4 catches a given organ cancer in a "rare and extraordinary" case

(CNN) – Four European patients have developed breast cancer after receiving organs from the same donor, explains a case report.

The patients developed breast cancer years after their transplant, three of them dying of the disease.

Dr. Frederike Bemelman, professor of nephrology at the University of Amsterdam and author of the report, pointed out that it is "an extremely rare case", the first one that She has been meeting for 20 years in the field of immunology of transplantation. "There is always a small risk" that something goes wrong during a medical procedure, she said. "Even if you undergo a simple gall bladder procedure, you also have a small chance that something will happen to you during the procedure."

The 53-year-old donor had no known medical condition and the malignancy was unknown when her kidneys, lungs, liver and heart were removed.

Three of the organ recipients died after cancer metastasis or spread from their place of origin to new areas of the body.

The fourth survived after a series of treatments, including removal of the right kidney given, discontinuation of immunosuppressive therapy – standard drugs after transplantation to avoid rejection of the new organ – and chemotherapy.

In his report, Bemelman pointed out that once a donor-derived cancer occurs, it is extremely helpful to remove the donor organ. "This allows the patient to stop taking immunosuppressive medication and the immune system can recover and fight the tumor cells," she said.

However, Graham Lord, a professor of medicine and an honorary consultant in nephrology at King's College London, said patients are usually asked to replace the organ, depending on the type of cancer and survival rates . Lord was not involved in this case.

& # 39; Undetectable malignancy & # 39;

The organ donor died in 2007 due to a stroke, after which his lungs, kidneys, heart and liver were made available for donation.

As part of the standard screening process, a complete physical test consisting of a breast test and ultrasounds of the abdomen and heart were performed, but the malignant tumor disappeared.

Lord said that it was "essentially an undetectable malignity at the time of the gift".

Sixteen months after the transplant, the lung recipient, a 42-year-old woman, was admitted to the hospital with transplant disorders, according to the report. After breast cancer cells were detected in her lymph nodes, a DNA analysis showed that the cancer was from the donor.

The left kidney recipient, a 62-year-old woman, and the 59-year-old woman who received the liver died of the same cancer in 2013 and 2014 respectively.

The benefits of giving outweigh the risks

The study suggests that the donor had "micro metastases", groups of cancer cells that spread from their original site but were too small to be detected.

Earlier reports have noted that cancer transmission can occur during an organ transplant, but it is thought that this is the first case of breast cancer transferred.

Organ donations are not allowed by anyone with active malignancy, with the exception of most skin cancers and some localized tumors. The risk of tumor transmission is between 0.01% and 0.05% for each organ transplant.

"The benefits of organ transplantation far outweigh these small risks," said Bemelman. "People should not be worried."

Lord explained that this "rare and extraordinary event" could potentially be avoided in the future, as there are ongoing experimental programs for the early diagnosis of cancer.

It is unclear whether a CT scan would have revealed the donor's malignancy before transplants, but Bemelman is questionable. She cautioned against the routine use of CT scans for all donors, as this would increase irrelevant results and could lead to a decrease in the number of "very rare" donors.