Status:
Ready to upload
Record number:
2048
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for CNS lymphoma (Council of Europe, 2018): donors with primary CNS lymphoma have an unacceptable risk for tumor transmission.
Time to detection:
22 months
Alerting signals, symptoms, evidence of occurrence:
The recipient presented with multiple cutaneous lesions
Demonstration of imputability or root cause:
No assertion that the recipient Kaposi sarcoma arose from the donor.
Imputability grade:
0 Excluded
Groups audience:
Keywords:
Suggest new keywords:
Malignancy
Case Report
Deceased donor
Liver transplant
Liver recipient
Liver transplantation
CNS lymphoma
Kaposi's sarcoma
Therapy discussed
Reference attachment:
Suggest references:
Isik B, Yilmaz S, Kirimlioglu V, Kirimlioglu H, Yilmaz M, Sogutlu G, et al. Kaposi's sarcoma after liver transplantation from a donor with a history of ventriculoperitoneal shunt and craniotomy for primary central nervous system lymphoma: report of a case. Surgery Today. 2008;38(1):90-4.
Note:
First review MN 4/16/22
Second review by K. Moench (2022-04-24): Rather classify "risk of harm" since the lymphoma was not transmitted and the Kaposi sarcoma is not necessarily of donor origin? Interesting case and brilliant summary, Mike!
Agree with risk of harm. MN 2022-05-04.
Expert comments for publication:
The main argument of the authors is that donors with CNS lymphomas that have not metastasized outside of the CNS can be considered as organ donors. This is based on the case report of this donor who had a high grade CNS B cell lymphoma that was found by multiple studies to be restricted to the CNS, despite recent craniotomy and ventriculoperitoneal shunt. It is important to note that the Council of Europe currently considers CNS lymphoma to represent an unacceptable risk for tumor transmission. Nevertheless, it is notable that no tumor developed in this liver recipient. (No information is provided regarding the recipients of two kidneys that were also transplanted from this donor). It is also important to understand that an unacceptable risk of tumor transmission does not necessarily imply a 100% risk of transmission. In the case of other CNS tumors, recent studies have shown a lower risk of transmission than had been previously assumed. Therefore it is important to report cases such as this, and it is also important to remember that they represent anecdotal reports. The development of HHV8-negative Kaposi sarcoma in the HIV-negative recipient is of interest, but it is not clear how this might relate to a donor CNS lymphoma. The donor HIV status and tumor EBV status are not reported. Kaposi sarcoma therapy consisted of reduced immunosuppression leading to liver failure, retransplantation, and patient death with continued lesions.