Pagina Iniziale » Fegato » Interventi Chirurgici sul Fegato » Trapianto di Fegato da Donatore Vivente
Trapianto di Fegato da Donatore Vivente
Cosa è?
Il trapianto di fegato da donatore vivente è una procedura chirurgica che prevede l’asportazione di una parte di fegato da un donatore volontario ed il suo successivo trapianto in un paziente portatore di una malattia cronica di fegato.
Il prelievo di una parte di fegato da un donatore vivente viene effettuato per il beneficio terapeutico del paziente in attesa del trapianto su esplicita, motivata e libera richiesta del donatore e del ricevente, dopo che entrambe abbiano ricevuto una corretta e completa informazione.
Perché si propone?
Nonostante i progressi ottenuti con la diffusione della cultura della donazione, il numero di organi disponibili per fare i trapianti resta insufficiente. Questo significa che un certo numero di pazienti non riuscirà mai a fare il trapianto di fegato con un organo prelevato da un donatore cadavere.
Per ovviare, almeno in parte, a questo problema, è stato proposto di prelevare una parte di fegato da un donatore volontario e trapiantarla successivamente nel paziente che necessita del nuovo organo. Questo è possibile grazie alla capacità del fegato di ricrescere quando ne venga asportata una porzione.
Questa tecnica, eseguita per la prima volta alla fine degli anni ’80, ha trovato un grande successo in Giappone, dove la donazione d’organi è un evento rarissimo, ed è stata poi applicata con successo anche nei pazienti adulti.
Come è regolato il trapianto di fegato da donatore vivente ?
Il trapianto di fegato da donatore vivente è regolato dalla Legge 16 Dicembre 1999, n. 483, “Norme per consentire il trapianto parziale di fegato”, pubblicata nella Gazzetta Ufficiale n. 297 del 20 dicembre 1999, che recita:
Art. 1.
(Trapianto parziale di fegato)
1. In deroga al divieto di cui all’articolo 5 del codice civile è ammesso disporre a titolo gratuito di parti di fegato al fine esclusivo del trapianto tra persone viventi.
2. Ai fini di cui al comma 1 si applicano, in quanto compatibili, le disposizioni della legge 26 giugno 1967, n. 458.
Art. 2.
(Entrata in vigore)
1. La presente legge entra in vigore il giorno successivo a quello della sua pubblicazione nella Gazzetta Ufficiale.
Chi lo può fare?
In Italia, l’indicazione ad essere operato di trapianto di fegato da donatore vivente è del tutto uguale a quella che deve portare ad eseguire un trapianto di fegato da donatore cadavere. Infatti, per richiedere il trapianto da donatore vivente il paziente deve già essere inserito in una lista di attesa per il trapianto convenzionale.
Il grande problema nasce invece nell’identificazione del possibile donatore. Infatti, solo un paziente su cinque trova un donatore idoneo all’asportazione parziale del fegato. I possibili donatori sono sottoposti ad un rigido protocollo di studio che deve verificare se sono effettivamente idonei alla donazione dal punto di vista delle condizioni generali e se sia possibile asportare una parte del fegato tale da non provocare disturbi allo stesso donatore e che sia poi sufficiente per il paziente che riceve il trapianto.
Quali sono i rischi?
Gli interventi sono due:
- quello sulla persona che dona e
- quello sul paziente che riceve il trapianto.
L’intervento sul donatore della parte di fegato da utilizzare per il trapianto comporta l’esecuzione di una resezione epatica. L’intervento di resezione epatica è considerato di chirurgia maggiore. L’estensione della parte da asportare viene definita caso per caso, in rapporto al peso del paziente che deve ricevere l’organo ed alle dimensioni del fegato del candidato alla donazione.
In ogni caso si tratta di un intervento che può presentare complicanze chirurgiche e non chirurgiche a breve e a lungo termine. Nel mondo si sono verificati alcuni casi di complicanze fatali per il donatore, in una percentuale valutabile intorno allo 0,5-1% dei casi. Altre complicanze, di varia intensità, legate al prelievo di una parte del fegato si possono verificare circa in un 20-40% di casi.
Il successivo trapianto di fegato non comporta invece rischi particolari rispetto al trapianto di fegato effettuato con un organo intero da donatore cadavere. Può verificarsi un aumento delle complicanze post-operatorie, legate alla necessità di dividere il fegato.
