A new treatment option for the approximately 6,000 patients waiting for a kidney transplant is the goal of a memorandum of understanding to launch a pilot program of cross-modality kidney donation between Italy and the US. The agreement was signed by the National Transplant Center and the Alliance for Paired Kidney Donation, a nonprofit foundation that runs one of the living kidney transplant programs in the US.

The new Italy-U.S. program concerns so-called "crossover" kidney transplants, that is, those that take place through the reciprocal "exchange" of the organ between couples in which the donor is genetically incompatible with his own recipient but compatible with the recipient of another couple.

Thanks to this agreement pairs of Italian and U.S. patients will be able to be crossover based on a shared algorithm that will verify the level of compatibility between those on the two waiting lists.In this way, patients with chronic renal failure who have an unsuitable volunteer donor available will have a greater chance of receiving the transplant they need.

In addition to the technical-operational aspects (requirements of participating hospitals, matching algorithm, overall governance of the activities), the agreement stipulates that costs related to the transplant procedure will be borne by U.S. insurance coverage for the U.S. patient and the Italian donor, while the Italian National Health Service will cover expenses for the Italian patient and the U.S. donor. Donors will travel: in fact, the kidney procurement and subsequent transplantation will take place in the recipient's country.

The pilot phase will involve the first three cases and will be confined to three hospitals: for Italy, the Kidney Transplant Center of the Policlinico Agostino Gemelli in Rome will participate, while for the U.S., the University of Toledo Medical Center and the hospital hubs of Thomas Jefferson University in Philadelphia will be involved. Once the operational and management experimentation is completed, the program will be reevaluated for a possible consolidation of the protocol and progressive expansion to other living kidney transplant centers in the Italian network.