Donor-transmitted cancer in kidney transplant recipients: a systematic review.
Level 4 - case-series / case-control
Systematic review of published case reports and case series
PubMed 32535833 · doi:10.1007/s40620-020-00775-4
What was done
A systematic review was conducted of published case reports and case series up to August 2019 to evaluate kidney transplant recipients with donor-transmitted malignancies, examining cancer types, recipient survival, and donor procurement details.
What was found
A total of 128 publications describing 234 kidney recipients were included. The most frequent transmitted malignancies were lymphoma (n = 48, 20.5%), renal cancer (n = 42, 17.9%), melanoma (n = 40, 17.1%), non-small cell lung cancer (n = 13, 5.6%), neuroendocrine cancers including small cell lung cancer (n = 11, 4.7%), and choriocarcinoma (n = 10, 4.3%), while glioblastoma (n = 6) and gastrointestinal cancers (n = 5) were rare. The 5-year overall survival was 19% for lung cancer, 43% for melanoma, 63% for lymphoma, and 93% for renal cell cancer. Metastasis outside the graft was the most important adverse prognostic factor.
Why it matters
This review compiles outcome data for rare donor-transmitted cancers, identifying which tumor types pose the highest mortality risk to kidney recipients.
Limits
The study is entirely based on case reports and series, introducing substantial publication and reporting bias. Information regarding donor causes of death and diagnostic evaluations at organ procurement was frequently omitted in the included literature.