Quali sono i vantaggi di questa procedura?
I vantaggi di questa procedura sono ovviamente per la persona che deve ricevere un trapianto. Si possono così riassumere:
- avere la certezza di poter fare il trapianto quando si identifichi il donatore
- ricevere un organo con caratteristiche assai favorevoli e sicure
- ridurre al minimo i problemi legati al trapianto da donatore cadavere
A chi ci si deve rivolgere per usufruire di questa possibilità?
Nell’aprile 2001 il Ministero della Salute ha autorizzato 15 centri italiani ad eseguire questo intervento, imponendo un rigido protocollo di comportamento.
Durante l’anno 2019 questi sono stati i centri che in Italia hanno eseguito trapianti di fegato con donatori viventi:
- Palermo – ISMETT : 14 (con attività pediatrica)
- Roma – Bambin Gesù: 5 (con attività pediatrica)
- Bergamo: 2
- Milano – Niguarda: 1
- Padova: 1
- Bologna – Policlinico Sant’Orsola: 1
Fonte: Report 2020 (attività anno 2019) del Centro Nazionale Trapianti
Consulta il Report 2021 (attività dell’anno 2020) del Centro Nazionale Trapianti.
Consulta il Report 2022 (attività dell’anno 2021) del Centro Nazionale Trapianti.
- Ultimo aggiornamento della pagina: 10/12/2023
Linee Guida per il Trapianto di Fegato
2023
Pollok J M; Tinguely P; Berenguer M; Niemann C U; Raptis D A; Spiro M
Enhanced recovery for liver transplantation: recommendations from the 2022 International Liver Transplantation Society consensus conference Journal Article
In: Lancet Gastroenterol Hepatol, vol. 8, no 1, pp. 81–94, 2023, ISSN: 2468-1253.
@article{pmid36495912,
title = {Enhanced recovery for liver transplantation: recommendations from the 2022 International Liver Transplantation Society consensus conference},
author = {Joerg M Pollok and Pascale Tinguely and Marina Berenguer and Claus U Niemann and Dimitri A Raptis and Michael Spiro},
doi = {10.1016/S2468-1253(22)00268-0},
issn = {2468-1253},
year = {2023},
date = {2023-01-01},
urldate = {2023-01-01},
journal = {Lancet Gastroenterol Hepatol},
volume = {8},
number = {1},
pages = {81--94},
abstract = {There is much controversy regarding enhanced recovery for recipients of liver transplants from deceased and living donors. The objectives of this Review were to summarise current knowledge on individual enhanced recovery elements on short-term outcomes, identify key components for comprehensive pathways, and create internationally accepted guidelines on enhanced recovery for liver-transplant recipients. The ERAS4OLT.org collaborative partnered by the International Liver Transplantation Society performed systematic literature reviews on the effect of 32 relevant enhanced perioperative recovery elements on short-term outcomes, and global specialists prepared expert statements on deceased and living donor liver transplantation. The Grading Recommendations, Assessment, Development and Evaluations approach was used for rating of quality of evidence and grading of recommendations. A virtual international consensus conference was held in January, 2022, in which results were presented, voted on by the audience, and discussed by an independent international jury of eight members, applying the Danish model of consensus. 273 liver transplantation specialists from 30 countries prepared expert statements on elements of enhanced recovery for liver transplantation based on the systematic literature reviews. The consensus conference yielded 80 final recommendations, covering aspects of enhanced recovery for preoperative assessment and optimisation, intraoperative surgical and anaesthetic conduct, and postoperative management for the recipients of liver transplants from both deceased and living donors, and for the living donor. The recommendations represent a comprehensive overview of the relevant elements and areas of enhanced recovery for liver transplantation. These internationally established guidelines could direct the development of enhanced recovery programmes worldwide, allowing adjustments according to local resources and practices.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2022
Brustia R; Monsel A; Skurzak S; Schiffer E; Carrier F M; Patrono D; Kaba A; Detry O; Malbouisson L; Andraus W; Vandenbroucke-Menu F; Biancofiore G; Kaido T; Compagnon P; Uemoto S; Laiz G R; Boer M D; Orloff S; Melgar P; Buis C; Zeillemaker-Hoekstra M; Usher H; Reyntjens K; Baird E; Demartines N; Wigmore S; Scatton O
Guidelines for Perioperative Care for Liver Transplantation: Enhanced Recovery after Surgery (ERAS) Recommendations Journal Article
In: Transplantation, vol. 106, no 3, pp. 552 – 561, 2022, ISSN: 00411337, (Cited by: 10; All Open Access, Green Open Access).
