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Italy-US Cross Kidney Donation Agreement Signed

Italy-US Cross Kidney Donation Agreement Signed

Rome, 8 September. (Adnkronos Salute) – A new opportunity to treat about 6 thousand patients waiting for a kidney transplant: this is the goal of the Memorandum of Understanding between Italy and the United States to launch a pilot program for kidney donation in a cross-modal way. , was signed today at the Ministry of Health. The agreement was signed by the National Transplantation Center (Cnt), represented by director Massimo Cardillo, and the Alliance for Paired Kidney Donation (Apkd), a non-profit foundation that manages one of the living kidney transplant programs in the United States. Its chairman, Michael A. Reese was represented by the director of the Kidney Transplant Center at the University of Toledo Medical Center in Ohio.

Overall, 2,043 kidney transplants were performed in Italy in 2021, of which 341 were from living donors: 5 of these were carried out through exchanges between donor and recipient pairs. The signing of the protocol was attended by Pierpaolo Silleri and Ignacio Marino, executive director of the Jefferson Italy Center, an organization that promotes health cooperation initiatives between Thomas Jefferson University in Philadelphia and Italian institutions.

“Currently about 30% of live kidney transplants are impossible due to incompatibility between the donor and the recipient – Sillery said – according to today’s agreement, although currently in the pilot phase, the search for a cross-compatible donor-recipient pair extends to a numerically homogeneous and genetically diverse population like the United States, This increases the probability of identifying compatible donors for these difficult-to-transplant patients who would otherwise require lifelong dialysis. The program can be expanded in the future to provide more options for those who unfortunately have none today.”

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The new Italy-US project concerns so-called ‘crossover’ kidney transplants, i.e. the mutual ‘transfer’ of an organ between a couple whose donor is genetically incompatible with its recipient, but compatible with the recipient. Another couple. Thanks to the agreement between Cnt and Apkd, pairs of Italian and American patients will be able to cross each other based on a shared algorithm that checks the level of compatibility between those registered on the two waiting lists: in this way, vulnerable chronic kidney failure patients and those with an unsuitable volunteer donor will have more chances to receive the transplant they need.

Along with technical-operational aspects (requirements of participating hospitals, applicable procedures, overall management of operations), the agreement provides that transplant-related costs will be borne by the US patient and US insurance for patients. Italian donor. , the Italian National Health Service will cover the costs for the Italian patient and the American donor. Donors will travel: The removal and subsequent kidney transplant will actually take place in the recipient’s country. The pilot phase concerns the first three cases and will be limited to three hospitals: for Italy, the Renal Transplantation Center of the Gemelli Hospital in Rome directed by Franco Citterio will participate when the contract is signed. Hospital Poles of the University of Toledo Medical Center and Thomas Jefferson University in Philadelphia, USA. Once the functional and management test is completed, the project will be re-evaluated for possible integration of the protocol and progressive expansion to other living kidney transplant centers of the Italian network.

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The one with the United States is the second international transaction protocol that our country has implemented: since 2018, an agreement involving France, Portugal and Spain has been in force, resulting in precisely three cross-substitutions with the latter nation. From 2015 to date, the Italian national crossover kidney transplant program has allowed 77 interventions to be carried out.

“Living kidney transplants are an excellent treatment option for recipients and completely safe for donors, but to date they account for less than 17% of kidney transplants performed each year in Italy – commented Cardillo – a percentage of strong growth, but still not enough and many are still waiting. Respond to patients. This agreement between Italy and the United States really opens a new frontier and will allow to significantly increase the chances of establishing positive matches between different patients “. The final goal is an international network of cross-transplants: “Starting from this experience, we can work for a cooperation agreement between all European countries, which will allow the internationalization of cross-donation programs. The benefit of patients “.

“In the United States, about 20% of the 6,000 living kidney transplants are performed thanks to transplants. We believe that this collaboration between Cnt and Apkd will significantly increase opportunities for Italian and American patients with kidney failure”, notes Reese. “The exchange of kidneys – he noted – shows us how differences can be a value and a resource: enlarging the donor pool increases the chances of transplantation, since genetic incompatibility is more easily recorded among ethnically homogeneous populations. “Rather than what happens today in crossing with citizens of southern Europe, the Italian The US population will give patients more opportunities to find compatible donors.

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