Status:
Ready to upload
Record number:
1866
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for colorectal cancer (Council of Europe, 2022):
Acceptance of pT1-tumours – see AJCC, 8th edition [18] – Donors with pT1 tumours should only be accepted for organ donation with the utmost caution, and a high transmission risk must be assumed. Patients with higher stages of newly diagnosed, active colorectal cancer should not be accepted for organ donation (unacceptable risk). Colorectal cancer in donor history: The presence of pT1/pT2 (Dukes’ A or B) colorectal carcinoma (infiltration of submucosa/muscularis propria) in the donor without lymph node or distant metastases is assumed to have a low transmission risk after adequate treatment and disease-free survival of > 5 years. Risk increases with stage, and probability of presumed cure has to be taken into account.
Time to detection:
13 months after transplantation
Alerting signals, symptoms, evidence of occurrence:
A routine postransplant abdominal ultrasound scan identified 3 lessions within the liver suspicious for metastatic disease. The explanted allograft had 3 confirmed large metastatic deposits. The patient followed retransplantation, and three years later he remained tumor free. All other recipients from the donor remained well.
Demonstration of imputability or root cause:
Microsatellite genotype analysis by quantitative fluorescence polymerase chain reaction of donor tissue and recipient DNA and tumor tissue revealed the adenocarcinoma to be of donor origin.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
Malignancy
Case report
Deceased donor
Liver transplant/Liver recipient/Liver transplantation
Micro satellite analysis
Large bowel adenocarcinoma
Colorectal adenocarcinoma
Reference attachment:
Suggest references:
Snape K, Izatt L, Ross P, Ellis D, Mann K, O'Grady J. Donor-transmitted malignancy confirmed by quantitative fluorescence polymerase chain reaction genotype analysis: a rare indication for liver retransplantation. Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society. 2008;14(2):155-8
Expert comments for publication:
The kidneys, corneas and heart valve from this donor did not show evidence of tumor transmission after 45 months followup. The report emphasizes that emergency reretransplantation had a good outcome, but this must be considered anecdoatel. The paper focuses mainly on the technical demonstration of donor derivation by molecular means.