Status:
Ready to upload
Record number:
1573
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:
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. Liver recipient with no symptoms but biopsied upon information regarding kidney lymphoma.
Demonstration of imputability or root cause:
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 nevertheless received prophylactic chemotherapy. This led to liver enzyme elevation related to hepatitis C virus reactivation, but resolved.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Suggest new keywords:
Chemotherapy
B-cell lymphoma
Non-Hodgkin's
Suggest references:
Dziewanowski K, 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
Note:
Two kidney recipients combined into one row, this row is redundant and can be removed
-not clear on what above note means- MN 9/2/15
Expert comments for publication:
Donor presented with CNS symptoms originally suspected due to autoimmune encephalomeningitis. Lymphoma later diagnosed in donor brain (posttransplant) and likely involved CNS in a secondary fashion. Intravascular B cell lymphoma (also known as angiotropic B cell lymphoma) is an uncommon variant that usually does not have lymphadenopathy. Malignant cells are found within small vessels.