114 results on '"Alessandro Nanni Costa"'
Search Results
52. Serum antiphospholipid antibodies in transplanted patients: potential follow-up markers to assess pregnancy risk?
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Martina Derme, Alessandro Nanni Costa, Giuseppe Orlando, Walter Malorni, Tania Colasanti, Maurizio Sorice, Elena Ortona, Marta Vomero, Francesca d’Alessandro, Marialuisa Framarino-dei-Malatesta, and Isabella Iannini
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Adult ,medicine.medical_specialty ,Antibodies, Antiphospholipid ,Antiphospholipid Syndrome ,Biomarkers ,Case-Control Studies ,Enzyme-Linked Immunosorbent Assay ,Female ,Gestational Age ,Humans ,Organ Transplantation ,Pilot Projects ,Predictive Value of Tests ,Pregnancy ,Pregnancy Complications ,Pregnancy Outcome ,Risk Assessment ,Risk Factors ,Time Factors ,Young Adult ,Antiphospholipid ,Organ transplantation ,Antibodies ,Antiphospholipid syndrome ,medicine ,Young adult ,Transplantation ,business.industry ,Obstetrics ,Case-control study ,Gestational age ,medicine.disease ,Predictive value of tests ,Immunology ,business ,Risk assessment - Published
- 2015
53. Liver transplantation in Italy: analysis of risk factors associated with graft outcome
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Alessandro Nanni Costa, Emanuela Taioli, Orsola Pugliese, Dino Alberto Mattucci, Sante Venettoni, and Francesca Quintieri
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Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,Longitudinal study ,Time Factors ,Adolescent ,medicine.medical_treatment ,Liver transplantation ,Risk Assessment ,Cold Ischemia Time ,Risk Factors ,Cause of Death ,Internal medicine ,medicine ,Humans ,Longitudinal Studies ,Child ,Proportional Hazards Models ,Transplantation ,Acute hepatic necrosis ,business.industry ,Cold Ischemia ,Graft Survival ,Age Factors ,Infant ,Middle Aged ,Survival Analysis ,Tissue Donors ,Liver Transplantation ,Surgery ,Liver graft ,Treatment Outcome ,Italy ,Child, Preschool ,Relative risk ,Female ,Graft survival ,business - Abstract
Objective To analyze the graft outcome after liver transplantation in Italy in the years 1995 to 2000. Methods We performed a longitudinal study with follow-up at 3 months, 1 year, 3 years, and 5 years on 1987 liver grafts. The effect of several variables on graft survival was also analyzed. Results Several variables affect graft survival: Donor and recipient older age, gender mismatching, prolonged cold ischemia time, acute hepatic necrosis, and retransplantation are reported to significantly affect liver graft survival. Donors older than 60 years show a relative risk of 1.59 (95% CI, 1.23–2.05) compared with donors with an age between 19 and 60 years; recipients older than 50 years show a relative risk of 1.29 (95% CI, 1.04–1.60) compared with recipients aged 19 to 50 years. A cold ischemia time of 12 hours or longer doubled the risk of failure (relative risk = 2.01, 95% CI, 1.36–2.96) compared with a cold ischemia time of less than 6 hours. Conclusions The results show that the overall quality of liver transplantation in Italy is satisfying and comparable to the outcome reported by international registries. Follow-up studies on large numbers of liver transplants are useful to define predictors of outcome, and subsequently modify the criteria for organ allocation.
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- 2006
54. Kidney graft survival in Italy and factors influencing it
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Sante Venettoni, Alessandro Nanni Costa, Emanuela Taioli, Dino Alberto Mattucci, Francesca Quintieri, and Orsola Pugliese
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Adult ,Male ,medicine.medical_specialty ,Time Factors ,Tissue and Organ Procurement ,030232 urology & nephrology ,030230 surgery ,Donor age ,03 medical and health sciences ,0302 clinical medicine ,Outcome Assessment, Health Care ,medicine ,Retrospective analysis ,Humans ,Aged ,Proportional Hazards Models ,Retrospective Studies ,Transplantation ,Kidney ,business.industry ,Graft Survival ,Organ Preservation ,Middle Aged ,Kidney Transplantation ,Survival Analysis ,Surgery ,medicine.anatomical_structure ,Italy ,Relative risk ,Multivariate Analysis ,Female ,Graft survival ,Registry data ,business - Abstract
Purpose National registry data are often a suitable basis for examination of transplant outcomes. Using data supplied by the Italian National Transplant Registry, established in 1995, we performed the first nationwide analysis of this kind. Methods A retrospective analysis of 4893 recipients of cadaveric kidneys transplanted in all Italian centers from 1995 through 2000 was done to study 5-year graft survival. The association between some donor and recipient variables and outcomes in renal transplantation was analyzed. Graft survival was 93% at 3 months, 89% at 1 year, 82% at 3 years, and 80% at 5 years after transplantation. Results A significant association between graft survival and donor age (old vs young, relative risk [RR] = 1.62, 95% CI 1.27–2.06) and recipient age (old vs young, RR = 1.25, 95% CI 1.02–1.53). Graft survival was also associated with cold ischemia time (24–36 hours, RR=1.39, 95% CI 1.05–1.85 and >36 hours, RR=1.94, 95% CI 1.32–2.86 vs 0–24 hours) and donor/recipient sex mismatch (female/male vs male/male, RR=1.50, 95% CI 1.17–1.93). Conclusion The quality of kidney transplantation in Italy is satisfactory and is comparable to that in other developed countries. Furthermore, our experience confirms that both donor and recipient factors are major determinants of renal allograft function.
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- 2005
55. Transplant quality in Italy: analysis of the 1995?2000 period
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L. Rizzato, Bruno Christian Ciancio, Mario Scalamogna, Emilio S. Curtoni, Sante Venettoni, Domenico Adorno, Alessandro Nanni Costa, Ignazio Roberto Marino, and Emanuela Taioli
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Male ,Nephrology ,United Network for Organ Sharing ,medicine.medical_specialty ,medicine.medical_treatment ,Liver transplantation ,Organ transplantation ,Age Distribution ,Internal medicine ,medicine ,Humans ,Lung transplantation ,Intensive care medicine ,Kidney transplantation ,Demography ,Heart transplantation ,Transplantation ,business.industry ,medicine.disease ,Kidney Transplantation ,Survival Analysis ,Liver Transplantation ,Treatment Outcome ,surgical procedures, operative ,Italy ,Heart Transplantation ,Female ,business ,Lung Transplantation - Abstract
Evaluation of outcomes is a major step in quality assessment of any health process. In the transplant field, the evaluation of outcome is extremely important for both patients' growing demand for health and for the joint commitment the transplant process requires. In this study, the outcome of 12,647 transplants, carried out between 1995 and 2000 were analysed. Graft survival at 5 years was 79% for kidney, 67% for liver, 72% for heart and 38% for lung. Patient survival was 92% for kidney, 76% for liver, 72% for heart and 38% for lung. In comparison to other international case records [Collaborative Transplant Study (CTS) and The United Network for Organ Sharing (UNOS)], results are similar or even better for all transplant programmes. As a whole, survival after solid organ transplant in Italy ranks among the best for both donations and transplantation. The quality of transplants carried out is above European standards. Nevertheless, the growing health needs of patients require improvement in both the procurement process and in the use of available organs.
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- 2004
56. Donor Action Program in the Emilia-Romagna Region of Italy
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Elena Sestigiani, Marzia Monti, Maria Rosa Pugliese, Alessandro Nanni Costa, Angelo Ghirardini, Lorenza Ridolfi, Daniela Degli Esposti, Ada Dormi, Paolo Mazzetti Gaito, and Nicola Venturoli
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Adult ,Male ,medicine.medical_specialty ,Brain Death ,Time Factors ,Tissue and Organ Procurement ,030230 surgery ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,law ,Intensive care ,Cause of Death ,medicine ,Humans ,Family ,Glasgow Coma Scale ,Organ donation ,Intensive care medicine ,Referral and Consultation ,Aged ,Transplantation ,business.industry ,030208 emergency & critical care medicine ,Middle Aged ,Intensive care unit ,Tissue Donors ,Severe brain damage ,Organ procurement ,Intensive Care Units ,Italy ,Emergency medicine ,Female ,Health Services Research ,business ,Program Evaluation - Abstract
Context The high demand for organs for transplantation necessitates enhancement of organ procurement activity worldwide. Objective To detect critical areas in the organ donation process and to assess whether careful monitoring of deaths in each intensive care unit could improve rates of identification of brain death. Design Records of patients who died in intensive care units in the Emilia-Romagna region between July 1, 1998 and June 30, 2000 were reviewed through the Donor Action program. Results Of the 2469 patients who died during the period studied, 1010 (40.9%) had severe brain damage, as indicated by a score of 3 on the Glasgow coma scale. A total of 857 patients with severe brain damage who had spent more than 6 hours in the intensive care unit (34.7% of all deaths) were considered as potential donors. Signs of brain death were observed in 383 (44.7%) of the 857 patients who died. Rates of identification of brain death increased from 36% to 55% during the study period. Conclusion Considering that the characteristics of the study population had not changed, we believe that the Donor Action program was an important factor leading to the observed improvement in identification of brain death.
