02953nas a2200349   4500008003900000245009700039210006900136260000800205300001200213490000700225520185000232653002302082653001902105653001602124653005002140653001102190653005302201653005002254653004902304653002602353653000902379653004402388653001502432653001602447653002202463100001502485700001302500700001702513700001302530700001602543856004402559       2005                          d00aCentral nervous system tumors in donors: misdiagnosis carries a high morbidity and mortality0 aCentral nervous system tumors in donors misdiagnosis carries a h  cMar  a583 - 40 v373 aINTRODUCTION: The cost of misdiagnosis of central nervous system (CNS) tumors in donors has not been previously described. The purpose of this study was to examine the Israel Penn International Transplant Tumor Registry experience with these donors. METHODS: All cases where an error in diagnosis was made due to intracranial hemorrhage from undiagnosed CNS tumors and where CNS metastases were misdiagnosed as primary brain tumor were examined. RESULTS: Forty-two organ recipients with misdiagnosed primary brain deaths from 29 donors were examined. After transplantation these donors were identified with: melanoma (23%), renal cell carcinoma (19%), choriocarcinoma (12%), sarcoma (10%), Kaposi's sarcoma (7%), and variable tumors (22%). The majority of patients were renal allograft recipients (84%) followed by liver (n = 4) and lung recipients (n = 1). The most commonly diagnostic error was with intracranial hemorrhage (ICH) (62%). A donor-related transmission rate of 74% (31/42) was identified among those patients with a misdiagnosed brain death. The majority of donor-transmitted cancers were identified in the recipient allograft (71%). Sixty-four percent of recipients suffered diffuse metastatic disease. Overall survival was poor, with a 5-year survival rate of 32% (10/31). Explantation was performed in 17 patients with confirmed donor-transmitted cancer, and in these patients a survival benefit was noted (10/17, 59%, vs 0/14, 0%; P < .01). CONCLUSIONS: Error in the diagnosis of donor brain death due to CNS tumors has significant and often fatal consequences. Allograft explantation for kidney recipients or retransplantation for extrarenal recipients may provide a survival benefit. Potential donors with unclear etiologies for brain death, particularly ICH, should be considered for a limited brain autopsy after donation.10a*Diagnostic Errors10a*Tissue Donors10aBrain Death10aCentral Nervous System Neoplasms / *diagnosis10aHumans10aKidney Transplantation / *mortality / *pathology10aLiver Transplantation / mortality / pathology10aLung Transplantation / mortality / pathology10aNeoplasms / mortality10aOhio10aPostoperative Complications / mortality10aRegistries10aReoperation10aSurvival Analysis1 aBuell, J F1 aGross, T1 aAlloway, R R1 aTrofe, J1 aWoodle, E S  uhttps://notifylibrary.org/reference/241