Donor Cancer Transmission: Focusing on the Evidence

Nalesnik, Michael A.

doi:10.1097/tp.0000000000004118

Cited by 2 publications

(3 citation statements)

References 5 publications

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“…2 Contemporary studies have highlighted the need to incorporate non-transmission events in estimates of cancer transmission risk and recommend reevaluation of classification systems that may inappropriately preclude transplantation due to overestimation of the absolute risk of cancer transmission. [3][4][5] Current clinical guidelines for donation recommend that donors with a history of invasive melanoma be rejected due to well-documented reports of poor recipient outcomes and a perceived high risk of transmission (>10%). 2,6,7 Conversely, noninvasive "in situ" melanomas are classified as having minimal (<0.1%) transmission risk and donors are acceptable in most circumstances.…”

Section: Introductionmentioning

confidence: 99%

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Transmission and Non-transmission of Melanoma From Deceased Solid Organ Donors to Transplant Recipients: Risks and Missed Opportunities

Rosales,

Hedley,

De La Mata

et al. 2024

Transplantation

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Background. Biovigilance concerns are in tension with the need to increase organ donation. Cancer transmission risk from donor to recipient may be overestimated, as non-transmission events are rarely reported. We sought to estimate melanoma transmission risk in deceased organ donation and identify missed opportunities for donation in an Australian cohort with high melanoma prevalence. Methods. We used a population-based approach and linked deceased organ donors, transplant recipients, and potential donors forgone, 2010–2018, with the Central Cancer Registry (CCR), 1976–2018. We identified melanomas using ICD-O-3 classification, assessed the probability of transmission, and compared suspected melanoma history in potential donors forgone with melanoma notifications in the CCR. Results. There were 9 of 993 donors with melanoma in CCR; 4 in situ low-risk and 5 invasive high-to-unacceptable risk. Four were unrecognized before donation. Of 16 transplant recipients at risk, we found 0 of 14 transmission events (2 recipients had insufficient follow-up). Of 35 of 3588 potential donors forgone for melanoma risk alone, 17 were otherwise suitable for donation; 6 of 35 had no melanoma in CCR, 2 of 35 had in situ melanomas and 9 of 35 had thin invasive melanomas (localized, ≤0.8 mm thickness). Conclusions. Our findings contribute to current evidence that suggests donors with melanomas of low metastatic potential may provide an opportunity to safely increase organ donation and so access to transplantation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Transmission and Non-transmission of Melanoma From Deceased Solid Organ Donors to Transplant Recipients: Risks and Missed Opportunities

Rosales,

Hedley,

De La Mata

et al. 2024

Transplantation

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“…An arbitrary 2-year cutoff time was stated to separate "donor-transmitted" from "donor-derived" tumors, the latter arising from donor cells but not present at the time of transplant. However, 31% of donor-transmitted tumors arose after 24 months, emphasizing the need for continued surveillance beyond the conventional 2 years [21].…”

Section: Introductionmentioning

confidence: 99%

Tumors after kidney transplantation: a population study

et al. 2023

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One of the main causes of post-transplant-associated morbidity and mortality is cancer. The aims of the project were to study the neoplastic risk within the kidney transplant population and identify the determinants of this risk. A cohort of 462 renal transplant patients from 2010 to 2020 was considered. The expected incidence rates of post-transplant cancer development in the referenced population, the standardized incidence ratios (SIR) taking the Italian population as a comparison, and the absolute risk and the attributable fraction were extrapolated from these cohorts of patients. Kidney transplant recipients had an overall cancer risk of approximately three times that of the local population (SIR 2.8). A significantly increased number of cases were observed for Kaposi’s sarcoma (KS) (SIR 195) and hematological cancers (SIR 6.8). In the first 3 years post-transplant, the risk to develop either KS or hematological cancers was four times higher than in the following years; in all cases of KS, the diagnosis was within 2 years from the transplant. Post-transplant immunosuppression represents the cause of 99% of cases of KS and 85% of cases of lymphomas, while only 39% is represented by solid tumors. Data related to the incidence, the percentages attributable to post-transplant immunosuppression, and the time of onset of neoplasms, particularly for KS and hematological tumors could help improve the management for the follow-up in these patients.

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Donor Cancer Transmission: Focusing on the Evidence

Cited by 2 publications

References 5 publications

Transmission and Non-transmission of Melanoma From Deceased Solid Organ Donors to Transplant Recipients: Risks and Missed Opportunities

Transmission and Non-transmission of Melanoma From Deceased Solid Organ Donors to Transplant Recipients: Risks and Missed Opportunities

Tumors after kidney transplantation: a population study

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