Graft removal in the case of non-life-sustaining organs (i.e., kidney) is a potential therapeutic consideration that should take the informed wishes of the recipient into consideration. Treatment of donor transmitted malignancy may also harness the alloimmune response without prior transplantectomy if the graft is not life sustaining. Cessation of immunosuppression and precipitation of graft rejection may lead to rapid rejection of the tumour as well as the graft, as documented by scattered reports in the literature. It must be emphasized that, although rejection of the graft is near certain, rejection of the tumour is by no means guaranteed with this method. This approach is generally not suitable for organs such as the heart, lung and liver, which must thus be treated by minimisation of immunosuppression and conventional therapy for the malignancy. Although re-transplantation has been attempted for non-renal allografts in some reports, the avoidance of tumour transmission has not always succeeded. It should be noted that mTOR inhibitors have some antineoplastic properties and switching the type of immunosuppression could be considered as one part of therapeutic management. However, oncologic consultation is encouraged.
