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Adverse Occurrence type:
In this series, 204 of 588 corneal donors (34.7%) had cancer. Of the cancer donors, 86.8% had solid cancer and 13.2% had hematological cancer. No cancer transmission was seen in 325 recipients.
Time to detection:
No cancer transmission seen. Recipients were followed for an average of 64.1 months (range 30-86 months).
Alerting signals, symptoms, evidence of occurrence:
None in recipients.
Demonstration of imputability or root cause:
Histologic study of the enucleated donor eye showed micrometastases in two cases. One donor with breast adenocarcinoma showed a single focus of malignant cells in the posterior pole, in the choroid. One donor with chronic myeloid leukemia showed leukemic infiltrates in the anterior and posterior poles, mainly in sclera and episclera with occasional foci in choroid and iris. None of the recipients developed cancer with 6.5 and 6 year follow up.
Suggest new keywords:
Lopez-Navidad A, Soler N, Caballero F, Lerma E, Gris O. Corneal transplantations from donors with cancer. Transplantation 2007;83:1345-1350.
For committee review
Expert comments for publication:
On the basis of their review, the authors suggest that in cases of donors with cancer: 1. eyes with macroscopic tumor masses should be rejected; 2. cornea and anterior chamber should be examined by slit lamp to discard those with tumor infiltration; 3. histopathological study of the eye should be performed prior to corneal transplantation and cornea should be rejected in cases of tumor cellular infiltration. They also recommend careful recipient follow up during the first two years after transplant.