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Lapointe M, Kerbaul F, Meckert F, Cognard N, Mathelin C, Lodi M. [Breast cancer and organ transplantation: Systematic review and meta-analysis]. GYNECOLOGIE, OBSTETRIQUE, FERTILITE & SENOLOGIE 2023; 51:60-72. [PMID: 36375787 DOI: 10.1016/j.gofs.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Our main objective was to investigate donor-transmitted epithelial cancers of all origins in comparison with breast cancers, with analysis of the carcinological outcome of recipients. Our secondary objective was to define medical check-up to be performed before any organ procurement from a donor with a history of breast cancer. METHODOLOGY We performed a systematic review of the literature up to June 1st 2022 by including all original articles (including clinical cases) reporting cases of epithelial cancer transmitted from donor to recipient, followed by a meta-analysis of epidemiological and survival data. RESULTS In total, we included 52 articles (31 clinical cases and 21 cohort studies), representing 91,388 donors, 236,142 recipients, and 2591 cases of transmitted cancer. The risk of transmitted cancer was significantly higher with a history of breast cancer compared with a history of other cancer (RR=9.48 P=0.0025). In clinical cases, the pre-donation check-up was specified in only 33.3% of publications. The time between transplantation and cancer occurrence was longer in cases of breast cancer transmission compared to other epithelial cancers: 1435.8 days versus 297.6 (P<0.001). CONCLUSION Organ donation from a person previously treated for breast cancer or having a risk of occult breast cancer is possible in some situations but requires an adapted pre-donation assessment, the respect of good practice guidelines and an expert opinion in complex situations.
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Affiliation(s)
- M Lapointe
- CHRU, 1, avenue Molière, 67200 Strasbourg, France
| | - F Kerbaul
- Direction prélèvement et greffe organes et tissus, direction générale médicale et scientifique, agence de la biomédecine, 93212 La Plaine cedex, France
| | - F Meckert
- Direction prélèvement et greffe organes et tissus, direction générale médicale et scientifique, agence de la biomédecine, 93212 La Plaine cedex, France
| | - N Cognard
- CHRU, 1, avenue Molière, 67200 Strasbourg, France
| | - C Mathelin
- CHRU, 1, avenue Molière, 67200 Strasbourg, France; Institut de cancérologie Strasbourg Europe (ICANS), 17, avenue Albert-Calmette, 67200 Strasbourg cedex, France; Institut de génétique et de biologie moléculaire et cellulaire (IGBMC), CNRS, UMR7104 Inserm U964, université de Strasbourg, 1, rue Laurent-Fries, 67400 Illkirch-Graffenstaden, France.
| | - M Lodi
- CHRU, 1, avenue Molière, 67200 Strasbourg, France; Institut de cancérologie Strasbourg Europe (ICANS), 17, avenue Albert-Calmette, 67200 Strasbourg cedex, France; Institut de génétique et de biologie moléculaire et cellulaire (IGBMC), CNRS, UMR7104 Inserm U964, université de Strasbourg, 1, rue Laurent-Fries, 67400 Illkirch-Graffenstaden, France
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Mahíllo B, Martín S, Molano E, Navarro A, Castro P, Pont T, Andrés A, Galán J, López M, Oliver E, Martínez A, Mosteiro F, Roque R, Pérez-Redondo M, Cid-Cumplido M, Ballesteros MA, Daga D, Quindós B, Sancho M, Royo-Villanova M, Bernabé E, Muñoz R, Chacón JI, Coll E, Domínguez-Gil B. Malignancies in Deceased Organ Donors: The Spanish Experience. Transplantation 2022; 106:1814-1823. [DOI: 10.1097/tp.0000000000004117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Domínguez-Gil B, Moench K, Watson C, Serrano MT, Hibi T, Asencio JM, Van Rosmalen M, Detry O, Heimbach J, Durand F. Prevention and Management of Donor-transmitted Cancer After Liver Transplantation: Guidelines From the ILTS-SETH Consensus Conference. Transplantation 2022; 106:e12-e29. [PMID: 34905759 DOI: 10.1097/tp.0000000000003995] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
As with any other intervention in health, liver transplantation (LT) entails a variety of risks, including donor-transmitted cancers (DTCs). At present, 2%-4% of used deceased organ donors are known to have a current or past history of malignancy. The frequency of DTCs is consistently reported at 3-6 cases per 10 000 solid organ transplants, with a similar frequency in the LT setting. A majority of DTCs are occult cancers unknown in the donor at the time of transplantation. Most DTCs are diagnosed within 2 y after LT and are associated with a 51% probability of survival at 2 y following diagnosis. The probability of death is greatest for DTCs that have already metastasized at the time of diagnosis. The International Liver Transplantation Society-Sociedad Española de Trasplante Hepático working group on DTC has provided guidance on how to minimize the occurrence of DTCs while avoiding the unnecessary loss of livers for transplantation both in deceased and living donor LT. The group endorses the Council of Europe classification of risk of transmission of cancer from donor to recipient (minimal, low to intermediate, high, and unacceptable), classifies a range of malignancies in the liver donor into these 4 categories, and recommends when to consider LT, mindful of the risk of DTCs, and the clinical condition of patients on the waiting list. We further provide recommendations to professionals who identify DTC events, stressing the need to immediately alert all stakeholders concerned, so a coordinated investigation and management can be initiated; decisions on retransplantation should be made on a case-by-case basis with a multidisciplinary approach.
