Record number:
286
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
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:
2.5 - 42 months
Alerting signals, symptoms, evidence of occurrence:
Series from the IPITTR of 20 recipients (17 kidneys, 2 livers and one heart) from 11 donors (10 deceased and 1 living donor) in whom the diagnosis of melanoma could be retrospectively established. Of the 20 recipients 16 developed metastatic malignant melanoma (13 kidneys, 2 livers and one heart), 3 never manifested evidence of malignancy (3 kidneys) and 1 had local spread beyond the allograft (1 kidney). No specific information is provided on the alerting signals, with a few exceptions: 1) One patient was noted to have a dark cyst in the renal allograft after it was revascularized. A biopsy of it showed malignant melanoma and allograft nephrectomy was performed. 2) In the patient who had local spread of malignant melanoma beyond the allograft, this was discovered 44 months after transplantation when the kidney was removed because of chronic rejection.
Demonstration of imputability or root cause:
Previous history of malignant melanoma in the donor (condition unknown at the moment of recovery) with same type of tumour in both donors and recipients. PCR. In some cases, more than one recipient from the same donor affected.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
References:
Suggest new keywords:
Registry series
Deceased donor
Suggest references:
AAA