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Brito-Suárez JM, Medina-Hernández E, Medeiros M, Cantú-Quintanilla G, Morales-Buenrostro LE, Diaz-González de Ferris ME, Valdez-Ortiz R. A.L.L. Y.O.U. N.E.E.D. I.S. L.O.V.E. Manual on health self-management and patient-reported outcomes among low-income young adult Mexicans on chronic dialysis: Feasibility study. J Pediatr Nurs 2022; 62:129-135. [PMID: 34801325 DOI: 10.1016/j.pedn.2021.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/27/2021] [Accepted: 10/28/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE We evaluated disease knowledge/self-management skills among low-income Mexican young adults maintained on dialysis and to test the effectiveness of the A.L.L. Y.O.U. N.E.E.D. I.S. L.O.V.E (AYNIL) Manual - Spanish Version on patient-reported outcomes. This is a low literacy teaching tool designed with patients and educators' input. DESIGN AND METHODS A quasi-experimental study was conducted in 17 chronic dialysis patients at Mexico City's Hospital General de México, Dr. Eduardo Liceaga. Ages 18-30-year-old completed disease knowledge/self-management and quality of life measures before the intervention and 6 weeks later. RESULTS Significant increases were observed on disease knowledge/self-management scores in the STARx questionnaire from 47 (IQ: 40,51) to 50 (IQ: 48,54) p = 0.04. The UNC-TRxANSITION Index increased significantly from 4.8 (IQ: 3.9,5.7) to 7.7 (IQ: 7.5,8.2) p ≤0.001. Significant increases in scores were detected in the "Burden of kidney disease" (p = 0.008), "Effects of kidney disease" " (p = 0.03) and " Dialysis staff encouragement" (p = 0.027) based on the KDQoL survey. CONCLUSIONS In this vulnerable population, the Spanish version of the A.L.L. Y.O.U. N.E.E.D. I.S. L.O.V.E. - AYNIL Manual improved CKD/ESRD disease knowledge/self-management skills and HRQoL. This study highlighted the need for low-literacy educational tools to improve patient-reported outcomes. PRACTICE IMPLICATIONS Young adults with CKD/ESRD can benefit from patient-centered educational interventions to enhance their autonomy and the development of self-management behaviors that improve patient-reported outcomes and potential complications of the disease. Special attention is needed in low-income patients with low rates of adherence to treatments and poor self-management skills.
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Affiliation(s)
- Juliette Marie Brito-Suárez
- Programa de Maestría y Doctorado en Ciencias de la Salud, Universidad Nacional Autónoma de México, Mexico City, Mexico; Unidad de Investigación y Diagnóstico en Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Elba Medina-Hernández
- Servicio de Nefrología, Hospital General de México, Dr. Eduardo Liceaga, Mexico City, Mexico
| | - Mara Medeiros
- Unidad de Investigación y Diagnóstico en Nefrología y Metabolismo Mineral Óseo, Hospital Infantil de México Federico Gómez, Mexico City, Mexico.
| | | | - Luis Eduardo Morales-Buenrostro
- Department of Nephrology and Mineral Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | - Rafael Valdez-Ortiz
- Servicio de Nefrología, Hospital General de México, Dr. Eduardo Liceaga, Mexico City, Mexico.