@article{Brustia2022552,
title = {Guidelines for Perioperative Care for Liver Transplantation: Enhanced Recovery after Surgery (ERAS) Recommendations},
author = {Raffaele Brustia and Antoine Monsel and Stefano Skurzak and Eduardo Schiffer and François Martin Carrier and Damiano Patrono and Abdourahamane Kaba and Olivier Detry and Luiz Malbouisson and Wellington Andraus and Franck Vandenbroucke-Menu and Gianni Biancofiore and Toshimi Kaido and Philippe Compagnon and Shinji Uemoto and Gonzalo Rodriguez Laiz and Marieke De Boer and Susan Orloff and Paola Melgar and Carlijn Buis and Miriam Zeillemaker-Hoekstra and Helen Usher and Koen Reyntjens and Emily Baird and Nicolas Demartines and Stephen Wigmore and Olivier Scatton},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85125006375&doi=10.1097%2fTP.0000000000003808&partnerID=40&md5=082ddb84c23154f85ae4617dbd1f8be7},
doi = {10.1097/TP.0000000000003808},
issn = {00411337},
year = {2022},
date = {2022-01-01},
urldate = {2022-01-01},
journal = {Transplantation},
volume = {106},
number = {3},
pages = {552 – 561},
publisher = {Lippincott Williams and Wilkins},
abstract = {Background. Enhanced Recovery After Surgery (ERAS) is a multimodal, evidence-based, program of care developed to minimize the response to surgical stress, associated with reduced perioperative morbidity and hospital stay. This study presents the specific ERAS Society recommendations for liver transplantation (LT) based on the best available evidence and on expert consensus Methods. PubMed and ClinicalTrials.gov were searched in April 2019 for published and ongoing randomized clinical trials on LT in the last 15 y. Studies were selected by 5 independent reviewers and were eligible if focusing on each validated ERAS item in the area of adult LT. An e-Delphi method was used with an extended interdisciplinary panel of experts to validate the final recommendations. Results. Forty-three articles were included in the systematic review. A consensus was reached among experts after the second round. Patients should be screened for malnutrition and treated whenever possible. Prophylactic nasogastric intubation and prophylactic abdominal drainage may be omitted, and early extubation should be considered. Early oral intake, mobilization, and multimodal-balanced analgesia are recommended. Conclusions. The current ERAS recommendations were elaborated based on the best available evidence and endorsed by the e-Delphi method. Nevertheless, prospective studies need to confirm the clinical use of the suggested protocol. © 2022 Lippincott Williams and Wilkins. All rights reserved.},
note = {Cited by: 10; All Open Access, Green Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2021
Cherqui D; Ciria R; Kwon C H D; Kim K; Broering D; Wakabayashi G; Samstein B; Troisi R I; Han H S; Rotellar F; Soubrane O; Briceño J; Alconchel F; Ayllón M D; Berardi G; Cauchy F; Luque I G; Hong S K; Yoon Y; Egawa H; Lerut J; Lo C; Rela M; Sapisochin G; Suh K
In: Annals of Surgery, vol. 273, no 1, pp. 96 – 108, 2021, ISSN: 00034932, (Cited by: 13).
