Italy Increases in the number of organ donors and the quality of assistance. Now a legislative change is desirable to simplify the procedures.
organ donation: an issue which in Italy is working hard to achieve a real understanding. Are long waiting lists for transplant, the highest number of patients (especially children) waiting for a body to return to normal life, on their skin while undergoing a difficult stand-by that medication, hospitalizations, diets and treatments, as well as a huge burden of suffering family and a financial investment to the very core and public health spending.
Until a few years ago, 200-300 Italian patients each year, they went abroad to more easily obtain an organ. Today this procedure is less practical for several reasons: first, increased donor Italian, second foreign countries have put a stop to the increasing demands of patients non-residents; last but not least - and here is the good news - the quality of our transplant surgery has improved significantly, resulting in many cases higher than that of other countries.
is useful, however, know how things work in Italy at the time: there are dozens of transplant centers for adults and very few centers specializing in pediatric transplantation. The donor children is the child up to fourteen years and, although, fortunately, the number of children dying is small, this implies a further prolongation of waiting time, especially given the pediatric list, unlike that of adults, is a national list. For adults, in fact, easier to receive a compatible organ, since there is a greater availability numbers, it is a regional list (to the north, the situation seems to be easier, thanks to increased awareness on the subject), and also the higher the chance that an adult can die.
A step forward was made recently on the topic of liver transplantation. Indeed, when the donor is an adult, the organ is treated with the method split-liver (literally "split liver"), a method that can satisfy two requests in one shot. In fact, dividing the liver into two parts, the left lobe, smaller, is intended to a pediatric recipient, and the right lobe, larger, to a recipient adult. Abroad, this may satisfy the needs of younger patients is more easily materialized, as the pediatric donors are considered children under eighteen years of age, this allows the specialists to divide the organ most frequently so the donor can save two lives at once.
Another growing method is that of living donor transplant from . That is, where is a person still alive to donate his organ (usually kidney, or part of the liver); This is possible when the tissue for transplant is compatible with the recipient. This mode is not unusual for relatives to be more complicated if the donor is a stranger to the family of the recipient. If there is no relationship between the two, is planned for the immediate intervention of the Judiciary, which must approve the procedure only after having ascertained that there are economic interests attributable to the sale of organs for a fee, but that it is an act of pure and totally free, very difficult thing to prove, in addition to practicing!
At Christmas 2009, much fanfare and tenderness elicited news of a mother who, at the age of forty-eight, twenty-eight gave a kidney to his son and saving him from dialysis and restoring a normal life. Same story happened last July in Treviso, not to mention the numerous other similar cases unfinished papers.
Another mode of living donors is that the bone marrow. Virtually painless and harmless, it can be done by anyone in good health and at any time, since the bone will "bank" waiting for a compatible receiver. In 2000 he became the news story of the conductor Fabrizio Frizzi, today testimonial ADM (Association of Bone Marrow Donors), which, thanks his generous gesture saved the lives of Valeria Favorito, now twenty years old, from a very aggressive form of acute myeloid leukemia. Two days after the bone marrow, Frizzi was safely in the conduct of a television program.
The quality of life of a transplanted organ over the years has improved considerably, and today, three years after surgery, a transplant kidney survival was 86%, 82% and a heart the liver to 73%, results comparable to those of the best centers abroad for organ transplantation.
With anti-rejection therapy, only 15% of patients can be said for not having taken the quality of life - including work - he had before his illness, and more is being tested to handle the rejection well, because the dosage and composition of drugs must take into account both the risk of excessive immunosuppression of the individual, is actual risk of contracting cancer in later years, just because of the medication.
The better for our country should be addressed on two fronts: the first is the enrichment of information that would help citizens to offer themselves as organ donors, this would avoid the length of the request to the family of a deceased pick up the bodies, because everything would be done automatically due to prior agreement to that end there are several associations - including AIDO el'ADO - offering an inscription that would legally take advantage if the candidate donor was going to meet death. The other front on the legislation, which could be updated taking into account the parameters of other countries where the donor is regarded as children until the age of eighteen, which could save the lives of many children waiting for a compatible organ.
A great feeling of optimism pervades us, observing the growth of stem cell research. These cells, taken from peripheral blood or umbilical cord, allow in the near future to repair damaged tissues and even organs, the first results that come from different groups of experiments are encouraging. The donation of the umbilical cord, therefore, requires an appropriate information campaign, so that at the time of childbirth, the mother, in agreement with the health facilities where it is active in a Bank of the umbilical cord, gives what would otherwise be thrown away from the hospital waste, but which turns out to be a legacy of hope for someone.
The blood remained within the cordon, rich in stem cells, is sucked and "bank" immediately after that, having stopped beating, the umbilical cord is cut, giving a real chance of recovery from serious illnesses such as beta-thalassemia.
Finally, a reflection is mandatory: when it expires in the squalor of commercializing the man as a kind of machine spare parts, reaching a low technical content of ethics, the very nature rebels against disease producing . This is the case of testing done on embryonic stem cells, which did not produce any significant results, but only the proliferation of cancer. When, however, for the love man, it combines science with a good ethics in order to heal without having to suppress another life, we discover how the human being has been created to give themselves, multiply and return.
Sabrina Pietrangeli Paluzzi
for optimism No 46, January 27, 2011
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