Status:
Ready to upload
Record number:
2348
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for lung cancer (Council of Europe, 2022): Any histotype of newly diagnosed lung cancer is an unacceptable risk for organ donation. Treated lung cancer is considered to be associated with a high transmission risk. Risk may decrease after curative therapy, with recurrence-free time and with increasing probability of cure.
Time to detection:
Liver: 9 months
Kidney: 21 months
Alerting signals, symptoms, evidence of occurrence:
Liver: fatigue, diarrhea, acute kidney injury, and liver dysfunction. Multiple lesions at magnetic resonance imaging with histology and immunhistochemistry (biopsy) , in accordance with lung adenocarcinoma.
Kidney: shortness of breath, fatigue, edema, elevated urine protein, and acute kidney injury. Retroperitoneal adenpathy at computed tomography of the abdomen and pelvis with histology and immunhistochemistry (biopsy) , in accordance with lung adenocarcinoma.
Demonstration of imputability or root cause:
Microsatellite analysis showed donor origin in both cases; the tumor in each case contained an identical mutation in the epidermal growth factor gene.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
Malignancy
Lung cancer, Adenocarcinoma
Microsatellite instability analysis
Case report
Deceased donor
Kidney transplant
Liver transplant
DNA typing
Microsatellite analyss
Therapy discussed
Reference attachment:
Suggest references:
Arsenault A, Sharma P, Buckley J, Braun A, Ewing E, Rhakra S, et al. Transmission of Lung Adenocarcinoma From a Single Donor in 2 Transplant Recipients: A Case Report With Literature Review. Transplant Proc. 2023;55(8):1888-92.
Note:
Uploaded 7/21/24 MN- please clone record for liver recipient
First review AE 29/7/24
Second review MN 7/30/24
Expert comments for publication:
No specific information regarding the donor or extent of donor evaluation is provided by the authors. We therefore do not know if a TC (CT) scan had been done, which is the best test for evaluating possible lung lesions.
The authors discuss the question of multicancer detection assays that analyze circulating cell-free DNA and circulating tumor DNA (ctDNA). This is interesting although technical timing and transplant time cosntraints are still barriers and this approach is not practical for donor screening at present.