Record to update:
Adverse Occurrence type:
MPHO Type:
Estimates Frequency:
Most recent risk assessment for pancreatic cancer (Council of Europe, 2016): active pancreatic cancer is considered an unacceptable risk for organ donation. Donors with a history of treated tumors are classified as high risk although it is possible that the risk may decrease in cases of early-stage disease following curative therapy and long recurrence free time.
Time to detection:
42 months.
Alerting signals, symptoms, evidence of occurrence :
Hyperglycemia and increased creatinine. Ultrasound at 2.5 years demonstrated ectasia of the pancreatic duct. Graft function improved but after one year, patient presented with abdominal pain, fever, and peripancreatic fluid collection. Laparotomy revealed a moderately differentiated pancreatic adenocarcinoma infiltrating the ileal segment.
Demonstration of imputability or root cause:
Pancreatectomy performed. Tumor sample submitted for molecular typing by DNA sequencing following group-specific amplification, donor alleles were identified, supporting, but not fully confirming according to authors, donor origin. The patient died 51 months after transplantation from metastatic disease in spite of withdrawal of immunosuppression and chemotherapy. No more than one recipient was affected (No disease evident in heart recipient (51 mo. followup), liver recipient (2 year followup, died of rejection), or lung recipient (died at 10 days with sepsis). Condition was not known in advance in the donor. No tumor evident at transplant evaluation according to authors.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
malignancy
Note:
Too many unnecessary keywords in original
Suggest new keywords:
Deceased donor
Case report
DNA typing
kidney transplant
pancreas transplant
chemotherapy
pancreatectomy
pancreas cancer
Adverse occurrence description:
Case Report: Adenocarcinoma in allograft pancreas
Suggest references:
(Use same reference as original) Roza et al. [1338]
Expert comments for publication:
Presence of donor DNA in tumor reasonable proof of origin; admixed recipient DNA could be vascular, inflammatory cells, etc.