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Research paper thumbnail of Sepsis at ICU admission does not decrease 30-day survival in very old patients: a post-hoc analysis of the VIP1 multinational cohort study

Annals of Intensive Care, 2020

Background: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patien... more Background: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival. Results: This prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81-86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger, had a higher SOFA score (9 vs. 7, p < 0.0001), required more vasoactive drugs [82.2% vs. 55.1%, p < 0.0001] and renal replacement therapies [17.4% vs. 9.9%; p < 0.0001], and had more life-sustaining treatment limitations [37.3% vs. 32.1%; p = 0.02]. Frailty was similar in both groups. Unadjusted 30-day survival was not significantly different between the two groups. After adjustment for age, gender, frailty, and SOFA score, sepsis had no impact on 30-day survival [HR 0.99 (95% CI 0.86-1.15), p = 0.917]. Inverse-probability weight (IPW)-adjusted survival curves for the first 30 days after ICU admission were similar for acute septic and non-septic patients [HR: 1.00 (95% CI 0.87-1.17), p = 0.95]. A matched-pair analysis in which patients with sepsis were matched with two control patients of the same gender with the same age, SOFA score, and level of frailty was also performed. A Cox proportional hazard regression model stratified on the matched pairs showed that 30-day survival was similar in both groups [57.2% (95% CI 52.7-60.7) vs. 57.1% (95% CI 53.7-60.1), p = 0.85]. Conclusions: After adjusting for organ dysfunction, sepsis at admission was not independently associated with decreased 30-day survival in this multinational study of 3869 VIPs. Age, frailty, and SOFA score were independently associated with survival.

Research paper thumbnail of Rimozione Extracorporea Delle Endotossine Mediante Emoperfusione Su Filtro Alla Polimixina B: Case Report

Research paper thumbnail of Correction: Communication and visiting policies in Italian intensive care units during the frst COVID-19 pandemic wave and lockdown: a nationwide survey

BMC Anesthesiology, Sep 1, 2022

Research paper thumbnail of Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey

BMC Anesthesiology

Background During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented n... more Background During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. Methods A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. Results Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICU...

Research paper thumbnail of Mortality attributable to different Klebsiella susceptibility patterns and to the coverage of empirical antibiotic therapy: a cohort study on patients admitted to the ICU with infection

Intensive Care Medicine, 2018

PurposeTo evaluate the prognostic importance of different Klebsiella spp. sensitivity patterns: m... more PurposeTo evaluate the prognostic importance of different Klebsiella spp. sensitivity patterns: multi-susceptible Klebsiella (MS-K), extended-spectrum cephalosporin-resistant, but carbapenem-susceptible Klebsiella (ESCR-CS-K), and carbapenem-resistant Klebsiella (CR-K).MethodsWe developed a prognostic model to predict hospital mortality in patients with infection on admission to the intensive care units (ICUs), and assessed its calibration in the subgroups of interest: patients with infections due to MS-K, ESCR-CS-K, CR-K. We assessed the calibration of the model also in ESCR-CS-K treated empirically with carbapenems and with piperacillin-tazobactam.ResultsA total of 13,292 adults with an ongoing infection were admitted to 137 Italian ICUs in 2012–2013. Of 801 Klebsiella spp. infected patients, 451 had MS-K, 116 ESCR-CS-K, and 234 CR-K. The prognostic model calibrated well for the MS-K and ESCR-CS-K subgroups. In the CR-K subgroup there were more deaths than predicted (standardized mortality ratio 1.20; 95% CI 1.08–1.31), indicating a negative prognostic role of the infection, mainly in the medium and high risk-of-death patients. When infection was caused by ESCR-CS-K, treatment with piperacillin-tazobactam increased adjusted mortality among the most severe patients (similarly to CR-K), while treatment with carbapenems did not (similarly to MS-K).ConclusionsIn low risk-of-death patients admitted to the ICU with a Klebsiella spp. infection, the appropriateness of empirical antibiotic therapy seemed uninfluential to eventual mortality, while it appeared to be crucial in high-risk ones. The use of piperacillin-tazobactam may be inappropriate in severe patients with ESCR-CS-K infection. CR-K is associated to a significant 20% increase of adjusted mortality, only for patients at higher risk of death.

