Record number:
918
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for sarcoma (Council of Europe, 2022):
Due to the very aggressive behavior of sarcoma, they are considered an unacceptable risk for organ donation at any stage of disease. Sarcoma in donor history: Because of the very aggressive behavior of sarcoma, they are mostly considered an unacceptable risk for organ donation. After curative treatment and a recurrence-free survival of > 5 years, sarcomas are still assumed to be associated with a high risk for transmission.
Time to detection:
4 months
Alerting signals, symptoms, evidence of occurrence:
Team alerted that recipients of the lung and the liver from the same donor had been diagnosed with angiosarcomas and had died shortly after. PET/CT scans shows a tumor in both transplanted kidneys, with lung metastases suspected. Both kidneys explanted - histology shows presence of sarcoma and likely angiosarcoma tumor cells, with strong proliferative signs. Tumor cells show positive immunohistochemisty for von-Willebrand factor and for vimentin, but negative for CD56, CKAE1/3, desmin, CEA, CD45, CD34, CD31, D2-40 and uPAR.
Demonstration of imputability or root cause:
Several recipients affected: two kidneys, liver and lung recipients (heart recipient disease-free in the report). FISH analysis of angiosarcomas from both male transplant recipients shows X chromosomes but no Y chromosomes in the tumor cells (female to male donation in both cases).
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