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Gondolesi GE, Rumbo C, Montes L, Novellis L, Ramisch D, Henríquez AR, Ortega M, Viano F, Schiano T, Descalzi V, Tiribelli C, Oltean M, Barros-Schelotto P, Solar H. Pathophysiology of ascites: The importance of the intestine. A surgical contribution to the understanding of a medical problem. Ann Hepatol 2024; 29:101498. [PMID: 38479458 DOI: 10.1016/j.aohep.2024.101498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 03/03/2024] [Indexed: 03/21/2024]
Abstract
The understanding of the mechanisms for the development of ascites has evolved over the years, involving the liver, peritoneum, heart, and kidneys as key responsible for its formation. In this article, we review the pathophysiology of ascites formation, introducing the role of the intestine as a major responsible for ascites production through "a game changer" case.
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Affiliation(s)
- Gabriel E Gondolesi
- General Surgery, Liver-pancreas and Intestinal transplantation. Hospital Universitario Fundación Favaloro. IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina.
| | - Carolina Rumbo
- General Surgery, Liver-pancreas and Intestinal transplantation. Hospital Universitario Fundación Favaloro. IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Leonardo Montes
- General Surgery, Liver-pancreas and Intestinal transplantation. Hospital Universitario Fundación Favaloro. IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Lucia Novellis
- General Surgery, Liver-pancreas and Intestinal transplantation. Hospital Universitario Fundación Favaloro. IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Diego Ramisch
- General Surgery, Liver-pancreas and Intestinal transplantation. Hospital Universitario Fundación Favaloro. IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Ariel Riquelme Henríquez
- General Surgery, Liver-pancreas and Intestinal transplantation. Hospital Universitario Fundación Favaloro. IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Mariana Ortega
- General Surgery, Liver-pancreas and Intestinal transplantation. Hospital Universitario Fundación Favaloro. IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Federico Viano
- Internal Medicine. Metabolic and Nutritional Support Unit. Sanatorio Allende, Córdoba, Argentina
| | - Thomas Schiano
- Recanati Miller Transplantation Institute Mount Sinai School of Medicine, New York, United States of America
| | - Valeria Descalzi
- General Surgery, Liver-pancreas and Intestinal transplantation. Hospital Universitario Fundación Favaloro. IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | | | - Mihai Oltean
- The Transplant Institute. Sahlgrenska University Hospital, Gothenburg 413 45, Sweden
| | - Pablo Barros-Schelotto
- General Surgery, Liver-pancreas and Intestinal transplantation. Hospital Universitario Fundación Favaloro. IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina
| | - Héctor Solar
- General Surgery, Liver-pancreas and Intestinal transplantation. Hospital Universitario Fundación Favaloro. IMeTTyB, Universidad Favaloro-CONICET, Buenos Aires, Argentina
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Mendizabal M, Thompson M, Gonzalez-Ballerga E, Anders M, Castro-Narro GE, Pessoa MG, Cheinquer H, Mezzano G, Palazzo A, Ridruejo E, Descalzi V, Velarde-Ruiz Velasco JA, Marciano S, Muñoz L, Schinoni MI, Poniachik J, Perazzo R, Cerda E, Fuster F, Varon A, Ruiz García S, Soza A, Cabrera C, Gomez-Aldana AJ, Beltrán FDM, Gerona S, Cocozzella D, Bessone F, Hernández N, Alonso C, Ferreiro M, Antinucci F, Torre A, Moutinho BD, Coelho Borges S, Gomez F, Murga MD, Piñero F, Sotera GF, Ocampo JA, Cortés Mollinedo VA, Simian D, Silva MO. Implementation of a re-linkage to care strategy in patients with chronic hepatitis C who were lost to follow-up in Latin America. J Viral Hepat 2023; 30:56-63. [PMID: 36197907 DOI: 10.1111/jvh.13758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/25/2022] [Accepted: 10/02/2022] [Indexed: 12/09/2022]
Abstract
To achieve WHO's goal of eliminating hepatitis C virus (HCV), innovative strategies must be designed to diagnose and treat more patients. Therefore, we aimed to describe an implementation strategy to identify patients with HCV who were lost to follow-up (LTFU) and offer them re-linkage to HCV care. We conducted an implementation study utilizing a strategy to contact patients with HCV who were not under regular follow-up in 13 countries from Latin America. Patients with HCV were identified by the international classification of diseases (ICD-9/10) or equivalent. Medical records were then reviewed to confirm the diagnosis of chronic HCV infection defined by anti-HCV+ and detectable HCV-RNA. Identified patients who were not under follow-up by a liver specialist were contacted by telephone or email, and offered a medical reevaluation. A total of 10,364 patients were classified to have HCV. After reviewing their medical charts, 1349 (13%) had undetectable HCV-RNA or were wrongly coded. Overall, 9015 (86.9%) individuals were identified with chronic HCV infection. A total of 5096 (56.5%) patients were under routine HCV care and 3919 (43.5%) had been LTFU. We were able to contact 1617 (41.3%) of the 3919 patients who were LTFU at the primary medical institution, of which 427 (26.4%) were cured at a different institutions or were dead. Of the remaining patients, 906 (76.1%) were candidates for retrieval. In our cohort, about one out of four patients with chronic HCV who were LTFU were candidates to receive treatment. This strategy has the potential to be effective, accessible and significantly impacts on the HCV care cascade.
