Surgeon Leaves Sicilian Transplant Program to Return to U.S.

An Italian-born liver transplant surgeon who went back to his native country in 1999 to head a transplant center in Palermo has returned to the United States, expressing frustration over the logistical and bureaucratic obstacles he encountered in Sicily.

Dr. Ignazio Marino, 47, had been director of ISMETT (Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione), a joint public/private venture of the University of Pittsburgh Medical Center (UPMC), the Italian government and Civico and Cervello hospitals in Palermo.

In announcing his decision to leave ISMETT and accept a position at the Thomas Jefferson University Hospital in Philadelphia, Marino cited "thousands of problems" in Sicily including corruption, nepotism, split loyalties of medical staff, poor motivation, and lack of support from his peers.

"Italy is plagued by a widespread reluctance to change and a great ability to defend big or small interests at the expense of the common good," Marino said.

Marino's departure has provoked a wave of public soul-searching in the Italian scientific community, and the country's head of state, President Carlo Azeglio Ciampi, said he was sorry to see the surgeon depart.

Nevertheless, the ISMETT joint venture -- widely regarded as a success despite Marino's frustration -- continues to move forward.. Since it was launched as the only transplant program in Italy south of Rome, surgeons have performed more than 120 liver and kidney transplants.

A UPMC spokesperson said ISMETT plans to expand clinical services to include heart transplantation later this year when it moves from its temporary quarters at Civico Hospital to its own building on the hospital campus.

Since Marino's resignation, Dr. John Fung, chief of transplant surgery at UPMC who had been traveling to Palermo at about monthly intervals, has assumed the role of interim transplant director of ISMETT pending recruitment of a fulltime successor.

Fung also has taken on the role of permanent Scientific Director of ISMETT, and "will help guide the expansion of clinical services at the new facility and provide oversight of academic affairs along with the UPMC administrative arm," the UPMC spokesperson said.

Other sources: UPMC, Italian Media, Irish Times, The Independent