first 100 solid organ transplant at ISMETT. In 2004, ISMETT obtained permission to perform heart-lung transplants, thus becoming a multi-organ transplant center. In 2003 ISMETT started a pediatric liver transplantation program, and that year performed the first children's transplant done in southern Italy. Transplantation of HIV+ patients In 2001, Ignazio Marino performed the first living donor transplant into and HIV-positive patient in Italy, a procedure that created controversy and criticism, including complaint from the Ministry of Health. The Ministry moved to censure Marino arguing that this particular type of transplant had the characteristics of clinical trials that required special authorization. That patient transplanted by Dr. Marino is still alive and enjoying an excellent quality of life free of dialysis, 16 years after the kidney transplant. Because of this success the rules in Italy have been changed and now HIV-positive patients are not any longer denied access to transplantation if they need it. In 2007, for the first time in the world, an ISMETT team led by Dr. Bruno Gridelli performed a lung transplant on an HIV positive patient In this case, the intervention was authorized by the Ministry and was included within an experimental program launched by the National Transplant Center. This time, no controversy was recorded and the procedure received congratulatory press. The Cell Factory In 2007, the Regenerative Medicine and Cell Therapy Unit (Unità di Medicina Rigenerativa e Terapie Cellulari), termed the Cell Factory, was opened at ISMETT with the aim to initiate a program of regenerative medicine that researches the reparation of damaged organs. The mobile production laboratories (GMP Facility) of the unit have been made part of a project sponsored by the Region of Sicily and the Budget and Finance under the "ICT for the excellence of the territories." Among the research trials carried out at the Cell Factory is the injection of fetal hepatocytes as a therapy to bridge the patients waiting for a liver transplant, transplantation of pancreatic islets for patients with diabetes type 1, and transplantation of human fetal skin cells for the treatment of lesions of the skin. The Center for Simulation The Center for Simulation became active at ISMETT in June, 2007 with the aim to prevent and reduce medical errors. The use of simulation for training staff is already quite widespread in certain sectors such as aviation, and has now spread into the medical field. The simulation center provides for