Donor transmission of malignant melanoma in a lung transplant recipient 32 years after curative resection

Abstract

Summary In the current era of organ shortages and long wait times for life‐saving transplants, marginal or extended donors are increasingly being considered; one such category of marginal organs is from donors with a previous history of malignancy. Melanoma in particular has been associated with increased risk of developing late recurrence. In this report, we describe a case of fatal donor melanoma transmission to a 64‐year‐old lung transplant recipient 32 years after surgical excision of the melanoma. Based on this report and review of the available literature, we conclude that a history of donor melanoma, regardless of the stage and time interval from ‘curative’ surgical resection, should remain a strong relative contraindication to transplantation.

Donor Cancer Transmission in Kidney Transplantation: A Systematic Review

“…Although the incidence of cancer transmission is low (approximately two cases per 10 000 organ transplant recipients) , if it occurs, significant morbidity and mortality are likely. Over the recent years, there have been increasing reports of fatal donor cancer transmission worldwide , such as the transmission of glioblastoma multiforme (GBM) from donors with a history of cerebral tumors and transmission of melanoma from donors with localized disease as long as 32 years prior to lung transplantation . Transplant clinicians are therefore reluctant to accept organs from donors with a cancer history, except for those with low‐grade tumors such as small, localized renal cell carcinomas (RCCs) or those with treated localized solid organ and skin cancers .…”

Transmission of breast cancer by a single multiorgan donor to 4 transplant recipients

“…Many reports have shown that cancer transmission can occur in solid organ transplantation . However, this is the first report describing breast cancer transmission after a multiorgan procedure from 1 donor to 4 recipients.…”

Donor Transmission of Melanoma Following Renal Transplant

“…As with our patient, donor transmission of melanoma generally presents in a metastatic fashion, sometimes with cutaneous manifestation or to other solid organs, but other times with miliary-like mucosal or peritoneal lesions [1, 2]. Recipients often die of complications related to uncontrolled metastatic disease [1, 3, 4].…”

“…Interestingly, although the majority of donors do not have a reported history of melanoma, the cause of death in donors is often attributed to intracranial hemorrhage, suggesting potentially undiagnosed metastatic disease [7]. In two case reports, previous donor history of melanoma was known, but treatment and presumed cure occurred 16 and 32 years prior to donor death and subsequent transmission of melanoma to recipients [2, 8]. This protracted latency period demonstrates the ability of melanoma tumor cells to lay dormant, and thus, any history of melanoma, no matter how remote, is generally considered an absolute contraindication to transplant [6, 8].…”