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. 2018 Feb 18:24:997-1007.
doi: 10.12659/msm.909059.

Outcomes of Organ Transplantation from Donors with a Cancer History

Shanzhou Huang  1   2   3 , Yunhua Tang  1   2   3 , Zebin Zhu  1   2   3 , Jie Yang  1   2   3 , Zhiheng Zhang  1   2   3 , Linhe Wang  1   2   3 , Chengjun Sun  1   2   3 , Yixi Zhang  1   2   3 , Qiang Zhao  1   2   3 , Maogen Chen  1   2   3 , Linwei Wu  1   2   3 , Dongping Wang  1   2   3 , Weiqiang Ju  1   2   3 , Zhiyong Guo  1   2   3 , Xiaoshun He  1   2   3
Affiliations

Outcomes of Organ Transplantation from Donors with a Cancer History

Shanzhou Huang et al. Med Sci Monit. .

Abstract

BACKGROUND The inherent challenges of selecting an acceptable donor for the increasing number and acuity of recipients has forced programs to take increased risks, including accepting donors with a cancer history (DWCH). Outcomes of organ transplantation using organs from DWCH must be clarified. We assessed transplant outcomes of recipients of organs from DWCH. MATERIAL AND METHODS Retrospective analysis of the Scientific Registry of Transplant Recipients data from January 1, 2000 to December 31, 2014 identified 8385 cases of transplants from DWCH. A Cox-proportional hazard regression model and log-rank test were used to compare patient survival and hazard levels of various cancer types. RESULTS DWCH was an independent risk factor of 5-year patient survival (HR=1.089, 95% CI: 1.009-1.176, P=0.03) and graft survival (HR=1.129, 95% CI: 1.056-1.208, P<0.01) in liver and heart transplantation (patient survival: HR=1.112, 95% CI: 1.057-1.170, P<0.01; graft survival: HR=1.244, 95% CI: 1.052-1.472, P=0.01). There was no remarkable difference between the 2 groups in kidney and lung transplantation. Donors with genitourinary and gastrointestinal cancers were associated with inferior outcomes in kidney transplantation. Transplantation from donors with central nervous system cancer resulted in poorer survival in liver transplant recipients. Recipients of organs from donors with hematologic malignancy and otorhinolaryngologic cancer had poorer survival following heart transplantation. CONCLUSIONS Under the current donor selection criteria, recipients of organs from DWCH had inferior outcomes in liver and heart transplantation, whereas organs from DWCH were safely applied in kidney and lung transplantation. Specific cancer types should be cautiously evaluated before performing certain types of organ transplantation.

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Conflict of interest statement

Conflicts of interest

None.

Figures

Figure 1
Figure 1
(A) The number of transplants from DWCH by year from January 1, 2000, to December 31, 2014. (B) Number of transplants from DWCH in different types of organ transplants yearly. (C) Proportion of DWCH in all donors by each year.
Figure 2
Figure 2
Adjusted patient and graft survival analysis between the two groups of transplantation from donors with or without a cancer history. (A, E) Comparison of patient and graft survival in kidney transplant. (B, F) Comparison of patient and graft survival in liver transplant. (C, G) Comparison of patient and graft survival in heart transplant. (D, H) Comparison of patient and graft survival in lung transplant.
Figure 3
Figure 3
(A–D) The adjusted cumulative probability of cancer after kidney, liver, heart and lung transplant, respectively.
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