Death from donor-transmitted malignancy despite emergency liver retransplantation

TitleDeath from donor-transmitted malignancy despite emergency liver retransplantation
Publication TypeJournal Article
Year of Publication2003
AuthorsLipshutz GS, Baxter-Lowe LA, Nguyen T, Jones KD, Ascher NL, Feng S
JournalLiver Transpl
Pagination1102 - 7
Date PublishedOct
Accession Number14526407
Keywords*Tissue Donors, Adenocarcinoma / *etiology / pathology, Adult, Fatal Outcome, Hepatitis B, Chronic / *surgery, Humans, Liver Transplantation / *adverse effects, Lung Neoplasms / *etiology / pathology, Male, Middle Aged, Reoperation

Transplantation of organs procured from donors with malignancies identified subsequent to implantation presents a significant dilemma regarding the optimal management strategy to simultaneously minimize the risk for cancer transmission and recipient morbidity. In this report, we present a patient who underwent orthotopic liver transplantation for hepatitis B cirrhosis. The donor had no previous history of cancer. On autopsy, enlarged mediastinal lymph nodes led to the discovery of a 1-cm lung tumor. Histological examination showed pulmonary adenocarcinoma with metastatic mediastinal disease. Despite urgent retransplantation within 7 days, the recipient developed metastatic pulmonary adenocarcinoma diagnosed 11 months after transplantation and died soon thereafter. Analysis of short tandem repeat regions of chromosomal DNA from the recipient, the 2 liver donors, and the posttransplantation tumor corroborates that the first donor was the source of the malignancy. This case of donor-transmitted malignancy underscores the need for vigilance by the procuring surgeon in identifying potential malignancy during organ retrieval and use of a full autopsy on selected donors after organ procurement.

Notify Library Reference ID913

Related Incidents