ISMETT

Last updated
ISMETT
Region of Sicily and the University of Pittsburgh Medical Center
ISMETTwordmark.png
ISMETT
Mediterranean Sea location map.svg
Red pog.svg
Location of ISMETT in the Mediterranean
Geography
LocationVia Ernesto Tricomi, 1, Palermo, Flag of Italy.svg  Italy
Coordinates 38°06′06″N13°21′29″E / 38.1016374°N 13.357948°E / 38.1016374; 13.357948 Coordinates: 38°06′06″N13°21′29″E / 38.1016374°N 13.357948°E / 38.1016374; 13.357948
Organisation
Funding Public-private partnership
Type Specialist
Services
Beds70
Speciality Organ transplantation
History
OpenedMarch 28, 1997
Links
Website http://www.ismett.edu/

ISMETT, in Italian, Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione translated as the Mediterranean Institute for Transplantation and Advanced Specialized Therapies, is a center for organ transplantation located in Palermo, Italy. ISMETT was founded in 1997 as a partnership between the Region of Sicily, the Civico and Cervello hospitals in Palermo, and the University of Pittsburgh Medical Center (UPMC). [1]

Contents

ISMETT primarily specializes in performing all types of organ transplantations, [2] using both deceased and living donor techniques. ISMETT has 70 beds (14 ICU, 21 in semi-intensive, and 35 inpatient), 7 outpatient beds, 4 operating rooms, a hospital pharmacy and laboratory analysis, infectious diseases and pathology in a facility that covers an area of 130,000-square-foot (12,000 m2).

History

The idea of creation of the Institute stemmed from a group of hepatologists at a hospital in Palermo that proposed to the University of Pittsburgh Medical Center (UPMC) the idea of a multi-organ transplant center to be realized in Sicily. Its creation was also prompted by a 1995 law passed in the United States that capped the total number of foreign patients that can be placed on a waiting list for transplants at 5%. For this reason, transplant leaders in Pittsburgh began looking toward opportunities in Europe and participated actively in the creation of a transplant center in Palermo. On May 23, 1996, the idea was presented to the Ministry of Health, who welcomed the project.

The first director was Ignazio R. Marino who performed the first successful liver transplantation in Sicily on July 31, 1999. Ignazio Marino's team performed the first 100 solid organ transplantations of ISMETT.

On March 20, 1997, the State-Region Conference officially approved the creation and clinical management of ISMETT in accordance with art. 9/bis of Legislative Decree no. 502/92 [1] and proceeded with construction of the new institute. The construction began in 1999 with the laying of a foundation stone and was completed in 2004 when the new center opened its doors.

As of 2007, ISMETT had revenues of €2,270,000. Its chairman was Camillo Ricordi, with Bruno Gridelli serving as its director-general and Ugo Palazzo serving as its director of health

Transplant activities

ISMETT began its clinical activity in 1999. On July 31, 1999 Ignazio Marino performed its first liver transplant from a cadaveric donor in Sicily. [3] The same year Ignazio Marino started a cadaveric and living donor kidney transplantation program. The team lead by Ignazio Marino performed the first 100 solid organ transplant at ISMETT. In 2004, ISMETT obtained permission to perform heart-lung transplants, thus becoming a multi-organ transplant center.

In 2003 ISMETT started a pediatric liver transplantation program, and that year performed the first children's transplant done in southern Italy. [4]

Transplantation of HIV+ patients

In 2001, Ignazio Marino performed the first living donor transplant into and HIV-positive patient in Italy, a procedure that created controversy and criticism, [5] including complaint from the Ministry of Health. The Ministry moved to censure Marino arguing that this particular type of transplant had the characteristics of clinical trials that required special authorization. That patient transplanted by Dr. Marino is still alive and enjoying an excellent quality of life free of dialysis, 16 years after the kidney transplant. Because of this success the rules in Italy have been changed and now HIV-positive patients are not any longer denied access to transplantation if they need it.

In 2007, for the first time in the world, an ISMETT team led by Dr. Bruno Gridelli performed a lung transplant on an HIV positive patient [6] In this case, the intervention was authorized by the Ministry and was included within an experimental program launched by the National Transplant Center. This time, no controversy was recorded and the procedure received congratulatory press.

The Cell Factory

In 2007, the Regenerative Medicine and Cell Therapy Unit (Unità di Medicina Rigenerativa e Terapie Cellulari), termed the Cell Factory, was opened at ISMETT with the aim to initiate a program of regenerative medicine that researches the reparation of damaged organs. [7] The mobile production laboratories (GMP Facility) of the unit have been made part of a project sponsored by the Region of Sicily and the Budget and Finance under the "ICT for the excellence of the territories."

