title: Renal transplantation. Strategies to prevent organ rejection--the role of an inter-regional reference center.
abstract: This paper summarizes the role of the Inter-Regional Reference Center (RC) of the North Italy Transplant program (NITp), in coordinating a donor procurement and organ transplantation network, with a special focus on the strategies to minimize immunological risk and complications after transplantation. In the NITp, patients enrolled on the renal transplantation (RT) waiting list are typed for HLA-A,B,DRB1 antigens with a genomic method. They are periodically screened for the presence of lymphocytotoxic antibodies in their serum by the RC and their suitability to receive the transplant is checked periodically. Cadaver kidney allocation is ruled by a computerized algorithm, named NITK3, established in 1997, which aims at ensuring quality, equity, transparency and traceability during all the phases of the allocation decision-making process. NITK3 has been set up by the NITp Working Group on the basis of biological, medical and administrative criteria and it is periodically reviewed after the analysis of transplant results. In this paper, we show the results of a preliminary analysis of RTs performed from 1998 to 2002 in nine out of sixteen centers of the NITp area, which demonstrates the general quality of the NITp program in terms of patients and graft survival and the special attention to the patients at higher immunological risk.
authors.affiliation: Dipartimento Trasfusionale e di Riferimento per il Trapianto di Organi e Tessuti, RCCS Ospedale Maggiore Policlinico, Milano; Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Cardillo
authors.forename: Francesca
authors.initials: F
authors.lastname: Poli
authors.forename: Fiorenza
authors.initials: F
authors.lastname: Barraco
authors.forename: Nicola De
authors.initials: N
authors.lastname: Fazio
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rossini
authors.forename: Luigi
authors.initials: L
authors.lastname: Boschiero
authors.forename: Arcangelo
authors.initials: A
authors.lastname: Nocera
authors.forename: Paolo
authors.initials: P
authors.lastname: Rigotti
authors.forename: Francesco
authors.initials: F
authors.lastname: Marchini
authors.forename: Graziella
authors.initials: G
authors.lastname: Zacchello
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Zanon
authors.forename: Silvio
authors.initials: S
authors.lastname: Sandrini
authors.forename: Stefano
authors.initials: S
authors.lastname: Chiaramonte
authors.forename: Cristina
authors.initials: C
authors.lastname: Maresca
authors.forename: Rossana
authors.initials: R
authors.lastname: Caldara
authors.forename: Piergiorgio
authors.initials: P
authors.lastname: Messa
authors.forename: Luisa
authors.initials: L
authors.lastname: Berardinelli
authors.forename: Andrea
authors.initials: A
authors.lastname: Ambrosini
authors.forename: Domenico
authors.initials: D
authors.lastname: Montanaro
authors.forename: Teresa
authors.initials: T
authors.lastname: Rampino
authors.forename: Enrico
authors.initials: E
authors.lastname: Minetti
authors.forename: Eliana
authors.initials: E
authors.lastname: Gotti
authors.forename: Luciana
authors.initials: L
authors.lastname: Ghio
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ginevri
authors.forename: Fulvio
authors.initials: F
authors.lastname: Albertario
authors.forename: Mario
authors.initials: M
authors.lastname: Scalamogna
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D006801:Humans; D007558:Italy; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D016730:Program Development; D015397:Program Evaluation; D012042:Registries; D014019:Tissue Donors; D009927:Tissue and Organ Procurement / Q000458:organization & administration*; D014850:Waiting Lists