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Gingras MC, Sabo A, Cardenas M, Rana A, Dhingra S, Meng Q, Hu J, Muzny DM, Doddapaneni H, Perez L, Korchina V, Nessner C, Liu X, Chao H, Goss J, Gibbs RA. Sequencing of a central nervous system tumor demonstrates cancer transmission in an organ transplant. Life Sci Alliance 2021; 4:4/9/e202000941. [PMID: 34301805 PMCID: PMC8321656 DOI: 10.26508/lsa.202000941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 11/24/2022] Open
Abstract
This study uses DNA sequencing to trace a donor organ transplant–mediated cancer transmission and illustrates how precise molecular pathology profiles might reduce future risk for transplant recipients. Four organ transplant recipients from an organ donor diagnosed with anaplastic pleomorphic xanthoastrocytoma developed fatal malignancies for which the origin could not be confirmed by standard methods. We identified the somatic mutational profiles of the neoplasms using next-generation sequencing technologies and tracked the relationship between the different samples. The data were consistent with the presence of an aggressive clonal entity in the donor and the subsequent proliferation of descendent tumors in each recipient. Deleterious mutations in BRAF, PIK3CA, SDHC, DDR2, and FANCD2, and a chromosomal deletion spanning the CDKN2A/B genes, were shared between the recipients’ lesions. In addition to demonstrating that DNA sequencing tracked a donor/recipient cancer transmission, this study established that the genetic profile of a donor tumor and its potential aggressive phenotype could have been determined before transplantation was considered. As the genetic correlates of tumor invasion and metastases become better known, adding genetic profiling by DNA sequencing to the data considered for transplant safety should be considered.
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Affiliation(s)
- Marie-Claude Gingras
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA .,Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Aniko Sabo
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Maria Cardenas
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Abbas Rana
- Abdominal Transplant Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Sadhna Dhingra
- Department of Pathology, Baylor College of Medicine, Houston, TX, USA
| | - Qingchang Meng
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Jianhong Hu
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Donna M Muzny
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Harshavardhan Doddapaneni
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Lesette Perez
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Viktoriya Korchina
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Caitlin Nessner
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Xiuping Liu
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Hsu Chao
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - John Goss
- Abdominal Transplant Center, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX, USA
| | - Richard A Gibbs
- Human Genome Sequencing Center, Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
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2
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Zhu M, Bian Y, Jiang J, Lei T, Shu K. Rapid screening for safety of donation from donors with central nervous system malignancies. Medicine (Baltimore) 2020; 99:e22808. [PMID: 33285676 PMCID: PMC7717844 DOI: 10.1097/md.0000000000022808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
With the increasing demand on organ transplants, it has become a common practice to include patients with primary central nervous system (CNS) malignancies as donors given the suggested low probability metastatic spread outside of the CNS. However, an extra-CNS spread of the disease cannot be excluded raising potential risks of cancer transmission from those donors. In order to balance between the risk of donor-derived disease transmission and the curative benefit for the recipient, a careful donor and organ selection is important. We performed a literature research and summarized all reported studies of organ transplants from donors suffered from primary CNS malignancies and determined the risk of tumor transmission to recipients. There were 22 cases of transplant-transmitted CNS tumors onto recipients since 1976. The association risks of cancer transmission were attributed to donor tumor histology, disruption of the blood-brain barrier, cerebrospinal fluid extra-CNS, and false diagnosis of primary intracranial tumor as well as the molecular properties of the primary tumor such as the existence of EGFR-amplification. The association risks and features of CNS tumors transmission recipients indicated that we need to reassess our thresholds for the potential fatal consequences of these donors.
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Affiliation(s)
| | | | - Jipin Jiang
- Institute of Organ Transplantation, Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei, People's Republic of China
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3
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Cacciatori A, Godino M, Bengochea M, Prinzo H. Organ Donation and Primary Central Nervous System Tumors. Transplant Proc 2020; 52:1024-1029. [PMID: 32199648 DOI: 10.1016/j.transproceed.2020.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/05/2020] [Indexed: 11/26/2022]
Abstract
Primary central nervous system tumors can be the cause of brain death. Not all of them contraindicate the donation of organs and tissues for transplant. A survey of cases was carried out in our country in which it was observed that the number of brain deaths caused by primary tumors was low, of the order of 2%, with an ẋ (media) of 3 by year, which would increase the potential for donation. Medical records, an anatomopathologic study, and a detailed physical examination will be fundamental when applying the donor selection criteria. Nuclear magnetic resonance in expert hands has a sensitivity of 96% to catalog the benignity or malignancy of this type of tumors.
