The natural history of cirrhosis is characterized by two main distinct stages: compensated and decompensated cirrhosis. The transition from compensated to decompensated is driven by development of clinically significant portal hypertension and systemic inflammation. Decompensating events include ascites, variceal bleeding, and hepatic encephalopathy, and are associated with significant morbidity and mortality. This group is mainly focused in prevention, diagnosis and management of such complications, from “bench to bedside”. Current clinical and translational research projects are related to: 1) coagulopathy of cirrhosis and its potential clinical implications; 2) alterations of platelet function associated with cirrhosis and acute-on-chronic liver failure; 3) use of TIPS (trans-jugular intrahepatic portosystemic shunt) to treat complications of portal hypertension: outcome prediction in cirrhosis; risk of decompensation and development of hepatocellular carcinoma despite etiological cure in patients with HCV-related cirrhosis; 4) impact of biological sex and gender in patients with chronic liver disease; 5) assessment and clinical implication of sarcopenia and frailty in patients with cirrhosis.

Publications

• Zanetto A, Pelizzaro F, Campello E, Bulato C, Balcar L, Gu W, Gavasso S, Saggiorato G, Zeuzem S, Russo FP, Mandorfer M, Reiberger T, Trebicka J, Burra P, Simioni P, Senzolo M. Severity of systemic inflammation is the main predictor of ACLF and bleeding in patients with acutely decompensated cirrhosis. J Hepatol. 2022 Sep 20:S0168-8278(22)03110-5. doi: 10.1016/j.jhep.2022.09.005
• Burra P, Zanetto A, Germani Sex bias in clinical trials in gastroenterology and hepatology. G.Nat Rev Gastroenterol Hepatol. 2022 Jul;19(7):413-414. doi: 10.1038/s41575-022-00638-2
• Senzolo M, Garcia-Tsao G, García-Pagán JC. Current knowledge and management of portal vein thrombosis in cirrhosis. J Hepatol. 2021 Aug;75(2):442-453. doi: 10.1016/j.jhep.2021.04.029.
• Burra P, Ferrarese A. Transplanting severely obese cirrhotic patients: Heavy clouds still on the horizon. United European Gastroenterol J. 2022 Jun;10(5):445-446. doi: 10.1002/ueg2.12234. Epub 2022 Apr 26. PMID: 35474616; PMCID: PMC9189458.
• Zanetto A, Campello E, Bulato C, Gavasso S, Saggiorato G, Shalaby S, Burra P, Angeli P, Senzolo M, Simioni P. Global hemostatic profiling in patients with decompensated cirrhosis and bacterial infections. JHEP Rep. 2022 Apr 20;4(7):100493. doi: 10.1016/j.jhepr.2022.100493. PMID: 35647501; PMCID: PMC9131254.

Funding:

Ordinary department funding.

People involved:

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

Group members:

Marco Senzolo, Martina Gambato and Giacomo Germani (Consultant Hepatologists); Sarah Shalaby (Gastroenterologist; PhD student); Sara Battistella, Marco Grasso, Francesca D’Arcangelo, Elisa Catanzaro, Lara Biribin, Elisa Zanatta, Giorgia Corrà, Marco Bucci (GI fellows).