Record number:
290
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:
18 and 24 months (two recipients from same donor)
Alerting signals, symptoms, evidence of occurrence:
Recipient 1: routine mamography shows a nodule in the breast, initally diagnosed as a primary breast cancer. Afterwards, pain and swelling of the graft + two subcutaneous nodules detected and biopsied, result compatible with secondary melanoma, with no primary melanoma identified. Recipient 2: Palpable lump over graft. Biopsy showed a secondary melanoma, with no primary melanoma identified.
Demonstration of imputability or root cause:
Previous history of melanoma in the donor (excised 16 years before donation), being apparently disease-free at the time of donation. Two kidney recipients from the same donor affected.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Suggest new keywords:
Case report
Kidney transplant
Suggest references:
AAA
Expert comments for publication:
This case is remarkable for the long disease free interval in the donor (16 years) with transmission to 2 renal recipients. Of note, the donor died of a presumed subarachnoid hemorrhage and autopsy was not performed. Therefore the presence of melanoma in the donor cannot be entirely excluded.