Three people died after the same organ donor gave them breast cancer, an "extraordinary" case report has revealed.
The donor, a 53-year-old woman, died of a stroke in 2007 and donated her kidneys, lungs, liver and heart to patients who needed transplants.
But within six years after the transplant of the woman's organs, four of the five recipients had died as a result.
The heart patient died of sepsis, but the other four developed breast cancer that spread to their healthy organs. Only one survived.
The cancer was not noticed by the doctors before the woman's organs were donated and acted like Trojan horses, secretly carrying the disease to the patients' body.
Experts say that the chances of getting cancer from a single organ transplant could be as small as one in 10,000.
And they believe that this is the first time that a patient has transmitted cancer to four recipients, and it has never been seen that it takes so long to develop tumors.
Only one in five people who received organs from the same woman survived more than six years, one died shortly after sepsis and another three were killed by breast cancer that was not detected until it spread to the healthy organs of the recipients .
Research by scientists from the University of Tübingen in Germany and the VU University Medical Center in Amsterdam, The Netherlands, revealed the strange tragedy that developed during the six years after the death of the donor.
Experts insist that donor evaluations work well and say there is a possibility of 0.01 to 0.05 percent contracting cancer from any donated organ.
The first person to be diagnosed in the peculiar case was a 42-year-old woman who received both lungs from the donor.
Less than a year and a half after receiving her new lungs, the woman was admitted to the hospital because they were not functioning properly.
Then, doctors discovered that he had breast cancer that had started in his lungs and spread to his bones: then it spread to his liver and he died in August 2009.
The disease is still called breast cancer even in other parts of the body because the tumors are made of cells specific to the original cancer that started in the breast tissue but spread.
The doctors proved that the cancer had originated in the organ donor when doing DNA tests.
When the news about the death of the lung transplant recipient came out, the 62-year-old woman who received the left kidney and the 32-year-old man who received the right kidney were warned about the risk of cancer.
Tests were performed on both, but no signs of the disease were found immediately.
But in 2011 the man was diagnosed with kidney cancer, and it was discovered that the woman had cancer in the liver, but not until five years later.
Increasing number of patients waiting for lung transplants
The number of people in the UK waiting for a lung transplant has increased by almost half in the last five years.
Currently, 354 people in the United Kingdom need a new lung to survive, compared to 242 people in 2013, an increase of 46%.
And about a quarter of the patients on the list will die before they have a new lung, or they become so fragile that they can no longer have a transplant.
NHS Blood and Transplant said that people on the list of organ donors are getting older and are less healthy, so their lungs are not suitable for transplants.
John Forsythe, associate medical director of NHS Blood and Transplant said: "Last year, 65 people died on the lung transplant waiting list and many of those lives could have been saved or transformed if more families had said yes to the donation.
"Sadly, many donation opportunities are lost every year because families do not know if their loved one wanted to be a donor or not.
"We urgently need people to tell their families that they want to donate."
The man has had his transplanted kidney removed and taken chemotherapy for a year, and has not had cancer since 2012.
However, the cancer of the woman, which was first noticed in the liver, appeared in the kidney, bones, spleen and other organs in the digestive tract.
His treatment was withdrawn and he died two months after being diagnosed, six full years after receiving the donor's kidney.
The fourth patient to get cancer of the transplanted organs was a 59-year-old woman who received the liver to replace her liver damaged by cirrhosis.
Her tumor was detected in 2011, but she refused to remove the liver, fearing complications similar to those experienced after the first operation in 2007.
The researchers said that "it felt good" and the treatment managed to stabilize the disease. But when the cancer began to spread in 2014, he refused any additional treatment and died.
The scientists suggest that keeping the organs warm without a blood supply could have allowed the tumor cells that were moving in the bloodstream to settle in the organs and begin to spread.
And because patients took medications to weaken their immune systems and prevent their bodies from rejecting organs, the cancer could have grown out of control.
But, they said, scanning the donors too intensely could bring to light minor problems that lead to more desperately rejected donors.
The authors, led by Yvette Matser, wrote: "The drawback of a routine CT scan for all donors is that it will increase the clinically irrelevant findings, which could lead to greater rejection of donors and a decrease in the already scarce group of donors. donors
"The extremely low rate of transmission of malignant diseases during transplantation demonstrates the effectiveness of current guidelines.
"A complete medical examination, including a breast exam, should always be performed as described in the guidelines of the Organ Acquisition and Transplant Network.
They added: "This extraordinary case points to the often fatal consequences of breast cancer derived from donors and suggests that removal of the donor organ and restoration of immunity may induce complete remission."
The findings were published in the American Journal of Transplantation.