Publications by authors named "Alba Cachero"

Article Synopsis
  • Wilson disease is a genetic disorder affecting copper metabolism, primarily linked to mutations in the ATP7B gene, showing a wide range of clinical symptoms among patients.
  • A study of 260 patients revealed that some common mutations, particularly p.Met645Arg and p.Gly869Arg, are underreported due to their milder symptoms, leading to a higher estimated prevalence than recorded (1:3,785, suggesting over 10,500 potential cases in Spain).
  • The findings indicate that individuals with the p.Met645Arg mutation often have fewer severe symptoms at diagnosis and are more likely to be diagnosed later in life, underscoring the need for increased awareness and early intervention.
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Article Synopsis
  • - Spain leads the world in deceased organ donation rates and has a well-established network of liver transplant centers; however, about 10% of patients on the liver transplant waiting list may die or deteriorate before receiving a transplant.
  • - The country currently lacks a unified national system for prioritizing liver transplants, leading to varying rules among institutions and some regional practices to address urgent needs.
  • - A new consensus document from the Spanish Society of Liver Transplantation (SETH) aims to standardize waiting list prioritization, enhance equity, and improve outcomes for patients with severe liver disease across Spain.
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Article Synopsis
  • The study investigates gender disparities in access to liver transplantation in Spain, focusing on the performance of the Gender-Equity Model adjusted by serum sodium (GEMA-Na) compared to the traditional Model for End-stage Liver Disease 3.0 (MELD 3.0).
  • It includes a nationwide cohort of 6,071 patients and finds that women have lower access to transplantation and a higher risk of mortality or delisting within the first 90 days.
  • GEMA-Na shows better predictive accuracy for waiting list outcomes than MELD 3.0, suggesting it could be the preferred method for prioritizing patients on the liver transplant waiting list.
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Background: Appropriate risk stratification for the difficulty of liver transplantation (LT) is essential to guide the selection and acceptance of grafts and avoid morbidity and mortality.

Methods: Based on 987 LTs collected from 5 centers, perioperative outcomes were analyzed across the 3 difficulty levels. Each LT was retrospectively scored from 0 to 10.

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Objective: A set of indicators has been reported to measure the quality of care for cirrhotic patients, and previously published studies report variable adherence rates to these indicators. This study aimed to assess the quality of care provided to cirrhotic outpatients before and after an educational intervention by determining its impact on adherence to quality indicators.

Methods: We conducted a quasi-experimental, cross-sectional study including 324 cirrhotic patients seen in 2017 and 2019 at a tertiary teaching hospital in Spain.

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Background & Aims: Pre-emptive transjugular intrahepatic portosystemic shunt (TIPS) is the treatment of choice for high-risk acute variceal bleeding (AVB; i.e., Child-Turcotte-Pugh [CTP] B8-9+active bleeding/C10-13).

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Long-term adaptive immune memory has been reported among immunocompetent individuals up to eight months following SARS-CoV-2 infection. However, limited data is available in convalescent patients with a solid organ transplant. To investigate this, we performed a thorough evaluation of adaptive immune memory at different compartments (serological, memory B cells and cytokine [IFN-γ, IL-2, IFN-γ/IL12 and IL-21] producing T cells) specific to SARS-CoV-2 by ELISA and FluoroSpot-based assays in 102 convalescent patients (53 with a solid organ transplants (38 kidney, 5 liver, 5 lung and 5 heart transplant) and 49 immunocompetent controls) with different clinical COVID-19 severity (severe, mild and asymptomatic) beyond six months after infection.

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Long-term humoral immunity and its protective role in liver transplantation (LT) patients have not been elucidated. We performed a prospective multicenter study to assess the persistence of immunoglobulin G (IgG) antibodies in LT recipients 12 months after coronavirus disease 2019 (COVID-19). A total of 65 LT recipients were matched with 65 nontransplanted patients by a propensity score including variables with recognized impact on COVID-19.

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Transplant and patient survival are the validated endpoints to assess the success of liver transplantation (LT). This study evaluates arterial and biliary complication-free survival (ABCFS) as a new metric. ABC, considered as an event, was an arterial or biliary complication of Dindo-Clavien grade ≥III complication dated at the interventional, endoscopic, or surgical treatment required to correct it.

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Background: Textbook outcome (TBO) is a patient-oriented composite criterion achieved when all desired main health outcomes are realized. The aim was to assess the incidence and the independent factors associated with TBO following LT.

Methods: This bicentric study included all patients who underwent their first elective liver-only LT between 2011 and 2015.

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Objective: To define technically Diff-LT.

Summary Of Background Data: Currently, there is no acknowledged definition of Diff-LT.

Methods: This retrospective study included all first consecutive liver-only transplantations performed in 2 centers from 2011 to 2015.

