[en] 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 I 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.
Disciplines :
Oncology Surgery Gastroenterology & hepatology
Author, co-author :
Detry, Olivier ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
De Roover, Arnaud ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
de Leval, Laurence ; Centre Hospitalier Universitaire de Liège - CHU > Anatomie pathologique
Herens, Christian ; Centre Hospitalier Universitaire de Liège - CHU > PLAN COS
Delwaide, Jean ; Centre Hospitalier Universitaire de Liège - CHU > Gastro-Entérologie-Hépatologie
Honore, Pierre ; Centre Hospitalier Universitaire de Liège - CHU > Chirurgie abdominale- endocrinienne et de transplantation
Meurisse, Michel ; Université de Liège - ULiège > Département des sciences cliniques > Chirurgicale abdominale
Language :
English
Title :
Transmission of an undiagnosed sarcoma to recipients of kidney and liver grafts procured in a non-heart beating donor
Publication date :
June 2005
Journal title :
Liver Transplantation
ISSN :
1527-6465
eISSN :
1527-6473
Publisher :
John Wiley & Sons Inc, Hoboken, United States - New Jersey
Detry O, Detroz B, D'Silva M, Pirenne J, Defraigne JO, Meurisse M, et al. Misdiagnosed malignancy in transplanted organs. Transpl Int 1993;6:50-54.
Penn I. Transmission of cancer from organ donors. Ann Transplant 1997;2:7-12.
Kauffman HM, McBride MA, Cherikh WS, Spain PC, Delmonico FL. Transplant tumor registry: donors with central nervous system tumors. Transplantation 2002;73:579-582.
Derry O, Honore P, Hans MF, Delbouille MH, Jacquet N, Meurisse M. Organ donors with primary central nervous system tumor. Transplantation 2000;70:244-248.
Lipshutz GS, Baxter-Lowe LA, Nguyen T, Jones KD, Ascher NL, Feng S. Death from donor-transmitted malignancy despite emergency liver retransplantation. Liver Transpl 2003;9:1102-1107.
Abt PL, Desai NM, Crawford MD, Forman LM, Markmann JW, Olthoff KM, et al. Survival following liver transplantation from non-heart-beating donors. Ann Surg 2004;239:87-92.
Wilson RE, Hager EB, Hampers CL, Corson JM, Merrill JP, Murray JE. Immunologic rejection of human cancer transplanted with a renal allograft. N Engl J Med 1968;278:479-483.
Penn I. Malignancy in transplanted organs. Transpl Int 1993;6: 1-3.
Kakar S, Burgart LJ, Charlton MR, Saito Y, Halling K, Thibodeau SN. Origin of adenocarcinoma in a transplanted liver determined by microsatellite analysis. Hum Pathol 2002;33: 435-436.
MacKie RM, Reid R, Junor B. Fatal melanoma transferred in a donated kidney 16 years after melanoma surgery. N Engl J Med 2003;348:567-568.
Kauffman HM, McBride MA, Delmonico FL. First report of the United Network for Organ Sharing Transplant Tumor Registry: donors with a history of cancer. Transplantation 2000;70:1747-1751.
Detry O, Honore P, Meurisse M, Jacquet N. Cancer in transplant recipients. Transplant Proc 2000;32:127.
Hojo M, Morimoto T, Maluccio M, Asano T, Morimoto K, Lagman M, et al. Cyclosporine induces cancer progression by a cell-autonomous mechanism. Nature 1999;397:530-534.
Guba M, Graeb C, Jauch KW, Geissler EK. Pro- and anti-cancer effects of immunosuppressive agents used for organ transplantation. Transplantation 2004;77:1777-1782.
Detry O, Honore P, Jacquet N, Meurisse M. Management of recipients of hepatic allografts harvested from donors with malignancy diagnosed shortly after transplantation. Clin Transplant 1998;12:579-581.
Florman S, Bowne W, Kim-Schluger L, Sung MW, Huang R, Forino M, et al. Unresectable squamous cell carcinoma of donor origin treated with immunosuppression withdrawal and liver retransplantation. Am J Transplant 2003;4:278-282.
Donovan JA, Simmons FA, Esrason KT, Jamehdor M, Busuttil RW, Novak JM, Grody WW. Donor origin of a posttransplant liver allograft malignancy identified by fluorescence in situ hybridation for the Y chromosome and DNA genotyping. Transplantation 1997;63:80-84.
