La parola all'esperto
Il rischio infettivo nel donatore d'organi
A cura di Prof. Paolo Grossi, Direttore U.O. Malattie infettive e tropicali
La carenza di donatori d�organo rappresenta un serio problema in tutto il mondo. Nonostante il notevole incremento del numero di donatori registrato nel nostro paese negli ultimi anni, (l�Italia si pone oggi ai primi posti nella graduatoria europea con un tasso di donazioni pari a 21,1 per milione di abitanti e rappresenta il Paese Europeo che ha registrato negli ultimi anni il pi� elevato tasso di crescita), la possibilit� di soddisfare le richieste di trapianto di rene, cuore e polmone rimane ancora insufficiente.
L�insufficiente reperimento di donatori, il rapporto rischi/benefici attesi con il trapianto e i tempi di trapianto (ischemia) condizionano modalit� e valutazione di idoneit� del potenziale donatore. Nonostante questi limiti e pur considerando che nella pratica trapiantologica, anche se viene tenuto un comportamento conforme con l�applicazione delle linee guida, il rischio di trasmissione di patologie sia infettive che neoplastiche � sempre presente; qualsiasi organo prelevato a scopo di trapianto deve avere una qualit� accettabile e non deve esporre il ricevente a rischi elevati. Al fine di incrementare il numero di organi disponibili per il trapianto, nel corso degli ultimi anni sono stati prelevati organi da donatori ad �idoneit� relativa�, quali donatori con infezione da virus dell�epatite B o C per riceventi che abbiano la medesima infezione e donatori con malattie infettive purch� trattate adeguatamente.
Con l�obiettivo di regolamentare tali pratiche, che devono peraltro rientrare solo nell�ambito di specifici protocolli di studio, come sancito dal decreto del Ministero della Salute del 2 agosto, 2002: Disposizioni in materia di criteri e modalit� per la certificazione di idoneit� degli organi prelevati a scopo di trapianto, sono state redatte a cura del Centro Nazionale Trapianti le linee guida sulla sicurezza del donatore d�organi.
Le linee-guida si prefiggono pertanto di definire i livelli di rischio. L�esito di un trapianto da donatore cadavere dipende da molteplici fattori, legati in parte alle condizioni del ricevente ed in parte alle caratteristiche del donatore.
Poich� il paziente in attesa per un trapianto pu� ricevere un organo a rischio aumentato, occorre sottolineare l�importanza consenso informato al momento dell�inserimento in lista, momento questo di riflessione che permette di valutare a freddo tutti gli aspetti del problema, affiancato anche dal proprio medico di fiducia, al fine di permettere alla persona stessa l�acquisizione di maggiore consapevolezza.
© 2005 Ospedale di Circolo e Fondazione Macchi
byNet Promotion sas
Societ� del gruppo
21 Aprile 2008
Questioni etico-deontologiche, medico-giuridiche e sociali
Dal 4 al 11 Maggio 2008
Ministero della Salute
Regioni e Provincie Autonome
Un po' di storia
Attivit� di donazione e trapianto Anno 2007
Il 12 settembre 1973 Christian Barnard, cardiochirurgo del �Groothe Schuur� di Citt� del Capo partecipava ad un congresso della Societ� dei Trapianti tenutosi a Villa Ponti a Varese...
Negli ultimi 10 anni l�Italia � il Paese europeo dove si � realizzato il pi� grande incremento in termini di donatori utilizzati ed oggi...
La parola all'esperto
Il rischio infettivo nel donatore d'organi
La carenza di donatori d�organo rappresenta un serio problema in tutto il mondo. Nonostante il notevole incremento del numero di donatori registrato nel nostro paese negli ultimi anni...
Il ruolo dell'infermiere
I dati della Regione Lombardia in materia di trapianti sono stati positivi per il 2007. I donatori utilizzati nel corso dello scorso anno sono stati 195, 2 in pi� rispetto all'anno precedente...
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