Transport of Human Organs in Italy: Location, Time, and Performances

doi:10.1016/j.transproceed.2017.02.033

Transplantation Proceedings

Volume 49, Issue 4, May 2017, Pages 622-628

https://doi.org/10.1016/j.transproceed.2017.02.033 Get rights and content

Abstract

Introduction

The outcome of transplantation activities depends on a variety of unpredictable factors. Up-to-date criteria on organ allocation foresee an efficient transport chain along with compliant performance parameters.

Methods and Objectives

The Centro Nazionale Trapianti and the Department of Civil, Chemical, Environmental, and Materials Engineering of the University of Bologna (respectively, CNT and DICAM) have been updating a national database of organ transplantation activities to investigate performance parameters and the main causes of disruption.

Results

Between June 2015 and July 2016, 617 of 1061 organs have been shipped by air (making for 486 flight events), of which 407 were accompanied by medical equipment. Origin/destination and distance matrixes have been drawn for both road and air transport. Each airport node is ranked based on the n° of organs ingoing/outgoing and each route link on its frequency. Performance parameters such as average speed, distance covered, and time have been computed and compared with each organ's cold ischemia time (CIT). Average distance frontiers are rather homogeneous, but much effort is necessary to reduce the number of events performed with approximately 90% or more of CIT spent.

Conclusions

The monitoring of organ transplantation activities' performance is a standalone action within Europe to support strategic policies to optimize the system. Thus, a clearer awareness on performances and issues related to organ transport has been made possible: analyses show that the higher uncertainty associated with total time of displacement by air is due to the steps which take place by road (length and paths must be optimized) and lung transports generally perform weaker than heart transports due to longer average distances travelled and smaller average speeds, often resulting in a total displacement time greater than 90% of CIT.

Section snippets

Methods

The existing 44 TCs within the national transplant network assessed by the Department of Civil, Chemical, Environmental, and Materials Engineering of the University of Bologna (DICAM) and CNT ensure kidney (41 of 44), liver (22 of 44), pancreas (17 of 44), heart (16 of 44), lung (11 of 44), and intestine (3 of 44) transplantation activities. As a whole, 20 TCs are located in the north, 11 in the center, 7 in the south, and 6 on the two major islands (with 4 in Sicily). Lombardia and the city of

Results

From July 2015 to June 2016, 1061 organ transportation events have occurred (Table 1). Of those, 65 involving air transport and 53 involving road transport have not been completed. Transport events usually involve one or two organs; notwithstanding, multiorgan transport events are present to allow cost savings if the TC destinations are compatible with the CIT.

Conclusions

The successful cooperation between CNT and DICAM Transport of the University of Bologna has allowed the creation of this stand-alone database and performance assessment method. Results, best practices, and challenging targets have already been disseminated nationwide at a conference which gathered the Ministry of Health, renowned surgeons, personnel from not-for-profit medical organizations, private airline contractors, and military forces involved in organ transportation activities,

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The collection of the Italian database on extraregional transplantation activities started in 2015 and is currently ongoing. The principal findings and purposes of the research that have been made possible by this tool have been presented [1,2,7,8]. The time window considered in this analysis spans from June 2015 to December 2017 when a total of 2645 organs (for a total of 1474 transportation events) took place.
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40th Congress of the Italian Transplantation SocietyOrgan donationTransport of Human Organs in Italy: Location, Time, and Performances

Abstract

Introduction

Methods and Objectives

Results

Conclusions

Section snippets

Methods

Results

Conclusions

Transplant Proc

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J Heart Lung Transplant

Transplant Proc

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Swiss Med Wkly

Influence of cold ischemia time and graft transport distance on postoperative outcome in human liver transplantation

Surg Today

The importance of cold and warm cardiac ischemia for survival after heart transplantation

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Ann Transplant

40th Congress of the Italian Transplantation Society
Organ donation
Transport of Human Organs in Italy: Location, Time, and Performances