Case report: Lung adenocarcinoma (2003)

Record number:

265

Adverse Occurrence type:

MPHO Type:

Estimated frequency:

Most recent risk assessment for Lung Cancer (Council of Europe, 2022): Any histotype of newly-diagnosed lung cancer is an unacceptable risk for organ donation. Lung cancer in the donor history: Treated lung cancer is considered to be associated with a high transmission risk. Risk may decrease after curative therapy, with recurrence-free time and with increasing probability of cure.

Time to detection:

11 months (tumor seen on donor autopsy and reported within first post-transplant week, recipient underwent retransplantation, presented at 11 months with abdominal pain and other symptoms; found to have tumor on thoracentesis/paracentesis specimens despite clear CT @ 10 months)

Alerting signals, symptoms, evidence of occurrence:

Once diagnosed on donor autopsy, urgent retransplantation was decided and performed within 7 days. The explanted liver did not show malignancy. However, the recipient developed metastatic pulmonary adenocarcinoma 11 months after transplantation and died soon thereafter. Clinical symptoms developed included abdominal pain, vomitting and satiety. Pleural effussion and ascites were detected. Thoracentesis and paracentesis consistent with metastatic pulmonary adenocarcinoma. Death occured after immunosuppression withdrawal, with thrombosis and possible massive thromboembolism.

Demonstration of imputability or root cause:

'-Diagnosed in the donor after liver transplantation having been performed. Donor autopsy revealed enlarged mediastinal lymph nodes + 1-cm lung tumor. Histological examination showed pulmonary adenocarcinoma with metastatic mediastinal disease.'-No other recipients affected (no other organs or tissues were used) '-Analysis of short tandem repeat regions of chromosomal DNA from the recipient, the 2 liver donors, and the posttransplantation tumor corroborated that the first donor was the source of the malignancy.

Imputability grade:

3 Definite/Certain/Proven

Groups audience:

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