Single center series: Donor gallbladder carcinoma transmitted by liver transplantation

Status: 
Ready to upload
Record number: 
2203
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Most recent risk assessment for biliary cancer (Council of Europe, 2018): donors with active biliary cancer are considered to represent an unacceptable risk for tumor transmission. Donors with a history of treated tumors are classified as high risk although it is possible that the risk may decrease in cases of early-stage disease following curative therapy and recurrence free time >5 years. (no specific data for gallbladder cancer available)
Time to detection: 
Shortly after time of liver transplant.
Alerting signals, symptoms, evidence of occurrence: 
All 3 cases were detected by histopathologic examination of the donor gallbladder. In one case a frozen section of cystic duct was performed and was negative at the time of transplant. The diagnosis in all 3 cases was made on permanent sections which would be available after the transplant had been performed. In all 3 cases CT imaging did not show tumor.
Demonstration of imputability or root cause: 
Histology of donor material
Imputability grade: 
3 Definite/Certain/Proven
Groups audience: 
Suggest new keywords: 
Malignancy
Single Center Series
Deceased donor
Liver transplant
Liver recipient
Histological examination
Gallbladder cancer
Therapy discussed
Suggest references: 
Chara C, Fernández de Sevilla E, Golse N, Cherqui D, Adam R, Allard MA. Accidental transplantation of hepatic graft with incidental T2 gallbladder carcinoma: a report of 3 cases. Transpl Int. 2020 Nov;33(11):1569-1571. doi: 10.1111/tri.13723. Epub 2020 Sep 11. PMID: 32852848.
Note: 
Uploaded MN 5/13/22 first review CLFF 5/19/22 2nd review MN 5/29
Expert comments for publication: 
This report from the Paul Brousse Hospital documents 3 examples of liver transplant with incidental gallbladder carcinoma out of 4009 liver transplants during 1993-2019.They note that, although rare, this possibility should be considered and the gallbladder examined at time of donation in old donors or donors with cholecystitis. Treatment is discussed, and they prefer retransplantation to resection when possible. Two patients underwent retransplantation, with one alive at 16 months without recurrence. The second patient died at 7 years without evidence of gallbladder cancer recurrence. One patient could not be transplanted and has stable lung metastases that are assumed to represent colorectal metastases unrelated to the donor gallbladder tumor.