A man who underwent a liver transplant to save his life died less than a year later from cancer he contracted from his donor.
The unnamed patient, 41, from California, had chronic liver disease and received a transplant from a deceased donor in 2001, who was later found to have undetected lung cancer.
The recipient died of the same lung cancer as his first donor a year later, despite surgeons performing a second emergency transplant to try to rid him of the disease.
The doctors involved in the case wrote in their report: “Clearly, the tumor cells escaped the confines of the transplanted liver a week after the transplant and gained access to the general circulation.”
They added that the situation is the “first case in the literature of transmission of donor cancer” despite removing the original organ and subjecting the recipient to a second transplant.
And the case is one of the few in the United States in which cancer has been transferred between organ donors and recipients.
Doctors believe that tiny cancer cells, too small to be detected by scans, migrated from the donor’s lungs to his liver, which would explain why his organ was declared cancer-free and safe to transplant.
The 41-year-old underwent a second liver transplant after the donor of the first was found to have lung cancer (file photo)
The patient originally needed a liver transplant because he developed cirrhosis from hepatitis B, a chronic liver condition that causes scar tissue to replace healthy tissue in the liver and decrease its function.
The donor was a 63-year-old man who had died from a stroke but had no history of cancer. Laboratory tests performed before the transplant found that there were no signs of cancer in the donor’s liver, lungs and chest.
However, when the donor was autopsied the day after surgery, a tumor was discovered in his lungs.
He was posthumously diagnosed with metastatic pulmonary adenocarcinoma, a lung cancer that had spread to the area of the chest between the lungs.
The autopsy findings led doctors to put the patient back on the list for another liver, which he received seven days later.
He recovered successfully from surgery.
For weeks after the second surgery, the patient continued to improve, but because of the donor’s cancer, he had a CT scan 10 months after the transplant, which showed no signs of cancer in the chest, abdomen or pelvis.
However, six weeks after the scan, the recipient developed abdominal pain, vomiting, and a feeling of fullness.
Blood tests, fluid tests and body scans revealed metastatic lung adenocarcinoma, the same type of cancer as her first donor.
And the immunosuppressive drugs the patient received to prevent organ rejection likely fueled the cancer, allowing it to grow and spread more easily, making it even more deadly.
He was prescribed chemotherapy and planned to start a few weeks later, but a month after his diagnosis, the man developed a fluid buildup and blood clot in his legs.
He was admitted to hospital for treatment but died within 24 hours.
Sample B shows tumor cells in the donor’s right lung and square C shows features in the recipient’s tumor cells, which have “similar characteristics to the donor’s tumor cells.”
Analysis of the cancers of the donors and the recipient “corroborates that the first donor was the source of the malignancy.”
The doctors wrote in the case report published in the journal Liver Transplantation that an analysis of tumor cells from both the donor and recipient “showed striking similarities to lung adenocarcinoma from donor 1.”
The recipient’s tumor cells had “identical” characteristics to donor 1’s lung tumor.
Additional testing revealed that the cancer “originated in donor 1, not donor 2 or the recipient himself.”
Cases of “transplanted” cancer are extremely rare and there are no statistics on the matter: only a few sporadic cases have been documented in the medical literature.
A 2013 review of these cases published in Cold Spring Harbor Perspectives in Medicine, states that there is no estimate of the risk of cancer transmission from the donor to the recipient and that there is limited data on the subject.
The report’s authors wrote: “The incidence of any cancer transmission is so low that reports of sporadic cases are the main source of information.”
A previous review A 1993 study that analyzed data from the 1970s also found that there were only “sporadic” reports of cancer transmitted through organ donation.
The 2013 review added: “The low frequency and highly variable stage of cancers mean that definitive risk calculations are impossible.”
However, the authors continued, it is “very likely that the data underestimate the true incidence.”
Using the limited data available, the authors of the 2013 report found that cancers known to have been transmitted from donor to recipient on at least one occasion include breast cancer, colon cancer, liver cancer, lung cancer, melanoma , ovarian cancer, prostate cancer and kidney cancer. cancer.