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Millán DAC, Fajardo-Cediel W, Tobar-Roa V, García-Perdomo HA, Autrán-Gómez AM. Strategies to Mitigate the Impact of COVID 19 Pandemic on Organ Donation and Kidney Transplantation in Latin America. Curr Urol Rep 2021; 22:59. [PMID: 34913144 PMCID: PMC8724642 DOI: 10.1007/s11934-021-01076-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 01/06/2023]
Abstract
PURPOSE OF REVIEW COVID-19 pandemics have severely affected Latin America. It has resulted in SARS-CoV-2-associated clinical adverse outcomes, but also in social and economic deterioration. Consequently, it generated a significant negative impact on organ donation and kidney transplantation (KTx) activity in our region, leading to a negative impact on these patients' survival and quality of life. For this reason, this article aimed to describe applicable logistics, organizational and clinical strategies to mitigate the effect of the COVID-19 pandemic on kidney donation and transplantation in our region. RECENT FINDINGS Absenteeism to hemodialysis sessions in patients with end-stage renal disease has been described in up to 54% in Latin America. Not surprisingly, there was a reduction in organ donation and transplants between 21 and 59%. Also, there is a higher incidence of COVID-19 positive tests in the waiting list population than KTx recipients (9.9%). However, there was a higher mortality rate in KTx recipients than the waiting list population (32%). Additionally, 59% of living donor kidney transplant programs suspended the evaluation of new donors due to the COVID-19 pandemic. Throughout this manuscript, we summarize some practical tips to resume organ donation and KTx during pandemics in Latin America, such as selecting healthy donors and recipients, universal SARS-CoV-2 screening, implementing COVID-19 accessible pathways, and telehealth as a standard, and postpone all non-urgent visits.
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Affiliation(s)
- David Andrés Castañeda Millán
- Department of Surgery, Urology Unit, Hospital Universitario Nacional de Colombia, Universidad Nacional de Colombia, Bogotá, Colombia.
| | | | - Verónica Tobar-Roa
- Urology Department and Kidney Transplant Unit, Clínica FOSCAL, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia
| | | | - Ana María Autrán-Gómez
- Oficina de Investigación Confederación Americana de Urologia (CAU), Buenos Aires, Argentina
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Torales S, Berardo J, Hasdeu S, Esquivel MP, Rosales A, Azofeifa C, Salazar J, Cerdas M, Gianneo O, Esteche M, Leguizamo E, Lemgruber A, Beltrán M, Caccavo F. [Comparative economic evaluation of renal replacement therapies in Argentina, Costa Rica, and UruguayAvaliação econômica comparativa de terapias de substituição renal na Argentina, na Costa Rica e no Uruguai]. Rev Panam Salud Publica 2021; 45:e119. [PMID: 34703459 PMCID: PMC8529996 DOI: 10.26633/rpsp.2021.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 06/15/2021] [Indexed: 11/24/2022] Open
Abstract
Objetivo. Evaluar las diferencias de costos y prevalencia de las terapias de remplazo renal (TRR) como el trasplante, la diálisis peritoneal y la hemodiálisis en Argentina, Costa Rica y Uruguay, mediante estrategias costo-efectivas de difusión. Métodos. Costos y prevalencia de principales financiadores y prestadores por país, y análisis de costo-efectividad mediante modelo de Markov a 5 años, evaluando estrategias de asignación de recursos expresadas por razón incremental de costo-efectividad en costo por año de vida ajustado por calidad. Resultados. Se observa dispersión entre los países en el acceso y los valores prestacionales de TRR, que afectan su prevalencia y el punto de equilibrio monetario. Desde el punto de vista de los costos, es más eficiente promover la realización de trasplantes y de diálisis peritoneal, y desalentar la indicación de hemodiálisis, aunque la disponibilidad de cada TRR por país requirió evaluaciones particulares. Conclusiones. Promover la realización de trasplantes ahorra costos, aunque los puntos de equilibrio variables requieren determinar diferentes umbrales de costo-efectividad por país. En Argentina y Uruguay, la administración de TRR mejoraría su eficiencia si se aumentan la cantidad de pacientes en diálisis peritoneal y las tasas de donación para trasplantes. En Costa Rica (donde hay tasas elevadas de trasplantes y margen presupuestario), la incorporación de técnicas dialíticas se ajusta por demanda e incidencia de pacientes con ERCT.