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Affiliation(s)
- Manuel Mendizabal
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Argentina
| | - Marcos Thompson
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Argentina
| | - Esteban Gonzalez-Ballerga
- Sección Hepatología, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Margarita Anders
- Unidad de Hepatología y Trasplante Hepático, Hospital Alemán, Buenos Aires, Argentina
| | - Graciela E Castro-Narro
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de Mexico, Mexico
| | - Mario G Pessoa
- Divisão de Gastroenterologia e Hepatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Hugo Cheinquer
- Departamento de Gastroenterología y Hepatología, Universidad Federal do Rio Grande do Sul e do Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Gabriel Mezzano
- Sección de Gastroenterología, Hospital El Salvador, Santiago, Chile
| | - Ana Palazzo
- Servicio de Gastroenterología, Sección de Hepatología, Hospital Padilla, Tucumán, Argentina
| | - Ezequiel Ridruejo
- Sección Hepatología, Departamento de Medicina, Centro de Educación Médica e Investigaciones Clínicas Norberto Quirno "CEMIC", Buenos Aires, Argentina
| | - Valeria Descalzi
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | | | - Sebastian Marciano
- Sección Hepatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Linda Muñoz
- Hospital Universitario "Dr. José E. González", Monterrey, Mexico
| | - Maria I Schinoni
- Núcleo de Hepatología, Hospital Universitario Prof. Edgard Santos, Universidad Federal de Bahia, Salvador, Brazil
| | - Jaime Poniachik
- Sección de Gastroenterología, Departamento de Medicina, Hospital Clínico de la Universidad de Chile, Santiago, Chile
| | - Rosalía Perazzo
- Unidad de Gastroenterología, Hospital Miguel Perez Carreño, Caracas, Venezuela
| | - Eira Cerda
- Hospital Central Militar, Escuela Militar de Graduados de Sanidad, Ciudad de México, Mexico
| | - Francisco Fuster
- Unidad de Hepatología, Hospital Gustavo Fricke, Viña del Mar, Chile
| | - Adriana Varon
- Fundación Cardioinfantil, Instituto de Cardiología, Bogotá, Colombia
| | | | - Alejandro Soza
- Departamento de Gastroenterología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cecilia Cabrera
- Unidad de Gastroenterología, Hospital Nacional Daniel A. Carrión, Callao, Peru
| | - Andres J Gomez-Aldana
- Unidad de Gastroenterología y Trasplante Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | | | - Solange Gerona
- Unidad de Hígado, Hospital de Fuerzas Armadas, Montevideo, Uruguay
| | | | - Fernando Bessone
- Departamento de Gastroenterología, Facultad de Medicina, Hospital Provincial del Centenario, University of Rosario School of Medicine, Rosario, Argentina
| | - Nelia Hernández
- Clínica de Gastroenterología, Hospital de Clínicas, Facultad de Medicina, UdelaR, Montevideo, Uruguay
| | - Cristina Alonso
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Argentina
| | - Melina Ferreiro
- Sección Hepatología, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Florencia Antinucci
- Unidad de Hepatología y Trasplante Hepático, Hospital Alemán, Buenos Aires, Argentina
| | - Aldo Torre
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de Mexico, Mexico
| | - Bruna D Moutinho
- Divisão de Gastroenterologia e Hepatologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | | | - Fernando Gomez
- Sección de Gastroenterología, Hospital El Salvador, Santiago, Chile
| | - Maria Dolores Murga
- Servicio de Gastroenterología, Sección de Hepatología, Hospital Padilla, Tucumán, Argentina
| | - Federico Piñero
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Argentina
| | - Gisela F Sotera
- Sección Hepatología, Hospital de Clínicas "José de San Martín", Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Jhonier A Ocampo
- Unidad de Hepatología y Trasplante Hepático, Hospital Alemán, Buenos Aires, Argentina
| | - Valeria A Cortés Mollinedo
- Departamento de Gastroenterología, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de Mexico, Mexico
| | - Daniela Simian
- Sección de Gastroenterología, Departamento de Medicina, Hospital Clínico de la Universidad de Chile, Santiago, Chile
| | - Marcelo O Silva
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Argentina
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Fernandez MF, Schelotto PB, Mendez G, Descalzi V, Gondolesi G. Liver Transplantation for Metastatic Neuroendocrine Tumors. EXP CLIN TRANSPLANT 2022; 20:228-230. [PMID: 35037606 DOI: 10.6002/ect.2021.0345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Maria Florencia Fernandez
- From the Unit of Hepatobiliary Surgery, General Surgery, Liver, Pancreas, and Intestinal Transplant Program, University Hospital Favaloro Foundation, Buenos Aires, Argentina
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Piñero F, Tanno M, Aballay Soteras G, Tisi Baña M, Dirchwolf M, Fassio E, Ruf A, Mengarelli S, Borzi S, Fernández N, Ridruejo E, Descalzi V, Anders M, Mazzolini G, Reggiardo V, Marciano S, Perazzo F, Spina JC, McCormack L, Maraschio M, Lagues C, Gadano A, Villamil F, Silva M, Cairo F, Ameigeiras B. Argentinian clinical practice guideline for surveillance, diagnosis, staging and treatment of hepatocellular carcinoma. Ann Hepatol 2021; 19:546-569. [PMID: 32593747 DOI: 10.1016/j.aohep.2020.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 02/08/2023]
Abstract
The A.A.E.E.H has developed this guideline for the best care of patients with hepatocellular carcinoma (HCC) from Argentina. It was done from May 2018 to March 2020. Specific clinical research questions were systematically searched. The quality of evidence and level of recommendations were organized according to GRADE. HCC surveillance is strongly recommended with abdominal ultrasound (US) every six months in the population at risk for HCC (cirrhosis, hepatitis B or hepatitis C); it is suggested to add alpha-feto protein (AFP) levels in case of inexeperienced sonographers. Imaging diagnosis in patients at risk for HCC has high specificity and tumor biopsy is not mandatory. The Barcelona Clinic Liver Cancer algorithm is strongly recommended for HCC staging and treatment-decision processes. Liver resection is strongly recommended for patients without portal hypertension and preserved liver function. Composite models are suggested for liver transplant selection criteria. Therapies for HCC with robust clinical evidence include transarterial chemoembolization (TACE) and first to second line systemic treatment options (sorafenib, lenvatinib, regorafenib, cabozantinib and ramucirumab). Immunotherapy with nivolumab and pembrolizumab has failed to show statistical benefit but the novel combination of atezolizumab plus bevacizumab has recently shown survival benefit over sorafenib in frontline.
