cometadata/datacite-titles-descriptions-related-identifiers huggingface dataset:
DOI: 10.5281/zenodo.4633386
title: Raw Data for the article: Impact of Extended-Criteria Donor Liver Grafts on Benchmark Metrics of Clinical Outcome After Liver Transplantation: A Single Center Experience

description: <strong>Background: </strong>The adoption of extended criteria for donors remains the best strategy to widen the pool of available liver graft against the chronic shortage of donors. Benchmarking in liver transplantation (LT) offers the unprecedented opportunity to compare clinical outcome measures to a set of validated reference values. We aimed to evaluate the impact of marginal grafts usage in a cohort of low-risk benchmark cases from an area with a very low rate of deceased donation. <strong>Methods: </strong>A cohort of low-risk benchmark cases was identified from all adult patients who underwent LT at our center. Among these patients, those transplanted with a graft from an extended-criteria donor (ECD) were identified. Benchmark metrics (length of hospital and intensive care unit stay, incidences of mortality, graft loss, and postoperative complication) were compared with benchmark cutoffs and between the 2 groups. <strong>Results: </strong>Two hundred forty-five patients satisfied the inclusion criteria, 146 (60%) of whom received an organ from an ECD. Overall, all benchmark metrics where within the cutoffs limits, except for graft loss (14% vs 11%) and mortality (10% vs 9% 1 year after LT). The ECD group was associated with more grade III complications (60% vs 45%, P = .031), graft loss (18% vs 8%, P = .038), and mortality (14% vs 4%, P = .009). Hepatocellular carcinoma diagnosis was found to be associated with less mortality (odds ratio = 0.42, P = .048). <strong>Conclusion: </strong>While ECD graft usage is associated with slightly worse prognosis, our experience suggests that their use can be considered safe, especially when matched on hepatocellular carcinoma recipients.
DOI: 10.5281/zenodo.4633410
title: Raw Data for the article: Near Infra-Red Technology to Evaluate Segment IV in Split Liver Transplantation

description: <strong>Background: </strong>Indocyanine green injected intravenously has been employed in many fields of hepatobiliary surgery such as liver and biliary tree mapping, tumor detection, and graft evaluation in liver transplant. This latter application has, in our opinion, particular potentials when a split liver transplantation is performed 1-3. <strong>Methods: </strong>In this study, we used infrared technology to evaluate in real-time the segment 4 region in a recipient of extended right lobe transplantation. Donor data: 50 years old male, brain death, height, 1.70 mt, weight 69 kg; surgical technique employed was in situ standard split liver procurement. Recipient data: 46 years old male, height 1.75 mt; weight 67 k 23 g, affected by cirrhosis secondary HCV infection, with MELD Na 33. Standard orthotopic liver transplantation was performed with indocyanine green intravenous injection at 15 min after arterial reperfusion. <strong>Results: </strong>Infrared technology, showed in this video, demonstrates progressive improvement of segment IV viability which was confirmed by the post-operative contrast-enhanced CT scan performed before discharge. The transplant procedure was uneventful and the patient discharged to home 10 days after surgery. <strong>Conclusion: </strong>The case reported in this video is, to the best of our knowledge, the first in the English literature showing how near infrared technology has predictive value on the evaluation of a split graft. Fast diffusion of the colorant allows dynamic early evaluation and may confirm the presence of intra-hepatic venous shunt, which will determine a full recovery of the originally ischemic area. On the contrary, a permanent absence of the staining might be predictive of dysfunction.
DOI: 10.5281/zenodo.4633409
title: Raw Data for the article: Near Infra-Red Technology to Evaluate Segment IV in Split Liver Transplantation

