Status:
Ready to upload
Record number:
2168
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for melanoma (Council of Europe, 2022): Due to the very aggressive behaviour of this tumour, it is considered an unacceptable risk for organ donation.
Malignant melanoma in the donor history: Due to the lack of exhaustive data, transplanting organs from donors with treated malignant melanoma must still be considered to be associated with a high transmission risk. If precise donor data about staging, therapy, follow-up, and recurrence-free survival are available, and evaluation by the dermato-oncologist concludes there is a low probability of recurrence and metastasis, organ donation might be considered for selected recipients.
Time to detection:
Not specified; however it was in the first post-transplant year since the patient underwent bilateral allograft nephrectomy at 1 year post-transplant.
Alerting signals, symptoms, evidence of occurrence:
Patient was notified after a liver recipient from the same donor developed donor-origin metastatic melanoma in the cerebrum.
Demonstration of imputability or root cause:
Presence of melanoma in liver recipient from same donor shortly after transplantation is presumptive evidence of transmission; no additional workup details provided.
Imputability grade:
3 Definite/Certain/Proven
Groups audience:
Keywords:
Suggest new keywords:
Malignancy
Case Report
Deceased donor
Kidney transplantation
Kidney recipient
Kidney transplant
Histologic analysis
Melanoma
Therapy discussed
Reference attachment:
Suggest references:
Chen KT, Olszanski A, Farma JM. Donor transmission of melanoma following renal transplant. Case Rep Transplant. 2012;2012:764019. doi: 10.1155/2012/764019. Epub 2012 Nov 4. PMID: 23259141; PMCID: PMC3504199.
Note:
Uploaded MN 5/8/22
First review MN 11/11/23
Second review MCS 13/08/2024
Expert comments for publication:
The patient had received a prior transplant in 2008 that failed; retransplant was in 2010. Workup showed biopsy positive metastatic melanoma involving left allograft kidney. Bilateral allograft nephrectomies were performed. Follow up 4 months later showed a subcutaneous thigh deposit and PET scan showed multiple foci of uptake on skin, subcutaneous tissue, and bone. MRI showed a temporal lobe lesion that was resected and shown to be melanoma. Further therapy included whole brain irradiation and ipilimumab. The patient had no evidence of disease at 16 months following allograft nephrectomy.
The authors discuss transplant-related melanoma transmission in regard to circulating tumor cells and note controversy regarding the status of donors with a history of in situ melanoma. They also note that, although prognosis is generally poor, durable remissions are possible in some cases.