113 results on '"Alessandro Nanni Costa"'
Search Results
102. The Counselling by CNT for the Exportation of Umbilical Cord Stem Cells for Autologous Use
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Giorgia Santangelo, Alessandro Nanni Costa, Sante Venettoni, Francesca d’Alessandro, Elisa Faraci, Antonella Tancredi, Erica Villa, Silvia Pisanu, and Letizia Lombardini
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Service (business) ,medicine.medical_specialty ,Higher education ,business.industry ,Immunology ,Exportation ,Information quality ,Cell Biology ,Hematology ,Biochemistry ,Surgery ,Test (assessment) ,Transplantation ,Donation ,Family medicine ,Telephone number ,medicine ,business - Abstract
The Italian law does not currently offer the service of collecting and preserving a cord blood unit for autologous use within Italy if there are no indications that these cells can be used for familiar use; whilst it allows for the exportation of these units to be stored in banks outside Italy. The authorisation for exportation is issued by the Ministry of Health, after counselling with the Centre National Transplantation. The counselling provides a telephone number for the user of this service (usually future mothers) to contact experienced personnel (medic and non) and it was intended to help make decisions based on accurate and complete information, with the appropriate support, including psychological support. From 2005 to July 2008, 13,400 counsels were made. The number of contacts has increased greatly over the years and they have increased from 58 in the first year to 6858 during 2007. During 2008 (January-July period) there were on average 31 contacts per day, for a total of 3760. During the interviews information was gathered on: personal data of the future mother, education qualifications, date of birth, name of the structure where the the birth was to take place and the name of foreign bank where the collected sample was to be exported to. The future mothers were also asked for their reasons to want the collection and autologous preservation. The average age of women who requested counselling was 34 years with a range from 18 to 58 years. 70% of women were primipare and here the demand for autologous conservation came from a desire to ensure a “biological insurance” for their child. The same reason was reported by the multiparous women, but often in this case the autologous conservation was motivated both by a voluntary donation to the previous pregnancy (30%) and by a disease present in their first or another child (15%). At the beginning of the exportation request, a clear prevalence of women with academic qualifications (degree) was revealed, whilst further into the procedure the female graduates accounted for 53%, those with diploma of higher education averaged at 42% and lower education at 40%. Most women liked the interview for the additional information that was provided further to that received from the private bank, not least because the information was supported by scientific data. This has meant that a small but significant number of women decided not to continue with the exportation procedure (53 women), whilst 63 decided to donate. One of the reasons for exportation was linked to the limitations of the opening hours of the structures where the cord blood units can be stored. However 37% of women who have given birth in structures equipped for donation, said they definitely did not take this hypothesis into account. In all cases where the pregnancy came about after artificial insemination, the parents opted for exportation. Most pregnant women were informed of the possibility of exportation by their gynecologist or by the test laboratory, without being given any scientific information and there were a few cases where parents were also informed of the possibility of donation. It is necessary that in the future Italy enhances collection and donation and that the scientists and institutions make an effort to improve the quality of information along with the greater dissemination of the idea of donation, in contrast to the now growing tendency on the part of private companies to encourage a “biological insurance” where purely economic interests often come before any scientific aim or health protection.