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- 2002
57. The Role of National Experts in Organ Allocation. Italian Experience
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Antonia DʼErrico, Vincenzo Morabito, A. Ricci, Alessandro Nanni Costa, L. Rizzato, Adrea Gianelli Castiglione, Letizia Lombardini, Paolo Grossi, and Giovambattista Ippoliti
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Transplantation ,business.industry ,Environmental resource management ,Business ,Environmental planning - Published
- 2017
58. International Initiative to Enhance the Organ Donation and Transplantation Systems in the Black Sea Area
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Alessandro Nanni Costa, Beatriz Domínguez, Estephan Arredondo, Pavla Brezoysky, Ana França, María Paula Gómez, Karim Laoubdia, Karl-Heinz Buchheit, Marie-Odile Ott, Martí Manyalich, Efstratios Chatzixiros, Marta López-Fraga, and Chloë Ballesté
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Transplantation ,business.industry ,Environmental resource management ,Medicine ,Black sea ,Organ donation ,business ,Environmental planning - Published
- 2017
59. Inhalt Band 38, 2011
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Paola Di Ciaccio, Marzia Filippetti, Zhenzhen Chen, Axel Pruß, Ramadan Jashari, Françoise Faucon, Alessandro Nanni Costa, Eliza Rahn, Hai Yao, Ulrich Kalus, Angelo Ghirardini, D. Willemijn Maas, Marja J. van Wijk, Arlinke G. Bokhorst, Maura Mareri, Kelvin G. M. Brockbank, Beatrice Van Hoeck, Stephane Vandenbulcke, Yedong Fan, Friedger von Auer, Ina Wilkemeyer, Sascha Rolf Lüder, Boris M. Hogema, George Galea, G. Caspari, Francesca Vespasiano, Seppe De Gelas, Axel Pruss, Gregory J. Wright, and Jan Schroeter
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Immunology and Allergy ,Hematology - Published
- 2011
60. Contents Vol. 38, 2011
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Françoise Faucon, Axel Pruss, Beatrice Van Hoeck, Alessandro Nanni Costa, Ina Wilkemeyer, Boris M. Hogema, Eliza Rahn, Angelo Ghirardini, George Galea, Maura Mareri, Sascha Rolf Lüder, Axel Pruß, Seppe De Gelas, Ramadan Jashari, Paola Di Ciaccio, Friedger von Auer, Hai Yao, D. Willemijn Maas, Yedong Fan, Arlinke G. Bokhorst, Marja J. van Wijk, Marzia Filippetti, Jan Schroeter, Gregory J. Wright, G. Caspari, Francesca Vespasiano, Kelvin G. M. Brockbank, Zhenzhen Chen, Stephane Vandenbulcke, and Ulrich Kalus
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Immunology and Allergy ,Hematology - Published
- 2011
61. Physical activity in solid organ transplant recipients: preliminary results of the Italian project
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Alessandro Nanni Costa, Maddalena Tonioli, Patrizio Sarto, Sergio Stefoni, Vania Cuna, Giovanni Mosconi, Manuela Trerotola, Valentina Totti, Giulio Sergio Roi, Mosconi, Giovanni, Cuna, Vania, Tonioli, Maddalena, Totti, Valentina, Roi, Giulio S, Sarto, Patrizio, Stefoni, Sergio, Trerotola, Manuela, and Costa, Alessandro Nanni
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Male ,lcsh:Diseases of the circulatory (Cardiovascular) system ,Anaerobic Threshold ,lcsh:RC870-923 ,Kidney transplant ,Body Mass Index ,lcsh:Dermatology ,Prospective Studies ,Liver transplant ,Exercise Tolerance ,General Medicine ,Middle Aged ,surgical procedures, operative ,Italy ,Nephrology ,Female ,Cardiology and Cardiovascular Medicine ,Human ,Adult ,medicine.medical_specialty ,Adolescent ,Physical activity ,Strengthening exercises ,Physical exercise ,Motor Activity ,Cardio-vascular disease prevention ,Young Adult ,Oxygen Consumption ,medicine ,Aerobic exercise ,Humans ,Muscle Strength ,Sports activity ,Exercise ,Aged ,business.industry ,Resistance Training ,lcsh:RL1-803 ,Lifestyle ,lcsh:Diseases of the genitourinary system. Urology ,Aerobic activity ,Transplant Recipients ,Prospective Studie ,lcsh:RC666-701 ,Muscle strength ,Physical therapy ,Exercise Test ,Solid organ transplantation ,business ,human activities - Abstract
Background/Aims: The role of physical activity in transplanted patients is often underestimated. We discuss the Italian National Transplant Centre experience, which started in 2008 studying transplanted patients involved in sports activities. The study was then developed through a model of cooperation between surgeons, sports physicians and exercise specialists. Methods: A multicentre study was realized in 120 transplanted patients of which 60 treated with supervised physical activity (three sessions/week of aerobic and strengthening exercises) and 60 controls. We present the results of the first 26 patients (16 males, 10 females; 47.8±10.0 years; 21 kidney, 5 liver transplanted; time from transplant 2.3±1.4 years) who completed 12 months of supervised physical activity. Results: Data showed an increase of peak aerobic power (t=4.535; PConclusion: These preliminary results confirm the positive effects of supervised physical exercise. It can be considered as an input to promote other detailed exercise protocols.
- Published
- 2014
62. A Bayesian methodology to improve prediction of early graft loss after liver transplantation derived from the Liver Match study
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Mario Angelico, Alessandra Nardi, Renato Romagnoli, Tania Marianelli, Stefano Ginanni Corradini, Francesco Tandoi, Caius Gavrila, Mauro Salizzoni, Antonio D. Pinna, Umberto Cillo, Bruno Gridelli, Luciano G. De Carlis, Michele Colledan, Giorgio E. Gerunda, Alessandro Nanni Costa, Mario Strazzabosco, M. Angelico, U. Cillo, S. Fagiuoli, M. Strazzabosco, P. Caraceni, P.L. Toniutto, A. Nanni Costa, Torino M. Salizzoni, R. Romagnoli, G. Bertolotti, D. Patrono, L. De Carlis, A. Slim, J.M.E. Mangoni, G. Rossi, L. Caccamo, B. Antonelli, V. Mazzaferro, E. Regalia, C. Sposito, M. Colledan, V. Corno, F. Tagliabue, S. Marin, A. Vitale, E. Gringeri, M. Donataccio, D. Donataccio, U. Baccarani, D. Lorenzin, D. Bitetto, U. Valente, M. Gelli, P. Cupo, G.E. Gerunda, G. Rompianesi, A.D. Pinna, G.L. Grazi, A. Cucchetti, C. Zanfi, A. Risaliti, M.G. Faraci, G. Tisone, A. Anselmo, I. Lenci, D. Sforza, S. Agnes, M. Di Mugno, A.W. Avolio, G.M. Ettorre, L. Miglioresi, G. Vennarecci, P. Berloco, M. Rossi, S. Ginanni Corradini, A. Molinaro, F. Calise, V. Scuderi, O. Cuomo, C. Migliaccio, L. Lupo, G. Notarnicola, B. Gridelli, R. Volpes, S. Li Petri, F. Zamboni, G. Carbotta, S. Dedola, A. Nardi, T. Marianelli, C. Gavrila, A. Ricci, F. Vespasiano, Angelico, M., Nardi, A., Romagnoli, R., Marianelli, T., Corradini, S. G., Tandoi, F., Gavrila, C., Salizzoni, M., Pinna, A. D., Cillo, U., Gridelli, B., De Carlis, L. G., Colledan, M., Gerunda, G. E., Costa, A. N., Strazzabosco, M., Fagiuoli, S., Caraceni, P., Toniutto, P. L., Sal-izzoni, T. M., Bertolotti, G., Patrono, D., Decarlis, L., Slim, A., Mangoni, J. M. E., Rossi, G., Caccamo, L., Antonelli, B., Mazzaferro, V., Regalia, E., Sposito, C., Corno, V., Marin, S., Vitale, A., Gringeri, E., Donataccio, M., Donataccio, D., Baccarani, U., Lorenzin, D., Bitetto, D., Valente, U., Gelli, M., Cupo, P., Rompianesi, G., Grazi, G. L., Cucchetti, A., Zanfi, C., Risaliti, A., Faraci, M. G., Tisone, G., Anselmo, A., Lenci, I., Sforza, D., Agnes, S., Di Mugno, M., Avolio, A. M., Ettorre, G. M., Miglioresi, L., Vennarecci, G., Berloco, P., Rossi, M., Corradini, G., Molinaro, A., Calise, F., Scuderi, V., Cuomo, O., Migliaccio, C., Lupo, L., Notarnicola, G., Volpes, R., Lipetri, S., Zamboni, G., Carbotta, G., Dedola, S., Angelico, M, Nardi, A, Romagnoli, R, Marianelli, T, Corradini, S, Tandoi, F, Gavrila, C, Salizzoni, M, Pinna, A, Cillo, U, Gridelli, B, DE CARLIS, L, Colledan, M, Gerunda, G, Costa, A, Strazzabosco, M, and Fagiuoli, S
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Graft Rejection ,Male ,liver match ,Multivariate analysis ,medicine.medical_treatment ,Settore MED/18 - CHIRURGIA GENERALE ,Disease ,Liver transplantation ,Body Mass Index ,Cohort Studies ,MED/12 - GASTROENTEROLOGIA ,Risk Factors ,liver transplantation ,early graft loss ,Age Factor ,Prospective Studies ,Multivariate Analysi ,hepatitis c ,donor risk index ,donor-recipient match ,graft failure ,transplantation outcome ,risk factors ,Donor Risk Index ,Donor-recipient match ,Graft failure ,Hepatitis C ,Risk factors ,Transplantation outcome ,Settore MED/12 - Gastroenterologia ,Cold Ischemia ,Graft Survival ,Age Factors ,Gastroenterology ,Middle Aged ,Tissue Donors ,Treatment Outcome ,Italy ,Cohort ,Female ,Human ,Adult ,United Network for Organ Sharing ,medicine.medical_specialty ,Tissue Donor ,Delayed Graft Function ,Bayesan methodology ,Risk Assessment ,End Stage Liver Disease ,medicine ,Humans ,Aged ,Proportional Hazards Models ,Hepatology ,business.industry ,Proportional hazards model ,Risk Factor ,Bayes Theorem ,medicine.disease ,Surgery ,Prospective Studie ,Multivariate Analysis ,Proportional Hazards Model ,Cohort Studie ,Primary Graft Dysfunction ,business ,Body mass index ,Transplantation Outcome - Abstract
Background: To generate a robust predictive model of Early (3 months) Graft Loss after liver transplantation, we used a Bayesian approach to combine evidence from a prospective European cohort (Liver-Match) and the United Network for Organ Sharing registry. Methods: Liver-Match included 1480 consecutive primary liver transplants performed from 2007 to 2009 and the United Network for Organ Sharing a time-matched series of 9740 transplants. There were 173 and 706 Early Graft Loss, respectively. Multivariate analysis identified as significant predictors of Early Graft Loss: donor age, donation after cardiac death, cold ischaemia time, donor body mass index and height, recipient creatinine, bilirubin, disease aetiology, prior upper abdominal surgery and portal thrombosis. Results: A Bayesian Cox model was fitted to Liver-Match data using the United Network for Organ Sharing findings as prior information, allowing to generate an Early Graft Loss-Donor Risk Index and an Early Graft Loss-Recipient Risk Index. A Donor-Recipient Allocation Model, obtained by adding Early Graft Loss-Donor Risk Index to Early Graft Loss-Recipient Risk Index, was then validated in a distinct United Network for Organ Sharing (year 2010) cohort including 2964 transplants. Donor-Recipient Allocation Model updating using the independent Turin Transplant Centre dataset, allowed to predict Early Graft Loss with good accuracy (c-statistic: 0.76). Conclusion: Donor-Recipient Allocation Model allows a reliable donor and recipient-based Early Graft Loss prediction. The Bayesian approach permits to adapt the original Donor-Recipient Allocation Model by incorporating evidence from other cohorts, resulting in significantly improved predictive capability. © 2013 Editrice Gastroenterologica Italiana S.r.l.
- Published
- 2014
63. Energy Expenditure During a Day of Sport Competitions in Kidney Transplant Recipients
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Matteo Parigino, Alessandro Nanni Costa, Sergio Stefoni, Giovanni Mosconi, Davide Pisoni, Giulio Sergio Roi, Roi GS, Parigino M, Pisoni D, Mosconi G, Nanni Costa A, and Stefoni S.
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Adult ,Male ,medicine.medical_specialty ,Urinary system ,Energetic cost ,MEDLINE ,Kidney transplant ,medicine ,Humans ,Intensive care medicine ,Transplantation ,Kidney ,business.industry ,Middle Aged ,Kidney Transplantation ,ENERGY EXPENDITURE ,Surgery ,medicine.anatomical_structure ,Energy expenditure ,Physical Fitness ,PHYSICAL ACTIVITY ,Energy Metabolism ,business ,Sports - Abstract
No abstract available
- Published
- 2010
64. Reliability of ultrasound screening of liver and kidney donors: a retrospective study
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Nicola Venturoli, Luigi Bolondi, Petrini F, Alessandro Nanni Costa, Lorenza Ridolfi, Gerardo Martinelli, Maria Rosa Pugliese, and Stefania Taddei
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Adult ,medicine.medical_specialty ,Tissue and Organ Procurement ,Adolescent ,Abdominal ultrasound ,Kidney ,Ultrasound screening ,medicine ,Humans ,Mass Screening ,Retrospective Studies ,Ultrasonography ,Transplantation ,business.industry ,Liver and kidney ,Ultrasound ,Reproducibility of Results ,Retrospective cohort study ,Middle Aged ,Kidney Transplantation ,Tissue Donors ,Liver Transplantation ,Liver ,Radiology ,business - Abstract
The reliability of abdominal ultrasound in screening liver and kidney donors was assessed by correlating ultrasound findings with the suitability of organs for transplantation as determined by direct examination of the organs. We evaluated 100 multiorgan donors (100 livers, 200 kidneys) during a 15-month period. Abdominal ultrasound showed the following results for liver and kidney, respectively: specificity, 95.6% and 98.9%; sensitivity, 62.5% and 66.6%; and accuracy, 93% and 97%. These results show that abdominal ultrasound is a valuable tool for determining suitability of organs for transplantation when the ultrasound findings are normal. When ultrasound findings are abnormal, further studies are necessary to determine the suitability of the organs for transplantation.
