Stefano Fagiuoli

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This study looked at whether it is safe to stop using hepatitis B immunoglobulin (HBIG) in liver transplant patients who are infected only with hepatitis B virus (HBV). Researchers followed 222 patients who stopped taking HBIG about 11.6 years after their transplant for an average of 24 months. They found that only 5.4% of patients experienced a return of the hepatitis B virus, and all patients maintained normal liver function and showed no signs of liver disease, demonstrating that stopping HBIG is safe for these patients. Who this helps: This benefits liver transplant patients infected with hepatitis B and their doctors by reducing the need for long-term treatment.

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This study looked at how well the RETREAT score predicts the chances of liver cancer coming back after a liver transplant. Out of 298 patients followed for about 5.3 years, 19% had their cancer return, with lower rates for those in the low-risk group (4% at one year) and higher rates for those in the high-risk group (23% at ten years). Understanding this score helps doctors better assess patients' risks and manage their care after transplantation. Who this helps: This benefits patients who have undergone liver transplantation for cancer, as well as their doctors managing their treatment.

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This study looked at how doctors in Italy prevent the return of hepatitis B virus (HBV) in patients who have received a liver transplant. The researchers found that while most experts agree that using a combination of hepatitis B immunoglobulin (HBIG) and certain medications is the best approach, there is still a lot of inconsistency in how these treatments are given, especially for low-risk patients. This matters because having clear guidelines could improve patient care and outcomes after liver transplants. Who this helps: This helps patients receiving liver transplants and their healthcare providers.

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This study looked at how to prevent the return of Hepatitis B virus (HBV) in patients who have received liver transplants. It found that using hepatitis B immune globulin (HBIG) is still very important for high-risk patients, as it effectively reduces the chance of reinfection. Overall, HBIG accounts for about 12.4% of lifetime liver transplant costs, but its use remains crucial despite its expenses because not using it could lead to worse health outcomes. Who this helps: This helps patients who have undergone liver transplants and are at risk of HBV infection.

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This study looked at how well Yttrium-90 radioembolization works for patients with liver cancer (hepatocellular carcinoma) over the long term. Researchers found that the average survival time after treatment was about 16.7 months, and 31% of patients had a complete response to the treatment. It’s important because better responses to this therapy are linked to longer survival, suggesting that improving treatment plans can help patients live longer. Who this helps: This helps patients with hepatocellular carcinoma and their doctors by providing insights into effective treatment options.

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This study focused on new techniques for treating children with a serious condition called portal vein obstruction, which can lead to dangerous bleeding. Researchers explored two innovative methods of reopening the blocked portal vein without changing the body’s natural flow and found that these methods are effective in helping kids who haven’t responded to traditional treatments. This approach can reduce complications and improve the health and quality of life for these young patients. Who this helps: This helps children suffering from portal vein obstruction and their families.

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This study looked at the safety and complications associated with a common medical procedure called ultrasound-guided percutaneous liver biopsy, involving 1,838 patients across three hospitals in Italy. The researchers found that only 1.4% experienced major complications, such as bleeding or low blood pressure, and 7.4% reported pain after the procedure. Since most complications were rare and pain was the main predictor of them, patients might not need to be monitored for long periods afterward, which could allow for a faster recovery at home. Who this helps: Patients undergoing liver biopsies.

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This study looked at a type of treatment called Y-90 radioembolization for patients with liver cancer (hepatocellular carcinoma). Researchers found that patients who received at least 233.2 Gy of radiation had better chances of seeing their tumors shrink (complete radiological response), without harming nearby healthy tissue. This is important because it shows a clear dosage threshold that could help improve cancer treatment outcomes while minimizing side effects. Who this helps: This helps patients with liver cancer by improving their treatment options and outcomes.

