Chirurgia generale e trapianti di fegato

Dipartimento di Trapiantologia epatica, epatologia e infettivologia
Azienda Ospedaliero-Universitaria Pisana
Ospedale Cisanello
Via Paradisa, 2
56124, Pisa
Tel.: 050 995421
Fax: 050 995420
trapiantofegato@ao-pisa.toscana.it

Principal investigator: Franco Filipponi, surgeon

Team members
Giuseppe Arenga surgeon
Emanuele Balzano surgeon
Gabriele Catalano surgeon
Paolo De Simone surgeon
Aristide Ferrara surgeon
Davide Ghinolfi surgeon
Giovanni Tincani surgeon
Paola Carrai hepatologist
Stefania Petruccelli hepatologist

Introduction

The General Surgery and Liver Transplantation Unit is part of the Department of Liver Transplantation, Hepatology and Infectious Disease of the University of Pisa Medical School Hospital. Both the Unit and the Department are chaired by Prof Franco Filipponi. The Department also includes the Hepatology Unit (director Dr. Maurizia R. Brunetto); the Infectious Disease Unit (director Dr. Francesco Menichetti); the Intensive Care Section (director Gianni Biancofiore); the Laboratory for Immunosuppressants (director Dr. Arianna Precisi o Procissi), and the Liver Radiology and Interventional Techniques Section (director Prof. Riccardo A. Lencioni). The activities of the Department are carried out in cooperation with the Oncology Unit, the Radiology Department, the Blood Center and the Laboratory Unit of the University of Pisa Medical School Hospital. The Unit includes a Coordination section for all outpatient activities and coordination of deceased donation and liver transplant procedures and step-down surgical wards, and is run on a model of integration among transplant physicians, surgeons and nurses across the whole continuum of the care process.

Main research themes

  1. Treatment of hepatocellular carcinoma by liver transplantation
    • Expansion of indications to liver transplantation beyond conventional Milan criteria by use of an integrated approach with selective pre-transplant tumor downstaging
    • Definition of clinical, histological, biochemical, and genomic criteria to select patients eligible to liver transplantation beyond Milan criteria
    • Definition of prognostic models to allow for selection of patients eligible to liver transplantation beyond Milan criteria
  2. Treatment of hepatocellular carcinoma by liver resection
    • The role of liver surgery for treatment of advanced hepatocellular carcinoma
    • Analysis of the results of major liver resection in patients with advanced hepatocellular carcinoma and portal thrombosis
    • Combined use of liver surgery and radiology-assisted techniques for advanced hepatocellular carcinoma
  3. Treatment of cholangiocarcinoma by liver resection
    • The role of extended liver resection for treatment of hilar cholangiocarcinoma
    • Analysis of the results of major liver resections for treatment of Klatskin tumors
    • Neo-adjuvant therapies in the treatment of hilar cholangiocarcinoma
  4. Treatment of liver colorectal metastases
    • The role of isolated liver perfusion in the treatment of liver colorectal metastases
    • Analysis of the results of isolated liver perfusion in the treatment of liver colorectal metastases
  5. Treatment of advanced hepatocellular carcinoma by VEGF and mTOR inhibitors:
    • Brivanib in the treatment of advanced hepatocellular carcinoma
    • Brivanib after sorafenib and brivanib vs. sorafenib in the treatment of hepatocellular carcinoma
    • mTOR after liver transplantation or liver surgery for prevention of hepatocellular carcinoma recurrences.