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Affiliation(s)
- Federico Piñero
- Hepatology and Liver Unit, Hospital Universitario Austral, School of Medicine, Austral University, B1629HJ Buenos Aires, Argentina.
| | - Mario Tanno
- Hospital Centenario de Rosario, Santa Fe, Argentina
| | | | - Matías Tisi Baña
- Internal Medicine and Epidemiology Department, Hospital Universitario Austral, School of Medicine, Austral University, B1629HJ Buenos Aires, Argentina
| | | | | | - Andrés Ruf
- Hospital Privado de Rosario, Santa Fe, Argentina
| | | | - Silvia Borzi
- Instituto Rossi, La Plata, Buenos Aires, Argentina
| | | | - Ezequiel Ridruejo
- Hepatology and Liver Unit, Hospital Universitario Austral, School of Medicine, Austral University, B1629HJ Buenos Aires, Argentina; Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Ciudad de Buenos Aires, Argentina
| | | | | | - Guillermo Mazzolini
- Hepatology and Liver Unit, Hospital Universitario Austral, School of Medicine, Austral University, B1629HJ Buenos Aires, Argentina
| | | | | | | | | | | | | | - Cecilia Lagues
- Hepatology and Liver Unit, Hospital Universitario Austral, School of Medicine, Austral University, B1629HJ Buenos Aires, Argentina
| | | | | | - Marcelo Silva
- Hepatology and Liver Unit, Hospital Universitario Austral, School of Medicine, Austral University, B1629HJ Buenos Aires, Argentina
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Ridruejo E, Piñero F, Mendizabal M, Cheinquer H, Wolff FH, Anders M, Reggiardo V, Ameigeiras B, Palazzo A, Alonso C, Schinoni MI, Zuain MGV, Tanno F, Figueroa S, Santos L, Peralta M, Soza A, Vistarini C, Adrover R, Fernández N, Perez D, Hernández N, Estepo C, Bruno A, Descalzi V, Sixto M, Borzi S, Cocozzella D, Zerega A, de Araujo A, Varón A, Silva M. Decompensated cirrhosis and liver transplantation negatively impact in DAA treatment response: Real-world experience from HCV-LALREAN cohort. J Med Virol 2020; 92:3545-3555. [PMID: 32749710 DOI: 10.1002/jmv.26383] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 07/10/2020] [Accepted: 07/27/2020] [Indexed: 09/03/2023]
Abstract
INTRODUCTION Although the effectiveness of direct-acting antivirals (DAAs) for the treatment of chronic hepatitis C virus (HCV) has been reported in real-world settings, predictive factors of treatment failure are lacking. Therefore, we sought to explore the baseline predictors of treatment response to DAAs. METHODS This was a prospective multicenter cohort study from the Latin American Liver Research Educational and Awareness Network (LALREAN) including patients who received DAA treatment from May 2016 to April 2019. A multivariate logistic regression model was conducted to identify variables associated with unachieved sustained virological response (SVR), defined as treatment failure (odds ratios [OR] and 95% confidence intervals [CIs]). RESULTS From 2167 patients (55.2% with cirrhosis) who initiated DAA therapy, 89.4% completed a full-course treatment (n = 1938). Median treatment duration was 12 weeks, and 50% received ribavirin. Definitive suspension due to intolerance or other causes was observed in only 1.0% cases (n = 20). Overall non-SVR12 was 4.5% (95% CI, 3.5-5.7). There were no significant differences in treatment failure according to HCV genotypes and the degree of fibrosis. Independently associated variables with DAA failure were liver function impairment according to the Child-Pugh score B OR, 2.09 (P = .06), Child-Pugh C OR, 11.7 (P < .0001); and liver transplant (LT) recipient OR, 3.75 (P = .01). CONCLUSION In this real-life setting, higher DAA treatment failure rates were observed in patients with decompensated cirrhosis and in LT recipients. These predictive baseline factors should be addressed to individualize the appropriate time-point of DAA treatment (NCT03775798; www. CLINICALTRIALS gov).
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Affiliation(s)
- Ezequiel Ridruejo
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
- Hepatology Section, Department of Medicine, Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Ciudad de Buenos Aires, Argentina
| | - Federico Piñero
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Manuel Mendizabal
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Hugo Cheinquer
- Gastroenterology and Hepatology Division, Universidad de Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Fernando Herz Wolff
- Gastroenterology and Hepatology Division, Universidad de Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Margarita Anders
- Gastroenterology and Hepatology Division, Hospital Alemán, Ciudad de Buenos Aires, Argentina
| | - Virginia Reggiardo
- Gastroenterology and Hepatology Division, Hospital Provincial del Centenario, Rosario, Argentina
| | - Beatriz Ameigeiras
- Gastroenterology and Hepatology Division, Hospital Ramos Mejía, Ciudad de Buenos Aires, Argentina
| | - Ana Palazzo
- Gastroenterology and Hepatology Division, Hospital Padilla, Tucumán, Argentina
| | - Cristina Alonso
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - María Isabel Schinoni
- Gastroenterology and Hepatology Division, Universidade Federal do Bahia, Salvador do Bahia, Brazil
| | | | - Federico Tanno
- Gastroenterology and Hepatology Division, Hospital Provincial del Centenario, Rosario, Argentina
| | - Sebastián Figueroa
- Gastroenterology and Hepatology Division, Hospital Arturo Oñativia, Salta, Argentina
| | - Luisa Santos
- Gastroenterology and Hepatology Division, Fundación Cardioinfantil, Bogotá, Colombia
| | - Mirta Peralta
- Liver Unit, Hospital Francisco J. Muñiz, Ciudad de Buenos Aires, Argentina
| | - Alejandro Soza
- Gastroenterology and Hepatology Division, Hospital Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Cecilia Vistarini
- Gastroenterology and Hepatology Division, Hospital Ramos Mejía, Ciudad de Buenos Aires, Argentina
| | - Raúl Adrover
- Gastroenterology and Hepatology Division, Hospital San Roque, La Plata, Argentina
| | - Nora Fernández
- Gastroenterology and Hepatology Division, Hospital Británico, Ciudad de Buenos Aires, Argentina
| | - Daniela Perez
- Gastroenterology and Hepatology Division, Hospital Padilla, Tucumán, Argentina
| | - Nelia Hernández
- Gastroenterology and Hepatology Division, Hospital de Clínicas, Montevideo, Uruguay
| | - Claudio Estepo
- Gastroenterology and Hepatology Division, Hospital Cosme Argerich, Ciudad de Buenos Aires, Argentina
| | - Andres Bruno
- Gastroenterology and Hepatology Division, Hospital Cosme Argerich, Ciudad de Buenos Aires, Argentina
| | - Valeria Descalzi