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- 2008
103. Guest Editors’ Introduction
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Alessandro Nanni Costa and Emanuela Taioli
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Transplantation ,medicine.medical_specialty ,business.industry ,medicine ,Physiology ,Cancer risk ,Solid organ transplantation ,Intensive care medicine ,business - Published
- 2008
104. Prevalence of hypertension in a potential donors population
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Alessandro Nanni Costa, Angelo Ghirardini, Paolo Mazzetti Gaito, Maria Rosa Pugliese, Nicola Venturoli, Lorenza Ridolfi, Daniela Degli Esposti, Gerardo Martinelli, and Petrini F
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medicine.medical_specialty ,education.field_of_study ,business.industry ,Internal medicine ,Population ,Internal Medicine ,medicine ,Organ donation ,education ,business ,Cutaneous collagenous vasculopathy ,Surgery ,Cause of death - Published
- 2001
105. Hypertension, left ventricular hypertrophy and organ suitability to transplantation in potential donors
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Marzia Monti, Daniela Degli Esposti, Alessandro Nanni Costa, Angelo Ghirardini, Lorenza Ridolfi, Petrini F, Maria Rosa Pugliese, Paolo Mazzetti Gaito, Gerardo Martinelli, and Nicola Venturoli
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medicine.medical_specialty ,Kidney ,Lung ,End organ damage ,business.industry ,medicine.disease ,Left ventricular hypertrophy ,Transplantation ,medicine.anatomical_structure ,Internal medicine ,Internal Medicine ,medicine ,Cardiology ,Organ donation ,business ,Cutaneous collagenous vasculopathy ,Cause of death - Published
- 2001
106. Response
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Sergio Stefoni, Alessandro Nanni-Costa, and Vittorio Bonomini
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- 1992
107. Hospital attitude survey on organ donation in the Emilia-Romagna region, Italy
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Alessandro Nanni Costa, Angelo Ghirardini, Paolo Mazzetti Gaito, Lorenza Ridolfi, Maria Rosa Pugliese, Nicola Venturoli, Ada Dormi, and Daniela Degli Esposti
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Adult ,Male ,medicine.medical_specialty ,Tissue and Organ Procurement ,Attitude of Health Personnel ,media_common.quotation_subject ,MEDLINE ,Transplant coordinator ,Transplant surgery ,Medicine ,Humans ,Organ donation ,media_common ,Aged ,Transplantation ,business.industry ,Middle Aged ,Surgery ,Organ procurement ,Knowledge ,Italy ,Family medicine ,Donation ,Grief ,Female ,business - Abstract
The role of hospital staff in the organ procurement process is crucial. Nevertheless, there is little literature about their attitudes toward donation. The Donor Action Hospital Attitude Survey (HAS) comprises a series of questions to assess hospital staff's attitudes, beliefs, and knowledge on organ donation and transplantation. Further analysis of the data will help identify any weak areas in the staff viewpoint and information, highlight potential needs for more education on specific issues, and establish a baseline to monitor future improvements. We used the Donor Action HAS in the Emilia-Romagna region, Italy. The aim of this paper is to assess and better understand the personnel's viewpoint in the 12 main hospitals of the region. The survey was carried out among hospital staff involved in organ donation. 1576 responses were collected (52 % of distributed questionnaires), of which 1024 came from nurses, 475 from physicians, and 77 from other backgrounds. Questions were subdivided into categories, and for every point an overall mark (maximum 3/3) was calculated. Results: 1. Involvement in donation process during the past year: 1.24 /3, 2. Attitudes to organ donation (OD): 2.51 /3, 3. Skills / Self-confidence in donation practices: 1.36 /3, 4. Satisfaction with local transplant coordinator (TC) services: 2.31 /3. The attitude towards organ donation was positive, 1386 respondents support organ donation. A high percentage (93.6 % of respondents) is of the opinion that transplantation helps save other people's lives. Most uncertainty arises on the question whether donation helps families with grief. It is remarkable that only 53 % of those prepared to donate organs have informed the family of their wish. Many respondents do not feel comfortable performing key tasks close to donation. Major difficulties were observed in explaining to a family the concept of brain death (0.98 /3). Knowledge on the concept of brain-death was one of the most requested subjects for improvement. Emilia-Romagna is the region with one of the highest donation rates in Italy (29.9 pmp in 2000). Nevertheless, more profound knowledge of the local situation could help further improve donation.
