13th Congress of the Polish Transplantation Society: Part IIOrgan donationProstate Cancer in Deceased Organ Donors: Loss of Organ or Transplantation With Active Surveillance
Section snippets
Material and Methods
We retrospectively analyzed 72 cases in which transplanted organs were derived from donors whose prostate glands were histologically examined because of elevated PSA level (>10 ng/dL) and abnormal digital rectal examination. Intraoperatively diagnosed pelvic lymph node enlargement was another indication for histologic examination of prostate glands. Examination was first performed on frozen sections. Final diagnoses were made after 7 days by routine histologic examinations. All OLTx were
Results
Among all examined prostate glands (n = 72) there were 19 cases (26.40%) of cancer. Twelve were previously diagnosed during examination of frozen specimens and confirmed during final examination. Eleven livers derived from these donors were disqualified from OLTx and 1 was transplanted after risk acceptance and receipt of formal consent from the recipient. In the remaining 7 cases harvested livers were transplanted because of positive results of frozen section analyses, and prostate cancers
Discussion
Prostate cancer among donors raises serious clinical and decision-making issues. On the one hand, we are facing organ shortage; on the other hand, expanding the donor pool to patients with malignant disease raises concerns about disease transmission. Up to now, it was necessary to exclude the presence of prostate and any other carcinoma in donors before transplant of harvested organs. However, normal concentration of PSA in donors cannot justify the exclusion of prostate cancer; the
Conclusions
- 1.
Number of prostate cancer cases will systematically grow due to extending donor organ age.
- 2.
Diagnosis of prostate cancer in potential organ donors cannot disqualify them from transplantation.
- 3.
Deceased donor pool can be extended to patients with early-stage prostate cancer.
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Cited by (4)
Use of liver grafts from cadaveric donors: Implementation impact of a local evaluation and procurement team in Mexico
2021, Revista de Gastroenterologia de MexicoDiscovered cancers at postmortem donor examination: A starting point for quality improvement of donor assessment
2021, Transplantation ReviewsCitation Excerpt :A complete summary of cancers discovered with whole autopsy with available data is found in Table 1. There were four studies [18–21] limited to autopsy assessment of the prostate gland with a median number of donors of 148 (range 11–340), a median number of donors with prostate cancer of 12.5 (range 1–41) and a median number of cancers which were specifically discovered at the post-transplant/limited autopsy of 6.5 (range 1–41). In these studies, the prostate was studied after the removal of organs or tissues and there were no transmission events in the recipients.
Malignancies in Deceased Organ Donors: The Spanish Experience
2022, Transplantation