Registry series: New Italian guidelines for donors with prostate cancer (2010)

(Council of Europe, 2018): If recent Gleason score is available, then small intra-prostatic, low-grade (Gleason score ≤ 6) tumours are considered minimal risk, intra-prostatic tumours with Gleason score 7 are considered low-to-intermediate risk and intra-prostatic(pT2c) tumours with Gleason score > 7 are considered high risk. Histological examination of the entire prostate with a valid grading of the tumour is time-consuming and the results might not always be available before an organ is transplanted. Donors with extra-prostatic tumour extension should be unequivocally excluded from donation and represent an unacceptable risk. The acceptable time intervals for complete remission of historical prostate cancer are correlated to stage and Gleason grade of the tumour. Donors with a history of curatively treated prostate cancer ≤pT2 (tumour confined to prostate) and Gleason 3 + 3 as well as donors with very small prostate cancers and Gleason 3 + 3 under ‘active surveillance’ can be accepted for organ donation as minimal transmission risk at any time after diagnosis with the prerequisite of a frequently performed and non-suspicious follow-up. Prostate cancer confined to the prostate and Gleason grade 7 or less after curative treatment and cancer-free period > 5 years is considered minimal risk. Higher stages and higher Gleason grades require an individual risk assessment. A history of extra-prostatic tumour extension poses a high risk for transmission.