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108. A colloquium on the congress 'A gift for life. Considerations on organ donation'
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Martí Manyalich, Nunziata Comoretto, Eduardo Martin Escobar, Alessandro Nanni Costa, Mariangela Gritta Grainer, Jose O. Medina-Pestana, Pier Paolo Donadio, Francis L. Delmonico, Félix Cantarovich, Valter Duro Garcia, Mario Abbud-Filho, Blanca Martinez Lopez de Arroyabe, Beatriz Domínguez-Gil, Anna Guermani, Antonio Gioacchino Spagnolo, Gregorio Garrido, J M. Simón i Castellvì, Jean Laffitte, Rafael Matesanz, Elisabeth Coll, Ferdinand Muehlbacher, Walter Schaupp, Marco Brunetti, Beatriz Mahillo, G. Paez, Ricardo Valero, Riccardo Bosco, Alexandra K. Glazier, Francesco Giordano, and Håkan Gäbel
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Transplantation ,Tissue and Organ Procurement ,Ethical issues ,biology ,business.industry ,Religion and Medicine ,Garcia ,Congresses as Topic ,Morals ,biology.organism_classification ,Tissue Donors ,Italy ,Patient Education as Topic ,Social Justice ,Cadaver ,Living Donors ,Humans ,Medicine ,Family ,Organ donation ,business ,Humanities - Abstract
Alessandro Nanni Costa, J. M. Simon i Castellvi, Antonio G. Spagnolo, Nunziata Comoretto, Jean Laffitte, Hakan Gabel, Francis L. Delmonico, Ferdinand Muehlbacher, Walter Schaupp, Alexandra K. Glazier, Valter D. Garcia, Mario Abbud-Filho, Jose O. Medina-Pestana, Mariangela Gritta Grainer, Pier Paolo Donadio, Anna Guermani, Riccardo Bosco, Francesco Giordano, Blanca Martinez Lopez de Arroyabe, Marco Brunetti, Marti Manyalich, Gloria Paez, Ricardo Valero, Rafael Matesanz, Elisabeth Coll, Beatriz Dominguez-Gil, Beatriz Mahillo, Eduardo Martin Escobar, Gregorio Garrido, and Felix Cantarovich
109. Improving donor identification with the Donor Action programme
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Maria Rosa Pugliese, Daniela Degli Esposti, Ada Dormi, Nicola Venturoli, Paolo Mazzetti Gaito, Andrea Buscaroli, Kyriakoula Petropulacos, Alessandro Nanni Costa, and Lorenza Ridolfi
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Adult ,Male ,Brain Death ,Patient Identification Systems ,Transplantation ,Tissue and Organ Procurement ,Italy ,Humans ,Female ,Middle Aged ,Tissue Donors ,Aged - Abstract
The increasing demand for organs for transplantation entails a consensual need for enhancement of organ procurement activity. As organ donors reside mainly in hospital intensive care units (ICUs), the Donor Action programme is aimed at identifying critical areas in ICUs, in order to improve the first step of organ donation. The purpose of this paper is to analyse the problem of identification of potential donors by means of a chart revision of patients who died in 14 ICUs in the Emilia-Romagna region between 1 July 1998 and 31 December 2000. All deaths and patients with severe brain insult (score on Glasgow Coma Scale (GCS) = 3/15) were assessed by the local transplant coordinators together with a professional at the Transplant Reference Centre. Brain death diagnoses and potential donor referrals were therefore assessed in the study period, which was subdivided into five semesters. Of the 3,056 deaths reported in 30 months, 1,248 were due to severe brain damage (GCS score = 3). Brain death diagnosis (BD) was performed in 509 patients (40.8%). Although we applied the same parameters over the whole length of the study, we observed a significant increase in BDs (from 87 in the first semester to 125 in the last, 30.5% to 53.0% of the patients with GCS 3 ( P=0.003, chi(2) for trend=16.072), in spite of a slight decrease in the total number of deaths and in the total number of patients with GCS score = 3 (from 649 to 587, and from 44% to 41%, respectively). Study population characteristics could have contrasted with rather than facilitated our results: age and gender did not change significantly, whilst cause of death showed a significant reduction in trauma and an increase in cerebrovascular incidents over the whole length of the study. We can conclude that the more careful assessment of patients dying in ICUs, by the Donor Action programme, significantly contributed to the improvement of BDs observed in the study period. Therefore, Donor Action seems to be an efficient quality control programme to improve identification of potential donors, the first stage of organ procurement.
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110. External proficiency testing exercises on human leukocyte antigen typing in Italy between 1998 and 2002.
