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Viganò M, Beretta M, Lepore M, Abete R, Benatti SV, Grassini MV, Camagni S, Chiodini G, Vargiu S, Vittori C, Iachini M, Terzi A, Neri F, Pinelli D, Casotti V, Di Marco F, Ruggenenti P, Rizzi M, Colledan M, Fagiuoli S. Vaccination Recommendations in Solid Organ Transplant Adult Candidates and Recipients. Vaccines (Basel) 2023; 11:1611. [PMID: 37897013 PMCID: PMC10611006 DOI: 10.3390/vaccines11101611] [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] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 10/05/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
Prevention of infections is crucial in solid organ transplant (SOT) candidates and recipients. These patients are exposed to an increased infectious risk due to previous organ insufficiency and to pharmacologic immunosuppression. Besides infectious-related morbidity and mortality, this vulnerable group of patients is also exposed to the risk of acute decompensation and organ rejection or failure in the pre- and post-transplant period, respectively, since antimicrobial treatments are less effective than in the immunocompetent patients. Vaccination represents a major preventive measure against specific infectious risks in this population but as responses to vaccines are reduced, especially in the early post-transplant period or after treatment for rejection, an optimal vaccination status should be obtained prior to transplantation whenever possible. This review reports the currently available data on the indications and protocols of vaccination in SOT adult candidates and recipients.
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Affiliation(s)
- Mauro Viganò
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy (S.F.)
| | - Marta Beretta
- Pulmonary Medicine Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.B.); (F.D.M.)
| | - Marta Lepore
- Unit of Nephrology and Dialysis, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.L.); (P.R.)
| | - Raffaele Abete
- Cardiology Division, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy (C.V.)
| | - Simone Vasilij Benatti
- Infectious Diseases Unit, ASST Papa Giovanni XXII, 24127 Bergamo, Italy; (S.V.B.); (M.R.)
| | - Maria Vittoria Grassini
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy (S.F.)
- Section of Gastroenterology & Hepatology, Department of Health Promotion Sciences Maternal and Infant Care, Internal Medicine and Medical Specialties, PROMISE, University of Palermo, 90128 Palermo, Italy
| | - Stefania Camagni
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (S.C.); (F.N.); (D.P.); (M.C.)
| | - Greta Chiodini
- Pulmonary Medicine Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.B.); (F.D.M.)
| | - Simone Vargiu
- Pulmonary Medicine Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.B.); (F.D.M.)
| | - Claudia Vittori
- Cardiology Division, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy (C.V.)
| | - Marco Iachini
- Unit of Nephrology and Dialysis, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.L.); (P.R.)
| | - Amedeo Terzi
- Cardiothoracic Department, ASST Papa Giovanni XXII, 24127 Bergamo, Italy;
| | - Flavia Neri
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (S.C.); (F.N.); (D.P.); (M.C.)
| | - Domenico Pinelli
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (S.C.); (F.N.); (D.P.); (M.C.)
| | - Valeria Casotti
- Pediatric Hepatology, Gastroenterology and Transplantation Unit, ASST Papa Giovanni XXII, 24127 Bergamo, Italy;
| | - Fabiano Di Marco
- Pulmonary Medicine Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.B.); (F.D.M.)
- Department of Health Sciences, University of Milan, 20158 Milan, Italy
| | - Piero Ruggenenti
- Unit of Nephrology and Dialysis, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (M.L.); (P.R.)
- Department of Renal Medicine, Clinical Research Centre for Rare Diseases “Aldo e Cele Daccò”, Institute of Pharmacologic Research “Mario Negri IRCCS”, Ranica, 24020 Bergamo, Italy
| | - Marco Rizzi
- Infectious Diseases Unit, ASST Papa Giovanni XXII, 24127 Bergamo, Italy; (S.V.B.); (M.R.)
| | - Michele Colledan
- Department of Organ Failure and Transplantation, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy; (S.C.); (F.N.); (D.P.); (M.C.)
| | - Stefano Fagiuoli
- Gastroenterology Hepatology and Transplantation Unit, ASST Papa Giovanni XXIII, 24127 Bergamo, Italy (S.F.)
- Department of Medicine, University of Milan Bicocca, 20126 Milan, Italy
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Francica A, Loforte A, Attisani M, Maiani M, Iacovoni A, Nisi T, Comisso M, Terzi A, De Bonis M, Vendramin I, Boffini M, Musumeci F, Luciani GB, Rinaldi M, Pacini D, Onorati F. Corrigendum: Five-Year Outcome After Continuous Flow LVAD With Full-Magnetic (HeartMate 3) Versus Hybrid Levitation System (HeartWare): A Propensity-Score Matched Study From an All-Comers Multicentre Registry. Transpl Int 2023; 36:12088. [PMID: 37877015 PMCID: PMC10593037 DOI: 10.3389/ti.2023.12088] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/26/2023]
Abstract
[This corrects the article DOI: 10.3389/ti.2023.11675.].
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Affiliation(s)
| | - Antonio Loforte
- Division of Cardiac Surgery, S. Orsola University Hospital, IRCCS Bologna, Bologna, Italy
- City of Health and Science Hospital, Cardiac Surgery University Unit, University of Turin, Turin, Italy
| | - Matteo Attisani
- City of Health and Science Hospital, Cardiac Surgery University Unit, University of Turin, Turin, Italy
| | - Massimo Maiani
- Division of Cardiac Surgery, Ospedale S. Maria della Misericordia, Udine, Italy
| | - Attilio Iacovoni
- Division of Cardiac Surgery, Papa Giovanni XXII Hospital of Bergamo, Bergamo, Italy
| | - Teodora Nisi
- Division of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Marina Comisso
- Division of Cardiac Surgery, San Camillo Forlanini Hospital, Rome, Italy
| | - Amedeo Terzi
- Division of Cardiac Surgery, Papa Giovanni XXII Hospital of Bergamo, Bergamo, Italy
| | - Michele De Bonis
- Division of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Igor Vendramin
- Division of Cardiac Surgery, Ospedale S. Maria della Misericordia, Udine, Italy
| | - Massimo Boffini
- City of Health and Science Hospital, Cardiac Surgery University Unit, University of Turin, Turin, Italy
| | - Francesco Musumeci
- Division of Cardiac Surgery, San Camillo Forlanini Hospital, Rome, Italy
| | | | - Mauro Rinaldi
- City of Health and Science Hospital, Cardiac Surgery University Unit, University of Turin, Turin, Italy
| | - Davide Pacini
- Division of Cardiac Surgery, S. Orsola University Hospital, IRCCS Bologna, Bologna, Italy
| | - Francesco Onorati
- Division of Cardiac Surgery, University Hospital of Verona, Verona, Italy
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Francica A, Loforte A, Attisani M, Maiani M, Iacovoni A, Nisi T, Comisso M, Terzi A, De Bonis M, Vendramin I, Boffini M, Musumeci F, Luciani GB, Rinaldi M, Pacini D, Onorati F. Five-Year Outcome After Continuous Flow LVAD With Full-Magnetic (HeartMate 3) Versus Hybrid Levitation System (HeartWare): A Propensity-Score Matched Study From an All-Comers Multicentre Registry. Transpl Int 2023; 36:11675. [PMID: 37727385 PMCID: PMC10505657 DOI: 10.3389/ti.2023.11675] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/08/2023] [Indexed: 09/21/2023]
Abstract
Despite the withdrawal of the HeartWare Ventricular Assist Device (HVAD), hundreds of patients are still supported with this continuous-flow pump, and the long-term management of these patients is still under debate. This study aims to analyse 5 years survival and freedom from major adverse events in patients supported by HVAD and HeartMate3 (HM3). From 2010 to 2022, the MIRAMACS Italian Registry enrolled all-comer patients receiving a LVAD support at seven Cardiac Surgery Centres. Out of 447 LVAD implantation, 214 (47.9%) received HM3 and 233 (52.1%) received HVAD. Cox-regression analysis adjusted for major confounders showed an increased risk for mortality (HR 1.5 [1.2-1.9]; p = 0.031), for both ischemic stroke (HR 2.08 [1.06-4.08]; p = 0.033) and haemorrhagic stroke (HR 2.6 [1.3-4.9]; p = 0.005), and for pump thrombosis (HR 25.7 [3.5-188.9]; p < 0.001) in HVAD patients. The propensity-score matching analysis (130 pairs of HVAD vs. HM3) confirmed a significantly lower 5 years survival (81.25% vs. 64.1%; p 0.02), freedom from haemorrhagic stroke (90.5% vs. 70.1%; p < 0.001) and from pump thrombosis (98.5% vs. 74.7%; p < 0.001) in HVAD cohort. Although similar perioperative outcome, patients implanted with HVAD developed a higher risk for mortality, haemorrhagic stroke and thrombosis during 5 years of follow-up compared to HM3 patients.
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Affiliation(s)
| | - Antonio Loforte
- Division of Cardiac Surgery, S. Orsola University Hospital, IRCCS Bologna, Bologna, Italy
- City of Health and Science Hospital, Cardiac Surgery University Unit, University of Turin, Turin, Italy
| | - Matteo Attisani
- City of Health and Science Hospital, Cardiac Surgery University Unit, University of Turin, Turin, Italy
| | - Massimo Maiani
- Division of Cardiac Surgery, Ospedale S. Maria della Misericordia, Udine, Italy
| | - Attilio Iacovoni
- Division of Cardiac Surgery, Papa Giovanni XXII Hospital of Bergamo, Bergamo, Italy
| | - Teodora Nisi
- Division of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Marina Comisso
- Division of Cardiac Surgery, San Camillo Forlanini Hospital, Rome, Italy
| | - Amedeo Terzi
- Division of Cardiac Surgery, Papa Giovanni XXII Hospital of Bergamo, Bergamo, Italy
| | - Michele De Bonis
- Division of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Igor Vendramin
- Division of Cardiac Surgery, Ospedale S. Maria della Misericordia, Udine, Italy
| | - Massimo Boffini
- City of Health and Science Hospital, Cardiac Surgery University Unit, University of Turin, Turin, Italy
| | - Francesco Musumeci
- Division of Cardiac Surgery, San Camillo Forlanini Hospital, Rome, Italy
| | | | - Mauro Rinaldi
- City of Health and Science Hospital, Cardiac Surgery University Unit, University of Turin, Turin, Italy
| | - Davide Pacini
- Division of Cardiac Surgery, S. Orsola University Hospital, IRCCS Bologna, Bologna, Italy
| | - Francesco Onorati
- Division of Cardiac Surgery, University Hospital of Verona, Verona, Italy
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Saddoud Z, Oueslati I, Terzi A, Gioui H, Ajili M, Yazidi M, Chihaoui M. Évaluation de l’adhérence au régime méditerranéen chez les patients diabétiques de type 2. Annales d'Endocrinologie 2023. [DOI: 10.1016/j.ando.2022.12.331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Lechiancole A, Loforte A, Scandroglio M, Comisso M, Iacovoni A, Maiani M, Gliozzi G, De Bonis M, Musumeci F, Terzi A, Pacini D, Livi U. Does the distance between residency and implanting center affect the outcome of patients supported by left ventricular assist devices? A multicenter Italian study on radial mechanically assisted circulatory support (MIRAMACS) analysis. Artif Organs 2022; 46:1932-1936. [PMID: 35718933 DOI: 10.1111/aor.14343] [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] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/16/2022] [Accepted: 06/13/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients with LVAD require continuous monitoring and care, and since Implanting Centers (ICs) are more experienced in managing LVAD patients than other healthcare facilities, the distance between patient residency and IC could negatively affect the outcomes. METHODS Data of patients discharged after receiving an LVAD implantation between 2010 and 2021 collected from the MIRAMACS database were retrospectively analyzed. The population was divided into two groups: A (n = 175) and B (n = 141), according to the distance between patient residency and IC ≤ or >90 miles. The primary endpoint was freedom from Adverse Events (AEs), a composite outcome composed of death, cerebrovascular accident, hospital admission because of GI bleeding, infection, pump thrombosis, and right ventricular failure. Secondary endpoints were incidences of mortality and complications. All patients were followed-up regularly, according to participating center protocols. RESULTS Baseline clinical characteristics and indications for LVAD did not differ between the two groups. The mean duration of support was 25.5 ± 21 months for Group A and 25.7 ± 20 months for Group B (p = 0.79). At 3 years, freedom from AEs was similar between Group A and Group B (p = 0.36), and there were no differences in rates of mortality and LVAD-related complications. CONCLUSIONS Distance from the IC does not represent a barrier to successful outcomes as long as regular and continuous follow-up is provided.
