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. 2019 Apr;32(2):323-330.
doi: 10.1007/s40620-018-00573-z. Epub 2019 Jan 2.

How safe are organs from deceased donors with neoplasia? The results of the Italian Transplantation Network

Albino Eccher  1 , Letizia Lombardini  2   3 , Ilaria Girolami  4 , Francesca Puoti  2 , Gianluigi Zaza  5 , Giovanni Gambaro  5 , Amedeo Carraro  6 , Giovanni Valotto  4 , Luca Cima  7 , Luca Novelli  8 , Desley Neil  9 , Umberto Montin  6   10 , Aldo Scarpa  4 , Matteo Brunelli  4 , Alessandro Nanni Costa  2   3 , Antonia D'Errico  11
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How safe are organs from deceased donors with neoplasia? The results of the Italian Transplantation Network

Albino Eccher et al. J Nephrol. 2019 Apr.

Abstract

Guidelines for donor selection have changed to expand the donor pool, considering potential donors affected by a neoplasm. Aim of this retrospective study is to look at the use of organs from donors with a current or history of neoplasm within the Italian Transplant Network. Data, collected and validated by Italian National Health Institute for the time interval 2006-2015, have been reviewed retrospectively by mean of multivariable pivot tables. Donors with neoplasia represented about 5% of all donors, resulting in about 4% of all transplants. Donors presented a benign neoplasm in 29.08% of cases, a malignancy with variable risk of transmission in 69.75% while in 1.34% the nature of neoplasm could not be assessed. Considering all procedures, rate of transmission of a malignancy was 0.03% (10 cases) of all 29858 transplants of the time interval. Notably, cases of transmission were not from donors of this pool, but from donors that, according to our protocols, had no elements of suspect at time of donation. As recipient safety is always the priority and as guidelines have set exclusion criteria for donors with some specific types of malignancy, these results show that use of this type of donors is safe and improve organ pool. Furthermore represent basis for improvement and standardization of donor assessment protocols suggesting that efforts in data collection systems, to produce complete and homogeneous data, are mandatory.

Keywords: Donor evaluation; Donor with malignancy; Neoplastic transmission; Risk assessment; Transplantation.

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