- Hepatology and Liver Transplant Unit, Fundación Favaloro, Ciudad de Buenos Aires, Argentina
| | - Marcela Sixto
- Gastroenterology and Hepatology Division, Hospital José María Cullen, Santa Fe, Argentina
| | - Silvia Borzi
- Gastroenterology and Hepatology Division, Hospital Rossi, La Plata, Argentina
| | - Daniel Cocozzella
- Gastroenterology and Hepatology Division, Hospital San Roque, La Plata, Argentina
| | - Alina Zerega
- Hepatology and Liver Transplant Unit, Sanatorio Allende, Córdoba, Argentina
| | - Alexandre de Araujo
- Gastroenterology and Hepatology Division, Hospital de Clínicas de Porto Alegre, de Porto Alegre, Brazil
| | - Adriana Varón
- Liver Unit, Hospital Francisco J. Muñiz, Ciudad de Buenos Aires, Argentina
| | - Marcelo Silva
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
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Mendizabal M, Piñero F, Ridruejo E, Herz Wolff F, Anders M, Reggiardo V, Ameigeiras B, Palazzo A, Alonso C, Schinoni MI, Videla Zuain MG, Tanno F, Figueroa S, Santos L, Peralta M, Soza A, Vistarini C, Adrover R, Fernández N, Perez D, Hernández N, Estepo C, Bruno A, Descalzi V, Sixto M, Borzi S, Cocozzella D, Zerega A, de Araujo A, Varón A, Rubinstein F, Cheinquer H, Silva M. Disease Progression in Patients With Hepatitis C Virus Infection Treated With Direct-Acting Antiviral Agents. Clin Gastroenterol Hepatol 2020; 18:2554-2563.e3. [PMID: 32113892 DOI: 10.1016/j.cgh.2020.02.044] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 01/23/2020] [Accepted: 02/22/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Little is known about how a sustained virologic response (SVR) to treatment of hepatitis C virus infection with direct-acting antivirals (DAAs) affects patient mortality and development of new liver-related events. We aimed to evaluate the incidence of disease progression in patients treated with DAAs. METHODS We performed a prospective multicenter cohort study of 1760 patients who received DAA treatment at 23 hospitals in Latin America, from May 1, 2016, through November 21, 2019. We excluded patients with a history of liver decompensation, hepatocellular carcinoma (HCC), or solid-organ transplantation. Disease progression after initiation of DAA therapy included any of the following new events: liver decompensation, HCC, liver transplantation, or death. Evaluation of variables associated with the primary outcome was conducted using a time-dependent Cox proportional hazards models. RESULTS During a median follow-up period of 26.2 months (interquartile range, 15.3-37.5 mo), the overall cumulative incidence of disease progression was 4.1% (95% CI, 3.2%-5.1%), and after SVR assessment was 3.6% (95% CI, 2.7%-4.7%). Baseline variables associated with disease progression were advanced liver fibrosis (hazard ratio [HR], 3.4; 95% CI, 1.2-9.6), clinically significant portal hypertension (HR, 2.1; 95% CI, 1.2-3.8), and level of albumin less than 3.5 mg/dL (HR, 4.1; 95% CI, 2.3-7.6), adjusted for SVR achievement as a time covariable. Attaining an SVR reduced the risk of liver decompensation (HR, 0.3; 95% CI, 0.1-0.8; P = .016) and de novo HCC (HR, 0.2; 95% CI, 0.1%-0.8%; P = .02) in the overall cohort. CONCLUSIONS Treatment of hepatitis C virus infection with DAAs significantly reduces the risk of new liver-related complications and should be offered to all patients, regardless of disease stage. Clinicaltrials.gov: NCT03775798.
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Affiliation(s)
- Manuel Mendizabal
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina.
| | - Federico Piñero
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Ezequiel Ridruejo
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina; Centro de Educación Médica e Investigaciones Clínicas, CEMIC, Ciudad de Buenos Aires, Argentina
| | | | | | | | | | | | - Cristina Alonso
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | | | | | | | | | | | - Mirta Peralta
- Hospital Francisco J. Muñiz, Ciudad de Buenos Aires, Argentina
| | - Alejandro Soza
- Hospital Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | | | | | | | - Claudio Estepo
- Hospital Cosme Argerich, Ciudad de Buenos Aires, Argentina
| | - Andres Bruno
- Hospital Cosme Argerich, Ciudad de Buenos Aires, Argentina
| | | | | | | | | | | | | | - Adriana Varón
- Hospital Francisco J. Muñiz, Ciudad de Buenos Aires, Argentina
| | | | - Hugo Cheinquer
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Marcelo Silva
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
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Gonzalez-Polo V, Pucci-Molineris M, Cervera V, Gambaro S, Yantorno SE, Descalzi V, Tiribelli C, Gondolesi GE, Meier D. Group 2 innate lymphoid cells exhibit progressively higher levels of activation during worsening of liver fibrosis. Ann Hepatol 2020; 18:366-372. [PMID: 31053540 DOI: 10.1016/j.aohep.2018.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 12/16/2018] [Accepted: 12/17/2018] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The interleukin-33/interleukin-13 pathway is involved in the immunopathology of liver fibrosis and recently characterized group 2 innate lymphoid cells (ILC2) were identified as profibrotic immune cells in the liver of mouse models. Our aim was to elucidate whether ILC2 might be present in human liver tissue and whether ILC2 contribute to liver fibrosis. MATERIALS AND METHODS To identify ILC2 in liver tissue and blood, we purified mononuclear immune cells from needle biopsies, cirrhotic explant specimen, and paired peripheral blood samples. Cell suspensions were incubated with specific markers for ILC2 and analyzed by flow cytometry. The CD69 marker was included to assess the activation level of ILC2. In addition, we determined the IL-33 plasma level. RESULTS Results were correlated with the METAVIR fibrotic score of patients enrolled in this study. We detected ILC2 in a higher percentage of CD45+ cells in liver tissue than in paired peripheral blood. The number of ILC2 was significantly increased in fibrotic tissue, but only slightly increased in paired peripheral blood. A higher percentage of CD69+ ILC2 was observed in fibrotic tissue, and this increase correlates positively with aggravation of liver fibrosis measured by fibrotic METAVIR score. A higher level of plasma IL-33 was only detected in samples obtained from cirrhotic patients. CONCLUSION Our study indicates that ILC2 are present in the human liver and are activated in tissue contributing to the immunopathology of human liver fibrosis, independently of the etiology; which might be a potential new therapeutic target.