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Affiliation(s)
- Andrea Lechiancole
- Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, S. Maria della Misericordia University Hospital of Udine, Udine, Italy
| | - Antonio Loforte
- Division of Cardiac Surgery, S. Orsola University Hospital, ALMA Mater Studiorum University of Bologna, IRCCS Bologna, Bologna, Italy
| | - Mara Scandroglio
- Division of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Marina Comisso
- Cardiothoracic Department, San Camillo Forlanini Hospital, Rome, Italy
| | - Attilio Iacovoni
- Cardiothoracic Department, Papa Giovanni XXII Hospital of Bergamo, Bergamo, Italy
| | - Massimo Maiani
- Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, S. Maria della Misericordia University Hospital of Udine, Udine, Italy
| | - Gregorio Gliozzi
- Division of Cardiac Surgery, S. Orsola University Hospital, ALMA Mater Studiorum University of Bologna, IRCCS Bologna, Bologna, Italy
| | - Michele De Bonis
- Division of Cardiac Surgery, IRCCS San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | | | - Amedeo Terzi
- Cardiothoracic Department, Papa Giovanni XXII Hospital of Bergamo, Bergamo, Italy
| | - Davide Pacini
- Division of Cardiac Surgery, S. Orsola University Hospital, ALMA Mater Studiorum University of Bologna, IRCCS Bologna, Bologna, Italy
| | - Ugolino Livi
- Cardiothoracic Department, Azienda Sanitaria Universitaria Friuli Centrale, S. Maria della Misericordia University Hospital of Udine, Udine, Italy
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Terzi A, Ines N, Ala M, Tayssir B, Khanfir M, Ben G, Lamloum M, Said F, Houman M. Vascularites à ANCA associées aux connectivites. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.218] [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: 11/16/2022]
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Cinelli F, Sciatti E, Rondi M, Sanvito R, Capoferri A, Innocente F, Fino C, Terzi A. P55 A CHALLENGING RIGHT ATRIAL MASS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
A 64–year–old woman presented at the Emergency Department with worsening dyspnoea and fever. Blood tests revealed normal white blood count, elevated C–reactive protein (244 mg/L) and D–dimer (2618 ng/mL). At arterial blood gases test hypoxaemia and hypocapnia was found (pH 7.48, pO2 83 mmHg, pCO2 30 mmHg, base excess –1.2 mmol/L, lactates 1.0 mmol/L). She underwent thoracic computed tomography (CT), which showed right inferior pulmonary embolism with infarction. A transthoracic echocardiography (TTE) revealed the presence of a mobile heterogeneous iso–hyperechoic neoformation completely occupying the right atrial cavity and moving partially across the tricuspid valve (Figure 1). A right atrial thrombotic formation was hypothesized and, due to its dimension, despite a valid hemodynamic, the patient underwent thrombolysis with rtPA 100 mg iv infusion over 2 hours. However, the next day at CT and TTE the mass was still there and unmodified. The screening for thrombophilia and for cancer markers were negative. Cardiac magnetic resonance imaging was waived because the clinical conditions were rapidly deteriorating. Indeed, the patient was transferred for urgent cardiac surgery. The excised mass was 5 cm x 3.5 cm large and adherent to the right atrial roof, 1 cm close to the atrioventricular node. It was completely removed by the cardiac surgeon (Figure 2). The subsequent journey was regular, without complications. The histologic exam revealed that the mass was a giant myxoma (Figure 3). At follow–up the patient persisted asymptomatic. Figure 1. Transthoracic echocardiography. Figure 2. The excised right atrial mass. Figure 3. Histologic examination of the right atrial mass.
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Affiliation(s)
- F Cinelli
- ASST BERGAMO OVEST – OSPEDALE DI TREVIGLIO–CARAVAGGIO, TREVIGLIO; ASST PAPA GIOVANNI XXIII, BERGAMO
| | - E Sciatti
- ASST BERGAMO OVEST – OSPEDALE DI TREVIGLIO–CARAVAGGIO, TREVIGLIO; ASST PAPA GIOVANNI XXIII, BERGAMO
| | - M Rondi
- ASST BERGAMO OVEST – OSPEDALE DI TREVIGLIO–CARAVAGGIO, TREVIGLIO; ASST PAPA GIOVANNI XXIII, BERGAMO
| | - R Sanvito
- ASST BERGAMO OVEST – OSPEDALE DI TREVIGLIO–CARAVAGGIO, TREVIGLIO; ASST PAPA GIOVANNI XXIII, BERGAMO
| | - A Capoferri
- ASST BERGAMO OVEST – OSPEDALE DI TREVIGLIO–CARAVAGGIO, TREVIGLIO; ASST PAPA GIOVANNI XXIII, BERGAMO
| | - F Innocente
- ASST BERGAMO OVEST – OSPEDALE DI TREVIGLIO–CARAVAGGIO, TREVIGLIO; ASST PAPA GIOVANNI XXIII, BERGAMO
| | - C Fino
- ASST BERGAMO OVEST – OSPEDALE DI TREVIGLIO–CARAVAGGIO, TREVIGLIO; ASST PAPA GIOVANNI XXIII, BERGAMO
| | - A Terzi
- ASST BERGAMO OVEST – OSPEDALE DI TREVIGLIO–CARAVAGGIO, TREVIGLIO; ASST PAPA GIOVANNI XXIII, BERGAMO
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Zucchetti O, Iacovoni A, Vittori C, Abete R, Terzi A, Campo G, Senni M. P226 LONGITUDINAL EVALUATION OF CONGESTION AND RENAL FUNCTION IN ADVANCED HEART FAILURE PATIENTS TREATED WITH A LEFT VENTRICULAR ASSIST DEVICE. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
In patients affected by advanced heart failure (advHF) long term mechanical support with left ventricular assist devices (LVADs) is a established therapeutic option. Congestion and renal function in pts treated with a LVAD require expert management.
Aim
Describe the longitudinal trend of congestion and renal function during a 12th follow–up in advHF pts treated with a LVAD, examine the correlation between congestion and renal function, study predictors of sustained improvement of congestion and renal function.
Methods
retrospective single–centre analysis of 39 pts treated with a LVAD and followed in ASST–PG23 Hospital for at least 12 months. Biochemical, echocardiographic and clinical parameters were collected at specific time points from baseline to 12 months after hospitalization during which a LVAD was implanted. Congestion was studied with BNP, bilirubin, haematocrit and daily diuretics dosage. Renal function was studied with absolute changes of eGFR (Cockcroft–Gault). Primary endpoint was sustained improvement of congestion and renal function, derived after comparing baseline pre–LVAD and 12th month parameters.
Results
congestion improved early after LVAD implantation, with steep and high reduction of BNP, bilirubin and daily diuretics dosage. The improvement was higher in those pts with a baseline BNP>median. Bilirubin, haematocrit and daily diuretics dosage showed statistically significant correlations with BNP. Sustained improvement of congestion was present in 59% pts, in particular in those with higher baseline BNP (p = 0.04 after χ²–test). Renal function showed an early steep improvement from baseline pre–LVAD to discharge, more significant in those pts with baseline CKD; during the following months renal function did not show significant changes. Sustained improvement of renal function was present in 54% pts, in particular in those with baseline CKD (p = 0.002 after χ²–test). No significant correlations were found after comparing the trend of congestion and renal function. At multivariable logistic regression, no significant predictors were found for sustained improvement of congestion or renal function.
Conclusions
A multiparametric evaluation of congestion in pts with a LVAD is feasible. The benefit derived from LVAD support appears to be higher in those pts with a baseline higher risk, both in term of congestion and renal function. No significant correlation between the trend of congestion and renal function was found.
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Affiliation(s)
- O Zucchetti
- OSPEDALE DI MANERBIO – ASST GARDA, MANERBIO; ASST PAPA GIOVANNI XXIII, BERGAMO; AZIENDA OSPEDALIERO–UNIVERSITARIA DI FERRARA, FERRARA
| | - A Iacovoni
- OSPEDALE DI MANERBIO – ASST GARDA, MANERBIO; ASST PAPA GIOVANNI XXIII, BERGAMO; AZIENDA OSPEDALIERO–UNIVERSITARIA DI FERRARA, FERRARA
| | - C Vittori
- OSPEDALE DI MANERBIO – ASST GARDA, MANERBIO; ASST PAPA GIOVANNI XXIII, BERGAMO; AZIENDA OSPEDALIERO–UNIVERSITARIA DI FERRARA, FERRARA
| | - R Abete
- OSPEDALE DI MANERBIO – ASST GARDA, MANERBIO; ASST PAPA GIOVANNI XXIII, BERGAMO; AZIENDA OSPEDALIERO–UNIVERSITARIA DI FERRARA, FERRARA
| | - A Terzi
- OSPEDALE DI MANERBIO – ASST GARDA, MANERBIO; ASST PAPA GIOVANNI XXIII, BERGAMO; AZIENDA OSPEDALIERO–UNIVERSITARIA DI FERRARA, FERRARA
| | - G Campo
- OSPEDALE DI MANERBIO – ASST GARDA, MANERBIO; ASST PAPA GIOVANNI XXIII, BERGAMO; AZIENDA OSPEDALIERO–UNIVERSITARIA DI FERRARA, FERRARA
| | - M Senni
- OSPEDALE DI MANERBIO – ASST GARDA, MANERBIO; ASST PAPA GIOVANNI XXIII, BERGAMO; AZIENDA OSPEDALIERO–UNIVERSITARIA DI FERRARA, FERRARA
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Lechiancole A, Loforte A, Trumello C, Scandroglio M, Gliozzi G, Comisso M, Iacovoni A, Terzi A, Maiani M, Musumeci F, De Bonis M, Pacini D, Livi U. C15 DOES THE DISTANCE BETWEEN RESIDENCY AND IMPLANTING CENTER AFFECT THE OUTCOME OF PATIENTS SUPPORTED BY LEFT VENTRICULAR ASSIST DEVICE? A MULTICENTER ITALIAN STUDY ON RADIAL MECHANICALLY ASSISTED CIRCULATORY SUPPORT (MIRAMACS) ANALYSIS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac011.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Background
Patients with LVAD require continuous monitoring and care, and since Implanting Centers (IC) are more experienced in managing LVAD patients than other health care facilities, the distance between patient residency and IC could negatively affect the outcomes.