@article{Cherqui202196,
title = {Expert consensus guidelines on minimally invasive donor hepatectomy for living donor liver transplantation from innovation to implementation: A joint initiative from the international laparoscopic liver society (ILLS) and the Asian-Pacific hepato-pancreato-biliary association (A-PHPBA)},
author = {Daniel Cherqui and Ruben Ciria and Choon Hyuck David Kwon and Ki-Hun Kim and Dieter Broering and Go Wakabayashi and Benjamin Samstein and Roberto I. Troisi and Ho Seong Han and Fernando Rotellar and Olivier Soubrane and Javier Briceño and Felipe Alconchel and María Dolores Ayllón and Giammauro Berardi and Francois Cauchy and Irene Gómez Luque and Suk Kyun Hong and Young-Yin Yoon and Hiroto Egawa and Jan Lerut and Chung-Mau Lo and Mohamed Rela and Gonzalo Sapisochin and Kyung-Suk Suh},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85098676552&doi=10.1097%2fSLA.0000000000004475&partnerID=40&md5=93cd12ffcabe36ce8cde34e0c0368823},
doi = {10.1097/SLA.0000000000004475},
issn = {00034932},
year = {2021},
date = {2021-01-01},
urldate = {2021-01-01},
journal = {Annals of Surgery},
volume = {273},
number = {1},
pages = {96 – 108},
publisher = {Lippincott Williams and Wilkins},
abstract = {Objective: The Expert Consensus Guidelines initiative on MIDH for LDLT was organized with the goal of safe implementation and development of these complex techniques with donor safety as the main priority. Background: Following the development of minimally invasive liver surgery, techniques of MIDH were developed with the aim of reducing the short- and long-term consequences of the procedure on liver donors. These techniques, although increasingly performed, lack clinical guidelines. Methods: A group of 12 international MIDH experts, 1 research coordinator, and 8 junior faculty was assembled. Comprehensive literature search was made and studies classified using the SIGN method. Based on literature review and experts opinions, tentative recommendations were made by experts subgroups and submitted to the whole experts group using on-line Delphi Rounds with the goal of obtaining >90% Consensus. Pre-conference meeting formulated final recommendations that were presented during the plenary conference held in Seoul on September 7, 2019 in front of a Validation Committee composed of LDLT experts not practicing MIDH and an international audience. Results: Eighteen Clinical Questions were addressed resulting in 44 recommendations. All recommendations reached at least a 90% consensus among experts and were afterward endorsed by the validation committee. Conclusions: The Expert Consensus on MIDH has produced a set of clinical guidelines based on available evidence and clinical expertise. These guidelines are presented for a safe implementation and development of MIDH in LDLT Centers with the goal of optimizing donor safety, donor care, and recipient outcomes. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.},
note = {Cited by: 13},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2020
Millson C; Considine A; Cramp M E; Holt A; Hubscher S; Hutchinson J; Jones K; Leithead J; Masson S; Menon K; Mirza D; Neuberger J; Prasad R; Pratt A; Prentice W; Shepherd L; Simpson K; Thorburn D; Westbrook R; Tripathi D
Adult liver transplantation: A UK clinical guideline - Part 1: Pre-operation Journal Article
In: Frontline Gastroenterology, vol. 11, no 5, pp. 375 – 384, 2020, ISSN: 20414137, (Cited by: 11; All Open Access, Green Open Access, Hybrid Gold Open Access).
@article{Millson2020375,
title = {Adult liver transplantation: A UK clinical guideline - Part 1: Pre-operation},
author = {Charles Millson and Aisling Considine and Matthew E Cramp and Andrew Holt and Stefan Hubscher and John Hutchinson and Kate Jones and Joanna Leithead and Steven Masson and Krish Menon and Darius Mirza and James Neuberger and Raj Prasad and Anthony Pratt and Wendy Prentice and Liz Shepherd and Ken Simpson and Doug Thorburn and Rachel Westbrook and Dhiraj Tripathi},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85081693914&doi=10.1136%2fflgastro-2019-101215&partnerID=40&md5=630321fcf4832e47fc9820f8516d6370},
doi = {10.1136/flgastro-2019-101215},
issn = {20414137},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Frontline Gastroenterology},
volume = {11},
number = {5},
pages = {375 – 384},
publisher = {BMJ Publishing Group},
abstract = {Liver transplantation is a highly successful treatment for all types of liver failure, some non-liver failure indications and liver cancer. Most referrals come from secondary care. This first part of a two-part guideline outlines who to refer, and how that referral should be made, including patient details and additional issues such as those relevant to alcohol and drug misuse. The process of liver transplant assessment involves the confirmation of the diagnosis and non-reversibility, an evaluation of comorbidities and exclusion of contraindications. Finally, those making it onto the waiting list require monitoring and optimising. Underpinning this process is a need for good communication between patient, their carers, secondary care and the liver transplant service, synchronised by the transplant coordinator. Managing expectation and balancing the uncertainty of organ availability against the inevitable progression of underlying liver disease requires sensitivity and honesty from all healthcare providers and the assessment of palliative care needs is an integral part of this process. © Author(s) (or their employer(s)) 2020.},
note = {Cited by: 11; All Open Access, Green Open Access, Hybrid Gold Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Millson C; Considine A; Cramp M E; Holt A; Hubscher S; Hutchinson J; Jones K; Leithead J; Masson S; Menon K; Mirza D; Neuberger J; Prasad R; Pratt A; Prentice W; Shepherd L; Simpson K; Thorburn D; Westbrook R; Tripathi D
Adult liver transplantation: UK clinical guideline - Part 2: Surgery and post-operation Journal Article
In: Frontline Gastroenterology, vol. 11, no 5, pp. 385 – 396, 2020, ISSN: 20414137, (Cited by: 12; All Open Access, Green Open Access, Hybrid Gold Open Access).