Research paper thumbnail of La lesione cerebrale acuta e la potenzialità di donazione d’organi nelle terapie intensive italiane: analisi multicentrica

DESCRIPTION Esiste un consenso generale in merito al fatto che il problema maggiore nel mondo dei... more DESCRIPTION Esiste un consenso generale in merito al fatto che il problema maggiore nel mondo dei trapianti è costituito dalla carenza di donatori e, quindi, dall'insufficienza di organi disponibili rispetto al numero di potenziali riceventi. L’identificazione nelle Unità di Terapia Intensiva del potenziale donatore di organi è il punto chiave ed il presupposto fondamentale dell’attività di procurement di organi ai fini di trapianto terapeutico. La popolazione ricoverata in UTI per LCA, da cui origina il pool di potenziali donatori di organi, sembra progressivamente ridursi di numerosità e dimostra un’età media in graduale e continuo incremento. Ciò espone ad un aumento sia della possibilità di coesistenza di patologie neoplastiche sia dell’incidenza di infezioni e di insufficienze mono o poliorganiche. Tali percentuali dimostrano un progressivo incremento nel periodo analizzato. . La distribuzione delle diagnosi sottostanti la LCA si è profondamente modificata nel corso degli a...

Research paper thumbnail of Sepsis at ICU admission does not decrease 30-day survival in very old patients: a post-hoc analysis of the VIP1 multinational cohort study

Annals of Intensive Care, 2020

Background The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patient... more Background The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival. Results This prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81–86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger,...

Research paper thumbnail of ODM LECCE: Corso teorico pratico sull'emergenza-urgenza - SINDROME IPERCAPNICA

Research paper thumbnail of Hospitals with and without neurosurgery: a comparative study evaluating the outcome of patients with traumatic brain injury

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Background We leveraged the data of the international CREACTIVE consortium to investigate whether... more Background We leveraged the data of the international CREACTIVE consortium to investigate whether the outcome of traumatic brain injury (TBI) patients admitted to intensive care units (ICU) in hospitals without on-site neurosurgical capabilities (no-NSH) would differ had the same patients been admitted to ICUs in hospitals with neurosurgical capabilities (NSH). Methods The CREACTIVE observational study enrolled more than 8000 patients from 83 ICUs. Adult TBI patients admitted to no-NSH ICUs within 48 h of trauma were propensity-score matched 1:3 with patients admitted to NSH ICUs. The primary outcome was the 6-month extended Glasgow Outcome Scale (GOS-E), while secondary outcomes were ICU and hospital mortality. Results A total of 232 patients, less than 5% of the eligible cohort, were admitted to no-NSH ICUs. Each of them was matched to 3 NSH patients, leading to a study sample of 928 TBI patients where the no-NSH and NSH groups were well-balanced with respect to all of the variabl...

Research paper thumbnail of Volume 14 Numero 3 luglio-settembre 2010 I documenti sono in formato PDF, consultabili utilizzando Acrobat Reader Validazione di metodiche siero-virologiche nel monitoraggio di HHV-8 in donatori/riceventi multiorgano solido

Obiettivi. Negli ultimi 20 anni, a fronte di un aumento del successo dei trapianti d'organo da ca... more Obiettivi. Negli ultimi 20 anni, a fronte di un aumento del successo dei trapianti d'organo da cadavere, le infezioni virali-e tra queste soprattutto quelle sostenute da Herpesvirus-restano una complicazione frequente e grave, in grado di mettere a rischio la vita dei pazienti determinando il fallimento del trapianto con conseguente rigetto dell'organo. L'Herpesvirus umano di tipo 8 (HHV-8) è coinvolto nella patogenesi del sarcoma di Kaposi, una grave complicazione post-trapianto legata ai pesanti regimi immunosoppressivi cui sono sottoposti i pazienti. In Italia la sieroprevalenza si aggirerebbe mediamente intorno al 15% con valori anche superiori al 20% nel sud e nelle isole. Pertanto l'impiego di strategie sierologiche e molecolari risulta indispensabili per contenere il rischio di trasmissione di HHV-8 mediante trapianto d'organo e per scongiurare l'insorgenza di malattia nei riceventi. A tale scopo, è stato condotto uno studio su coppie donatori/riceventi organo solido (SOT) al fine di determinare la presenza di HHV-8 nella Regione Puglia e di valutare l'accuratezza delle metodiche siero-virologiche impiegate. Materiali e metodi. Nel periodo 2009-2010 sono state analizzate 48 coppie di donatori/riceventi fegato e reni presso il Laboratorio di Virologia, UOC di Microbiologia e Virologia del Policlinico di Bari. I pazienti venivano monitorati all'ingresso e a diversi intervalli di tempo dal trapianto mediante tecniche sierologiche (IgG EIA test e IFA test, Biotrin srl) e molecolari (HHV-8 DNA PCR Real Time, Nanogen Elitech Group) secondo il protocollo indicato dalla ditta. Le combinazioni sierologiche delle coppie al tempo del trapianto erano le seguenti: D-/R-; D+/R+; D+/R-; D-/R+. Risultati. Tra i 48 SOT, il 73% apparteneva al gruppo D-/R-, il 4,2% al gruppo D+/R+, il 14,6% a quello D+/R-e l'8,3% a quello D-/R+. Nei donatori la sieroprevalenza era pari al 19%, nei SOT era del 12,5% prima e del 25% dopo il trapianto con un tasso di sieroconversione pari al 14,3% stimato con test in IFA. Riguardo ai risultati molecolari, il 6,2% dei donatori è risultato HHV-8 DNA positivo, mentre il 14,6% dei SOT mostrava DNAemia a varie epoche dal trapianto. In generale la ricerca immunosierologica con tecnica IFA sembrerebbe assicurare migliore performance di sensibilità rispetto a quella in ELISA. Conclusioni. La contemporanea presenza di HHV-8 DNA con positività IgG in IFA ed ELISA fra donatori/SOT era associata a un più alto rischio di sarcoma di Kaposi a diversi intervalli di tempo dal trapianto. Sono stati riscontrati risultati discordanti tra il metodo IFA ed ELISA ma occorrono ulteriori studi per verificare la sensibilità e la specificità dei due test correlandoli alla clinica del paziente. Volume 14 Numero 3 luglio-settembre 2010 I documenti sono in formato PDF, consultabili utilizzando Acrobat Reader

