Letizia Morlacchi - Academia.edu (original) (raw)
Papers by Letizia Morlacchi
International Journal of Surgery Case Reports, 2020
Highlights • Lung donation after cardiac death is a valuable option to fight organ shortage.• Gra... more Highlights • Lung donation after cardiac death is a valuable option to fight organ shortage.• Grafts from an extended uncontrolled DCD donor were transplanted.• The recipient was a high-risk fragile patient with cystic fibrosis.• Ex-vivo lung perfusion has a pivotal role in graft function evaluation.• Good results were achieved despite several relative contraindications.
European Respiratory Journal, 2020
Scientific Reports
Despite the promising results achieved so far in long-term survival after lung transplantation (L... more Despite the promising results achieved so far in long-term survival after lung transplantation (LuTx), airway complications (ACs) still arise in the post-operative period. Early diagnosis and prompt treatment of ACs play a critical role in preventing their onset. Specifically, large bronchi ischemia has been recognized as a triggering factor for ACs. Autofluorescence bronchoscopy, which was first introduced for early cancer diagnosis, displays ischemic mucosae as red spots, while normal vascularized mucosae appear in green. The aim of this study is to investigate whether a significant correlation exists between ACs and the red/green (RG) ratio detected on scheduled autofluorescence bronchoscopy up to 1 year after LuTx. This prospective, observational, single-center cohort study initially considered patients who underwent LuTx between July 2014 and February 2016. All patients underwent concomitant white-light and autofluorescence bronchoscopy at baseline (immediately after LuTx), on ...
Journal of Cystic Fibrosis
Transplantation Proceedings
Pleuroparenchymal fibroelastosis (PPFE) is a rare condition, characterized by predominantly upper... more Pleuroparenchymal fibroelastosis (PPFE) is a rare condition, characterized by predominantly upper-lobe pleural and subjacent parenchymal fibrosis, the latter being intra-alveolar with accompanying elastosis of the alveolar walls that leads a clinical progression to respiratory failure. This condition may not be as rare as it seems to be, because nowadays the increasing awareness among specialists is raising the number of new diagnoses. Limited data are available about the prognosis, both for secondary and idiopathic forms. Nevertheless, the idiopathic form seems to be rapidly progressive and no treatment can control the disease, which is why management is challenging. Since the disease was characterized, PPFE cases have been reported in the literature, but most have been secondary rather than idiopathic. Of these, few have successfully undergone lung transplantation as a treatment of end-stage respiratory failure. We here report a successful case of a 38-year-old man affected by idiopathic PPFE who underwent bilateral lung transplantation after extracorporeal membrane oxygenation bridging for an abrupt transition to critical clinical conditions. After a complex postoperative course and a first year characterized by acute rejection, the patient is alive at 5 years with a good quality of life. Our experience confirms that lung transplantation would be a valuable treatment option in case of end-stage idiopathic PPFE cases.
The Journal of Heart and Lung Transplantation
Journal of Cystic Fibrosis, 2016
Clinical Microbiology and Infection
Alessandra Bandera, MD, PhD, Stefano Aliberti, MD, Roberta Gualtierotti, MD, Marina Baldini, MD, ... more Alessandra Bandera, MD, PhD, Stefano Aliberti, MD, Roberta Gualtierotti, MD, Marina Baldini, MD, Francesco Blasi, MD, Matteo Cesari, MD, PhD, Giorgio Costantino, MD, Anna Ludovica Fracanzani, MD, Andrea Gori, MD, Nicola Montano, MD, Valter Monzani, MD, Alessandro Nobili, MD, Flora Peyvandi, MD, Antonio Pesenti, MD, Daniele Prati, MD, Luca Valenti, MD, Giuliana Fusetti, Luigia Scudeller, MD, Silvano Bosari, MD, COVID19 Network, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Scientific Direction, Department of Transfusion Medicine and Biobank, Infectious Diseases Unit, Internal Medicine, Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Internal Medicine, Immunology and Allergology, Respiratory Unit and Cystic Fibrosis Adult Center, Cardiology Unit, Emergency Medicine, Acute Internal Medicine, Internal Medicine, Internal Medicine and Metabolic Diseases, Geriatric Unit, Istituto di Ricerche Farmacologiche Mario Negri IRCCS
Internal and Emergency Medicine
PLOS ONE
Objective To describe the symptoms and clinical course of SARS-CoV-2 infection in patients with c... more Objective To describe the symptoms and clinical course of SARS-CoV-2 infection in patients with cystic fibrosis (CF). Methods We carried out a prospective multicentre cohort study based on 32 CF centres and 6597 patients. Centres were contacted to collect baseline and follow-up data of patients who reported symptoms suggestive of COVID-19 or who had contact with a positive/suspected case between the end of February and July 2020. Symptoms and clinical course of the infection were compared between patients who tested positive by molecular testing (cases) and those who tested negative (controls). Results Thirty patients were reported from the centres, 16 of them tested positive and 14 tested negative. No differences in symptoms and outcome of the disease were observed between groups. Fever, cough, asthenia and dyspnea were the most frequently reported symptoms. Eight cases (50%) were hospitalized but none required ICU admission. Two adults with a history of lung transplant required no...
