Expanding the Donor Pool for Organ Transplant Using Organs From Donors With Cancer
Menée en Angleterre et en Ecosse à partir de données 2000-2016 de registres portant sur 282 donneurs d'organes décédés et présentant une ou plusieurs tumeurs cérébrales (âge médian : 42 ans ; 55 % de femmes ; 887 greffons), cette étude analyse le risque de transmission du cancer au receveur de la greffe d'organe
Every day in the US, 17 patients die waiting for a potentially lifesaving organ transplant and many more remain on kidney dialysis because of the shortage of kidneys for transplant. Many strategies have been used to increase the donor pool. To date, malignancy has been a relative contraindication for donors to be considered for organ transplant because of data showing poor outcomes from an era when organs from deceased patients with cancer were commonly used and when staging for cancer by imaging was poor. Even though the use of patients with brain cancer as donors has become practice in some parts of the world due to the low likelihood of systemic spread, data examining this practice have come only from small series and have been conflicting. In this issue of JAMA Surgery, Greenhall and colleagues present data for 778 transplants using organs from 282 donors with brain cancer. Through the 17-year study period with a median follow-up of 7 years, no case of cancer transmission has been found. These findings demand a reexamination of transplant using organs from patients with brain cancer.
JAMA Surgery , éditorial, 2022