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Affiliation(s)
- A Cacciatori
- National Institute of Donations and Transplants, Montevideo, Uruguay.
| | - M Godino
- National Institute of Donations and Transplants, Montevideo, Uruguay
| | - M Bengochea
- National Institute of Donations and Transplants, Montevideo, Uruguay
| | - H Prinzo
- Department of Neurosurgery, UDELAR, Montevideo, Uruguay
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4
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Westphal GA, Garcia VD, de Souza RL, Franke CA, Vieira KD, Birckholz VRZ, Machado MC, de Almeida ERB, Machado FO, Sardinha LADC, Wanzuita R, Silvado CES, Costa G, Braatz V, Caldeira Filho M, Furtado R, Tannous LA, de Albuquerque AGN, Abdala E, Gonçalves ARR, Pacheco-Moreira LF, Dias FS, Fernandes R, Giovanni FD, de Carvalho FB, Fiorelli A, Teixeira C, Feijó C, Camargo SM, de Oliveira NE, David AI, Prinz RAD, Herranz LB, de Andrade J. Guidelines for the assessment and acceptance of potential brain-dead organ donors. Rev Bras Ter Intensiva 2017; 28:220-255. [PMID: 27737418 PMCID: PMC5051181 DOI: 10.5935/0103-507x.20160049] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Organ transplantation is the only alternative for many patients with terminal diseases. The increasing disproportion between the high demand for organ transplants and the low rate of transplants actually performed is worrisome. Some of the causes of this disproportion are errors in the identification of potential organ donors and in the determination of contraindications by the attending staff. Therefore, the aim of the present document is to provide guidelines for intensive care multi-professional staffs for the recognition, assessment and acceptance of potential organ donors.
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Affiliation(s)
- Glauco Adrieno Westphal
- Corresponding author: Glauco Adrieno Westphal, Centro
Hospitalar Unimed, Rua Orestes Guimarães, 905, Zip code: 89204-060 -
Joinville (SC), Brazil. E-mail:
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5
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Georgieva LA, Gielis EM, Hellemans R, Van Craenenbroeck AH, Couttenye MM, Abramowicz D, Van Beeumen G, Siozopoulou V, Van Rosmalen M, Bracke B, Hartman V, De Greef K, Roeyen G, Chapelle T, Ysebaert D, Bosmans JL. Single-Center Case Series of Donor-Related Malignancies: Rare Cases With Tremendous Impact. Transplant Proc 2017; 48:2669-2677. [PMID: 27788799 DOI: 10.1016/j.transproceed.2016.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 07/26/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND Donor-related malignancy is a rare complication of organ transplantation. METHODS In this case series, we discuss three cases of donor-related cancers in kidney transplant recipients who were registered in our center between 1979 and 2015. They account for an incidence of 0.29% of donor-related malignancies of a total of 1015 transplanted kidney grafts (deceased and living donors). The three cases that we describe presented in different ways and with different severity, although the response to the initiated treatment was comparable. RESULTS All three patients not only survived their cancer episode but also had a complete oncological remission and underwent successful second kidney transplantation, accounting for a 100% survival rate in our small cohort. CONCLUSIONS Despite the very low incidence of this complication, transplant clinicians must be aware of the occurrence of donor-related malignancies when selecting a donor and should be able to diagnose and treat a case of donor-related cancer.
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Affiliation(s)
- L A Georgieva
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - E M Gielis
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium; University of Antwerpen, Wilrijk, Belgium
| | - R Hellemans
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - A H Van Craenenbroeck
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium; University of Antwerpen, Wilrijk, Belgium
| | - M M Couttenye
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium; University of Antwerpen, Wilrijk, Belgium
| | - D Abramowicz
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium; University of Antwerpen, Wilrijk, Belgium
| | - G Van Beeumen
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium
| | - V Siozopoulou
- Department of Pathology, Antwerp University Hospital, Edegem, Belgium
| | | | - B Bracke
- Department of Hepatobiliary, Endocrine, and Transplantation Surgery, Antwerp University Hospital, Edegem, Belgium
| | - V Hartman
- Department of Hepatobiliary, Endocrine, and Transplantation Surgery, Antwerp University Hospital, Edegem, Belgium
| | - K De Greef
- University of Antwerpen, Wilrijk, Belgium; Department of Hepatobiliary, Endocrine, and Transplantation Surgery, Antwerp University Hospital, Edegem, Belgium
| | - G Roeyen
- Department of Hepatobiliary, Endocrine, and Transplantation Surgery, Antwerp University Hospital, Edegem, Belgium
| | - T Chapelle
- Department of Hepatobiliary, Endocrine, and Transplantation Surgery, Antwerp University Hospital, Edegem, Belgium
| | - D Ysebaert
- University of Antwerpen, Wilrijk, Belgium; Department of Hepatobiliary, Endocrine, and Transplantation Surgery, Antwerp University Hospital, Edegem, Belgium
| | - J L Bosmans
- Department of Nephrology, Antwerp University Hospital, Edegem, Belgium; University of Antwerpen, Wilrijk, Belgium.