- Published
- 2000
65. Organ donation and transplantation as health programs in Italy
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Alessandro Nanni Costa, Petrini F, Sergio Venturi, Nicola Venturoli, Stefania Taddei, Marzia Monti, Maria Rosa Pugliese, Gerardo Martinelli, and Lorenza Ridolfi
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medicine.medical_specialty ,Tissue and Organ Procurement ,030232 urology & nephrology ,Regional Medical Programs ,030230 surgery ,Organ transplantation ,Health care rationing ,03 medical and health sciences ,0302 clinical medicine ,Intensive care ,Outcome Assessment, Health Care ,Health care ,Humans ,Organizational Objectives ,Medicine ,Organ donation ,Intensive care medicine ,Health Education ,Transplantation ,Health Care Rationing ,business.industry ,Public health ,Organ Transplantation ,medicine.disease ,Tissue Donors ,humanities ,Health Planning ,Italy ,Medical emergency ,business ,Health department - Abstract
Organ and tissue donation and transplantation have a role in public health programs as organizational projects designed by public health departments to increase the quality and number of donations and transplantations. These programs serve as communication projects to inform public opinion on cerebral death, organ and tissue shortages, procurement and allocation rules, and the quality of life of transplanted patients. The health department of Emilia-Romagna created a regional law and a multimedia communication program for these purposes, resulting in a 95% increase of cadaver donor in 4 years. In 1995, regional activity reached the European mean level and afterwards surpassed it. In 1997, the bone bank was activated, followed in 1998 by the heart valve and vascular segment bank. The regional health department now considers transplant activities a primary goal; human and professional relations between intensive care units and the transplant reference center are considered crucial; cooperation among health departments, medical teams involved in organ procurement and transplant activities has been fostered, and the local coordination network has been active and efficient. The public information campaign has proven important in providing information both to professionals and citizens.
- Published
- 2000
66. Altered thymic endocrine activity along with impairments of peripheral zinc metabolism and T-lymphocyte populations are associated with myasthenia gravis: a follow-up study
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Nicola Fabris, Rita Rinaldi, Alessandro Nanni Costa, Mario Schiavina, E. Mocchegiani, Caterina Tonon, Federico Licastro, Giovanni Bontempo, and Roberto D'Alessandro
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Adult ,Male ,Thymic Factor, Circulating ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Immunology ,Thymus Gland ,Biology ,Basal (phylogenetics) ,Thymulin ,chemistry.chemical_compound ,T-Lymphocyte Subsets ,Internal medicine ,Myasthenia Gravis ,medicine ,Humans ,Immunology and Allergy ,Endocrine system ,Lymphocyte Count ,Aged ,Immunosuppression ,T lymphocyte ,Middle Aged ,Thymectomy ,medicine.disease ,Myasthenia gravis ,CD4 Lymphocyte Count ,Zinc ,Endocrinology ,Neurology ,chemistry ,Female ,Neurology (clinical) ,Immunosuppressive Agents ,Follow-Up Studies ,Hormone - Abstract
Thymic endocrine activity was assessed by a bioassay to determine the basal activity of thymulin (TH), a zinc dependent hormone, and its in vitro reactivation in two different age groups of patients with myasthenia gravis (MG). Before thymectomy, basal TH plasma levels were increased in patients over the age of 50 years. Plasma zinc levels were increased in all patients, this increment being very high in old patients. One year after thymectomy both TH and zinc plasma levels decreased. While zinc plasma levels were within the normal ranges for their respective ages, TH levels were lower in young and higher in old patients than in age comparable controls. Young patients with MG showed increased CD3,DR positive peripheral T-cells as well as lymphocytes with the CD16,CD56 phenotype. An increment of CD3 positive cells along with CD4 and CD16,CD56 positive cells were found in older patients. Thymectomy partially affected blood lymphocyte representation only in young patients, since CD3,DR T-cells decreased one year after surgery. No significant variations in T-cell representation were found in old patients after thymectomy. Immunosuppression in thymectomized patients did not significantly affected TH and zinc plasma levels. Very high levels of TH and the presence of additional alterations in T-lymphocyte subsets in old patients suggested that differential age related pathogenetic immunological mechanisms might be associated with the disease.
- Published
- 1997
67. The joint action MODE (Mutual Organ Donation and Transplantation Exchanges): a sound contribution to implementation of health policies in organ donation and transplantation
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Alessandro Nanni Costa, Paola Di Ciaccio, Claudia Ferraro, Pavel Brezovsky, and Eduardo Martín-Escobar
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Medical education ,business.industry ,Methodology ,Public Health, Environmental and Occupational Health ,Health services research ,Virtuous circle and vicious circle ,Transplantation ,Donation ,Action plan ,Health care ,Medicine ,Organ donation ,business ,Health policy - Abstract
Background The main objective of the joint action MODE is the transfer of best-practices in the field of organ donation and transplantation and the creation of positive synergies among participating European (EU) Member States (MS) apt to support authorities in possible decision-making and policy contexts. Methods The consortium has chosen to foster the exchange of best-practice through a series of exchange visits followed by the provision of a set of specialized trainings. Each participating MS has presented its strengths and weaknesses through a questionnaire based on the Organ Action Plan. Once the situation was clearer, countries with the strongest program organized and hosted the on-site visits and each country had the opportunity to perform five exchange visits on five selected topics. Specific courses for healthcare staff of organ coordinating and transplantation centres were organized. Based on evaluation of the results of the on-site visits and training needs indicated by the partners, the chosen topics were: • reporting on adverse events and reactions • quality assurance programme of the donation process in Spain • quality assurance of the transplantation process Results and conclusions The outcome is that within the EU, even among MS with well-developed services, the organ donation and transplantation activity has substantial differences so that all participating countries would benefit from investigating foreign donation and transplant systems. Collaboration at EU level can be beneficial for all systems and the joint action MODE indicated that in some countries the sharing of expertise across the EU Member States has already proved to be useful in starting a virtuous circle in organization and training that would allow to increase organ donor rates and improve overall performance.
- Published
- 2013
68. Donazione e trapianti d’organo
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Franco Filipponi, Laura Coletti, Alessandro Nanni Costa, Paolo De Simone, and Emanuela Grasso
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Il trapianto e terapia consolidata nel trattamento delle insufficienze terminali di organi quali il rene, il fegato, il cuore, i polmoni, il pancreas e l’intestino. L’adozione di sistemi organizzativi dedicati alle attivita di donazione e trapianto, il ricorso alle evidenze scientifiche e alle migliori risorse tecnologiche e l’integrazione pluridisciplinare e multi-professionale possono contribuire a ridurre i rischi associati al trapianto di organi [1].
- Published
- 2013
69. Integrated Human Surveillance Systems of West Nile Virus Infections in Italy: The 2012 Experience
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Alessandro Nanni Costa, Antonino Bella, Simonetta Pupella, Christian Napoli, Giuliano Grazzini, Loredana Nicoletti, Letizia Lombardini, Silvia Declich, Francesca Yoshie Russo, Caterina Rizzo, and Maria Grazia Pompa
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Male ,medicine.medical_specialty ,West Nile virus ,viruses ,Health, Toxicology and Mutagenesis ,lcsh:Medicine ,Blood Donors ,Disease ,medicine.disease_cause ,Article ,Blood donations ,West Nile virus infections ,Epidemiology ,medicine ,Humans ,Aged ,Transmission (medicine) ,business.industry ,Public health ,lcsh:R ,Public Health, Environmental and Occupational Health ,virus diseases ,Middle Aged ,Virology ,Tissue Donors ,Geographic distribution ,One Health ,Italy ,Population Surveillance ,surveillance ,epidemiology ,Female ,Seasons ,West Nile Fever ,business - Abstract
In Italy, a West Nile virus (WNV) surveillance plan was firstly implemented in 2008 and 2009 in two affected regions and, since 2010, according to a national plan, a WNV neuroinvasive disease (WNND) surveillance has to be carried out each year during the period 15 June–30 November, in those regions where WNV circulation has been demonstrated among humans, animals or vectors. Moreover, since WNV can be transmitted to humans even by blood transfusions and organ transplants obtained from infected donors, the national surveillance integrates the blood transfusions and organs transplant surveillances too. The paper describes the results of this integrated human surveillance in Italy in 2012. Overall, in 2012, 28 autochthonous confirmed cases of WNND were reported, 14 blood donations were found WNV positive by Nucleic Acid Amplification Test and no solid organ donors tested positive for WNV. Moreover, 17 cases of WNV fever were confirmed in Veneto region. When comparing the number of WNND cases reported to the surveillance system in previous 4 years (43 cases during the period 2008–2011), with those reported in 2012 an important increase was observed in 2012. The geographic distribution of human cases was consistent with the WNV circulation among animals and vectors. Moreover, the implementation of preventive measures for WNV transmission through blood components allowed the detection of blood donors positive for WNV, avoiding the further spread of the disease. Since surveillance strategies and preventive measures are based on the integration among human, animal and vector control activities, the Italian experience could be considered a good example of collaboration among different sectors of public health in a “one health” perspective.
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- 2013
70. Skills and requirements of a transplant hepatologist: board certification of the Italian Association for the Study of the Liver (AISF)
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Patrizia Burra, Alessandro Nanni Costa, Paolo Caraceni, Stefano Fagiuoli, Pierluigi Toniutto, Luca S. Belli, Mario Angelico, Burra P, Belli L, Fagiuoli S, Angelico M, Costa AN, Caraceni P, Toniutto P., Burra, P, Belli, L, Fagiuoli, S, Angelico, M, Costa, A, Caraceni, P, and Toniutto, P
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medicine.medical_specialty ,Cirrhosis ,Certification ,medicine.medical_treatment ,Eligibility Determination ,Liver transplantation ,Training ,Transplant hepatologist ,End Stage Liver Disease ,Liver disease ,Fulminant hepatic failure ,medicine ,Outpatient setting ,Humans ,Intensive care medicine ,Physician's Role ,Societies, Medical ,Settore MED/12 - Gastroenterologia ,Hepatology ,business.industry ,Gastroenterology ,LIVER TRANSPLANTATION ,medicine.disease ,Settore MED/18 - Chirurgia Generale ,surgical procedures, operative ,Italy ,Waiting list ,Clinical Competence ,Board certification ,business - Abstract
a b s t r a c t Liver transplantation has indeed evolved from an experimental procedure in the early 1980s to the most effective treatment for patients with advanced liver cirrhosis and for selected patients with hepatocellular carcinoma and fulminant hepatic failure. In this new scenario, the transplant hepatologist plays a crucial clinical role, with essential duties and skills to manage the complexities encountered in waitlisted patients or transplant recipients. The clinical tasks of the transplant hepatologist include the management of patients with end-stage liver disease who are candidates for liver transplantation and/or on the waiting list, as well as the care of transplant recipients, in both the in- and outpatient setting. Starting in 2013, the Italian Association of the Study of the Liver, with the endorsement of the National Transplant Centre, will be offering a formal certification process for transplant hepatologists, implemented in accordance to Union Europeenne des Medecins Specialistes-European Board of Transplant Medicine procedures. The Special Article outlines the requirements for board certification of the Italian Association for the Study of the Liver transplant hepatologist.
