Record number:
917
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for neuroendocrine tumors (including high grade neuroendocrine carcinomas, low(er) grade neuroendocrine tumors, carcinoid tumors, pheochromocytomas and paragangliomas) (Council of Europe, 2022):
Due to their potential for undetected metastasis, high-grade neuro-endocrine carcinomas are an unacceptable risk for organ donation. Insufficient information exists to guide practice for neuro-endocrine tumours, carcinoid tumours, phaeochromocytomas and paragangliomas. In the case of critically ill recipients, these tumours might be acceptable after a careful individual risk–benefit analysis. Neuro-endocrine tumours in the donor history: No data are available from the literature. Due to this and their potential for undetected metastasis, treated high-grade neuro-endocrine neoplasms in the donor history are classified as high risk for organ donation. In the case of a previous history (> 5 years) of neuro-¬endocrine tumours (carcinoid tumours, phaeochromocytomas and paragangliomas) without any kind of disease recurrence or progression, donors should be considered high risk in the absence of sufficient information to guide practice.
Time to detection:
4 months
Alerting signals, symptoms, evidence of occurrence:
At 4 months, abdominal CT scan reveals multiple small low-density hepatic lesions too small to characterize (CT performed as control due to cholangiocarcinoma as cause of liver transplant). Eight months after transplantation, liver enzymes elevated, CT with multiple liver lesions consistent with metastases and CA19-9 increased. Percutaneous biopsy reveals a small cell carcinoma, supported by immunohistochemistry staining for cytokeratin and synaptophysin.
Demonstration of imputability or root cause:
FISH analysis (female to male donation) and DNA analysis (comparison of DNA isolated from the tumor with genotypes of tissue from the patient - explanted liver- and donor-gallbladder) consistent with donor origin. No other recipients (kidneys) affected.
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