Italy and Spain recently successfully transplanted two patients, the first in Pisa and the second in Barcelona by undertaking an international cross-kidney transplantation chain (the so-called “cross over” program), involving two non-compatible donor-recipient pairs from Barcelona and Pisa.
This success was made possible thanks to the South Alliance for Transplant (SAT), an international agreement involving Spain, France, Italy and Portugal aiming to increase welfare responses to patients waiting to receive a transplant by expanding the pool of potential donors to those patients who can not receive the organ from their donor, due to the presence of specific antibodies which determine its incompatibility.
In practice, in a case of incompatible donor-receiving couples, the search for compatible donors will, under the “international crossover protocol”, spread across the border, thereby giving the possibility to an incompatible donor-receiving couple to receive and donate a kidney crossing their immunological compatibility with those of another donor-receiving couple in the same condition, from a neighbor country.
In this particular case, the first research to identify the international cross-over chain involved 113 incompatible donor-recipient pairs (79 Spanish couples, 19 Portuguese and 15 Italian) and 14 hospitals (10 Spanish, 1 Portuguese and 3 Italian- Pisa, Siena and Bologna ).
The start of the close collaboration between the experts of the CNT (National Transplant Center) and the ON (Organización Nacional Trasplantes) for the setting up of the chain dates back to 23 May and required an intense commitment to the coordination of all phases of immunological evaluation and organizational coordination. The picking and transplanting operations were carried out in Italy at the University Hospital of Pisa and in Barcelona with through the renal transplantation surgical team of the Puigvert Foundation of the Autonomous University of Barcelona.
The realization of this project represents, according to the Director of the National Transplant Center dott. Alessandro Nanni Costa “an essential and innovative tool to enlarge the pool of potential donors, as well as an important opportunity for growth for both systems, considered unanimously among the most advanced organizations in Europe and in the world”.
Since 2015, a national cross-over program has been active in Italy, involving 21 couples and allowed to perform 21 transplants (of which 17 couples have returned to cross-over chains from a Samaritan donor). To date, 36 couples are active in the national crossover program .
In March 2018, the first crossover chain triggered by a deceased donor was undertaken by the University of Padua. A second chain of this type took place in July. Using deceased donors to start the chain will increase the pool of potential compatible donors and boost the number of chains involving incompatible couples and patients.
Check out the schedule and steps that led to this unique achievement here.