Status:
Ready to upload
Record number:
2035
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
(Council of Europe Guidelines 2020): MGUS (monoclonal gammopathy of undetermined significance) with accurate diagnosis and appropriate follow-up without progression to multiple myeloma or related disorders after a definite disease-free interval of 5-10 years may be considered for organ donation and be assumed to pose a low risk for transmission.
It might be reasonable to accept an organ donor with a pre-diagnosed MGUS, especially in cases of confirmed MGUS without progression where the diagnosis has been confirmed years before.
Most recent risk assessment for leukemia, lymphoma and plasmacytoma (Council of Europe, 2022):
Leukaemia, lymphoma and plasmacytoma diagnosed during donor procurement: These cancers are classified as an unacceptable risk for organ donation. Leukaemia, lymphoma and plasmacytoma in the donor history: Active (acute or chronic) leukaemia, lymphoma and plasmacytoma are an unacceptable risk for organ donation. Treated acute leukaemia and lymphoma after a definite disease-free interval of 10 years may be considered for organ donation with an assumed high risk for transmission.
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:
Keywords:
Suggest new keywords:
Review article
Deceased donor
Living donor
Malignancy
MGUS (monoclonal gammopathy of unknown significance)
Reference attachment:
Suggest references:
Cowan AJ, Johnson CK, Libby EN. Plasma cell diseases and organ transplant: A comprehensive review. Am J Transplant. 2018;18(5):1046-58.
Note:
Please add the classification of Monoclonal Gammopathy of undetermined significance (MGUS) (or however it is worded) under the Malignancy->Blood and lymphoid classification and change the selection from "lymphoma, B cell other..." to that one.
Agree Crl-ludwig 2nd review
OK done (EP)
Expert comments for publication:
This article largely deals with evidence-based information on various plasma cell dyscrasias in the recipient, but does also include a section on MGUS (monoclonal gammopathy of undetermined significance) in organ donors. They cite several reports: Serra et al (NDT Plus. 2011;4(4):256-7), in which 2 cases of living donor kidney transplant with donor MGUS did not transmit disease, Felldin et al (Am J Transplant 2016;16(9):2676-83), in which 2 deceased donors with MGUS (diagnosed retrospectively) transmitted 2 lymphoplasmacytic lymphomas, 2 MGUS and 3 multiple myelomas to all 7 organ recipients, and two additional case reports (Grey et al, Br. J Haematol 2000;108(3):592-4 and Peri et al, Am J Transplant 2006;6(2):419-22) of donor origin myeloma arising after kidney transplant. The article also includes guidelines for risk assessment of progression of multiple myeloma, which may be helpful in assessing donors.