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Affiliation(s)
- Virginia Gonzalez-Polo
- Laboratorio de Investigación Traslacional e Inmunología Asociada al Trasplante, Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, BA, Argentina; Instituto de Trasplante Multiórganico, Hospital Universitario Fundación Favaloro, Buenos Aires, BA, Argentina
| | - Melisa Pucci-Molineris
- Laboratorio de Investigación Traslacional e Inmunología Asociada al Trasplante, Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, BA, Argentina; Instituto de Trasplante Multiórganico, Hospital Universitario Fundación Favaloro, Buenos Aires, BA, Argentina
| | - Victorio Cervera
- Instituto de Trasplante Multiórganico, Hospital Universitario Fundación Favaloro, Buenos Aires, BA, Argentina
| | - Sabrina Gambaro
- Laboratorio de Investigación Traslacional e Inmunología Asociada al Trasplante, Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, BA, Argentina; Instituto de Trasplante Multiórganico, Hospital Universitario Fundación Favaloro, Buenos Aires, BA, Argentina
| | - Silvina E Yantorno
- Instituto de Trasplante Multiórganico, Hospital Universitario Fundación Favaloro, Buenos Aires, BA, Argentina
| | - Valeria Descalzi
- Instituto de Trasplante Multiórganico, Hospital Universitario Fundación Favaloro, Buenos Aires, BA, Argentina
| | | | - Gabriel E Gondolesi
- Laboratorio de Investigación Traslacional e Inmunología Asociada al Trasplante, Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, BA, Argentina; Instituto de Trasplante Multiórganico, Hospital Universitario Fundación Favaloro, Buenos Aires, BA, Argentina
| | - Dominik Meier
- Laboratorio de Investigación Traslacional e Inmunología Asociada al Trasplante, Instituto de Medicina Traslacional, Trasplante y Bioingeniería (IMeTTyB), Universidad Favaloro-CONICET, Buenos Aires, BA, Argentina; Instituto de Trasplante Multiórganico, Hospital Universitario Fundación Favaloro, Buenos Aires, BA, Argentina.
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Mendizabal M, Haddad L, Marciano S, Ganem FO, Paz S, Gruz F, Ridruejo E, Lurbet MF, Fernandez N, Descalzi V, Anders M, Gadano A, Martínez A, Silva YM. Hepatitis E infection is an infrequent cause of acute hepatitis in the metropolitan area of Buenos Aires. J Clin Virol 2020; 126:104309. [PMID: 32155452 DOI: 10.1016/j.jcv.2020.104309] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/01/2020] [Accepted: 03/05/2020] [Indexed: 12/17/2022]
Abstract
Background Argentina is considered a region of low seroprevalence of hepatitis E virus (HEV), however; no studies have evaluated its burden among acute hepatitis cases. OBJECTIVES We aimed to estimate the proportion of acute HEV and outcome in a cohort of patients with acute hepatitis from 6 liver units in the Metropolitan area of Buenos Aires (MABA). STUDY DESIGN We performed a prospective cohort study including patients ≥18 years with acute hepatitis (increase in transaminases x 5 ULN) fromJuly 2016 to May 2018. Severe hepatitis was defined as acute hepatitis + INR> 1.5 and acute liver failure as severe hepatitis + encephalopathy. In patients in whom other etiologies were excluded, HEV tests were performed: anti-HEV IgM/G and HEV-RNA in serum and feces. RESULTS Overall, 268 patients with acute hepatitis were included in the study. The most frequent etiologies of acute hepatitis were hepatitis B (67patients, 25 %), hepatotoxicity (65, 24 %) and autoimmune hepatitis (26, 10 %). Acute HEV infection was confirmed in 8 (2.98 %; 95 %CI 1.25-5.63) patients who tested positive for anti-HEV IgM. A total of 63 (23.5 %) patients were hospitalized and 9 (3.3 %) patients died. Overall, 48 (18 %) patients developed severe hepatitis, 6 (2.2 %) have acute liver failure, 6 (1.9 %) underwent liver transplantation and 9 (3.4 %) patients died. CONCLUSIONS the proportion of acute HEV in MABA was low during the period studied. We believe our findings will aid physicians prioritize other etiologies of acute hepatitis over HEV in order to optimize diagnostic resources and offer better care to their patients.
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Affiliation(s)
- Manuel Mendizabal
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Argentina; Latin American Liver Research, Educational and Awareness Network (LALREAN).
