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Dallapiccola B, Moriconi S, Rugge M, Cardillo M, Carcassi C, Colledan M, Strologo LD, Vici CD, Facchin P, Gridelli B, La Rocca V, Lombardini L, Mazzucato M, Peritore D, Amoroso A. Organ Donation from Patients with a Rare Disease is Often Safe: The Italian Guidelines. Clin Transplant 2022; 36:e14769. [PMID: 35906735 DOI: 10.1111/ctr.14769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/19/2022] [Accepted: 07/04/2022] [Indexed: 11/29/2022]
Abstract
Although a disease is defined as rare when it has a prevalence of less than 1: 2000, the overall prevalence of rare diseases in the population is greater than 1%. Among potential organ donors, a similar frequency is observed. To date, guidelines have not been established, and operational decisions have been made empirically, case- by-case, based on the experience and expertise of clinicians. For this reason, the Italian Superior Health Council (CSS) has appointed a working Group to address "patients with a rare disease as potential organ donors", with the aim of devising recommendations for the management of transplant cases in which the donors have a rare disease. This group evaluated 493 diseases (10% of all rare diseases, including over 95% of patients with a rare disease) to deliver a technical report dealing with the suitability of organ donation and transplantation, with a focus on the organs most frequently used, including kidney, liver, heart, lung, and pancreas. This work has made it clear that a rare disease "per se" does not contraindicate organ donation at all. Indeed, in donors affected by a rare disease, almost 80% of the organs are suitable for transplantation, approximately 7% are unsuitable, and approximately 14% are suitable as non-standard with an acceptable risk. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Bruno Dallapiccola
- Direzione Scientifica IRCCS Ospedale Pediatrico Bambino Gesù, IRCCS, Roma, Italy.,Consiglio Superiore di Sanità, Ministero della Salute, Italy
| | | | - Massimo Rugge
- Consiglio Superiore di Sanità, Ministero della Salute, Italy.,Ospedale Giustinianeo, Padova - Università degli Studi di Padova - Direttore Registro Tumori del Veneto, Italy
| | - Massimo Cardillo
- Consiglio Superiore di Sanità, Ministero della Salute, Italy.,Centro Nazionale Trapianti, Istituto Superiore di Sanità, Roma, Italy
| | - Carlo Carcassi
- Dipartimento di Scienze Mediche e Sanità Pubblica, Università di Cagliari - U.O.C. Genetica Medica ASSL Cagliari - Ospedale R. Binaghi, Cagliari, Italy
| | - Michele Colledan
- SC Chirurgia Generale 3, Trapianti addominali, Ospedale di Bergamo - ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Luca Dello Strologo
- U.O.C. di Follow-up del Trapianto Renale, Dipartimento Pediatrie Specialistiche, IRCCS Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Carlo Dionisi Vici
- U.O.C. Patologia Metabolica, Dipartimento Pediatrie Specialistiche, IRCCS Ospedale Pediatrico Bambino Gesù, Roma, Italy
| | - Paola Facchin
- Unità di Epidemiologia e Medicina di Comunità, Dipartimento di salute della donna e del bambino, Università di Padova, Italy.,Coordinamento Malattie Rare Regione del Veneto, Azienda Ospedale Università di Padova, Italy
| | - Bruno Gridelli
- IRCCS ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), Palermo - Fondazione Ri.MED, Italy
| | | | | | - Monica Mazzucato
- Coordinamento Malattie Rare Regione del Veneto, Azienda Ospedale Università di Padova, Italy
| | - Daniela Peritore
- Centro Nazionale Trapianti, Istituto Superiore di Sanità, Roma, Italy
| | - Antonio Amoroso
- Dipartimento di Scienze Mediche, Università di Torino - Centro Regionale Trapianti Regione Piemonte - SC Immunogenetica e Biologia dei Trapianti Az, Ospedaliera Universitaria Città della Salute e della Scienza, Torino, Italy
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