The Use of Neoplastic Donors to Increase the Donor Pool

Fiaschetti, P.; Pretagostini, R.; Stabile, D.; Peritore, D.; Oliveti, A.; Gabbrielli, Francesco; Cenci, Simone; Ricci, A.; Vespasiano, Francesca; Grigioni, Francesco

doi:10.1016/j.transproceed.2012.06.030

Cited by 19 publications

(26 citation statements)

References 2 publications

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“…Heart transplants may be relatively low risk for donor transmission given that the heart is an uncommon metastatic target, most likely due to the rarity of primary cancers, as well as differences in a malignancy's hematologic and lymphatic access and molecular profile . While donor transmission of cancer presents a real risk, our analysis suggests that more attention should be placed on other donor markers of poor transplant outcomes, including increased donor age, expanded donor criteria, and history of hypertension …”

Section: Discussionmentioning

confidence: 92%

“…Early analysis of the Israel Penn International Transplant Tumor Registry by Buell et al found that among 296 cases of known or incidental donor malignancies, 42% had confirmed donor transmission. Subsequent case studies found that transmission rates between organ donor and recipient range from 0% to 42%, with aggressive malignancies—including breast cancer and melanoma—more likely to be transmitted than low‐grade malignancies . A more recent examination of all solid organ transplantations concluded that the risk of donor‐origin cancers in transplant recipients was in fact minimal, with transmission as low as 0.06% …”

Section: Introductionmentioning

confidence: 99%

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Donor history of malignancy: A limited risk for heart transplant recipients

Rudasill

Iyengar

Sanaiha

et al. 2020

Clinical Transplantation

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Organ donor contraindications are frequently reassessed for impact on recipient outcomes in attempt to meet demand for transplantation. This study retrospectively analyzed the United Network for Organ Sharing (UNOS) registry for adult heart transplants from 1987 to September 2016 to characterize the impact of donor malignancy history in heart transplantation. Kaplan‐Meier estimates illustrated 10‐year survival. Propensity score matching was utilized for 1:1 matching of donors with and without history of malignancy, and Cox proportional hazards and logistic regressions were used to analyze the matched population. Of 38 781 heart transplants, 622 (1.6%) had a donor history of malignancy. Cox regressions demonstrated that donor malignancy predicted increased 10‐year mortality (HR = 1.16 [1.01‐1.33]), but this difference did not persist when conditioned upon 1 year post‐transplant survival (log‐rank = 0.643). Cox regressions of the propensity score‐matched population (455 pairs) found no association between donor malignancy and 10‐year mortality (HR = 1.02 [0.84‐1.24]). Older age and higher rates of hypertension were observed in donors with a history of malignancy whose recipients died within the first year post‐transplant. Therefore, increased recipient mortality is likely due to donor characteristics beyond malignancy, creating the potential for expanded donor selection.

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Section: Discussionmentioning

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Donor history of malignancy: A limited risk for heart transplant recipients

Rudasill

Iyengar

Sanaiha

et al. 2020

Clinical Transplantation

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“…Of the 15 donor-transmitted cancers, 6 were renal; 5 were lung; 2 were lymphoma; 1 was neuroendocrine, and 1 colon cancer [38] . Some recent Italian series have shown no disease transmission with use of grafts from donors with lowgrade malignancies or neoplasms of low metastatic potential [39,40] . An accurate donor evaluation coupled with histological information of tumor grade allows to reduce to acceptable rates the risk of donor-to-recipient transmission [39,40] .…”

Section: Malignanciesmentioning

confidence: 99%

“…Some recent Italian series have shown no disease transmission with use of grafts from donors with lowgrade malignancies or neoplasms of low metastatic potential [39,40] . An accurate donor evaluation coupled with histological information of tumor grade allows to reduce to acceptable rates the risk of donor-to-recipient transmission [39,40] . Donors with a documented history of malignancy should not discarded per se, especially for low-grade central nervous system tumors and malignancies treated successfully with long-term diseasefree survival rates.…”

Section: Malignanciesmentioning

confidence: 99%

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Strategies to optimize the use of marginal donors in liver transplantation

Pezzati

Ghinolfi

Simone

et al. 2015

WJH

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Liver transplantation is the treatment of choice for end stage liver disease, but availability of liver grafts is still the main limitation to its wider use. Extended criteria donors (ECD) are considered not ideal for several reasons but their use has dramatically grown in the last decades in order to augment the donor liver pool. Due to improvement in surgical and medical strategies, results using grafts from these donors have become acceptable in terms of survival and complications; nevertheless a big debate still exists regarding their selection, discharge criteria and allocation policies. Many studies analyzed the use of these grafts from many points of view producing different or contradictory results so that accepted guidelines do not exist and the use of these grafts is still related to non-standardized policies changing from center to center. The aim of this review is to analyze every step of the donationtransplantation process emphasizing all those strategies, both clinical and experimental, that can optimize results using ECD.

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Urologische Nachsorge und Entwicklung von Malignomen nach Nierentransplantation

Giessing

2015

Urologe

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Urological evaluation following RT must ensure correct urine transport and voiding function. Transplant ureter strictures, relevant ureteral reflux and voiding dysfuntion (e.g., neurologic dysfunction, benign prostate hypeplasia) must be excluded or treated. Urinary tract infection (UTI), which can be life threatening in the immunosuppressed transplant recipient, must be diagnosed and treated consequently and for an adequate period of time. Prophylaxis of UTIs is indicated in patients with recurrent symptomatic UTI as well as in the initial 6 months following renal transplantation. Asymptomatic bacteriuria must not necessarily be treated. The incidence of urological malignancies like renal cell carcinoma, urothelial cancer of the bladder, and penile carcinoma is increased following RT, while the incidence of prostate and testis cancer is the same as in the nontransplant population. Surgical and nonsurgical treatment options do not differ from the normal population. Adaptation, cessation, or switching of the immunosuppressive regimen in case of urologic malignancy must be decided on the individual recipient basis.

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The Use of Neoplastic Donors to Increase the Donor Pool

Cited by 19 publications

References 2 publications

Donor history of malignancy: A limited risk for heart transplant recipients

Donor history of malignancy: A limited risk for heart transplant recipients

Strategies to optimize the use of marginal donors in liver transplantation

Urologische Nachsorge und Entwicklung von Malignomen nach Nierentransplantation

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