Adverse Occurrence type:
Most recent risk assessment for melanoma (Council of Europe, 2022): Due to the very aggressive behaviour of this tumour, it is considered an unacceptable risk for organ donation. Malignant melanoma in the donor history: Due to the lack of exhaustive data, transplanting organs from donors with treated malignant melanoma must still be considered to be associated with a high transmission risk. If precise donor data about staging, therapy, follow-up and recurrence-free survival are available, and evaluation by the dermato-oncologist concludes there is a low probability of recurrence and metastasis, organ donation might be considered for selected recipients.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Onset of dyspnea with heavy exertion, dry cough. CT scan of chest showed several nodules and enlarging lymph node. Endobrochial biopsies revealed melanoma.
Demonstration of imputability or root cause:
Previous history of melanoma in the donor (32 years earlier), but not known to have an active malignancy at the time of donation. Donor with surgical excision of melanoma 32 years before donation. DNA typing by PCR demonstrated donor origin. 24 months after transplantation none of the other recipients transplanted from the same donor had developed a melanoma.
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Expert comments for publication:
Longest reported disease-free interval for transmission of donor-derived melanoma.