References

  1. Single-session percutaneous ethanol ablation of early-stage hepatocellular carcinoma with a multipronged injection needle: results of a pilot clinical study. Lencioni R, Crocetti L, Cioni D, Pina CD, Oliveri F, De Simone P, Brunetto M, Filipponi F. J Vasc Interv Radiol. 2010 Oct;21(10):1533-8.PMID: 20817558 [PubMed - in process]
  2. Loco-regional interventional treatment of hepatocellular carcinoma: techniques, outcomes, and future prospects. Lencioni R, Crocetti L, De Simone P, Filipponi F. Transpl Int. 2010 Jul;23(7):698-703. Epub 2010 May 14.
  3. Hepatocellular carcinoma: CT for tumor response after transarterial chemoembolization in patients exceeding Milan criteria--selection parameter for liver transplantation. Bargellini I, Vignali C, Cioni R, Petruzzi P, Cicorelli A, Campani D, De Simone P, Filipponi F, Bartolozzi C. Radiology. 2010 Apr;255(1):289-300.
  4. Long-term outcome of initially unresectable metastatic colorectal cancer patients treated with 5-fluorouracil/leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) followed by radical surgery of metastases. Masi G, Loupakis F, Pollina L, Vasile E, Cupini S, Ricci S, Brunetti IM, Ferraldeschi R, Naso G, Filipponi F, Pietrabissa A, Goletti O, Baldi G, Fornaro L, Andreuccetti M, Falcone A. Ann Surg. 2009 Mar;249(3):420-5.
  5. Conversion to everolimus monotherapy in maintenance liver transplantation: feasibility, safety, and impact on renal function. De Simone P, Carrai P, Precisi A, Petruccelli S, Baldoni L, Balzano E, Ducci J, Caneschi F, Coletti L, Campani D, Filipponi F. Transpl Int. 2009 Mar;22(3):279-86. Epub 2008 Dec 2.
  6. Doxorubicin-eluting bead-enhanced radiofrequency ablation of hepatocellular carcinoma: a pilot clinical study.
  7. Lencioni R, Crocetti L, Petruzzi P, Vignali C, Bozzi E, Della Pina C, Bargellini I, Cioni D, Oliveri F, De Simone P, Bartolozzi C, Brunetto M, Filipponi F. J Hepatol. 2008 Aug;49(2):217-22. Epub 2008 Apr 24.
  8. Cost analysis of tumor downsizing for hepatocellular carcinoma liver transplant candidates. De Simone P, Vignali C, Petruccelli S, Carrai P, Coletti L, Montin U, Catalano G, Urbani L, Filipponi F. Transplant Proc. 2006 Dec;38(10):3561-3.
  9. Treatment with 5-fluorouracil/folinic acid, oxaliplatin, and irinotecan enables surgical resection of metastases in patients with initially unresectable metastatic colorectal cancer.
  10. Masi G, Cupini S, Marcucci L, Cerri E, Loupakis F, Allegrini G, Brunetti IM, Pfanner E, Viti M, Goletti O, Filipponi F, Falcone A. Ann Surg Oncol. 2006 Jan;13(1):58-65. Epub 2006 Jan 1
  11. Posttransplant hepatocellular carcinoma metastasis at a skull trauma site. De Simone P, Carrai P, Morelli L, Coletti L, Petruccelli S, Filipponi F, Doria R, Menichetti F, Vannozzi R. Transplantation. 2005 Nov 15;80(9):1358-9.
  12. Hepatic resection after liver transplantation as a graft-saving procedure: indication criteria, timing and outcome. Catalano G, Urbani L, Biancofiore G, Bindi L, Boldrini A, Consani G, Bisą M, Campatelli A, Petruzzi P, Cioni R, Vignali C, Mosca F, Filipponi F. Transplant Proc. 2004 Apr;36(3):545-6.

Clinical trials

  1. CA 182-033: brivanib vs. sorafenib as first line for advanced hepatocellular carcinoma Bristol-Myers-Squibb
    7 patients recruited to date
  2. CA 182-034: brivanib after sorafenib failure for advanced hepatocellular carcinoma Bristol-Myers-Squibb
    5 patients recruited
  3. CA 182-035: brivanib after TACE for advanced hepatocellular carcinoma Bristol-Myers-Squibb
    Recruitment ongoing
  4. Everolimus after liver transplantation for hepatocellular carcinoma beyond Milan criteria No sponsor
    17 patients

Main collaborations

  • Department of Radiology, University of Pisa Medical School Hospital, Pisa
  • Department of Oncology, University of Pisa Medical School Hospital, Pisa
  • Radiotherapy, University of Pisa Medical School Hospital, Pisa
  • Pharmacology, University of Pisa Medical School Hospital, Pisa
  • Blood Center, University of Pisa Medical School Hospital, Pisa
  • Infectious Disease, University of Pisa Medical School Hospital, Pisa
  • Gastroenterology, University of Pisa Medical School Hospital, Pisa

torna su