Philippe Compagnon

• University of Geneva

Beta cell replacement therapy for type 1 diabetes is hindered by poor graft survival and suboptimal function, largely due to inadequate vascularization and lack of supportive microenvironment. To address these challenges, we developed a clinically scalable, extracellular matrix (ECM)–mimetic hydrogel, termed Amniogel, derived from human amniotic me...

Importance Surgical site infections (SSIs) are one of the most common health care–associated infections. Surgical site infections can have harmful effects in liver transplant (LT) recipients. Objective To assess the incidence of SSI after LT and identify risk factors associated with SSIs and whether SSIs are associated with death and graft loss....

The liver is the most common site of metastasis of colorectal cancer (CRC), and colorectal liver metastasis is one of the major causes of CRC-related deaths worldwide. The tumor microenvironment, particularly the extracellular matrix (ECM), plays a critical role in CRC metastasis and chemoresistance. Based on findings from clinical and basic resear...

Background & Aims Immune checkpoint inhibitors (ICI) are increasingly used in patients with advanced hepatocellular carcinoma (HCC) patients awaiting liver transplantation (LT). However, concerns about the risk of post-transplant rejection persist. Methods We conducted an international retrospective cohort study including 119 HCC patients who rece...

The growing disparity between the demand for pancreas transplants and the availability of suitable organs underscores the urgent need for innovative donor strategies, including the utilization of donors after circulatory death (DCD). This scoping review presents a comprehensive comparative analysis of transplantation outcomes between DCD and donors...

Type 1 diabetes (T1D), an autoimmune disorder, affects approximately 8.5 million individuals globally and imposes a significant strain on healthcare systems. Islet transplantation is a viable treatment for restoring normoglycemia, despite being compromised by inflammation, poor vascularization and immune response. To address these challenges, rese...

Transjugular intrahepatic portosystemic shunt (TIPS) reduces portal hypertension complications. Its impact on hepatocellular carcinoma (HCC) remains unclear. We evaluated 42,843 liver transplant candidates with HCC from the Scientific Registry of Transplant Recipients (2002–2022). 4,484 patients with and without TIPS were propensity score-matched 1...

Background Immune checkpoint inhibitors (ICI) represent a major breakthrough in cancer immunotherapy. Several molecules have shown efficacy in HCC and are increasingly used as a bridging therapy before liver transplantation. Initial reports have raised concern about severe rejections in patients following ICI therapy. Aims This meta-analysis asses...

Background Transjugular intrahepatic portosystemic shunt (TIPS) is used to mitigate the side effects of portal hypertension. However, its impact on hepatocellular carcinoma (HCC) remains unclear. Aims We aimed to evaluate its effect on HCC dynamics and patients’ survival. Methods We analysed 43’734 liver transplant candidates diagnosed with HCC f...

The advent of tissue engineering in general surgical has awakened a paradigm shift in therapeutic approaches, introducing promising solutions to once insurmountable health problems. This chapter explores the application of the cutting-edge cell-on-scaffold technology, a milestone of regenerative surgery, across a range of surgical disciplines, incl...

Islet of Langerhans transplantation has gained a clear place in the therapeutic armamentarium for type 1 diabetes and is now considered standard-of-care in many countries in which it is available. Depending on the indication, patient profile or goals to be achieved, islet transplantation is an excellent first-line approach or a valid alternative to...

Diabetes is a chronic and progressive disease that affects an increasing number of patients. The prevalence of associated psychological comorbidities is high and often requires the implementation of targeted psychological interventions. Pancreas or islet transplantation remains a therapeutic option to consider, for a part of patients with type 1 di...

In this study, we identified new lipid species associated with the loss of pancreatic β-cells triggering diabetes. We performed lipidomics measurements on serum from prediabetic mice lacking β-cell prohibitin-2 (a model of monogenic diabetes) patients without previous history of diabetes but scheduled for pancreaticoduodenectomy resulting in the ac...

Simple Summary Hepatocellular carcinoma (HCC) represents one of the main indications for liver transplantation. Over recent years, immune checkpoint inhibitor (ICI) therapy has improved its management, making patients with more advanced HCC potential candidates for transplantation. However, acute rejection has been observed after ICI therapy, chall...

