Transmission of an undiagnosed sarcoma to recipients of kidney and liver grafts procured in a non-heart beating donor.
Transmission of an undiagnosed cancer with solid organ transplantation is a rare but dreadful event. In this paper the authors report the transmission of an undiagnosed sarcoma to recipients of kidney and liver grafts procured in a Maastricht category 3 non-heart beating donor. To the authors' knowledge this case is the first report of such a transmission with a liver graft procured in a non-heart beating donor. The cancer transferal was diagnosed 1 year after transplantation in the recipients of the liver and of one kidney. The liver recipient died from multiple organ failure after a failed attempt of tumor resection. The kidney recipient underwent immunosuppression withdrawal and transplantectomy. Non-heart beating donors should not be particularly at risk for undiagnosed cancer transmission if the procurement is performed according to the same rules of careful inspection of the abdominal and thoracic organs. After diagnosis of donor cancer transmission, kidney recipients should have the graft removed, and immunosuppression should be interrupted. The management of liver graft recipients is very difficult in this setting, and long-term survival was very rarely reported.
Detry
Olivier
O
Department of Abdominal Surgery, University of Liège, CHU Sart Tilman, Liège, Belgium. Oli.Detry@chu.ulg.ac.be
De Roover
Arnaud
A
de Leval
Laurence
L
Herens
Christian
C
Delwaide
Jean
J
Honoré
Pierre
P
Meurisse
Michel
M
D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery; D017809:Fatal Outcome; D006084:Graft Rejection; D006801:Humans; D007150:Immunohistochemistry; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000601:surgery; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000379:methods; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000473:pathology*; D012086:Reoperation; D018570:Risk Assessment; D012509:Sarcoma / Q000473:pathology / Q000556:secondary* / Q000601:surgery; D014019:Tissue Donors; D014057:Tomography, X-Ray Computed