UPMC Moves To New Transplant, Medical Facility That Now Also Serves Foreign Patients

University of Pittsburg Medical Center
Thursday, 27 May 2004

After operating out of temporary quarters for five years, the University of Pittsburgh Medical Center (UPMC) has opened Italy's only facility dedicated entirely to transplantation of all solid organs and therapies for the treatment of end-stage organ failure. The move to the newly constructed building allows the Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT), or the Mediterranean Institute for Transplantation and Advanced Specialized Therapies, to offer all transplant services, including an expansion of its living donor transplant and other surgical programs, and opens the door to foreign patients who might have otherwise sought medical treatment in the United States.

Until now, mostly liver and kidney transplantation services had been provided mainly for patients from Sicily and the south of Italy, with a limited number of living donor procedures performed.

As services are expanded to include other specialized services and organ transplants, including those for children, some 150 jobs are expected to be created by the end of the year, a significant number for a region that has one of the worst unemployment rates in Italy. Currently, ISMETT employs more than 300 physicians, nurses, allied health professionals and administrative staff.

Based in Palermo, ISMETT is a partnership between UPMC and the Region of Sicily, through Palermo's Cervello and Civico hospitals. As a public-private partnership, it is one of the first "Management Experimentation" projects currently active in Italy, which are designed to offer innovative solutions and become models of Italy's national health care system management. It also represents one of the most unique and largest partnerships of its kind involving an academic medical center. Unlike other international initiatives by American medical centers, the focus is not just on medical technology but also on the transfer of management and administration knowledge.

Specifically, ISMETT was established to overcome Sicily's delay in the field of transplantation and to meet the needs of thousands of patients who had been forced to refer to other Italian or foreign centers for transplantation and specialized treatments at government expense. In addition, the Region of Sicily envisioned ISMETT to be a center of health care excellence for the entire Mediterranean basin. Now with the ISMETT's new building and expanded clinical capabilities, this goal seems more attainable. Of interest to UPMC is the fact that many of its foreign patients who have found it more difficult to travel to Pittsburgh in recent years can now receive the same level of care in Palermo. U.S.-imposed quotas on the number of transplants performed for foreign patients and problems obtaining visas have made coming to U.S. centers more and more difficult for foreign patients.

"Even before we signed the agreement with the Region of Sicily, we were committed to providing patients with the best possible care by sharing our management and administrative experience, advanced technology solutions and clinical training and medical consultation services. But with our move to the new building, we feel that UPMC, working with our Italian partners, is in a better position to have a positive impact on this community," said Michael Costelloe, director general of ISMETT and senior vice president, International Affairs, UPMC.

The new building, located on the Civico Hospital campus, has expanded ISMETT's capacity from 22 to 70 beds and doubled the number of operating rooms from two to four. The five-level, 130,000 square-foot building designed by Pittsburgh-based L.D. Astorino & Associates Ltd., houses all clinical, scientific and surgical services, including an outpatient clinic, a unit with 44 private rooms, a 14-bed intensive care unit and a 12-bed post-anesthesia care unit, as well as dedicated space for dialysis, radiology, pharmacy and pathology services.

The most advanced technologies have been installed, from equipment for diagnostic imaging to a fully integrated electronic medical record system.

Since 1999, ISMETT's clinical activity had been carried out in temporary space located in the Thoracic Surgery pavilion at Civico Hospital. The costs of construction of the new building, amounting to about $58 million, were paid for by the Italian government through funds the Region of Sicily obtained under a national initiative to modernize clinical facilities.

As part of its agreement with the Region of Sicily, UPMC offers the local health care community the resources and specialty training programs of a leading American academic medical center. Nurses who work at ISMETT have been trained in the American model, and unlike their peers at other Italian hospitals, have more responsibility in clinical decision-making. Likewise, physicians who train at ISMETT are given more hands-on clinical experience than they would receive elsewhere in Italy. Students and faculty from the University of Pittsburgh School of Medicine also benefit through ISMETT's various educational and research collaborations and are able to pursue unique opportunities in Palermo that enhance their education or research endeavors.

On March 27, ISMETT held a special scientific symposium to help inaugurate the new facility. More than 400 Italian physicians and surgeons attended, and speakers included leading experts in transplantation clinical and research science from Italy and the United States, with several from the University of Pittsburgh. ISMETT moved its outpatient clinic to the new building in December 2002. As construction neared completion, other clinical programs were transitioned to the new building. The last of its inpatients were transferred on May 21.

ISMETT's medical director is Bruno Gridelli, M.D., who was a clinical fellow at the Thomas E. Starzl Transplantation Institute at the University of Pittsburgh from 1983 to 1985.

Dr. Gridelli came to ISMETT from a leading Italian transplant program, the Ospedali Riuniti in Bergamo, Italy, where he was director.

For more information, or to contact University of Pittsburg Medical Center, see their website at: www.upmc.com