Single center series and subject review: Cancer transmission through cornea transplantation

Status: 
Ready to upload
Record number: 
1902
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Cancer transmission through cornea transplantation is very rare and therefore, corneae are accepted for transplant even though the donor has a known systemic cancer. Exceptions are hematological donor cancers and malignant melanoma as well as primary cancers of the donor eye (e.g. retinoblastoma, anterior segment cancer). For more Information see also the "Guide to the Quality and safety of tissues for transplantation" of the Council of Europe (free download).
Time to detection: 
None, no transmission reported.
Alerting signals, symptoms, evidence of occurrence: 
None, no transmission reported.
Demonstration of imputability or root cause: 
None, no transmission reported.
Groups audience: 
Suggest new keywords: 
malignancy
single center series
cornea transplant
Donor cancer without transmission
Suggest references: 
Salame N, Viel JF, Arveux P, Delbosc B. Cancer transmission through corneal transplantation. Cornea. 2001;20(7):680-2.
Note: 
First review done on September 28, 2018 (Kerstin) @ the Notify Team: again, I propose to add a new category under risk of harm that says something like "donor cancer without transmission". The term "unsuitable MPHO released for clinical use" is wrong because those rgoans and tissues from donors with cancer are mostly absolutely not unsuitable. They just have a certain risk for transmission. Please discuss and try to find a solution. Thanks! 7/27/19- second review; I agree with her suggestion; OK to upload MN NEW Adverse occurrence type: Risk of harm => Donor disease without transmission (EP)
Expert comments for publication: 
Retrospective analysis from 2001 of cornea transplants in a single center in France. Study population were all recipients who lived in the same cancer registry department (143 out of 548 total recipients in a 9-year period). No graft recipient developed a known malignancy of the donor. Of 40 recipients who received corneae from donors with cancer (data from cancer registry and eye bank), one developed cancer (prostate) after transplant which was not identical to the donor cancer (lymphoma). Unfortunately, the specific donor cancer diagnoses are not reported in the paper and there is no information about stages, grading, treatment, cancer-free survival etc. Of the remaining 103 recipients whose donors had NO confirmed cancer, 5 developed cancer after cornea transplant (colon, prostate, bladder, lymphoma). There was no increased overall incidence of cancer in the study population compared to the reference population. Note that this study was restricted to corneal transplants and did not include the newer forms of transplant such as keratolimbal transplants, which have a risk of donor cancer transmission somewhat closer to vascularized transplants and for which different standards apply.