The mastery of hepatobiliary surgery requires one to be an accomplished surgical craftsman with an in-depth knowledge of anatomy and physiology, a capable internist, and a skilled radiologist. With exponential developments in technology and an improved understanding of disease processes, most complex hepatobiliary problems are best managed by secur...

Pancreas transplantation for patients with type 1 diabetes is a therapeutic option when other treatments are not effective and physical complications occur. Psychological burden is prominent in patients, and non-adherence to treatment is often one manifestation of such difficulties. Time projection is an important factor affected by chronic disease...

Background and aim: Liver graft utilization rates are a hot topic due to the worldwide organ shortage and an increasing number of transplant candidates on waiting lists. Liver perfusion techniques have been introduced in several countries, and may help to increase the organ supply, as they potentially allow the assessment of livers before use. Me...

Artificial intelligence (AI) refers to computer algorithms used to complete tasks that usually require human intelligence. Typical examples include complex decision-making and- image or speech analysis. AI application in healthcare is rapidly evolving and it undoubtedly holds an enormous potential for the field of solid organ transplantation. In th...

Introduction: The presence of median arcuate ligament (MAL) during orthotopic liver transplantation (OLT) may cause a significant reduction of the arterial hepatic flow. The aim of the present study is to investigate the impact of MAL on biliary complications in patients who underwent OLT. Methods: We performed a retrospective case-control study...

This article provides an overview of recent advances in the diagnosis and treatment of extrahepatic cholangiocarcinomas (EH-CCAs), focusing on the role of endoscopy, surgery, and transplantation. It reviews optimal evaluation and management of patients with EH-CCA, including a careful integration of clinical information, imaging studies, cytology a...

Background: Pediatric liver surgery is complex, and complications are not uncommon. Centralization of highly specialized surgery has been shown to improve quality of care. In 2012, pediatric liver surgery was centralized in Switzerland in one national center. This study analyses results before and after centralization. Methods: Retrospective monoce...

Evidence suggests that liver graft quality impacts on post-transplant recurrence of hepatocellular carcinoma (HCC). As of today, selection criteria only use variables related to tumor characteristics. Within the Scientific Registry of Transplant Recipients, we identified patients with HCC who underwent liver transplantation between 2004 and 2016 (d...

Background: Enhanced Recovery After Surgery (ERAS) is a multimodal, evidence-based, program of care developed to minimize the response to surgical stress, associated with reduced perioperative morbidity and hospital stay. This study presents the specific ERAS Society recommendations for liver transplantation (LT) based on the best available eviden...

Objective: To evaluate the short- and long-term outcomes of renoportal anastomosis (RPA) in a large multicentric series. Summary background: The current knowledge on RPA for portal reconstruction during liver transplantation (LT) in patients with diffuse portal vein thrombosis (PVT) and a large splenorenal shunt (SRS) is poor and limited to case...

Background & Aims In France, liver graft refused at least five times can be “rescued” and allocated to a centre which chooses a recipient from its own waiting-list, instead of a patient-based allocation frame. We explored whether these “rescued” grafts penalise grafts’/patients’ survival or affect the survival benefit. Methods Among 7895 candidate...

Macrovascular invasion is considered a contraindication to liver transplantation for hepatocellular carcinoma (HCC) due to a high risk of recurrence. The aim of the present multicenter study was to explore the outcome of HCC patients transplanted after a complete radiological regression of the vascular invasion by loco‐regional therapies, and defin...

Background: The French transplant governing system defined "Rescue" (the so-called "Hors Tour") livers as those livers which were declined for the five top-listed patients. This study compares the outcomes following liver transplantation (LT) in patients who received a donor liver through a rescue allocation (RA) procedure or according to MELD sco...

Résumé But de l’étude Le but de l’étude était d’évaluer le rôle pronostique de 4 solutions de conservation en transplantation hépatique (TH). Patients et méthodes Il s’agit d’une étude rétrospective à partir de toutes les TH de tous les centres français (n = 22) enregistrées dans la base de données prospective de l’Agence de la Biomédecine (Crist...

Objective: The goal of this study was to evaluate the prognostic role of four preservation solutions in liver transplantation (LT). Patients and methods: This is a retrospective study originating from 22 French centers performing LT, registered in the prospective databank of the Cristal Biomedicine Agency between 2008 and 2013. The preservation...