@article{Millson2020385,
title = {Adult liver transplantation: UK clinical guideline - Part 2: Surgery and post-operation},
author = {Charles Millson and Aisling Considine and Matthew E Cramp and Andrew Holt and Stefan Hubscher and John Hutchinson and Kate Jones and Joanna Leithead and Steven Masson and Krish Menon and Darius Mirza and James Neuberger and Raj Prasad and Anthony Pratt and Wendy Prentice and Liz Shepherd and Ken Simpson and Doug Thorburn and Rachel Westbrook and Dhiraj Tripathi},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85081578908&doi=10.1136%2fflgastro-2019-101216&partnerID=40&md5=b1f346377e62d61cd21a9ff44b52b1d9},
doi = {10.1136/flgastro-2019-101216},
issn = {20414137},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Frontline Gastroenterology},
volume = {11},
number = {5},
pages = {385 – 396},
publisher = {BMJ Publishing Group},
abstract = {Survival rates for patients following liver transplantation exceed 90% at 12 months and approach 70% at 10 years. Part 1 of this guideline has dealt with all aspects of liver transplantation up to the point of placement on the waiting list. Part 2 explains the organ allocation process, organ donation and organ type and how this influences the choice of recipient. After organ allocation, the transplant surgery and the critical early post-operative period are, of necessity, confined to the liver transplant unit. However, patients will eventually return to their referring secondary care centre with a requirement for ongoing supervision. Part 2 of this guideline concerns three key areas of post liver transplantation care for the non-transplant specialist: (1) overseeing immunosuppression, including interactions and adherence; (2) the transplanted organ and how to initiate investigation of organ dysfunction; and (3) careful oversight of other organ systems, including optimising renal function, cardiovascular health and the psychosocial impact. The crucial significance of this holistic approach becomes more obvious as time passes from the transplant, when patients should expect the responsibility for managing the increasing number of non-liver consequences to lie with primary and secondary care. © Author(s) (or their employer(s)) 2020.},
note = {Cited by: 12; All Open Access, Green Open Access, Hybrid Gold Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Ghinolfi D; Lai Q; Dondossola D; Carlis R D; Zanierato M; Patrono D; Baroni S; Bassi D; Ferla F; Lauterio A; Lazzeri C; Magistri P; Melandro F; Pagano D; Pezzati D; Ravaioli M; Rreka E; Toti L; Zanella A; Burra P; Petta S; Rossi M; Dutkowski P; Jassem W; Muiesan P; Quintini C; Selzner M; Cillo U
Machine Perfusions in Liver Transplantation: The Evidence-Based Position Paper of the Italian Society of Organ and Tissue Transplantation Journal Article
In: Liver Transplantation, vol. 26, no 10, pp. 1298 – 1315, 2020, ISSN: 15276465, (Cited by: 28).
