LINE #1 – Transplantation and end-stage organ failure

Description: End-stage organ failure describes a common condition of various organs in which, as a result of acute, chronic, or acute-on-chronic diseases of various nature (e.g., degenerative, inflammatory, immune, infectious, neoplastic, metabolic, toxic), the organ’s function is compromised in a progressive and irreversible manner. This condition is characterized by a failure to respond to standard medical therapy, increased number of hospitalizations, reduced quality of life, and increased mortality. In many cases, an organ transplant is the only possible therapy. The criteria to identify organ failure and the indication to transplantation are defined by national and international guidelines. Projects relating to these preclinical, clinical, and translational lines of research are designed to prevent, delay, and treat vital organ end-stage failure.

Goals:

  • Study the physiopathology, immune, genetic, cellular, and biomolecular mechanisms of diseases that can cause end-stage organ failure.
  • Develop screening programs for diseases that can cause end-stage organ failure.
  • Identify prognostic factors in the natural history of diseases that cause end-stage organ failure, with the purpose of defining profiles of evolution (progression of disease, onset of complications) and therapeutic response useful for improving the quality of care.
  • Study comorbidities associated with end-stage organ failure that negatively affect the prognosis (e.g., neurological disorders and portal hypertension in liver disease, cirrhotic cardiomyopathy, renal dysfunction in heart failure, vasculopathy and obesity in diabetes, neurological disorders in metabolic syndrome).
  • Develop innovative strategies and medical therapies to treat the underlying disease and its complications (e.g., infectious, neoplastic, immune, inflammatory, vascular, neurological) in order to prevent, delay, or treat end-stage organ failure and related complications, increase radical surgical interventions, customize care, and improve quality of life and “end-of-life” management.
  • Identify prognostic factors in the medical history of organ transplant recipients with the aim of reducing the incidence of complications, and improving the quality of care and post-transplant outcomes.
  • Study the physiopathologic, immunologic, genetic, cellular, and molecular mechanisms underlying complications after the transplant (damage from ischemia-reperfusion, primary graft failure, delayed functional recovery, small-for-size graft syndrome, and inflammatory, immunologic, infectious, vascular, neurologic, and neoplastic complications).
  • Develop new strategies and innovative medical therapies to prevent the onset of post-transplant complications, improve effectiveness of the treatment of complications (e.g., new medications and protocols for immunosuppression or induction of tolerance, drugs for treatment of infection and multi-resistant microorganisms), eligibility of organ transplant candidates (e.g., screening and treatment of neoplastic and pre-neoplastic lesions, liver tumor downstaging), effectiveness and efficacy of organ allocation methods, number of living donors (e.g., training and education programs), use of marginal organs (e.g., donor-recipient matching, organ preservation and reconditioning after procurement to reduce ischemia-reperfusion injury), use of grafts from incompatible AB0 donors, and partial organs from living or deceased donors.