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Abruzzo and Molise are two regions located in central Italy. They have 1.273.665 and 327.987 inhabitants respectively. These regions have 15 hospitals with Intensive Care Units (ICU), 4 of which have neurosurgery units. The total number of hospital beds is 5350, 87 of these are ICU beds. In 2001 Abruzzo and Molise Transplant Reference Centre received 60 notifications of brain-dead patients as potential organ donors. In 35 cases (58.3%) organ procurement did not take place; in 23 cases (38.3%) for objection of the family of the deceased, in 11 cases (18.3%) for medical reasons, in 1 case (1.6%) for cardiac arrest. There were 25 actual donors (41.6% of the total number of potential donors reported) from whom organs were retrieved for transplantation. This means 15,5/milion population. The donors were 9 women and 16 men. Donor age ranged between 3 and 80 years (mean age 51,9 years). The organs retreived from 21 out of 25 actual donors (35%) were transplanted. Sixteen cases were multi-organ (76%), with an average of 2.6 organs per donor. In order to evaluate the real donor potential in Abruzzo and Molise and emeliorate the quality of donation process, our Transplant Reference Centre collected data regading dead patients with cerebral diseases. Herein we reported first six months results of 2001. Hospitals (Hosp.)Hosp. bedsICU bedsHosp. deaths ICU deathsDead patients with cerebral diseases not in ICU Dead patients with cerebral diseases in ICU W Neursurgery24813211701979358 W/o Neurosurgery2869557921639958 Total5350871962360192116 Analyzing these data we can point out that more patients with cerebral diseases die outside ICU (192 vs 116), likely because some of these patients with poor prognosis of functional recovery have not been admitted in ICU, for shortage (87/5350) or no optimal utilization of ICU beds The following data were calculated by appling international organ procurement efficiency indexes (donors per 100 hospital beds, donors per 100 hospital deaths, donors per 100 ICU deaths). HospitalsPotential donors awaited /year2001 referred potential donors Hospital beds (range)Hospital deaths(range)ICU deaths W Neurourgery30-11130-695440 W/o Neurosurgery34-6720-314420 Total64-17850-1009860 In Abruzzo and Molise organ procurement value is near to the national rate (17.1 pmp), but should be greatly improved, both by perfecting the programm of donor identification and persisting in embarked educational programms in order to reduce the rate of objections.

To assess the ability of peripheral blood mononuclear cells (PBMC) of patients with systemic sclerosis (SSc) to produce interleukin 6 (IL-6), transforming growth factor beta 1 (TGF-beta 1), to identify the IL-6 producer cells in the in vitro model, and to correlate these data with the clinical evidence of our patients.We used a sandwich ELISA to quantitate IL-6 and TGF-beta 1 levels in sera, plasma, and supernatants, and an imunofluorescence technique to evaluate IL-6 producing cells in our patients.IL-6 was detected in sera from 8 of 20 patients and no controls (p0.05). A significant increase of IL-6 production was observed in both spontaneous and phytohemagglutinin (PHA) induced cultures of PBMC from patients with SSc vs controls. No differences in TGF-beta 1 production were observed, either in sera or supernatants, between patients and controls. A significant increase of IL-6 synthesizing cells was observed after 3 h of PHA stimulation in patients vs controls (p0.05).Spontaneous IL-6 production and the higher number of IL-6 producing cells in patients with SSc suggest that these cells have been already primed in vivo. The absence of PBMC primed for TGF-beta 1 production supports the hypothesis that cells other than lymphocytes produce and secrete this cytokine in the skin of patients. Higher serum levels of IL-6 observed in a subset of patients did not correlate with either severity or duration of disease.