Record number:
199
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment (Council of Europe, 2022): Oesophageal, gastric, pancreatic, liver and biliary cancers diagnosed during donor procurement : These tumours are classified as unacceptable risk. Oesophageal, gastric, pancreatic, liver and biliary cancers in the donor history: Treated tumours of these kinds in the donor history are classified as high risk due to their aggressive behaviour. Risk may decrease for early stages after curative therapy, with recurrence-free time > 5 years and with increasing probability of cure, especially in cases of long-term survivors
Time to detection:
9 months
Alerting signals, symptoms, evidence of occurrence:
Lymphangitis carcinomatosa of the lung 9 months after transplantation, likely contributing to the death of the patient 15 months after transplantation.
Demonstration of imputability or root cause:
- Condition known in the donor: donor tumour originally diagnosed on adrenal tissue removed from the donor kidney during bench preparation. - At the time of the diagnosis this kidney and the liver of the multi-organ donor had been transplanted. Liver patient urgently retransplanted in 24 hours and tumor found in explant (hilar lymph nodes). Renal recipient opted not to have a transplant nephrectomy. Contralateral kidney discarded.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Suggest new keywords:
pancreatic adenocarcinoma
pancreatic (ductal) adenocarcinoma
Case report
liver transplant
kidney transplant
Suggest references:
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Expert comments for publication:
It is notable that allograft hepatectomy in the liver recipient within 24 hours led to tumor-free survival at one year reported followup, despite the fact that donor hilar lymph nodes removed with the allograft contained adenocarcinoma.