A Celebration 20 Years in the Making

By: Lawerence Synett

It was a hot summer day when the first liver transplant in Sicily was performed at UPMC-managed ISMETT. That day 20 years ago changed the course of Sicilian health care and gave new hope to patients suffering from end-stage organ failure.

“The events that took place during the last 20 years, seen from this part of the world, have something to teach all of us,” said Dr. Salvo Gruttadauria, director of the Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation at ISMETT. “If you choose the right model to follow, the impossible becomes possible.”

Before ISMETT, there were no liver transplant centers in Sicily or in southern Italy. Patients and physicians had to choose between certain death and traveling to other Italian regions or even abroad, often referred to as “journeys to hope.”

ISMETT drastically reduced these trips, guaranteeing highly specialized care to Sicilian patients in their own region.

“I was transplanted on Aug. 4, 1999,” said Alfredo Valenza, the second liver transplant recipient in Italy. “I felt like I was a guinea pig, but I was really happy. I almost died 20 years ago, but maybe I survived because I have a role in this world – to make everyone aware of the importance of organ donation.”

Over the last 20 years, ISMETT has brought life-saving transplants home. Since July 1999, approximately 2,197 transplants have been performed and nearly 56% of those were liver transplants. Last year, 8% of patients treated at ISMETT came from other Italian regions or abroad. ISMETT is also the first Italian hospital dedicated to solid organ transplants — liver, kidneys, heart, lungs and pancreas.

Gruttadauria still remembers the first liver transplant performed in Sicily.

“I was a member of the team that performed the organ procurement in Catania and the transplant in Palermo,” he said. “I was in the operating room for close to 23 hours. Like any new procedure, it posed more risks and difficulties. Luckily, everything went for the best.”

At that time, Gruttadauria was 29 years old and the first fellow hired at ISMETT.

“Today, a liver transplant lasts six hours on average,” he said. “It’s a fairly standard procedure that in 70% of cases doesn’t require blood transfusions.”

Giuseppe Arena, chief nursing officer at ISMETT, was in the early stages of his career in 1999. Having previously worked in Cologno Monzese and Palermo, he joined ISMETT and went to UPMC Presbyterian for training with 14 other nurses.

“Everybody should have the opportunity to experience such great professional and personal growth,” Arena said. “We acquired new theoretical and practical knowledge. Training lasted all day and each of us was assigned to a different unit. I was sent to the ICU.”

Arena was also on duty in the ICU the day before the first liver transplant.

“Everybody was excited. We all felt the responsibility,” he said. “In the United States, we had basically observed; now we were in charge, and there was no room for mistakes.”

The relationship that ISMETT has grown with Pittsburgh remains of key importance today—with a new biomedical research center and second hospital to be built near Palermo soon and managed by UPMC.

“When in doubt, we request a second opinion from our colleagues in Pittsburgh, even though now our relationship has become equal, and sometimes they ask our support,” Arena said.