Status:
Ready to upload
Record number:
1907
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
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:
9 months
Alerting signals, symptoms, evidence of occurrence:
Mass lesion was detected in allograft kidney, biopsy showed small cell lung carcinoma
Demonstration of imputability or root cause:
Molecular profiling of microsatellite loci
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
Case report
Deceased donor
Kidney transplant
DNA typing
Microsatellite analysis
Lung cancer, small cell
Transplantectomy
Chemotherapy
Withdrawal of immunosuppression
Small cell carcinoma
Reference attachment:
Suggest references:
Schroettner P, Gruellich C, Hasskarl J, Waller CF. Achievement of a continuous complete remission in a kidney transplant patient with advanced donor-derived small cell carcinoma. Transplantation. 2010;90(1):94-5.
Note:
second Review Carl-Ludwig: ok
Expert comments for publication:
This is a follow-up report of a prior case report (NOTIFY record 1788) in which small cell lung cancer was transmitted to two renal recipients. The current article details therapy and outcome of one of the patients. Allograft nephrectomy and discontinuation of immunosuppression was followed by 4 cycles of carboplatinum and etoposide. Partial remission was observed at completion of therapy. One year later no tumor was detectable. The patient remained in remission at the time of this report, an additional 2 years after that. The authors argue that this provides evidence for an alloresponse against the tumor. This may be true, since there are reports of donor tumor remission following cessation of immunosuppression. However, no direct evidence of an alloresponse is presented and the report must be considered anecdotal, if interesting. Unfortunately, there is no way to predict who will and who will not respond to withdrawal of immunosuppression in this circumstance.