description: <strong>Background: </strong>Indocyanine green injected intravenously has been employed in many fields of hepatobiliary surgery such as liver and biliary tree mapping, tumor detection, and graft evaluation in liver transplant. This latter application has, in our opinion, particular potentials when a split liver transplantation is performed 1-3. <strong>Methods: </strong>In this study, we used infrared technology to evaluate in real-time the segment 4 region in a recipient of extended right lobe transplantation. Donor data: 50 years old male, brain death, height, 1.70 mt, weight 69 kg; surgical technique employed was in situ standard split liver procurement. Recipient data: 46 years old male, height 1.75 mt; weight 67 k 23 g, affected by cirrhosis secondary HCV infection, with MELD Na 33. Standard orthotopic liver transplantation was performed with indocyanine green intravenous injection at 15 min after arterial reperfusion. <strong>Results: </strong>Infrared technology, showed in this video, demonstrates progressive improvement of segment IV viability which was confirmed by the post-operative contrast-enhanced CT scan performed before discharge. The transplant procedure was uneventful and the patient discharged to home 10 days after surgery. <strong>Conclusion: </strong>The case reported in this video is, to the best of our knowledge, the first in the English literature showing how near infrared technology has predictive value on the evaluation of a split graft. Fast diffusion of the colorant allows dynamic early evaluation and may confirm the presence of intra-hepatic venous shunt, which will determine a full recovery of the originally ischemic area. On the contrary, a permanent absence of the staining might be predictive of dysfunction.
DOI: 10.5281/zenodo.4633438
title: Raw Data for the article: Preliminary Analysis of the Impact of the Coronavirus Disease 2019 Outbreak on Italian Liver Transplant Programs

description: Liver Transplant Programs in Italy have faced a sequela of management and clinical decision‐making problems due to the high incidence in some regions of the country of severe acute respiratory syndrome Coronavirus 2 (SARS‐CoV‐2). The Italian Society for Organ Transplantation (SITO) and the Board of Liver Transplant Program Directors issued a survey to assess the initial impact of this pandemic event on the routine activity of 22 Italian Liver Transplant Programs. One hundred percent of participants completed the survey within a few days. The analysis is presented dividing the centers in two macro‐areas: north‐central Italy and south‐central Italy. The reason for this is that the two areas had a different incidence of the infection and because they have distinctive rates of cadaveric donation. Overall, all centers remained open although a reduction in the activity was noted. Transplant Programs reduced their outpatient activity both in terms of pre‐transplant evaluation (68% of the centers) and transplant recipient follow‐up (100%); a reduction in transplant activity was observed in the first two weeks of March only in the north‐central macro area (23 LTs vs 39 in 2018 and 60 in 2019); overall, SARS‐CoV‐2 infection was registered for 24 liver transplant recipients and 37 health care providers in liver transplant units. In the perspective of the increasing magnitude of the epidemic, more data will be required to define appropriate strategies for the increasingly complex management of liver transplant patients.
DOI: 10.5281/zenodo.4633437
title: Raw Data for the article: Preliminary Analysis of the Impact of the Coronavirus Disease 2019 Outbreak on Italian Liver Transplant Programs

description: Liver Transplant Programs in Italy have faced a sequela of management and clinical decision‐making problems due to the high incidence in some regions of the country of severe acute respiratory syndrome Coronavirus 2 (SARS‐CoV‐2). The Italian Society for Organ Transplantation (SITO) and the Board of Liver Transplant Program Directors issued a survey to assess the initial impact of this pandemic event on the routine activity of 22 Italian Liver Transplant Programs. One hundred percent of participants completed the survey within a few days. The analysis is presented dividing the centers in two macro‐areas: north‐central Italy and south‐central Italy. The reason for this is that the two areas had a different incidence of the infection and because they have distinctive rates of cadaveric donation. Overall, all centers remained open although a reduction in the activity was noted. Transplant Programs reduced their outpatient activity both in terms of pre‐transplant evaluation (68% of the centers) and transplant recipient follow‐up (100%); a reduction in transplant activity was observed in the first two weeks of March only in the north‐central macro area (23 LTs vs 39 in 2018 and 60 in 2019); overall, SARS‐CoV‐2 infection was registered for 24 liver transplant recipients and 37 health care providers in liver transplant units. In the perspective of the increasing magnitude of the epidemic, more data will be required to define appropriate strategies for the increasingly complex management of liver transplant patients.
DOI: 10.5281/zenodo.4633468
title: Raw Data for the article: The Role of Salvage Transplantation in Patients Initially Treated With Open Versus Minimally Invasive Liver Surgery: An Intention-to-Treat Analysis