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Affiliation(s)
| | - Kerstin Moench
- Donor Transplant Coordination Unit, Westpfalz-Klinikum, Kaiserslautern, Germany
| | - Christopher Watson
- The Roy Calne Transplant Unit and Department of Surgery, University of Cambridge, Cambridge, United Kingdom
| | - M Trinidad Serrano
- Hepatology Section, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
| | - Taizo Hibi
- Department of Pediatric Surgery and Transplantation, Kumamoto University Graduate School of Medical Sciences, Kumamoto, Japan
| | - José M Asencio
- Liver Transplant Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - Olivier Detry
- Department of Abdominal Surgery and Transplantation, Centre Hospitalier Universitaire de Liege, University of Liege, Liege, Belgium
| | | | - François Durand
- Hepatology Department, Liver Intensive Care Unit, Hospital Beaujon, Clichy, France
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Eccher A, Cima L, Ciangherotti A, Montin U, Violi P, Carraro A, Tedeschi U, Nacchia F, Fior F, Rostand M, Boschiero L, D'Errico A, Scarpa A, Casartelli-Liviero M, Ferrari G, Rodini V, Tomaselli E, Zampicinini L, Vanzo F, Bovo C, Feltrin G, Neil D, Brunelli M. Rapid screening for malignancy in organ donors: 15-year experience with the Verona “Alert” protocol and review of the literature. Clin Transplant 2017; 31:e13045. [DOI: 10.1111/ctr.13045] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023]
Affiliation(s)
- Albino Eccher
- Pathology Unit; Department of Diagnostics and Public Health; University and Hospital Trust of Verona; Verona Italy
| | - Luca Cima
- Pathology Unit; Department of Diagnostics and Public Health; University and Hospital Trust of Verona; Verona Italy
| | - Andrea Ciangherotti
- Department of Surgical Science; General and Hepatobiliary Surgery; University and Hospital Trust of Verona; Verona Italy
| | - Umberto Montin
- Liver Transplant Unit; Department of Surgical Science; University and Hospital Trust of Verona; Verona Italy
| | - Paola Violi
- Liver Transplant Unit; Department of Surgical Science; University and Hospital Trust of Verona; Verona Italy
| | - Amedeo Carraro
- Liver Transplant Unit; Department of Surgical Science; University and Hospital Trust of Verona; Verona Italy
| | - Umberto Tedeschi
- Liver Transplant Unit; Department of Surgical Science; University and Hospital Trust of Verona; Verona Italy
| | - Francesco Nacchia
- Department of Surgical Science; Kidney Transplant Center; University and Hospital Trust of Verona; Verona Italy
| | - Francesca Fior
- Department of Surgical Science; Kidney Transplant Center; University and Hospital Trust of Verona; Verona Italy
| | - Momo Rostand
- Department of Surgical Science; Kidney Transplant Center; University and Hospital Trust of Verona; Verona Italy
| | - Luigino Boschiero
- Department of Surgical Science; Kidney Transplant Center; University and Hospital Trust of Verona; Verona Italy
| | - Antonietta D'Errico
- Pathology Unit; Department of Specialised; Experimental and Diagnostic Medicine; S. Orsola-Malpighi University Hospital of Bologna; Bologna Italy
| | - Aldo Scarpa
- Pathology Unit; Department of Diagnostics and Public Health; University and Hospital Trust of Verona; Verona Italy
| | - Marilena Casartelli-Liviero
- Neurosurgery and Intensive Care Unit; Department of Surgical Science; University and Hospital Trust of Verona; Verona Italy
| | - Giuseppe Ferrari
- Neurosurgery and Intensive Care Unit; Department of Surgical Science; University and Hospital Trust of Verona; Verona Italy
| | - Viviana Rodini
- Neurosurgery and Intensive Care Unit; Department of Surgical Science; University and Hospital Trust of Verona; Verona Italy
| | - Elisabetta Tomaselli
- Neurosurgery and Intensive Care Unit; Department of Surgical Science; University and Hospital Trust of Verona; Verona Italy
