The Kidney Transplant Center at the Gemelli Polyclinic Foundation (GPF) started his activities in 1970, under a specific authorization from the Italian Ministry of Health.
Today four Living donors Kidney Transplant Program are active at the GPF:
All patients with end stage renal failure on chronic dialysis treatment with a potential living donor, related or unrelated, are evaluated for living donor kidney transplantation. This program includes AB0 compatible and HLA compatible recipients.
All patients with end stage renal failure and creatinine clearance below 15 ml/min are enrolled in this program. It is possible to receive a transplant from a compatible living donor, related or unrelated, instead of starting a dialysis treatment.
All patients with end stage renal failure (creatinine clearance below 15 ml/min), with a potential living donor, related or unrelated, but with incompatible blood group, are enrolled in this program. When ABO incompatibility is present between donor and recipient, pre-transplant desensitization is mandatory.
The desensitization with plasmapheresis is indicated in the presence of anti-A, anti-B, anti-AB titers. Before and during the desensitization process immunosuppressive treatment is given before the transplant. In a few cases, it may not be possible to desensitize the recipient and so direct transplantation may not be feasible. In this case, Paired Kidney Donation is the best treatment available.
For patients with a positive cross-match due to the presence of anti-HLA or anti-AB0 antibodies, a program of paired living donor kidney exchange is dedicated, in order to find a compatible combination, within a national or international pool of other incompatible couples. Practically, when donors and their recipients are not compatible for a transplant and cannot be desensitized, matching with another couple, in the same condition, may results in an acceptable combination for the transplant.
If both donors and recipients are willing to participate in the PKD program, the transplant is scheduled when a possible combination is found in the list. PKD programs provide a way for incompatible couples to receive a living-donor transplant, instead of being on dialysis and on the deceased-donor waiting list for several years.
Absolute contraindication to renal transplantation are active infections, recent neoplasia, unresolved anomalies of the urinary tract in the recipient.
Before renal transplantation, donors and recipients will be extensively evaluated to rule out contra-indications to the transplant. The evaluation will be complete within one week. If no contra-indications will be found during the evaluation process, compatible couples can be transplanted in the following week.
The Liver Transplant Medicine Unit deals with patients with chronic and neoplastic liver disease, also considering assessing their suitability to be placed on the waiting list at our transplant center.
The unit is in charge of the clinical management of patients during the period of stay on the waiting list for OLT both in hospital and outpatient settings.
The unit supports fellow surgeons in the management of medical problems incident in post-transplantation both in the early and late stages. All the activities of the UOC aimed at liver transplantation are carried out in synergy both with the transplant surgical team and with the other professional figures of hepatological interest of the Foundation.
The assistance activities of the UOC are divided into 9 standard hospital beds, of which 5 in elective hospitalization, located on the 7th floor wing P and in an outpatient location located within the liver disease center ( floor 3 wing A, visits by appointment on Wednesdays and Thursdays).