Methods
Data of patients discharged after receiving a LVAD implantation between 2010 and 2021 collected into the MIRAMACS database were retrospectively analyzed. The population was divided into two groups: A (n = 175) and B (n = 141), according to a distance between patient residency and IC ≤ or >of 90 miles. The primary end–point was freedom form Adverse Events (AEs), a composite outcome composed by death, cerebrovascular accident, hospital admission because of GI bleeding, infection, pump thrombosis or right ventricular failure. Secondary end–points were incidences of mortality and complications. All patients were followed–up regularly, according to participating centers protocols, by means of clinical visits, telemonitoring and local care–sharing.
Results
Baseline clinical characteristics and indications for LVAD did not differ between the two groups (Figure 1). Mean duration of support was 25.5±21 months for Group A and 25.7±20 months for Group B (p = 0.79). At 3 years, freedom from AEs was similar between Group A and B (p = 0.32, Figure 2), and there were no differences in rates of mortality and LVAD–related complications (Figure 2).
Conclusions
Distance from the IC does not represent a barrier to successful outcome, as long as regular and continuous follow–up is provided. Telemonitoring could offer several benefits, including early detection of complications and continuous evaluation of patient conditions and data of the pump. Moreover, it seemed to reduce the patient anxiety related to the device, increasing direct communication with the VAD–team. On the other hand, shared health programs with local facilities remains an attractive way to follow–up patient, provided that LVAD specific resources and trained staff are available. The dissemination of LVAD–specific care knowledge is also important to face urgent or emergent needs in the rapidly enlarging population of LVAD patients, by empowering local healthcare facilities.
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Affiliation(s)
- A Lechiancole
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - A Loforte
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - C Trumello
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - M Scandroglio
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - G Gliozzi
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - M Comisso
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - A Iacovoni
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - A Terzi
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - M Maiani
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - F Musumeci
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - M De Bonis
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - D Pacini
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
| | - U Livi
- AZIENDA SANITARIA UNIVERSITARIA FRIULI CENTRALE – OSPEDALE S. MARIA DELLA MISERICORDIA, UDINE; S. ORSOLA UNIVERSITY HOSPITAL, BOLOGNA; SAN RAFFAELE UNIVERSITY HOSPITAL, MILANO; SAN CAMILLO HOSPITAL, ROMA; PAPA GIOVANNI XXII HOSPITAL OF BERGAMO, BERGAMO
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Lechiancole A, Loforte A, De Bonis M, Iacovoni A, Musumeci F, Cavalli G, Maiani M, Comisso M, Trumello C, Terzi A, Pacini D, Livi U. Living at Distance from the Implanting Center: Any Impact on LVAD Patients Outcome? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.382] [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: 11/29/2022] Open
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11
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Sinning C, Zengin E, Diller GP, Onorati F, Castel MA, Petit T, Chen YS, Lo Rito M, Chiarello C, Guillemain R, Coniat KNL, Magnussen C, Knappe D, Becher PM, Schrage B, Smits JM, Metzner A, Knosalla C, Schoenrath F, Miera O, Cho MY, Bernhardt A, Weimann J, Goßling A, Terzi A, Amodeo A, Alfieri S, Angeli E, Ragni L, Napoleone CP, Gerosa G, Pradegan N, Rodrigus I, Dumfarth J, de Pauw M, François K, Van Caenegem O, Ancion A, Van Cleemput J, Miličić D, Moza A, Schenker P, Thul J, Steinmetz M, Warnecke G, Ius F, Freyt S, Avsar M, Sandhaus T, Haneya A, Eifert S, Saeed D, Borger M, Welp H, Ablonczy L, Schmack B, Ruhparwar A, Naito S, Hua X, Fluschnik N, Nies M, Keil L, Senftinger J, Ismaili D, Kany S, Csengeri D, Cardillo M, Oliveti A, Faggian G, Dorent R, Jasseron C, Blanco AP, Márquez JMS, López-Vilella R, García-Álvarez A, López MLP, Rocafort AG, Fernández ÓG, Prieto-Arevalo R, Zatarain-Nicolás E, Blanchart K, Boignard A, Battistella P, Guendouz S, Houyel L, Para M, Flecher E, Gay A, Épailly É, Dambrin C, Lam K, Ka-Lai CH, Cho YH, Choi JO, Kim JJ, Coats L, Crossland DS, Mumford L, Hakmi S, Sivathasan C, Fabritz L, Schubert S, Gummert J, Hübler M, Jacksch P, Zuckermann A, Laufer G, Baumgartner H, Giamberti A, Reichenspurner H, Kirchhof P. Study design and rationale of the pAtients pResenTing with cOngenital heaRt dIseAse Register (ARTORIA-R). ESC Heart Fail 2021; 8:5542-5550. [PMID: 34510806 PMCID: PMC8712832 DOI: 10.1002/ehf2.13574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/30/2021] [Accepted: 08/04/2021] [Indexed: 01/03/2023] Open
Abstract
Aim Due to improved therapy in childhood, many patients with congenital heart disease reach adulthood and are termed adults with congenital heart disease (ACHD). ACHD often develop heart failure (HF) as a consequence of initial palliative surgery or complex anatomy and subsequently require advanced HF therapy. ACHD are usually excluded from trials evaluating heart failure therapies, and in this context, more data about heart failure trajectories in ACHD are needed to guide the management of ACHD suffering from HF. Methods and results The pAtients pResenTing with cOngenital heaRt dIseAse Register (ARTORIA‐R) will collect data from ACHD evaluated or listed for heart or heart‐combined organ transplantation from 16 countries in Europe and the Asia/Pacific region. We plan retrospective collection of data from 1989–2020 and will include patients prospectively. Additional organizations and hospitals in charge of transplantation of ACHD will be asked in the future to contribute data to the register. The primary outcome is the combined endpoint of delisting due to clinical worsening or death on the waiting list. The secondary outcome is delisting due to clinical improvement while on the waiting list. All‐cause mortality following transplantation will also be assessed. The data will be entered into an electronic database with access to the investigators participating in the register. All variables of the register reflect key components important for listing of the patients or assessing current HF treatment. Conclusion The ARTORIA‐R will provide robust information on current management and outcomes of adults with congenital heart disease suffering from advanced heart failure.
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Affiliation(s)
- Christoph Sinning
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,German Centre of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Elvin Zengin
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | | | - Francesco Onorati
- Divisione Ospedaliero Universitaria Cardiochirurgia Verona, Verona, Italy
| | - María-Angeles Castel
- Heart Failure and Heart Transplantation Unit, Cardiology Department, ICCV, Hospital Clinic Barcelona, IDIBAPS, Barcelona, Spain
| | - Thibault Petit
- Adult Congenital and Pediatric Heart Unit, Freeman Hospital Newcastle Upon Tyne, Newcastle Upon Tyne, UK
| | - Yih-Sharng Chen
- Department of Cardiovascular Surgery, National Taiwan University Hospital, Taipei, Taiwan
| | - Mauro Lo Rito
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Carmelina Chiarello
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Romain Guillemain
- Chirurgie cardio vasculaire, Hôpital Européen Georges-Pompidou HEGP, Paris, France
| | - Karine Nubret-Le Coniat
- Programme de transplantation et d'assistance cardiaque adulte et pédiatrique au CHU de Bordeaux, Haut Lévêque Hospital, Pessac, France
| | - Christina Magnussen
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,German Centre of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Dorit Knappe
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Peter Moritz Becher
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,German Centre of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | - Benedikt Schrage
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,German Centre of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany
| | | | - Andreas Metzner
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Christoph Knosalla
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,German Centre of Cardiovascular Research DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany.,Charité University Medicine Berlin, Corporate Member of Freie University Berlin, Humboldt-University Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Felix Schoenrath
- Department of Cardiothoracic and Vascular Surgery, German Heart Center Berlin, Berlin, Germany.,German Centre of Cardiovascular Research DZHK (German Center for Cardiovascular Research), Partner Site Berlin, Berlin, Germany
| | - Oliver Miera
- Department of Congenital Heart Disease/Pediatric Cardiology, German Heart Center Berlin, Berlin, Germany
| | - Mi-Young Cho
- Department of Congenital Heart Surgery/Pediatric Heart Surgery German Heart Center Berlin, Berlin, Germany
| | - Alexander Bernhardt
- German Centre of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.,Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Jessica Weimann
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Alina Goßling
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | | | - Antonio Amodeo
- Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Sara Alfieri
- Bambino Gesù Pediatric Hospital and Research Institute, Rome, Italy
| | - Emanuela Angeli
- Pediatric Cardiac Surgery and Adult Congenital Heart Disease Program, Department of Cardio - Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero - Universitaria di Bologna, Bologna, Italy
| | - Luca Ragni
- Pediatric Cardiology and Adult Congenital Heart Disease Program, Department of Cardio-Thoracic and Vascular Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Gino Gerosa
- Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, University of Padova, Padova, Italy
| | - Nicola Pradegan
- Cardiac Surgery Unit, Cardio-Thoraco-Vascular and Public Health Department, Padova University Hospital, University of Padova, Padova, Italy
| | - Inez Rodrigus
- Department of Cardiac Surgery, Universitair Ziekenhuis Antwerpen, Antwerpen, Belgium
| | - Julia Dumfarth
- Department of Cardiac Surgery, University of Innsbruck, Innsbruck, Austria
| | - Michel de Pauw
- Department of Cardiology, Universitair Ziekenhuis Gent, Ghent, Belgium
| | - Katrien François
- Department of Cardiovascular Surgery, Universitair Ziekenhuis Gent, Ghent, Belgium
| | - Olivier Van Caenegem
- Division of Cardiovascular Intensive Care and Heart Transplantation, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Arnaut Ancion
- Department of Cardiology, Centre Hospitalier Universitaire de Liège, Liège, Belgium
| | - Johan Van Cleemput
- Department of Cardiology, Universitair Ziekenhuis Leuven, Leuven, Belgium
| | - Davor Miličić
- Department of Cardiology, Medical Faculty University of Zagreb, Zagreb, Croatia
| | - Ajay Moza
- Department of Cardiovascular Surgery, University Hospital Aachen, Aachen, Germany
| | - Peter Schenker
- Department of Surgery, University Hospital Bochum, Bochum, Germany
| | - Josef Thul
- Department of Pediatric Cardiology, University Hospital Giessen/Marburg, Giessen, Germany
| | - Michael Steinmetz
- Department of Pediatric Cardiology, University Hospital Göttingen, Göttingen, Germany.,German Center of Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Gregor Warnecke
- Department of Cardiac Surgery, University Hospital Heidelberg, Heidelberg, Germany
| | - Fabio Ius
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Susanne Freyt
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Murat Avsar
- Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Tim Sandhaus
- Department of Cardiovascular Surgery, University Hospital Jena, Jena, Germany
| | - Assad Haneya
- Department of Cardiovascular Surgery, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Sandra Eifert
- Department of Cardiovascular Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Diyar Saeed
- Department of Cardiovascular Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Michael Borger
- Department of Cardiovascular Surgery, Heart Center Leipzig, Leipzig, Germany
| | - Henryk Welp
- Department of Cardiac Surgery, University Hospital Münster, Münster, Germany
| | - László Ablonczy