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- 2013
71. Incidence and prevalence of cancer in kidney transplantation waiting list patients: An italian experience
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Gianni Cappelli, Alessandro Nanni Costa, Irene Capelli, Ilaria Gandolfini, Carlo Buzio, Sergio Stefoni, A. Ricci, Elisa Persici, Elisabetta Rubbiani, Francesca Centofanti, Giovanni Mosconi, Mosconi G, Centofanti F, Capelli I, Ricci A, Persici E, Gandolfini I, Rubbiani E, Buzio C, Cappelli G, Costa AN, and Stefoni S.
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Adult ,Male ,Pediatrics ,medicine.medical_specialty ,Time Factors ,Adolescent ,Waiting Lists ,Biomedical Engineering ,Medicine (miscellaneous) ,Bioengineering ,Kidney transplant ,Biomaterials ,Young Adult ,Neoplasms ,Epidemiology ,KIDNEY TRANSPLANTATION ,Prevalence ,Medicine ,Humans ,NEOPLASTIC DETECTION ,Kidney transplantation ,Aged ,Retrospective Studies ,business.industry ,Incidence (epidemiology) ,Incidence ,Neoplastic disease ,Cancer ,General Medicine ,KIDNEY TRANSPLANT WAITING LIST ,Middle Aged ,medicine.disease ,CANCER ,Transplantation ,Italy ,Waiting list ,Kidney Failure, Chronic ,Female ,business ,transplantation - Abstract
Introduction Evaluation of kidney transplant candidates is based on strict exclusion of major pathologies, such as neoplastic disease. The aim of this study is to evaluate epidemiological and clinical impact of tumor disease in an Italian renal transplant waiting list and to propose a screening schedule for neoplastic detection. Materials and methods We retrospectively observed data of patients enrolled on the Emilia-Romagna kidney transplant waiting list between 1st August 2008 and 31st December 2010, evaluating the different causes of getting out from the list, the histologic type and incidence of cancer and the correlation between cancer onset and clinical features. The ratio of observed to expected cancer numbers (standardized incidence ratio, SIR), was estimated. Results We observed 2345 patients; 1297 got out from the waiting list; 57 of them (4,4%) got out because the onset of tumor. The overall incidence rate of cancer was 1354.8 (x 100000 person-year) (1045.9 person-year in patients awaiting for first transplant(FT), 1851.5 person-year in patients awaiting for second transplant(ST)). The overall prevalence of cancer was 2,43% (2.2% in FT, 3.4% in ST) with a SIR of 1.8; In our population the prevalence of cancers related to ESKD was 52.6% with a SIR of 15.8. Conclusion Kidney transplant waiting list patients present a higher incidence and prevalence of cancer compared to general population; it could be important to evaluate them for ESKD related malignancies because of their high incidence.
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- 2013
72. Heterogeneity of West Nile virus genotype 1a in Italy, 2011
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Anna Pierro, Vittorio Sambri, Alessandro Nanni Costa, Maria Paola Landini, Patrizia Bagnarelli, Antonino Di Caro, Paolo Gaibani, Giuseppe Ippolito, Paolo Grossi, Fabrizio Carletti, Roberto Rigoli, Giada Rossini, Maria Rosaria Capobianchi, Sandro Piga, G. Rossini, F. Carletti, R. Rigoli, S. Piga, P. Bagnarelli, P. Gaibani, A. Pierro, A. Nanni Costa, P. Grossi, G. Ippolito, M. P. Landini, A. Di Caro, M. R. Capobianchi, and V. Sambri
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Lineage (genetic) ,Genotype ,West Nile virus ,viruses ,Molecular Sequence Data ,Envelope Gene ,Biology ,medicine.disease_cause ,03 medical and health sciences ,Genotype 1b ,Viral Envelope Proteins ,Virology ,medicine ,Cluster Analysis ,Humans ,Phylogeny ,030304 developmental biology ,0303 health sciences ,Phylogenetic tree ,030306 microbiology ,virus diseases ,Genetic Variation ,Sequence Analysis, DNA ,Serum samples ,3. Good health ,nervous system diseases ,GENOME ,Italy ,RNA, Viral ,West Nile Fever - Abstract
West Nile virus (WNV) is currently circulating in several European countries and, over recent decades, concomitantly with enhanced surveillance studies and improved diagnostic capabilities, an increase in the geographical distribution and in the number of cases in Europe has been documented. In Italy in 2011, 14 human cases of WNV neuroinvasive infections due to lineage 1 strains were registered in several Italian regions. Here we report WNV partial sequences obtained from serum samples of two patients living in different regions of Italy (Veneto and Sardinia). Phylogenetic analysis, performed on a fragment (566 nt) of the envelope gene, showed that WNV strains circulating in Italy in 2011 belong to lineage 1a, but are different from lineage 1a strains isolated in 2008–2009.The data reported here are consistent with the hypothesis of multiple recent introductions of WNV lineage 1a strains into Italy.
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- 2012
73. Hospital cluster of HBV infection: molecular evidence of patient-to-patient transmission through lancing device
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Alessandro Nanni Costa, Giuseppe Ippolito, Lorena Martini, Anna Rosa Garbuglia, Simone Lanini, Vincenzo Puro, Pierluca Piselli, William Arcese, Mariacarmela Solmone, Maria Rosaria Capobionchi, and Piero Borgia
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Adult ,Male ,Bacterial Diseases ,Pediatrics ,medicine.medical_specialty ,Hepatitis B virus ,Non-Clinical Medicine ,Epidemiology ,Science ,Molecular evidence ,Gastroenterology and Hepatology ,Disease cluster ,medicine.disease_cause ,Disease Outbreaks ,Cohort Studies ,medicine ,Humans ,Biological evidence ,Biology ,Phylogeny ,Aged ,Aged, 80 and over ,Cross Infection ,Multidisciplinary ,Population Biology ,Infectious Hepatitis ,Transmission (medicine) ,business.industry ,Liver Diseases ,Middle Aged ,Hepatitis B ,Virology ,Infectious Diseases ,Case-Control Studies ,Medicine ,Female ,business ,Settore MED/15 - Malattie del Sangue ,Research Article - Abstract
IntroductionIn western countries the transmission of hepatitis B virus (HBV) transmission through multi-patients lancing devices has been inferred since early '90s, however no study has ever provided biological evidence which directly link these device with HBV cross-infection. Here we present results of an outbreak investigation which could associate, by molecular techniques, the use of lancing device on multiple patients with HBV transmission in an Italian oncohematology unit.MethodsThe outbreak investigation was designed as a retrospective cohort study to identify all potential cases. All cases identified were eventually confirmed through molecular epidemiology techniques. Audit of personnel including extensive review of infection control measures and reviewing personnel's tests for HBV was done identify transmission route.ResultsBetween 4 May 2006 and 21 February 2007, six incident cases of HBV infection were reported among 162 patients admitted in the oncohematology. The subsequent molecular instigation proved that 3 out 6 incident cases and one prevalent cases (already infected with HBV at the admission) represented a monophyletic cluster of infection. The eventual environmental investigation found that an identical HBV viral strain was present on a multi-patients lancing device in use in the unit and the inferential analysis showed a statistically significant association between undergoing lancing procedures and the infection.DiscussionThis investigation provide molecular evidence to link a HBV infection cluster to multi-patients lancing device and highlights that patients undergoing capillary blood sampling by non-disposable lancing device may face an unacceptable increased risk of HBV infection. Therefore we believe that multi-patients lancing devices should be banned from healthcare settings and replace with disposable safety lancets that permanently retract to prevent the use of the same device on multiple patients. The use of non-disposable lancing devices should be restricted to individual use at patients' home.
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- 2012
74. Infections and organ transplantation: new challenges for prevention and treatment--a colloquium
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Paolo Grossi, Sabrina Basso, Patrizia Burra, Giuseppi Gerna, Emily A. Blumberg, Raymund R. Razonable, Patrizia Comoli, Alessandro Nanni Costa, Antonio Lanzavecchia, Camille N. Kotton, Jay A. Fishman, Fabrizio Ginevri, Alessandra Agnese Grossi, Anne Kabanova, Elisabetta Loggi, Kryssia I. Rodriguez-Castro, Raffaele Bruno, Gian Maria Rossolini, Deirdre Fehily, Fabio Arena, Michael G. Ison, R. Lattes, Pietro Andreone, Luisa Pasulo, Francesco Paolo Schena, Valerio Cozza, Elenora De Martin, Daniele Lilleri, Matthew J. Kuehnert, Antoni Rimola, Stefano Fagiuoli, Marco Zecca, Gabriele Sganga, Grossi, P, Costa, A, Fehily, D, Blumberg, E, Kuehnert, M, Fishman, J, Ison, M, Lattes, R, Kotton, C, Lilleri, D, Kabanova, A, Lanzavecchia, A, Gerna, G, Razonable, R, Comoli, P, Zecca, M, Basso, S, Ginevri, F, Grossi, A, Schena, F, Rimola, A, Burra, P, De Martin, E, Rodriguez-Castro, K, Fagiuoli, S, Pasulo, L, Bruno, R, Andreone, P, Loggi, E, Arena, F, Rossolini, G, Sganga, G, Cozza, V, Grossi PA., Costa AN., Fehily D., Blumberg EA., Kuehnert MJ., Fishman JA., Ison MG., Lattes R., Kotton CN., Lilleri D., Kabanova A., Lanzavecchia A., Gerna G., Razonable RR., Comoli P., Zecca M., Basso S., Ginevri F., Grossi A., Schena FP., Rimola A., Burra P., De Martin E., Rodriguez-Castro KI., Fagiuoli S., Pasulo L., Bruno R., Andreone P., Loggi E., Arena F., Maria Rossolini G., Sganga G., and Cozza V.
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medicine.medical_specialty ,Tissue and Organ Procurement ,Settore MED/18 - CHIRURGIA GENERALE ,Communicable Diseases ,Risk Assessment ,Organ transplantation ,chronic hepatitis B ,liver transplantation ,HBsAg donors ,Disease Transmission ,Risk Factors ,Neoplasms ,medicine ,Disease Transmission, Infectious ,media_common.cataloged_instance ,Humans ,European Union ,European union ,media_common ,Organ Transplantation ,United States ,Tissue Donors ,Transplantation ,business.industry ,Infectious ,Surgery ,business ,Infection ,Disease transmission ,Humanities - Abstract
Paolo A. Grossi, Alessandro Nanni Costa, Deirdre Fehily, Emily A. Blumberg, Matthew J. Kuehnert, Jay A. Fishman, Michael G. Ison, Roberta Lattes, Camille N. Kotton, Daniele Lilleri, Anne Kabanova, Antonio Lanzavecchia, Giuseppi Gerna, Raymund R. Razonable, Patrizia Comoli, Marco Zecca, Sabrina Basso, Fabrizio Ginevri, Alessandra Grossi, Francesco P. Schena, Antoni Rimola, Patrizia Burra, Elenora De Martin, Kryssia Isabel Rodriguez-Castro, Stefano Fagiuoli, Luisa Pasulo, Raffaele Bruno, Pietro Andreone, Elisabetta Loggi, Fabio Arena, Gian Maria Rossolini, Gabriele Sganga, and Valerio Cozza
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- 2012
75. Gestione del trapianto d’organo: la morte cerebrale e l organizzazione nazionale
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Alessandro Nanni Costa
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Il trapianto e una procedura salvavita resa possibile dalla disponibilita di donatori. Nella sua peculiarita di passaggio da vita a morte per il donatore e a nuova vita per il suo ricevente, e una pratica medica in cui si incrociano e sommano livelli diversi: l’aspetto umano, la competenza e la capacita del personale medico e sanitario che segue tutto il processo di prelievo-trapianto, il funzionamento della rete in ciascuna delle sue parti, al fine di rendere efficace e di successo un processo lungo, delicato e complesso.
