Status:
Ready to upload
Record number:
1912
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for thyroid cancer (Council of Europe, 2022):
Solitary papillary thyroid carcinoma < 0.5 cm is considered minimal risk and 0.5-2 cm is considered low to intermediate risk. Minimally invasive follicular carcinoma < 1 cm is considered minimal risk and 1-2 cm is considered low to intermediate risk. Newly diagnosed medullary and anaplastic thyroid cancers are an unacceptable risk for organ donation. Thyroid cancer in the donor history: Treated, small, differentiated thyroid cancers (papillary and follicular) are acceptable, analogous to the above recommendations for newly diagnosed thyroid cancers. Curative therapy and adequate follow-up are assumed. No recommendations exist for medullary and anaplastic thyroid cancer but, because of their aggressive clinical behaviour, they should be accepted for organ donation, if at all, only with the highest caution and after a long-term recurrence-free follow-up.
Time to detection:
N/A: Subject review and suggested guidelines for donation in the setting of live kidney donors with a history of thyroid cancer
Alerting signals, symptoms, evidence of occurrence:
N/A: Subject review and suggested guidelines for donation in the setting of live kidney donors with a history of thyroid cancer
Demonstration of imputability or root cause:
N/A: Subject review and suggested guidelines for donation in the setting of live kidney donors with a history of thyroid cancer
Imputability grade:
Not Assessable
Groups audience:
Keywords:
Suggest new keywords:
Review article
Living donor
Kidney transplant
Papillary carcinoma
Thyroid papillary carcinoma
Thyroid cancer, other or type not specified
Malignancy
Reference attachment:
Suggest references:
Adler JT, Yeh H, Barbesino G, Lubitz CC. Reassessing risks and benefits of living kidney donors with a history of thyroid cancer. Clin Transplant. 2017;31(11).
Note:
Can add papillary carcinoma under the thyroid section in adverse occurrence type as a selection choice, and then change the choice to papillary carcinoma (MN)
Second review done Oct 21, 2018 (Kerstin)
Added selection for papillary carcinoma under the thyroid section and changed MPHO type to kidney instead of "Multiple types or not specified" (EP)
Expert comments for publication:
The authors provide evidence that current suggested guidelines for accepting organs from potential donors with a history of thyroid cancer may be overly conservative. They suggest for donors with a history of low-risk papillary thyroid cancer: a) a 1 year waiting period after resection if there is an excellent response to therapy with no evidence of persistence, recurrence or metastases; b) a 1-2 year waiting period for potential donors with detectable but persistently low or declining thyroglobulin level without structural evidence of disease; c) a 3 year waiting period for potential donors with intermediate or high risk tumors with structurally incomplete response. This last group should also be discussed on a case-by-case basis. Several other points: a) if a lobectomy is performed instead of total thyroidectomy, thyroglobulin level should not be used as a tumor marker and the decision based on clinical and pathologic data; b) these recommendations are restricted to papillary tumors and do not include follicular cancer (including Hurthle cell carcinoma), poorly differentiated thyroid cancer, anaplastic thyroid cancer, medullary thyroid cancer, or thyroid lymphoma. The recommendations appear reasonable, given that the transmission of thyroid cancer appears to be extremely rare (the authors note a single report of follicular carcinoma transmission in the literature).