- Gottsegen György Hungarian Institute of Cardiology, Budapest, Hungary
| | - Bastian Schmack
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, Essen, Germany
| | - Arjang Ruhparwar
- Department of Thoracic and Cardiovascular Surgery, West German Heart and Vascular Center, University of Duisburg-Essen, Essen, Germany
| | - Shiho Naito
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Xiaoqin Hua
- Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Nina Fluschnik
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Moritz Nies
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Laura Keil
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Juliana Senftinger
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Djemail Ismaili
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Shinwan Kany
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | - Dora Csengeri
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany
| | | | | | - Giuseppe Faggian
- Divisione Ospedaliero Universitaria Cardiochirurgia Verona, Verona, Italy
| | | | | | | | | | - Raquel López-Vilella
- Heart Failure and Transplantation Unit, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Ana García-Álvarez
- Heart Failure and Heart Transplantation Unit, Cardiology Department, ICCV, Hospital Clinic Barcelona, IDIBAPS, Barcelona, Spain
| | - María Luz Polo López
- Cirugia Cardiovascular, Servicio de Cirugia Cardiovascular Infantil y de Cardiopatías Congénitas, Hospital Universitario La Paz, Madrid, Spain
| | - Alvaro Gonzalez Rocafort
- Cirugia Cardiovascular, Servicio de Cirugia Cardiovascular Infantil y de Cardiopatías Congénitas, Hospital Universitario La Paz, Madrid, Spain
| | - Óscar González Fernández
- Heart Failure and Transplant Unit, Cardiology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Raquel Prieto-Arevalo
- Department of Cardiology, Gregorio Marañon University Hospital CIBER-CV, Madrid, Spain
| | | | | | - Aude Boignard
- Department of Cardiology and Cardiovascular Surgery, CHU Michallon, Grenoble, France
| | - Pascal Battistella
- Department of Cardiology, Montpellier University Hospital, Montpellier Cedex 5, France
| | - Soulef Guendouz
- Département de Cardiologie, Hôpital Henri-Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France
| | - Lucile Houyel
- M3C-Necker Enfants malades, AP-HP, Université de Paris, Paris, France
| | - Marylou Para
- Department of Cardiovascular Surgery and Transplantation, Bichat Hospital, AP-HP, Paris, France
| | - Erwan Flecher
- Division of Thoracic and Cardiovascular Surgery, Rennes University Hospital, Rennes, France
| | - Arnaud Gay
- Thoracic and Cardiovascular Surgery Department, Rouen University Hospital, Rouen, France
| | - Éric Épailly
- Department of Cardiac Surgery, Strasbourg University Hospital, Strasbourg, France
| | - Camille Dambrin
- Service de Cardiologie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Kaitlyn Lam
- Department of Cardiology, Fiona Stanly Hospital, Perth, Australia
| | - Cally Ho Ka-Lai
- Department of Cardiothoracic Surgery, Queen Mary Hospital, Hong Kong, China
| | - Yang Hyun Cho
- Department of Thoracic and Cardiovascular Surgery, Sungkyunkwan University, Seoul, South Korea
| | - Jin-Oh Choi
- Division of Cardiology, Department of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Jae-Joong Kim
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Louise Coats
- Adult Congenital and Pediatric Heart Unit, Freeman Hospital Newcastle Upon Tyne, Newcastle Upon Tyne, UK.,Congenital Heart Disease Research Group, Population Health Sciences Institute Newcastle University, Newcastle upon Tyne, UK
| | - David Steven Crossland
- Adult Congenital and Pediatric Heart Unit, Freeman Hospital Newcastle Upon Tyne, Newcastle Upon Tyne, UK.,Congenital Heart Disease Research Group, Population Health Sciences Institute Newcastle University, Newcastle upon Tyne, UK
| | | | - Samer Hakmi
- Department of Cardiology & Critical Care Medicine, Asklepios Klinik St. Georg, Hamburg, Germany
| | - Cumaraswamy Sivathasan
- Department of Cardiothoracic Surgery, Mount Elizabeth Medical Centre, Singapore, Singapore
| | - Larissa Fabritz
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,Institute of Cardiovacsular Sciences and SWBH and UHB NHS Trusts, Birmingham, UK.,Department of Cardiology, University Hospital Birmingham, Birmingham, UK
| | - Stephan Schubert
- Center for Congenital Heart Disease/Pediatric Cardiology, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - Jan Gummert
- Department for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center NRW, Ruhr-University Bochum, Bad Oeynhausen, Germany
| | - Michael Hübler
- German Centre of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.,Department of Pediatric Cardiac Surgery, University Heart & Vascular Center Hamburg, Hamburg, Germany
| | - Peter Jacksch
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria
| | - Andreas Zuckermann
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Günther Laufer
- Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria
| | - Helmut Baumgartner
- Department of Cardiology III, University Hospital Münster, Münster, Germany
| | - Alessandro Giamberti
- Department of Congenital Cardiac Surgery, IRCCS Policlinico San Donato, San Donato Milanese, Italy
| | - Hermann Reichenspurner
- German Centre of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.,Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany
| | - Paulus Kirchhof
- Department of Cardiology, University Heart and Vascular Centre Hamburg, Hamburg, Germany.,German Centre of Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.,Institute of Cardiovacsular Sciences and SWBH and UHB NHS Trusts, Birmingham, UK
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12
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Vaisitti T, Peritore D, Magistroni P, Ricci A, Lombardini L, Gringeri E, Catalano S, Spada M, Sciveres M, Di Giorgio A, Limongelli G, Varrenti M, Gerosa G, Terzi A, Pace Napoleone C, Amodeo A, Ragni L, Strologo LD, Benetti E, Fontana I, Testa S, Peruzzi L, Mitrotti A, Abbate S, Comai G, Gotti E, Schiavon M, Boffini M, De Angelis D, Bertani A, Pinelli D, Torre M, Poggi C, Deaglio S, Cardillo M, Amoroso A. The frequency of rare and monogenic diseases in pediatric organ transplant recipients in Italy. Orphanet J Rare Dis 2021; 16:374. [PMID: 34481500 PMCID: PMC8418291 DOI: 10.1186/s13023-021-02013-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/24/2021] [Indexed: 12/28/2022] Open
Abstract
Background Rare diseases are chronic and life-threatening disorders affecting < 1 person every 2,000. For most of them, clinical symptoms and signs can be observed at birth or childhood. Approximately 80% of all rare diseases have a genetic background and most of them are monogenic conditions. In addition, while the majority of these diseases is still incurable, early diagnosis and specific treatment can improve patients’ quality of life. Transplantation is among the therapeutic options and represents the definitive treatment for end-stage organ failure, both in children and adults. The aim of this paper was to analyze, in a large cohort of Italian patients, the main rare genetic diseases that led to organ transplantation, specifically pointing the attention on the pediatric cohort. Results To the purpose of our analysis, we considered heart, lung, liver and kidney transplants included in the Transplant Registry (TR) of the Italian National Transplantation Center in the 2002–2019 timeframe. Overall, 49,404 recipients were enrolled in the cohort, 5.1% of whom in the pediatric age. For 40,909 (82.8%) transplant recipients, a disease diagnosis was available, of which 38,615 in the adult cohort, while 8,495 patients (17.2%) were undiagnosed. There were 128 disease categories, and of these, 117 were listed in the main rare disease databases. In the pediatric cohort, 2,294 (5.6%) patients had a disease diagnosis: of the 2,126 (92.7%) patients affected by a rare disease, 1,402 (61.1%) presented with a monogenic condition. As expected, the frequencies of pathologies leading to organ failure were different between the pediatric and the adult cohort. Moreover, the pediatric group was characterized, compared to the adult one, by an overall better survival of the graft at ten years after transplant, with the only exception of lung transplants. When comparing survival considering rare vs non-rare diseases or rare and monogenic vs rare non-monogenic conditions, no differences were highlighted for kidney and lung transplants, while rare diseases had a better survival in liver as opposed to heart transplants. Conclusions This work represents the first national survey analyzing the main genetic causes and frequencies of rare and/or monogenic diseases leading to organ failure and requiring transplantation both in adults and children. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-021-02013-x.
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Affiliation(s)
- Tiziana Vaisitti
- Department of Medical Sciences, University of Torino, Via Nizza 52, 10126, Torino, Italy
| | - Daniela Peritore
- National Transplant Center, Istituto Superiore Di Sanità, Roma, Italy
| | - Paola Magistroni
- Immunogenetics and Transplant Biology, Azienda Ospedaliera Universitaria Città Della Salute E Della Scienza Di Torino, Torino, Italy
| | - Andrea Ricci
- National Transplant Center, Istituto Superiore Di Sanità, Roma, Italy
| | | | - Enrico Gringeri
- Hepatobiliary Surgery and Liver Transplantation Unit, Padova University Hospital, Padova, Italy
| | - Silvia Catalano
- General Surgery 2U - Liver Transplant Center, Azienda Ospedaliera Universitaria Città Della Salute E Della Scienza Di Torino, University of Turin, Torino, Italy
| | - Marco Spada
- Divison of Hepatobiliopancreatic Surgery, Liver and Kidney Transplantation, Research Unit of Clinical Hepatogastroenterology and Transplantation, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Angelo Di Giorgio
- Paediatric Hepatology, Gastroenterology and Transplantation, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Giuseppe Limongelli
- Center for Coordination on rare diseases - Regione Campania, Cardiovascular Rare and Genetic Diseases Unit, Department of Cardiology, Monaldi Hospital, AORN Dei Colli,, Naples, Italy
| | - Marisa Varrenti
- DeGasperis CardioCenter, Niguarda Great Metropolitan Hospital, Milan, Italy
| | - Gino Gerosa
- Heart Transplantation Unit, Cardio-Thoraco-Vascular Sciences and Public Health Department, University Padova Hospital, Padova, Italy
| | - Amedeo Terzi
- UOS Transplantation Surgery, Asst Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - Carlo Pace Napoleone
- Pediatric Cardiac Surgery and Congenital Cardiopathies Unit, Regina Margherita Children's Hospital, Azienda Ospedaliera Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | | | - Luca Ragni
- Paediatric Cardiology and ACHD Unit, S. Orsola, Malpighi Hospital, Bologna, Italy
| | - Luca Dello Strologo
- Renal Transplant Unit. Bambino Gesù Children's Research Hospital IRCCS, Rome, Italy
| | - Elisa Benetti
- Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women's and Children's Health, Padua University Hospital, Padua, Italy
| | - Iris Fontana
- Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - Sara Testa
- Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Licia Peruzzi
- Pediatric Nephrology Unit, Regina Margherita Children's Hospital, Azienda Ospedaliera Universitaria Città Della Salute E Della Scienza Di Torino, Turin, Italy
| | - Adele Mitrotti
- Azienda Ospedaliera, Universitaria Policlinico Di Bari, Bari, Italy
| | | | - Giorgia Comai
- Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, Bologna, Italy
| | - Eliana Gotti
- Unit of Nephrology, Azienda Socio Sanitaria Territoriale Papa Giovanni XXIII, Bergamo, Italy
| | - Marco Schiavon
- Thoracic Surgery and Lung Transplant Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University Hospital of Padua, Padua, Italy
| | - Massimo Boffini
- Heart and Lung Transplant Center, Cardiac Surgery Division, Surgical Sciences Department, University of Torino, Torino, Italy
| | | | - Alessandro Bertani
- Division of Thoracic Surgery and Lung Transplantation, Department for the Treatment and Study of Cardiothoracic Diseases and Cardiothoracic Transplantation, IRCCS-ISMETT, Palermo, Italy
| | - Domenico Pinelli
- Department of Organ Failure and Transplantation, ASST Giovanni XXIII, Bergamo, Italy
| | | | - Camilla Poggi
- Department of Thoracic Surgery, Policlinico Umberto I Hospital, University of Rome Sapienza, Rome, Italy
| | - Silvia Deaglio
- Department of Medical Sciences, University of Torino, Via Nizza 52, 10126, Torino, Italy. .,Immunogenetics and Transplant Biology, Azienda Ospedaliera Universitaria Città Della Salute E Della Scienza Di Torino, Torino, Italy.