| | - Leila Haddad
- Sección Hepatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Sebastián Marciano
- Sección Hepatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Departamento de Investigación, Hospital Italiano de Buenos Aires, Argentina
| | | | - Silvina Paz
- Unidad de Hígado, Hospital Británico, Buenos Aires, Argentina
| | - Fernando Gruz
- Hospital Italiano de La Plata, Buenos Aires, Argentina
| | - Ezequiel Ridruejo
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Argentina; Latin American Liver Research, Educational and Awareness Network (LALREAN); Sección Hepatología, Centro de Educación Médica e Investigaciones Clínicas "CEMIC", Buenos Aires, Argentina
| | - María Fernanda Lurbet
- Sección Hepatología, Centro de Educación Médica e Investigaciones Clínicas "CEMIC", Buenos Aires, Argentina
| | - Nora Fernandez
- Latin American Liver Research, Educational and Awareness Network (LALREAN); Unidad de Hígado, Hospital Británico, Buenos Aires, Argentina
| | - Valeria Descalzi
- Latin American Liver Research, Educational and Awareness Network (LALREAN); Unidad de Hígado y Trasplante Hepático, Fundación Favaloro, Buenos Aires, Argentina
| | - Margarita Anders
- Latin American Liver Research, Educational and Awareness Network (LALREAN); Unidad de Hígado y Trasplante Hepático, Hospital Alemán, Buenos Aires, Argentina
| | - Adrián Gadano
- Sección Hepatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina; Departamento de Investigación, Hospital Italiano de Buenos Aires, Argentina
| | - Alfredo Martínez
- Laboratorio de Virología, Centro de Educación Médica e Investigaciones Clínicas "CEMIC", Buenos Aires, Argentina
| | - Y Marcelo Silva
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Pilar, Argentina; Latin American Liver Research, Educational and Awareness Network (LALREAN)
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9
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Piñero F, Mendizabal M, Ridruejo E, Herz Wolff F, Ameigeiras B, Anders M, Schinoni MI, Reggiardo V, Palazzo A, Videla M, Alonso C, Santos L, Varón A, Figueroa S, Vistarini C, Adrover R, Fernández N, Perez D, Tanno F, Hernández N, Sixto M, Borzi S, Bruno A, Cocozzella D, Soza A, Descalzi V, Estepo C, Zerega A, de Araujo A, Cheinquer H, Silva M. Treatment with direct-acting antivirals for HCV decreases but does not eliminate the risk of hepatocellular carcinoma. Liver Int 2019; 39:1033-1043. [PMID: 30636361 DOI: 10.1111/liv.14041] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 12/14/2018] [Accepted: 12/30/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND & AIMS Data from Europe and North America have been published regarding the risk of developing hepatocellular carcinoma (HCC) after treatment with direct antiviral agents (DAA). We proposed to evaluate cumulative incidence and associated risk factors for de novo HCC. METHODS This was a prospective multicentre cohort study from Latin America including 1400 F1-F4-treated patients with DAAs (F3-F4 n = 1017). Cox proportional regression models (hazard ratios, HR and 95% CI) were used to evaluate independent associated variables with HCC. Further adjustment with competing risk regression and propensity score matching was carried out. RESULTS During a median follow-up of 16 months (IQR 8.9-23.4 months) since DAAs initiation, overall cumulative incidence of HCC was 0.02 (CI 0.01; 0.03) at 12 months and 0.04 (CI 0.03; 0.06) at 24 months. Cumulative incidence of HCC in cirrhotic patients (n = 784) was 0.03 (CI 0.02-0.05) at 12 months and 0.06 (CI 0.04-0.08) at 24 months of follow-up. Failure to achieve SVR was independently associated with de novo HCC with a HR of 4.9 (CI 1.44; 17.32), after adjusting for diabetes mellitus, previous interferon non-responder, Child-Pugh and clinically significant portal hypertension. SVR presented an overall relative risk reduction for de novo HCC of 73% (CI 15%-91%), 17 patients were needed to be treated to prevent one case of de novo HCC in this cohort. CONCLUSIONS Achieving SVR with DAA regimens was associated with a significant risk reduction in HCC. However, this risk remained high in patients with advanced fibrosis, thus demanding continuous surveillance strategies in this population.
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Affiliation(s)
| | | | - Ezequiel Ridruejo
- Hospital Universitario Austral, Pilar, Argentina.,Centro de Educación Médica e Investigaciones Clínicas, Buenos Aires, Argentina
| | | | | | | | | | | | - Ana Palazzo
- Hospital Padilla, San Miguel de Tucumán, Argentina
| | - María Videla
- Sanatorio Sagrado Corazón, Buenos Aires, Argentina
| | | | | | | | | | | | | | | | | | | | | | | | | | - Andres Bruno
- Hospital Cosme Argerich, Buenos Aires, Argentina
| | | | - Alejandro Soza
- Hospital Pontificia Universidad Católica de Chile, Santiago, Chile
| | | | | | | | | | - Hugo Cheinquer
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Haddad L, Marciano S, Cleres M, Zerega A, Piñero F, Orozco F, Braslavsky G, Mendizabal M, Gondolesi G, Gil O, Silva M, Mastai R, Imventarza O, Descalzi V, Gadano A. Characteristics of Liver Transplantation in Argentina: A Multicenter Study. Transplant Proc 2018; 50:478-484. [PMID: 29579832 DOI: 10.1016/j.transproceed.2017.11.072] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 11/11/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION There is a lack of information regarding outcomes after liver transplant in Latin America. OBJECTIVES This study sought to describe outcomes after liver transplant in adult patients from Argentina. METHODS We performed an ambispective cohort study of adult patients transplanted between June 2010 and October 2012 in 6 centers from Argentina. Only patients who survived after the first 48 hours postransplantation were included. Pretransplantation and posttransplantation data were collected. RESULTS A total of 200 patients were included in the study. Median age at time of transplant was 50 (interquartile range [IQR] 26 to 54) years. In total, 173 (86%) patients had cirrhosis, and the most frequent etiology in these patients was hepatitis C (32%). A total of 35 (17%) patients were transplanted with hepatocellular carcinoma. In patients with cirrhosis, the median Model for End-Stage Liver Disease (MELD) score at time of liver transplant was 25 (IQR 19 to 30). Median time on the waiting list for elective patients was 101 (IQR 27 to 295) days, and 3 (IQR 2 to 4) days for urgent patients. Almost 40% of the patients were readmitted during the first 6 months after liver transplant. Acute rejection occurred in 27% of the patients. Biliary and vascular complications were reported in 39 (19%) and 19 (9%) patients, respectively. Renal failure, diabetes, and dyslipidemia were present in 40 (26%), 87 (57%), and 77 (50%) at 2 years, respectively. CONCLUSIONS We believe the information contained in this article might be of value for reviewing current practices and developing local policies.
