Management of recipients of hepatic allografts harvested from donors with malignancy diagnosed shortly after transplantation

Transmission of undiagnosed malignancy with the graft is a dramatic complication of liver transplantation. Alternatives in the management of the recipients of livers, harvested from donors with malignancy diagnosed shortly after transplantation, are either early re-transplantation or close follow-up without re-operation. We reported 4 cases of liver recipients whose allografts were harvested from donors who were diagnosed with malignancy shortly after the liver transplantation. One recipient underwent re-transplantation, and the three other allografts were not removed. No recipient developed recurrence in the follow-up. While graft removal may be the only way to avoid tumor recurrence in recipients of liver graft harvested from donor with malignancy, close follow-up without re-operation may also be considered. The risk of tumor transferral may depend on the histopathological aggressiveness and metastatic potential of the donor tumor, and may be low for low-grade, local tumors. This risk should be evaluated by analyzing large series, using databases of Eurotransplant or United Network for Organ Sharing.