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Adverse Occurrence type:
Most recent risk assessment for Lung Cancer (Council of Europe, 2022): Any histotype of newly-diagnosed lung cancer is an unacceptable risk for organ donation. Lung cancer in the donor history: Treated lung cancer is considered to be associated with a high transmission risk. Risk may decrease after curative therapy, with recurrence-free time and with increasing probability of cure.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
None; incidental finding in one kidney transplant in the allograft kidney at recipient necropsy after death due to severe cardiopulmonary disease seven months after transplantation; donor malignancy was detected at donor necropsy 3 days after transplantation of kidneys (lung adenocarcinoma with cerebral metastasis). Recipient of kidney did not undergo transplant nephrectomy due to poor cardiovascular status and high risk of mortality from additional surgery. Transmitted tumor remained clinically asymptomatic.
Demonstration of imputability or root cause:
Presence of an invasive, poorly differentiated adenocarcinoma with the same histological characteristics as donor tumor limited to the allograft kidney.
Suggest new keywords:
Harvey, L.; Fox, M. Transferral of malignancy as a complication of organ transplantation: an insuperable problem? J Clin Pathol 1981; 34 (2) :116 - 22
Included under "harm to recipient" rather than "risk of harm" because a) it will be easier to find and b) the tumor was growing and can be predicted to have caused harm in the near future.
Expert comments for publication:
Transmitted lung cancers become apparent in recipients a median of 9.2 months posttransplant according to DTAC data (unpublished). No information was available regarding the outcome of the recipient of the contralateral kidney.