Prostate cancer in deceased organ donors: a review

Abstract

Objective: To estimate the risk of prostate cancer transmission in relation with organ procurement.

Methods: A literature search from the Medline database using the following keywords-transplantation, prostate cancer, organ procurement, donor transmitted malignancies, disease transmission, staging, evaluation, and PSA-was conducted to select 16 articles written in English and French over the last 15 years.

Results: The incidence of prostate cancer in deceased organ donors (DOD) has been estimated to be between 3% and 18.5%. There were more than 120 solid-organ transplantations performed with organs coming from DOD with a proven prostate cancer without any case of cancer transmission or death related to malignancy and only 1 case of transmission by the donor after a heart transplant has been described.

Conclusion: Transmission of prostate cancer by a transplanted organ seems incidental. When PSA is measured, it should be suspected only if the value is beyond 20 ng/ml and in all cases, should be interpreted taking digital rectal examination (DRE) into account. Organs from a DOD with a DRE proving a T3-T4 prostate cancer should not be procured. Suspect iliac lymph nodes during the preparation of the vessels for cannulation must lead to the discontinuation of the procurement or a histological analysis.