| | - Massimo Cardillo
- National Transplant Center, Istituto Superiore Di Sanità, Roma, Italy
| | - Antonio Amoroso
- Department of Medical Sciences, University of Torino, Via Nizza 52, 10126, Torino, Italy.,Immunogenetics and Transplant Biology, Azienda Ospedaliera Universitaria Città Della Salute E Della Scienza Di Torino, Torino, Italy
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13
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Loforte A, Gliozzi G, Attisani M, Montalto A, Iacovoni A, Onorati F, Maiani M, Scandroglio M, Terzi A, De Bonis M, Faggian G, Livi U, Musumeci F, Rinaldi M, Pacini D. Multicenter Italian Study on Radial Mechanically Assisted Circulatory Support (MIRAMACS): Preliminary Results. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1180] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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14
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Bertoglio P, Ventura L, Aprile V, Cattoni M, Nachira D, Lococo F, Rodriguez M, Guerrera F, Minervini F, Gnetti L, Bacchin D, Franzi F, Querzoli G, Rindi G, Bellafiore S, Femia F, Viti A, Kestenholz P, Ruffini E, Paci M, Margaritora S, Imperatori A, Lucchi M, Ampollini L, Terzi A. P08.01 Prognostic Impact of Second Predominant Pattern in Lung Adenocarcinoma: Analysis From a Large Multicentric European Database. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.420] [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: 11/29/2022]
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15
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Bottio T, Bagozzi L, Fiocco A, Nadali M, Caraffa R, Bifulco O, Ponzoni M, Lombardi CM, Metra M, Russo CF, Frigerio M, Masciocco G, Potena L, Loforte A, Pacini D, Faggian G, Onorati F, Sponga S, Livi U, Iacovoni A, Terzi A, Senni M, Rinaldi M, Boffini M, Marro M, Jorgji V, Carrozzini M, Gerosa G. COVID-19 in Heart Transplant Recipients: A Multicenter Analysis of the Northern Italian Outbreak. JACC Heart Fail 2021; 9:52-61. [PMID: 33309578 PMCID: PMC7604081 DOI: 10.1016/j.jchf.2020.10.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/04/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVES The aim of this study was to assess the clinical course and outcomes of all heart transplant recipients affected by coronavirus disease-2019 (COVID-19) who were followed at the leading heart transplant centers of Northern Italy. BACKGROUND The worldwide severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) pandemic has created unprecedented challenges for public health, demanding exceptional efforts for the successful management and treatment of affected patients. Heart transplant patients represent a unique cohort of chronically immunosuppressed subjects in which SARS-CoV-2 may stimulate an unpredictable clinical course of infection. METHODS Since February 2020, we enrolled all 47 cases (79% male) in a first cohort of patients, with a mean age of 61.8 ± 14.5 years, who tested positive for SARS-CoV-2, out of 2,676 heart transplant recipients alive before the onset of the COVID-19 pandemic at 7 heart transplant centers in Northern Italy. RESULTS To date, 38 patients required hospitalization while 9 remained self-home quarantined and 14 died. Compared to the general population, prevalence (18 vs. 7 cases per 1,000) and related case fatality rate (29.7% vs. 15.4%) in heart transplant recipients were doubled. Univariable analysis showed older age (p = 0.002), diabetes mellitus (p = 0.040), extracardiac arteriopathy (p = 0.040), previous PCI (p = 0.040), CAV score (p = 0.039), lower GFR (p = 0.004), and higher NYHA functional classes (p = 0.023) were all significantly associated with in-hospital mortality. During the follow-up two patients died and a third patient has prolonged viral-shedding alternating positive and negative swabs. Since July 1st, 2020, we had 6 new patients who tested positive for SARS-CoV-2, 5 patients asymptomatic were self-quarantined, while 1 is still hospitalized for pneumonia. A standard therapy was maintained for all, except for the hospitalized patient. CONCLUSIONS The prevalence and mortality of SARS-CoV-2 should spur clinicians to immediately refer heart transplant recipients suspected as having SARS-CoV2 infection to centers specializing in the care of this vulnerable population.
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Affiliation(s)
- Tomaso Bottio
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy,Address for correspondence: Dr. Tomaso Bottio, Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Via Giustiniani 2, 35128 Padova, Italy
| | - Lorenzo Bagozzi
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Alessandro Fiocco
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Matteo Nadali
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Raphael Caraffa
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Olimpia Bifulco
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Matteo Ponzoni
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Carlo Maria Lombardi
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University, Cardiothoracic Department, Spedali Civili of Brescia, Brescia, Italy
| | - Marco Metra
- Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University, Cardiothoracic Department, Spedali Civili of Brescia, Brescia, Italy
| | - Claudio Francesco Russo
- Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department, Niguarda Hospital, Milan, Italy
| | - Maria Frigerio
- Transplant Cardiology Unit, Cardiac Thoracic and Vascular Department, Niguarda Hospital, Milan, Italy
| | - Gabriella Masciocco
- Transplant Cardiology Unit, Cardiac Thoracic and Vascular Department, Niguarda Hospital, Milan, Italy
| | - Luciano Potena
- Cardiac, Thoracic, Vascular and Transplant Department, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Antonio Loforte
- Cardiac, Thoracic, Vascular and Transplant Department, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Davide Pacini
- Cardiac, Thoracic, Vascular and Transplant Department, Policlinico S. Orsola-Malpighi, University of Bologna, Bologna, Italy
| | - Giuseppe Faggian
- Division of Cardiac Surgery, Department of Surgery, University of Verona, Verona, Italy
| | - Francesco Onorati
- Division of Cardiac Surgery, Department of Surgery, University of Verona, Verona, Italy
| | - Sandro Sponga
- Cardiac Surgery Department, University of Udine, Udine, Italy
| | - Ugolino Livi
- Cardiac Surgery Department, University of Udine, Udine, Italy
| | - Attilio Iacovoni
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Amedeo Terzi
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Michele Senni
- Cardiovascular Department, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Mauro Rinaldi
- Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Massimo Boffini
- Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Matteo Marro
- Division of Cardiac Surgery, Department of Surgical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy
| | - Vjola Jorgji
- Hacohen Lab, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Massimiliano Carrozzini
- Cardiac Surgery Unit, Cardiac Thoracic and Vascular Department, Niguarda Hospital, Milan, Italy
| | - Gino Gerosa
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
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16
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Iacovoni A, Boffini M, Pidello S, Simonato E, Barbero C, Sebastiani R, Vittori C, Fontana A, Terzi A, De Ferrari GM, Rinaldi M. A case series of novel coronavirus infection in heart transplantation from 2 centers in the pandemic area in the North of Italy. J Heart Lung Transplant 2020; 39:1081-1088. [PMID: 32709482 PMCID: PMC7318961 DOI: 10.1016/j.healun.2020.06.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 06/19/2020] [Accepted: 06/22/2020] [Indexed: 01/08/2023] Open
Abstract
Background Little is known about the coronavirus SARS-CoV-2 disease (COVID-19) in solid organ transplanted patients. We here report a series of heart transplanted patients with COVID-19 from two centers of Italy. Methods All heart transplanted patients of Transplant Centers of Bergamo and Torino with a microbiologically confirmed SARS-CoV-2 infection were enrolled. Data collection included clinical presentation, laboratory and radiological findings, treatment and outcome. Follow-up was performed by visit or phone. Results From February to March 2020 twenty-six heart transplanted patients (age 62±12 years; 77% males; time from transplant 10±10 years; 69% with comorbidities) had a microbiologically confirmed COVID-19. The most frequent symptom was fever, followed by cough. Seventeen patients had a pneumonia, 8 of them severe pneumonia. Seven patients died (27%) and 17 (65%) were hospitalized. Discontinuation of immunosuppression was associated with death (71 vs 21%, p=0.02). Conversely, all patients receiving steroids survived (p<0.001). Patients who received heart transplantation during COVID-19 outbreak survived and no acute graft rejection occurred. Patients who died were older than survivors, had a longer time from transplant and a worse clinical presentation at diagnosis. The current regimen enabled the prolonged survival and function of orthotopic cardiac xenografts in altogether 6 of 8 baboons, of which 4 were now added. These results exceed the threshold set by the Advisory Board of the International Society for Heart and Lung Transplantation. Conclusions COVID-19 has a significant impact on long term heart transplanted patients. Conversely, SARS-CoV-2 infection seems to have a limited influence on more recent transplants. Our experience may suggest that heart transplantation programs can be maintained even during the pandemic phase if specific and tailored paths to prevent and to limit virus transmission are provided.