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Affiliation(s)
- L Haddad
- Sección Hepatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - S Marciano
- Departamento de Investigación, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - M Cleres
- Unidad de hepatología y Trasplante Hepático, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - A Zerega
- Unidad de Trasplante Hepático, Sanatorio Allende, Córdoba, Argentina
| | - F Piñero
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Buenos Aires, Argentina
| | - F Orozco
- Unidad de Trasplante Hepático Hospital Alemán, Buenos Aires, Argentina
| | - G Braslavsky
- Unidad de Trasplante Hepático Hospital Dr. Cosme Argerich, Buenos Aires, Argentina
| | - M Mendizabal
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Buenos Aires, Argentina
| | - G Gondolesi
- Unidad de hepatología y Trasplante Hepático, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - O Gil
- Unidad de Trasplante Hepático, Sanatorio Allende, Córdoba, Argentina
| | - M Silva
- Unidad de Hígado y Trasplante Hepático, Hospital Universitario Austral, Buenos Aires, Argentina
| | - R Mastai
- Unidad de Trasplante Hepático Hospital Alemán, Buenos Aires, Argentina
| | - O Imventarza
- Unidad de Trasplante Hepático Hospital Dr. Cosme Argerich, Buenos Aires, Argentina
| | - V Descalzi
- Unidad de hepatología y Trasplante Hepático, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina
| | - A Gadano
- Sección Hepatología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Gondolesi G, Barros Schelotto P, Halac E, Romero P, Dip M, Cervio G, Ramisch D, Klein F, Niveyro S, Orce G, Yantorno S, Descalzi V, Imventarza O. Three liver transplants after a single cadaveric procurement: split liver transplantation plus domino liver transplantation, an infrequent but valid alternative for maximizing transplant sharing and applicability--report of the first Latin American case. Liver Transpl 2014; 20:1138-40. [PMID: 24838195 DOI: 10.1002/lt.23914] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 05/12/2014] [Indexed: 01/12/2023]
Affiliation(s)
- Gabriel Gondolesi
- Institute of Multiorgan Transplantation, Unit of Hepatology, Hepatobiliary Surgery and Hepatic Transplantation, University Hospital, Favaloro Foundation, Buenos Aires, Argentina
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12
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Gruz F, Cleres M, Loredo D, Fernández MG, Raffa S, Yantorno S, Romero GA, Munné MS, González JE, Descalzi V. [Hepatitis E: an infrequent virus or an unfrecuently investigated agent?]. Acta Gastroenterol Latinoam 2013; 43:143-145. [PMID: 23940917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Two cases of hepatitis E that were assisted in our Unit of Hepatology and Liver Transplantation are described in this article. The first patient had prior hepatic involvement and therefore a more severe course, whereas the second case, with normal liver function, only developed a self-limited acute hepatitis.
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Affiliation(s)
- Fernando Gruz
- Unidad de Hepatología y Trasplante Hepático, Hospital Universitario Fundación Favaloro, Ciudad Autónoma de Buenos Aires, Argentina.
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13
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Gruz F, Cleres M, Raffa S, Yantorno S, Santilli JP, Vigliano C, Schelotto PB, Gondolesi GE, Descalzi V. [Hepatocellular carcinoma within Milan criteria and beyond: outcomes of liver transplantation in a single Argentinian institution]. Acta Gastroenterol Latinoam 2013; 43:106-112. [PMID: 23940910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Hepatocellular carcinoma (HCC) recurrence following liver transplantation is associated to bad prognosis. We retrospectively analyzed the data of 95 patients who underwent liver transplantation for HCC. Recurrence rate and variables associated with recurrence were reviewed. According to the findings on the explanted livers they were divided in two groups: Milan (M) 67% and non-Milan (NM) 33%. Global recurrence rate, and M-group and NM-group recurrence rates were 19%; 12% and 32%, respectively (P = 0.001). Although in the univariate analysis we found some factors associated to recurrence (hemocromathosis, year of transplant, bilobar distribution, vascular invasion and previous chemoembolization), they were not independent predictors of recurrence in the multivariate analysis. Actuarial survival in cirrhotic patients with and without HCC at 1, 3 and 5 years was 86% and 91% (NS), 77% and 88% (NS), and 67% and 86% (P = 0.002), respectively; whereas actuarial survival of the M and NM groups was 86% and 71%; 82% and 61%, and 78% and 58%, respectively (P = 0.02). We had a satisfactory five-year global survival in our series even though one third of our patients grafted for HCC were outside Milan criteria.
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Affiliation(s)
- Fernando Gruz
- Unidad de Hepatología y Trasplante Hepático, Hospital Universitario Fundación Favaloro, Buenos Aires, Argentina.
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14
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Riegersperger M, Plischke M, Steiner-Boker S, Seidinger D, Winkelmayer W, Sunder-Plassmann G, Vlahovic P, Vlahovic P, Cvetkovic T, Djordjevic V, Velickovic-Radovanovic R, Stefanovic N, Ignjatovic A, Sladojevic N, Cademartori V, Massarino F, Parodi EL, Russo R, Sofia A, Fontana I, Viviani GL, Garibotto G, Mai M, Mai W, Taner B, Wadei H, Prendergast M, Gonwa T, Martin J, Martin J, Aurore S, Aline CS, Nicolas M, Manolie M, Catherine S, Eric A, Christophe M, Brakemeier S, Liefeldt L, Glander P, Waiser J, Lachmann N, Schonemann C, Zukunft B, Illigens P, Schmidt D, Wu K, Rudolph B, Neumayer HH, Budde K, Pallardo Mateu L, Gavela Martinez E, Sancho Calabuig A, Crespo Albiach J, Beltran Catalan S, Gavela Martinez E, Kanter Berga J, Kimura T, Yagisawa T, Ishikawa N, Sakuma Y, Hujiwara T, Nukui A, Yashi M, Duraes J, Malheiro J, Fonseca I, Rocha A, Martins LS, Almeida M, Dias L, Castro-Henriques