Wednesday May 16 5:17 PM ET|
"Some Tumors Spread with Heart or Lung Transplants"
Some Tumors Spread with Heart or Lung Transplants
By Anthony Brown, MD
CHICAGO (Reuters Health) - A small new study suggests that
about a third of patients who receive a heart and/or lung
transplant from donors with certain types of cancer may develop
the malignancy themselves.
The findings were presented here on Monday at a joint
meeting of the American Society of Transplantation and the
American Society of Transplant Surgeons.
In a study of 22 patients who received a heart or lung
transplant from a donor with cancer, Dr. Joseph F. Buell and
colleagues from the University of Cincinnati in Ohio found that
eight, or 36%, developed cancer themselves.
"There really has been no data on cancer transmission in
cardiothoracic transplant recipients," Buell told Reuters
Health. "In the past, we have been very reluctant to use organs
from donors with cancer. This study gives us defined risks and
eliminates the generalized phobia of using organs from donors
with malignancies," he stated. The findings may therefore provide
some hope to those desperately seeking an organ from any
source--even donors diagnosed with cancer.
The patients included 17 heart recipients, 3 lung
recipients, and 2 people who received both heart and lungs.
Rates of cancer transmission appeared to vary depending on
the type of malignancy. For donors with a tumor involving the
nervous system, or neurologic tumors, the transmission rate was
17%. For non-nervous system tumors, the rate was 63%.
No tumor transmission occurred with donors who had brain
tumor types known as astrocytomas or glioblastomas, but another
nervous system cancer, medulloblastoma, did transfer to a
There were two cases in which a donor's kidney cancer was
transmitted to recipients.
The two most aggressively transmitted types of cancer were
choriocarcinoma and melanoma. Choriocarcinoma arises from fetal
tissue, while melanoma is a relatively rare, but potentially
life-threatening form of skin cancer.
Two thirds of patients who received a transplant from a
donor with choriocarcinoma had evidence of cancer spread within 3
months of transplantation. The two patients who received a
transplant from a donor with melanoma developed the disease
themselves and died within 6 months of transplantation.
However, the stage of the donor's cancer can have a big
impact on the risk of its spreading to the recipient. Buell
explained that if a donor's kidney cancer is contained in the
organ and has not spread to his or her blood vessels, it is
unlikely to be transmitted to an organ recipient.
And the risk of spread of neurological tumors is small unless
the donor has had certain surgical procedures, such as having a
shunt placed to drain fluid or having the skull opened
surgically, Buell added.
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