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This study looked at how liver transplant recipients in Bergamo, Italy, felt about and responded to COVID-19 vaccinations from May to October 2023. Out of 753 invited patients, 356 participated, and by October 2023, 22% had received all recommended doses. They found that while 12% had COVID-19 before vaccination, 26% experienced it afterward, but none of the vaccinated patients had serious complications from COVID-19 or the vaccine itself. Who this helps: This research benefits liver transplant patients by confirming the safety and effectiveness of COVID-19 vaccines for them.

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This study looked at how well the Stanford Integrated Psychosocial Assessment helps evaluate patients being considered for liver transplants at a hospital in Bergamo. Researchers analyzed a group of patients to identify important factors like mental health issues, substance use, and social situations that could affect their transplant eligibility. They found that understanding these factors is crucial for ensuring patients are well-prepared for the transplant process, which can improve their chances of success. Who this helps: This helps patients undergoing liver transplantation and the healthcare providers supporting them.

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This research paper discusses the challenges of managing Hepatitis B virus (HBV) infection in patients receiving treatments that weaken the immune system, like those for cancer or autoimmune diseases. The study found that many patients at risk for HBV are not being tested before starting these treatments, which can lead to HBV reactivation—a serious condition that can occur in about 20% of HBsAg positive patients and 5% of HBsAg negative carriers. By screening patients for HBV, doctors can take preventive steps to avoid complications, which is crucial for patient safety. Who this helps: This helps patients undergoing immunosuppressive treatment and their doctors.

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This study looked at how to prevent the recurrence of hepatitis B (HBV) in patients who received a liver transplant for liver disease caused by HBV, focusing specifically on those with liver cancer. Researchers analyzed data from over 1,200 liver transplant recipients in Italy between 2010 and 2021 and found that using a combination of treatments (lifelong hepatitis B immunoglobulin plus nucleos(t)ide analogues) effectively reduced HBV recurrence to only 2.1% for patients without cancer and 3.1% for those with cancer. Importantly, while HBV recurrence was low and did not affect survival for non-cancer patients, it was linked to a higher risk of cancer recurrence in patients who had liver cancer, with a rate of 10.8%. Who this helps: This research benefits patients undergoing liver transplantation, especially those dealing with HBV and liver cancer.

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This study looked at patients in Italy who have both Hepatitis C (HCV) and Type 2 Diabetes (T2D) to see how their health and treatment patterns compared to those with only HCV. Researchers found that patients who had both conditions were older (average age 1277 patients was significantly higher than 6576 patients with only HCV) and generally had more health issues. These dual-diagnosis patients also had more hospital visits and medications prescribed to them compared to those with HCV alone, which highlights the added health challenges they face. Who this helps: This information benefits patients with both HCV and Type 2 Diabetes, as well as their healthcare providers in managing their care.

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This study looked at how well obeticholic acid (OCA) works and its safety over the long term for patients with primary biliary cholangitis (PBC). Researchers followed 747 patients for about 2 years and found that the drug improved liver function in 57% of patients while 17% stopped taking the medication mainly due to itching. The research is important because it shows that OCA can help manage PBC effectively over time, especially for patients who respond well to the treatment. Who this helps: This benefits patients with PBC and their doctors.

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This study looked at the impact of the hepatitis D virus (HDV) on both native Italians and immigrants in Italy, examining 515 patients who were positive for hepatitis B. They found that 83.9% of these patients had detectable levels of the virus, with native Italians generally being older and more likely to suffer from severe liver conditions like cirrhosis (70.3% vs. 50.5% in migrants) and liver cancer (14.8% vs. 0.5% in migrants). The findings are important because they show that while severe liver disease is frequent in both groups, many patients actually have milder cases, which suggests that the treatment and care for chronic HDV infections may need to be tailored differently for these populations. Who this helps: This information benefits patients and doctors by providing insights for better management of hepatitis D infections.

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This study looked at the number of people in Italy with chronic Hepatitis B (CHB) and Delta virus (CHD) in 2024, using information from healthcare records and surveys. They found that about 112,000 adults have chronic Hepatitis B and around 9,360 have chronic Delta virus. This information is important for health officials as it helps them make informed decisions about healthcare policies and resources to manage these infections. Who this helps: Patients with Hepatitis B and Delta virus, as well as healthcare providers and policymakers.

