119 / 172
e180
Abstracts of the 22
nd
National Congress of Digestive Diseases / Digestive and Liver Disease 48S2 (2016) e67–e231
similar between the two treatment groups (OR=1.01, 0.53-1.87,
p=0.98) but MWA outperformed RFA in cases of larger nodules (OR
0.46, 0.24-0.89, p=0.02). 3-year SR was higher after RFA without
statistically significant difference (OR=0.95, 0.58-1.57, p=0.85).
Major complications were more frequent, although not significantly,
in MWA patients (OR=1.63, 0.88-3.03, p=0.12).
Conclusions:
Our results indicate a similar efficacy between the two
percutaneous techniques with an apparent superiority of MWA in
larger neoplasms.
P.10.8
PREVALENCE AND RISK FACTORS OF METABOLIC SYNDROME
AFTER LIVER TRANSPLANTATION: A SINGLE CENTRE EXPERIENCE
Pepe V.*
1
, Germani G.
1
, Ferrarese A.
1
, Zanetto A.
1
, Bortoluzzi I.
1
,
Nadal E.
1
, Russo F.P.
1
, Senzolo M.
1
, Cillo U.
2
, Gringeri E.
2
, Burra P.
1
1
Multivisceral Transplant Unit, Department of Surgery, Oncology
and Gastroenterology, Padova University Hospital, Padova, Italy,
2
Hepatobiliary Surgery and Liver Transplant Unit, Padova University
Hospital, Padova, Italy
Background and aim:
Metabolic syndrome (MS) is a condition
affecting more than half of liver transplanted recipients, resulting
in an increased mortality and morbidity in the long term after
transplantation. However, only few studies have evaluated the short
and long-term prevalence of the MS after liver transplantation (LT)
and its potential risk factors. The aim of this study was to evaluate
the short and long-term prevalence of MS after LT and to identify
potential risk factors for its development.
Material and methods:
Patients who underwent LT at the Padova
Liver Transplant Center between January 2000 and March 2013
(retrospective cohort) and between April 2013 and April 2014
(prospective cohort) and who were regularly followed-up at
Multivisceral Transplant Unit were included in the study. Patients
<18 years, who underwent multiorgan transplantation or re-LT and
who had a diagnosis of MS at the time of LT were excluded from both
cohorts. For each patient general and metabolic (pre- and post-LT)
variables, donor characteristics, transpant variables were recorded.
Results:
One-hundred-sixty-one patients (120 male) were included
in the retrospective cohort. Mean±SD age at transplant was 52.5±9.5
years. The most common indication to liver transplantation was
HCV-related cirrhosis (49.1%). A post-LT significant increase in
BMI values (27 ± 4 vs. 25.1 ± 3.4, p<0.001), in diabetes mellitus and
sistemic hypertension prevalence (38.5% vs. 11.8%, p<0.001 and
57.1% vs. 11.2%, p<0.001, respectively) and in total cholesterol and
triglyceride levels (176.8±51.1 vs. 123.5±62.2, p<0.001 and 146.7±81.1
vs. 93.9±61.2, p <0.001, respectively) was found compared to pre-LT
values. At a mean post-transplant follow-up of 6.9±4.2 years 81/161
(50.3%) patients developed MS. Recipient male sex (OR 2.36, 95%CI
0.94-5.85; p=0.045), a higher pre-LT BMI (OR per unit 1.14, 95%CI
1.01-1.28; p=0.03), and the presence of pre-LT diabetes mellitus (OR
5.98, 95%CI 1.48-32.55; p=0.04) were found to be associated with
the development of post-LT MS. Fifteen patients were included in
the prospective cohort (10 male), with a mean±SD age of 52.2±5.8
years (range: 46-65). One third of patients (5/15) were transplanted
for HCV-related cirrhosis. At 3, 6 and 12 months after LT a significant
increase in BMI, diabetes and hypertension prevalence and in
cholesterol and tryglicerides levels was found compared to pre-
transplant values and 5/15 (33.3%), 3/11 (27.3%) e 4/10 (40%) patients
developed MS.
Conclusions:
In conclusion, these data show that post-LT MS is
affecting nearly half of LT patients, starting early after LT. Recipient
male gender, pre-transplant diabetes and increased BMI are
risk factors for MS after LT. Lifestyle modifications, especially in
overweight LT-recipients should be recommended starting in the
early post-LT period. This would reduce the incidence of post-LT MS
and the related cardio-vascular events.
P.10.9
ACCURACY OF INTESTINAL PERMEABILITY IN PREDICTING THE
DEVELOPMENT OF COMPLICATIONS IN PATIENTS WITH LIVER
CIRRHOSIS
Ponzani F.R.*
1
, Valenza V.
2
, Annichiarico B.E.
1
, Siciliano M.
1
,
Pompili M.
1
, Gasbarrini A.
1
1
Internal Medicine and Gastroenterology, A Gemelli Hospital, Rome,
Italy,
2
Nuclear Medicine, A. Gemelli Hospital, Rome, Italy
Background and aim:
Liver cirrhosis complications are often
associated with increased intestinal permeability (IP), which is
in turn common in the advanced stages of the disease. However,
at what extent IP could be useful to predict the development of
complication is still unknown. To evaluate the accuracy of IP in
predicting the development of hepatic encephalopathy (HE) and
spontaneous bacterial peritonitis (SBP) in comparison with Child-
Pugh and MELD score.
Material and methods:
Cirrhotic patients without concomitant
diseases or medications potentially altering IP and with no evidence
of active alcohol consumption were prospectively evaluated; IP was
Table 1
(abstract P.10.7)
Characteristics of the included studies
Sample
Recruitment
Study
CP
Tumorsize (cm)
Number
Study
Arm
size
period
design
Region
(A/B/C)
mean (range)
nodules*
Quality
Ohmoto 2009 (20)
RFA
34
2002-2006
R
Japan
20/11/3
1.6 (0.7-2)
1.08
H
MWA
49
31/14/4
1.7 (0.8-2)
1.14
Lu 2005 (22)
RFA
53
1997-2002
R
China
49/4/0
2.6 (1-6.1)
1.35
M
MWA
49
39/10/0 2.5 (0.9-7.2)
2
Shibata 2002 (25)
RFA
36
1999-2000
RCT
Japan
21/15/0
1.6 (0.7-2)
1.08
M
MWA
36
19/17/0
1.7 (0.8-2)
1.14
Ding 2013 (26)
RFA
85
2006-2010
R
China
49/36/0 2.38 (1-4.8)
1.15
H
MWA
113
75/38/0 2.55 (0.8-5)
1.15
Zhang 2013 (27)
RFA
78
2006
R
China
78/0/0
NA
1.24
H
MWA
77
77/0/0
NA
1.36
Abdelaziz 2014 (28)
RFA
45
2009-2013
R
Egypt
24/21/0
2.95±1.03
1
M
MWA
66
2.9±0.97
1
Vogl 2015 (29)
RFA
25
2008-2010
R
Germany
NA
NA
1.28
M
MWA
28
NA
NA
1.28
* Number of nodules per patient; + Expressed as mean ± standard deviation. Abbreviations: RFA, Radiofrequency Ablation; MWA, Microwave Ablation; RCT,
Randomized-controlled trial; R, retrospective; CP, Child-Pugh; M, Moderate; H, High