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- 2012
76. European Living Donation and Public Health (EULID Project)
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Rosana Turcu, George K. Kyriakides, Ingela Fehrman-Ekholm, Leonídio Dias, Alessandro Nanni Costa, Andy Maxwell, Christian Hiesse, Dorota Lewandowska, Assumpta Ricart, Danica Asvec, Martí Manyalich, David Paredes, Pål-Dag Line, Ana Menjivar, and Chloë Ballesté
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medicine.medical_specialty ,Public health ,business.industry ,Donations of organs ,International health ,Salut pública ,Occupational safety and health ,Transplantation ,Europe ,Health promotion ,Donation ,Environmental health ,Family medicine ,Medicine ,Health education ,business ,Europa ,Health policy ,Donació d'òrgans - Abstract
Donation from alive people has been growing strongly in the recent years, thanks to the advance in the field of organ transplantation and its success as a treatment to procure quality-adjusted life years for many patients with end–stage diseases. The choice of transplantation from a living donor (LD) offers some advantages compared to that for a deceased donor. However, it also carries disadvantages related to donor risks in terms of health and safety, and there are several controversial ethical aspects to be taken into account. There is no specific pronouncement of the European Union in relation to standards to quality and safety for the living donor process, and there is a great heterogeneity among European Countries legislation, ethical concern, and protection systems and donor´s data registries on the topic. The EULID project aims to establish European common standard framework regarding living donor issues to guarantee their health and safety thorough common practices and regulation.
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- 2012
77. Liver transplantation from hepatitis B surface antigen positive donors: a safe way to expand the donor pool
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Alessandro Nanni Costa, Paolo Grossi, Antonio Daniele Pinna, L. Micco, Mauro Bernardi, Pietro Andreone, Andrea Bontadini, Stefano Gitto, Gian Luca Grazi, Christian Brander, Alessandro Cucchetti, Giorgio Ercolani, Elisabetta Loggi, Florian Bihl, Loggi E, Micco L, Ercolani G, Cucchetti A, Bihl FK, Grazi GL, Gitto S, Bontadini A, Bernardi M, Grossi P, Nanni Costa A, Pinna AD, Brander C, and Andreone P.
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Male ,HBsAg ,Hepatitis B surface antigen-positive donor ,Marginal graft ,medicine.medical_treatment ,T-Lymphocytes ,Liver transplantation ,medicine.disease_cause ,Model for End-Stage Liver Disease ,MARGINAL GRAFT ,virus diseases ,Liver transplantation, Hepatitis B surface antigen-positive donor, Hepatitis B virus (HBV), Marginal graft, Immune response ,Hepatitis B ,Middle Aged ,Tissue Donors ,Treatment Outcome ,HBeAg ,Female ,Immunosuppressive Agents ,Adult ,Tissue and Organ Procurement ,Hepatitis C virus ,Molecular Sequence Data ,HEPATITIS B VIRUS (HBV) ,Antiviral Agents ,NO ,IMMUNE RESPONSE ,medicine ,Humans ,Hepatitis B virus (HBV) ,Amino Acid Sequence ,Immune response ,Hepatitis B Antibodies ,Aged ,Hepatitis ,Hepatitis B virus ,LIVER TRANSPLANTATION ,HEPATITIS B SURFACE ANTIGEN-POSITIVE DONOR ,Hepatitis B Surface Antigens ,Hepatology ,business.industry ,medicine.disease ,digestive system diseases ,Liver Transplantation ,Immunology ,business ,Follow-Up Studies - Abstract
Background & Aims The main limitation of orthotopic liver transplantation (OLT) is the scarcity of available donor organs. A possibility to increase the organ pool is to use grafts from hepatitis B virus surface antigen (HBsAg) positive donors, but few data are currently available in this setting. We assessed the clinical, serovirological, and immunological outcomes of liver transplant from HBsAg positive donors in a single centre study. Methods From 2005 to 2009 10 patients underwent OLT from HBsAg positive donors, for HBV-related disease (n=6) or HBV-unrelated disease (n=4). The median follow-up was 42months (range 12–60). All recipients were HBcAb positive and were given antiviral prophylaxis. Results Patients transplanted for HBV-related disease never cleared HBsAg. Two HBsAg negative patients never tested positive for HBsAg, whereas the others experienced an HBsAg appearance, followed by spontaneous production of anti-HBs, allowing HBsAg clearance. No patient ever had any sign of HBV hepatitis. HBV replication was effectively controlled by antiviral therapy. The immunologic sub-study showed that a most robust anti-HBV specific T cell response was associated with the control of HBV infection. Conclusions OLT from HBsAg positive donors seems to be a safe procedure in the era of highly effective antiviral therapy.
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- 2011
78. Cord blood stem cell banking: a snapshot of the Italian situation
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Francesca, Capone, Letizia, Lombardini, Simonetta, Pupella, Giuliano, Grazzini, Alessandro Nanni, Costa, and Giovanni, Migliaccio
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Cryopreservation ,Italy ,Blood Banks ,Humans ,Fetal Blood - Abstract
In Italy, the law does not permit the setting up of private banks to preserve cord blood (CB) stem cells for personal use. However, since 2007 the right to export and preserve them in private laboratories located outside Italy has existed, and an increasing number of women are requesting this collection of umbilical CB at delivery to enable storage of stem cells for autologous use.Since private banks recruit clients mainly via the Internet, we examined the content of 24 Italian-language websites that offer stem cells storage (from CB or amniotic fluid), to assess what information is available.We found that the majority of private banks give no clear information about the procedures of collection, processing, and banking of CB units and that the standards offered by private CB banks strongly differ in terms of exclusion or acceptance criteria from the public banks. These factors may well influence the overall quality of the CB units stored in private CB banks. Of note, during the period 2007 to 2009, the number collected for autologous use did not create a downward trend on the number of units stored in public CB banks for allogeneic use.CB is a valuable community resource but expectant parents should be better informed as to the quality variables necessary for its storage, both by institutions and by professionals. Currently, most of the advertising is insufficient to justify the expense and the hopes pinned on autologous use of CB stem cells.
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- 2011
79. The critical pathway for deceased donation: reportable uniformity in the approach to deceased donation
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Beatriz, Domínguez-Gil, Francis L, Delmonico, Faissal A M, Shaheen, Rafael, Matesanz, Kevin, O'Connor, Marina, Minina, Elmi, Muller, Kimberly, Young, Marti, Manyalich, Jeremy, Chapman, Günter, Kirste, Mustafa, Al-Mousawi, Leen, Coene, Valter Duro, García, Serguei, Gautier, Tomonori, Hasegawa, Vivekanand, Jha, Tong Kiat, Kwek, Zhonghua Klaus, Chen, Bernard, Loty, Alessandro Nanni, Costa, Howard M, Nathan, Rutger, Ploeg, Oleg, Reznik, John D, Rosendale, Annika, Tibell, George, Tsoulfas, Anantharaman, Vathsala, and Luc, Noël
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Death ,Brain Death ,Infection Control ,Tissue and Organ Procurement ,Cadaver ,Critical Pathways ,Humans - Abstract
The critical pathway of deceased donation provides a systematic approach to the organ donation process, considering both donation after cardiac death than donation after brain death. The pathway provides a tool for assessing the potential of deceased donation and for the prospective identification and referral of possible deceased donors.
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- 2011
80. Physical activity and renal transplantation
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Giovanni, Mosconi, Giulio Sergio, Roi, Alessandro, Nanni Costa, Sergio, Stefoni, Mosconi G, Roi GS, Nanni Costa A, and Stefoni S.
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Clinical Trials as Topic ,Postoperative Complications ,Physical activity ,Aerobic capacity ,KIDNEY TRANSPLANTATION ,muscle strength ,Humans ,Kidney Failure, Chronic ,Motor Activity ,Sedentary Behavior ,Algorithms ,Sports - Abstract
A sedentary lifestyle is an important risk factor leading to cardiovascular disease. Cardiovascular disease is particularly frequent in kidney transplant recipients, with a mortality rate of 38%. In this population, besides the classic risk factors (genetics, age, smoking, etc.) and disease-related factors (chronic renal failure, dialysis vintage) there are the side effects of immunosuppressive therapy such as diabetes and metabolic syndrome. Despite the general advice given on an appropriate lifestyle, most transplanted patients lead a sedentary life which may result in overweight. In this study the physiopathological effects of a sedentary lifestyle were analyzed with reference to the recent literature regarding the efficacy of physical activity in transplanted patients. Studies in the general population have demonstrated the beneficial effect of physical activity on the prevention of cardiovascular disease. There are only few studies within the kidney transplant population regarding regular physical activity and these studies were performed with heterogeneous protocols and different observation periods, and are therefore difficult to compare. Overall, positive results in terms of maximal aerobic capacity, muscle strength and perception of well-being have been obtained in the short and medium term (1 year). Further studies are necessary to verify the effect of physical activity on long-term patient and graft survival. In order to enhance physical activity in transplanted patients, local programs in collaboration with sports rehabilitation centers are to be recommended.