Internal and Emergency Medicine
Journal of Cystic Fibrosis
Transplant Infectious Disease
Biomedicines
The role of S1P in Cystic Fibrosis (CF) has been investigated since 2001, when it was first descr... more The role of S1P in Cystic Fibrosis (CF) has been investigated since 2001, when it was first described that the CFTR channel regulates the inward transport of S1P. From then on, various studies have associated F508del CFTR, the most frequent mutation in CF patients, with altered S1P expression in tissue and plasma. We found that human bronchial epithelial immortalized and primary cells from CF patients express more S1P than the control cells, as evidenced by mass spectrometry analysis. S1P accumulation relies on two- to four-fold transcriptional up-regulation of SphK1 and simultaneous halving of SGPL1 in CF vs. control cells. The reduction of SGPL1 transcription protects S1P from irreversible degradation, but the excessive accumulation is partially prevented by the action of the two phosphatases that are up-regulated compared to control cells. For the first time in CF, we describe that Spns2, a non-ATP dependent transporter that normally extrudes S1P out of the cells, shows deficient...
International Journal of Surgery Case Reports
Nephrology Dialysis Transplantation
Background and Aims Acute kidney Injury (AKI) occurs in more than 50% of patients after lung tran... more Background and Aims Acute kidney Injury (AKI) occurs in more than 50% of patients after lung transplantation (LTx). Our aim was to describe the incidence, risk factors and outcomes associated with AKI after LTx in a retrospective monocentric cohort study. Method We studied all recipients of LTx (> 16 years of age) occurring at Ospedale Maggiore Policlinico Milano between Jan 1st 2015 and Dec 31st 2017. AKI was defined according to KDIGO classification, eGFR was calculated according to CKD (Chronic Kidney Disease) Epidemiology Collaboration formula and CKD was defined by an eGFR< 60 ml/min per 1.73 m2. Chi square, Fisher exact test, t.-test and logistic regression were used to define risk factors for AKI in the early post-surgical period and for CKD at 1 and 2 years after LTx. AKI-related survival was estimated using Kaplan Meyer model. Results Of 78 LTx patients enrolled in our Center, 50% of patients was affected by cystic fibrosis. Median age at transplant was 43 years (27-5...
The Journal of Heart and Lung Transplantation
International Journal of Surgery Case Reports, 2020
Highlights • Lung donation after cardiac death is a valuable option to fight organ shortage.• Gra... more Highlights • Lung donation after cardiac death is a valuable option to fight organ shortage.• Grafts from an extended uncontrolled DCD donor were transplanted.• The recipient was a high-risk fragile patient with cystic fibrosis.• Ex-vivo lung perfusion has a pivotal role in graft function evaluation.• Good results were achieved despite several relative contraindications.
European Respiratory Journal, 2020
Scientific Reports
Despite the promising results achieved so far in long-term survival after lung transplantation (L... more Despite the promising results achieved so far in long-term survival after lung transplantation (LuTx), airway complications (ACs) still arise in the post-operative period. Early diagnosis and prompt treatment of ACs play a critical role in preventing their onset. Specifically, large bronchi ischemia has been recognized as a triggering factor for ACs. Autofluorescence bronchoscopy, which was first introduced for early cancer diagnosis, displays ischemic mucosae as red spots, while normal vascularized mucosae appear in green. The aim of this study is to investigate whether a significant correlation exists between ACs and the red/green (RG) ratio detected on scheduled autofluorescence bronchoscopy up to 1 year after LuTx. This prospective, observational, single-center cohort study initially considered patients who underwent LuTx between July 2014 and February 2016. All patients underwent concomitant white-light and autofluorescence bronchoscopy at baseline (immediately after LuTx), on ...
Journal of Cystic Fibrosis
Transplantation Proceedings
Pleuroparenchymal fibroelastosis (PPFE) is a rare condition, characterized by predominantly upper... more Pleuroparenchymal fibroelastosis (PPFE) is a rare condition, characterized by predominantly upper-lobe pleural and subjacent parenchymal fibrosis, the latter being intra-alveolar with accompanying elastosis of the alveolar walls that leads a clinical progression to respiratory failure. This condition may not be as rare as it seems to be, because nowadays the increasing awareness among specialists is raising the number of new diagnoses. Limited data are available about the prognosis, both for secondary and idiopathic forms. Nevertheless, the idiopathic form seems to be rapidly progressive and no treatment can control the disease, which is why management is challenging. Since the disease was characterized, PPFE cases have been reported in the literature, but most have been secondary rather than idiopathic. Of these, few have successfully undergone lung transplantation as a treatment of end-stage respiratory failure. We here report a successful case of a 38-year-old man affected by idiopathic PPFE who underwent bilateral lung transplantation after extracorporeal membrane oxygenation bridging for an abrupt transition to critical clinical conditions. After a complex postoperative course and a first year characterized by acute rejection, the patient is alive at 5 years with a good quality of life. Our experience confirms that lung transplantation would be a valuable treatment option in case of end-stage idiopathic PPFE cases.
