Adverse Occurrence type:
Most recent risk assessment for sarcoma (Council of Europe, 2022): Due to the very aggressive behavior of sarcoma, they are considered an unacceptable risk for organ donation at any stage of disease. Sarcoma in donor history: Because of the very aggressive behavior of sarcoma, they are mostly considered an unacceptable risk for organ donation. After curative treatment and a recurrence-free survival of > 5 years, sarcomas are still assumed to be associated with a high risk for transmission.
Time to detection:
Alerting signals, symptoms, evidence of occurrence:
Liver: Transplanted because of hepatitis C and HCC. Cholestasis 13 months after Tx. Ultrasound and CT reveals a large necrotic lession within the left liver. Surgery reveals a tumor, resection being impossible. Histology reveals a sarcoma. The patient died 5 days after surgery because of multiorgan failure.
Demonstration of imputability or root cause:
- DCD with liver and kidneys transplanted. Liver and one of the kidney recipients affected. Second kidney with PNF removed shortly after Tx. No evidence of tumor 15 months later. - Histology of tumors found in liver and kidney recipients histologically comparable. - Kariotype gender mismatch in liver recipient (donor female-recipient male).
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