The transplant is often synonymous with a new life. For four European patients, this was not the case. Transplanted lungs, liver, left kidney and right kidney from the same donor, the recipients all developed cancer several years after the transplant. Facts reported in a study ofAmerican Journal of Transplantation.
It all started in 2007, when the 53-year-old future donor died of a stroke. Different organs are taken from him for possible transplants. The usual medical examinations are carried out. For each transplant, the tissues of each organ are scrupulously analyzed. No problem is detected at this time.
Four women affected
But sixteen months after her double lung transplant, a first 42-year-old patient was hospitalized. His tests show the presence of cancer cells in his lymph nodes. A few months later, in 2009, the patient died of her troubles. No link was then established between his transplant and his cancer.
Several years later, it is the repetition of the scenario that will challenge the doctors. In 2013 and 2014, the beneficiaries of the left kidney (62 years old) and the liver (59 years old) both succumbed to the same malignant tumor. For these three patients, the cancer actually metastasized and spread throughout the body. Treatment was thus almost impossible.
The last receiver was luckier. She also contracted cancer after having her right kidney transplant. But heavy care, including chemotherapy, suspension of immunosuppressive drugs and ablation of this diseased organ allowed him to stay alive.
An undetectable tumor
Very quickly, DNA analyzes proved that the cancer came from their common donor. The latter was actually suffering from micrometastases, at the time impossible to detect. Carried out by Professor Frederike Bemelman of the University of Amsterdam, the American Journal of Transplantation study shows that these micrometastases were still “dormant” in the original body and proliferated once transplanted. Graham Lord Professor of Medicine in Nephrology at King’s College London, confirms at the American channel CNN : “The malignant nature of the tumor was almost undetectable at the time of the organ donation”.
The researchers also assured that it was a case of “extreme rarity”. Normally, organ donation is not allowed for people who have already contracted tumors, even after their death. There are exceptions, for example in some cases of skin cancer or localized tumors. Provisions that keep the risk of transmission of an affected organ at a low rate, between 0.01% to 0.05% for each organ.
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