The Use of Neoplastic Donors to Increase the Donor Pool

Fiaschetti, P.; Pretagostini, R.; Stabile, D.; Peritore, D.; Oliveti, A.; Gabbrielli, Francesco; Cenci, Simone; Ricci, A.; Vespasiano, Francesca; Grigioni, Francesco

doi:10.1016/j.transproceed.2012.06.030

Cited by 21 publications

(26 citation statements)

References 2 publications

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“…Heart transplants may be relatively low risk for donor transmission given that the heart is an uncommon metastatic target, most likely due to the rarity of primary cancers, as well as differences in a malignancy's hematologic and lymphatic access and molecular profile . While donor transmission of cancer presents a real risk, our analysis suggests that more attention should be placed on other donor markers of poor transplant outcomes, including increased donor age, expanded donor criteria, and history of hypertension …”

Section: Discussionmentioning

confidence: 92%

“…Early analysis of the Israel Penn International Transplant Tumor Registry by Buell et al found that among 296 cases of known or incidental donor malignancies, 42% had confirmed donor transmission. Subsequent case studies found that transmission rates between organ donor and recipient range from 0% to 42%, with aggressive malignancies—including breast cancer and melanoma—more likely to be transmitted than low‐grade malignancies . A more recent examination of all solid organ transplantations concluded that the risk of donor‐origin cancers in transplant recipients was in fact minimal, with transmission as low as 0.06% …”

Section: Introductionmentioning

confidence: 99%

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Donor history of malignancy: A limited risk for heart transplant recipients

Rudasill

Iyengar

Sanaiha

et al. 2020

Clinical Transplantation

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Organ donor contraindications are frequently reassessed for impact on recipient outcomes in attempt to meet demand for transplantation. This study retrospectively analyzed the United Network for Organ Sharing (UNOS) registry for adult heart transplants from 1987 to September 2016 to characterize the impact of donor malignancy history in heart transplantation. Kaplan‐Meier estimates illustrated 10‐year survival. Propensity score matching was utilized for 1:1 matching of donors with and without history of malignancy, and Cox proportional hazards and logistic regressions were used to analyze the matched population. Of 38 781 heart transplants, 622 (1.6%) had a donor history of malignancy. Cox regressions demonstrated that donor malignancy predicted increased 10‐year mortality (HR = 1.16 [1.01‐1.33]), but this difference did not persist when conditioned upon 1 year post‐transplant survival (log‐rank = 0.643). Cox regressions of the propensity score‐matched population (455 pairs) found no association between donor malignancy and 10‐year mortality (HR = 1.02 [0.84‐1.24]). Older age and higher rates of hypertension were observed in donors with a history of malignancy whose recipients died within the first year post‐transplant. Therefore, increased recipient mortality is likely due to donor characteristics beyond malignancy, creating the potential for expanded donor selection.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Donor history of malignancy: A limited risk for heart transplant recipients

Rudasill

Iyengar

Sanaiha

et al. 2020

Clinical Transplantation

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“…Of the 15 donor-transmitted cancers, 6 were renal; 5 were lung; 2 were lymphoma; 1 was neuroendocrine, and 1 colon cancer [38] . Some recent Italian series have shown no disease transmission with use of grafts from donors with lowgrade malignancies or neoplasms of low metastatic potential [39,40] . An accurate donor evaluation coupled with histological information of tumor grade allows to reduce to acceptable rates the risk of donor-to-recipient transmission [39,40] .…”

Section: Malignanciesmentioning

confidence: 99%

“…Some recent Italian series have shown no disease transmission with use of grafts from donors with lowgrade malignancies or neoplasms of low metastatic potential [39,40] . An accurate donor evaluation coupled with histological information of tumor grade allows to reduce to acceptable rates the risk of donor-to-recipient transmission [39,40] . Donors with a documented history of malignancy should not discarded per se, especially for low-grade central nervous system tumors and malignancies treated successfully with long-term diseasefree survival rates.…”

Section: Malignanciesmentioning

confidence: 99%

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Strategies to optimize the use of marginal donors in liver transplantation

Pezzati

Ghinolfi

Simone

et al. 2015

WJH

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Liver transplantation is the treatment of choice for end stage liver disease, but availability of liver grafts is still the main limitation to its wider use. Extended criteria donors (ECD) are considered not ideal for several reasons but their use has dramatically grown in the last decades in order to augment the donor liver pool. Due to improvement in surgical and medical strategies, results using grafts from these donors have become acceptable in terms of survival and complications; nevertheless a big debate still exists regarding their selection, discharge criteria and allocation policies. Many studies analyzed the use of these grafts from many points of view producing different or contradictory results so that accepted guidelines do not exist and the use of these grafts is still related to non-standardized policies changing from center to center. The aim of this review is to analyze every step of the donationtransplantation process emphasizing all those strategies, both clinical and experimental, that can optimize results using ECD.

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Managing Thyroid Nodules in Brain‐Dead Donors: Our Experience and a Review of the Literature

Locatello,

Caiazza,

Cavallo Ronchi

et al. 2024

Head & Neck

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BackgroundThyroid nodules are common findings during the diagnostic work‐up in potential organ donors. A fast yet thorough assessment to rule out cancer is mandatory but their management remains heterogeneous among hospitals and the evidence in this field is scarce. We present our institutional experience and review the most recent literature on this topic.MethodsRetrospective case series and systematic review of the literature.ResultsIn the years 2000–2023, 47 total thyroidectomies were performed on potential brain‐dead donors. Intraoperative frozen section (FS) revealed 6 cases (13.9%) of papillary carcinoma that led to organ discarding in 3 cases (6.9%). The mean operative time of the procedures was 42.75 min and no procurement‐delaying complications were registered.ConclusionTotal thyroidectomy with an intraoperative FS is a sound method for assessing suspicious nodules before organ harvesting. Future randomized studies comparing its performance against fine needle aspiration biopsy are needed to define the most cost‐effective and time‐saving strategy.

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The Use of Neoplastic Donors to Increase the Donor Pool

Cited by 21 publications

References 2 publications

Donor history of malignancy: A limited risk for heart transplant recipients

Donor history of malignancy: A limited risk for heart transplant recipients

Strategies to optimize the use of marginal donors in liver transplantation

Managing Thyroid Nodules in Brain‐Dead Donors: Our Experience and a Review of the Literature

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