The Journal of Heart and Lung Transplantation
Journal of Cystic Fibrosis, 2016
Clinical Microbiology and Infection
Alessandra Bandera, MD, PhD, Stefano Aliberti, MD, Roberta Gualtierotti, MD, Marina Baldini, MD, ... more Alessandra Bandera, MD, PhD, Stefano Aliberti, MD, Roberta Gualtierotti, MD, Marina Baldini, MD, Francesco Blasi, MD, Matteo Cesari, MD, PhD, Giorgio Costantino, MD, Anna Ludovica Fracanzani, MD, Andrea Gori, MD, Nicola Montano, MD, Valter Monzani, MD, Alessandro Nobili, MD, Flora Peyvandi, MD, Antonio Pesenti, MD, Daniele Prati, MD, Luca Valenti, MD, Giuliana Fusetti, Luigia Scudeller, MD, Silvano Bosari, MD, COVID19 Network, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Scientific Direction, Department of Transfusion Medicine and Biobank, Infectious Diseases Unit, Internal Medicine, Hemophilia and Thrombosis Center and Fondazione Luigi Villa, Internal Medicine, Immunology and Allergology, Respiratory Unit and Cystic Fibrosis Adult Center, Cardiology Unit, Emergency Medicine, Acute Internal Medicine, Internal Medicine, Internal Medicine and Metabolic Diseases, Geriatric Unit, Istituto di Ricerche Farmacologiche Mario Negri IRCCS
Internal and Emergency Medicine
PLOS ONE
Objective To describe the symptoms and clinical course of SARS-CoV-2 infection in patients with c... more Objective To describe the symptoms and clinical course of SARS-CoV-2 infection in patients with cystic fibrosis (CF). Methods We carried out a prospective multicentre cohort study based on 32 CF centres and 6597 patients. Centres were contacted to collect baseline and follow-up data of patients who reported symptoms suggestive of COVID-19 or who had contact with a positive/suspected case between the end of February and July 2020. Symptoms and clinical course of the infection were compared between patients who tested positive by molecular testing (cases) and those who tested negative (controls). Results Thirty patients were reported from the centres, 16 of them tested positive and 14 tested negative. No differences in symptoms and outcome of the disease were observed between groups. Fever, cough, asthenia and dyspnea were the most frequently reported symptoms. Eight cases (50%) were hospitalized but none required ICU admission. Two adults with a history of lung transplant required no...
Internal and Emergency Medicine
Journal of Cystic Fibrosis
Transplant Infectious Disease
Biomedicines
The role of S1P in Cystic Fibrosis (CF) has been investigated since 2001, when it was first descr... more The role of S1P in Cystic Fibrosis (CF) has been investigated since 2001, when it was first described that the CFTR channel regulates the inward transport of S1P. From then on, various studies have associated F508del CFTR, the most frequent mutation in CF patients, with altered S1P expression in tissue and plasma. We found that human bronchial epithelial immortalized and primary cells from CF patients express more S1P than the control cells, as evidenced by mass spectrometry analysis. S1P accumulation relies on two- to four-fold transcriptional up-regulation of SphK1 and simultaneous halving of SGPL1 in CF vs. control cells. The reduction of SGPL1 transcription protects S1P from irreversible degradation, but the excessive accumulation is partially prevented by the action of the two phosphatases that are up-regulated compared to control cells. For the first time in CF, we describe that Spns2, a non-ATP dependent transporter that normally extrudes S1P out of the cells, shows deficient...
International Journal of Surgery Case Reports
Nephrology Dialysis Transplantation
Background and Aims Acute kidney Injury (AKI) occurs in more than 50% of patients after lung tran... more Background and Aims Acute kidney Injury (AKI) occurs in more than 50% of patients after lung transplantation (LTx). Our aim was to describe the incidence, risk factors and outcomes associated with AKI after LTx in a retrospective monocentric cohort study. Method We studied all recipients of LTx (> 16 years of age) occurring at Ospedale Maggiore Policlinico Milano between Jan 1st 2015 and Dec 31st 2017. AKI was defined according to KDIGO classification, eGFR was calculated according to CKD (Chronic Kidney Disease) Epidemiology Collaboration formula and CKD was defined by an eGFR< 60 ml/min per 1.73 m2. Chi square, Fisher exact test, t.-test and logistic regression were used to define risk factors for AKI in the early post-surgical period and for CKD at 1 and 2 years after LTx. AKI-related survival was estimated using Kaplan Meyer model. Results Of 78 LTx patients enrolled in our Center, 50% of patients was affected by cystic fibrosis. Median age at transplant was 43 years (27-5...
The Journal of Heart and Lung Transplantation