Status:
Ready to upload
Record number:
1787
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:
A few days (exact interval not specified) after transplantation, review of the donor biopsy showed increased plasma cells raising suspicion of malignant plasma cell proliferation. The liver was removed after 9 days and replaced by a new graft and examination of the allograft explant confirmed plasma cell myeloma. 3 years after this, a solitary asmyptomatic mass was detected in the peritoneum. This was removed and shown to be a lambda light chain-restricted EBV negative plasmacytoma. HLA phenotyping showed a combination of first donor and recipient phenotypes, without evidence of cells from the second donor.
Alerting signals, symptoms, evidence of occurrence:
Initial rescreening of the first liver allograft raised the issue of plasmacytoma; followup screening showed an asymptomatic peritoneal mass that was successfully treated by excision.
Demonstration of imputability or root cause:
Histologic examination of first allograft liver and HLA typing of peritoneal mass.
Imputability grade:
2 Probable
Groups audience:
Keywords:
References:
Suggest new keywords:
case report
DBD/donation after brain death
Liver transplant
Multiple myeloma/plasmacytoma leukemia
Blood and lymphoid
DNA typing
histologic analysis
Reference attachment:
Suggest references:
Sosin M, Nassif SR, Girlanda R, Desai CS, Satoskar R, Kallakury B, et al. Isolated peritoneal donor-related plasmacytoma 3 years after liver transplantation: a case report. Am J Transplant. 2014 Feb;14(2):472–6.
Note:
first Review Carl-Ludwig 2018-05-06
second MN 5/20/18
Expert comments for publication:
Although the peritoneal plasmacytoma was lambda light chain restricted and the explant liver from the first donor showed atypical plasma cells that raised concern and apparent confirmation of plasmacytoma, it is curious that the immunocytochemical characterization of the liver plasma cell infiltrate is not reported, as this would have strengthened the position that a donor plasmacytoma was transmitted, as opposed to having arisen posttransplant as a form of post-transplant lymphoproliferative disorder (PTLD).