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Death from donor‐transmitted malignancy despite emergency liver retransplantation
Author(s) -
Lipshutz Gerald S.,
BaxterLowe Lee Ann,
Nguyen Tim,
Jones Kirk D.,
Ascher Nancy L.,
Feng Sandy
Publication year - 2003
Publication title -
liver transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.814
H-Index - 150
eISSN - 1527-6473
pISSN - 1527-6465
DOI - 10.1053/jlts.2003.50174
Subject(s) - medicine , malignancy , liver transplantation , autopsy , transplantation , adenocarcinoma , lung cancer , surgery , cancer
Transplantation of organs procured from donors with malignancies identified subsequent to implantation presents a significant dilemma regarding the optimal management strategy to simultaneously minimize the risk for cancer transmission and recipient morbidity. In this report, we present a patient who underwent orthotopic liver transplantation for hepatitis B cirrhosis. The donor had no previous history of cancer. On autopsy, enlarged mediastinal lymph nodes led to the discovery of a 1‐cm lung tumor. Histological examination showed pulmonary adenocarcinoma with metastatic mediastinal disease. Despite urgent retransplantation within 7 days, the recipient developed metastatic pulmonary adenocarcinoma diagnosed 11 months after transplantation and died soon thereafter. Analysis of short tandem repeat regions of chromosomal DNA from the recipient, the 2 liver donors, and the posttransplantation tumor corroborates that the first donor was the source of the malignancy. This case of donor‐transmitted malignancy underscores the need for vigilance by the procuring surgeon in identifying potential malignancy during organ retrieval and use of a full autopsy on selected donors after organ procurement. ( Liver Transpl 2003;9:1102‐1107. )