Status:
Ready to upload
Record number:
2195
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for choriocarcinoma (Council of Europe, 2018):
Potential donors with recently diagnosed choriocarcinoma represent an Unacceptable Risk for organ donation. Those with a history of choriocarcinoma represent a High or Unacceptable risk for organ donation due to the reported high transmission and mortality rates, depending upon recurrence free time, which is not clearly defined in the literature.
Time to detection:
5 weeks
Alerting signals, symptoms, evidence of occurrence:
Patient had erythema and discomfort at operative site, fever, chills, cough, hematuria and dysuria. Ultrasound was negative and she was treated for urinary tract infection. In the interim, the physicians were informed of elevated hCG and metastatic choriocarcinoma in a partial liver recipient from the same donor. hCG in the kidney recipient was tested and found to be elevated.
Demonstration of imputability or root cause:
The donor was a 25 year old woman with non traumatic brain hemorrhage 48 days after giving birth. hCG level was rising and this information was available at time of transplant but was not considered. One of two partial liver recipients form the donor had elevated hCG and died of metastatic choriocarcinoma 8 weeks after transplant. A second partial liver recipient (male) and a second kidney recipient (male) did not develop tumors. (The kidney recipient underwent transplant nephrectomy following notification of donor cancer).
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
Malignancy
Case Report
Deceased donor
DBD/donation after brain death
Kidney transplant
Kidney recipient
Kidney transplantation
Liver transplant
Liver recipient
Liver transplantation
Choriocarcinoma
Therapy discussed
Reference attachment:
Suggest references:
Aghsaeifard Z, Latifi M, Bagherpour F, Rahbar M, Rahimzadeh H, Namdari F, Dialameh H, Taheri Mahmoudi M, Dehghani S. Choriocarcinoma transmitted with the transplant: Case study. SAGE Open Med Case Rep. 2022 Apr 14;10:2050313X221087567. doi: 10.1177/2050313X221087567. PMID: 35449531; PMCID: PMC9016535.
Note:
Uploaded MN 5/13/22
First review MN 5/15/22
Second review 1/30/23
Expert comments for publication:
The authors stress that retrospective review of donor records showed increasing hCG level prior to death. Additionally, the donor was a woman of childbearing age who had recently given birth and died of cerebral hemorrhage. They stress closer attention to such signs. Although 2 males who received organs from the donor did not develop tumor, transmission of choriocarcinoma can occur regardless of recipient sex. The authors also note that allograft nephrectomy might have been attempted in the kidney recipient.