1488 Suivi ambulatoire du patient transplanté hépatique : le rôle essentiel du médecin généraliste Les patients greffés hépatiques représentent une population croissante en Suisse. La morbidité et la mortalité après cette procédure sont liées, dans la phase précoce, aux complications chirurgicales et infectieuses ainsi que, dans une moindre mesure,...

The population of liver transplant recipients has increased in Switzerland over the last few years. Morbidity and mortality after liver transplantation are due, in the early post-transplant period, to surgical and infectious complications as well as to rejection, whereas cardiovascular, metabolic, renal and oncologic complications are the most freq...

Abdominal surgery is sometimes needed in patients with portal hypertension. The indication may be related to the underlying liver disease, including liver resection for liver cancer and parietal surgery. Surgery may also be performed for another indication, unrelated to the liver disease. Portal hypertension increases both morbidity and mortality a...

Hepatic artery thrombosis (HAT) is a serious and life‐threatening complication that can occur any time after liver transplantation. HAT is generally subdivided into 2 categories. Early HAT frequently presents with profound graft dysfunction and sepsis, and requires urgent revascularization or retransplantation. This article is protected by copyrigh...

Prognosis and oncologic treatment feasibility in solid organ transplant patients with de novo cancer remain poorly described. We investigated the impact of immunosuppressive therapy modifications after de novo cancer diagnosis on oncologic treatment feasibility, toxicities, and prognosis. Patients with de novo cancer (excluding nonmelanoma skin can...

Liver transplantation (LT) has become the standard of care for selected primary and secondary malignancies. Considered a contra-indication to transplantation until recently, unresectable colorectal liver metastases (CRLM) have gained interest since the publication of the SECA trial by the University of Oslo. It showed a 5-year overall survival of 6...

The use of downstaging prior to liver transplantation for hepatocellular carcinoma (HCC) still needs refinement. This study included patients with HCC listed for transplantation according to the Total Tumor Volume (TTV) ≤115 cm³ and alpha‐fetoprotein (AFP) ≤400 ng/ml criteria, with and without previous downstaging. Overall, 455 patients were listed...

Background: Emergency digestive surgery is being increasingly performed in elderly patients. The aim of the present study was to identify the predictors of mortality and morbidity following emergency digestive surgery in patients aged 80 years and older. Methods: A single-center retrospective review was performed of consecutive patients aged ≥65...

Background: Technical advances in laparoscopy and enhanced recovery after surgery programs have progressively decreased the need for hospitalization. The present study aimed to explore the feasibility and safety of an early discharge protocol after minor laparoscopic liver resection (LLR). Methods: The study sample consisted of patients with bot...

Background & aims: The Barcelona Clinic Liver Cancer (BCLC) guidelines recommend resection for very early and early single hepatocellular carcinoma (HCC) patients. It is not known whether a delay in resection from the time of diagnosis (the time-to-surgery (TTS), i.e., the elapsed time from diagnosis to surgery) affects outcomes. We aim to evaluat...

The salvage liver transplantation (LT) strategy was conceived for initially resectable and transplantable hepatocellular carcinoma (HCC) to obviate upfront transplantation, with salvage LT in the case of recurrence. The longterm outcomes of a second resection for recurrent HCC have improved. The aim of this study was to perform an intention-to-trea...

But Analyser les résultats de la transplantation hépatique (TH) selon l’attribution au tour (T) ou hors tour (HT, greffons refusés par ≥ 5 équipes). Méthodes De 2011 à 2015, 249 premières TH électives, non combinées ont été analysées rétrospectivement : groupe T = 185 (74,2 %) et groupe HT = 64 (25 %) avant et après score de propension (PSM). Rés...

Background: Western guidelines recommend resection for hepatocellular carcinoma (HCC) in so-called ideal cirrhotic patients with a Barcelona Clinic Liver Cancer (BCLC) stage 0-A tumour. This study compares short-term outcomes following resection between patients defined as ideal and nonideal according to the BCLC guidelines. Methods: This prospe...

The salvage liver transplantation (SLT) strategy was conceived for initially resectable and transplantable (R&T) hepatocellular carcinoma (HCC) patients, to try to obviate upfront liver transplantation, with the "safety net" of SLT in case of postresection recurrence. The SLT strategy is successful or curative when patients are recurrence free foll...

Backgrounds/Aims Postoperative diaphragmatic hernia, following liver resection, is a rare complication. Methods Data of patients who underwent major hepatectomy for liver tumors, between 2011 and 2015 were retrospectively reviewed. The literature was searched for studies reporting the occurrence of diaphragmatic hernia following liver resection....