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Affiliation(s)
- Santiago Torales
- Dirección de Investigación en Salud Ministerio de Salud de la Nación Argentina Dirección de Investigación en Salud, Ministerio de Salud de la Nación, Argentina
| | - José Berardo
- Universidad Nacional del Litoral Argentina Universidad Nacional del Litoral, Argentina
| | - Santiago Hasdeu
- Universidad Nacional del Comahue Argentina Universidad Nacional del Comahue, Argentina
| | - María Paula Esquivel
- Caja Costarricense de Seguro Social Costa Rica Caja Costarricense de Seguro Social, Costa Rica
| | - Alfonso Rosales
- Caja Costarricense de Seguro Social Costa Rica Caja Costarricense de Seguro Social, Costa Rica
| | - Carlos Azofeifa
- Caja Costarricense de Seguro Social Costa Rica Caja Costarricense de Seguro Social, Costa Rica
| | - Jordan Salazar
- Caja Costarricense de Seguro Social Costa Rica Caja Costarricense de Seguro Social, Costa Rica
| | - Manuel Cerdas
- Hospital México San José Costa Rica Hospital México, San José, Costa Rica
| | - Oscar Gianneo
- Fondo Nacional de Recursos Uruguay Fondo Nacional de Recursos, Uruguay
| | - Martín Esteche
- Fondo Nacional de Recursos Uruguay Fondo Nacional de Recursos, Uruguay
| | - Eliana Leguizamo
- Fondo Nacional de Recursos Uruguay Fondo Nacional de Recursos, Uruguay
| | - Alexandre Lemgruber
- Organización Panamericana de la Salud Washington D.C. Estados Unidos de América Organización Panamericana de la Salud, Washington D.C., Estados Unidos de América
| | - Mauricio Beltrán
- Organización Panamericana de la Salud Washington D.C. Estados Unidos de América Organización Panamericana de la Salud, Washington D.C., Estados Unidos de América
| | - Francisco Caccavo
- Organización Panamericana de la Salud Washington D.C. Estados Unidos de América Organización Panamericana de la Salud, Washington D.C., Estados Unidos de América
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Luyckx VA, Al-Aly Z, Bello AK, Bellorin-Font E, Carlini RG, Fabian J, Garcia-Garcia G, Iyengar A, Sekkarie M, van Biesen W, Ulasi I, Yeates K, Stanifer J. Sustainable Development Goals relevant to kidney health: an update on progress. Nat Rev Nephrol 2020; 17:15-32. [PMID: 33188362 PMCID: PMC7662029 DOI: 10.1038/s41581-020-00363-6] [Citation(s) in RCA: 86] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/29/2020] [Indexed: 12/13/2022]
Abstract
Globally, more than 5 million people die annually from lack of access to critical treatments for kidney disease — by 2040, chronic kidney disease is projected to be the fifth leading cause of death worldwide. Kidney diseases are particularly challenging to tackle because they are pathologically diverse and are often asymptomatic. As such, kidney disease is often diagnosed late, and the global burden of kidney disease continues to be underappreciated. When kidney disease is not detected and treated early, patient care requires specialized resources that drive up cost, place many people at risk of catastrophic health expenditure and pose high opportunity costs for health systems. Prevention of kidney disease is highly cost-effective but requires a multisectoral holistic approach. Each Sustainable Development Goal (SDG) has the potential to impact kidney disease risk or improve early diagnosis and treatment, and thus reduce the need for high-cost care. All countries have agreed to strive to achieve the SDGs, but progress is disjointed and uneven among and within countries. The six SDG Transformations framework can be used to examine SDGs with relevance to kidney health that require attention and reveal inter-linkages among the SDGs that should accelerate progress. Working towards sustainable development is essential to tackle the rise in the global burden of non-communicable diseases, including kidney disease. Five years after the Sustainable Development Goal agenda was set, this Review examines the progress thus far, highlighting future challenges and opportunities, and explores the implications for kidney disease. Each Sustainable Development Goal (SDG) has the potential to improve kidney health and prevent kidney disease by improving the general health and well-being of individuals and societies, and by protecting the environment. Achievement of each SDG is interrelated to the achievement of multiple other SDGs; therefore, a multisectoral approach is required. The global burden of kidney disease has been relatively underestimated because of a lack of data. Structural violence and the social determinants of health have an important impact on kidney disease risk. Kidney disease is the leading global cause of catastrophic health expenditure, in part because of the high costs of kidney replacement therapy. Achievement of universal health coverage is the minimum requirement to ensure sustainable and affordable access to early detection and quality treatment of kidney disease and/or its risk factors, which should translate to a reduction in the burden of kidney failure in the future.