Research paper thumbnail of Sepsis at ICU admission does not decrease 30-day survival in very old patients: a post-hoc analysis of the VIP1 multinational cohort study

Annals of Intensive Care, 2020

Background: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patien... more Background: The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival. Results: This prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81-86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger, had a higher SOFA score (9 vs. 7, p < 0.0001), required more vasoactive drugs [82.2% vs. 55.1%, p < 0.0001] and renal replacement therapies [17.4% vs. 9.9%; p < 0.0001], and had more life-sustaining treatment limitations [37.3% vs. 32.1%; p = 0.02]. Frailty was similar in both groups. Unadjusted 30-day survival was not significantly different between the two groups. After adjustment for age, gender, frailty, and SOFA score, sepsis had no impact on 30-day survival [HR 0.99 (95% CI 0.86-1.15), p = 0.917]. Inverse-probability weight (IPW)-adjusted survival curves for the first 30 days after ICU admission were similar for acute septic and non-septic patients [HR: 1.00 (95% CI 0.87-1.17), p = 0.95]. A matched-pair analysis in which patients with sepsis were matched with two control patients of the same gender with the same age, SOFA score, and level of frailty was also performed. A Cox proportional hazard regression model stratified on the matched pairs showed that 30-day survival was similar in both groups [57.2% (95% CI 52.7-60.7) vs. 57.1% (95% CI 53.7-60.1), p = 0.85]. Conclusions: After adjusting for organ dysfunction, sepsis at admission was not independently associated with decreased 30-day survival in this multinational study of 3869 VIPs. Age, frailty, and SOFA score were independently associated with survival.

Research paper thumbnail of Rimozione Extracorporea Delle Endotossine Mediante Emoperfusione Su Filtro Alla Polimixina B: Case Report

Research paper thumbnail of Correction: Communication and visiting policies in Italian intensive care units during the frst COVID-19 pandemic wave and lockdown: a nationwide survey

BMC Anesthesiology, Sep 1, 2022

Research paper thumbnail of Communication and visiting policies in Italian intensive care units during the first COVID-19 pandemic wave and lockdown: a nationwide survey

BMC Anesthesiology

Background During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented n... more Background During the first coronavirus disease 2019 (COVID-19) pandemic wave, an unprecedented number of patients with respiratory failure due to a new, highly contagious virus needed hospitalization and intensive care unit (ICU) admission. The aim of the present study was to describe the communication and visiting policies of Italian intensive care units (ICUs) during the first COVID-19 pandemic wave and national lockdown and compare these data with prepandemic conditions. Methods A national web-based survey was conducted among 290 Italian hospitals. Each ICU (active between February 24 and May 31, 2020) was encouraged to complete an individual questionnaire inquiring the hospital/ICU structure/organization, communication/visiting habits and the role of clinical psychology prior to, and during the first COVID-19 pandemic wave. Results Two hundred and nine ICUs from 154 hospitals (53% of the contacted hospitals) completed the survey (202 adult and 7 pediatric ICUs). Among adult ICU...

