Transmission of an undiagnosed sarcoma to recipients of kidney and liver grafts procured in a non-heart beating donor

Abstract

Transmission of an undiagnosed cancer with solid organ transplantation is a rare but dreadful event. In this paper the authors report the transmission of an undiagnosed sarcoma to recipients of kidney and liver grafts procured in a Maastricht category 3 non-heart beating donor. To the authors' knowledge this case is the first report of such a transmission with a liver graft procured in a non-heart beating donor. The cancer transferal was diagnosed 1 year after transplantation in the recipients of the liver and of one kidney. The liver recipient died from multiple organ failure after a failed attempt of tumor resection. The kidney recipient underwent immunosuppression withdrawal and transplantectomy. Non-heart beating donors should not be particularly at risk for undiagnosed cancer transmission if the procurement is performed according to the same rules of careful inspection of the abdominal and thoracic organs. After diagnosis of donor cancer transmission, kidney recipients should have the graft removed, and immunosuppression should be interrupted. The management of liver graft recipients is very difficult in this setting, and long-term survival was very rarely reported. (Liver Transpl 2005;11:696-699.)

Donor cell leukemia: insight into cancer stem cells and the stem cell niche

“…7 Notably, transfer of malignant cells can also occur with solid-organ transplantation. [8][9][10] Defining the true incidence of DCL is difficult because of vagaries in its recognition and in reporting; therefore, the majority of evidence in the literature is anecdotal. In 1982 Boyd et al 11 reported an incidence as high as 5%, and a recent large survey by the European group for Blood and Marrow Transplantation (EBMT) reported 14 cases from 10 489 transplantations performed during a 21-year period.…”

Risks and Mechanisms of Oncological Disease Following Stem Cell Transplantation

“…Other histological variants of tumors developed following organ transplantation include malignant meningioma [69] and medulloblastoma [70]. These, and some other reported cases (in particular, see [71]), have led to important developments in guidelines for donor selection (see [68,72]). Most importantly, tumor development in stem cell transplantation recipients can be based on the analogous mechanism: i.e., not on the malignant transformation of donor stem cells (prior to, or following, stem cell transplantation).…”

Donor derived malignancy following transplantation: a review

“…Besides these retrospective studies there have been many case reports of tumor transmission (melanoma, sarcoma, renal cell carcinoma, etc) (Stephens et al 2000;Milton et al 2006;Neipp et al 2006;Cankovic et al 2006;Detry et al 2005;Morris-Stiff et al 2004;Gerstenkorn and Thomusch 2003;Lipshutz et al 2003;Loren et al 2003;Kakar et al 2002;Barrou et al 2001;Winter et al 2001;Conlon and Smith 1995;Oesterwitz and Lucius 1991;Barnes and Fox 1976), some of which may have been included in the reviews described.…”