L'albero della vita di Gustav Klimt
Centro Trapianti di reni dell'Ospedale di Circolo di Varese.
Luned� 21 gennaio 2008, � stato eseguito presso l'Azienda Ospedaliera di Varese il primo trapianto renale da donatore vivente. Si tratta di due coniugi, risultati compatibili. L'intervento � stato eseguito da un'equipe interdisciplinare composta da chirurghi della Chirurgia generale, diretta dal prof. Renzo Dionigi, Coordinatore del Centro Trapianti, dell'Urologia, diretta dal prof. Alberto Marconi, della Chirurgia vascolare, diretta dal prof. Patrizio Castelli e dal prof. Salvatore Cuffari, anestesista. L'intervento di asportazione del rene dal donatore vivente � stato eseguito con la tecnica chirurgica mini-invasiva per via laparoscopica, mentre il trapianto del rene � stato eseguito secondo la tecnica tradizionale chirurgica.
Oltre 400 sono i trapianti di rene eseguiti dal 1996: � il soddisfacente bilancio del Centro Trapianti di reni dell'Ospedale di Circolo di Varese. Era l'ottobre del 1996 quando l'equipe guidata dall'allora primario di Urologia, il prof. Aldo Bono, in collaborazione con la Nefrologia diretta dal prof. Luigi Gastaldi, esegu� il primo trapianto di rene. Da quegli anni l'attivit� del Centro Trapianti ha segnato un aumento progressivo di anno in anno: 51 i trapianti effettuati nel 2007, portando il Centro varesino al quarto posto in Lombardia per numero di interventi, dopo il Niguarda, il Policlinico di Milano, e il Centro di Brescia.
L'attivit� del Centro Trapianti � condotta in collaborazione con l'U.O. Nefrologia, diretta dal dott. Giacomo Colussi, e coordinata dal dott. Donato Donati che cura con il dott. Andrea Ambrosini il monitoraggio delle problematiche nefrologiche e la terapia immunosoppressiva, mentre le procedure di prevenzione ed il controllo delle eventuali complicanze infettive vengono gestite dal prof. Paolo Grossi, direttore dell'U.O. Malattie Infettive, nonch� second opinion di tutto il territorio nazionale.
Nel febbraio 2006, si � effettuato anche il primo trapianto combinato di rene-pancreas in paziente HIV positivo. Il Centro Trapianti di Varese � l'unico in Italia ad essere autorizzato all'esecuzione di tale metodica. Secondo analogo intervento si � effettuato nell'aprile del 2007.

Insufficienza renale cronica e indicazioni al trapianto.
I reni hanno il compito di depurare il sangue filtrando un gran numero di sostanze dannose. In alcuni soggetti, tuttavia, queste funzioni possono alterarsi, o perch� i reni non riescono a trattenere regolarmente gli elettroliti (sali minerali presenti nelle cellule, fondamentali per determinare l'equilibrio dei liquidi nel corpo) o perch� l'organo non � pi� in grado di mantenere nel sangue le sostanze nocive entro i limiti sopportati dall'organismo. L'insufficienza renale cronica � caratterizzata da una perdita permanente della funzione renale. Le sostanze di rifiuto dell'organismo si accumulano nel sangue e possono portare a una intossicazione che, con il passare degli anni, pu� arrecare danni anche irreversibili. I sintomi che devono far pensare ad una insufficienza renale cronica sono: pressione alta, stanchezza, scarso appetito e pallore. La causa � spesso una malattia, come l'ipertensione, il diabete e la glomerulonefrite (membranosa, membrano-proliferativa, glomerulosclerosi focale, nefropatia IgA, malattia policistica). Queste ultime comprendono un gruppo di malattie infiammatorie del rene che colpiscono le strutture funzionali pi� importanti dell'organo: i glomeruli, cio� gli elementi microscopici deputati alla filtrazione dei prodotti di scarto e alla loro eliminazione con le urine.
L'emodialisi e la dialisi peritoneale, terapia d'obbligo nei casi pi� gravi della malattia, non permettono un recupero dello stato funzionale dei reni, inoltre determinano una dipendenza temporale alla macchina dialitica per molte ore la settimana, con importanti limitazioni della sfera sociale e lavorativa. Il trapianto renale invece pu� permettere un recupero di molti aspetti correlati con la funzione renale e soprattutto riduce o addirittura annulla le limitazioni socio-lavorative, favorendo un netto miglioramento della qualit� di vita. Il trapianto quindi � il trattamento di scelta dell'insufficienza renale cronica.
© 2005 Ospedale di Circolo e Fondazione Macchi
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21 Aprile 2008
Questioni etico-deontologiche, medico-giuridiche e sociali

Dal 4 al 11 Maggio 2008
Ministero della Salute
Regioni e Provincie Autonome
Attivit�
Un po' di storia
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...
Attivit� di donazione e trapianto Anno 2007
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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