Research paper thumbnail of Mortality attributable to different Klebsiella susceptibility patterns and to the coverage of empirical antibiotic therapy: a cohort study on patients admitted to the ICU with infection

Intensive Care Medicine, 2018

PurposeTo evaluate the prognostic importance of different Klebsiella spp. sensitivity patterns: m... more PurposeTo evaluate the prognostic importance of different Klebsiella spp. sensitivity patterns: multi-susceptible Klebsiella (MS-K), extended-spectrum cephalosporin-resistant, but carbapenem-susceptible Klebsiella (ESCR-CS-K), and carbapenem-resistant Klebsiella (CR-K).MethodsWe developed a prognostic model to predict hospital mortality in patients with infection on admission to the intensive care units (ICUs), and assessed its calibration in the subgroups of interest: patients with infections due to MS-K, ESCR-CS-K, CR-K. We assessed the calibration of the model also in ESCR-CS-K treated empirically with carbapenems and with piperacillin-tazobactam.ResultsA total of 13,292 adults with an ongoing infection were admitted to 137 Italian ICUs in 2012–2013. Of 801 Klebsiella spp. infected patients, 451 had MS-K, 116 ESCR-CS-K, and 234 CR-K. The prognostic model calibrated well for the MS-K and ESCR-CS-K subgroups. In the CR-K subgroup there were more deaths than predicted (standardized mortality ratio 1.20; 95% CI 1.08–1.31), indicating a negative prognostic role of the infection, mainly in the medium and high risk-of-death patients. When infection was caused by ESCR-CS-K, treatment with piperacillin-tazobactam increased adjusted mortality among the most severe patients (similarly to CR-K), while treatment with carbapenems did not (similarly to MS-K).ConclusionsIn low risk-of-death patients admitted to the ICU with a Klebsiella spp. infection, the appropriateness of empirical antibiotic therapy seemed uninfluential to eventual mortality, while it appeared to be crucial in high-risk ones. The use of piperacillin-tazobactam may be inappropriate in severe patients with ESCR-CS-K infection. CR-K is associated to a significant 20% increase of adjusted mortality, only for patients at higher risk of death.

Research paper thumbnail of La lesione cerebrale acuta e la potenzialità di donazione d’organi nelle terapie intensive italiane: analisi multicentrica

DESCRIPTION Esiste un consenso generale in merito al fatto che il problema maggiore nel mondo dei... more DESCRIPTION Esiste un consenso generale in merito al fatto che il problema maggiore nel mondo dei trapianti è costituito dalla carenza di donatori e, quindi, dall'insufficienza di organi disponibili rispetto al numero di potenziali riceventi. L’identificazione nelle Unità di Terapia Intensiva del potenziale donatore di organi è il punto chiave ed il presupposto fondamentale dell’attività di procurement di organi ai fini di trapianto terapeutico. La popolazione ricoverata in UTI per LCA, da cui origina il pool di potenziali donatori di organi, sembra progressivamente ridursi di numerosità e dimostra un’età media in graduale e continuo incremento. Ciò espone ad un aumento sia della possibilità di coesistenza di patologie neoplastiche sia dell’incidenza di infezioni e di insufficienze mono o poliorganiche. Tali percentuali dimostrano un progressivo incremento nel periodo analizzato. . La distribuzione delle diagnosi sottostanti la LCA si è profondamente modificata nel corso degli a...

Research paper thumbnail of Sepsis at ICU admission does not decrease 30-day survival in very old patients: a post-hoc analysis of the VIP1 multinational cohort study

Annals of Intensive Care, 2020

Background The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patient... more Background The number of intensive care patients aged ≥ 80 years (Very old Intensive Care Patients; VIPs) is growing. VIPs have high mortality and morbidity and the benefits of ICU admission are frequently questioned. Sepsis incidence has risen in recent years and identification of outcomes is of considerable public importance. We aimed to determine whether VIPs admitted for sepsis had different outcomes than those admitted for other acute reasons and identify potential prognostic factors for 30-day survival. Results This prospective study included VIPs with Sequential Organ Failure Assessment (SOFA) scores ≥ 2 acutely admitted to 307 ICUs in 21 European countries. Of 3869 acutely admitted VIPs, 493 (12.7%) [53.8% male, median age 83 (81–86) years] were admitted for sepsis. Sepsis was defined according to clinical criteria; suspected or demonstrated focus of infection and SOFA score ≥ 2 points. Compared to VIPs admitted for other acute reasons, VIPs admitted for sepsis were younger,...