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This study looked at how well certain scores can predict graft loss (the failure of the transplanted liver) and death in patients who develop recurrent primary biliary cholangitis (rPBC) after receiving a liver transplant. Out of 332 patients followed for an average of 8.7 years, 16% experienced graft loss and 31% died. The researchers found that specific factors, such as disease activity and certain risk scores, were associated with worse outcomes, highlighting the need for effective treatment of rPBC as soon as it occurs. Who this helps: This benefits patients who have undergone liver transplants and healthcare providers working to manage their care.

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This study looked at a condition called metabolic-dysfunction-associated steatotic liver disease (MASLD) that can develop after liver transplantation. Researchers found that while this condition doesn't seem to affect how long patients live after a transplant, it is linked to higher risks of heart problems and cancer. Factors like metabolic changes in patients before and after the transplant, along with age and certain genetic traits, increase the chances of developing this liver disease. Who this helps: This information is beneficial for transplant patients and doctors managing their post-surgery care.

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This study looked at how to improve immunosuppressive therapy for adults who have received liver transplants. The Italian Liver Transplant Working Group updated their previous recommendations based on new research and expert opinions, covering areas such as managing organ rejection and special cases like those with frailty or blood type mismatches. The updated guidelines suggest a general move away from using steroids, while also considering specific needs for different patient groups, which can help improve patient outcomes significantly. Who this helps: This helps patients who have received liver transplants and their doctors by providing clearer treatment guidelines.

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This study looked at the lifetime healthcare costs for adults in Italy who received a liver transplant because of hepatitis B. Researchers found that the average lifetime cost for these patients is around €395,986, with the highest expenses coming from complications like kidney failure (31.9% of total costs) and medications to prevent organ rejection (20.6%). Understanding these costs is important because it highlights the financial burden of liver transplants related to hepatitis B and can help inform healthcare policies and funding. Who this helps: This information benefits healthcare policymakers and hospital administrators.

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This study looked at a specific marker called CD64 found on white blood cells (neutrophils) to see if it could help identify bloodstream infections in patients with liver cirrhosis. Researchers found that cirrhotic patients with infections had much higher levels of CD64 (6.0) compared to those without infections (2.0), showing that it might be a useful tool for diagnosis. Understanding and using this marker could improve how doctors detect infections in these high-risk patients, which is very important because timely treatment can save lives. Who this helps: This helps patients with liver cirrhosis and their doctors by improving infection diagnosis.

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This research looked at the importance of vaccinations for children who are candidates for or have received solid organ transplants. It found that these young patients are at a higher risk for infections due to their weak immune systems and suggested that getting vaccinated before surgery is crucial for their protection. Ensuring these children are vaccinated can help improve their health outcomes and reduce the chances of serious infections after transplantation. Who this helps: This helps children waiting for or recovering from organ transplants and their families.

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This study looked at a treatment method for patients with a blocked portal vein, which can lead to serious health issues like high blood pressure in the liver. Researchers found that out of 15 patients treated, 87% had successful procedures that improved their condition, and all of these patients saw better clinical results within an average follow-up period of 20 months. This is important because it shows that using special techniques in radiology can effectively improve blood flow and reduce complications related to portal vein blockages. Who this helps: This helps patients with chronic portal vein issues, including those who have undergone liver transplants.

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This research paper examines how to manage antibiotic use in liver transplant patients who may be infected with tough-to-treat bacteria known as multi-drug-resistant organisms. The review highlights the challenges doctors face, especially distinguishing between patients who are at low risk or high risk for these infections, even after screening tests show different results. The study proposes a new strategy to guide treatment decisions, aiming to improve patient outcomes after liver transplants. Who this helps: This helps liver transplant patients and their doctors.

