(Case report): Donor-derived small cell carcinoma in transplant kidney (2007)

Status: 
Ready to upload
Record number: 
1788
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Most recent risk assessment for neuroendocrine tumors (including high grade neuroendocrine carcinomas, low(er) grade neuroendocrine tumors, carcinoid tumors, pheochromocytomas and paragangliomas) (Council of Europe, 2022): Due to their potential for undetected metastasis, high-grade neuro-endocrine carcinomas are an unacceptable risk for organ donation. Insufficient information exists to guide practice for neuro-endocrine tumours, carcinoid tumours, phaeochromocytomas and paragangliomas. In the case of critically ill recipients, these tumours might be acceptable after a careful individual risk–benefit analysis. Neuro-endocrine tumours in the donor history: No data are available from the literature. Due to this and their potential for undetected metastasis, treated high-grade neuro-endocrine neoplasms in the donor history are classified as high risk for organ donation. In the case of a previous history (> 5 years) of neuro-¬endocrine tumours (carcinoid tumours, phaeochromocytomas and paragangliomas) without any kind of disease recurrence or progression, donors should be considered high risk in the absence of sufficient information to guide practice.
Time to detection: 
9 months
Alerting signals, symptoms, evidence of occurrence: 
Routine exam showed elevated creatinine; biopsy showed small cell carcinoma in allograft kidney
Demonstration of imputability or root cause: 
DNA short tandem repeat analysis showed tumor to be of donor origin
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
case report
malignancy
lung cancer/ small cell
small cell carcinoma
kidney transplant
Suggest references: 
Göbel H, Gloy J, Neumann J, Wiech T, Pisarski P, Böhm J. Donor-derived small cell lung carcinoma in a transplanted kidney. Transplantation. 2007 Sep 27;84(6):800–2.
Expert comments for publication: 
Tumor present in allograft kidney and regional lymph nodes; carboplatin and etoposide given, patient reported well with enlarged nodes, follow-up interval not reported. Second kidney asymptomatic, but biopsy showed small cell carcinoma in allograft with spread to iliopsoas muscle. Allograft nephrectomy and similar chemotherapy given, patient reported well without follow-up interval reported. Donor had smoking history, not further specified. (A follow-up report (NOTIFY record 1907) document extended survival of the patient given chemotherapy, with a discussion by the authors suggesting a role for reconstituted anti-tumor alloreactivity following discontinuation of immunosuppression).