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M Scalamogna

Publications and source records attributed to M Scalamogna.

At least 73 records · Page 4Linked to original sources
PubMed1995

Cadaver kidney transplantation in the north Italy transplant program in the nineties.

The most relevant changes which have taken place in the NITp in the nineties include the introduction of HLA-DRB1 matching, the extension of both recipient and donor selection criteria, and an increase in donor procurement and consequently, in transplantation activity. Some of the changes in policy resulted from extensive analysis of our previous experience. For the future years, the NITp has set the following priorities: Consolidate the increase of donor procurement activity registered in the past 15 months by educational campaigns for health workers and the public, and organizational measures aimed at strengthening ICUs, nominating transplant coordinators and introducing a system of reimbursement for organs procured. Improve the quality of results in terms of patient rehabilitation and cost-benefit through: continued evaluation of protocols for patient admission on the waiting lists and careful selection of donors; and prospective use of genomic HLA Class II matching and also consider genomic typing for HLA Class I which is almost a reality. Establish a single pool of patients on the waiting list evaluated according to common protocols with the possibility of performing the transplant in each of the authorized centers in turn, respecting the best HLA match and the local use of organs. Finally, standards for donor treatment, organ procurement, histocompatibility testing and transplantation must be established. For this purpose, accreditation programs which have begun to be applied in Europe seem to be the adequate tool.

Adolescent↗
PubMed1993

Genomic HLA-DR compatibility in long-term surviving recipients of cadaver kidney transplants.

The finding that HLA-DR compatibility assessed by DNA typing correlates with short-term graft outcome better than serology prompted us to study the degree of genomic HLA-DR compatibility on 55 patients with a graft functioning for more than 10 years (group A), compared with 82 patients with more recent transplants regardless of survival (group B). Because adequate blood donor samples were not available for group A long-term survivors, we used donor renal cells obtained by fine needle aspiration biopsy as a source of DNA. We found that in long-term survivors, the distribution of HLA-DR mismatches was significantly different from that observed in group B patients. In particular, whereas a similar proportion of patients with 1 mismatch was seen in both groups, 27.3% of group A patients vs. 6.1% of group B patients had no mismatch, and 23.6% of group A vs. 41.5% of group B patients received transplants with no HLA-DR compatibility (P = 0.001). We also investigated a possible correlation between number of incompatibilities and graft function. Well-matched patients received less steroid pulses than less well-matched recipients, and steroid-resistant rejection episodes were more common among less well-matched recipients. These results suggest a prognostic role of genomic HLA-DR compatibility on long-term success of cadaver kidney transplantation.

Adult↗
PubMed1986

The cadaver kidney transplant program of North Italy before and after cyclosporine.

NITp is an organization that since 1972 has served an area of approximately 17 million inhabitants through 8 transplant centers, 20 active donor-procuring centers, and 1 coordinating center. The activity of NITp can be divided into three historical periods. In the first period (1972-1977, 408 transplants), collaboration was initiated and protocols implemented. In the second (1978-1982, 592 transplants), a policy was established as follows: three deliberate transfusions of standard packed red cells were given pretransplant to all untransfused patients on the waiting list. Priority was given to immunized patients when an HLA-A, -B-compatible kidney was available and an effort was made to ensure at least two HLA-A, -B matches to nonimmunized patients. All transplanted patients were treated with conventional therapy (corticosteroids and azathioprine). Evaluation of data of this period showed that both graft and patient survival had increased; a center effect was evident; the policy of giving a kidney with at least two HLA-A, -B matches seemed to improve the results; and preformed panel-reacting antibodies had a negative effect on graft survival. The third period began in January 1983 when some centers in the NITp started to use CsA. By December 31, 1985, 589 of 863 transplants performed had been treated with CsA. Data analysis showed that CsA significantly increased the one-year success rate in both first and second transplants; other factors, such as HLA-A, -B and -DR matching, transplant center, old age of the kidney donor (51-60 years), and cold and warm ischemia times seemed less or not important. Preformed panel-reacting lymphocytotoxic antibodies did not influence graft outcome significantly, but a trend was observed in that immunized recipients did worse than non-immunized recipients. The transfusion effect could not be evaluated in our CsA patients since they all are transfused pretransplant; a prospective study is necessary to evaluate if such an effect is still present. Until more data are collected in our setting to allow a sound evaluation of the consequences of CsA treatment, no changes are warranted in the NITp policy.

Cyclosporins↗
PubMed1982

Effectiveness of red blood cells filtered through cotton wool to prevent antileukocyte antibody production in multitransfused patients.

The effectiveness of red blood cells made leukocyte-free by filtration through cotton wool to prevent the production of antileukocyte antibodies was evaluated in children suffering from Cooley's anemia. Two studies were performed: study I was carried out prospectively in two groups of non transfused patients, one group treated with leukocyte-free filtered red cells, the other with buffy-coat-free packed red cell units. Different types of antileukocyte antibodies were looked for in both groups and the results were compared. In study II the behavior of pre-existing lymphocytotoxic antibodies found in the serum of children previously transfused with standard or buffy-coat-free packed red cell units was followed after the patients had been passed to a program of transfusion with leukocyte-free filtered red cells. Study I showed that none of the patients transfused with leukocyte-free filtered red cell units have produced antileukocyte antibodies, while these could be found in 2/3 of the patients transfused with buffy-coat-free packed red cell units. Study II showed that the repeated transfusion of leukocyte-free filtered red cells to patients who possessed in their serum preformed lymphocytotoxic antibodies did not cause any increase in the potency or spectrum of these antibodies, but was in fact accompanied in some cases by their decrease or disappearance. It is concluded that filtration through cotton is an easy and inexpensive means of preparing leukocyte-free red blood cells for transfusion capable of preventing (or reducing) the production of antileukocyte antibodies in multitransfused patients.

Antilymphocyte Serum↗