title: Expanding the criteria of organ procurement from donors with prostate cancer: the application of the new Italian guidelines.
abstract: Prostate cancer (CaP) represents the most prevalent malignancy in men more than 60-year-old, posing a problem in organ procurement from elderly subjects. However, most of the currently diagnosed CaP are low-grade and intraprostatic, with low metastatic risk, and there is recent evidence that most patients are overdiagnosed. The Italian National guidelines about organ acceptance from neoplastic donors changed in March 2005, extending the pool of potential candidates with CaP and introducing the function of a second opinion expert. Between 2001 and February 2005, 40 candidate donors with total PSA>/=10 and/or positive digital rectal examination underwent histopathological analysis of the prostate: 15 (37.5%) donors harboured CaP, and 25 (62%) were judged at 'standard risk'. After the introduction of the new guidelines in 2005, the second opinion expert judged at 'standard risk' 48 of 65 donors, while 17 of 65 needed histopathological analysis. Four (6.2%) donors harboured CaP, and 61 (94%) where judged at 'standard risk', with a significant increase of donated and actually transplanted organs. The application of the new guidelines and the introduction of a second opinion expert allowed a significant extension of the 'standard risk' category also to CaP patients, decreasing the histopathological examinations and expanding the donor pool.
authors.affiliation: S.Orsola-Malpighi Hospital, Bologna University, Bologna, Italy.
authors.forename: A
authors.initials: A
authors.lastname: D'Errico-Grigioni
authors.forename: M
authors.initials: M
authors.lastname: Fiorentino
authors.forename: F
authors.initials: F
authors.lastname: Vasuri
authors.forename: B
authors.initials: B
authors.lastname: Corti
authors.forename: L
authors.initials: L
authors.lastname: Ridolfi
authors.forename: W F
authors.initials: WF
authors.lastname: Grigioni
authors.forename: Alberto
authors.initials: A
authors.lastname: Bagni
authors.forename: Maria Giulia
authors.initials: MG
authors.lastname: Pirini
authors.forename: Deborah
authors.initials: D
authors.lastname: Malvi
authors.forename: Benedetta
authors.initials: B
authors.lastname: Fabbrizio
authors.forename: Giacomo
authors.initials: G
authors.lastname: Caprara
authors.forename: Nicola
authors.initials: N
authors.lastname: Alvaro
mesh_terms: D000328:Adult; D000368:Aged; D051517:Digital Rectal Examination; D017408:Guidelines as Topic; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000473:pathology*; D012017:Referral and Consultation; D014019:Tissue Donors / Q000600:supply & distribution*; D009927:Tissue and Organ Procurement / Q000331:legislation & jurisprudence*
chemical_list: D017430:Prostate-Specific Antigen