Browsing by Author "Mendizabal, Manuel"
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Item Direct-Acting Antivirals and Hepatocellular Carcinoma: No Evidence of Higher Wait-List Progression or Posttransplant Recurrence(2020) Piñero, Federico; Boin, Ilka; Chagas, Aline; Quiñonez, Emilio; Marciano, Sebastián; Vilatobá, Mario; Santos, Luisa; Anders, Margarita; Hoyos Duque, Sergio; Soares Lima, Agnaldo; Menendez, Josemaría; Padilla, Martín; Poniachik, Jaime; Zapata, Rodrigo; Maraschio, Martín; Chong Menéndez, Ricardo; Muñoz, Linda; Arufe, Diego; Figueroa, Rodrigo; Mendizabal, Manuel; Hurtado Gomez, Sahara; Stucchi, Raquel; Maccali, Claudia; Vergara Sandoval, Rodrigo; Bermudez, Carla; McCormack, Lucas; Varón, Adriana; Gadano, Adrián; Mattera, Juan; Rubinstein, Fernando; Carrilho, Flair; Silva, MarceloThe association between direct-acting antivirals (DAAs) and hepatocellular carcinoma (HCC) wait-list progression or its recurrence following liver transplantation (LT) remains uncertain. We evaluated the impact of DAAs on HCC wait-list progression and post-LT recurrence. This Latin American multicenter retrospective cohort study included HCC patients listed for LT between 2012 and 2018. Patients were grouped according to etiology of liver disease: hepatitis C virus (HCV) negative, HCV+ never treated with DAAs, and HCV+ treated with DAAs either before or after transplantation. Multivariate competing risks models were conducted for both HCC wait-list progression adjusted by a propensity score matching (pre-LT DAA effect) and for post-LT HCC recurrence (pre- or post-LT DAA effect). From 994 included patients, 50.6% were HCV-, 32.9% were HCV+ never treated with DAAs, and 16.5% were HCV+ treated with DAAs either before (n = 66) or after LT (n = 98). Patients treated with DAAs before LT presented similar cumulative incidence of wait-list tumor progression when compared with those patients who were HCV+ without DAAs (26.2% versus 26.9%; P = 0.47) and a similar HCC-related dropout rate (12.1% [95% CI, 0.4%-8.1%] versus 12.9% [95% CI, 3.8%-27.2%]), adjusted for baseline tumor burden, alpha-fetoprotein values, HCC diagnosis after listing, bridging therapies, and by the probability of having received or not received DAAs through propensity score matching (subhazard ratio [SHR], 0.9; 95% CI, 0.6-1.6; P = 0.95). A lower incidence of posttransplant HCC recurrence among HCV+ patients who were treated with pre- or post-LT DAAs was observed (SHR, 0.7%; 95% CI, 0.2%-4.0%). However, this effect was confounded by the time to DAA initiation after LT. In conclusion, in this multicenter cohort, HCV treatment with DAAs did not appear to be associated with an increased wait-list tumor progression and HCC recurrence after LT.Publication Latin American association for the study of the liver (ALEH) guidance on postoperative care after liver transplantation(2025) Codes, Liana; Zapata, Rodrigo; Mendizabal, Manuel; De Medeiros, Alfeu; De Lucca, Leonardo; Sá, Luiz; Andraus, Wellington; Gadano, Adrian; Padilla, Martin; Villamil, Alejandra; Silveira, Raquel; Castro, Graciela; Pages, Josefina; Terrabuio, Debora; Urzúa, Alvaro; Guimarães, Mário; Mainardi, Victoria; Pedro, Rodolpho; Imventarza, Oscar; Gerona, Solange; Wolff, Rodrigo; Abdala, Edson; Tenorio, Laura; Cerda, Eira; Cairo, Fernando; Uribe, Mario; Lisboa, Paulo; Members of ALEH Special Interest Group on Liver TransplantationLiver transplantation (LT) is a well-established therapy for patients with decompensated cirrhosis and early-stage hepatocellular carcinoma. Liver transplantation activity varies sharply across Latin American (LATAM) countries due to differences in resources, expertise, and funding and local attitudes toward organ donation and transplantation. This current guidance of postoperative care after LT is the first position paper of the Latin American Association for the Study of the Liver (ALEH) Special Interest Group (SIG), drawing evidence-based recommendations regarding immediate and long-term postoperative care of LT recipients, taking into consideration their applicability in Latin America.Publication Latin American association for the study of the liver (ALEH) guidance on preoperative care in liver transplantation: referral criteria, patient assessment, and waiting list management(2025) Mainardi, Victoria; Pages, Josefina; Menendez, Josemaría; Zapata, Rodrigo; Díaz, Luis; Marciano, Sebastian; Cairo, Fernando; Padilla, Martin; Tenorioz, Laura; Urzua, Alvaro; Navarro, Lucia; Dominguez, Nicolas; Coste, Pablo; Mendizabal, Manuel; Martinez, Jorge; Lopez, Sergio; Varon, Adriana; De Medeiros, Alfeu; Abad, Jhon; Restrepo, Juan; Codes, Liana; Lisboa, Paulo; Pérez, Norma; Castro, Graciela; Terrabuio, Débora; Mário, Pessoa; Girala, Marcos; Lucca Schiavon, Leonardo; Aguileraz, Edgard; Valenzuela, Kenia; Samada, Marcia; Gerona, Solange; Villamil, AlejandraLiver transplantation (LT) is the standard of care therapy for patients with decompensated cirrhosis, early-stage hepatocellular carcinoma, acute liver failure, and other expanding indications. Latin America is a highly heterogeneous region characterized by an uneven distribution of socio-economic conditions and irregular access to health resources, and consequently LT activity varies across the region. This current guidance on preoperative care in LT represents a collaborative effort to assess and standardize preoperative evaluation of liver transplant candidates in Latin America. It is the first position paper of the special interest group on LT of the Latin American Association for the Study of the Liver (ALEH), which provides evidence-based comprehensive recommendations regarding whom to refer, how to assess LT candidates and how to manage patients on the waiting list, taking into consideration their applicability in Latin America.