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Affiliation(s)
- Attilio Iacovoni
- Cardiology Division, Cardiovascular Department, Heart Transplant Center, ASST Papa Giovanni XXIII Hospital of Bergamo, Bergamo, Italy
| | - Massimo Boffini
- Cardiac Surgery Division, Surgical Sciences Department, Heart and Lung Transplant Center, Città della Salute e della Scienza University Hospital of Torino, Torino, Italy.
| | - Stefano Pidello
- Cardiology Division, Medical Sciences Department, Heart and Lung Transplant Center, Città della Salute e della Scienza University Hospital of Torino, Torino, Italy
| | - Erika Simonato
- Cardiac Surgery Division, Surgical Sciences Department, Heart and Lung Transplant Center, Città della Salute e della Scienza University Hospital of Torino, Torino, Italy
| | - Cristina Barbero
- Cardiac Surgery Division, Surgical Sciences Department, Heart and Lung Transplant Center, Città della Salute e della Scienza University Hospital of Torino, Torino, Italy
| | - Roberta Sebastiani
- Cardiology Division, Cardiovascular Department, Heart Transplant Center, ASST Papa Giovanni XXIII Hospital of Bergamo, Bergamo, Italy
| | - Claudia Vittori
- Cardiology Division, Cardiovascular Department, Heart Transplant Center, ASST Papa Giovanni XXIII Hospital of Bergamo, Bergamo, Italy
| | - Alessandra Fontana
- Cardiology Division, Cardiovascular Department, Heart Transplant Center, ASST Papa Giovanni XXIII Hospital of Bergamo, Bergamo, Italy
| | - Amedeo Terzi
- Cardiac Surgery Division, Cardiovascular Department, Heart Transplant Center, ASST Papa Giovanni XXIII Hospital of Bergamo, Bergamo, Italy
| | - Gaetano Maria De Ferrari
- Cardiology Division, Medical Sciences Department, Heart and Lung Transplant Center, Città della Salute e della Scienza University Hospital of Torino, Torino, Italy
| | - Mauro Rinaldi
- Cardiac Surgery Division, Surgical Sciences Department, Heart and Lung Transplant Center, Città della Salute e della Scienza University Hospital of Torino, Torino, Italy
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Roviglione G, Clarizia R, Mautone D, Bruni F, Stepniewska AK, Manzone M, Terzi A, Bertoglio P, Finelli A, Ceccaroni M. Diaphragmatic Endometriosis: Classification of Lesions in a Retrospective Series of 150 Patients Treated by Minimally-Invasive Surgery in a Single Third-Level Referral Center. J Minim Invasive Gynecol 2019. [DOI: 10.1016/j.jmig.2019.09.762] [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: 11/16/2022]
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18
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Bertoglio P, Cattoni M, Nachira D, Lococo F, Aprile V, Rodriguez M, Guerrera F, Franzi F, Viti A, Bellafiore S, Rindi G, Bacchin D, Lozano Escario M, Femia F, Querzoli G, Tobar LG, Ruffini E, Paci M, Margaritora S, Lucchi M, Imperatori A, Terzi A. P2.17-29 Impact of Second Predominant Pattern on Recurrence in Early Stage Resected Lung Adenocarcinoma: A Multicentric Study. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.1940] [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: 11/16/2022]
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19
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Molinari A, Leo E, Ferraresi M, Ferrari S, Terzi A, Sommaruga S. Distal Extended Endovascular Aortic Repair PETTICOAT: A Modified Technique to Improve False Lumen Remodeling in Acute Type B Aortic Dissection. J Vasc Surg 2019. [DOI: 10.1016/j.jvs.2019.06.099] [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: 11/29/2022]
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20
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Giannini C, Ladisa M, Lutz-Bueno V, Terzi A, Ramella M, Fusaro L, Altamura D, Siliqi D, Sibillano T, Diaz A, Boccafoschi F, Bunk O. X-ray scanning microscopies of microcalcifications in abdominal aortic and popliteal artery aneurysms. IUCrJ 2019; 6:267-276. [PMID: 30867924 PMCID: PMC6400185 DOI: 10.1107/s2052252519001544] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 01/28/2019] [Indexed: 05/27/2023]
Abstract
Abdominal aortic and popliteal artery aneurysms are vascular diseases which show massive degeneration, weakening of the vascular wall and loss of the vascular tissue functionality. They are driven by inflammatory, hemodynamical factors and biological alterations that may lead, in the case of an abdominal aortic aneurysm, to sudden and dangerous ruptures of the arteries. Here, human aortic and popliteal aneurysm tissues were obtained during surgical repair, and studied by synchrotron radiation X-ray scanning microdiffraction and small-angle scattering, to investigate the microcalcifications present in the tissues. Data collected during the experiments were transformed into quantitative microscopy images through the combination of statistical approaches and crystallographic methods. As a result of this multi-step analysis, microcalcifications, which are markers of the pathology, were classified in terms of chemical and structural content. This analysis helped to identify the presence of nanocrystalline hy-droxy-apatite and microcrystalline cholesterol, embedded in myofilament, and elastin-containing tissue with low collagen content in predominantly nanocrystalline areas. The generality of the approach allows it to be transferred to other types of tissue and other pathologies affected by microcalcifications, such as thyroid carcinoma, breast cancer, testicular microli-thia-sis or glioblastoma.
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Affiliation(s)
- C. Giannini
- Institute of Crystallography, National Research Council, via Amendola 122/O, Bari, Bari 70125, Italy
| | - M. Ladisa
- Institute of Crystallography, National Research Council, via Amendola 122/O, Bari, Bari 70125, Italy
| | - V. Lutz-Bueno
- Paul Scherrer Institut, Forschungsstrasse 111, Villigen PSI, 5232, Switzerland
| | - A. Terzi
- Institute of Crystallography, National Research Council, via Amendola 122/O, Bari, Bari 70125, Italy
| | - M. Ramella
- Department of Health Sciences, University of Piemonte Orientale, Via Solaroli 17, Novara, 28100, Italy
| | - L. Fusaro
- Department of Health Sciences, University of Piemonte Orientale, Via Solaroli 17, Novara, 28100, Italy
| | - D. Altamura
- Institute of Crystallography, National Research Council, via Amendola 122/O, Bari, Bari 70125, Italy
| | - D. Siliqi
- Institute of Crystallography, National Research Council, via Amendola 122/O, Bari, Bari 70125, Italy
| | - T. Sibillano
- Institute of Crystallography, National Research Council, via Amendola 122/O, Bari, Bari 70125, Italy
| | - A. Diaz
- Paul Scherrer Institut, Forschungsstrasse 111, Villigen PSI, 5232, Switzerland
| | - F. Boccafoschi
- Institute of Crystallography, National Research Council, via Amendola 122/O, Bari, Bari 70125, Italy
- Department of Health Sciences, University of Piemonte Orientale, Via Solaroli 17, Novara, 28100, Italy
| | - O. Bunk
- Paul Scherrer Institut, Forschungsstrasse 111, Villigen PSI, 5232, Switzerland
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Abstract
Since the 1950s when the first devices for mechanical circulatory support were developed, there has been an impressive evolution of their technology. The first pioneering pumps were used to rescue acute complications after cardiac surgery. Advances in technology, increased knowledge of flow dynamics, and a more appropriate selection of the patients who actually need this support have contributed to significantly improve the benefits of this therapy. Today, mechanical circulatory support is an essential tool for the treatment of advanced heart failure. This strategy is used either as a bridge to heart transplantation or as a destination therapy for patients who do not meet the transplant criteria. A third indication is the bridge to recovery option for those patients in whom the improvement in cardiac function may be so important that the pump can be removed and the transplantation circumvented. In addition, mechanical circulatory support has fostered marked improvements in several clinical aspects affecting both patient health and quality of life. Despite the improvements in the technology of the devices of the last generation, severe adverse effects are still the Achilles heel of mechanical circulatory support therapy. This review summarizes the history, the technology, the clinical outcomes, and the possible future directions of this therapy.
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Affiliation(s)
- Amedeo Terzi
- UOS Chirurgia dei Trapianti, ASST Papa Giovanni XXIII, Bergamo, Italy
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22
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Buzzi M, Versura P, Grigolo B, Cavallo C, Terzi A, Pellegrini M, Giannaccare G, Randi V, Campos EC. Comparison of growth factor and interleukin content of adult peripheral blood and cord blood serum eye drops for cornea and ocular surface diseases. Transfus Apher Sci 2018; 57:549-555. [PMID: 29929885 DOI: 10.1016/j.transci.2018.06.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 04/03/2018] [Revised: 05/31/2018] [Accepted: 06/05/2018] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Various blood-derived products have been proposed for the topical treatment of ocular surface diseases. The aim of the study was to compare the different content of Growth Factors (GFs) and Interleukins (ILs) in peripheral blood (PB-S) and Cord Blood (CB-S) sera. MATERIALS AND METHODS Sera were obtained from 105 healthy adult donors (PB-S) and 107 umbilical/placental veins at the time of delivery (CB-S). The levels of epithelial-GF (EGF), fibroblast-GF (FGF), platelet-derived-GF (PDGF), insulin-GF (IGF), transforming-GF alpha (TGF-α,) and beta 1-2-3 (TGF-β1-β2-β3), vascular endothelial-GF (VEGF), nerve-GF (NGF), Interleukin (IL)-1β,IL-4,IL-6,IL-10, and IL-13 were assessed by Bio-Plex Protein Array System (Bio-Rad Laboratories, CA, USA). The Mann-Whitney test for unpaired data was applied to compare GFs and ILs levels in the two sources. The associations among each GF/IL level and the obstetric data for CB-S and hematological characteristics for PB-S were also investigated. RESULTS The levels of EGF, TGF-α, TGF-β2, FGF, PDGF, VEGF, NGF, IL-1B, IL-4, IL-6, IL-10, and IL-13 were significantly higher in CB-S compared to PB-S. Conversely, the levels of IGF-1, IGF-2, and TGF-β1 were significantly higher in PB-S. The female sex and the weight of the child showed a significant association in predicting EGF and PDGF levels. CONCLUSION A significantly different content in those GFs and ILs was demonstrated in the two blood sources. Since each GF/IL selectively regulates different cellular processes involved in corneal healing, the use of PB-S or CB-S should be chosen on the basis of the cellular mechanism to be promoted in each clinical case.
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Affiliation(s)
- M Buzzi
- Emilia Romagna Cord Blood Bank-Transfusion Service, S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - P Versura
- Ophthalmology Unit, DIMES, Alma Mater Studiorum University of Bologna and S.Orsola-Malpighi Teaching Hospital, Bologna, Italy.
| | - B Grigolo
- RAMSES Laboratory, Department of Research & Innovation, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - C Cavallo
- RAMSES Laboratory, Department of Research & Innovation, Istituto Ortopedico Rizzoli, Bologna, Italy
| | - A Terzi
- Emilia Romagna Cord Blood Bank-Transfusion Service, S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - M Pellegrini
- Ophthalmology Unit, DIMES, Alma Mater Studiorum University of Bologna and S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - G Giannaccare
- Ophthalmology Unit, DIMES, Alma Mater Studiorum University of Bologna and S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - V Randi
- Emilia Romagna Cord Blood Bank-Transfusion Service, S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
| | - E C Campos
- Ophthalmology Unit, DIMES, Alma Mater Studiorum University of Bologna and S.Orsola-Malpighi Teaching Hospital, Bologna, Italy
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23
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Guerra P, Colombo L, Maira G, Pagliaini R, Terzi A, Pizzocaro C, Dottorini ME, Lomuscio G, Bestagno M. Therapeutic Possibilities of 131I-Mibg in Metastatic Carcinoid Tumors - Preliminary Report. Tumori 2018; 76:484-7. [PMID: 2256196 DOI: 10.1177/030089169007600514] [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] [Indexed: 11/16/2022]
Abstract
The poor results of traditional therapy in advanced carcinoid tumors and the well-proven uptake of 131I-MIBG shown by some of these tumors induced us to attempt a radiometabolic approach. We selected for the treatment 5 patients (3 men and 2 women) who showed progression of disease, a fairly good uptake of 131l-MIBG with severe related symptoms, and a poor response to traditional therapy. A cumulative radioactivity of 5.5-29.6 GBq was given. Acute side effects after 131l-MIBG ad ministration or late radiation-induced damages were not observed. Symptoms increased during the first 2-4 weeks in 2 patients: in one of these relief was achieved with drugs. Results concerning objective remission of the disease were unsatisfactory. In contrast, definite improvement of symptoms was shown in 2 of 5 patients, resulting in a better quality of life.
