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How safe are organs from deceased donors with neoplasia? The results of the Italian Transplantation Network

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Abstract

Guidelines for donor selection have changed to expand the donor pool, considering potential donors affected by a neoplasm. Aim of this retrospective study is to look at the use of organs from donors with a current or history of neoplasm within the Italian Transplant Network. Data, collected and validated by Italian National Health Institute for the time interval 2006–2015, have been reviewed retrospectively by mean of multivariable pivot tables. Donors with neoplasia represented about 5% of all donors, resulting in about 4% of all transplants. Donors presented a benign neoplasm in 29.08% of cases, a malignancy with variable risk of transmission in 69.75% while in 1.34% the nature of neoplasm could not be assessed. Considering all procedures, rate of transmission of a malignancy was 0.03% (10 cases) of all 29858 transplants of the time interval. Notably, cases of transmission were not from donors of this pool, but from donors that, according to our protocols, had no elements of suspect at time of donation. As recipient safety is always the priority and as guidelines have set exclusion criteria for donors with some specific types of malignancy, these results show that use of this type of donors is safe and improve organ pool. Furthermore represent basis for improvement and standardization of donor assessment protocols suggesting that efforts in data collection systems, to produce complete and homogeneous data, are mandatory.

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Funding

Supported by Internal Funding (MB, GZ and AD-FUR 2017).

Author information

Authors and Affiliations

  1. Department of Pathology and Diagnostics, Pathology Unit, University and Hospital Trust of Verona, P.le Stefani n. 1, 37126, Verona, Italy

    Albino Eccher, Ilaria Girolami, Giovanni Valotto, Aldo Scarpa & Matteo Brunelli

  2. National Health Institute, Rome, Italy

    Letizia Lombardini, Francesca Puoti & Alessandro Nanni Costa

  3. National Transplant Centre, Rome, Italy

    Letizia Lombardini & Alessandro Nanni Costa

  4. Renal Unit, University and Hospital Trust of Verona, Verona, Italy

    Gianluigi Zaza & Giovanni Gambaro

  5. General Surgery and Liver Transplant Unit, University and Hospital Trust of Verona, Verona, Italy

    Amedeo Carraro & Umberto Montin

  6. Surgical Pathology Unit, Santa Chiara Hospital, Trento, Italy

    Luca Cima

  7. Institute of Histopathology and Molecular Diagnosis, Careggi University Hospital, Florence, Italy

    Luca Novelli

  8. University Hospital Birmingham, Birmingham, UK

    Desley Neil

  9. General Surgery Unit, Hospital Trust of Feltre, Feltre, Italy

    Umberto Montin

  10. Pathology Unit, S. Orsola-Malpighi University Hospital of Bologna, Bologna, Italy

    Antonia D’Errico

Authors
  1. Albino Eccher
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  2. Letizia Lombardini
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  3. Ilaria Girolami
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  5. Gianluigi Zaza
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  6. Giovanni Gambaro
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  7. Amedeo Carraro
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  8. Giovanni Valotto
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  9. Luca Cima
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  10. Luca Novelli
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  11. Desley Neil
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  12. Umberto Montin
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  13. Aldo Scarpa
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  14. Matteo Brunelli
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  15. Alessandro Nanni Costa
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  16. Antonia D’Errico
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Corresponding author

Correspondence to Albino Eccher.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (authorization 1745CESC on behalf of MeTTOs group) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Eccher, A., Lombardini, L., Girolami, I. et al. How safe are organs from deceased donors with neoplasia? The results of the Italian Transplantation Network. J Nephrol 32, 323–330 (2019). https://doi.org/10.1007/s40620-018-00573-z

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  • DOI: https://doi.org/10.1007/s40620-018-00573-z

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