Record number:
81
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:
4 months
Alerting signals, symptoms, evidence of occurrence:
Intraperitoneal and intrahepatic mass identified on routine ultrasound. Histopathological examination revealed a poorly differentiated, small-cell pleomorphic cancer, identified as a glioma metastasis by S100- and glial fibrillary acidic protein immunohistochemical staining.
Demonstration of imputability or root cause:
Donor known to have glioblastoma multiforme (GBM). Surgical resection was performed 4 months prior to death, which occurred due to a relapse in the brain stem. Confirmation of transmission based on histopathology and immunohistochemistry.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
Neoplasia
Single Center Series
Case Report
Deceased donor
Liver transplant
Histologic analysis
Immunohistochemistry
Central nervous system
Astrocytoma/glioblastoma multiform E. (WHO grade 4)
Glioblastoma multiforme
Reduction of immunosuppression
Patient death
Suggest references:
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Expert comments for publication:
Case series is of 13 donors with CNS neoplasms (4 GBM, 3 meningioma, 2 astrocytoma, 2 angioma, 1 neurocytoma, 1 ependymoma). This case represents the only transmission in this series. Both kidneys and heart from the same donor also transplanted with no evidence of transmission.