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Affiliation(s)
- Valerie A Luyckx
- Renal Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. .,Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa. .,Institute of Biomedical Ethics and the History of Medicine, University of Zürich, Zürich, Switzerland.
| | - Ziyad Al-Aly
- Department of Medicine, Washington University in Saint Louis, Saint Louis, MO, USA.,Clinical Epidemiology Center, Veterans Affairs Saint Louis Health Care System, Saint Louis, MO, USA
| | - Aminu K Bello
- Division of Nephrology & Immunology, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | | | - Raul G Carlini
- Sección de Investigación, Servicio de Nefrología y Trasplante Renal, Hospital Universitario de Caracas, Caracas, Venezuela
| | - June Fabian
- Wits Donald Gordon Medical Centre, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Witwatersrand, South Africa
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Hospital, 278, Guadalajara, Mexico
| | - Arpana Iyengar
- Department of Paediatric Nephrology, St. John's National Academy of Health Sciences, Bangalore, India
| | | | - Wim van Biesen
- Renal Division, Ghent University Hospital, Ghent, Belgium
| | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Karen Yeates
- Division of Nephrology, Department of Medicine, Queen's University, Kingston, Ontario, Canada
| | - John Stanifer
- Munson Nephrology, Munson Healthcare, Traverse City, MI, USA
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Díaz-González Á, Sanduzzi-Zamparelli M, da Fonseca LG, Di Costanzo GG, Alves R, Iavarone M, Leal C, Sacco R, Matilla AM, Hernández-Guerra M, Aballay Soteras G, Wörns MA, Pinter M, Varela M, Ladekarl M, Chagas AL, Mínguez B, Arenas JI, Granito A, Sánchez-Torrijos Y, Rojas Á, Rodríguez de Lope C, Alvares-da-Silva MR, Pascual S, Rimassa L, Lledó JL, Huertas C, Sangro B, Giannini EG, Delgado M, Vergara M, Perelló C, Lue A, Sala M, Gallego A, Coll S, Hernáez T, Piñero F, Pereira G, França A, Marín J, Anders M, Mello V, Lozano M, Nault JC, Menéndez J, García Juárez I, Bruix J, Reig M. International and multicenter real-world study of sorafenib-treated patients with hepatocellular carcinoma under dialysis. Liver Int 2020; 40:1467-1476. [PMID: 32170821 DOI: 10.1111/liv.14436] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Revised: 03/06/2020] [Accepted: 03/09/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND & AIMS Information on safety and efficacy of systemic treatment in patients with hepatocellular carcinoma (HCC) under dialysis are limited due to patient exclusion from clinical trials. Thus, we aimed to evaluate the rate, prevalence, tolerability, and outcome of sorafenib in this population. METHODS We report a multicenter study comprising patients from Latin America and Europe. Patients treated with sorafenib were enrolled; demographics, dose modifications, adverse events (AEs), treatment duration, and outcome of patients undergoing dialysis were recorded. RESULTS As of March 2018, 6156 HCC patients were treated in 44 centres and 22 patients were concomitantly under dialysis (0.36%). The median age was 65.5 years, 40.9% had hepatitis C, 75% had Child-Pugh A, and 85% were Barcelona Clinic Liver Cancer-C. The median time to first dose modification, treatment duration and overall survival rate were 2.4 months (interquartile ranges [IQR], 0.8-3.8), 10.8 months (IQR, 4.5-16.9), and 17.5 months (95% CI, 7.2-24.5), respectively. Seventeen patients required at least 1 dose modification. The main causes of first dose modification were asthenia/worsening of Eastern Cooperative Oncology Group-Performance Status and diarrhoea. At the time of death or last follow-up, four patients were still on treatment and 18 had discontinued sorafenib: 14 were due to tumour progression, 2 were sorafenib-related, and 2 were non-sorafenib-related AE. CONCLUSIONS The outcomes observed in this cohort seem comparable to those in the non-dialysis population. Thus, to the best of our knowledge, this is the largest and most informative dataset regarding systemic treatment outcomes in HCC patients undergoing dialysis.