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This paper examines liver damage, known as hepatotoxicity, caused by cancer immunotherapy, specifically immune checkpoint inhibitors. Researchers found that this can range from mild symptoms to severe cases, including rare instances of acute liver failure. Effective management includes regular monitoring and may involve treatments like corticosteroids, but there is still little definitive guidance on how to handle the most severe cases. Who this helps: This research is beneficial for oncologists and cancer patients undergoing immunotherapy.

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The study looked at how effective and safe the drug lusutrombopag is for treating cirrhotic patients with very low platelet counts (a condition called severe thrombocytopenia). Out of 66 patients treated, 84% avoided needing platelet transfusions and 74% raised their platelet counts to a safe level, with counts increasing from an average of 37,000 to 58,000 per microliter. This matters because it offers a real-world example of how lusutrombopag can help these patients manage their condition more effectively without increasing risks. Who this helps: This helps patients with chronic liver disease who struggle with low platelet counts.

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This study looked at patients needing liver transplants in Italy, comparing those with a condition called metabolic dysfunction-associated steatotic liver disease (MASLD) to those without it. Out of nearly 13,200 patients, the number with MASLD waiting for a transplant rose significantly, from 9.5% in 2012 to 11.8% in 2022, and they faced a higher risk of dying while waiting (1.62 times more than those without MASLD). This research highlights the importance of recognizing and prioritizing patients with MASLD on waiting lists to help improve their chances of survival and success after transplant. Who this helps: Patients with MASLD who are waiting for a liver transplant.

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This study examined patients with chronic Hepatitis D virus (HDV) infection in Italy, focusing on their health profiles and whether they could qualify for certain treatments. Out of 5,492 patients tested, 422 (10.2%) were found to be positive for HDV, with many of these patients being younger and having existing liver conditions like cirrhosis or cancer. The findings highlight that a significant number of patients have other health issues that could limit their treatment options, particularly affecting 53% of them. Who this helps: This helps patients with chronic Hepatitis D and their doctors by providing insights into treatment eligibility and the prevalence of other health problems.

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This study looked at how well the drug sorafenib works for patients with liver cancer who had a liver transplant and then experienced a recurrence of the cancer. Among 81 liver transplant recipients treated with sorafenib, the average survival time was about 18.7 months, despite many having more advanced disease. This matters because it shows that, even with challenges like additional treatments and complications, sorafenib can still provide significant benefits for these patients. Who this helps: This helps liver transplant patients dealing with recurrent liver cancer and their doctors.

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The study looked at how a new scoring system based on MRI scans can predict the health outcomes of patients with primary sclerosing cholangitis (PSC), a liver disease. Researchers analyzed images from 87 PSC patients and found that specific features, such as the number of bile duct blockages and the size of the spleen, can help determine the risk of severe complications. They created a quantitative score called qMRCP-PSC, which showed better accuracy in predicting patient survival compared to existing methods, with a strong performance metric (C-statistic of 0.80). Who this helps: This benefits patients with PSC and their doctors by providing a more reliable way to assess risk and monitor the disease.

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This study looked at the one-year survival rates of COVID-19 patients who were hospitalized and found that 33.6% of them died within a year after discharge. Most deaths occurred while the patients were still in the hospital, with 3.7% of those who were discharged dying afterward, mainly due to serious pre-existing health conditions like cancer and heart disease, rather than the severity of their pneumonia from COVID-19. Understanding which patients are more at risk can help doctors to create better follow-up care for those who have survived COVID-19. Who this helps: This information benefits doctors and healthcare providers working with COVID-19 patients.

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This study looked at two tools, the AFP score and Metroticket 2.0, which help doctors decide which patients with liver cancer (HCC) are suitable for a liver transplant. Both tools were tested on over 2,400 patients who had transplants and showed similar levels of accuracy in predicting if cancer would return after the transplant. Patients who qualified as low-risk using both tools had a 7.7% chance of cancer coming back after five years and a 70% chance of surviving five years after the transplant. Who this helps: Patients with liver cancer seeking a liver transplant.

