Record to update:
Adverse Occurrence type:
MPHO Type:
Estimates Frequency:
Most recent risk assessment for Liver Cancer (Council of Europe, 2016): Active liver or biliary cancer is considered to represent an Unacceptable Risk for organ donation. Tumors that have been treated are considered High Risk. This risk may decrease for early stage tumors after curative therapy or increasing recurrence-free time with increasing probability of cure. (Note that the present case report is of a donor cancer limited to the allograft liver, but the type of cancer beyond adenocarcinoma is not determined).
Time to detection:
6 months
Alerting signals, symptoms, evidence of occurrence :
Abnormal T-tube cholangiogram was performed in anticipation of T-tube removal 6 months after transplantation, which revealed multiple irregularities of intrahepatic ducts. Needle liver biopsy showed small focus of moderately well-differentiated adenocarcinoma. No extrahepatic metastases found.
Demonstration of imputability or root cause:
Fluorescence in situ hybridization for the Y chromosome indicates male origin of malignancy (donation male to female). Donor-related disease confirmed by comparative DNA analysis of genomic sequences from the donor liver, associated tumor, and recipient peripheral blood. 54 weeks after first transplant, second transplant performed. Explanted liver with multiple malignant nodules. Recipient with no evidence of malignancy 25 months after second transplant.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
case report
Suggest new keywords:
Carcinoma of unknown primary site
Liver transplant
Deceased donor
XY chromosomes
FISH (fluorescence in situ hybridization)
DNA typing
Malignancy
Transplantectomy
Adverse occurrence description:
Case report: Adenocarcinoma of unknown origin