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It is well known that organ transplants can transmit infectious diseases from donors to recipients in rare cases. But even more rarely, transplants can transmit cancer, as a new case shows.
According to a new report, four people in Europe have developed breast cancer after receiving organs from the same donor.
Three of the patients have died of cancer, highlighting "the often fatal consequences of donor-derived breast cancer," the authors write in their report, published in the July issue of the American Journal of Transplantation. [The 9 Most Interesting Transplants]
Cancer not detected
The 53-year-old organ donor died of a stroke in 2007, according to the report, written by researchers in the Netherlands and Germany. She was suffering from no known pathology that would have prevented organ donation and multiple tests revealed no signs of cancer. Doctors transplanted the kidneys, lungs, liver and heart to the recipients. (The transplanted patient died of unrelated causes shortly after transplantation.)
But 16 months later, a woman who received a lung transplant became ill and had cancer in the lymph nodes of her chest. An analysis of the cancer cells revealed that they were in fact breast cancer cells and that the DNA of the cancer cells showed that these cells came from the organ donor. Lung cancer spread and she died about a year after being diagnosed with cancer.
At that time, the other three living patients who had received the donations were informed. The doctors told them that the lung recipient had died of breast cancer related to his transplant. These patients have been screened for cancer, initially negative.
But in 2011, the liver transplant had cancer cells in the liver. The patient did not want another liver transplant because she was afraid of potential complications. Radiation therapy for cancer was initially helpful, but the cancer came back later and this patient died in 2014.
The patient who received the left kidney was also diagnosed with breast cancer in 2013 – six years after her transplant. The cancer had already spread to many other organs and the patient died two months later.
A 32-year-old man who received the right kidney was also diagnosed with breast cancer cells in his transplanted kidney in 2011. But doctors were able to remove the kidney, and the patient stopped taking medications to remove his system. immune. He also underwent chemotherapy. The treatment was successful and the man was still free of cancer 10 years after the transplant surgery.
Low risk
Getting cancer through an organ transplant is "a very very rare event," said Dr. Lewis Teperman, director of organ transplantation at Northwell Health in New Hyde Park, New York, who does not Was not involved in this case. According to the report, transplant recipients have a chance of being between 1 in 10,000 and 5 out of 10,000.
"The supply of organs is incredibly safe," Teperman told Live Science. This is because organ donors undergo rigorous screening, including family history of illness, such as cancer, and multiple laboratory tests. In this case, the 53-year-old donor underwent a physical examination as well as an ultrasound of the abdomen and heart, a chest x-ray and an examination of the airways.
However, even with these robust procedures in place, "it's impossible to control everything," and there's a very small chance that a donor will suffer from an undetected illness that could be transmitted, said Teperman. .
In this case, the patient had an undetected breast cancer. The donor may have had "micro metastases" or groups of cancer cells that have spread from the original cancer site but are too small to be detected by screening or imaging tests, indicates The report.
It is also easier for these cancer cells to grow in transplant patients because patients take drugs to suppress their immune system. These drugs are necessary so that the patient's body does not reject the new organ, but any foreign cancer cell "would not be rejected either," said Teperman.
It is possible that a CT scan of the donor in this case caught the cancer, but the authors noted that it would be impossible to select all donors in this way, according to The Independent. Performing such tests could lead to the detection of false positives and rejection of healthy donors, which would lead to a "diminishing donor pool already scarce," the authors write in the study.
"You would have so much trouble that you would never get any organs," said Teperman.
The report concludes that the low rate of cancer transmission through transplantation "implies that current cancer screening practices by donors are effective". The researchers wrote that if cancer passes from donor to recipient, physicians should consider removing grafts from all other patients who have received organs from this donor.
Original article on Science live.
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