A, Cabrita A, Mai M, Mai W, Wadei H, Prendergast M, Gonwa T, Volpe A, Quaglia M, Menegotto A, Fenoglio R, Izzo C, Airoldi A, Terrone C, Stratta P, Ahmed B, Mireille K, Nilufer B, Annick M, Karl Martin W, Anh-Dung H, Dimitri M, Philippe M, Judith R, Daniel A, Liefeldt L, Glander P, Glander P, Lan Y, Schmidt D, Heine C, Budde K, Neumayer HH, Schmidt D, Glander P, Glander P, Budde K, Neumayer HH, Liefeldt L, Quaglia M, Quaglia M, Capone V, Izzo C, Menegotto A, Fenoglio R, Airoldi A, Stratta P, Grace B, Clayton P, Cass A, Mcdonald S, Yagisawa T, Yagisawa T, Yashi M, Kimura T, Nukui A, Fujiwara T, Sakuma Y, Ishikawa N, Iwabuchi T, Muraishi O, Torregrosa V, Barros X, Martinez de Osaba MJ, Paschoalin R, Campistol JM, Hassan R, El-Hefnawy A, Soliman S, Shokeir A, Cobanoglu Kudu A, Gungor O, Kircelli F, Altinel E, Asci G, Ozbek SS, Toz H, Ok E, Sandrini S, Setti G, Valerio F, Possenti S, Torrisi I, Polanco N, Garcia-Puente L, Gonzalez Monte E, Morales E, Gutierrez E, Bengoa I, Hernandez A, Caballero J, Morales JM, Andres A, Sgarlato V, Sgarlato V, Comai G, La Manna G, Moretti I, Grandinetti V, Martelli D, Scolari MP, Stefoni S, Valentini C, Valentini C, Persici E, La Manna G, Cappuccilli ML, Sgarlato V, Liviano D'arcangelo G, Fabbrizio B, Carretta E, Mosconi G, Scolari MP, Feliciangeli G, Grigioni FW, Stefoni S, Apicella L, Guida B, Vitale S, Garofalo G, Russo L, Maresca I, Rossano R, Memoli B, Carrano R, Federico S, Sabbatini M, Carta P, Zanazzi M, DI Maria L, Caroti L, Miejshtri A, Tsalouchos A, Bertoni E, Sezer S, Erkmen Uyar M, Colak T, Bal Z, Tutal E, Kalaci G, Ozdemir Acar FN, Jacquelinet C, Bayat S, Pernin V, Portales P, Szwarc I, Garrigue V, Vetromile F, Delmas S, Eliaou JF, Mourad G, Huber L, Huber L, Slowinski T, Naik M, Glander P, Liefeldt L, Schmidt D, Neumayer HH, Budde K, Nakai K, Fujii H, Kono K, Goto S, Ishimura T, Takeda M, Fujisawa M, Nishi S, Pereira Paschoalin R, Paschoalin R, Torregrosa JV, Barros Freiria X, Duran Rebolledo CE, Sanchez Escuredo A, Sole M, Campistol JM, Youssouf S, Tabbasm F, Bell R, Al-Jayyousi R, Warwick G, Grall A, Treguer L, Essig M, Lecaque C, Noel N, Buchler M, Bertrand D, Rivalan J, Braun L, Villemain F, Hurault de Ligny B, Totet A, Pestourie N, Toubas D, Nevez G, Le Meur Y, Nour el Houda B, Mustapha H, Wafaa F, Inass L, Rambabova Bushljetikj I, Rambabova Bushljetikj I, Masin-Spasovska J, Spasovski G, Popov Z, Sikole A, Ivanovski N, Raimundo M, Guerra J, Teixeira C, Santana A, Silva S, Mil Homens C, Gomes Da Costa A, Loredo D, Cleres M, Gondolesi G, Gutierrez LM, Fortunato RM, Descalzi V, Raffaele P. Transplantation - clinical II. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Mas V, Maluf D, Archer KJ, Potter A, Suh J, Gehrau R, Descalzi V, Villamil F. Transcriptome at the time of hepatitis C virus recurrence may predict the severity of fibrosis progression after liver transplantation. Liver Transpl 2011; 17:824-35. [PMID: 21618696 DOI: 10.1002/lt.22309] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Allograft gene expression analysis may provide insights into the mechanisms involved in liver damage during hepatitis C virus recurrence (HCVrec) after orthotopic liver transplantation (OLT) and allow the identification of patients who have a higher risk of developing severe disease. Forty-three OLT recipients with hepatitis C virus (HCV) were evaluated. Genomewide gene expression analysis was performed with formalin-fixed, paraffin-embedded (FFPE) liver biopsy samples obtained from 21 OLT recipients with HCV at the time of clinical HCVrec, which was defined as increased alanine aminotransferase levels and detectable HCV RNA levels in serum. Patients were classified into 3 groups according to the severity of the fibrosis in the liver biopsies at 36 months post-OLT : group 1 (G1) for mild fibrosis (F0-F1), group 2 for moderate fibrosis (F2), and group 3 (G3) for severe fibrosis (F3-F4). No significant differences were observed between the groups with respect to donor age, histology during HCVrec, treated episodes of acute cellular rejection, or immunosuppression therapy. The results were validated in the remaining 22 OLT recipients with HCV using quantitative real-time polymerase chain reaction. Fifty-seven beadtypes showed significantly different expression (P < 0.001) between the groups during HCVrec. In G3, the gene expression of interleukin-28RA (IL-28RA), IL-28, and angiotensin-converting enzyme was up-regulated. Samples from G1 and G3 were used to determine whether a multigenetic classifier could be derived to predict the group class. The final model included the intercept and 9 bead types. Pairwise scatter plots of these 9 bead types revealed that G1 and G3 were well separated with respect to each gene. Our analysis has demonstrated the utility of a set of molecular markers indicating HCVrec severity early after OLT.
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Affiliation(s)
- Valeria Mas
- Division of Transplantation, Department of Surgery, Virginia Commonwealth University, Richmond, VA 23298-0057, USA.
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Martinuzzo M, Ruf A, Cerrato G, Chavez L, Lloret SP, Cairo F, Gruz F, Fuxman C, Descalzi V, Podestá G, Villamil F, Forastiero R. FACTOR V IS AN INDEPENDENT PREDICTOR OF MORTALITY IN PATIENTS WITH CIRRHOSIS: USEFUL TOOL IN PATIENTS WAITING FOR LIVER TRANSPLANTATION. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb02003.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Levi D, Tanno H, Descalzi V. [Criteria to hepatitis C treatment response]. Acta Gastroenterol Latinoam 2006; 36 Suppl 1:S50-2; discussion S74-82. [PMID: 16862861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Diana Levi
- Servicio de Hepatología, Hospital Bonorino Udaondo, Ciudad Autónoma de Buenos Aires
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Colombato L, Descalzi V, Gadano A. [Chronic hepatitis C. First treatment]. Acta Gastroenterol Latinoam 2005; 35 Suppl 1:S37-S39. [PMID: 20214297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
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