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Review
. 2022 Sep 1;106(9):1814-1823.
doi: 10.1097/TP.0000000000004117. Epub 2022 Apr 1.

Malignancies in Deceased Organ Donors: The Spanish Experience

Beatriz Mahíllo  1 , Silvia Martín  1 , Esteban Molano  1 , Aurora Navarro  2 , Pablo Castro  3 , Teresa Pont  4 , Amado Andrés  5 , Juan Galán  6 , Montserrat López  7 , Eva Oliver  8 , Adolfo Martínez  9 , Fernando Mosteiro  10 , Rebeca Roque  11 , Marina Pérez-Redondo  12 , Manuela Cid-Cumplido  13 , María A Ballesteros  14 , Domingo Daga  15 , Brígida Quindós  16 , Micaela Sancho  17 , Mario Royo-Villanova  18 , Esther Bernabé  1 , Raúl Muñoz  1 , José Ignacio Chacón  19 , Elisabeth Coll  1 , Beatriz Domínguez-Gil  1
Affiliations
Free article
Review

Malignancies in Deceased Organ Donors: The Spanish Experience

Beatriz Mahíllo et al. Transplantation. .
Free article

Abstract

Background: To better define the risk of malignancy transmission through organ transplantation, we review the Spanish experience on donor malignancies.

Methods: We analyzed the outcomes of recipients of organs obtained from deceased donors diagnosed with a malignancy during 2013-2018. The risk of malignancy transmission was classified as proposed by the Council of Europe.

Results: Of 10 076 utilized deceased donors, 349 (3.5%) were diagnosed with a malignancy. Of those, 275 had a past (n = 168) or current (n = 107) history of malignancy known before the transplantation of organs into 651 recipients. Ten malignancies met high-risk criteria. No donor-transmitted cancer (DTC) was reported after a median follow-up of 24 (interquartile range [IQR]: 19-25) mo. The other 74 donors were diagnosed with a malignancy after transplantation. Within this group, 64 donors (22 with malignancies of high or unacceptable risk) whose organs were transplanted into 126 recipients did not result in a DTC after a median follow-up of 26 (IQR: 22-37) mo, though a prophylactic transplantectomy was performed in 5 patients. The remaining 10 donors transmitted an occult malignancy to 16 of 25 recipients, consisting of lung cancer (n = 9), duodenal adenocarcinoma (n = 2), renal cell carcinoma (n = 2), extrahepatic cholangiocarcinoma (n = 1), prostate cancer (n = 1), and undifferentiated cancer (n = 1). After a median follow-up of 14 (IQR: 11-24) mo following diagnosis, the evolution was fatal in 9 recipients. In total, of 802 recipients at risk, 16 (2%) developed a DTC, which corresponds to 6 cases per 10 000 organ transplants.

Conclusions: Current standards may overestimate the risk of malignancy transmission. DTC is an infrequent but difficult to eliminate complication.

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Conflict of interest statement

The authors declare no funding or conflicts of interest.

Comment in

References

    1. Global Observatory on Donation and Transplantation. Global Observatory on Donation and Transplantation. 2020. Available at http://www.transplant-observatory.org/ . Accessed December 15, 2021.
    1. de la Rosa G, Domínguez-Gil B, Matesanz R, et al. Continuously evaluating performance in deceased donation: the Spanish quality assurance program. Am J Transplant. 2012;12:2507–2513.
    1. Irish GL, Coates PT, Clayton PA. Cancer post kidney transplant: the question of risk. J Nephrol. 2020;33:1129–1131.
    1. Nalesnik MA, Woodle ES, Dimaio JM, et al. Donor-transmitted malignancies in organ transplantation: assessment of clinical risk. Am J Transplant. 2011;11:1140–1147.
    1. Advisory Committee on the Safety of Blood, Tissues and Organs. Transplantation of organs from deceased donors with cancer or a history of cancer. 2014. Revised December 2020. Available at https://assets.publishing.service.gov.uk/government/uploads/system/uploa... . Accessed 15, December 2021.