Adverse Occurrence type:
Most recent risk assessment for melanoma (Council of Europe, 2018): donors with active melanoma represent an unacceptable risk for organ donation. Donors with a history of treated melanoma are generally considered to represent a high transmission risk. Opinions vary. The SaBTO/UK states that a superficial spreading melanoma with tumor thickness less than 1.5 mm and with curative surgery and cancer free interval of more than five years is associated with a low transmission risk, although this conclusion is based on a small number of cases. UNOS/DTAC considers all patients with a history of melanoma to represent a high risk for transmission.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Lung: A mass was detected in the lung recipient´s allograft on routine chest X-ray three months after transplantation, it was followed with serial X-rays and when it failed to resolve, a biospy was performed. This demonstrated malignant melanoma, confirmed to be of donor origin by HLA-DR typing.
Demonstration of imputability or root cause:
Lung: mass in the lung recipient´s allograft, biopsy demonstrated malignant melanoma, confirmed to be of donor origin by HLA-DR typing.
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Expert comments for publication:
Renal recipient from same donor had microscopic melanoma in kidney; a second renal recipient and heart recipient did not have evidence of tumor.