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Affiliation(s)
- P Guerra
- Servizio Medicina Nucleare, Spedali Civili, Brescia, Italy
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24
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Abstract
Total body water (TBW) and extracellular water (ECW) were determined in 9 CAPD patients on treatment from 5 to 14 months (mean 8.6 months). The mean value of TBW was normal and directly correlated to body weight, but TBW was abnormally distributed between extracellular and intracellular space. ECW volume was significantly lower than the predicted value (12.1 ± 1.4 I versus 16.8 ± 1.9 I) and out of proportion to TBW (34.8 ± 3.9% versus 47.8 ± 1.5%). The calculated ICW, therefore, appeared clearly hyperexpanded. The data suggest that cell overhydration was the distinctive feature in our CAPD patients.
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Affiliation(s)
- G. Panzetta
- Divisione di Nefrologia, Università di Verona Medicina Nucleare, Spedali Civili di Brescia Clinica Medica I, Università di Padova Divisione di Nefrologia, Spedali Civili di Brescia
| | - U. Guerra
- Divisione di Nefrologia, Università di Verona Medicina Nucleare, Spedali Civili di Brescia Clinica Medica I, Università di Padova Divisione di Nefrologia, Spedali Civili di Brescia
| | - A. D'angelo
- Divisione di Nefrologia, Università di Verona Medicina Nucleare, Spedali Civili di Brescia Clinica Medica I, Università di Padova Divisione di Nefrologia, Spedali Civili di Brescia
| | - S. Sandrini
- Divisione di Nefrologia, Università di Verona Medicina Nucleare, Spedali Civili di Brescia Clinica Medica I, Università di Padova Divisione di Nefrologia, Spedali Civili di Brescia
| | - A. Terzi
- Divisione di Nefrologia, Università di Verona Medicina Nucleare, Spedali Civili di Brescia Clinica Medica I, Università di Padova Divisione di Nefrologia, Spedali Civili di Brescia
| | - L. Oldrizzi
- Divisione di Nefrologia, Università di Verona Medicina Nucleare, Spedali Civili di Brescia Clinica Medica I, Università di Padova Divisione di Nefrologia, Spedali Civili di Brescia
| | - R. Maiorca
- Divisione di Nefrologia, Università di Verona Medicina Nucleare, Spedali Civili di Brescia Clinica Medica I, Università di Padova Divisione di Nefrologia, Spedali Civili di Brescia
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Pizzocaro C, Rossini PL, Terzi A, Farfaglia R, Lazzari L, Simoncini E, Giubbini R. Sentinel Node Biopsy in Breast Cancer: The Experience of Brescia Civic Hospital. Tumori 2018; 86:309-11. [PMID: 11016711 DOI: 10.1177/030089160008600412] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The accuracy of the sentinel node technique in the evaluation of axillary node involvement in breast cancer was evaluated in 83 consecutive patients with monofocal T1–2 carcinoma, who were clinically N0 and who underwent lymphoscintigraphy with 99mTc-colloid integrated with intraoperative sentinel node detection by a portable probe. Lymphoscintigraphy revealed at least one sentinel node in 75 patients (90.4%), always identified by the probe. In eight patients (9.6%) the sentinel node was detected neither by lymphoscintigraphy nor by the probe. All removed lymph nodes were analyzed by hematoxylin-eosin histology and the sentinel node by immunostaining. In 28/75 patients (37.3%) at least one metastatic axillary lymph node was detected; in 16 of the 28 N+ subjects (57%) only the sentinel node was positive. The false negative rate (sentinel node negative/other axillary lymph nodes positive) was 17.85% (5/28 patients). In 9/23 patients (39%) micrometastases were found in the sentinel node only. In conclusion, specific sentinel node positivity in 57% of cases supports the validity of the sentinel node concept. Moreover, nine patients would have been considered No by standard hematoxylin-eosin histology without sentinel node-aided immunostaining. A 17.8% false negative rate calls for caution in patients with negative sentinel nodes.
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Affiliation(s)
- C Pizzocaro
- Divisione di Medicina Nucleare, Spedali Civili, Brescia, Italy
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Iacovoni A, Bellavia D, Coronnello C, Simon M, Link C, Falletta C, Romano G, Sciacca S, Di Gesaro G, Maalouf J, Pilato M, Gorcsan III J, Terzi A, Clemenza F. Predicting Acute and Chronic Right Ventricular Failure in Patients Undergoing Left Ventricular Assist Device Implant: The Importance of Right Atrial Strain and Regional Deformation of the Right Ventricular Free Wall. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.982] [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: 11/27/2022] Open
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27
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Terzi A, Storelli E, Bettini S, Sibillano T, Altamura D, Salvatore L, Madaghiele M, Romano A, Siliqi D, Ladisa M, De Caro L, Quattrini A, Valli L, Sannino A, Giannini C. Effects of processing on structural, mechanical and biological properties of collagen-based substrates for regenerative medicine. Sci Rep 2018; 8:1429. [PMID: 29362434 PMCID: PMC5780384 DOI: 10.1038/s41598-018-19786-0] [Citation(s) in RCA: 69] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 12/11/2017] [Indexed: 12/21/2022] Open
Abstract
The aim of this work was to investigate the structural features of type I collagen isoforms and collagen-based films at atomic and molecular scales, in order to evaluate whether and to what extent different protocols of slurry synthesis may change the protein structure and the final properties of the developed scaffolds. Wide Angle X-ray Scattering data on raw materials demonstrated the preferential orientation of collagen molecules in equine tendon-derived collagens, while randomly oriented molecules were found in bovine skin collagens, together with a lower crystalline degree, analyzed by the assessment of FWHM (Full Width at Half Maximum), and a certain degree of salt contamination. WAXS and FT-IR (Fourier Transform Infrared) analyses on bovine collagen-based films, showed that mechanical homogenization of slurry in acidic solution was the treatment ensuring a high content of super-organization of collagen into triple helices and a high crystalline domain into the material. In vitro tests on rat Schwannoma cells showed that Schwann cell differentiation into myelinating cells was dependent on the specific collagen film being used, and was found to be stimulated in case of homogenization-treated samples. Finally DHT/EDC crosslinking treatment was shown to affect mechanical stiffness of films depending on collagen source and processing conditions.
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Affiliation(s)
- A Terzi
- Institute of Crystallography (IC), National Research Council, Bari, Italy
| | - E Storelli
- Department of Engineering for Innovation, University of Salento, Lecce, Italy
- Neuropathology Unit, Institute of Experimental Neurology and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - S Bettini
- Department of Engineering for Innovation, University of Salento, Lecce, Italy
| | - T Sibillano
- Institute of Crystallography (IC), National Research Council, Bari, Italy
| | - D Altamura
- Institute of Crystallography (IC), National Research Council, Bari, Italy
| | - L Salvatore
- Department of Engineering for Innovation, University of Salento, Lecce, Italy
| | - M Madaghiele
- Department of Engineering for Innovation, University of Salento, Lecce, Italy
| | - A Romano
- Neuropathology Unit, Institute of Experimental Neurology and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - D Siliqi
- Institute of Crystallography (IC), National Research Council, Bari, Italy
| | - M Ladisa
- Institute of Crystallography (IC), National Research Council, Bari, Italy
| | - L De Caro
- Institute of Crystallography (IC), National Research Council, Bari, Italy
| | - A Quattrini
- Neuropathology Unit, Institute of Experimental Neurology and Division of Neuroscience, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Valli
- Department of Biological and Environmental Sciences and Technologies, University of Salento, Lecce, Italy
| | - A Sannino
- Department of Engineering for Innovation, University of Salento, Lecce, Italy
| | - C Giannini
- Institute of Crystallography (IC), National Research Council, Bari, Italy.
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Bubak J, Roviglione G, Clarizia R, Mautone D, Bruni F, Terzi A, Ceccaroni M. Diaphragmatic Endometriosis – Endoscopic Management Based on 12-Year Retrospective Study. J Minim Invasive Gynecol 2017. [DOI: 10.1016/j.jmig.2017.08.353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bertoglio P, Viti A, Salgarello M, Pasetto S, Bogina G, Terzi A. P1.08-005 Preoperative Analysis of 18FDG-PET Features May Predict Loco-Regional Invasiveness in NSCLC. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.968] [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: 11/24/2022]
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Marrone C, Ferrero P, Uricchio N, Sebastiani R, Vittori C, Ciuffreda M, Terzi A, Galletti L. The unnatural history of failing univentricular hearts: outcomes up to 25 years after heart transplantation. Interact Cardiovasc Thorac Surg 2017; 25:892-897. [DOI: 10.1093/icvts/ivx352] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 09/19/2017] [Indexed: 11/12/2022] Open
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31
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Iacovoni A, Vittori C, Fontana A, Carobbio A, Fino C, D'Elia E, Terzi A, Senni M. Echocardiographic outflow pump ramp test in centrifugal-flow left ventricular assist device. Int J Artif Organs 2017; 40:0. [PMID: 28430303 DOI: 10.5301/ijao.5000573] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/21/2017] [Indexed: 11/20/2022]
Abstract
This study sought to develop a novel echocardiogram outflow ramp test to detect device malfunctions in centrifugal-flow left ventricular assist devices (LVADs). This new ramp pump test is based on the direct analyses of systolic and diastolic ratio (S/D) Doppler velocity in the outflow cannula in the HeartWare LVAD during progressive increases in speed. The results showed that in patients with normal pump function, the Doppler velocity S/D ratio gradually decreased during LVAD speed increases. This test is easily performed and seems promising to detect normal pump function in patients assisted by a centrifugal flow LVAD.
