Donor-transmitted malignancies in organ transplantation: assessment of clinical risk.


Journal Article

The continuing organ shortage requires evaluation of all potential donors, including those with malignant disease. In the United States, no organized approach to assessment of risk of donor tumor transmission exists, and organs from such donors are often discarded. The ad hoc Disease Transmission Advisory Committee (DTAC) of the Organ Procurement and Transplantation Network/United Network for Organ Sharing (OPTN/UNOS) formed an ad hoc Malignancy Subcommittee to advise on this subject. The Subcommittee reviewed the largely anecdotal literature and held discussions to generate a framework to approach risk evaluation in this circumstance. Six levels of risk developed by consensus. Suggested approach to donor utilization is given for each category, recognizing the primacy of individual clinical judgment and often emergent clinical circumstances. Categories are populated with specific tumors based on available data, including active or historical cancer. Benign tumors are considered in relation to risk of malignant transformation. Specific attention is paid to potential use of kidneys harboring small solitary renal cell carcinomas, and to patients with central nervous system tumors. This resource document is tailored to clinical practice in the United States and should aid clinical decision making in the difficult circumstance of an organ donor with potential or proven neoplasia.

Full Text

Duke Authors

Cited Authors

  • Nalesnik, MA; Woodle, ES; Dimaio, JM; Vasudev, B; Teperman, LW; Covington, S; Taranto, S; Gockerman, JP; Shapiro, R; Sharma, V; Swinnen, LJ; Yoshida, A; Ison, MG

Published Date

  • June 2011

Published In

Volume / Issue

  • 11 / 6

Start / End Page

  • 1140 - 1147

PubMed ID

  • 21645251

Pubmed Central ID

  • 21645251

Electronic International Standard Serial Number (EISSN)

  • 1600-6143

Digital Object Identifier (DOI)

  • 10.1111/j.1600-6143.2011.03565.x


  • eng

Conference Location

  • United States