Status:
Ready to upload
Record number:
1552
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for choriocarcinoma (Council of Europe, 2022):
Due to the high transmission and mortality rates, it is considered an unacceptable risk for organ donation in any stage of disease. History of choriocarcinoma: Due to the reported high transmission and mortality rates, it is considered to be associated with a high or unacceptable risk for transmission through organ donation, depending on the recurrence-free period prior to donor death.
Time to detection:
1 day
Alerting signals, symptoms, evidence of occurrence:
Autopsy performed 1 day after donation in a 30 year old female donor showed widespread choriocarcinoma. The cause of death was cerebral haemorrhage. The kidney recipient was immediately nephrectomized, immunosupression was stopped (graft showed multiple foci of choriocarcinoma), HCG increased, chemotherapy (Actinomycin+VP16) was given. After 2 years: normal HCG, no metastasis, re-transplantation intended. The liver recipient could not be retransplanted due to poor health, 2 doses Ledertextrate were somministrated. The recipient passed away 39 days post-transplant and choriocarcinoma was found in allograft liver at autopsy.
Demonstration of imputability or root cause:
Choriocarcinoma found in both donor and in kidney and liver recipients.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
choriocarcinoma
chemotherapy
metastatic disease
transplantectomy
hCG (human chorionic gonadotropin)
Suggest references:
Detroz, B.; Detry, O.; D'Silva, M.; Pirenne, J.; Defraigne, J.O.; Meurisse, M.; Honore, P.; Jacquet, N. Organ transplantation with undetected donor neoplasm Transplant Proc 1991; 23 (5) :2657
Note:
Remove "chorion carcinoma, abnormal blood counts, first generation and second generation" from Keywords (OK)
Expert comments for publication:
1991 reference; CNS hemorrhage in a young woman should prompt consideration of possible underlying causes.