Backgrounds/Aims: Postoperative diaphragmatic hernia, following liver resection, is a rare complication. Methods: Data of patients who underwent major hepatectomy for liver tumors, between 2011 and 2015 were retrospectively reviewed. The literature was searched for studies reporting the occurrence of diaphragmatic hernia following liver resection....

Background & Aims Numerous guidelines for the management of HCC have been developed. The AGREE II is the only validated instrument to assess the methodological quality of guidelines. We aim to appraise the methodological quality of existing guidelines for the resection of hepatocellular carcinoma (HCC) using the Appraisal of Guidelines for Research...

Background: Control of warm ischemia (WI) lesions that occur with donation after circulatory death (DCD) would significantly increase the donor pool for liver transplantation. We aimed to determine whether a novel, oxygenated and hypothermic machine perfusion device (HMP Airdrive system) improves the quality of livers derived from DCDs using a lar...

En materia de trasplantes, el injerto constituye la esencia del procedimiento. Sin él, no hay transplante. Cuando está disponible, debe ser perfecto desde los puntos de vista anatómico y funcional, pues la vida del receptor depende de ello. Esto requiere una extracción y conservación minuciosas. En el 90% de los casos, el injerto se extrae de un do...

Surgical management of inferior vena cava tumor thrombosis involves vascular control of the infrahepatic/infrarenal, retrohepatic/suprahepatic/infradiaphragmatic, and supradiaphragmatic inferior vena cava. Standard total vascular exclusion of the liver is indicated for surgery of level III (retrohepatic inferior vena cava and/or hepatic veins invol...

Cholangiocarcinoma is an aggressive biliary neoplasm lacking effective therapeutic agents. Immunotherapies targeting the PD-L1/PD-1 immune checkpoint have shown encouraging results in solid and hematologic cancers in clinical trials. Response to these immunomodulators is correlated with PD-L1 expression. Our goal was to characterize PD-L1 expressio...

The risk of cancer after solid organ transplantation is increased by 2.6 compared to overall population. Cancer is currently the third leading cause of death in solid organ transplanted patients, making screening and early management of de novo cancers a major challenge. This increased risk of cancer in this population results from the combination...

Background: The impact of postoperative complications (POCs) on long-term outcomes following hepatocellular carcinoma (HCC) resection remains to be ascertained. Methods: All consecutive HCC resected at a single center were analyzed. Patients with POCs, classified according to Clavien classification, were compared to those without in terms of dem...

Résumé La chirurgie robotique est actuellement en plein essor. L’utilisation du robot dans les spécialités chirurgicales s’est considérément développée depuis l’autorisation de sa mise en service sur le marché médical international par la Food and Drug Administration en 2000. La première hépatectomie laparoscopique robot-assistée a été réalisée en...

Background: The management of pancreatic trauma is complex. The aim of this study was to report our experience in the management of pancreatic trauma. Methods: All patients hospitalized between 2005 and 2013 for pancreatic trauma were included. Traumatic injuries of the pancreas were classified according to the American Association for Surgery of T...

Background After comparing with open approach, left lateral sectionectomy (LLS) has become standard in terms of short-term outcomes without jeopardizing long-term survival when performed for malignancy. The aim of this study was to compare the short-term and economic outcomes of laparoscopic (L-LLS) and robotic (R-LLS) LLS. Methods All consecutive...

Surgery using a robotic platform is expanding rapidly today, with a notable surge since its authorization on the international medical market by the US Food and Drug Administration in 2000. The first hepatectomy by a robotic approach was reported in 2002, 10 years after the first laparoscopic hepatectomy. Yet, in hepatic surgery, series are scarce...

Context: The management of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) is challenging, especially if it is not treatable by surgery or embolization. Objectives: The present study aims to compare the survival rates of liver transplanted patients receiving sorafenib or best supportive care (BSC) for HCC recurrence no...

Veno-venous bypass (VVB) using a patent para-umbilical vein during liver transplantation (LT) has not been reported previously. Here, we report the decompression of the porto-mesenteric compartment via a patent para-umbilical vein in a patient needing a VVB during LT. Pre-transplant CT-scan showed a large patent para-umbilical vein. A femoro-axilla...