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Affiliation(s)
- Álvaro Díaz-González
- Barcelona Clínic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Marco Sanduzzi-Zamparelli
- Barcelona Clínic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Leonardo G da Fonseca
- Barcelona Clínic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
| | | | | | - Massimo Iavarone
- CRC "A. M. and A. Migliavacca" Center for Liver Disease, Division of Gastroenterology and Hepatology, IRCCS Cà Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Cassia Leal
- Gastroenterology and Hepatology Department, Federal Hospital of State Servants and Fluminense Federal University (Hospital Universitário Antônio Pedro), Río de Janeiro, Brazil
| | - Rodolfo Sacco
- Gastroenterology and Metabolic Diseases, Pisa University Hospital, Pisa, Italy
| | - Ana M Matilla
- Digestive Diseases Department, University General Hospital Gregorio Marañón, Madrid, Spain
| | | | - Gabriel Aballay Soteras
- Liver Transplant Unit, Hospital General de Agudos Dr Cosme Argerich, Buenos Aires Autonomous City, Argentina
| | - Marcus-Alexander Wörns
- First Department of Medicine, University Medical Centre of the Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Matthias Pinter
- Division of Gastroenterology & Hepatology, Department of Internal Medicine III, Vienna Liver Cancer Study Group, AKH & Medical University of Vienna, Vienna, Austria
| | - María Varela
- Liver Unit, Central University Hospital of Asturias, Institute of Oncology of Asturias (IUOPA), Foundation for Biosanitary Research and Innovation of the Principality of Asturias (FINBA), Oviedo, Spain
| | - Morten Ladekarl
- Department of Oncology, Aarhus University Hospital, and Department of Oncology, Clinical Cancer Research Center, Aalborg University Hospital, Aarhus, Denmark
| | - Aline L Chagas
- Division of Clinical Gastroenterology and Hepatology, Department of Gastroenterology, University of São Paulo School of Medicine, Cancer Institute of the State of São Paulo, Sao Paulo, Brazil
| | - Beatriz Mínguez
- Liver Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Vall d'Hebron Institut of Research, Center for Biomedical Research in Liver and Digestive Diseases Network (CIBERehd), Autonomous University of Barcelona, Barcelona, Spain
| | - Juan I Arenas
- Digestive Diseases Department, Donostia University Hospital, San Sebastián, Spain
| | - Alessandro Granito
- Unit of Internal Medicine, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Yolanda Sánchez-Torrijos
- UCM Digestive Diseases and Center for Biomedical Research in Liver and Digestive Diseases Network (CIBERehd), Institute of Biomedicine of Seville (IBiS), SeLiver Group, Virgen del Rocío/CSIC/US, Sevilla, Spain
| | - Ángela Rojas
- UCM Digestive Diseases and Center for Biomedical Research in Liver and Digestive Diseases Network (CIBERehd), Institute of Biomedicine of Seville (IBiS), SeLiver Group, Virgen del Rocío/CSIC/US, Sevilla, Spain
| | - Carlos Rodríguez de Lope
- Digestive Diseases Department, Marqués de Valdecilla University Hospital, Marqués de Valdecilla Research Institute (IDIVAL), Santander, Spain
| | - Mario R Alvares-da-Silva
- GI/Liver Unit, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sonia Pascual
- Hepatic Unit, Gastroenterology Service, General University Hospital of Alicante, Center for Biomedical Research in Liver and Digestive Diseases Network (CIBERehd), Alicante, Spain
| | - Lorenza Rimassa