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This study looked at how taking many medications (polypharmacy) and being older affects the risk of dangerous drug interactions in patients with hepatitis C who are treated with specific antiviral drugs. Researchers analyzed data from nearly 6.9 million people and found that 56.5% of patients on one antiviral (sofosbuvir/velpatasvir) were taking two or more additional drugs, compared to 32.3% of those on another antiviral (glecaprevir/pibrentasvir). If these interactions occur, they could either lower the effectiveness of the antiviral treatment or increase the levels of other medications in the body, leading to possible health risks. Who this helps: Patients with hepatitis C and their doctors.

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This study looked at the liver damage risks associated with small molecule protein kinase inhibitors (PKIs) used for cancer treatment. It found that many of these drugs can raise liver enzyme levels, with some carrying special warnings about this risk. Although severe liver damage is rare and often reversible through dose adjustments or switching medications, it's essential for patients to be closely monitored before and during treatment to ensure their safety. Who this helps: This information is valuable for cancer patients and their doctors.

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This study examined the impact of metabolic dysfunction (MD) on the risk of liver cancer in 2,611 Italian patients who were successfully treated for hepatitis C and had serious liver damage. Researchers found that 58% of these patients had MD, which was linked to a nearly twofold increased risk of developing liver cancer compared to those without MD. Specifically, patients with diabetes as part of their MD had the highest risk, highlighting the importance of monitoring metabolic health in these individuals. Who this helps: This information benefits doctors and patients who have been treated for hepatitis C, particularly those with liver damage and metabolic issues.

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This study looked at transplanting livers from donors whose hearts had stopped beating, particularly when there was a significant delay (up to 51 minutes) before the organs were preserved using a method called abdominal normothermic regional perfusion (aNRP). The findings showed that out of 24 liver transplants performed this way, most patients (only 2 out of 21) survived for at least a year, and complications were manageable, suggesting that this method can be a safe and cost-effective alternative to traditional preservation techniques. It highlights the potential for using organs that might have been previously discarded, ultimately expanding the donor pool. Who this helps: This benefits patients waiting for liver transplants and doctors involved in organ transplantation.

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This study looked at Hepatitis C Virus (HCV) screening among people born between 1969 and 1989 in Lombardy, Italy. Researchers tested 120,193 individuals and found that 604 (0.50%) had antibodies for HCV, with 125 of those (28.3%) showing active infections. The overall prevalence of active infection was low at 0.10%, although it was higher in older patients and those hospitalized. This is important because identifying and treating HCV early can help reduce its spread and improve health outcomes. Who this helps: This benefits patients at risk of HCV and healthcare providers involved in screening and treatment.

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This study looked at how doctors treat problems with the hepatic artery in children who have received liver transplants. Researchers reviewed cases from 17 patients, finding that 76% of the procedures successfully reopened or fixed artery issues. After treatment, 82% of the patients were still doing well with their liver graft after about a year, showing that these endovascular treatments can be effective for fixing serious complications. Who this helps: This helps pediatric liver transplant patients and their doctors.

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This research looks at how important vaccinations are for adults who are receiving or are candidates for solid organ transplants, as these patients are at higher risk for infections. It highlights that vaccinated patients generally have better protection, but their response to vaccines can be weaker, especially right after the transplant or after treatment for organ rejection. The study emphasizes that getting vaccinated before transplant surgery is essential for their health. Who this helps: This benefits patients awaiting organ transplants and those who have recently received one.

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This study looked at how liver transplant recipients (LTRs) respond to SARS-CoV-2, the virus that causes COVID-19, compared to other organ transplant patients and the general population in Italy during the first wave of the pandemic. Out of nearly 14,200 liver transplant patients, only 89 were infected with COVID-19, which is lower than the infection rates for other organ transplant patients (361 out of about 30,000) and comparable to the general population. These findings indicate that liver transplant patients may have a unique immune response that protects them from severe COVID-19 illness, similar to people who have not had transplants. Who this helps: This information benefits liver transplant patients and their healthcare providers.

