Case report: Transmitted Melanoma treated with Ipilimumab (kidney transplant) (2019)

Status:

Ready to upload

Record number:

2027

Adverse Occurrence type:

Melanoma

MPHO Type:

Kidney

Estimated frequency:

Most recent risk assessment for melanoma (Council of Europe, 2022): Due to the very aggressive behaviour of this tumour, it is considered an unacceptable risk for organ donation. Malignant melanoma in the donor history: Due to the lack of exhaustive data, transplanting organs from donors with treated malignant melanoma must still be considered to be associated with a high transmission risk. If precise donor data about staging, therapy, follow-up, and recurrence-free survival are available, and evaluation by the dermato-oncologist concludes there is a low probability of recurrence and metastasis, organ donation might be considered for selected recipients.

Time to detection:

3 months

Alerting signals, symptoms, evidence of occurrence:

Abdominal pain and acute graft functional deterioration led to CT scan that showed pathologic fractures of L1 and L3 with multifocal iliac bone lytic lesions

Demonstration of imputability or root cause:

Bone biopsy showed melanoma; HLA typing of tumor cells showed XY karyotype (patient was female). Recipients of contralateral kidney and corneas from same donor also developed melanoma.

Imputability grade:

3 Definite/Certain/Proven

Groups audience:

Keywords:

FISH (fluorescence in situ hybridization)

sex chromosome

cornea

References:

Successful Treatment and Five Years of Disease-free Survival in a Donor Transmitted Metastatic Melanoma with Ipilimumab Therapy

Suggest new keywords:

Case report

Kidney transplant

Melanoma

Deceased donor

Malignancy

Cytogenetic analysis

FISH

Sex chromosomes

Reference attachment:

Singh-2019-Successful Treatment and Five Years.pdf

Suggest references:

Singh P, Pandey D, Rovin B, Pesavento TE, Olencki T. Successful Treatment and Five Years of Disease-free Survival in a Donor Transmitted Metastatic Melanoma with Ipilimumab Therapy. Cureus. 2019;11(5):e4658.

Note:

Please clone record for cornea transplant MPHO type, reference is made to another recipient who developed melanoma after receiving donor cornea - OK done (EP)

Expert comments for publication:

The main point of the paper is the successful use of ipilimumab (anti-CTLA-4) for the control of melanoma in this renal recipient. Two other additional reports of successful use (Chen et al. Case Rep Transplant 2012, 2012:1-3, Boyle et al. Transplant Proc. 2017, 49:1551-1554) are referenced. The possibility of triggering rejection must be considered, but should be weighed against the dismal prognosis of melanoma in these patients.