description: Despite gaining wide consensus in the management of hepatocellular carcinoma (HCC), minimally invasive liver surgery (MILS) has been poorly investigated for its role in the setting of salvage liver transplantation (SLT). A multicenter retrospective analysis was carried out in 6 Italian centers on 211 patients with HCC who were initially resected with open (n = 167) versus MILS (n = 44) and eventually wait-listed for SLT. The secondary endpoint was identification of risk factors for posttransplant death and tumor recurrence. The enrolled patients included 211 HCC patients resected with open surgery (n = 167) versus MILS (n = 44) and wait-listed for SLT between January 2007 and December 2017. We analyzed the intention-to-treat survival of these patients. MILS was the most important protective factor for the composite risk of delisting, posttransplant patient death, and HCC recurrence (OR, 0.26; 95% confidence interval [CI], 0.11-0.63; P = 0.003). MILS was also the only independent protective factor for the risk of post-SLT patient death (OR, 0.29; 95% CI, 0.09-0.93; P = 0.04). After propensity score matching, MILS was the only independent protective factor against the risk of delisting, posttransplant death, and HCC recurrence (OR, 0.22; 95% CI, 0.07-0.75; P = 0.02). On the basis of the current analysis, MILS seems protective over open surgery for the risk of delisting, posttransplant patient death, and tumor recurrence. Larger prospective studies balancing liver function and tumor stage are strongly favored to better clarify the beneficial effect of MILS for HCC patients eventually referred to SLT.
DOI: 10.5281/zenodo.4633467
title: Raw Data for the article: The Role of Salvage Transplantation in Patients Initially Treated With Open Versus Minimally Invasive Liver Surgery: An Intention-to-Treat Analysis

description: Despite gaining wide consensus in the management of hepatocellular carcinoma (HCC), minimally invasive liver surgery (MILS) has been poorly investigated for its role in the setting of salvage liver transplantation (SLT). A multicenter retrospective analysis was carried out in 6 Italian centers on 211 patients with HCC who were initially resected with open (n = 167) versus MILS (n = 44) and eventually wait-listed for SLT. The secondary endpoint was identification of risk factors for posttransplant death and tumor recurrence. The enrolled patients included 211 HCC patients resected with open surgery (n = 167) versus MILS (n = 44) and wait-listed for SLT between January 2007 and December 2017. We analyzed the intention-to-treat survival of these patients. MILS was the most important protective factor for the composite risk of delisting, posttransplant patient death, and HCC recurrence (OR, 0.26; 95% confidence interval [CI], 0.11-0.63; P = 0.003). MILS was also the only independent protective factor for the risk of post-SLT patient death (OR, 0.29; 95% CI, 0.09-0.93; P = 0.04). After propensity score matching, MILS was the only independent protective factor against the risk of delisting, posttransplant death, and HCC recurrence (OR, 0.22; 95% CI, 0.07-0.75; P = 0.02). On the basis of the current analysis, MILS seems protective over open surgery for the risk of delisting, posttransplant patient death, and tumor recurrence. Larger prospective studies balancing liver function and tumor stage are strongly favored to better clarify the beneficial effect of MILS for HCC patients eventually referred to SLT.
DOI: 10.5281/zenodo.4633496
title: Raw Data for the article: Vascular Remodeling of Visceral Arteries Following Interruption of the Splenic Artery During Liver Transplantation