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This study looked at trends in chronic hepatitis B virus infection among patients in Italy over a 10-year period by comparing two groups of patients. It found that between 2012-2015 and 2019-2021, the number of patients with a specific marker of viral activity decreased from 12.3% to 7.2%, indicating better management of the disease, while about 25% of patients still had cirrhosis, with a notable decrease in the likelihood of cirrhosis by 40% in the newer group. The results highlight improvements in hepatitis B management in Italy, yet emphasize that hepatitis D virus remains a significant issue, particularly for patients with cirrhosis and migrants. Who this helps: This benefits patients with chronic hepatitis B and healthcare providers managing their treatment.

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Researchers studied the impact of hepatic encephalopathy (HE) on patients with severe liver disease (cirrhosis) after they were hospitalized. They found that after one year, 30.4% of patients with HE died, compared to 23.4% of those without HE, indicating that HE significantly raises the risk of death. Additionally, HE was linked to more hospital readmissions, making it a critical factor for treatment decisions, including liver transplants. Who this helps: This research benefits patients with liver disease and their doctors by highlighting the importance of monitoring and treating HE.

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This study looked at how access to liver transplants varies for patients with severe liver failure in Europe. Researchers found that, out of 351 patients, only 8% were able to receive a transplant, and those in centers that listed and transplanted more patients (over 10) had a better one-year survival rate of 36% compared to 20% in centers that did less. This inequity in access to life-saving transplants highlights the need for better strategies to ensure all patients receive the care they need. Who this helps: Patients with severe liver failure.

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This study looked at liver injuries that occurred after people received SARS-CoV-2 vaccinations. Researchers analyzed data from 87 patients across 18 countries, finding that 63% were women and the average age was 48 years. Most liver injuries happened around 15 days post-vaccination, with 59% of injuries linked to the Pfizer-BioNTech vaccine, and although most patients recovered, one individual needed a liver transplant. Who this helps: This information is useful for patients and doctors to understand potential liver-related side effects of COVID-19 vaccines.

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The study looked at hospitalized COVID-19 patients to understand blood clotting problems and identify factors that could predict complications like blood clots or excessive bleeding. Researchers found that patients, especially those in the intensive care unit, had issues like faster clot formation and higher levels of certain proteins that indicate blood clotting problems. Specifically, they saw that higher levels of two proteins, t-PA and PAI-1, predicted blood clots, while lower levels of another protein, FXIII, indicated a risk of bleeding, making this information crucial for managing treatment. Who this helps: This helps doctors treating hospitalized COVID-19 patients.

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This study looked at how the stiffness of the lungs, measured by a number called compliance, affects patients with severe COVID-19-related breathing difficulties. Researchers found that the stiffness of the lungs at the start of treatment did not depend on how long the patient had been sick, with an average compliance measurement of 41 ml/cmHO. While turning patients onto their stomachs (prone positioning) improved oxygen levels for everyone, it only made the lung stiffness better in those with the worst initial measurements. Who this helps: This information helps doctors better understand and treat patients with severe COVID-19 lung complications.

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This study looked at how imaging techniques are used to diagnose and treat portal vein thrombosis (PVT), especially in children. It found that using different imaging methods, such as ultrasound and CT scans, helps doctors identify the severity and type of PVT, which can range from partial blockages to complete ones. Understanding and treating PVT is important because it can lead to serious health problems, and effective imaging can significantly improve patient outcomes. Who this helps: This helps patients with portal vein thrombosis and their doctors.

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In this study, doctors treated a 56-year-old man with liver cancer who experienced severe skin reactions and worsening health after receiving a type of chemotherapy called epirubicin during a procedure. They used a drug called dexrazoxane eight hours after the procedure, which improved his skin condition and helped resolve other serious health issues. This matters because it shows that dexrazoxane can effectively reduce harmful side effects from chemotherapy, potentially improving outcomes for patients undergoing similar treatments. Who this helps: This helps patients undergoing chemotherapy for liver cancer and their doctors.