@article{Ghinolfi20201298,
title = {Machine Perfusions in Liver Transplantation: The Evidence-Based Position Paper of the Italian Society of Organ and Tissue Transplantation},
author = {Davide Ghinolfi and Quirino Lai and Daniele Dondossola and Riccardo De Carlis and Marinella Zanierato and Damiano Patrono and Stefano Baroni and Domenico Bassi and Fabio Ferla and Andrea Lauterio and Chiara Lazzeri and Paolo Magistri and Fabio Melandro and Duilio Pagano and Daniele Pezzati and Matteo Ravaioli and Erion Rreka and Luca Toti and Alberto Zanella and Patrizia Burra and Salvatore Petta and Massimo Rossi and Philippe Dutkowski and Wayel Jassem and Paolo Muiesan and Cristiano Quintini and Markus Selzner and Umberto Cillo},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85091043508&doi=10.1002%2flt.25817&partnerID=40&md5=267430f507cb79fa548dc0a52ec1b081},
doi = {10.1002/lt.25817},
issn = {15276465},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Liver Transplantation},
volume = {26},
number = {10},
pages = {1298 – 1315},
publisher = {John Wiley and Sons Ltd},
abstract = {The use of machine perfusion (MP) in liver transplantation (LT) is spreading worldwide. However, its efficacy has not been demonstrated, and its proper clinical use has far to go to be widely implemented. The Società Italiana Trapianti d’Organo (SITO) promoted the development of an evidence-based position paper. A 3-step approach has been adopted to develop this position paper. First, SITO appointed a chair and a cochair who then assembled a working group with specific experience of MP in LT. The Guideline Development Group framed the clinical questions into a patient, intervention, control, and outcome (PICO) format, extracted and analyzed the available literature, ranked the quality of the evidence, and prepared and graded the recommendations. Recommendations were then discussed by all the members of the SITO and were voted on via the Delphi method by an institutional review board. Finally, they were evaluated and scored by a panel of external reviewers. All available literature was analyzed, and its quality was ranked. A total of 18 recommendations regarding the use and the efficacy of ex situ hypothermic and normothermic machine perfusion and sequential normothermic regional perfusion and ex situ MP were prepared and graded according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. A critical and scientific approach is required for the safe implementation of this new technology. Copyright © 2020 by the American Association for the Study of Liver Diseases.},
note = {Cited by: 28},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2016
Burra P; Burroughs A; Graziadei I; Pirenne J; Valdecasas J C; Muiesan P; Samuel D; Forns X
EASL Clinical Practice Guidelines: Liver transplantation Journal Article
In: Journal of Hepatology, vol. 64, no 2, pp. 433 – 485, 2016, ISSN: 01688278, (Cited by: 497).
@article{Burra2016433,
title = {EASL Clinical Practice Guidelines: Liver transplantation},
author = {Patrizia Burra and Andrew Burroughs and Ivo Graziadei and Jacques Pirenne and Juan Carlos Valdecasas and Paolo Muiesan and Didier Samuel and Xavier Forns},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84954380926&doi=10.1016%2fj.jhep.2015.10.006&partnerID=40&md5=38d57da89522e00bb97e9097fa4a26e2},
doi = {10.1016/j.jhep.2015.10.006},
issn = {01688278},
year = {2016},
date = {2016-01-01},
urldate = {2016-01-01},
journal = {Journal of Hepatology},
volume = {64},
number = {2},
pages = {433 – 485},
publisher = {Elsevier B.V.},
note = {Cited by: 497},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2015
Cillo U; Burra P; Mazzaferro V; Belli L; Pinna A D; Spada M; Costa A N; Toniutto P; Avolio A; Cescon M; Regalia E; Romagnoli R; Santaniello W; Rossi M; Corno V; Caraceni P; Coco B; Fraquelli M; Rendina M; Angelico M; Fagiuoli S; Bruno R; Costa A N; Feo T D; Ridolfi L; Pretagostini R; Amoroso A; Biancofiore G; Gasperi A D; Rocca G D; Feltracco P; Colli A; Sacchini D; Pegoraro R; Gardini I
A Multistep, Consensus-Based Approach to Organ Allocation in Liver Transplantation: Toward a "Blended Principle Model" Journal Article
In: American Journal of Transplantation, vol. 15, no 10, pp. 2552 – 2561, 2015, ISSN: 16006135, (Cited by: 126; All Open Access, Bronze Open Access).
