Status:
Ready to upload
Record number:
1556
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for leukemia, lymphoma and plasmacytoma (Council of Europe, 2022):
Leukaemia, lymphoma and plasmacytoma diagnosed during donor procurement: These cancers are classified as an unacceptable risk for organ donation. Leukaemia, lymphoma and plasmacytoma in the donor history: Active (acute or chronic) leukaemia, lymphoma and plasmacytoma are an unacceptable risk for organ donation. Treated acute leukaemia and lymphoma after a definite disease-free interval of 10 years may be considered for organ donation with an assumed high risk for transmission.
Time to detection:
0 - 5 days
Alerting signals, symptoms, evidence of occurrence:
None (incidental biopsy finding). Recipient 1: incidental finding in wedge biopsy from time of transplant; Recipient 2: needle biopsy day 5 after transplant
Demonstration of imputability or root cause:
Transmitted B-cell lymphoma (no evidence in donor: normal full and differential blood count, normal lymph node histology at time of organ procurement) from male donor into 2 female kidney recipients. Discovered by routine biopsy at time of transplant (recip.1) and needle biopsy on day 5 posttransplant (recip.2). Subsequently, donor cells in recipient´s peripheral blood were confirmed by highly sensitive nested PCR (proof of Y-chromosome of male donor) while at the same time peripheral blood flow cytometry did not show any donor cells. In both cases transplantnephrectomy and withdrawal of immunosuppression led to elimination of all donor cells (microchimerism was shown on day 6 after transplantation and day 1 after transplant nephrectomy but was negative 1 month after transplantnephrectomy). Both recipients are well after 12 months.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
References:
Suggest references:
Novel surveillance and cure of a donor-transmitted lymphoma in a renal allograft recipient