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Francesca Quintieri, Orsola Pugliese, Mirella Mariani, Manuela Testi, and Alessandro Nanni Costa
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PERFORMANCE ,IMMUNOGENETICS ,BONE marrow transplantation ,TRANSPLANTATION of organs, tissues, etc. - 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. [ABSTRACT FROM AUTHOR]
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- 2004
111. Hepatitis B-core Antibody Positive Donors in Liver Transplantation and Their Impact on Graft Survival: Evidence From The Liver Match Cohort Study
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Angelico M, Nardi A, Marianelli T, Caccamo L, Romagnoli R, Tisone G, Pinna AD, Avolio AW, Fagiuoli S, Burra P, Strazzabosco M, Nanni Costa A, U Cillo, P Caraceni, P L Toniutto, M Salizzoni, G Bertolotti, D Patrono, L De Carlis, A Slim, J M E Mangoni, G Rossi, 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, G L Grazi, A Cucchetti, C Zanfi, A Risaliti, M G Faraci, A Anselmo, I Lenci, D Sforza, S Agnes, M Di Mugno, G M Ettorre, L Miglioresi, G Vennarecci, Roma Sapienza, 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, C Gavrila, A Ricci, F Vespasiano, Angelico, M, Nardi, A, Marianelli, T, Caccamo, L, Romagnoli, R, Tisone, G, Pinna, A, Avolio, A, Fagiuoli, S, Burra, P, Strazzabosco, M, Costa, A, M, Angelico, A, Nardi, T, Marianelli, L, Caccamo, R, Romagnoli, G, Tisone, Ad, Pinna, Aw, Avolio, S, Fagiuoli, P, Burra, M, Strazzabosco, A, Nanni Costa, Cillo, U, Caraceni, P, L Toniutto, P, Salizzoni, M, Bertolotti, G, Patrono, D, De Carlis, L, Slim, A, E Mangoni, J M, Rossi, G, Antonelli, B, Mazzaferro, V, Regalia, E, Sposito, C, Colledan, M, Corno, V, Tagliabue, F, Marin, S, Vitale, A, Gringeri, E, Donataccio, M, Donataccio, D, Baccarani, U, Lorenzin, D, Bitetto, D, Valente, U, Gelli, M, Cupo, P, E Gerunda, G, Rompianesi, G, L Grazi, G, Cucchetti, A, Zanfi, C, Risaliti, A, G Faraci, M, Anselmo, A, Lenci, I, Sforza, D, Agnes, S, Di Mugno, M, M Ettorre, G, Miglioresi, L, Vennarecci, G, Sapienza, Roma, Berloco, P, Rossi, M, Ginanni-Corradini, S, Molinaro, A, Calise, F, Scuderi, V, Cuomo, O, Migliaccio, C, Lupo, L, Notarnicola, G, Gridelli, B, Volpes, R, Li Petri, S, Zamboni, F, Carbotta, G, Dedola, S, Gavrila, C, Ricci, A, Vespasiano, F, Mario Angelico, Alessandra Nardi, Tania Marianelli, Lucio Caccamo, Renato Romagnoli, Giuseppe Tisone, Antonio D. Pinna, Alfonso W. Avolio, Stefano Fagiuoli, Patrizia Burra, Mario Strazzabosco, Alessandro Nanni Costa, For the Liver Match Investigators [.., Paolo Caraceni, and ]
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Male ,HBsAg ,medicine.medical_treatment ,Settore MED/18 - CHIRURGIA GENERALE ,graft survival ,De novo HBV infection ,Donor Risk Index ,Donor-recipient matching ,HBcAb positive donors ,Liver transplantation ,medicine.disease_cause ,Gastroenterology ,Cohort Studies ,Model for End-Stage Liver Disease ,MED/12 - GASTROENTEROLOGIA ,HBcAb positive donor ,liver transplantation ,Prospective Studies ,Prospective cohort study ,Settore MED/12 - Gastroenterologia ,Hepatitis B Core Antigen ,Hazard ratio ,Middle Aged ,Hepatitis B ,Hepatitis B Core Antigens ,Tissue Donors ,Italy ,Hepatocellular carcinoma ,HCV ,outcome ,Female ,Human ,hbcab positive donors ,Adult ,medicine.medical_specialty ,donor risk index ,HBcAb positive ,Tissue Donor ,survival ,donor-recipient matching ,Donor Selection ,Hepatitis B Antibodie ,HBV, liver transplantation ,Internal medicine ,medicine ,Humans ,de novo hbv infection ,Hepatitis B Antibodies ,Donor-recipient matching, HBcAb positive donors, De novo HBV infection, Donor Risk Index ,Aged ,Hepatitis B virus ,Hepatitis ,Hepatology ,business.industry ,LIVER TRANSPLANTATION ,medicine.disease ,Surgery ,Prospective Studie ,Liver Transplantation ,Graft Survival ,Cohort Studie ,business - Abstract
