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According to a new report by a team of doctors in the Netherlands, the organs donated by one woman have transmitted breast cancer to four different transplant patients. This is a case that the authors have described as "extraordinary".
The report was published in the July issue of the American Journal of Transplantation, LiveScience reports Saturday.
The donor was a 53-year-old woman who died of a cerebral hemorrhage. At the time, a physical examination, laboratory tests, X-rays and ultrasounds showed that the woman had no problem medical history. His heart, lungs, liver and kidneys were then transplanted into five individuals.
The heart catcher has died of sepsis – a potentially life-threatening immune response to infection – only a few months after transplantation, according to the report.
Receptors of the right kidney, left kidney, lungs and liver all survived longer. But in the 16 months to 6 years following transplantation, the four patients developed metastatic breast cancer, the type that spread to other organs of the body, making it much more difficult to treat. The DNA test of the cancer cells revealed that they came from the donor.
It turned out that the donor had breast cancer at the time of donation, but the doctors did not know. Otherwise, his organs would not have been given to other people. People with active or invasive cancers are considered "unsuitable for organ donation," write the authors.
Receptors of liver, lung and left kidney eventually died because of breast cancer derived from their donor. The right kidney recipient, a 32-year-old man, survived after withdrawal from kidney and chemotherapy treatment. He realized a complete remission of cancer in 2012. During his last follow-up in spring 2017, he was still free from cancer and ready to search for a new kidney, according to the report.
Getting a cancer from a given organ is extremely rare
This is not the first case of cancer to be transmitted to a transplant recipient through the intermediary of a given organ. The authors wrote that there had already been "a lot" of reports on the phenomenon. What makes this case unique, they added, is that a donor has transmitted breast cancer to four people – and that the transmitted cancer has taken so long to develop and cause symptoms in the body of the receivers.
However, according to the report, the risk of developing a donor-derived cancer after organ transplantation is very low – between 0.01% and 0.05% by organ transplantation.
"The supply of organs is incredibly safe," LiveScience told Dr. Lewis Teperman, director of organ transplantation at Northwell Health, who was not involved in the case. But he added that it is "impossible to control everything" and that there is very little chance that a donor will transmit a hidden disease.
It is not clear why the test missed donor breast cancer
It is unclear why donor breast cancer was not detected until its organs were donated, but it is possible that it has undergone micrometastases or groups of cancer cells that are are detached be seen by imaging tests, the authors have written. Transplant patients must also take drugs that suppress their immune system, which reduces the risk of organ rejection, but may facilitate the survival of cancer cells, reports LiveScience.
It is also unclear whether a full body scan – an imaging test that provides more detail than normal X-rays – may have caught the donor's cancer. But the authors wrote that screening all potential organ donors with this test can detect "irrelevant" problems that weaken the already scarce supply of organs. For now, they concluded, the extremely low risk of getting cancer from an organ donor suggests that current screening practices are "effective."
The co-author of the study, Dr. Frederike J. Bemelman, did not immediately respond to INSIDER's request for comment.
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