Melanoma in Solid Organ Transplant Recipients

Donors With Previous Malignancy: When Is It Safe to Proceed With Organ Transplantation?

The growing number of organ donors in the United States, from 14,011 in 2012 to 21,374 in 2022, highlights progress in addressing the critical issue of organ shortages. However, the demand remains high, with 17 patients dying daily while on the waiting list. As of August 2023, over 103,544 individuals are awaiting transplants, predominantly for kidneys (85.7%). To expand the donor pool, the inclusion of elderly donors, including those with a history of malignancies, is increasingly considered. In 2022, 7% of all donors were aged 65 and above, despite the complexities their medical histories may introduce, particularly the risk of donor-transmitted cancer (DTC). This review examines the challenges and potential benefits of using donors with known malignancy histories, balancing the risks of DTC against the urgency for transplants. A critical analysis is presented on current knowledge and the decision-making processes that consider cancer types, stages, and patient survival outcomes. The goal is to identify missed opportunities and improve strategies for safe and effective organ transplantation from this donor demographic.

UCHL3 plays an important role in the occurrence and development of melanoma

It has been reported that ubiquitin C-terminal hydrolase-L3 (UCHL3) plays an important role in cancer development; however, the role of UCHL3 in melanoma remains unclear. The present study aimed to investigate the role of ubiquitin C-terminal hydrolase-L3 (UCHL3) and determine its underlying molecular mechanisms in melanoma occurrence and development using in vitro studies. Reverse transcription-quantitative PCR analysis was performed to detect UCHL3 mRNA expression. The MTT assay was performed to assess cell proliferation. Cell apoptosis was analyzed via flow cytometry and the TUNEL assay. Cell ultrastructure was observed via transmission electron microscopy. LC3B protein expression was detected via cellular immunofluorescence, while neural precursor cell-expressed developmentally downregulated protein 8 (NEDD8) and LC3 protein expression levels, and NEDD8 ubiquitination were detected via western blot analysis. The results demonstrated that transfection with small interfering (si)RNA-UCHL3 significantly suppressed cell proliferation, whereas apoptosis was significantly enhanced, as well as autophagy, autophagosome formation and LC3B protein expression. In addition, NEDD8 protein expression and autophagosome numbers significantly decreased, while the LC3II/LC3I ratio significantly increased. NEDD8 knockdown via transfection with si-NEDD8 had similar effects to si-UCHL3, as well as si-UCHL3+ si-NEDD8. Taken together, the results of the present study suggest that UCHL3 knockdown decreases melanoma cell proliferation by increasing cell autophagy through regulating NEDD8 expression and autophagosome numbers.