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Antibody-mediated rejection (AMR) after liver transplantation is uncommon but, when present, manifests as graft dysfunction. We report the case of a 54-year-old woman who developed portal hypertension with pleural effusion and ascites secondary to sinusoidal obstruction syndrome (SOS) due to acute AMR following an ABO-matched liver transplantation for autoimmune cirrhosis and hepatocellular carcinoma. Initial immunosuppression comprised basiliximab, decreasing prednisone, tacrolimus, and mycophenolate mofetil.

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The protective capacity and duration of humoral immunity after SARS-CoV-2 infection are not yet understood in solid organ transplant recipients. A prospective multicenter study was performed to evaluate the persistence of anti-nucleocapsid IgG antibodies in liver transplant recipients 6 months after coronavirus disease 2019 (COVID-19) resolution. A total of 71 liver transplant recipients were matched with 71 immunocompetent controls by a propensity score including variables with a well-known prognostic impact in COVID-19.

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The description of protective humoral and T cell immune responses specific against SARS-CoV-2 has been reported among immunocompetent (IC) individuals developing COVID-19 infection. However, its characterization and determinants of poorer outcomes among the at-risk solid organ transplant (SOT) patient population have not been thoroughly investigated. Cytokine-producing T cell responses, such as IFN-γ, IL-2, IFN-γ/IL-2, IL-6, IL-21, and IL-5, against main immunogenic SARS-CoV-2 antigens and IgM/IgG serological immunity were tracked in SOT (n = 28) during acute infection and at two consecutive time points over the following 40 days of convalescence and were compared to matched IC (n = 16) patients admitted with similar moderate/severe COVID-19.

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Introduction: Liver retransplantation (LRT) is a controversial indication. Our aim was to evaluate the rate of LRT at our institution, and to analyze its indications and short- and long-term results.

Methods: We conducted a retrospective study of a prospectively collected database, including 1645 LT from 1984 to 2018.

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Background & Aims: The incidence and outcomes of coronavirus disease 2019 (COVID-19) in immunocompromised patients are a matter of debate.

Methods: We performed a prospective nationwide study including a consecutive cohort of liver transplant patients with COVID-19 recruited during the Spanish outbreak from 28 February to 7 April, 2020. The primary outcome was severe COVID-19, defined as the need for mechanical ventilation, intensive care, and/or death.

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Article Synopsis
  • * Researchers applied a new testing protocol to analyze samples from 220 patients across various Spanish hospitals, finding that 88.6% had at least one RAS, with specific patterns linked to different HCV subtypes.
  • * The findings reveal that certain patients had RAS not affected by the drugs they received, indicating the necessity for thorough RAS testing, especially since ribavirin treatment did not impact RAS diversity or type.
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Background: Post-banding ulcer bleeding is a rare complication of endoscopic band ligation of esophageal varices with high morbidity and mortality. There exist no management guidelines for this complication.

Aims: To determine the incidence, outcome and risk factors of post-banding ulcer bleeding.

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Background & Aims: Around 5% of patients with chronic hepatitis C virus (HCV) infection treated with direct-acting antiviral (DAA) agents do not achieve sustained virological response (SVR). The currently approved retreatment regimen for prior DAA failure is a combination of sofosbuvir, velpatasvir, and voxilaprevir (SOF/VEL/VOX), although there is little data on its use in clinical practice. The aim of this study was to analyse the effectiveness and safety of SOF/VEL/VOX in the real-world setting.

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Several techniques have been proposed for liver transplantation with inadequate hepatic artery (HA) anastomosis. We aimed to analyze outcomes of arterial reconstruction with the splenic artery (SA). This was a prospective study of our experience with recipients who underwent arterial anastomosis on the SA compared with patients who underwent standard HA.

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Unlabelled: The presence of cirrhosis increases the mortality of patients with peptic ulcer bleeding (PUB). Both acute variceal bleeding (AVB) and PUB are associated with substantial mortality in cirrhosis. This multicenter cohort study was performed to assess whether the mortality of patients with cirrhosis with PUB is different from that of those with AVB.

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Background & Aims: Early placement of a transjugular intrahepatic portosystemic shunts (TIPS) is considered the treatment of choice for patients with acute variceal bleeding (AVB) and cirrhosis who have a high risk of death (Child-Pugh class B with active bleeding at endoscopy or Child-Pugh class C). It has been proposed that patients of Child-Pugh class B, even with active bleeding, should not be considered high risk. Alternative criteria have been proposed for identification of high-risk patients, such as Child-Pugh class C with plasma level of creatinine of 1 mg/dL or more (ChildC-C1) and a model for end-stage liver disease (MELD) score of 19 or more.

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