Case Report: Transmission of (probable gastrointestinal) adenocarcinoma by kidney transplant (2017)

In this case the original localization of the presumed transmitted gastrointestinal cancer cannot be established. The authors suggest upper gastrointestinal origin based on the presence of a Virchow's node in one of the recipients. The Council of Europe recommendations for upper and lower gastroinstenstinal cancer are included: Most recent risk assessment for gastric cancer (Council of Europe, 2022): Oesophageal, gastric, pancreatic, liver, and biliary cancers diagnosed during donor procurement: These tumours are classified as unacceptable risk. Oesophageal, gastric, pancreatic, liver, and biliary cancers in the donor history: Treated tumours of these kinds in the donor history are classified as high risk due to their aggressive behaviour. Risk may decrease for early stages after curative therapy, with recurrence-free time > 5 years and with increasing probability of cure, especially in cases of long-term survivors. Most recent risk assessment for colorectal cancer (Council of Europe, 2022): 1) Colorectal cancer diagnosed during donor procurement: Donors with pT1 tumours (where pT1 is defined in AJCC, 8th edition) should only be accepted for organ donation with the utmost caution, and a high transmission risk must be assumed. Patients with higher stages of newly diagnosed, active colorectal cancer should not be accepted for organ donation (unacceptable risk). 2) Colorectal cancer in donor history: The presence of pT1/pT2 colorectal carcinoma (infiltration of submucosa/muscularis propria) in the donor without lymph node or distant metastases is assumed to have a low transmission risk after adequate treatment and disease-free survival of > 5 years. Risk increases with stage, and probability of presumed cure has to be taken into account.