Donor-transmitted malignancy confirmed by quantitative fluorescence polymerase chain reaction genotype analysis: a rare indication for liver retransplantation

摘要

The incidence of donor-derived malignancy is thought to be of the order of 0:02%-0.2%.(1,2) There have been reports of transmission from donor to recipient of a variety of malignancies, including malignant melanoma, choriocarcinoma, neuroendocrine tumors, and adenocarcinomas of the lung, prostate, and pancreas.(3-9) Identifying the origin of a malignancy post transplant as being either donor-derived or recipient-derived has important clinical consequences, including withdrawal of immunosuppression and retransplantation. It also has implications for other recipients of donor organs. In sex-mismatched allografts, this distinction can be made with chromosomal analysis.(56) More recently, microsatellite analysis has allowed the detection of tumor lineage of both donor(7.10-14) and recipient origin.(15.16) We present a case of a liver transplant recipient found to have adenocarcinoma of donor origin and subsequently managed by retransplantation.