A histopathologic screening method for rational use of organs from prostate-specific antigen-positive multiorgan donors: the Italian Emilia-Romagna Region experience.
Reduction of waiting-list length requires extension of the organ-donor pool to elderly males bearing an higher risk of prostate cancer incidence. Prostate-cancer screening in organ donors is currently based on prostate-specific antigen (PSA) assays (total PSA and free/total PSA). However, the specificity of these assays is restricted, limiting risk-benefit analysis. Since 2001, 33 multiorgan donor candidates presenting within Emilia-Romagna (Italy) with suspect ultrasonography or abnormal PSA values were submitted to a histopathologic screening method of the entire prostate based on extemporary frozen-section analysis (maximum 1 hour) of over 50% of the organ at 0.1 mm cutting levels. Extemporary diagnosis of adenocarcinoma was made in 12 (36%) cases, corresponding to 4.5% of the male candidates aged more than 50 years in the donor pool. In all cases, the final diagnosis confirmed the extemporary analysis. As well as maximizing safety, this novel approach should permit more refined risk-benefit analysis.
D'Errico Grigioni
Antonia
A
Pathology Unit, F. Addarii Institute of Oncology, Department of Oncology and Haematology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy. grigioni@med.unibo.it
Corti
Barbara
B
Fiorentino
Michelangelo
M
Pirini
Maria Giulia
MG
Ridolfi
Lorenza
L
Venturoli
Nicola
N
Grigioni
Walter Franco
WF
D000368:Aged; D000369:Aged, 80 and over; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D018579:Patient Selection; D011467:Prostate / Q000033:anatomy & histology; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000473:pathology*; D014019:Tissue Donors
D017430:Prostate-Specific Antigen