Since 1963, when Thomas E. Strarzl performed the fi rst human liver transplantation in a baby, a long way has been passed in the fi eld of solid organ transplantation. Improvements in the surgical techniques and in immunosuppression in the early years not always achieved the expected results, and outcome was more often measured in months rather than years. In the late 1980s, a dramatic improvement in the patient’s management and the discoveries of new immunosuppressive drugs led the shifting of organ transplantation from an experimental procedure to a real treatment that could have been offered to a larger proportion of patients affected by end-stage acute or chronic organ failures. From those years, the clinical and scientifi c interest in organ transplantation has broadened, involving ethical issues, transplant infectious disease, critical care management, and new strategies to increase the donor pool. Furthermore, because posttransplant outcome is now measured in terms of years and decades, new clinical issues have been raised, like management of metabolic disease or viral reinfection or neoplastic disease, either recurrence or de novo.
Under the incentive of my active associate Giorgio Ercolani, we decided to try to summarize in a single book the new immunological strategies, the surgical innovative techniques, risks of infections after transplantation with a look to potential transmission from donors and innovative transplant procedures. We have asked my friend Dr. Alessandro Nanni Costa, President of the Italian Transplant Network, to report the Italian Guidelines in the evaluation and management of potential donors. We have then tried to focus on peculiar aspects of transplantation of liver, kidney, and small bowel underlining the indications, the technical aspects with special attention to living donor transplantation and the diagnosis and the management of the complications. Finally, two separate chapters are dedicated to the most frequently combined abdominal solid organ transplants (liverkidney and kidney-pancreas). I would like to thank all the contributors for the excellent work they have done, and I believe that this book might be useful for all physicians and surgeons involved in this field.
Antonio D. Pinna , MD