Status:
Ready to upload
Record number:
2173
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Most recent risk assessment for breast cancer (Council of Europe, 2022):
Newly diagnosed invasive breast cancer is an unacceptable risk for organ donation.
Breast cancer in the donor history: Organs from donors with invasive breast cancer might be accepted in selected cases after full treatment, complete remission and stringent follow-up for > 5 years, depending on the initial stage and E/P and HER2/neu receptor expression, always bearing in mind the risk of transmission due to possible late metastases. Breast cancer stage 1 (AJCC, 8th edition) with curative surgery and cancer-free period > 5 years seems to be associated with low to intermediate risk for transmission. All other invasive breast cancer stages are considered high-risk for transmission, independent of the presumed recurrence-free survival and treatment.
Time to detection:
Single center review (1970-1999) kidney transplants from female donors with history of breast cancer:
Period 1 (1970-1980): 2 deceased donors, 3 kidney transplants (survival 2 mo, 2.5 mo, 12 mo -> with breast cancer development after 4 mo. in one recipient)
Period 2) 1980-1999: 6 living donors - 4 with early stage and "cured", 1 with Stage III diagnosed 16 months and 1 with Stage IV disease diagnosed 3 weeks after donation. a recipient of the latter donor developed breast cancer 12.6 mo post tx, after cessation of Immunosuppression. Tamoxifen and cessation of immunosuppression led to remission of 36 months at the time of the abstract.
Alerting signals, symptoms, evidence of occurrence:
Not reported (abstract)
Demonstration of imputability or root cause:
not reported (abstract)
Imputability grade:
2 Probable
Groups audience:
Keywords:
References:
Suggest new keywords:
Malignancy
Registry Series
Deceased donor
Living donor
Kidney transplant
Kidney recipient
Breast cancer, other or type not specified
Therapy discussed
Reference attachment:
Suggest references:
Friedman A et al. Collective experience with renal transplantation from donors with a history of breast cancer. Am J Transplant 2008 3(S5):288-289.
Note:
Uploaded MN 5/8/22
First review CLFF 5/25/22
Expert comments for publication:
This abstract covers an earlier period of transplantation (1970-1999) and notes that it is difficult to perform proper screening in deceased donors and that it may be possible to use living donors with a remote history (e.g. > 48 months) of early stage breast cancer with informed consent and in the absence of an alternative donor.