Among the research trials carried out at the Cell Factory is the injection of fetal hepatocytes as a therapy to bridge the patients waiting for a liver transplant, transplantation of pancreatic islets for patients with diabetes type 1, and transplantation of human fetal skin cells for the treatment of lesions of the skin.

The Center for Simulation

The Center for Simulation became active at ISMETT in June, 2007 [8] with the aim to prevent and reduce medical errors. The use of simulation for training staff is already quite widespread in certain sectors such as aviation, and has now spread into the medical field. The simulation center provides for the implementation of higher risk procedures without risk to personnel and without involving patients.

The center has five life-sized and technologically sophisticated simulator mannequins that can mimic the signs and symptoms of real patients. The center was created thanks to a donation from the Foundation Fiandaca. The training activities of the centre, which is open to all health care providers, began in January, 2008 .

See also

Related Research Articles

Organ transplantation Medical procedure in which an organ is removed from one body and placed in the body of a recipient

Organ transplantation is a medical procedure in which an organ is removed from one body and placed in the body of a recipient, to replace a damaged or missing organ. The donor and recipient may be at the same location, or organs may be transported from a donor site to another location. Organs and/or tissues that are transplanted within the same person's body are called autografts. Transplants that are recently performed between two subjects of the same species are called allografts. Allografts can either be from a living or cadaveric source.

Liver transplantation

Liver transplantation or hepatic transplantation is the replacement of a diseased liver with the healthy liver from another person (allograft). Liver transplantation is a treatment option for end-stage liver disease and acute liver failure, although availability of donor organs is a major limitation. The most common technique is orthotopic transplantation, in which the native liver is removed and replaced by the donor organ in the same anatomic position as the original liver. The surgical procedure is complex, requiring careful harvest of the donor organ and meticulous implantation into the recipient. Liver transplantation is highly regulated, and only performed at designated transplant medical centers by highly trained transplant physicians and supporting medical team. The duration of the surgery ranges from 4 to 18 hours depending on outcome. Favorable outcomes require careful screening for eligible recipient, as well as a well-calibrated live or cadaveric donor match.

Everolimus Chemical compound

Everolimus is a medication used as an immunosuppressant to prevent rejection of organ transplants and in the treatment of renal cell cancer and other tumours. Much research has also been conducted on everolimus and other mTOR inhibitors as targeted therapy for use in a number of cancers.

Anti-thymocyte globulin (ATG) is an infusion of horse or rabbit-derived antibodies against human T cells, which is used in the prevention and treatment of acute rejection in organ transplantation and therapy of aplastic anemia.

Hematopoietic stem cell transplantation Medical procedure to replace blood or immune stem cells

Hematopoietic stem-cell transplantation (HSCT) is the transplantation of multipotent hematopoietic stem cells, usually derived from bone marrow, peripheral blood, or umbilical cord blood. It may be autologous, allogeneic or syngeneic.

Kidney transplantation Medical procedure

Kidney transplantation or renal transplantation is the organ transplant of a kidney into a patient with end-stage kidney disease. Kidney transplantation is typically classified as deceased-donor or living-donor transplantation depending on the source of the donor organ.

University of Pittsburgh Medical Center Global medical organization

The University of Pittsburgh Medical Center (UPMC) is a $21 billion integrated global nonprofit health enterprise that has 89,000 employees, 40 hospitals with more than 8,000 licensed beds, 700 clinical locations including outpatient sites and doctors' offices, a 3.7 million-member health insurance division, as well as commercial and international ventures. It is closely affiliated with its academic partner, the University of Pittsburgh. It is considered a leading American health care provider, as its flagship facilities have ranked in U.S. News & World Report "Honor Roll" of the approximately 15 to 20 best hospitals in America for over 15 years. As of 2016, flagship hospital, UPMC Presbyterian is ranked 12th nationally among the best hospitals by U.S. News & World Report and ranked in 15 of 16 specialty areas when including UPMC Magee-Womens Hospital. This does not include UPMC Children's Hospital of Pittsburgh which ranked in the top 10 of pediatric centers in a separate US News ranking.

Regenerative medicine Field of medicine involved in regenerating tissues

Regenerative medicine deals with the "process of replacing, engineering or regenerating human or animal cells, tissues or organs to restore or establish normal function". This field holds the promise of engineering damaged tissues and organs by stimulating the body's own repair mechanisms to functionally heal previously irreparable tissues or organs.

