Record number:
70
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
- Most recent risk assessment for astrocytoma WHO grades 3 or 4 and glioblastoma WHO grade 4 (Council of Europe, 2025):
Spontaneous extraneural metastases of grade 3 astrocytomas and grade 4 glioblastomas are rare, but such metastases have been observed, and seem to occur more frequently when associated with prior surgical treatment and/or ventriculo-peritoneal drainage or chemo-/radiotherapy.
Potential donors with WHO grade 3 astrocytomas can be accepted as organ donors. Transmission risk is considered low to intermediate for tumours without any risk factors.
Potential donors with glioblastoma IDH-wildtype or astrocytoma IDH-mutant are considered intermediate risk for transmission, depending on different national recommendations, which are expected to be adjusted with increasing evidence.
The transmission risk is increased in all cases with previous interventions such as tumour resection, ventriculo-peritoneal/-atrial drainage and/or cranial chemo-/radiotherapy.
Time to detection:
20 months
Alerting signals, symptoms, evidence of occurrence:
Metastatic disease resulting in death 80 months after transplantation.
Demonstration of imputability or root cause:
Known condition in the donor (grade III astrocytoma, with no other risk factor for transmission)
Imputability grade:
Not Assessable
Groups audience:
Keywords:
Suggest new keywords:
Neoplasia
Registry Series
Deceased donor
Central nervous system
Astrocytoma (WHO grade 3)
Suggest references:
Buell JF, Trofe J, Sethuraman G, Hanaway MJ, Beebe TM, Gross TG, et al. Donors with central nervous system malignancies: are they truly safe? Transplantation. 2003 Jul 27;76(2):340–3.
Expert comments for publication:
In this series, it is noted that 1 of 4 donors with Grade III or IV astrocytoma transmitted malignancy, out of a total of 25 organs transplanted. Additional donors in this series (of 25 transplanted organs) included 5 with prior surgical intervention, 4 with radiation and 4 with chemotherapy.