Transplant tumor registry: donors with central nervous system tumors1.
Level 3 - non-randomized controlled study
Retrospective registry-based comparative cohort study
PubMed 11889434 · doi:10.1097/00007890-200202270-00017
What was done
United Network for Organ Sharing (UNOS) registry records were analyzed over a 96-month period, identifying 42,340 cadaveric donors, of whom 397 had a history of or died from a central nervous system (CNS) tumor. A total of 1,220 organs were transplanted from these 397 donors. Recipient posttransplant malignancies and patient survival were assessed over a mean follow-up of 36 months and compared against donors without CNS tumors.
What was found
Patient survival for recipients receiving organs from CNS tumor donors showed no difference compared with recipients of organs from donors without CNS tumors. CNS tumor donors were not selectively allocated to more urgent or older recipients. Across follow-up, 39 recipients developed posttransplant malignancies, but zero were donor-derived. Utilization rates of CNS tumor donors varied widely across individual organ procurement organizations.
Why it matters
Given severe organ shortages and high waitlist mortality, these findings suggest that many donors with CNS tumors can be safely utilized without substantial risk of transmitting cancer to recipients.
Limits
The study relies on registry data over a relatively short mean follow-up period of 36 months, which may miss late-developing transmissions. High-risk tumor subtypes (e.g., glioblastoma multiforme, medulloblastoma) were not separately broken down with numerical risk estimates in the abstract, and reporting of secondary malignancies in registries can be subject to underreporting.
Cited by
- supports Organ transplants from donors with glioblastoma multiforme have transmitted metastatic cancer to the transplant recipients.