Status:
Ready to upload
Record number:
2033
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
This is a heterogeneous review of donors with a history of cancer (please refer to expert comment)
Time to detection:
N/A
Alerting signals, symptoms, evidence of occurrence:
N/A
Demonstration of imputability or root cause:
N/A
Imputability grade:
Not Assessable
Groups audience:
Suggest new keywords:
Registry series
donor cancer without transmission
History of cancer
Reference attachment:
Suggest references:
Huang S, Tang Y, Zhu Z, Yang J, Zhang Z, Wang L, et al. Outcomes of Organ Transplantation from Donors with a Cancer History. Med Sci Monit. 2018;24:997-1007.
Note:
Carl-Ludwig: I checked the cox-regression statement: I find not variables, against which they adjusted survival analysis excluding a selection bias between recipients for grafts from DWCH versus DWNCH. Still recipients of DWCH do better or equivalent to recipients of DWNCH and ECD accordingt to SRTR definition. I am not happy with the statistics - on the one side in favor of not to discard DWCH in general, but on the other side we miss data describing the decision to use a grafts from a DWCCH versus DWNCH+/-ECD on the real life. I am not sure how we can obtain such data. Agree to Michael, for me ok to add "The survival analysis should not be over- or underestimated because some limitations due to missing data exist. Still the data do not justify to exclude donors per se without individual risk benefit assessment."
Technical advice: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5825978/ is the link, the pdf excceds 512 MB.
Expert comments for publication:
This is a 15 year review of outcomes of transplants from donors with a history of cancer (1/1/2000-12/31/2014) based on SRTR data. As such, it is qualified by the knowledge that registry data is not exactly perfect. There was a trend to use more of these donors during the study period (a total of 8385 donors with a history of cancer are included). The results are general, though they conclude that heart recipients who received organs from donors with a history of hematologic or otolaryngology cancers had a lower 5 year adjusted patient survival, perhaps also related to treatment, and they suggest caution in this circumstance. In general, recipients who received organs from donors with a history of cancer had a lower patient and graft survival. Again, further granularity is not provided. They suggest that GI and GU cancers in renal recipients are risk factors for survival. From a statistical standpoint, they found no difference in recipients who received organs from donors with CNS tumors.
This is a reasonable statistical analysis of this subject; it may have varying application to individual cases and a review of the paper is suggested before trying to apply these general data to individual cases in which an all or nothing situation may apply. The fact that donor transmission is such an unusual event may make large scale statistical analyses of limited use in making clinical decisions for individual cases. However, in general, the paper suggests that donors with a history of cancer may represent an underutilized source of organs for transplant and the possibility of utilizing such donors should be seriously considered.