Retransplantation of a cardiac allograft inadvertently harvested from a donor with metastatic melanoma

TitleRetransplantation of a cardiac allograft inadvertently harvested from a donor with metastatic melanoma
Publication TypeJournal Article
Year of Publication2003
AuthorsLoren AW, Desai S, Gorman RC, Schuchter LM
Pagination741 - 3
Date PublishedAug 27
Accession Number12973122
Keywords*Heart Transplantation, *Tissue Donors, Heart Neoplasms / *secondary, Humans, Male, Melanoma / *secondary, Middle Aged, Reoperation, Research Support, U.S. Gov't, P.H.S., Transplantation, Homologous

Donor-derived melanoma is easily transmitted through organ transplants and is highly aggressive in transplant recipients. The best treatment-withdrawal or reduction of immunosuppression-permits tumor rejection but risks allograft rejection. In recipients of nonrenal allografts, the prognosis is particularly grim, with transmission rates and mortality approaching 100%. Retransplantation has been proposed as a possible strategy but has never been performed for a cardiac allograft. This is the first report of cardiac retransplantation and only the second case of retransplantation of any nonrenal organ. Our patient received a heart transplant from a donor found to have occult metastatic melanoma at autopsy. He underwent retransplantation 17 days later. Close clinical and radiographic follow-up reveal no evidence of melanoma 22 months after transplantation. Based on the rapid development of donor-derived melanoma in previous reports, our patient is likely to remain free of donor cancer. Retransplantation and low-dose immunosuppression may have been lifesaving.

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