- Medical Oncology and Hematology Unit, Humanitas Cancer Center, Humanitas Clinical and Research Center - IRCCS, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - José L Lledó
- Gastroenterology and Liver Diseases department, Ramón y Cajal University Hospital, Center for Biomedical Research in Liver and Digestive Diseases Network (CIBERehd), Madrid, Spain
| | - Carlos Huertas
- Digestive Diseases Department, Doctor Josep Trueta University Hospital, Girona, Spain
| | - Bruno Sangro
- Liver Unit, University of Navarra Clinic, Health Research Institute of Navarra (IDISNA), Center for Biomedical Research in Liver and Digestive Diseases Network (CIBERehd), Pamplona, Spain
| | - Edoardo G Giannini
- Gastroenterology Unit, Department of Internal Medicine, IRCCS-San Martino Policlinico Hospital, University of Genoa, Genoa, Italy
| | - Manuel Delgado
- Digestive Diseases Department, La Coruña University Hospital, A Coruña, Spain
| | - Mercedes Vergara
- Liver Unit, Digestive Diseases Department, Parc Taulí University Hospital, Parc Taulí I3PT Research and Innovation Institute, Autonomous University of Barcelona, Sabadell, Spain
| | - Christie Perelló
- Liver Unit, Puerta de Hierro University Hospital, Puerta de Hierro Majadahonda Health Research Institute (IDIPHISA), Madrid, Spain
| | - Alberto Lue
- Digestive Diseases Department, Hepatology Unit and Liver Transplant, Lozano Blesa Clinical University Hospital, Zaragoza, Spain
| | - Margarita Sala
- Liver Unit, Digestive Diseases Department, Germans Trias i Pujol University Hospital, Center for Biomedical Research in Liver and Digestive Diseases Network (CIBERehd), Badalona, Spain
| | - Adolfo Gallego
- Digestive Diseases Department, Santa Creu i Sant Pau University Hospital, Barcelona, Spain
| | - Susanna Coll
- Liver Section, Gastroenterology Department, Hospital del Mar, IMIM Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Tania Hernáez
- Digestive Diseases Department, San Pedro Hospital, Logroño, Spain
| | - Federico Piñero
- Liver Unit, Austral University Hospital, Buenos Aires, Argentina
| | - Gustavo Pereira
- Gastroenterology and Hepatology Unit, Bonsucesso Federal Hospital, Ministry of Health, Río de Janeiro, Brazil
| | - Alex França
- Liver Unit, Department of Medicine, Federal University of Sergipe, Sergipe, Brazil
| | - Juan Marín
- Pablo Tobón Uribe Hospital, Medellín, Colombia
| | - Margarita Anders
- Liver Diseases and Liver Transplant Unit, German Hospital, Buenos Aires, Argentina
| | - Vivianne Mello
- Multidisciplinary Assistance in Oncology (AMO) Clinic, Salvador, Brazil
| | - Mar Lozano
- Digestive Diseases Department, Infanta Leonor University Hospital, Madrid, Spain
| | - Jean C Nault
- Cordeliers Research Center, Sorbonne University, Inserm, USPC, Paris Descartes University, Paris Diderot University, Paris 13 University, Functional Genomics of Solid Tumors Laboratory, Jean Verdier Hospital, Paris-Seine-Saint University Hospital -Denis, Public Assistance Hospitals of Paris, Bondy, France
| | - Josemaría Menéndez
- Liver Transplant and Liver Diseases Unit, Central Hospital of the Armed Forces (Military Hospital), Montevideo, Uruguay
| | - Ignacio García Juárez
- Gastroenterology Department, National Institute of Medical Sciences and Nutrition Salvador Zubirán, City of Mexico, Mexico
| | - Jordi Bruix
- Barcelona Clínic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
| | - María Reig
- Barcelona Clínic Liver Cancer (BCLC) Group, Liver Unit, Hospital Clínic of Barcelona, IDIBAPS, Barcelona, Spain
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