with biopsy-proven IgAN, who underwent KT at Policlinico di Sant'Orsola Hospital - University of Bologna from 2005 to 2021.

A cross-sectional study on the prevalence of eating disorders in liver transplanted patients with type 2 diabetes and/or overweight/obesity.

Liver transplantation (LT) associates with weight gain and metabolic complications. However, risk of eating disorders post-transplantation and factors influencing their onset remain poorly understood. This study aimed to fill this knowledge gap by characterizing the risk of having eating disorders or Orthorexia Nervosa (ON) according to the EAT-26, BES and Bratman screening questionnaires in 104 liver transplant recipients (mean age 62.

High bone fracture risk in a large modern cohort of liver transplant recipients.

Liver transplantation (LT) has historically been associated with a high prevalence of osteoporosis, but most of the available data date back to late 1990s-early 2000s with limited sample size. Our aim was to assess the prevalence of bone fragility fractures and contributing factors in a large modern cohort of liver transplant recipients. Retrospective study of 429 consecutive patients receiving liver transplantation from 1/1/2010 to 31/12/2015.

Porto-sinusoidal vascular disorder in surgical candidates for liver metastases: Prevalence, noninvasive diagnosis, and burden on surgical outcomes.

Chemotherapy can cause vascular and metabolic liver injury in patients with liver metastases, but scarce data are available. We aimed to (i) describe the prevalence of porto-sinusoidal vascular disorder (PSVD) among patients undergoing resection for liver metastases; and (ii) assess whether liver (LSM) and spleen stiffness measurements could diagnose PSVD and predict postoperative complications. This is a prospective single-center study enrolling consecutive patients undergoing hepatic resection for metastases at a tertiary center.

Are there any benefits of prolonged hypothermic oxygenated perfusion?: Results from a national retrospective study.

Dual hypothermic oxygenated perfusion (DHOPE) is increasingly being used to extend liver preservation to improve transplant logistics. However, little is known about its benefits in high-risk liver grafts. This study aimed to investigate whether prolonged DHOPE provides benefits other than improved logistics in all liver types.

"Eculizumab First" in the Management of Posttransplant Thrombotic Microangiopathy.

Introduction: Posttransplant thrombotic microangiopathy (PT-TMA) is an uncommon event that characterizes approximately 3% to 14% of kidney transplants (KTs), and that is associated with a higher risk of delayed graft function and graft loss. PT-TMA occurs more frequently within the first 3 months after transplant and can be a manifestation of disease or the recurrence of previous atypical hemolytic uremic syndrome (aHUS). Abnormalities in complement regulation genes could explain the increased susceptibility of some patients to PT-TMA.

Beyond histology: A tissue algorithm predictive of post-surgical recurrence in hepatocellular carcinomas, including TERT promoter mutation.

Surgical resection for hepatocellular carcinoma (HCC) is burdened with a high recurrence rate and a lack of reliable prognostic factors. The aim of this study was to integrate the HCC pathological features with gene mutations to improve the prognostic role of pathological analysis. This is a monocentric prospective study, including 67 patients resected for HCC.

Recipient hepatectomy technique may affect oncological outcomes of liver transplantation for hepatocellular carcinoma.

To date, caval sparing (CS) and total caval replacement (TCR) for recipient hepatectomy in liver transplantation (LT) have been compared only in terms of surgical morbidity. Nonetheless, the CS technique is inherently associated with an increased manipulation of the native liver and later exclusion of the venous outflow, which may increase the risk of intraoperative shedding of tumor cells when LT is performed for HCC. A multicenter, retrospective study was performed to assess the impact of recipient hepatectomy (CS vs.

Gut microbiome dynamics and Enterobacterales infection in liver transplant recipients: A prospective observational study.

Background & Aims: The aim of this study was to investigate gut microbiome (GM) dynamics in relation to carbapenem-resistant Enterobacterales (CRE) colonization, CRE infection, and non-CRE infection development within 2 months after liver transplant (LT).

Methods: A single-center, prospective study was performed in patients undergoing LT from November 2018 to January 2020. The GM was profiled through 16S rRNA amplicon sequencing of a rectal swab taken on the day of transplantation, and fecal samples were collected weekly until 1 month after LT.