Background & Aims: The appropriate allocation of grafts from HBcAb positive donors in liver transplantation is crucial, yet a consensus is still lacking. Methods: We evaluated this issue within Liver Match, a prospective observational Italian study. Data from 1437 consecutive, first transplants performed in 2007-2009 using grafts from deceased heart beating donors were analyzed (median follow-up: 1040 days). Of these, 219 (15.2%) were HBcAb positive. Sixty-six HBcAb positive grafts were allocated to HBsAg positive and 153 to HBsAg negative recipients. Results: 329 graft losses occurred (22.9%): 66 (30.1%) among 219 recipients of HBcAb positive grafts, and 263 (21.6%) among 1218 recipients of HBcAb negative grafts. Graft survival was lower in recipients of HBcAb positive compared to HBcAb negative donors, with unadjusted 3-year graft survival of 0.69 (s.e. 0.032) and 0.77 (0.013), respectively (log-rank, p = 0.0047). After stratifying for recipient HBsAg status, this difference was only observed among HBsAg negative recipients (log rank, p = 0.0007), 3-year graft survival being excellent (0.88, s.e. 0.020) among HBsAg positive recipients, regardless of the HBcAb donor status (log rank, p = 0.4478). Graft loss due to de novo HBV hepatitis occurred only in one patient. At Cox regression, hazard ratios for graft loss were: MELD (1.30 per 10 units, p = 0.0002), donor HBcAb positivity (1.56, p = 0.0015), recipient HBsAg positivity (0.43, p
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- 2012
112. Italian Transplant Research Network. Quality and safety in the Italian donor evaluation process
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Nanni Costa A, Grossi P, Gianelli Castiglione A, GRIGIONI, FRANCO, ALESSANDRO NANNI COSTA, Nanni Costa A, Grossi P, Gianelli Castiglione A, and Grigioni WF
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The shortage of available organs, has increasingly prompted the use of elderly donors, with a consequent growth of possible risk factors. In this context the risk of donor-recipient transmission of infectious or neoplastic pathologies may be considered as a major issue; in each case for each organ potentially available, acceptable quality must be provided and unacceptable risks must be avoided. METHODS: We are presenting here the process of risk management followed by the Italian centers. In 2001, the Italian National Transplant Centre created a national commission of experts, with the mission of defining guidelines for the evaluation process of the potential organ donor. As a supplement to these measures, the Italian National Transplant Centre has supported transplant network health workers through ad hoc developed information tools and an expert task force (second opinion) for evaluation of doubtful cases. RESULTS: Starting from the date of guidelines application and second opinion start up, 9519 potential cadaveric donors were reported in Italy. Of these, 1611 presented a neoplastic or infectious risk. Over this period, 4861 donors were used for transplantation, equal to 48.5% of reported donors. Among the 1611 donors, who had been diagnosed at risk, 674 were neoplastic-disease affected donors and 937 infection-disease affected donors. CONCLUSIONS: At the European level, several new activities have been recently implemented to increase organ safety. In Italy, new guidelines and actions to ensure organ safety have been implemented. The evaluation of the impact of these actions will be performed in the near future.
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- 2008
113. Italian Transplant Research Network. The Italian multiorgan donor cancer screening protocol: 2002-2005 experience
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Zucchini N, FIORENTINO, MICHELANGELO, Rizzato L, Venettoni S, Nanni Costa A, D'ERRICO, ANTONIETTA, GRIGIONI, FRANCO, ALESSANDRO NANNI COSTA, Zucchini N, Fiorentino M, D'Errico Grigioni A, Rizzato L, Venettoni S, Nanni Costa A, and Grigioni WF.
- Published
- 2008
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