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| 1 | Pediatric liver transplantation显示文摘In previous decades,pediatric liver transplantation has become a state-of-the-art operation with excellent success and limited mortality.Graft and patient survival have continued to improve as a result of improvements in medical,surgical and anesthetic management,organ availability,immunosuppression,and identification and treatment of postoperative complications.The utilization of split-liver grafts and living-related donors has provided more organs for pediatric patients.Newer immunosuppression regimens,including induction therapy,have had a significant impact on graft and patient survival.Future developments of pediatric liver transplantation will deal with long-term followup,with prevention of immunosuppression-related complications and promotion of as normal growth as possible.This review describes the state-of-the-art in pediatric liver transplantation. | Marco Spada Silvia Riva Giuseppe Maggiore Davide Cintorino Bruno Gridelli | 2009 | World Journal of Gastroenterology2009，15，6： | 20 |
| 2 | Early graft dysfunction following adult-to-adult livingrelated liver transplantation:Predictive factors and outcomes显示文摘AIM:To describe a condition that we define as early graft dysfunction(EGD)which can be identified preoperatively. METHODS:Small-for-size graft dysfunction following living-related liver transplantation(LRLT)is characterized by EGD when the graft-to-recipient body weight ratio(GRBWR)is below 0.8%.However, patients transplanted with GRBWR above 0.8%can develop dysfunction of the graft.In 73 recipients of LRLT(GRBWR>0.8%),we identified 10 patients who developed EGD.The main measures of outcomes analyzed were overall mortality,number of re-transplants and length of stay in days(LOS).Furthermore we analyzed other clinical pre-transplant variables,intraoperative parameters and post transplant data.RESULTS:A trend in favor of the non-EGD group(3-mo actuarial survival 98%vs 88%,P=0.09;3-mo graft mortality 4.7%vs 20%,P=0.07)was observed as well as shorter LOS(13 d vs 41.5 d;P=0.001)and smaller requirement of peri-operative Units of Plasma (4 vs 14;P=0.036).Univariate analysis of pre- transplant variables identified platelet count,serum bilirubin,INR and Meld-Na score as predictors of EGD. In the multivariate analysis transplant Meld-Na score (P=0.025,OR:1.175)and pretransplant platelet count(P=0.043,OR:0.956)were independently associated with EGD. CONCLUSION:EGD can be identified preoperatively and is associated with increased morbidity after LRLT. A prompt recognition of EGD can trigger a timely treatment. | Salvatore Gruttadauria Fabrizio di Francesco Giovanni Battista Vizzini Angelo Luca Marco Spada Davide Cintorino Sergio Li Petri Giada Pietrosi Duilio Pagano Bruno Gridelli | 2009 | World Journal of Gastroenterology2009，15，36： | 2 |
| 3 | Liver regeneration after liver resection: Clinical aspects and correlation with infective complications显示文摘AIM:To investigate whether early liver regeneration after resection in patients with hepatic tumors might be influenced by post-operative infective complications.METHODS:A retrospective analysis of 27 liver resections for tumors performed in a single referral center from November 2004 to January 2010.Regeneration was evaluated by multidetector computed tomographyat a mean follow-up of 43.85 d.The Clavien-Dindo classification was used to evaluate postoperative events in the first 6 mo after transplantation,and Centers for Disease Control and Prevention definitions were used for healthcare associated infections data.Generalized linear regression models with Gaussian family distribution and log link function were used to reveal the principal promoters of early liver regeneration.RESULTS:Ten of the 27 patients(37%)underwent chemotherapy prior to surgery,with a statistically significant prevalence of patients with metastasis(P=0.007).Eight patients(30%)underwent embolization,3 with primary tumors,and 5 with secondary tumors.Twenty patients(74%)experienced complications,with 12(60%)experiencing Clavien-Dindo Grade 3a to 5 complications.Regeneration≥100%occurred in 10(37%)patients.The predictors were smaller future remnant liver volume(-0.002;P<0.001),and a greater spleen volume/future remnant liver volume ratio(0.499;P=0.01).Patients with a resection of≥5 Couinaud segments experienced greater early regeneration(P=0.04).Nine patients experienced surgical site infections,and in 7 cases Clavien-Dindo Grade 3a to 4 complications were detected(P=0.016).There were no significant differences between patients with primary or secondary tumors,and either onset or infections or severity of surgical complications.CONCLUSION:Regardless of the onset of infective complications,future remnant liver and spleen volumes may be reliable predictors of early liver regeneration after hepatic resection on an otherwise healthy liver. | Duilio Pagano Marco Spada Vishal Parikh Fabio Tuzzolino Davide Cintorino Luigi Maruzzelli Giovanni Vizzini Angelo Luca Alessandra Mularoni Paolo Grossi Bruno Gridelli Salvatore Gruttadauria | 2014 | World Journal of Gastroenterology2014，20，22： | 2 |
| 4 | Right hepatic lobe living donation: A 12 years single Italian center experience显示文摘Mini invasive techniques are taking over conventional open liver resections in the setting of left lateral segmentectomy for living liver donation,and hydride procedure are being implemented for the living related right hepatectomy.Our center routinely performs laparoscopic left lateral segmentectomy for pediatric recipient and has been the first in the Europe performing an entirely robotic right hepatectomy.Great emphasis is posed on living donor safety which is the first priority during the entire operation,then the most majority of our procedures are still conventional open right hepatectomy(RHLD),defined as removal of a portion of liver corresponding to Couinaud segments 5-8,in order to obtain a graft for adult to adult living related liver transplant.During this 10 years period some changes,herein highlighted,have occurred to our surgical techniques.This study reports the largest Italian experience with RHLD,focused on surgical technique evolution over a 10 years period.Donor safety must be the first priority in right-lobe living-related donation:the categorization of complications of living donors,specially,after this'highly sensitive'procedure,reflects the need for prompt and detailed reports. | Salvatore Gruttadauria Duilio Pagano Davide Cintorino Antonio Arcadipane Mario Traina Riccardo Volpes Angelo Luca Giovanni Vizzini Bruno Gridelli Marco Spada | 2013 | World Journal of Gastroenterology2013，19，38： | 2 |
| 5 | Surgical Management of Complex Liver Trauma: A Single Liver Transplant Center Experience显示文摘 | Li Petri Sergio Gruttadauria Salvatore Pagano Duilio Echeverri Gabriel J Di Francesco Fabrizio Cintorino Davide Spada Marco Gridelli Bruno | 2012 | The American Surgeon2012，，1： | 1 |
| 6 | Liver resections for liver transplantations显示文摘Split-Liver and living-related donor liver transplantation are the newest and both technically and ethically most challenging developments in liver transplantation and have contributed to a reduction in donor shortage.We report the technical aspects of surgical procedures performed to achieve a partial graft from a cadaveric and a live donor. | Salvatore Gruttadauria Fabrizio di Francesco Duilio Pagano Sergio Li Petri Davide Cintorino Marco Spada Bruno Gridelli | 2010 | World Journal of Gastrointestinal Surgery2010，2，3： | 0 |
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