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How safe are organs from deceased donors with neoplasia? The results of the Italian Transplantation Network

  • Albino EccherEmail author
  • Letizia Lombardini
  • Ilaria Girolami
  • Francesca Puoti
  • Gianluigi Zaza
  • Giovanni Gambaro
  • Amedeo Carraro
  • Giovanni Valotto
  • Luca Cima
  • Luca Novelli
  • Desley Neil
  • Umberto Montin
  • Aldo Scarpa
  • Matteo Brunelli
  • Alessandro Nanni Costa
  • Antonia D’Errico
Original Article
  • 51 Downloads

Abstract

Guidelines for donor selection have changed to expand the donor pool, considering potential donors affected by a neoplasm. Aim of this retrospective study is to look at the use of organs from donors with a current or history of neoplasm within the Italian Transplant Network. Data, collected and validated by Italian National Health Institute for the time interval 2006–2015, have been reviewed retrospectively by mean of multivariable pivot tables. Donors with neoplasia represented about 5% of all donors, resulting in about 4% of all transplants. Donors presented a benign neoplasm in 29.08% of cases, a malignancy with variable risk of transmission in 69.75% while in 1.34% the nature of neoplasm could not be assessed. Considering all procedures, rate of transmission of a malignancy was 0.03% (10 cases) of all 29858 transplants of the time interval. Notably, cases of transmission were not from donors of this pool, but from donors that, according to our protocols, had no elements of suspect at time of donation. As recipient safety is always the priority and as guidelines have set exclusion criteria for donors with some specific types of malignancy, these results show that use of this type of donors is safe and improve organ pool. Furthermore represent basis for improvement and standardization of donor assessment protocols suggesting that efforts in data collection systems, to produce complete and homogeneous data, are mandatory.

Keywords

Transplantation Donor with malignancy Donor evaluation Risk assessment Neoplastic transmission 

Notes

Funding

Supported by Internal Funding (MB, GZ and AD-FUR 2017).

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (authorization 1745CESC on behalf of MeTTOs group) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Copyright information

© Italian Society of Nephrology 2019

Authors and Affiliations

  • Albino Eccher
    • 1
    Email author
  • Letizia Lombardini
    • 2
    • 3
  • Ilaria Girolami
    • 1
  • Francesca Puoti
    • 2
  • Gianluigi Zaza
    • 4
  • Giovanni Gambaro
    • 4
  • Amedeo Carraro
    • 5
  • Giovanni Valotto
    • 1
  • Luca Cima
    • 6
  • Luca Novelli
    • 7
  • Desley Neil
    • 8
  • Umberto Montin
    • 5
    • 9
  • Aldo Scarpa
    • 1
  • Matteo Brunelli
    • 1
  • Alessandro Nanni Costa
    • 2
    • 3
  • Antonia D’Errico
    • 10
  1. 1.Department of Pathology and Diagnostics, Pathology UnitUniversity and Hospital Trust of VeronaVeronaItaly
  2. 2.National Health InstituteRomeItaly
  3. 3.National Transplant CentreRomeItaly
  4. 4.Renal UnitUniversity and Hospital Trust of VeronaVeronaItaly
  5. 5.General Surgery and Liver Transplant UnitUniversity and Hospital Trust of VeronaVeronaItaly
  6. 6.Surgical Pathology UnitSanta Chiara HospitalTrentoItaly
  7. 7.Institute of Histopathology and Molecular DiagnosisCareggi University HospitalFlorenceItaly
  8. 8.University Hospital BirminghamBirminghamUK
  9. 9.General Surgery UnitHospital Trust of FeltreFeltreItaly
  10. 10.Pathology UnitS. Orsola-Malpighi University Hospital of BolognaBolognaItaly

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