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- 2011
81. Current situation of donation after circulatory death in European countries
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Beatriz, Domínguez-Gil, Bernadette, Haase-Kromwijk, Hendrik, Van Leiden, James, Neuberger, Leen, Coene, Philippe, Morel, Antoine, Corinne, Ferdinand, Muehlbacher, Pavel, Brezovsky, Alessandro Nanni, Costa, Rafail, Rozental, and Rafael, Matesanz
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Brain Death ,Tissue and Organ Procurement ,ddc:617 ,Lung Transplantation/statistics & numerical data ,Graft Survival ,Kidney Transplantation ,Tissue Donors ,Liver Transplantation ,Tissue Donors/statistics & numerical data ,Death ,Europe ,Tissue and Organ Procurement/statistics & numerical data ,Kidney Transplantation/statistics & numerical data ,Pancreas Transplantation/statistics & numerical data ,Humans ,Liver Transplantation/statistics & numerical data ,Pancreas Transplantation ,Lung Transplantation - Abstract
The aim of the present study was to describe the current situation of donation after circulatory death (DCD) in the Council of Europe, through a dedicated survey. Of 27 participating countries, only 10 confirmed any DCD activity, the highest one being described in Belgium, the Netherlands and the United Kingdom (mainly controlled) and France and Spain (mainly uncontrolled). During 2000-2009, as DCD increased, donation after brain death (DBD) decreased about 20% in the three countries with a predominant controlled DCD activity, while DBD had increased in the majority of European countries. The number of organs recovered and transplanted per DCD increased along time, although it remained substantially lower compared with DBD. During 2000-2008, 5004 organs were transplanted from DCD (4261 kidneys, 505 livers, 157 lungs and 81 pancreas). Short-term outcomes of 2343 kidney recipients from controlled versus 649 from uncontrolled DCD were analyzed: primary non function occurred in 5% vs. 6.4% (P = NS) and delayed graft function in 50.2% vs. 75.7% (P
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- 2011
82. Liver Match, a prospective observational cohort study on liver transplantation in Italy: study design and current practice of donor-recipient matching
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Mario Angelico 1, Umberto Cillo, Stefano Fagiuoli, Antonio Gasbarrini, Caius Gavrila, Tania Marianelli, Alessandro Nanni Costa, Alessandra Nardi, Mario Strazzabosco, Patrizia Burra, Salvatore Agnes, Umberto Baccarani, Fulvio Calise, Michele Colledan, Oreste Cuomo, Luciano De Carlis, Matteo Donataccio, Giuseppe M Ettorre, Giorgio E Gerunda, Bruno Gridelli, Luigi Lupo, Vincenzo Mazzaferro, Antonio Pinna, Andrea Risaliti, Mauro Salizzoni, Giuseppe Tisone, Umberto Valente, Giorgio Rossi, Massimo Rossi, Fausto Zamboni, S Fagiuoli, A Gasbarrini, M Strazzabosco, D Prati, F Piscaglia, P G Toniutto, L Rizzato, S Venettoni, A Nardi, A Ricci, R Romagnoli, G Bertolotti, D Patrono, J M E Mangoni, L Caccamo, B Antonelli, E Regalia, C Sposito, V Corno, F Tagliabue, S Marin, E Gringeri, D Donataccio, F Bresadola, D Lorenzin, M Gelli, G Rompianesi, A Cucchetti, M G Faraci, D Sforza, S Agnes, M Di Mugno, L Miglioresi, M Rossi, S Ginanni Corradini, A Molinaro, V Scuderi, G Arenga, G Notarnicola, B Gridelli, S Li Petri, G Carbotta, S Dedola, C Gavrila, F Vespasiano, Angelico M, Cillo U, Fagiuoli S, Gasbarrini A, Costa AN, Strazzabosco M, Prati D, Piscaglia F, Toniutto PG, Burra P, Rizzato L, Venettoni S, Marianelli T, Salizzoni M, Romagnoli R, Bertolotti G, Patrono D, De Carolis L, Mangoni JM, Rossi G, Caccamo L, Antonelli B, Mazzaferro V, Regalia E, Sposito C, Colledan M, Corno V, Tagliabue F, Marin S, Gringeri E, Donataccio, Donataccio D, Bresadola F, Lorenzin D, Valente U, Gelli M, Gerunda GE, Rompianesi G, Pinna A, Grazi GL, Cucchetti A, Risaliti A, Faraci MG, Tisone G, Sforza D, Agnes S, Di Mugno M, Ettorre GM, Miglioresi L, Berloco P, Rossi M, Ginanni Corradini S, Molinaro A, Calise F, Scuderi V, Cuomo O, Arenga G, Lupo L, Notarnicola G, Gridelli B, Li Petri S, Zamboni F, Carbotta G, Dedola S, Nardi A, Gavrila C, Ricci A, Vespasiano F, Baccarani U, 1, Mario Angelico, Cillo, Umberto, Fagiuoli, Stefano, Gasbarrini, Antonio, Gavrila, Caiu, Marianelli, Tania, Nanni Costa, Alessandro, Nardi, Alessandra, Strazzabosco, Mario, Burra, Patrizia, Agnes, Salvatore, Baccarani, Umberto, Calise, Fulvio, Colledan, Michele, Cuomo, Oreste, De Carlis, Luciano, Donataccio, Matteo, M Ettorre, Giuseppe, E Gerunda, Giorgio, Gridelli, Bruno, Lupo, Luigi, Mazzaferro, Vincenzo, Pinna, Antonio, Risaliti, Andrea, Salizzoni, Mauro, Tisone, Giuseppe, Valente, Umberto, Rossi, Giorgio, Rossi, Massimo, Zamboni, Fausto, Fagiuoli, S, Gasbarrini, A, Strazzabosco, M, Prati, D, Piscaglia, F, G Toniutto, P, Rizzato, L, Venettoni, S, Nardi, A, Ricci, A, Romagnoli, R, Bertolotti, G, Patrono, D, E Mangoni, J M, Caccamo, L, Antonelli, B, Regalia, E, Sposito, C, Corno, V, Tagliabue, F, Marin, S, Gringeri, E, Donataccio, D, Bresadola, F, Lorenzin, D, Gelli, M, Rompianesi, G, Cucchetti, A, G Faraci, M, Sforza, D, Agnes, S, Di Mugno, M, Miglioresi, L, Rossi, M, Ginanni Corradini, S, Molinaro, A, Scuderi, V, Arenga, G, Notarnicola, G, Gridelli, B, Li Petri, S, Carbotta, G, Dedola, S, Gavrila, C, Vespasiano, F, Angelico, M, Cillo, U, Marianelli, T, Costa, A, Burra, P, Baccarani, U, Calise, F, Colledan, M, Cuomo, O, DE CARLIS, L, Donataccio, M, Ettorre, G, Gerunda, G, Lupo, L, Mazzaferro, V, Pinna, A, Risaliti, A, Salizzoni, M, Tisone, G, Valente, U, Rossi, G, Zamboni, F, and Liver Match, I
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impact of donor/recipient matching on outcomes ,Male ,Alcoholic liver disease ,Cirrhosis ,Multicenter Study ,Humans ,Prospective Study ,Liver Transplantation ,Donor Risk Index ,Hepatocellular Carcinoma ,Italy ,Donor Liver transplant Recipient ,donor match, liver transplantation, donor, recipient ,Settore MED/18 - CHIRURGIA GENERALE ,medicine.medical_treatment ,liver-match, liver transplant ,Liver transplantation ,Model for End-Stage Liver Disease ,MED/12 - GASTROENTEROLOGIA ,Prospective Studies ,Prospective cohort study ,Child ,Liver transplant ,donor ,Aged, 80 and over ,Settore MED/12 - Gastroenterologia ,education.field_of_study ,liver transplantation ,Histocompatibility Testing ,Graft Survival ,Liver Neoplasms ,Gastroenterology ,Middle Aged ,liver transplantations ,liver transplant ,information on donors and recipients ,recipient ,Tissue Donors ,Treatment Outcome ,Donor ,Recipient ,Hepatocellular carcinoma ,Female ,Cohort study ,Adult ,medicine.medical_specialty ,Tissue and Organ Procurement ,Adolescent ,Waiting Lists ,Population ,NO ,Internal medicine ,medicine ,education ,donor match ,Aged ,Hepatology ,business.industry ,Patient Selection ,Settore MED/09 - MEDICINA INTERNA ,medicine.disease ,Fibrosis ,Surgery ,business - Abstract
BACKGROUND: The Liver Match is an observational cohort study that prospectively enrolled liver transplantations performed at 20 out of 21 Italian Transplant Centres between June 2007 and May 2009. Aim of the study is to investigate the impact of donor/recipient matching on outcomes. In this report we describe the study methodology and provide a cross-sectional description of donor and recipient characteristics and of graft allocation. METHODS: Adult primary transplants performed with deceased heart-beating donors were included. Relevant information on donors and recipients, organ procurement and allocation were prospectively entered in an ad hoc database within the National Transplant Centre web-based Network. Data were blindly analysed by an independent Biostatistical Board. RESULTS: The study enrolled 1530 donor/recipient matches. Median donor age was 56 years. Female donors (n = 681, median 58, range 12-92 years) were older than males (n = 849, median 53, range 2-97 years, p < 0.0001). Donors older than 60 years were 42.2%, including 4.2% octogenarians. Brain death was due to non-traumatic causes in 1126 (73.6%) cases. Half of the donor population was overweight, 10.1% was obese and 7.6% diabetic. Hepatitis B core antibody (HBcAb) was present in 245 (16.0%) donors. The median Donor Risk Index (DRI) was 1.57 (>1.7 in 35.8%). The median cold ischaemia time was 7.3h (≥ 10 in 10.6%). Median age of recipients was 54 years, and 77.7% were males. Hepatocellular carcinoma (HCC) was the most frequent indication overall (44.4%), being a coindication in roughly 1/3 of cases, followed by viral cirrhosis without HCC (28.2%) and alcoholic cirrhosis without HCC (10.2%). Hepatitis C virus infection (with or without HCC) was the most frequent etiologic factor (45.9% of the whole population and 71.4% of viral-related cirrhosis), yet hepatitis B virus infection accounted for 28.6% of viral-related cirrhosis, and HBcAb positivity was found in 49.7% of recipients. The median Model for End Stage Liver Disease (MELD) at transplant was 12 in patients with HCC and 18 in those without. Multivariate analysis showed a slight but significant inverse association between DRI and MELD at transplant. CONCLUSIONS: The deceased donor population in Italy has a high-risk profile compared to other countries, mainly due to older donor age. Almost half of the grafts are transplanted in recipients with HCC. Higher risk donors tend to be preferentially allocated to recipients with HCC, who are usually less ill and older. No other relevant allocation strategy is currently adopted at national level.
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- 2010
83. International forum on tissue coding: response from Italy
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Alessandro Nanni Costa and Angelo Ghirardini
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Transplantation ,Electronic Data Processing ,Tissue and Organ Procurement ,business.industry ,Biomedical Engineering ,Transplants ,Cell Biology ,Computational biology ,Tissue Banks ,Biology ,Bone and Bones ,Tissue Donors ,Biomaterials ,Transplant surgery ,Text mining ,Italy ,Tissue bank ,business ,Bone Banks ,Coding (social sciences) - Published
- 2010
84. 'A gift for life. Considerations on organ donation'
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Alessandro Nanni, Costa
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Tissue and Organ Procurement ,Italy ,Humans ,Gift Giving ,Societies, Medical ,Tissue Donors - Published
- 2009
85. Intracerebral Hemorrhage
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Jacinto Sánchez‐Ibáñez, Eliana Porta, Blanca Miranda, and Alessandro Nanni Costa
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medicine.medical_specialty ,business.industry ,medicine ,Intensive care medicine ,business ,Surgery - Published
- 2009
86. Experimental hepatology applied to stem cells
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Maria Teresa Conconi, S. Tomat, Alessandro Nanni Costa, Patrizia Burra, Erica Villa, Emanuele Cozzi, Malcolm R. Alison, Fabio Farinati, Francesco Paolo Russo, Antonio Gasbarrini, and Stuart J. Forbes
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medicine.medical_specialty ,Xenotransplantation ,medicine.medical_treatment ,Settore MED/12 - GASTROENTEROLOGIA ,liver ,stem cells ,hepatology ,Cancer stem cell ,medicine ,Animals ,Humans ,Progenitor cell ,Intensive care medicine ,Societies, Medical ,Hepatology ,business.industry ,Gastroenterology ,Embryonic stem cell ,Liver Transplantation ,Transplantation ,medicine.anatomical_structure ,Italy ,Immunology ,Somatic cell nuclear transfer ,Bone marrow ,Stem cell ,business ,Liver Failure ,Stem Cell Transplantation - Abstract
Transplantation is an accepted treatment today for many people suffering from organ failure. More and more patients are referred for transplant surgery, and the waiting lists are growing longer because not enough organs and tissues are donated for transplantation. This has led to several potentially viable alternatives being considered, including bio-artificial support devices, the transplantation of mature cells or stem/progenitor cells and the potential transplantation of xenogenic organs and cells [Burra P, Samuel D, Wendon J, Pietrangelo A, Gupta S. Strategies for liver support: from stem cells to xenotransplantation. J Hepatol 2004;41:1050–9]. Numerous investigators around the world are engaged in these investigations and the pace of discovery has begun to accelerate in recent years. To take stock of the achievements of recent years, the AISF sponsored a Single-Topic Conference, held in Padua on 26–27 May, 2006, with the participation of many leading investigators from various parts of Italy and Europe. This present paper summarizes the content of the Conference. Different issues were analysed, from the biology of stem cells to the possible use of gene therapy. The speakers were clinicians and scientists interested in diseases not only of the liver but also of other organs such as the kidney or heart. The fact that numerous specialties were represented helped the audience to understand the stem cell research area from different standpoints, and what research has achieved so far.