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Affiliation(s)
- Attilio Iacovoni
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Regional Healthcare and Social Services (ASST), Bergamo - Italy
| | - Claudia Vittori
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Regional Healthcare and Social Services (ASST), Bergamo - Italy
| | - Alessandra Fontana
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Regional Healthcare and Social Services (ASST), Bergamo - Italy
| | - Alessandra Carobbio
- FROM Research Foundation, Papa Giovanni XXIII Hospital, Regional Healthcare and Social Services (ASST), Bergamo - Italy
| | - Carlo Fino
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Regional Healthcare and Social Services (ASST), Bergamo - Italy
| | - Emilia D'Elia
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Regional Healthcare and Social Services (ASST), Bergamo - Italy
| | - Amedeo Terzi
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Regional Healthcare and Social Services (ASST), Bergamo - Italy
| | - Michele Senni
- Cardiovascular Department, Papa Giovanni XXIII Hospital, Regional Healthcare and Social Services (ASST), Bergamo - Italy
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32
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Solli P, Terzi A, Scarci M, Viti A, Bedetti B, Bahkhri K, Coonar A, Bertolaccini L. P-197FEASIBILITY OF MAJOR LUNG RESECTIONS IN THE ELDERLY PATIENTS: A MORBIDITY RISK STRATIFICATION MODEL. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.195] [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: 11/12/2022] Open
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Yildiz F, Coban S, Terzi A, Aksoy N, Bitiren M. Protective Effect of Micronized Purified Flavonoid Fraction on Ischemia/Reperfusion Injury of Rat Liver. Transplant Proc 2016; 47:1507-10. [PMID: 26093753 DOI: 10.1016/j.transproceed.2015.04.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Flavonoids have been subjected to considerable investigation because of its antioxidant and anti-inflammatory properties. However, there is no previously reported study about its effect on hepatic ischemia/reperfusion (I/R). We investigated the effects of micronized purified flavonoid fraction (MPFF) on hepatic I/R injury in rats. METHODS Thirty rats were recruited in the study as follows: group A, sham operation (n = 10); group B, I/R (n = 10); and group C, I/R+MPFF (n = 10). In group C, rats received (80 mg/kg/day) MPFF by gavage for 3 days before surgery, 30 minutes before ischemia and just before the reperfusion. Blood samples were taken, and serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), and lactate dehydrogenase (LDH) levels were measured to assess liver functions. Liver tissues were taken for histological evaluation and to determine the total antioxidant capacity (TAC), catalase (CAT), total oxidant status (TOS), oxidative stress index (OSI), and myeloperoxidase (MPO). RESULTS The present data showed a decrease in AST, ALT, and LDH levels in the MPFF-treated rats when compared with I/R group rats (P < .001 for all). In the MPFF-treated rats, tissue levels of TOS, OSI, and MPO were significantly lower than those in the I/R group (P < .01, P < .001, and P < .05, respectively). Increases in TAC and CAT levels were statistically significant in the MPFF-treated rats compared with the I/R group (P = .01 for both). On the other hand, MPFF attenuated histological alterations that were induced by I/R. CONCLUSIONS The present study demonstrates that MPFF ameliorates I/R-induced liver damage, probably through antioxidant and anti-inflammatory properties.
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Affiliation(s)
- F Yildiz
- Department of General Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey.
| | - S Coban
- Department of General Surgery, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - A Terzi
- Department of General Surgery, Harran University School of Medicine, Sanliurfa, Turkey
| | - N Aksoy
- Department of Biochemistry, Harran University School of Medicine, Sanliurfa, Turkey
| | - M Bitiren
- Department of Pathology, Harran University School of Medicine, Sanliurfa, Turkey
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Simon C, Grazioli L, Cugola D, Macchitelli V, Innocente F, Terzi A, Merlo M, Brucato AM, Lorini LM, Galletti L. Use of "LIMON Test" in Constrictive Pericarditis: a case series. J Cardiothorac Surg 2015. [PMCID: PMC4693943 DOI: 10.1186/1749-8090-10-s1-a37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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35
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Bertolaccini L, Felloni G, Salgarello M, Viti A, Bianchi A, Terzi A. Preoperative Positron Emission Tomography Fractal Biopsy of Thymic Epithelial Neoplasm. Ann Oncol 2015. [DOI: 10.1093/annonc/mdv053.02] [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: 11/13/2022] Open
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36
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Viti A, Bertolaccini L, Russi E, Merlano M, Colantonio I, Terzi A. 201 * CLINICAL IMPACT OF RADICAL LOCO-REGIONAL SURGERY IN SYNCHRONOUS OLIGOMETASTATIC NON-SMALL-CELL LUNG CANCER. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.201] [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: 11/12/2022] Open
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37
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Bertolaccini L, Viti A, Terzi A. B-001 * ERGON - TRIAL: ERGONOMIC EVALUATION OF SINGLE-PORT ACCESS VERSUS THREE-PORT ACCESS VIDEO-ASSISTED THORACIC SURGERY. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu167.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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38
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Viti A, Bertolaccini L, Cavallo A, Fortunato M, Bianchi A, Terzi A. 18-Fluorine fluorodeoxyglucose positron emission tomography in the pretreatment evaluation of thymic epithelial neoplasms: a metabolic biopsy confirmed by Ki-67 expression. Eur J Cardiothorac Surg 2014; 46:369-74; discussion 374. [DOI: 10.1093/ejcts/ezu030] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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39
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Filosso PL, Venuta F, Oliaro A, Ruffini E, Rendina EA, Margaritora S, Casadio C, Terzi A, Rena O, Lococo F, Guerrera F. Thymoma and inter-relationships between clinical variables: a multicentre study in 537 patients. Eur J Cardiothorac Surg 2014; 45:1020-7. [DOI: 10.1093/ejcts/ezt567] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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40
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Viti A, Bertolaccini L, Cavallo A, Bianchi A, Fortunato M, Terzi A. 127 * 18-FLUORINE FLUORODEOXYGLUCOSE POSITRON EMISSION TOMOGRAPHY IN THE PRETREATMENT EVALUATION OF THYMIC EPITHELIAL NEOPLASMS: A "METABOLIC BIOPSY" CONFIRMED BY KI-67 EXPRESSION. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.127] [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: 11/12/2022] Open
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41
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Bertolaccini L, Viti A, Cavallo A, Terzi A. Results of Li-Tho trial: a prospective randomized study on effectiveness of LigaSure(R) in lung resections. Eur J Cardiothorac Surg 2013; 45:693-8; discussion 698. [DOI: 10.1093/ejcts/ezt445] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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42
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Bertolaccini L, Viti A, Cavallo A, Terzi A. B-006RESULTS OF LI-THO TRIAL: A PROSPECTIVE RANDOMIZED STUDY ON EFFECTIVENESS OF LIGASURE® IN LUNG RESECTIONS. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.6] [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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43
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Filosso PL, Rendina A, Guerrera F, Ruffini E, Margaritora S, Casadio C, Terzi A, Lococo F, Rena O, Venuta F. BTOG-115THYMOMA AND INTER-RELATIONSHIPS BETWEEN CLINICAL VARIABLES: A MULTICENTRE STUDY IN 537 PATIENTS. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt288.115] [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: 11/13/2022] Open
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44
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Bertolaccini L, Viti A, Cavallo A, Terzi A. Correlation sometimes implies causation: possible roles of correlation analysis between 18fluorine-fluorodeoxyglucose positron emission tomography/computed tomography and thymic epithelial neoplasms. Eur J Cardiothorac Surg 2013; 44:187-8. [DOI: 10.1093/ejcts/ezs686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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45
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Bertolaccini L, Lanzi E, Viti A, Chauvie S, Bianchi A, Cavallo A, Terzi A. 37O 18-F FDG PET TOTAL GLYCOLYTIC VOLUME IN THYMIC EPITHELIAL NEOPLASMS EVALUATION: AN EASILY REPRODUCIBLE IMAGE BIOMARKER. Lung Cancer 2013. [DOI: 10.1016/s0169-5002(13)70258-7] [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: 10/26/2022]
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46
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Bertolaccini L, Viti A, Gorla A, Terzi A. Home-management of malignant pleural effusion with an indwelling pleural catheter: Ten years experience. Eur J Surg Oncol 2012; 38:1161-4. [DOI: 10.1016/j.ejso.2012.08.021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2012] [Accepted: 08/20/2012] [Indexed: 12/20/2022] Open
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Seddio F, Gorislavets N, Iacovoni A, Cugola D, Fontana A, Galletti L, Terzi A, Ferrazzi P. Is heart transplantation for complex congenital heart disease a good option? A 25-year single centre experience. Eur J Cardiothorac Surg 2012; 43:605-11; discussion 611. [PMID: 22733841 DOI: 10.1093/ejcts/ezs350] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [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: 11/13/2022] Open
Abstract
OBJECTIVES Heart transplantation (HTx) in patients with complex congenital heart disease (CHD) is a challenge because of structural anomalies and multiple previous procedures. We analysed our results in adult and paediatric patients to evaluate outcome and assess risk factors affecting mortality. METHODS Between 1985 and 2011, among 839 patients who underwent HTx, 85 received transplantation for end-stage CHD. Patients were divided into four age subgroups: <1 year (8 patients, Group I), 1-10 years (20 patients, Group II), 11-18 years (24 patients, Group III) and >18 years (33 patients, Group IV) and into two time periods: 1985-2000 (47 patients) and 2001-2011 (38 patients). Anatomical diagnoses were single-ventricle defect in 37 patients (44%) and two-ventricle defect in 48 patients (56%). Seventy-three patients (86%) had undergone one or more cardiac surgical procedures prior to HTx (mean 2.4 ± 0.9). Twenty-two of them were suffering from Fontan failure. Mean pulmonary artery pressure was 25.2 ± 14.2 mmHg. Mean transpulmonary gradient was 9.4 ± 6.9 mmHg. RESULTS Mean follow-up after HTx was 7.8 ± 6.8 years. Survival at 1 month was 37.7% in Group I, 85.8% in Group II, 96.8% in Group II and 98.4% in Group IV and was significantly worse in younger recipients. Overall 30-day mortality was 17.6%. Currently 56 patients (65.8%) are alive. Overall survival at 1, 5, 10 and 15 years is 83-, 73-, 67- and 58%, respectively. There were 14 late deaths. Univariate analysis found that risk factors for early and late death were those related to recipient illness, such as pre-transplant creatinine, intravenous inotropic drugs, intravenous diuretics, mechanical ventilation and presence of protein-losing enteropathy (PLE). Multivariate analysis for all events (early and late deaths) identified preoperative mechanical ventilation as an independent risk factor for mortality. Number of previous procedures did not influence survival. Previous Fontan procedure did not increase mortality. We documented the reversibility of PLE in survivors. CONCLUSIONS We demonstrated that heart transplantation for patients with CHD can be performed with the expectation of excellent results. Previous procedures, including the Fontan operation, do not reduce survival. Mortality is related to preoperative patient condition. We advocate early referral of complex CHD patients for transplant assessment and for inclusion in waiting lists before the detrimental effects of end-stage failure manifest themselves.
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Affiliation(s)
- Francesco Seddio
- Paediatric Cardiovascular Surgery Unit, Bergamo Hospital, Bergamo, Italy.
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Bertolaccini L, Rizzardi G, Luzzi L, Terzi A. Treatment of Late Tracheomediastinal Fistula following Diagnostic Mediastinoscopy Treated by Multiple Pedicled Muscle Flaps. Thorac Cardiovasc Surg 2011; 59:364-6. [DOI: 10.1055/s-0030-1250481] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bertolaccini L, Rizzardi G, Terzi A. Single-port video-assisted thoracic surgery resection: the Copernican revolution of a geometrical approach in thoracic surgery? Interact Cardiovasc Thorac Surg 2011; 12:516. [DOI: 10.1510/icvts.2010.256222a] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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50
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Rizzardi G, Campione A, Scanagatta P, Terzi A. Paraneoplastic extra limbic encephalitis associated with thymoma. Interact Cardiovasc Thorac Surg 2009; 9:755-6. [DOI: 10.1510/icvts.2009.211276] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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