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Copyright ©2014 Baishideng Publishing Group Inc.
World J Gastroenterol. May 28, 2014; 20(20): 6170-6179
Published online May 28, 2014. doi: 10.3748/wjg.v20.i20.6170
Table 1 Published cases of donor transmitted cancer among liver allograft recipients
Cancer typeDonor’s cause of deathCancer known in donorRecipient outcome and cause of deathRef.
ChoriocarcinomaCerebral haemorrhageIdentified on autopsyDeath due to DTC[52]
Cerebral haemorrhageIdentified in the placentaDeath due to DTC[53]
NSNoDeath due to DTC[54]
Cerebral haemorrhageDiagnosed retrospectively by testing the stored serumDeath due to DTC[55]
Cerebral haemorrhageNoDeath due to DTC[56]
ColonCerebrovascular eventNoDeath due to DTC[57]
Cerebrovascular eventNoDeath due to DTC, despite re-transplant[13]
Cerebral haemorrhageNoDeath due to DTC[58]
CNS-astrocytomaAstrocytomaYesDeath due to DTC[59]
CNS-glioma, GBMGBMYesDeath due to liver failure[60]
GBMYesDeath due to DTC[61]
Malignant gliomaYesDeath due to DTC[62]
CNS-pinealoblastomaPinealoblastomaYesDeath due to DTC[63]
Kaposi’s sarcomaNSNSDeath due to DTC[54]
LymphomaSuspected meningitisDiagnosed after donationDeath due to DTC[64]
MelanomaCerebral haemorrhageNoDeath due to DTC[24]
Cerebral haemorrhageNoDeath due to DTC[65]
Sub-arachnoid haemorrhageNoDeath due to DTC[66]
Cerebral haemorrhageNoDeath due to DTC[67]
NSNoDeath due to DTC[68]
Neuroendocrine cancerSub-arachnoid bleedNoDeath due to DTC[69]
Cerebrovascular eventNoDeath due to DTC[70]
NSNoAlive on chemotherapy[71]
OvaryAnoxic brain injuryNoDeath due to DTC[15]
PancreasCerebral haemorrhageNoAlive at 1 yr following urgent re-transplant[72]
Unspecified adenocarcinomaNSNSAlive at 8 mo following re-transplantation[74]
Unspecified squamous carcinomaCerebral haemorrhageNoAlive at 30 mo following re-transplantation[75]
UrotheliumSub-arachnoid haemorrhageNoAlive at 4 yr following re-transplantation[76]
Sub-arachnoid haemorrhageNoNS[77]
Table 2 Summary of council of europe and organ procurement and transplantation network/united network for organ sharing guidelines for donor with cancer history
Council of Europe guidelines[17]: Donors with unacceptable risk of transmission
Features applicable to cancer of any histological type at any time prior to donation
Presence of metastasis - lymphatic or distant
Absence of curative surgical treatment or missed follow-up (except low-grade prostate cancer under surveillance)
Palliative therapy for cancer
Non-CNS cancer at any time prior to donation
Malignant melanoma, including carcinoma-in-situ
Chronic Leukaemia
Thyroid (except capsulated papillary or minimally invasive follicular type)
Non-CNS cancer diagnosed during donor procurement
All cancers, except:
Renal cell cancer < 2.5-4.0 cm (pT1a), tumour free resection margin and Fuhrman grade I or II
Localised low grade (Gleason score ≤ 6) prostate cancer
Small gastrointestinal stromal tumours
Localised non-melanoma skin cancer
Cancers of the CNS
WHO grade IV cancers
WHO grade III cancers with following features:
Presence of ventriculo-peritoneal or ventriculo-atrial shunts
Systemic chemotherapy
OPTN/UNOS guidelines[18] - intermediate or high risk of transmission
Intermediate risk of transmission (1%-10%) Breast cancer, stage 0 Colon cancer, stage 0 Renal cell cancer (resected, solitary): 4-7 cm, well differentiated, stage I Treated non-CNS malignancy (≥ 5 yr prior) with cure rate 90%-99%High risk of transmission (> 10%) Breast cancer, stage > 0 Colon cancer, stage > 0 Renal cell cancer: > 7 cm or stage II-IV Choriocarcinoma Leukaemia Lymphoma Small cell cancer: lung/neuroendocrine Metastatic carcinoma Sarcoma Lung cancer: stage I-IV Any CNS tumour with ventriculo-peritoneal or ventriculo-atrial shunt, surgery (other than uncomplicated biopsy), irradiation or extra-cranial metastases CNS tumour of WHO grade III or IV Any other cancer with insufficient follow-up or probability of cure < 90%
Table 3 Increased risk of cancer after liver transplantation compared with general population adjusted for age, gender and year
Cancer typeStandardised incidence ratio
All cancers2-3
Kaposi’s sarcoma37-144
Non-melanoma skin cancer6-38
Upper aero-digestive tract10-15
Colorectal (PSC-IBD)3
Melanoma, lung2
Colorectal (non PSC-IBD)Not increased
MyelomaNot increased
BreastNot increased
ProstateNot increased