The natural history of cirrhosis is characterized by two main distinct stages: compensated and decompensated cirrhosis. The transition from compensated to decompensated cirrhosis is driven by development of clinically significant portal hypertension. Decompensating events include ascites, variceal bleeding, and hepatic encephalopathy, and are associated with significant morbidity and mortality. In patients with decompensated cirrhosis, systemic inflammation is the main driver for development of further decompensation and acute-on-chronic liver failure. Our group is focused on the prevention, diagnosis and management of cirrhosis complications, from “bench to bedside”. Current clinical and translational research projects are related to: 1) coagulopathy of cirrhosis and its potential clinical implications, including alteration of platelet functions; 2) use of TIPS (trans-jugular intrahepatic portosystemic shunt) and endovascular therapies to treat complications of portal hypertension; 3) risk stratification and prediction of hepatocellular carcinoma; 4) assessment of sarcopenia/body mass composition and frailty in patients with cirrhosis, especially in candidates for liver transplantation; 5) impact of biological sex in patients with chronic liver disease. Moreover, we aim to better understand the natural history and risk of hepatic complications in patients with porto-sinusoidal vascular disorder (PSVD), with the goal of improving risk stratification and patient management.

Publications

• Zanetto A, Campello E, Bulato C, Willems R, Konings J, Roest M, Gavasso S, Nuozzi G, Toffanin S, Burra P, Russo FP, Senzolo M, de Laat B, Simioni P.
  Impaired whole blood thrombin generation is associated with procedure-related bleeding in acutely decompensated cirrhosis.
  J Hepatol. 2024 Dec 11:S0168-8278(24)02762-4. doi: 10.1016/j.jhep.2024.12.008
• Burra P, Zanetto A, Schnabl B, Reiberger T, Montano-Loza AJ, Asselta R, Karlsen TH, Tacke F.
  Hepatic immune regulation and sex disparities.
  Nat Rev Gastroenterol Hepatol. 2024 Dec;21(12):869-884. doi: 10.1038/s41575-024-00974-5
• Semmler G, Alonso López S, Pons M, Lens S, Dajti E, Griemsmann M, Zanetto A, Burghart L, Hametner-Schreil S, Hartl L, Manzano M, Rodriguez-Tajes S, Zanaga P, Schwarz M, Gutierrez ML, Jachs M, Pocurull A, Polo B, Ecker D, Mateos B, Izquierdo S, Real Y, Ahumada A, Bauer DJM, Mauz JB, Casanova-Cabral M, Gschwantler M, Russo FP, Azzaroli F, Maasoumy B, Reiberger T, Forns X, Genesca J, Bañares R, Mandorfer M; cACLD-SVR Study Group.
  Post-treatment LSM rather than change during treatment predicts decompensation in patients with cACLD after HCV cure.
  J Hepatol. 2024 Jul;81(1):76-83. doi: 10.1016/j.jhep.2024.03.015
• Zanetto A, Campello E, Bulato C, Willems R, Konings J, Roest M, Gavasso S, Nuozzi G, Toffanin S, Zanaga P, Burra P, Russo FP, Senzolo M, de Laat B, Simioni P.
  Whole blood thrombin generation shows a significant hypocoagulable state in patients with decompensated cirrhosis.
  J Thromb Haemost. 2024 Feb;22(2):480-492. doi: 10.1016/j.jtha.2023.10.008
• Senzolo M, Shalaby S, Grasso M, Vitale A, Pizzirani E, Barbiero G, Zanetto A, Feltracco P, Simioni P, Burra P, Cillo U.
  Role of nonneoplastic PVT in the natural history of patients with cirrhosis and first diagnosis of HCC.
  Hepatology. 2024 Feb 1;79(2):355-367. doi: 10.1097/HEP.0000000000000538
• Tandon P, Zanetto A, Piano S, Heimbach JK, Dasarathy S.
  Liver transplantation in the patient with physical frailty.
  J Hepatol. 2023 Jun;78(6):1105-1117. doi: 10.1016/j.jhep.2023.03.025
• Shalaby S, Battistel M, Groff S, Birbin L, Miraglia R, Angeli P, Feltracco P, Burra P, Zanetto A, Molvar CA, Gaba RC, Barbiero G, Senzolo M.
  Trans-splenic anterograde coil-assisted transvenous occlusion (TACATO) of bleeding gastric varices associated with gastrorenal shunts in cirrhosis.
  JHEP Rep. 2024 Dec 20;7(3):101301. doi: 10.1016/j.jhepr.2024.101301

Funding:

Ordinary department funding.
Telethon (https://www.fondazionetelethon.it/cosa-facciamo/ricerca/progetti-finanzi...)

People involved:

Patrizia Burra, Full Professor
Francesco Paolo Russo, Associate Professor
Giacomo Germani, Associate Professor
Alberto Zanetto, Assistant Professor
Alberto Ferrarese, Assistant Professor

Group members:

Marco Senzolo, Martina Gambato (Consultant Hepatologists); Elisa Pinto, Kymentie Ferdinande, Elisa Catanzaro, Sara Battistella (Gastroenterologist and PhD students); Francesca D’Arcangelo, Laura Marta Vivian (GI fellows).