Case report: Urothelial carcinoma related to BK virus

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Record number: 
MPHO Type: 
Estimated frequency: 
Most recent risk assessment for urothelial carcinoma (Council of Europe, 2022): No literature exists regarding newly diagnosed urothelial cancer and organ donation. Therefore, the highest caution is recommended, and the advice of a urologist may be sought in assessing the individual donor tumour transmission risk. National recommendations should be followed since they vary in accepting these tumours. Urothelial cancer in the donor history: Strict follow-up must have been provided after primary diagnosis because these tumours may be multicentric and tend to recur, with a need for repeated cystoscopy and TUR-B, and for restaging. Kidney transplantation will be associated with increased risk, but this has not been classified in the literature yet. After a disease-free interval > 5 years, the transmission risk of invasive urothelial cancer will depend on the probability of cure and must be assessed individually before accepting a potential organ donor. No specific recommendations are available from the literature.
Time to detection: 
8 years
Alerting signals, symptoms, evidence of occurrence: 
Not given; urothelial carcinoma was first diagnosed in the urinary bladder but was determined to have originated in the donor renal pelvis.
Demonstration of imputability or root cause: 
Origin in donor tissue: donor-derived and associated with BK virus infection, not donor transmitted
Imputability grade: 
0 Excluded
Groups audience: 
Suggest new keywords: 
Case report
Deceased donor
Kidney transplant
DNA typing
Urothelial (transitional cell) carcinoma
Suggest references: 
Muller DC, Ramo M, Naegele K, Ribi S, Wetterauer C, Perrina V, et al. Donor-derived, metastatic urothelial cancer after kidney transplantation associated with a potentially oncogenic BK polyomavirus. J Pathol. 2018;244(3):265-70.
Donor-derived cancer associated with posttransplant BK virus infection, not donor-transmitted cancer. Carl-Ludwig: agree to Michael, of note obervation together with other cases: donor derived UC: Stop immunosuppresion+surgical removal of graft + Chemo? -> high probability of tumor rejection (in contrast to recipient derived - we should follwo this observation). BK virus: observe issue.
Expert comments for publication: 
This is basically a molecular study to relate the BK virus infection to the development of posttransplant urothelial carcinoma. It does not represent a case of donor tumor transmission.