Record number:
65
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment (Council of Europe, 2022): Oesophageal, gastric, pancreatic, liver and biliary cancers diagnosed during donor procurement : These tumours are classified as unacceptable risk. Oesophageal, gastric, pancreatic, liver and biliary cancers in the donor history: Treated tumours of these kinds in the donor history are classified as high risk due to their aggressive behaviour. Risk may decrease for early stages after curative therapy, with recurrence-free time > 5 years and with increasing probability of cure, especially in cases of long-term survivors
Time to detection:
42 months
Alerting signals, symptoms, evidence of occurrence:
Hyperglycemia and increased creatinine. Ultrasound demonstrates ectasia of the pancreatic duct. Graft function improves but after one year, patient presents with abdominal pain, fever, and peripancreatic fluid collection. Laparotomy reveals a moderately differentiated adenocarcinoma consistent with a pancreatic primary neoplasia infiltrating the ileal segment.
Demonstration of imputability or root cause:
Allograft pancreatectomy performed. Tumor sample submitted for molecular typing by DNA sequencing following group-specific amplification, donor alleles were identified, which supports, but not fully confirms, donor origin. The patient died 51 months after transplantation from metastatic disease in spite of withdrawal of immunosuppression and chemotherapy. No more than one recipient was affected (Heart recipient well after 51 months, lung recipient died at 10 days from sepsis, no tumor, liver recipient without tumor for 2 years, died of sepsis). Condition was not known in advance in the donor.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
Neoplasia
Case Report
Deceased donor
Pancreas transplant
Kidney transplant
DNA typing
Transplantectomy
Patient death
Suggest references:
1. Roza AM, Johnson C, Juckett M, Eckels D, Adams M. Adenocarcinoma arising in a transplanted pancreas. Transplantation. 2001 Sep 27;72(6):1156–7.