Contemporary Lung Transplantation

Lung transplantation is a successful therapeutic option for patients with end-stage respiratory failure. Although the clinical outcomes of this procedure have been constantly improving, the care of patients undergoing lung transplantation is still a striking challenge for the entire team involved in the process. The complexity of a clinical lung transplant program requires a trained, multi-specialist team and continuing technical update. Technology provides exciting new opportunities for the improvement of clinical outcomes. 

This text provides a comprehensive, practical and up-to-date insight into clinical lung transplantation. It moves along the pre-, intra-, and post-operative phases of transplantation. It explores the most relevant surgical, medical and immunological concepts of this field. The content focuses not only on the technical, scientific and medical aspects of lung transplantation, but also on the administrative, regulatory and nursing topics of running a lung transplant program. Rather than presenting purely theoretical chapters, the text sets the focus on clinical dilemmas and practical issues involving all the professionals who actively run a lung transplant program.

The reader will be able to access the book for reference on any topic related to clinical care in lung transplantation. This text is intended as a practical resource for surgeons, physicians and health professionals involved in lung transplantation or in setting up a lung transplant program. All chapters are written by experts in their fields and will include the most up to date scientific and clinical information. The overall intent of this publication is to assist the health care provider in all the daily aspects of lung transplantation and to offer a modern, practical source of suggestions and answers. 

Dr. Alessandro Bertani

Dr. Bertani, born April 23rd, 1973, is a graduate of the University of Pavia School of Medicine in 1998. After completing his general surgery residency at the Department of General Surgery, Liver and Lung Transplantation in Bergamo (Italy), he trained as a clinical fellow in cardiothoracic transplant surgery (2002-2003) and Minimally Invasive Thoracic Surgery (2003-2004) at the University of Pittsburgh (USA). He also trained as a clinical fellow in Cardiothoracic Surgery (2005-2006) at ISMETT-UPMC Italy, Palermo. In 2006 he completed a PhD in Experimental Surgery and Microsurgery at the University of Pavia School of Medicine. He holds national boards in general surgery and thoracic surgery.

After joining ISMETT as an attending thoracic surgeon in 2007, Dr. Bertani was appointed in 2011 as the Chief of Thoracic Surgery and Lung Transplantation. In March 2023 he founded and was appointed as the Director of the Chest Center at ISMETT, a multidisciplinary Department focusing on lung, mediastinal and esophageal disease. He also is a Clinical Assistant Professor of Surgery at the University of Pittsburgh, and the Director of the ISMETT pre-clinical research laboratories in Palermo.

He performed more than 3000 general and thoracic surgery operations, including oncologic and benign, open and minimally invasive pulmonary, mediastinal and esophageal cases. He performed more than 1000 airway and gastrointestinal endoscopic procedures, including endoscopic ultrasound and interventional endoscopy. He trained many junior surgeons to perform independently thoracic surgery and lung transplant procedures.

Since 2005, Dr. Bertani contributed to the development of the lung transplant program at ISMETT that grew as one of Italy’s busiest programs performing approximately 15 cases/year, including cadaveric, lobar, adult, pediatric transplants and extra-corporeal supports. In 2006 Dr. Bertani performed the first case of lung transplantation in the world in an HIV-positive patient.

The clinical activity of Dr. Bertani also includes an active contribution to the development of lung transplant and thoracic surgery international activities for UPMC.

He is a member of several international medical societies including the Society of Thoracic Surgeons (STS), the European Society of Thoracic Surgeons (ESTS), the International Society for Heart and Lung Transplantation (ISHLT) and the European Society for Cardio-Thoracic Surgery (EACTS) and serves for several national scientific boards and committees. As a visiting professor, he joined different lung transplant and thoracic surgery centers worldwide. Dr. Bertani also sits on the board of directors of the European Society of Thoracic Surgeons (ESTS) and of the Italian VATS Group. As of 2024, he is the Director of Education of the ESTS.

Dr. Bertani acts as principal investigators for several research projects in the field of thoracic surgery and transplantation, both clinical and pre-clinical, which are mostly focused on lung cancer, minimally invasive surgery, organ preservation and clinical lung transplantation.

Dr. Patrizio Vitulo

Dr. Vitulo is a graduate of the University of Pavia School of Medicine in 1987. After completing his residency in Pulmonology at the Department of Respiratory Medicine of the San Matteo Hospital in Pavia, he trained as clinical fellow in the same hospital (Division on Pulmonology and Division of Cardiac Surgery) and in 1992 he became attending pulmonologist. He participated in the foundation of the Pavia Lung Transplant Program in 1991 and in 1992 was appointed as reference pulmonologist for lung transplantation at the same institution. In 2002 he was appointed Medical Director of the Pavia Lung Transplant Program.

He joined ISMETT (Mediterranean Institute for Transplants and Highly Specialized Therapies), Palermo, in 2005 as Head of Pulmonology Service, where he participated in the foundation of the first Lung Transplant Program in Southern Italy. He founded the Sicilian Regional Reference Center for Rare Pulmonary Diseases at ISMETT, particularly involved in pulmonary hypertension and interstitial lung diseases. In 2021 he founded and directed the first Phase 1 Clinical Trial Unit in Sicily.

He has trained junior pulmonologists to perform interventional bronchoscopy and transplant medicine. He is the Medical Director of the Respiratory Therapy Unit at ISMETT.

He is participating in several clinical trials in the field of rare lung diseases as principal investigator.

He is a member of international medical societies such as the European Respiratory Society, Pulmonary Vascular Research Institute, Italian Society of Pneumology and served as member of working groups in these organizations. He is co-founder of the Italian Network for Pulmonary Hypertension (IPHNET) and is vice-Director of its Scientific Committee.

Prof. Paolo Antonio Grossi

Prof. Paolo Grossi is Professor of Infectious Diseases at the University of Insubria in Varese, Italy. Since the beginning of his career he performed his clinical and research activity at the Infectious Diseases Department of the University of Pavia. In 1993 he moved, as visiting professor, to the University of Pittsburgh, Pennsylvania where he remained to the end of 1994. Since the year 2000 he is professor of Infectious Diseases and director of the residency programs in Infectious Diseases and in Hygiene and Preventive Medicine at the University of Insubria, Varese, Italy. From February 2001 he is the Director of the Infectious and Tropical Diseases Department of the Ospedale di Circolo and Fondazione Macchi of Varese, Italy, where, starting from April 2009 he is the Director of the Department of Transplantation. The main research interest is in the field of infectious complications in transplant recipients and he participated to many research project in this area. He is author or co-author of more than 200 publications in the field of infectious disease in immunocompromised patients. From 1999 he is the advisor for all infectious diseases related problems at the Italian National Centre for Transplantation in Italy and covers the role of “second opinion” for all organ donors with potentially transmissible infectious diseases. Since 2001 he is a member of the Steering Committee of the program of Liver, kidney, kidney-pancreas, Lung and Heart transplantation in HIV+ individuals in Italy. In April 2013 he was elected co-Chair of the ID Council of the International Society of Heart and Lung Transplantation and subsequently chair of the ID committee. He is currently the past-chair of the ID council of ISHLT. In July 2013 he was nominated member of the WHO International Health Regulations Roster of Experts, as an expert in Essential health technologies (Transplantation services).