En materia de trasplantes, el injerto constituye la esencia del procedimiento. Sin él, no hay transplante. Cuando está disponible, debe ser perfecto desde los puntos de vista anatómico y funcional, pues la vida del receptor depende de ello. Esto requiere una extracción y conservación minuciosas. En el 90% de los casos, el injerto se extrae de un do...

Background: The optimal strategy in patients with stage IVA colorectal cancer remains debated. This study was designed to compare the long-term outcomes and the pattern of recurrence following classical (CS) versus reverse (RS) strategy. Methods: Data from all consecutive patients, who have completed the CS and RS, were retrospectively reviewed....

ABSTRACT In case of hemodynamically significant spleno-renal shunt, ligation of the left renal vein is indicated during liver transplantation to improve the portal vein flow. In this setting, inadvertent ligation of a duplicate left inferior vena cava misdiagnosed with the left renal vein, might result into extensive thrombosis of the former. We re...

Background: Acute kidney injury (AKI) following hepatectomy remains understudied in terms of diagnosis, severity, recovery and prognostic value. The aim of this study was to assess the risk factors and prognostic value of AKI on short- and long-term outcomes following hepatectomy for hepatocellular carcinoma (HCC). Method: This is a retrospectiv...

Surgical resection for liver tumors of the caudate lobe is challenging owing to its location between the inferior vena cava and the portal bifurcation and its relationship to the hepatic veins. Some case reports of isolated laparoscopic caudate lobe resection have been reported in the literature with various techniques. The aim of this study was to...

The incidence of biliary complications following liver transplantation (LT) remains high, ranging from 10 to 50 % of patients, especially when the diameter of the bile duct is smaller than 7 mm. Biliary reconstruction is most often performed by duct-to-duct anastomosis. In a preliminary study (n = 20), we previously reported a technique of biliary...

Current knowledge indicates that malnutrition increases the rate of post-operative complications, particularly respiratory and infectious, after major surgery. Almost all liver surgery is performed in patients with cancer, a factor that increases the risk of malnutrition. The primary risk factors for post-operative complications are pre-operative h...

Résumé Il est désormais admis que la dénutrition augmente les complications postopératoires, en particulier respiratoires et infectieuses après chirurgie majeure. La chirurgie hépatique est principalement réalisée chez des malades porteurs de cancers, ce qui augmente le risque de dénutrition. Les principaux facteurs de risque de complications posto...

Context— The imbalance between the organ supply and the number of potential transplant recipients led to consideration of expanded-criteria liver donors. Objective— To compare right-lobe split-liver transplants (RL-SLTs) with orthotopic liver transplants (OLTs) from donors more than 70 years old (OLT-O) and OLTs from donors less than 55 years old...

Introduction Améliorer la qualité du greffon « dit marginal » représente un moyen de réduire la pénurie de greffons hépatiques. L’utilisation de machines de perfusion d’organe est un nouveau concept de conservation des greffons. Dans cette étude, nous avons étudié l’efficacité d’une machine de perfusion d’organe transportable (Airdrive®) sur la qua...

Objectives Appropriate patient selection is important to achieving good outcomes and obviating futile surgery in patients with huge (≥10 cm) hepatocellular carcinoma (HCC). The aim of this study was to identify independent predictors of futile outcomes, defined as death within 3 months of surgery or within 1 year from early recurrence following hep...

La chirurgia della vena cava inferiore (VCI) è realizzata soprattutto nel quadro dell’exeresi delle lesioni maligne primitive della VCI (leiomiosarcomi) e dei tumori epatici e renali secondariamente estesi alla vena cava. Essa si è considerevolmente sviluppata durante questi ultimi decenni con lo sviluppo delle metodiche di diagnostica per immagini...

Le shunt porto-systémique intrahépatique par voie transjugulaire (TIPS) est un traitement largement utilisé, depuis plus de 20 ans, dans les complications de l’hypertension portale telles que l’ascite réfractaire ou l’hémorragie digestive par rupture de varices œsophagiennes. L’encéphalopathie hépatique après TIPS est une complication fréquente mai...

Objectives: The aim of the study was to compare the long-term oncologic results of laparoscopic liver resection (LLR) versus open liver resection (OLR) for colorectal liver metastasis (CRLM) using a propensity score analysis. Subjects and methods: This propensity score matching (PSM) study was based on a prospective database of a single tertiary...