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- 2008
87. Infezione da virus West Nile in Italia: strategie per la prevenzione della trasmissione con il trapianto di organi e tessuti
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Grossi, PAOLO ANTONIO, Deirdre, Fehily, Eliana, Porta, Sante, Venettoni, and ALESSANDRO NANNI COSTA
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- 2008
88. A population-based study of cancer incidence in solid organ transplants from donors at various risk of neoplasia
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Alessandro Nanni Costa, Dino Alberto Mattucci, L. Rizzato, Serena Palmieri, Emanuela Taioli, and M. Caprio
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medicine.medical_specialty ,Population ,Cohort Studies ,Postoperative Complications ,Risk Factors ,Internal medicine ,Neoplasms ,Cadaver ,Living Donors ,Medicine ,Humans ,Organ donation ,Community Health Services ,Risk factor ,education ,Transplantation ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Incidence ,Cancer ,Organ Transplantation ,medicine.disease ,Tissue Donors ,Surgery ,Italy ,Skin cancer ,business ,Cohort study - Abstract
A population-based cohort study of recipients of organs from donors with a recognized history or active cancer has been conducted by linking the Italian National Registry of Transplanted Patients and the National Registry of Donors with Neoplasia Risk. Between 2002 and 2004, 8,198 solid organ transplants have been performed in Italy, 108 of them with organs from 59 cadaveric donors with various risk of neoplasia. There were two reported cases of nonmelanoma skin cancer during the follow up of the transplanted patients, which lasted 27.6+/-11.3 months (234 patient-years). In our study, recipients of organs from donors with various degree of neoplasia risk are exposed to a low risk of cancer transmission.
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- 2007
89. Criteria and terms for certified suitability of organ donors: assumptions andoperational strategies in Italy
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Sante, Venettoni, Walter, Grigioni, Paolo, Grossi, Andrea, Gianelli Castiglione, and Alessandro, Nanni Costa
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Hepatitis B Surface Antigens ,Tissue and Organ Procurement ,Incidence ,Decision Making ,Age Factors ,Organ Transplantation ,Hepatitis B ,Infections ,Risk Assessment ,Tissue Donors ,Central Nervous System Neoplasms ,Italy ,Risk Factors ,Neoplasms ,Practice Guidelines as Topic ,Cadaver ,Humans ,Guideline Adherence ,Registries - Abstract
Limited access to scarce resources, such as organs for transplantation, has increasingly prompted the use of elderly donors, with a consequent growth of possible risk factors linked to their particular features. Acceptable organ quality must therefore be guaranteed, without exposing recipients to unacceptable risks. For this reason, a set of guidelines for assessing donor suitability has been drawn up. This document standardizes the operative steps in the donor evaluation process and provides precise instructions for center staff. A pool of experts is available round the clock to offer advice on doubtful clinical cases. Such measures have allowed more effective use of available donors for transplantation.
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- 2007
90. Renal Function in Kidney and Liver Transplant Recipients After A 130-km Road Cycling Race
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Carlo Donati, Paola Todeschini, Giovanni Mosconi, Eric Ramazzotti, Alessandra Tacconi, Rocco Di Michele, Alessandro Nanni Costa, Manuela Trerotola, Marco Zancanaro, Valentina Totti, Giulio Sergio Roi, Mosconi, Giovanni, Roi, Giulio Sergio, Totti, Valentina, Zancanaro, Marco, Tacconi, Alessandra, Todeschini, Paola, Ramazzotti, Eric, Di Michele, Rocco, Trerotola, Manuela, Donati, Carlo, and Nanni Costa, Alessandro
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Transplantation ,medicine.medical_specialty ,Kidney ,Road cycling ,business.industry ,Renal function ,Original Clinical Science ,KIDNEY TRANSPLANTATION, RENAL FAUNCTION, FISICAL ACTIVITY ,Race (biology) ,medicine.anatomical_structure ,Medicine ,business ,Intensive care medicine ,Solid organ transplantation - Abstract
Background: A few patients, after receiving solid organ transplantation, return to performing various sports and competitions; however, at present, data no study had evaluated the effects of endurance cycling races on their renal function. Methods: Race times and short form (36) health survey questionnaires of 10 kidney transplant recipients (KTR) and 8 liver transplant recipients (LTR) transplanted recipients involved in a road cycling race (130 km) were compared with 35 healthy control subjects (HCS), also taking laboratory blood and urine tests the day before the race, at the end of the race, and 18 to 24 hours after competing. Results: The 3 groups showed similar race times (KTR, 5 hours 59 minutes ± 0 hours 39 minutes; LTR, 6 hours 20 minutes ± 1 hour 11 minutes; HCS, 5 hours 40 minutes ± 1 hour 28 minutes), similar short form (36) health survey scores, and similar trend of laboratory parameters which returned to baseline after 18 to 24 hours. After the race, there was an increase in creatinine (0.24 mg/dL; effect size [ES] = 0.78; P < 0.001), urea (22 mg/dL; ES = 1.42; P < 0.001), and a decrease of estimated glomerular filtration rate (−17 mL/min; ES = 0.85; P < 0.001). The increase of blood uric acid was more remarkable in HCS and KTR (2.3 mg/dL; ES = 1.39; P < 0.001). The KTR showed an increase of microalbuminuria (167.4 mg/L; ES = 1.20; P < 0.001) and proteinuria (175 mg/mL; ES = 0.97; P < 0.001) similar to LTR (microalbuminuria: 176.0 mg/L; ES = 1.26; P < 0.001; proteinuria: 213 mg/mL; ES = 1.18; P < 0.001), with high individual variability. The HCS had a nonsignificant increase of microalbuminuria (4.4 mg/L; ES = 0.03; P = 0.338) and proteinuria (59 mg/mL; ES = 0.33; P = 0.084). Conclusions: Selected and well-trained KTR and LTR patients can participate to an endurance cycling race showing final race times and temporary modifications of kidney function similar to those of HCS group, despite some differences related to baseline clinical conditions and pharmacological therapies. Patients involved in this study represent the upper limit of performance currently available for transplant recipients and cannot be considered representative of the entire transplanted population.
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- 2015
91. Epidemiological trends in nosocomial candidemia in intensive care
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Alessandro Nanni Costa, Claudio Viscoli, Matteo Bassetti, M. P. Molinari, Franco Bobbio Pallavicini, Raffaella Rosso, Elda Righi, and R. Fasce
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Adult ,Male ,medicine.medical_specialty ,Antifungal Agents ,Population ,lcsh:Infectious and parasitic diseases ,Medical microbiology ,Intensive care ,Epidemiology ,medicine ,Humans ,lcsh:RC109-216 ,Intensive care medicine ,education ,Fluconazole ,Fungemia ,Aged ,Candida ,Retrospective Studies ,Cross Infection ,education.field_of_study ,business.industry ,Incidence (epidemiology) ,Candidiasis ,Retrospective cohort study ,Middle Aged ,medicine.disease ,Drug Utilization ,Logistic Models ,Infectious Diseases ,Emergency medicine ,Etiology ,Female ,business ,Research Article - Abstract
Background Infection represents a frequent complication among patients in Intensive Care Units (ICUs) and mortality is high. In particular, the incidence of fungal infections, especially due to Candida spp., has been increasing during the last years. Methods In a retrospective study we studied the etiology of candidemia in critically ill patients over a five-year period (1999–2003) in the ICU of the San Martino University Hospital in Genoa, Italy. Results In total, 182 episodes of candidaemia were identified, with an average incidence of 2.22 episodes/10 000 patient-days/year (range 1.25–3.06 episodes). Incidence of candidemia increased during the study period from 1.25 in 1999 to 3.06/10 000 patient-days/year in 2003. Overall, 40% of the fungemia episodes (74/182) were due to C.albicans, followed by C. parapsilosis(23%), C.glabrata (15%), C.tropicalis (9%) and other species (13%). Candidemia due to non-albicans species increased and this was apparently correlated with an increasing use of azoles for prophylaxis or empirical treatment. Conclusion The study demonstrates a shift in the species of Candida causing fungemia in a medical and surgical ICU population during a 5 year period. The knowledge of the local epidemiological trends in Candida species isolated in blood cultures is important to guide therapeutic choices.
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- 2006
92. THE PRESENCE OF POSTTRANSPLANT HLA-SPECIFIC IgG ANTIBODIES DETECTED BY ENZYME-LINKED IMMUNOSORBENT ASSAY CORRELATES WITH SPECIFIC REJECTION PATHOLOGIES
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Bruno Brando, Sergio Stefoni, Alessandro Nanni Costa, Francesco Indiveri, Lucia Barbara DeSanctis, Maria Scolari, Giovanni Liviano D'Arcangelo, S. Iannelli, Borgnino Lc, Mario Savi, Andrea Buscaroli, and Vittorio Bonomini
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Cytotoxicity, Immunologic ,Graft Rejection ,chemistry.chemical_classification ,Transplantation ,Clinical events ,medicine.medical_treatment ,Enzyme-Linked Immunosorbent Assay ,Immunosuppression ,Human leukocyte antigen ,Specific igg ,Biology ,Serum samples ,Enzyme ,chemistry ,HLA Antigens ,Immunoglobulin G ,Immunology ,medicine ,biology.protein ,Humans ,Antibody - Abstract
Posttransplant monitoring of anti-HLA antibodies with routine techniques gives unsatisfactory results due to a variety of technical limitations. We investigated how a new alternative technique correlates with posttransplant clinical events. A total of 313 nonselected serum samples from 136 patients were screened by an ELISA utilizing captured soluble HLA class I antigens. We observed the absence of anti-HLA antibody production in acute rejection cases responding to standard antirejection therapy. On the other hand, we showed a clear presence of these antibodies in acute rejection episodes not responding to standard therapy (P
- Published
- 1997
93. Analysis of the complex effect of donor's age on survival of subjects who underwent heart transplantation
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Dino A. Mattucci, Alessandro Nanni Costa, Francesco Gabbrielli, Paola Pedotti, Sante Venettoni, and Emanuela Taioli
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Adult ,Graft Rejection ,Male ,medicine.medical_specialty ,Multivariate analysis ,Graft failure ,Adolescent ,medicine.medical_treatment ,Cohort Studies ,Internal medicine ,Medicine ,Humans ,Prospective cohort study ,Heart transplantation ,Transplantation ,Adult patients ,business.industry ,Graft Survival ,Age Factors ,Transplant Waiting List ,Middle Aged ,Tissue Donors ,Surgery ,Treatment Outcome ,Circulatory system ,Heart Transplantation ,Female ,business - Abstract
Background. Only half of the patients waiting for a heart transplant undergo surgery, whereas several patients continue to die while on the waiting list. Donor organ availability still represents a major problem with respect to reducing the length of the cardiac transplant waiting list. One option to improve donor availability is the use of so called marginal donors. The aims of the present study are to analyze the short-mid term survival of cardiac transplanted patients in Italy, and investigate the effect of donor age on prognosis. Methods. A prospective cohort study including all adult patients who underwent heart transplantations in Italy was used to analyze the main factors contributing to organ survival. Results. From 1995-2002, 2,504 adult subjects underwent a cardiac transplant, and were followed up for a period of 540.9 days. Overall, 1-year graft survival was 83.1%. Organs from donors older than 55 years had a lower survival than organs from younger donors. By multivariate analysis, both donor's and recipient's age seem to be important determinants of graft survival. A more sophisticated analysis shows that the trend of the risk of graft failure according to donor's age is not linear, with a peak at age 47.3 years, and differs according to sex. Conclusions. Results from the present analysis suggest that the association between heart transplant survival and donor's age is not a linear one, but follows a complex mathematical model, with influences of sex, at least in our sample.