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6
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Review of controversies in management of non-benign meningioma. J Clin Neurosci 2016; 31:37-46. [DOI: 10.1016/j.jocn.2016.03.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 03/21/2016] [Accepted: 03/27/2016] [Indexed: 11/23/2022]
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7
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Zhao P, Strohl A, Gonzalez C, Fishbein T, Rosen-Bronson S, Kallakury B, Ozdemirli M. Donor transmission of pineoblastoma in a two-yr-old male recipient of a multivisceral transplant: a case report. Pediatr Transplant 2012; 16:E110-4. [PMID: 21281415 DOI: 10.1111/j.1399-3046.2010.01463.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Transplant-transmitted malignances are rare but devastating events. Primary brain tumors are the least common among reported donor-derived malignancies. We report a case of donor-transmitted pineoblastoma, a PNET, in a two-yr-old male recipient, who presented with a rapidly growing mass in the right mandible, four months after multiple visceral organ transplantation. The recipient had liver, pancreas, and small bowel transplants because of end-stage liver failure and short gut syndrome, which was secondary to large bowel resection for management of gastroschisis complicated by intestinal volvulus. The donor autopsy results became available seven wk after transplantation, which found a pineoblastoma with meningeal spread. Evaluation of eyes, adrenal glands, bone marrow, and other organs did not identify metastasis outside the CNS. A biopsy of the recipient's right mandibular mass revealed a malignant small round blue cell tumor with the immunohistochemistry profile of a PNET. Staging evaluation revealed the tumor in the right mandible with bone marrow involvement. Further investigation showed that recipient's tumor and donor's pineoblastoma shared the same immunophenotype and HLA type, suggesting the recipient's tumor is a donor-transmitted pineoblastoma. This is the first case report of donor-transmitted pineoblastoma post-organ transplant.
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Affiliation(s)
- Po Zhao
- Department of Pathology, Georgetown University Hospital, Washington, DC 20007, USA.
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8
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Risks and Mechanisms of Oncological Disease Following Stem Cell Transplantation. Stem Cell Rev Rep 2010; 6:411-24. [DOI: 10.1007/s12015-010-9134-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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9
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Gandhi MJ, Strong DM. Donor derived malignancy following transplantation: a review. Cell Tissue Bank 2007; 8:267-86. [PMID: 17440834 DOI: 10.1007/s10561-007-9036-1] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2007] [Accepted: 02/12/2007] [Indexed: 02/06/2023]
Abstract
Organ and tissue transplant is now the treatment of choice for many end stage diseases. In the recent years, there has been an increasing demand for organs but not a similar increase in the supply leading to a severe shortage of organs for transplant resulted in increasing wait times for recipients. This has resulted in expanded donor criteria to include older donors and donors with mild disease. In spite of implementation of more stringent criteria for donor selection, there continues to be some risk of donor derived malignancy. Malignancy after transplantation can occur in three different ways: (a) de-novo occurrence, (b) recurrence of malignancy, and (c) donor-related malignancy. Donor related malignancy can be either due to direct transmission of tumor or due to tumor arising in cells of donor origin. We will review donor related malignancies following solid organ transplantation and hematopoeitic progenitor cell transplantation. Further, we will briefly review the methods for detection and management of these donor related malignancies.
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Affiliation(s)
- Manish J Gandhi
- Department of Pathology and Immunology, Washington University, 660 S Euclid Ave #8118, St Louis, MO 63110, USA.
