Although uncommon an organ or tissue transplant can result in transmission of a tumor from the donor to the recipient. Screening the donor for a history of neoplasia prior to harvesting is important. This information may not be available, especially in trauma patients.


Tumors that have been spread include:

(1) renal cell carcinoma

(2) malignant melanoma

(3) ocular tumors

(4) breast carcinoma

(5) lung carcinoma

(6) prostate carcinoma

(7) colon carcinoma

(8) pancreatic carcinoma

(9) Hodgkin's on non-Hodgkin's lymphoma

(10) brain tumors

(11) soft tissue sarcoma


Sources of malignant cells:

(1) occult tumor within an organ (such as a kidney)

(2) circulating malignant cells lodged within the donor tissue


Risk factors for tumor transmission:

(1) incomplete history obtained

(2) ignoring warning signs before and during harvesting and handling

(3) occult tumor that is too small to be detected


Highly processed tissues such as tendon or desiccated bone are not associated with tumor transmission.


Problems for the recipient:

(1) Immunosuppression may decrease the ability of the recipient to contain the tumor.

(2) Increasing host defenses against the tumor may damage the transplant.


Differential diagnosis:

(1) emergence of a tumor in the recipient that is unmasked by immunosuppression


It is important to monitor a recipient after a transplant and to have a high index of suspicion for uncommon complications. It is also important to be informed of new information about the donor that may come to light later.


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