description: It was with great interest that we read the article by Patrono et al. and the comment by Dondossola et al., and we share the same interest in the splenic artery as a resource both for arterial inflow problems as well as for portal flow modulation. Portal hyperperfusion (PHP) is a well‐known condition where portal venous flow to the liver increases, and it is a characteristic for small‐for‐size syndrome in living donor liver transplantation. The consequences of PHP are hepatocyte morphological alteration, clinical symptoms, and, most importantly, pathophysiological changes in liver hemodynamics, such as for the hepatic arterial buffer response. Consistent hyperdynamic splanchnic circulation in patients with portal hypertension may cause excessive portal flow. We here report the sequela of multidetector computed tomography (MDCT) scans of a patient who underwent liver transplantation (LT) with a whole liver in our unit and presented an unusual intraoperative finding of PHP.
DOI: 10.5281/zenodo.4633495
title: Raw Data for the article: Vascular Remodeling of Visceral Arteries Following Interruption of the Splenic Artery During Liver Transplantation

description: It was with great interest that we read the article by Patrono et al. and the comment by Dondossola et al., and we share the same interest in the splenic artery as a resource both for arterial inflow problems as well as for portal flow modulation. Portal hyperperfusion (PHP) is a well‐known condition where portal venous flow to the liver increases, and it is a characteristic for small‐for‐size syndrome in living donor liver transplantation. The consequences of PHP are hepatocyte morphological alteration, clinical symptoms, and, most importantly, pathophysiological changes in liver hemodynamics, such as for the hepatic arterial buffer response. Consistent hyperdynamic splanchnic circulation in patients with portal hypertension may cause excessive portal flow. We here report the sequela of multidetector computed tomography (MDCT) scans of a patient who underwent liver transplantation (LT) with a whole liver in our unit and presented an unusual intraoperative finding of PHP.
DOI: 10.5281/zenodo.4633526
title: Raw Data for the article: ERAS Protocol for Perioperative Care of Patients Treated with Laparoscopic Nonanatomic Liver Resection for Hepatocellular Carcinoma: The ISMETT Experience

description: <strong><em>Background:</em></strong> Liver resection (LR) remains the best therapeutic option for patients with early-stage hepatocellular carcinoma (HCC) with preserved hepatic function and who are not eligible for liver transplantation. After its inception, the enhanced recovery after surgery (ERAS) protocol was widely used for treating patients with liver cancer, although there are still no clear indications for improving upon it in both open and laparoscopic surgery. <strong><em>Objective:</em></strong> This study aims to describe our institute's experience in the application of the ERAS protocol in a cohort of HCC patients, and to explore possible factors that could have an impact on postoperative outcomes. <strong><em>Materials and Methods:</em></strong> We retrospectively analyzed our experience with LR performed from September 2017 to January 2020 in patients treated with ERAS protocol, focusing on describing impact on postoperative nutrition, analgesic requirements, and length of hospitalization. Demographics, operative factors, and postoperative complications of patients were reviewed. <strong><em>Results:</em></strong> During the study period, 89 HCC patients were eligible for LR, and 75% of patients presented with liver cirrhosis. The most prevalent among etiologic factors was hepatitis C virus infection (53 patients out of 89, 60%), followed by nonalcoholic steatohepatitis (18 patients, 20%). The median age was 70 years. Liver cirrhosis did not have an impact on postoperative course of patients. Patients who underwent laparoscopic surgery and nonanatomic LR experienced low complication rates, shorter length of stay, and shorter time of intravenous analgesic requirements. <strong><em>Conclusions:</em></strong> Continual refinement with ERAS protocol for treating HCC patients based on perioperative counseling and surgical decision-making is crucial to guarantee low complication rates, and reduce patient morbidity and time for recovery.
DOI: 10.5281/zenodo.4633525
title: Raw Data for the article: ERAS Protocol for Perioperative Care of Patients Treated with Laparoscopic Nonanatomic Liver Resection for Hepatocellular Carcinoma: The ISMETT Experience