Thomas Starzl American physician

Thomas Earl Starzl was an American physician, researcher, and expert on organ transplants. He performed the first human liver transplants, and has often been referred to as "the father of modern transplantation." A documentary, entitled "Burden of Genius," covering the medical and scientific advances spearheaded by Starzl himself, was released to the public in 2017 in a series of screenings.

Lung transplantation

Lung transplantation, or pulmonary transplantation, is a surgical procedure in which a patient's diseased lungs are partially or totally replaced by lungs which come from a donor. Donor lungs can be retrieved from a living donor or a deceased donor. A living donor can only donate one lung lobe. With some lung diseases, a recipient may only need to receive a single lung. With other lung diseases such as cystic fibrosis, it is imperative that a recipient receive two lungs. While lung transplants carry certain associated risks, they can also extend life expectancy and enhance the quality of life for end-stage pulmonary patients.

Organ procurement is a surgical procedure that removes organs or tissues for reuse, typically for organ transplantation.

Policlinico of Milan Hospital in Milan, Italy

The Policlinico of Milan also known as Ospedale Maggiore di Milano or Ca' Granda Ospedale Maggiore Policlinico, is one of the oldest hospitals in Italy, founded by Duke Francesco Sforza in 1456. Today it is a modern hospital with 900 beds, with wards for adults, pregnant women and children. During the first COVID-19 breakout in March of 2020, 300 of those beds were readapted for COVID-19 patients.

Ignazio Marino

Ignazio Roberto Maria Marino is an Italian transplant surgeon who was Mayor of Rome from 2013 to 2015.

Transplantable organs and tissues may both refer to organs and tissues that are relatively often or routinely transplanted, as well as relatively seldom transplanted organs and tissues and ones on the experimental stage.

Arvinder Singh Soin

Arvinder Singh Soin is a surgeon and pioneer in the field of liver transplantation. Currently, he is the Chairman of the Institute of Liver Transplantation and Regenerative Medicine, Medanta-The Medicity, Gurgaon, India. In 2010, Soin was awarded the Padma Shri by the President of India for his contributions to the field of medicine. Dr. Soin is also Co-Founder & Director of Aayna Clinic, India's leading centre for cosmetic dermatology, with clinics across New Delhi and Punjab. He is a key medical influencer in various public health domains in India, and has been a leading healthcare figure on Twitter during COVID-19.

Christoph Broelsch was a German surgeon and former high school teacher. Broelsch pioneered the liver transplant surgery, when he perofrmed the first successful liver transplant on a child in 1989.

MIRA is a multidisciplinary and complementary method for treating many chronic diseases. The MIRA Procedure is a result of combining efforts from different medical fields developed in the University of Chicago in 1992. It basically consists in medically grafting live rejuvenated tissue in the form of autologous adipose adult stem cells to a damaged organ in order to restore it and improve its function. This method is currently approved by the U.S. Food and Drug Administration (FDA).

A liver support system is a therapeutic device to assist in performing the functions of the liver in persons with liver damage. Such systems focus either on removing the accumating toxins, or providing additional replacement of the metabolic functions of the liver through the inclusion of hepatocytes to the device. The artificial extracorporeal liver support these systems provide are being trialled to help people with acute liver failure (ALF) or acute-on-chronic liver failure.

Intestine transplantation

Intestine transplantation is the surgical replacement of the small intestine for chronic and acute cases of intestinal failure. While intestinal failure can oftentimes be treated with alternative therapies such as parenteral nutrition (PN), complications such as PN-associated liver disease and short bowel syndrome may make transplantation the only viable option. One of the rarest type of organ transplantation performed, intestine transplantation is becoming increasingly prevalent as a therapeutic option due to improvements in immunosuppressive regimens, surgical technique, PN, and the clinical management of pre and post-transplant patients.

UPMC Heart and Transplant Hospital Hospital in Pittsburgh, PA

UPMC Heart and Transplant Hospital at UPMC Presbyterian is a planned, 620-bed non-profit, specialty hospital located in Oakland, Pittsburgh, Pennsylvania. The hospital is planned to be adjacent and attached to UPMC Presbyterian, and will be a member of the health network, University of Pittsburgh Medical Center. The hospital is designed to highlight the world-famous transplant program at UPMC, made famous by pioneer, Dr. Thomas Starzl. UPMC Heart and Transplant Hospital will the region's largest hospital dedicated to one specialty. As the hospital is slated to be a teaching hospital, it will be affiliated with University of Pittsburgh School of Medicine.

References