Record number:
254
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment (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
Time to detection:
8 - 9 years
Alerting signals, symptoms, evidence of occurrence:
Donor-derived tumor. 2 cases of de novo HCC arising in liver transplants after HBV reinfection.
Demonstration of imputability or root cause:
Tumor and nonneoplastic liver cells from the patient´s own liver and donor liver were isolated by laser microdissection and highly polymorphic short tardem DNA repeats (STR) were investigated. Isolated tumor cells revealed donor-specific STR genotypes that could clearly be discriminated from the genotype of the host. Authors concluded that HBV-associated de novo HCC in liver transplants is of donor, but not host origin.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
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Liver transplant
Single center series
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Expert comments for publication:
The extended post-transplant period before tumor development and the prior development of post-transplant cirrhosis are consistent with the interpretation that this represents a post-transplant event arising from donor cells, and not a tumor transmitted at the time of transplant. The purpose of the article is to highlight the methodology of host: donor distinction using DNA analysis.