description: <strong><em>Background:</em></strong> Liver resection (LR) remains the best therapeutic option for patients with early-stage hepatocellular carcinoma (HCC) with preserved hepatic function and who are not eligible for liver transplantation. After its inception, the enhanced recovery after surgery (ERAS) protocol was widely used for treating patients with liver cancer, although there are still no clear indications for improving upon it in both open and laparoscopic surgery. <strong><em>Objective:</em></strong> This study aims to describe our institute's experience in the application of the ERAS protocol in a cohort of HCC patients, and to explore possible factors that could have an impact on postoperative outcomes. <strong><em>Materials and Methods:</em></strong> We retrospectively analyzed our experience with LR performed from September 2017 to January 2020 in patients treated with ERAS protocol, focusing on describing impact on postoperative nutrition, analgesic requirements, and length of hospitalization. Demographics, operative factors, and postoperative complications of patients were reviewed. <strong><em>Results:</em></strong> During the study period, 89 HCC patients were eligible for LR, and 75% of patients presented with liver cirrhosis. The most prevalent among etiologic factors was hepatitis C virus infection (53 patients out of 89, 60%), followed by nonalcoholic steatohepatitis (18 patients, 20%). The median age was 70 years. Liver cirrhosis did not have an impact on postoperative course of patients. Patients who underwent laparoscopic surgery and nonanatomic LR experienced low complication rates, shorter length of stay, and shorter time of intravenous analgesic requirements. <strong><em>Conclusions:</em></strong> Continual refinement with ERAS protocol for treating HCC patients based on perioperative counseling and surgical decision-making is crucial to guarantee low complication rates, and reduce patient morbidity and time for recovery.
DOI: 10.5281/zenodo.4633547
title: Raw Data for the article: Laparoscopic Microwave Thermal Ablation for the Treatment of Hepatocellular Carcinoma in Chronic Hepatic Patients

description: <strong><em>Background:</em></strong> Laparoscopic microwave thermal ablation (LMWTA) is a well-established alternative treatment to liver resection for treatment of liver tumors. The aim of this study was to describe our experience in LMWTA for hepatocellular carcinoma (HCC) in chronic hepatic patients. <strong><em>Materials and Methods:</em></strong> A study group of 61 consecutive HCC patients treated with LMWTA from January, 2013 to May, 2020 were considered for this study. Patient characteristics, liver function test, operational characteristics, and complications were recorded. <strong><em>Results:</em></strong> Of the 61 patients who underwent LMWTA, median age was 64 (interquartile range [IQR]: 58-71) years, mean body mass index was 26.2 (IQR: 23.2-29.4); 44 patients (72%) presented with an hepatitis C virus etiology, 46 (75%) were Child-Pugh Class A, median model for end-stage liver disease (MELD) score was 8.0 (IQR: 7.0-9.4). Viral infection was confirmed to be the most important risk factor in determining progressive cirrhotic evolution with HCC expression. <strong><em>Conclusions:</em></strong> LMWTA is a safe alternative treatment to traditional surgery, and can be combined with surgery.
DOI: 10.5281/zenodo.4633546
title: Raw Data for the article: Laparoscopic Microwave Thermal Ablation for the Treatment of Hepatocellular Carcinoma in Chronic Hepatic Patients

description: <strong><em>Background:</em></strong> Laparoscopic microwave thermal ablation (LMWTA) is a well-established alternative treatment to liver resection for treatment of liver tumors. The aim of this study was to describe our experience in LMWTA for hepatocellular carcinoma (HCC) in chronic hepatic patients. <strong><em>Materials and Methods:</em></strong> A study group of 61 consecutive HCC patients treated with LMWTA from January, 2013 to May, 2020 were considered for this study. Patient characteristics, liver function test, operational characteristics, and complications were recorded. <strong><em>Results:</em></strong> Of the 61 patients who underwent LMWTA, median age was 64 (interquartile range [IQR]: 58-71) years, mean body mass index was 26.2 (IQR: 23.2-29.4); 44 patients (72%) presented with an hepatitis C virus etiology, 46 (75%) were Child-Pugh Class A, median model for end-stage liver disease (MELD) score was 8.0 (IQR: 7.0-9.4). Viral infection was confirmed to be the most important risk factor in determining progressive cirrhotic evolution with HCC expression. <strong><em>Conclusions:</em></strong> LMWTA is a safe alternative treatment to traditional surgery, and can be combined with surgery.