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- 2005
94. Genomic allelotyping for distinction of recurrent and de novo hepatocellular carcinoma after orthotopic liver transplantation
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Antonio Daniele Pinna, Alessandro Nanni Costa, Kyriakoula Petropulacos, Rosella Petraroli, Antonia D’Errico Grigioni, Michelangelo Fiorentino, Walter F. Grigioni, Elisa Gruppioni, Annalisa Altimari, Lorenza Ridolfi, Altimari, A, Gruppioni, E, Fiorentino, M, Petraroli, R, Pinna, A D, Petropulacos, K, Ridolfi, L, Costa, A N, Grigioni, W F, and D'Errico-Grigioni, A
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Oncology ,Adult ,Male ,medicine.medical_specialty ,recurrence ,Carcinoma, Hepatocellular ,Orthotopic liver transplantation ,Genotype ,Polymerase Chain Reaction ,Pathology and Forensic Medicine ,law.invention ,law ,Internal medicine ,Medicine ,Humans ,Molecular Biology ,Polymerase chain reaction ,Alleles ,business.industry ,Liver Neoplasms ,hepatocellular carcinoma ,Cell Biology ,DNA, Neoplasm ,Middle Aged ,medicine.disease ,Primary tumor ,digestive system diseases ,Liver Transplantation ,surgical procedures, operative ,Tandem Repeat Sequences ,Hepatocellular carcinoma ,de novo tumors ,Microsatellite ,Female ,Neoplasm Recurrence, Local ,business - Abstract
Distinction between recurrent and de novo hepatocellular carcinoma (HCC) after orthotopic liver transplantation (OLT) bears important clinical and therapeutic implications. Techniques for molecular profiling of clinically suspected de novo and recurrent HCC are required since the histological/clinical discrimination of donor vs. recipient tumor origin is difficult. Multiple PCR amplification of 16 highly polymorphic short tandem repeat (STR) DNA sequences (routinely used for paternity and forensic assays) was applied in two patients who developed a second HCC after OLT. In both patients the technique provided reliable evidence that the two second HCC were recurrences of the primary tumor. Multiple STR genetic allelotyping is an effective tool for clear-cut discrimination of donor/recipient origin of a second HCC after OLT. Its application could be of great therapeutic relevance for such OLT patients.
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- 2005
95. External proficiency testing exercises on human leukocyte antigen typing in Italy between 1998 and 2002
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Mirella Mariani, Francesca Quintieri, Orsola Pugliese, Alessandro Nanni Costa, and Manuela Testi
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Medical education ,Bone marrow transplantation ,business.industry ,General Chemical Engineering ,media_common.quotation_subject ,Human leukocyte antigen typing ,General Chemistry ,Transplantation ,Clinical Practice ,Health care ,Proficiency testing ,Medicine ,Quality (business) ,Safety, Risk, Reliability and Quality ,business ,Instrumentation ,Accreditation ,media_common - Abstract
External proficiency testing exercises are essential tools for measuring the quality of different kinds of performances related to health care and to ensure that they are uniform throughout a region. For many years, the Italian National Transplant Centre and the Italian National Institute of Health have been organizing external proficiency testing exercises for serological and genomic human leukocyte antigen (HLA) typing, following the rules of the European Federation of Immunogenetics. This society provides accreditation for immunogenetical tests to those European countries which want to collaborate on programmes on solid organ and bone marrow transplantation. The results of the Italian external proficiency testing exercises are very satisfactory because of the progressive improvement of the quality of HLA typing seen in Italian laboratories between 1998 and 2002. The attained outcome will certainly guarantee a more reliable service in clinical practice, and will contribute to the process of approaching the highest quality in health care.
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- 2004
96. INTESTINAL BLEEDING FOLLOWING PANCREAS TRANSPLANTATION WITH ENTERIC DRAINAGE
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Gabriella Amorese, Piero Marchetti, Fabio Vistoli, Alessandro Campatelli, Laura Coletti, Franco Mosca, Ugo Boggi, M Del Chiaro, Rosa Giannarelli, Alessandro Nanni Costa, and Stefano Signori
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Transplantation ,medicine.medical_specialty ,Intestinal bleeding ,Enteric drainage ,business.industry ,Internal medicine ,medicine.medical_treatment ,medicine ,Pancreas transplantation ,business ,Gastroenterology - Published
- 2004
97. Isolation of human hepatocytes from livers rejected for liver transplantation on a national basis: Results of a 2-year experience
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Lorenza Ridolfi, Alessio Cariani, Andrea Sanna, Anna Maria Zambito, Mauricio Sainz-Barriga, Giuseppe Piccolo, Alessandro Nanni-Costa, Gian Luigi Adani, Fabrizio Bresadola, Mario Scalamogna, Andrea Risaliti, U. Baccarani, and Annibale Donini
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Liver Cirrhosis ,medicine.medical_specialty ,Tissue and Organ Procurement ,Cirrhosis ,Cell Survival ,medicine.medical_treatment ,Cell ,Cell Separation ,In Vitro Techniques ,Liver transplantation ,Gastroenterology ,law.invention ,law ,Internal medicine ,medicine ,Humans ,Transplantation ,Hepatology ,business.industry ,Liver cell ,Bioartificial liver device ,Albumin ,medicine.disease ,Liver, Artificial ,Liver Transplantation ,medicine.anatomical_structure ,Hepatocyte ,Hepatocytes ,Surgery ,business - Abstract
The offer of liver transplantation to many patients affected by liver failure is limited by organ shortage. Clinical application of human-based liver cell therapies, such as bioartificial liver and hepatocyte transplantation, might support liver transplantation, allowing more patients to be treated and decreasing mortality in the waiting list. The development of a standardized method of hepatocyte isolation is a mainstay for large-scale application of liver cell therapy. The aim of this study is to analyze retrospectively a 2-year experience of human hepatocyte isolation from livers rejected from transplantation at organ harvesting, performed on a national basis in Italy. All the livers judged unsuitable for transplantation were considered for hepatocyte isolation. Macrosteatosis greater than 60% was the most common reason of refusal, followed by nonviral cirrhosis. Fifty-four organs were used. Human hepatocyte isolation resulted in more that 7 million liver cells/g of tissue digested with 73% 14% viability. Steatotic organs gave better results in terms of cell yield than cirrhotic livers. Isolated hepatocytes were able to perform specific liver functions, and evidence of factor IX and albumin messenger RNA (mRNA) production was reported when cells were plated in culture. Modifications of the traditional method of hepatocyte isolation, aimed at reducing ischemia-reperfusion damage and improving post-isolation cell conditions, showed improvements in post-isolation viability. In conclusion, we show that it is possible to use the vast majority of livers not suitable for transplantation on a national basis for human hepatocyte isolation, obtaining a large amount of viable functioning human hepatocytes that might be used for cell transplantation and therapy. (Liver Transpl 2003;9:506-512.) B
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- 2003
98. European Living Donation and Public Health (EULID Project)
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Martí Manyalich, Assumpta Ricart, Ana Menjívar, Chloë Ballesté, David Paredes, Leonídio Días, Christian Hiesse, Dorota Lewandowska, George Kyriakides, Pål-Dag Line, Ingela Fehrman-Ekholm, Danica Asvec, Alessandro Nanni Costa, Andy Maxwell, Rosana Turcu, Martí Manyalich, Assumpta Ricart, Ana Menjívar, Chloë Ballesté, David Paredes, Leonídio Días, Christian Hiesse, Dorota Lewandowska, George Kyriakides, Pål-Dag Line, Ingela Fehrman-Ekholm, Danica Asvec, Alessandro Nanni Costa, Andy Maxwell, and Rosana Turcu
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- 2012
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99. Project NOTIFY: A Global Database of Serious Adverse Events and Reactions in Organs, Tissues, and Cells
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Deirdre Fehily, Alessandro Nanni Costa, Luc Noel, Michael G. Ison, E. Chatzixiros, and Douglas M. Strong
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Toxicology ,Transplantation ,medicine.medical_specialty ,business.industry ,medicine ,Intensive care medicine ,Adverse effect ,business - Published
- 2012
100. Survey On Directed Family Cord Blood Banking for Transplantation Among the National Cord Blood Bank Network in Italy
- Author
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Alessandro Nanni Costa, Simonetta Pupella, Paola Bargamaschi, Alberto Bosi, Serena Urbani, Laura Salvaneschi, Mauro Pagliarino, Luigina Fazio, Letizia Lombardini, Paola Saracco, Giuliano Grazzini, Riccardo Saccardi, Anna Tamburini, and Maria Screnci
- Subjects
medicine.medical_specialty ,business.industry ,Immunology ,Disease progression ,Cell Biology ,Hematology ,Prenatal care ,Biochemistry ,Preliminary analysis ,Transplantation ,Hemopoietic stem cell ,Cord blood ,Internal medicine ,Overall survival ,Medicine ,Sibling ,business - Abstract
Abstract 4195 Directed family cord blood (DCB) storage provides hemopoietic stem cell source for transplantation (HSCT) for families with an existing or a potentially future recipient with HSCT curable disease (D). The National CB Banks Network in Italy (ITCBN) has a leading role in providing public DCB service for high-risk families, in compliance to GITMO directives for eligibility criteria (HSCT curable D: malignant MD, non MD, inherited ID). To provide best cost-effective practices recommendations it is important to report on DCB procedures and HSCT rate (HSCT-R) among public Banks. By 12.12.2008 almost 1800 DCB units were stored in 18 Italian Banks and 104 (9%) issued for HSCT. The present survey aims at summarizing the over 15 yrs DCB experience among 5 ITCBN Banks active since 1997 (range 1990-1997), and including 670 DCB units. Results Preliminary analysis reports a 94% overall compliance to eligibility criteria directives, and overall HSCT- R for an alive sibling of 12% (63/522); the 63 HSCT were 97% matched, for curing ID in 84% and with 72 % overall survival outcome. Different policies among Banks were compared (Bank vs others: 1) eligibility criteria distribution : Bank PV06 DCB for MD Conclusion. Advice for public long-term DCB storage should depend on HLA compatibility, potential recipient, disease progression, and likelihood/ timing of using DCB; Italian CB Banks are actively cohoperating to find best public banking practices to ensure a CDB storage system that is ethical, cost effective and responsive to patient needs. Disclosures: No relevant conflicts of interest to declare.
- Published
- 2009
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