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10
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11
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Andrés A. Cancer incidence after immunosuppressive treatment following kidney transplantation. Crit Rev Oncol Hematol 2005; 56:71-85. [PMID: 15978827 DOI: 10.1016/j.critrevonc.2004.11.010] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2004] [Revised: 10/25/2004] [Accepted: 11/01/2004] [Indexed: 12/19/2022] Open
Abstract
Cancer incidence is increased in renal transplant recipients due to immunosuppressant treatment that should be maintained to prevent and treat acute rejection. Use of new and very potent immunosuppressants has made it possible to reduce acute rejection incidence and improve renal graft survival, although increase of infections and post-transplant neoplasms have become clearer. On the other hand, renal transplant candidates who remain on dialysis have a greater prevalence of neoplasms than the age-matched general population, either because the neoplasm was the cause of their renal failure (multiple myeloma or kidney or urinary tract cancers) or because their renal disease entails a risk for cancer development (acquired cystic disease or analgesic nephropathy). Practically, all de novo neoplasms have a greater incidence in renal transplant patients. Cutaneous neoplasms are the most prevalent in renal transplant recipients and their incidence increases with transplant time. Post-transplant lymphoproliferative diseases are more frequent in patients who receive greater immunosuppression (antithymocyte/antilymphocyte globulin or OKT3) or are infected de novo by Epstein Barr Virus (EBV) through the transplanted kidney. Kaposi's sarcoma has a high incidence in the renal transplanted population, does not appear in the general population, and is related with Human Herpes Virus 8 (HHV-8) infections. The incidence of tumors in non-functioning native kidneys is especially high in renal transplant due to the presence of acquired cystic disease or analgesic nephropathy. Gold standards of post-transplant de novo renal neoplasm prevention are modulating immunosuppression and avoiding exposure to sunlight and to different oncogenic viruses (EBV, cytomegalovirus, hepatitis B and C viruses).
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Affiliation(s)
- Amado Andrés
- Department of Nephrology, Hospital 12 de Octubre, Avenida de Cordoba s/n, 28041 Madrid, Spain.
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12
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Brouns R, De Deyn PP. Neurological complications in renal failure: a review. Clin Neurol Neurosurg 2005; 107:1-16. [PMID: 15567546 DOI: 10.1016/j.clineuro.2004.07.012] [Citation(s) in RCA: 237] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2004] [Revised: 07/27/2004] [Accepted: 07/27/2004] [Indexed: 02/08/2023]
Abstract
Neurological complications whether due to the uremic state or its treatment, contribute largely to the morbidity and mortality in patients with renal failure. Despite continuous therapeutic advances, many neurological complications of uremia, like uremic encephalopathy, atherosclerosis, neuropathy and myopathy fail to fully respond to dialysis. Moreover, dialytic therapy or kidney transplantation may even induce neurological complications. Dialysis can directly or indirectly be associated with dialysis dementia, dysequilibrium syndrome, aggravation of atherosclerosis, cerebrovascular accidents due to ultrafiltration-related arterial hypotension, hypertensive encephalopathy, Wernicke's encephalopathy, hemorrhagic stroke, subdural hematoma, osmotic myelinolysis, opportunistic infections, intracranial hypertension and mononeuropathy. Renal transplantation itself can give rise to acute femoral neuropathy, rejection encephalopathy and neuropathy in graft versus host disease. The use of immunosuppressive drugs after renal transplantation can cause encephalopathy, movement disorders, opportunistic infections, neoplasms, myopathy and progression of atherosclerosis. We address the clinical, pathophysiological and therapeutical aspects of both central and peripheral nervous system complications in uremia.
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Affiliation(s)
- R Brouns
- Department of Neurology and Memory Clinic, Middelheim General Hospital, Antwerp, Belgium
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13
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14
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Armanios MY, Grossman SA, Yang SC, White B, Perry A, Burger PC, Orens JB. Transmission of glioblastoma multiforme following bilateral lung transplantation from an affected donor: case study and review of the literature. Neuro Oncol 2004; 6:259-63. [PMID: 15279719 PMCID: PMC1871995 DOI: 10.1215/s1152851703000474] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Donor-acquired solid organ malignancy is a rare complication of organ transplantation. We report a case of a patient who received bilateral lung transplants for pulmonary fibrosis from a donor with known glioblastoma multiforme (GBM). The lungs, heart, liver, and kidneys were harvested after a lethal intracranial bleed and accepted for transplantation by four centers. An enlarged hilar lymph node sampled at the time of transplant was found to contain GBM. Four months later, the patient developed diffuse interstitial pulmonary infiltrates with mediastinal lymphadenopathy. Lung biopsy confirmed metastatic GBM. The patient died 2 weeks after the diagnosis was established. The patient receiving the donor liver also developed GBM. We present a case study, review of the literature, and suggested interventions to minimize the risk of transmission.
