title: Italy-Greece cooperation for transplantation of medically urgent Greek patients: is it an effective, efficient model?
abstract: BACKGROUND
  In 2005 the Italian National Transplant Centre (CNT) signed a cooperation agreement with the Hellenic Transplant Organization (HTO) fostering the transfer and transplantation of urgent Greek liver patients at Italian transplantation centers. So as to not reduce access to transplantation for Italian patients, the agreement provided compensation for organs allocated to Greek transplant recipients. The aim of this study was to analyze the flow of patients from Greece to Italy and the number of received livers to consider the possibility to extend this kind of agreement to other countries, so that this should not penalize Italian recipients.
  
  
  METHODS
  The agreement provides the possibility for Greek patients affected by acute disease to be transferred to Italian transplantation centers participating in the agreement. Until 2008 livers transplanted into Greek recipients were returned through a preferential offer of surplus Greek organs, whereas from 2009 an obligation of payback was introduced.
  
  
  RESULTS
  During the reviewed period requests for transfer, transferred patients, and number of patients who later underwent transplantation in Italy were 56, 26, and 23, respectively. Livers offered by the Greek organization that were accepted, transferred, and transplanted in Italy have been 82, 50, and 44, respectively.
  
  
  CONCLUSIONS
  According to our analysis, the cooperation has had as positive impact for both Greece, which has difficulties transplanting urgent recipient because of the low number of donors, and for Italy, which is not penalized by the use of an organ in a Greek recipients, but is also rewarded for helpfulness.
authors.affiliation: CIR OCST "Italian Gate to Europe", Umberto I Policlinico Hospital, La Sapienza University, Italy. daniper33@hotmail.com
authors.forename: D
authors.initials: D
authors.lastname: Peritore
authors.forename: R
authors.initials: R
authors.lastname: Pretagostini
authors.forename: P
authors.initials: P
authors.lastname: Di Ciaccio
authors.forename: P
authors.initials: P
authors.lastname: Fiaschetti
authors.forename: F
authors.initials: F
authors.lastname: Gabbrielli
authors.forename: A
authors.initials: A
authors.lastname: Oliveti
authors.forename: D
authors.initials: D
authors.lastname: Stabile
authors.forename: A
authors.initials: A
authors.lastname: Ricci
authors.forename: F
authors.initials: F
authors.lastname: Vaia
authors.forename: A
authors.initials: A
authors.lastname: Nanni Costa
mesh_terms: D006115:Greece; D006801:Humans; D007558:Italy; D016031:Liver Transplantation; D014195:Travel; D016896:Treatment Outcome