Record number:
69
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
The donor tumor was suspected to be of lung primary site, but this could not be proven.
Most recent risk assessment for Lung Cancer (Council of Europe, 2022): Any histotype of newly-diagnosed lung cancer is an unacceptable risk for organ donation. Lung cancer in the donor history: Treated lung cancer is considered to be associated with a high transmission risk. Risk may decrease after curative therapy, with recurrence-free time and with increasing probability of cure.
Time to detection:
3 months
Alerting signals, symptoms, evidence of occurrence:
Increased creatinine. Graft biopsy showed no rejection but found to have malignant cells. An MRI performed the day after the biopsy revealed nodules in the transplanted kidney, indicative of carcinoma. Transplant-nephrectomy was performed.
The centre that had transplanted the second kidney was contacted and the patient recalled. Tumor lesions were also found within this graft.
Demonstration of imputability or root cause:
Tumor in the donor was diagnosed after transplantation had been carried out (brain biopsy of the donor, unknown by the transplantation team, had been performed). Immunohistochemical findings were compatible with anaplastic carcinoma, suspected to be of pulmonary origin, but no autopsy was done.
3 months later, tumor was found in both grafts. Histology of the brain biopsy of the donor and the graft biopsy of first recipient analyzed and the same anaplastic tumor detected. Immunohistochemical staining performed, not detailed. Specific tests on the other graft, not detailed. Patient underwent chemotherapy following allograft removal and was alive at time of report.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
Neoplasia
Case Report
Deceased donor
Kidney transplant
Histologic analysis
Carcinoma of unknown primary site
Lung and lower respiratory system
Transplantectomy
Chemotherapy
Patient survival
Malignancy
Suggest references:
1. Krapp JD, Brauer RB, Matevossian E, Gerauer KE, Thorban S, Becker K, et al. Donor transmitted anaplastic carcinoma in a kidney-transplant recipient. Transpl Int. Munksgaard International Publishers; 2005 Sep;18(9):1109–12.