Research paper thumbnail of ODM LECCE: Corso teorico pratico sull'emergenza-urgenza - SINDROME IPERCAPNICA

Research paper thumbnail of Hospitals with and without neurosurgery: a comparative study evaluating the outcome of patients with traumatic brain injury

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

Background We leveraged the data of the international CREACTIVE consortium to investigate whether... more Background We leveraged the data of the international CREACTIVE consortium to investigate whether the outcome of traumatic brain injury (TBI) patients admitted to intensive care units (ICU) in hospitals without on-site neurosurgical capabilities (no-NSH) would differ had the same patients been admitted to ICUs in hospitals with neurosurgical capabilities (NSH). Methods The CREACTIVE observational study enrolled more than 8000 patients from 83 ICUs. Adult TBI patients admitted to no-NSH ICUs within 48 h of trauma were propensity-score matched 1:3 with patients admitted to NSH ICUs. The primary outcome was the 6-month extended Glasgow Outcome Scale (GOS-E), while secondary outcomes were ICU and hospital mortality. Results A total of 232 patients, less than 5% of the eligible cohort, were admitted to no-NSH ICUs. Each of them was matched to 3 NSH patients, leading to a study sample of 928 TBI patients where the no-NSH and NSH groups were well-balanced with respect to all of the variabl...

Research paper thumbnail of Volume 14 Numero 3 luglio-settembre 2010 I documenti sono in formato PDF, consultabili utilizzando Acrobat Reader Validazione di metodiche siero-virologiche nel monitoraggio di HHV-8 in donatori/riceventi multiorgano solido

Obiettivi. Negli ultimi 20 anni, a fronte di un aumento del successo dei trapianti d'organo da ca... more Obiettivi. Negli ultimi 20 anni, a fronte di un aumento del successo dei trapianti d'organo da cadavere, le infezioni virali-e tra queste soprattutto quelle sostenute da Herpesvirus-restano una complicazione frequente e grave, in grado di mettere a rischio la vita dei pazienti determinando il fallimento del trapianto con conseguente rigetto dell'organo. L'Herpesvirus umano di tipo 8 (HHV-8) è coinvolto nella patogenesi del sarcoma di Kaposi, una grave complicazione post-trapianto legata ai pesanti regimi immunosoppressivi cui sono sottoposti i pazienti. In Italia la sieroprevalenza si aggirerebbe mediamente intorno al 15% con valori anche superiori al 20% nel sud e nelle isole. Pertanto l'impiego di strategie sierologiche e molecolari risulta indispensabili per contenere il rischio di trasmissione di HHV-8 mediante trapianto d'organo e per scongiurare l'insorgenza di malattia nei riceventi. A tale scopo, è stato condotto uno studio su coppie donatori/riceventi organo solido (SOT) al fine di determinare la presenza di HHV-8 nella Regione Puglia e di valutare l'accuratezza delle metodiche siero-virologiche impiegate. Materiali e metodi. Nel periodo 2009-2010 sono state analizzate 48 coppie di donatori/riceventi fegato e reni presso il Laboratorio di Virologia, UOC di Microbiologia e Virologia del Policlinico di Bari. I pazienti venivano monitorati all'ingresso e a diversi intervalli di tempo dal trapianto mediante tecniche sierologiche (IgG EIA test e IFA test, Biotrin srl) e molecolari (HHV-8 DNA PCR Real Time, Nanogen Elitech Group) secondo il protocollo indicato dalla ditta. Le combinazioni sierologiche delle coppie al tempo del trapianto erano le seguenti: D-/R-; D+/R+; D+/R-; D-/R+. Risultati. Tra i 48 SOT, il 73% apparteneva al gruppo D-/R-, il 4,2% al gruppo D+/R+, il 14,6% a quello D+/R-e l'8,3% a quello D-/R+. Nei donatori la sieroprevalenza era pari al 19%, nei SOT era del 12,5% prima e del 25% dopo il trapianto con un tasso di sieroconversione pari al 14,3% stimato con test in IFA. Riguardo ai risultati molecolari, il 6,2% dei donatori è risultato HHV-8 DNA positivo, mentre il 14,6% dei SOT mostrava DNAemia a varie epoche dal trapianto. In generale la ricerca immunosierologica con tecnica IFA sembrerebbe assicurare migliore performance di sensibilità rispetto a quella in ELISA. Conclusioni. La contemporanea presenza di HHV-8 DNA con positività IgG in IFA ed ELISA fra donatori/SOT era associata a un più alto rischio di sarcoma di Kaposi a diversi intervalli di tempo dal trapianto. Sono stati riscontrati risultati discordanti tra il metodo IFA ed ELISA ma occorrono ulteriori studi per verificare la sensibilità e la specificità dei due test correlandoli alla clinica del paziente. Volume 14 Numero 3 luglio-settembre 2010 I documenti sono in formato PDF, consultabili utilizzando Acrobat Reader