AOU Città della Salute e della Scienza di Torino

Centre information

AOU Città della Salute e della Scienza di Torino is a national health system (SSN) hospital with High Technological and Clinical Care Content, recognized as Hospital of National Significance and High Specialization and as Regional Reference Centre. The mission of AOU Città della Salute e della Scienza di Torino is to provide high quality clinical care together to training and research activities with a defined integration with University of Turin. The centre for rare hepatic diseases in Turin is one of the national reference centre for certification and management of these patients and a reference for patients, general practitioners, gastroenterologists and hepatologist in Italy. AOU Città della Salute e della Scienza di Torino is one of the biggest University Hospital in Europe, including Molinette Hospital and Regina Margherita Children’s Hospital. Molinette hospital is the oldest Hospital of Turin, the biggest in Piemonte Region and the third largest in Italy. It’s a highly qualified hospital integrated with the University of Turin and its mission is to cure, make research and teach. Integration between hospital activities, teaching and research helps to be constantly up to date with new technology, clinical practices, qualified diagnosis, and treatment procedures for in- and out- patients. Regina Margherita children’s Hospital deals with the prevention, diagnosis, and cure of children’s diseases. It’s a third level regional exclusively pediatric infrastructure (serving an area of about 5 million inhabitants and 500,000 children, and patients from other regions and countries for expertise on specific diseases). The Hospital has surgical, medical, and diagnostic specialities for the cure of babies, children and teenagers and it’s the referral centre for the most complex and rare children’s diseases. The aim is to ensure a coordinated and tailored-based approach to treatment and care service with quality-of-life improvement.

In our centre, we have access to specific diagnostic tools, highly specialized interventions and different medical specialties to complete diagnosis and manage comorbidities. Patients affected by autoimmune liver diseases (Primary Biliary Cholangitis, Autoimmune Hepatitis and Primary Sclerosing Cholangitis), Wilson disease, Biliary Atresia, Choledocal Cyst, Genetic Cholestatic Liver Diseases, Alagille Syndrome and Hepatoblastoma are the focus of our dedicated centre for rare hepatic diseases both in adult and pediatric population. Our mutidisciplinary team has a long-lasting experience in diagnosis, treatment, and management of these patients, including the access to liver transplant, of children, adolescents and adults, with a high and long experience in split (in situ or ex situ), reduced transplants and combined transplants. Systems of hypo and normo-thermic oxygenated graft perfusion are available, with possibility of using DCD donors. A transplant coordinating centre with appropriately trained recipient transplant coordinators is involved in pre-transplant assessment, preparation of the patient for listing, co-ordination of the transplant operation, education of the patients and their family.
An expanded newborn metabolic screening is available from 2017 in our region (Piemonte) for the early identification of babies with genetic and metabolic disorders. Newborn screening laboratory screens more than 35000 newborns at year for more than 50 disorders. A next generation sequencing of the clinical exome (approximately 6,700 genes) to rapidly detect monogenic liver diseases has been recently set- up for patients with undiagnosed liver diseases where there is a suspicion of hereditary conditions.
The acute care is guaranteed by a multidisciplinary team working in different pediatric and adult divisions, including a Liver Sub-intensive Care Unit and a Surgical Middle-intensive Care Unit, dedicated to patients subjected to transplantation or major surgical procedures, with all intensive care facilities for pediatric age. An open-ICU is guaranteed for continuous access of relatives.
The Healthcare provider has several high-volume out-patient clinics for adult and pediatric patients. The expertise is strengthened by the collaboration with consultants covering all subspecialties, including gastroenterology, infectious diseases, respiratory diseases, cardiology, nephrology, neurology, oncology, allergology, endocrinology and auxology, general surgery, pediatric surgery, cardiac surgery, neurosurgery, urology, orthopedic surgery, ENT, nutrition, radiology, pathology. Teamwork is guaranteed by weekly inter-disciplinary meetings that provide an opportunity for a comprehensive, multidisciplinary review of each patient’s diagnosis, disease staging and case management.
The presence of a palliative care network and a pediatric hospice is available to provide comprehensive care for children and their families who face a progressive, life-threatening condition and helping them fulfill their physical, psychological, and social needs.
Social and psychological support is provided to the patients, particularly through the whole transplant pathway. In-hospital school (elementary, middle, and secondary school) is present in the pediatric hospital. Different recreational activities to support the young patient are available, including a library open from Monday to Saturday. Experts in education work with the healthcare professionals helping patients to face anxiety related to surgery and other treatments.

Our centre participates to different national and international research projects and study groups and it is involved in clinical trials with and without experimental drugs at international level within the network’s area of expertise, taking part in several collaborative studies between the scientific Italian and European pediatric societies, e.g. in the following fields of interest: genetic diagnosis of liver diseases, genetic cholestasis, role of HNF1B deficiency in cholestatic liver disease, acute liver failure.
In summary, our mission consist in providing evidence-based, high quality, patient-centred clinical care, participating in international research projects and study groups and providing training in the field of rare liver disease.