| | - Laura Zampicinini
- Neurosurgery and Intensive Care Unit; Department of Surgical Science; University and Hospital Trust of Verona; Verona Italy
| | - Francesca Vanzo
- Arsenàl, Veneto's Research Center for eHealth Innovation; Veneto Italy
| | - Chiara Bovo
- Medical Direction; University and Hospital Trust of Verona; Verona Italy
| | - Giuseppe Feltrin
- Transplant Regional Center; Veneto Region; Hospital Trust of Padova; Padova Italy
| | - Desley Neil
- Pathology Unit; Department of Histopathology; Queen Elizabeth Hospital Birmingham; Birmingham UK
| | - Matteo Brunelli
- Pathology Unit; Department of Diagnostics and Public Health; University and Hospital Trust of Verona; Verona Italy
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Pabisiak K, Ostrowski M, Kram A, Safranow K, Słojewski M, Ciechanowski K. Prostate Specific Antigen–Positive Deceased Organ Donor: A Pathologist Is Indispensable. Transplant Proc 2016; 48:2450-2453. [DOI: 10.1016/j.transproceed.2015.12.142] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 12/30/2015] [Indexed: 10/20/2022]
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Renal donors with prostate cancer, no longer a reason to decline. Transplant Rev (Orlando) 2015; 30:48-50. [PMID: 26275676 DOI: 10.1016/j.trre.2015.06.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 06/14/2015] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To fully assess the true risk of prostate cancer transmission in during renal transplantation. METHODS A full review of all existing literature relevant to the topic. RESULTS There has not been a single documented case of transmission of prostate cancer during renal transplant. Prostate cancer in deceased organ donors has an incidence estimated between 3% and 18.5% and over 100 transplants have been performed using organs from donor with proven prostate cancer without issue. CONCLUSION Transmission of prostate cancer through kidney transplantation seems very unlikely. The risks of remaining on the waiting list are outweighed by a transmission risk and the potential benefit makes the case to have clear guidelines about donor prostate malignancy when accepting potential organs.
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Prostate cancer in deceased organ donors: A review. Transplant Rev (Orlando) 2014; 28:1-5. [DOI: 10.1016/j.trre.2013.10.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 10/15/2013] [Accepted: 10/16/2013] [Indexed: 11/19/2022]
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Abstract
De novo tumors are common complications after solid organ transplantation. Lymphoma and skin cancers are the most frequently observed malignancies. However, graft carcinomas can be observed to be five times more frequent after kidney transplantation compared to their incidence in the general population. We report a case of a 49-year-old female who developed an early adenocarcinoma of the graft as revealed by acute renal failure. She underwent transplantectomy and chemotherapy with hemodialysis therapy. Carcinoma of the graft is a rare but serious complication usually occurring late after transplantation. Close monitoring of a kidney recipient using abdominal ultrasound may detect this complication at early stages, which may improve the prognosis. Similarly, good screening of donors may prevent tumor transmission.
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Uchiyama H, Shimada M, Imura S, Morine Y, Kanemura H, Arakawa Y, Kanamoto M, Nishi M, Hanaoka J. Living donor liver transplantation using a left hepatic graft from a donor with a history of gastric cancer operation. Transpl Int 2009; 23:234-5. [PMID: 19659795 DOI: 10.1111/j.1432-2277.2009.00920.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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