Status:
Ready to upload
Record number:
2160
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Urothelial Carcinoma
Most recent risk assessment for urothelial carcinoma (Council of Europe, 2018):
No literature exists regarding newly diagnosed urothelial cancer and organ donation. Therefore, the highest caution is recommended and the advice of a urologist may be sought in assessing the individual donor tumour transmission risk. National recommendations should be followed since they vary in accepting these tumours.
In the case of patients with a history of urothelial carcinoma, it must be remembered that these tumors tend to be multicentric and can recur. Kidney transplantation is considered to be associated with an increased risk but the extent of this has not been classified. Similarly, potential donors with a past history of urothelial carcinoma and a disease free interval of at least 5 years should be assessed based on estimate of the probability of cure. No specific recommendations are available from the literature.
Time to detection:
Two cases reported. Case 1: 12 years after transplant; Case 2: 14 months after kidney tansplant #3 (located in allograft kidney/pelvis. (First transplant in 1988 resected due to rejection at unknown date; second transplant in 1991, removed in 2009; third transplant 2010).
Alerting signals, symptoms, evidence of occurrence:
Case 1: Fever, urinary symptoms and allograft pain,renal pelvic mass seen on ultrasound.
Case 2: Routine ultrasound showed allograft kidney lower pole mass
Demonstration of imputability or root cause:
Case 1: Tumor located in allograft renal pelvis, no additional donor/recipient studies reported.
Case 2: XY chroosome analysis showed tumor to be of male (donor) origin in this female recipient.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
Malignancy
Kidney transplant
Kidney recipient
Urothelial (transitional) cell carcinoma
Therapy discussed
Reference attachment:
Suggest references:
Hevia V, Gómez V, Alvarez S, Díez Nicolás V, Gómez Del Cañizo C, Orosa A, Galeano Álvarez C, Burgos Revilla FJ. Transitional cell carcinoma of the kidney graft: an extremely uncommon presentation of tumor in renal transplant recipients. Case Rep Transplant. 2013;2013:196528. doi: 10.1155/2013/196528. Epub 2013 May 26. PMID: 23781380; PMCID: PMC3677624.
Note:
Uploaded MN 5/7/22
first review CLFF 5/31/22
second review MN 1/26/23
Expert comments for publication:
The tumor in patient 1 would be considered a "donor-derived" tumor given the 12 year interval between transplant and tumor. In patient #2, the tumor was shown to be of donor (male) origin and arose 14 months after transplant #3, localized to the allograft. It may be donor derived, but given the short time interval, the possibility of an actual tumor transmission cannot be excluded. It is unlikely that the tumor arose from allografts #1 or 2 in this patient, given the prior removal of those grafts and tumor localization to the present allograft. Both patients were treated with resection of the allograft kidney and ureter and were free of tumor at the time of publication (14 month and 24 month followup).