@article{Cillo20152552,
title = {A Multistep, Consensus-Based Approach to Organ Allocation in Liver Transplantation: Toward a "Blended Principle Model"},
author = {U. Cillo and P. Burra and V. Mazzaferro and L. Belli and A. D. Pinna and M. Spada and A. Nanni Costa and P. Toniutto and Alfonso Avolio and Matteo Cescon and Enrico Regalia and Renato Romagnoli and Walter Santaniello and Massimo Rossi and Vittorio Corno and Paolo Caraceni and Barbara Coco and Mirella Fraquelli and Maria Rendina and Mario Angelico and Stefano Fagiuoli and Raffaele Bruno and Alessandro Nanni Costa and Tullia De Feo and Lorenza Ridolfi and Renzo Pretagostini and Antonio Amoroso and Giandomenico Biancofiore and Andrea De Gasperi and Giorgio Della Rocca and Paolo Feltracco and Agostino Colli and Dario Sacchini and Renzo Pegoraro and Ivan Gardini},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84941937152&doi=10.1111%2fajt.13408&partnerID=40&md5=acefb63024bdb5be01af492342953e9b},
doi = {10.1111/ajt.13408},
issn = {16006135},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {American Journal of Transplantation},
volume = {15},
number = {10},
pages = {2552 – 2561},
publisher = {John Wiley and Sons Inc},
abstract = {Since Italian liver allocation policy was last revised (in 2012), relevant critical issues and conceptual advances have emerged, calling for significant improvements. We report the results of a national consensus conference process, promoted by the Italian College of Liver Transplant Surgeons (for the Italian Society for Organ Transplantation) and the Italian Association for the Study of the Liver, to review the best indicators for orienting organ allocation policies based on principles of urgency, utility, and transplant benefit in the light of current scientific evidence. MELD exceptions and hepatocellular carcinoma were analyzed to construct a transplantation priority algorithm, given the inequity of a purely MELD-based system for governing organ allocation. Working groups of transplant surgeons and hepatologists prepared a list of statements for each topic, scoring their quality of evidence and strength of recommendation using the Centers for Disease Control grading system. A jury of Italian transplant surgeons, hepatologists, intensivists, infectious disease specialists, epidemiologists, representatives of patients' associations and organ-sharing organizations, transplant coordinators, and ethicists voted on and validated the proposed statements. After carefully reviewing the statements, a critical proposal for revising Italy's current liver allocation policy was prepared jointly by transplant surgeons and hepatologists. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.},
note = {Cited by: 126; All Open Access, Bronze Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2014
Martin P; Dimartini A; Feng S; Brown R; Fallon M
In: Hepatology, vol. 59, no 3, pp. 1144 – 1165, 2014, ISSN: 15273350, (Cited by: 509).
@article{Martin20141144,
title = {Evaluation for liver transplantation in adults: 2013 practice guideline by the American Association for the Study of Liver Diseases and the American Society of Transplantation},
author = {Paul Martin and Andrea Dimartini and Sandy Feng and Robert Brown and Michael Fallon},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84896833751&doi=10.1002%2fhep.26972&partnerID=40&md5=7e4ce834a5af7266516093a6b9ee57bc},
doi = {10.1002/hep.26972},
issn = {15273350},
year = {2014},
date = {2014-01-01},
urldate = {2014-01-01},
journal = {Hepatology},
volume = {59},
number = {3},
pages = {1144 – 1165},
note = {Cited by: 509},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2012
Newsome P N; Allison M E; Andrews P A; Auzinger G; Day C P; Ferguson J W; Henriksen P A; Hubscher S G; Manley H; McKiernan P J; Millson C; Mirza D; Neuberger J M; Oben J; Pollard S; Simpson K J; Thorburn D; Tomlinson J W; Wyatt J S
Guidelines for liver transplantation for patients with non-alcoholic steatohepatitis Journal Article
In: Gut, vol. 61, no 4, pp. 484 – 500, 2012, ISSN: 14683288, (Cited by: 56; All Open Access, Bronze Open Access, Green Open Access).
@article{Newsome2012484,
title = {Guidelines for liver transplantation for patients with non-alcoholic steatohepatitis},
author = {Philip Noel Newsome and M. E. Allison and P. A. Andrews and G. Auzinger and C. P. Day and J. W. Ferguson and P. A. Henriksen and S. G. Hubscher and H. Manley and P. J. McKiernan and C. Millson and D. Mirza and J. M. Neuberger and J. Oben and S. Pollard and K. J. Simpson and D. Thorburn and J. W. Tomlinson and J. S. Wyatt},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84857802209&doi=10.1136%2fgutjnl-2011-300886&partnerID=40&md5=4d1b4be8c510cb254385476f61d6c47b},
doi = {10.1136/gutjnl-2011-300886},
issn = {14683288},
year = {2012},
date = {2012-01-01},
urldate = {2012-01-01},
journal = {Gut},
volume = {61},
number = {4},
pages = {484 – 500},
note = {Cited by: 56; All Open Access, Bronze Open Access, Green Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
