Adverse Occurrence type:
Most recent risk assessment for sarcoma (Council of Europe, 2018): Donors with active sarcoma are considered to represent an unacceptable risk for organ donation regardless of disease stage. Donors with a history of sarcoma are also generally considered to represent unacceptable risks for transmission. After curative therapy and recurrence free survival of more than five years, they are still assumed to be associated with a high risk for transmission. Gastrointestinal stromal tumors are not grouped with other sarcomas and are considered separately.
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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