|Title||Rapid screening for malignancy in organ donors: 15-year experience with the Verona "Alert" protocol and review of the literature|
|Publication Type||Journal Article|
|Year of Publication||Submitted|
|Authors||Eccher A, Cima L, Ciangherotti A, Montin U, Violi P, Carraro A, Tedeschi U, Nacchia F, Fior F, Rostand M, Boschiero L, D'Errico A, Scarpa A, Casartelli-Liviero M, Ferrari G, Rodini V, Tomaselli E, Zampicinini L, Vanzo F, Bovo C, Feltrin G, Neil D, Brunelli M|
Prevention of transmission of malignancy from donors to recipients is an aim of donor assessment. We report the most stringent interpretation of the Italian National Guidelines.
A two-step ALERT process was used: ALERT1 consisting of clinical, radiological, and laboratory tests; ALERT2, consisting of intraoperative assessment in suspicious lesions.
Four hundred of 506 potential deceased donors entered the ALERT system. Forty-one of 400 (10%) donors were excluded due to unacceptable risk of transmission. Of the remaining 359 193 required histopathology, which excluded malignancy or determined acceptable risk in 161/193 (83%). Thirty-five malignancies were identified: 19 (54%) at ALERT1, four (11%) at ALERT2, nine (26%) picked up at ALERT1 and confirmed by ALERT2. Three (9%) were missed by ALERT and diagnosed at postmortem examination. Prostate (n=12%, 34%) and renal cell (n=7%, 20%) were the most frequent carcinomas. The majority (92%) of prostate adenocarcinomas were of low risk and donation proceeded compared to 43% of renal carcinomas. Four renal carcinomas, two breast carcinomas, and a single case of nine different malignancies excluded donation. Positive ALERT donors had statistically more malignant reports than negative ALERT donors (P=<.05> CONCLUSION:
Histopathology is an essential component of the multidisciplinary assessment of donors.
|Alternate Journal||Clin Transplant|
|Notify Library Reference ID||4699|