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Affiliation(s)
- Mary Y Armanios
- Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, MD 21231, USA.
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15
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Punnett AS, McCarthy LJ, Dirks PB, Hawkins C, Bouffet E. Patients with primary brain tumors as organ donors: case report and review of the literature. Pediatr Blood Cancer 2004; 43:73-7. [PMID: 15170894 DOI: 10.1002/pbc.20039] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Malignancy is considered a contra-indication to organ donation, with a few possible exceptions. We present the case of a child with fatal intracranial hemorrhage from a primary brain tumor (PBT) whose organs were denied for transplant after recovery. We review the literature of organ donors with PBTs in the context of the current organ shortage and discuss the implications for the practicing oncologist. Transmission of donor brain tumor to organ recipients has been documented but the incidence appears to be very low. Risk factors for tumor transmission include underlying donor tumor histology, history of craniotomy and/or shunt placement, use of systemic chemotherapy and radiation therapy, and duration of disease prior to donation. Ongoing data collection by national registries will provide more information on the potential risk to organ recipients. It may be appropriate to expand the donor pool to include donors with PBTs in certain situations. The transplantation team ultimately decides upon the use of organs from specific donors. Many families will appreciate the opportunity to donate specific tissues even if solid organ transplantation is prohibited.
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Affiliation(s)
- Angela S Punnett
- Pediatric Brain Tumor Program, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
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16
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Abstract
The escalating shortage of organs motivates frequent reconsideration of concepts that guide the decision to accept or decline organs from donors with central nervous system (CNS) malignancy. Currently, a minority of patients who die annually of CNS malignancies are organ donors. Specifically, the organs of less than 0.5% of the 13 000 patients dying from glioma are procured and transplanted every year in the United States. This review seeks to clarify the risk of cancer transmission from transplantation of organs from donors with glioma. After considering historical precedence, we will systematically outline the clinical features of a potential organ donor with glioma that might reflect upon the risk of cancer transmission. We will then present recent knowledge regarding basic glioma biology that speaks to their metastatic potential and suggest rational strategies for the post-transplant management of recipients of organs from donors with glioma.
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Affiliation(s)
- Federic P Collignon
- Department of Surgery, Division of Neurosurgery, Memorial Sloane Kettering Cancer Center, 1275 York Avenue, New York, NY, USA
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17
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Myron Kauffman H, McBride MA, Cherikh WS, Spain PC, Hanto DW, Delmonico FL. Donor-related malignancies. Transplant Rev (Orlando) 2002. [DOI: 10.1053/trte.2002.128240] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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18
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Kauffman HM, McBride MA, Cherikh WS, Spain PC, Delmonico FL. Transplant tumor registry: donors with central nervous system tumors1. Transplantation 2002; 73:579-82. [PMID: 11889434 DOI: 10.1097/00007890-200202270-00017] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Despite 13,000 central nervous system (CNS) tumor deaths per year in the United States, CNS tumor donors comprise only 1% of cadaveric donors recovered per year. Concern about tumor transmission may be a possible reason for this very small percentage. Both the size of the candidate waiting list and the number of deaths on the waiting list are progressively increasing because of the donor shortage. METHODS During a 96-month period, the United Network for Organ Sharing recorded 42,340 cadaver donors of whom 397 had a past history of a CNS tumor or the cause of death listed as a CNS tumor. A total of 1,220 organs were transplanted from these 397 donors. All recipients who reported a posttransplant malignancy during a mean follow-up of 36 months were identified. RESULTS There was no difference in patient survival of organs from CNS tumor donors when compared to donors with no CNS tumors. CNS tumor donors were not used more often for either urgent or older recipients. A total of 39 patients reported posttransplant malignancies but none of these tumors were donor-derived. There is a wide variation in the number of CNS tumor donors utilized by individual organ procurement organizations. CONCLUSIONS The risk of tumor transmission from donors with CNS malignancies seems to be small. Certain tumors, such as glioblastoma multiforme and medulloblastoma, carry a high risk of transmission and should be avoided. The risk of tumor transmission should be weighed against the risk of the patient dying on the waiting list without a transplant.
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Affiliation(s)
- H Myron Kauffman
- Research Department, United Network for Organ Sharing, Richmond, Virginia 23225, USA
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