Donor-Transmitted Malignancies in Organ Transplantation: Assessment of Clinical Risk

TitleDonor-Transmitted Malignancies in Organ Transplantation: Assessment of Clinical Risk
Publication TypeJournal Article
Year of Publication2011
AuthorsNalesnik MA, Woodle ES, DiMaio JM, Vasudev B, Teperman LW, Covington S, Taranto S, Gockerman JP, Shapiro R, Sharma V, Swinnen LJ, Yoshida A, Ison MG
JournalAmerican journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
Volume11
Issue6
Pagination1140 - 1147
Date PublishedJun
ISSN1600-6143 (Electronic) 1600-6135 (Linking)
Accession Number21645251
Abstract

The continuing organ shortage requires evaluation of all potential donors, including those with malignant disease. In the United States, no organized approach to assessment of risk of donor tumor transmission exists, and organs from such donors are often discarded. The ad hoc Disease Transmission Advisory Committee (DTAC) of the Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS) formed an ad hoc Malignancy Subcommittee to advise on this subject. The Subcommittee reviewed the largely anecdotal literature and held discussions to generate a framework to approach risk evaluation in this circumstance. Six levels of risk developed by consensus. Suggested approach to donor utilization is given for each category, recognizing the primacy of individual clinical judgment and often emergent clinical circumstances. Categories are populated with specific tumors based on available data, including active or historical cancer. Benign tumors are considered in relation to risk of malignant transformation. Specific attention is paid to potential use of kidneys harboring small solitary renal cell carcinomas, and to patients with central nervous system tumors. This resource document is tailored to clinical practice in the United States and should aid clinical decision making in the difficult circumstance of an organ donor with potential or proven neoplasia.

DOI10.1111/j.1600-6143.2011.03565.x
Alternate JournalAm J Transplant
Notify Library Reference ID1066

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