Molecular insights in transmission of cancer from an organ donor to four transplant recipients

Chloe E. Atreya, Eric A. Collisson, Meyeon Park, James P. Grenert, Spencer C. Behr, Amalia Gonzalez, Jonathan Chou, Samantha Maisel, Terence W. Friedlander, Chris E. Freise, Jun Shoji, Thomas J. Semrad, Jessica Van Ziffle, Peter Chin-Hong

Research output: Contribution to journalArticlepeer-review

Abstract

Organ donors are systematically screened for infection, whereas screening for malignancy is less rigorous. The true incidence of donortransmitted malignancies is unknown due to a lack of universal tumor testing in the posttransplant setting. Donor-transmitted malignancy may occur even when not suspected based on donor or recipient factors, including age and time to cancer diagnosis. We describe the detection of a gastrointestinal adenocarcinoma transmitted from a young donor to 4 transplant recipients. Multidimensional histopathologic and genomic profiling showed a CDH1 mutation and MET amplification, consistent with gastric origin. At the time of writing, one patient in this series remains alive and without evidence of cancer after prompt organ explant after cancer was reported in other recipients. Because identification of a donor-derived malignancy changes management, our recommendation is to routinely perform short tandem repeat testing (or a comparable assay) immediately upon diagnosis of cancer in any organ transplant recipient. Routine testing for a donor-origin cancer and centralized reporting of outcomes are necessary to establish a robust evidence base for the future development of clinical practice guidelines.

Original languageEnglish (US)
Pages (from-to)1446-1452
Number of pages7
JournalJNCCN Journal of the National Comprehensive Cancer Network
Volume18
Issue number11
DOIs
StatePublished - Nov 2020
Externally publishedYes

ASJC Scopus subject areas

  • Oncology

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