Case report: Donor Diffuse large B-cell lymphoma (intravascular) and liver transplant (2014)

Status: 
Ready to upload
Record number: 
1574
Adverse Occurrence type: 
MPHO Type: 
Estimated frequency: 
Most recent risk assessment for leukemia, lymphoma and plasmacytoma (Council of Europe, 2022): Leukaemia, lymphoma and plasmacytoma diagnosed during donor procurement: These cancers are classified as an unacceptable risk for organ donation. Leukaemia, lymphoma and plasmacytoma in the donor history: Active (acute or chronic) leukaemia, lymphoma and plasmacytoma are an unacceptable risk for organ donation. Treated acute leukaemia and lymphoma after a definite disease-free interval of 10 years may be considered for organ donation with an assumed high risk for transmission.
Time to detection: 
1 month
Alerting signals, symptoms, evidence of occurrence: 
Liver recipient with no symptoms but biopsied upon information regarding kidney lymphoma. Delayed recovery of graft function in kidney recipient number 1, adequate graft function for kidney recipient number 2. Protocol (1 month) kidney biopsy and histological examination disclosed diffuse large B-cell lymphoma of the intravascular type, transplant nephrectomy performed in both cases.
Demonstration of imputability or root cause: 
Multiorgan cadaveric donor retrieval of two kidneys and a liver. Similar histological features of intravascular B cell lymphoma found in both kidney recipients and the postmortem examination of the donor. No malignancy was observed in the liver transplant recipient who underwent liver and bone marrow biopsies and PET scan, who nevertheless received prophylactic chemotherapy. This led to liver enzyme elevation related to hepatitis C virus reactivation, but resolved.
Groups audience: 
Suggest references: 
Dziewanowski K1, Drozd R, Parczewski M, Klinke M. et al. (2014). Multiorgan transplantation from a deceased donor with intravascular diffuse large B-cell lymphoma: transmission of the disease and results of treatment. Clin Transplant. 28(10):1080-3. doi: 10.1111/ctr.12417
Expert comments for publication: 
Multiorgan cadaveric donor retrieval of two kidneys and a liver. Similar histological features of intravascular B cell lymphoma found in both kidney recipients and the postmortem examination of the donor. No malignancy was observed in the liver transplant recipient who underwent liver and bone marrow biopsies and PET scan, who nevertheless received prophylactic chemotherapy. This led to liver enzyme elevation related to hepatitis C virus reactivation, but resolved.