Recipient Outcomes in U.S. Cases of Post-Donation Living Donor Malignancy.
1United Network for Organ Sharing, Richmond, VA
2Duke Univ Medical Center, Durham, NC
3Univ of Pittsburgh, Pittsburgh, PA.
Meeting: 2016 American Transplant Congress
Abstract number: B301
Keywords: Donation, Kidney, Malignancy, Outcome
Session Information
Session Name: Poster Session B: PTLD/Malignancies: All Topics
Session Type: Poster Session
Date: Sunday, June 12, 2016
Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Halls C&D
Background: Under current OPTN policy, living donors (LD) are required to be followed for two years (yrs) post-donation. Cases of malignancy in LD post-donation can be reported via the OPTN Improving Patient Safety portal anytime. This analysis was performed to examine outcomes of recipients of such cases.
Data and Methods: OPTN data were analyzed for recipients of LD kidney transplants between 1/1/08 and 8/31/14 who had a malignancy reported for their LD through 11/6/15; three RCC cases in which the malignancy was known at the time of transplant were excluded. Case characteristics and recipient outcomes were examined, and graft and patient survival was estimated using unadjusted Kaplan-Meier analysis.
Results: There were 31 kidney recipients for analysis. The most common post-donation LD malignancy was breast cancer (35.5%), followed by melanoma (12.9%); the median number of days between donation and diagnosis was 386 (IQR=207-560). Two recipients developed non-donor related de novo skin malignancies of the head/lip/neck within 4-yrs post-transplant. The 1-yr patient survival rate was 100% while the 1-yr graft survival rate was 97.1%.
| Donor Case Characteristics | N (%) |
Days from Donation to Malignancy Diagnosis [median (IQR)] |
| Malignancy Report Year | ||
| 2011 | 2 (6.5%) | |
| 2012 | 5 (16.1%) | |
| 2013 | 8 (25.8%) | |
| 2014 | 8 (25.8%) | |
| 2015 | 8 (25.8%) | |
| Donor Reported Malignancy | 386 (207-560) | |
| Adenocarcinoma | 2 (6.5%) | * |
| Breast Cancer | 11 (35.5%) | 282 (207-727) |
| Leukemia/Lymphoma | 3 (9.7%) | 494 (323-538) |
| Skin (non-Melanoma) | 3 (9.7%) | 386 (240-513) |
| Melanoma | 4 (12.9%) | 160 (13-334) |
| Gynecological | 2 (6.5%) | * |
| Other | 6 (19.4%) | 427 (348-519) |
| Recipient Outcomes | ||
| Post-Transplant Malignancy: Skin (head/lip/neck) | 2 (6.5%) | |
| 1-yr Graft Survival [rate (95% CI)] | 96.8% (84.7%-100.0%) | |
| 1-yr Patient Survival [rate (95% CI)] | 100.0% (100.0%-100.0%) |
*Cannot report due to small sample size
Conclusions: There were no unintended malignancy transmissions, and the majority of recipients whose LD had a malignancy reported post-donation were malignancy free 1-yr post-transplant. Additionally, all of these recipients were alive and vast majority had a functioning graft 1-yr post-transplant. The data show good short-term outcomes, but long-term outcomes need to be assessed once more data accumulates.
CITATION INFORMATION: Wilk A, Taranto S, Nalesnik M. Recipient Outcomes in U.S. Cases of Post-Donation Living Donor Malignancy. Am J Transplant. 2016;16 (suppl 3).
To cite this abstract in AMA style:
Wilk A, Taranto S, Nalesnik M. Recipient Outcomes in U.S. Cases of Post-Donation Living Donor Malignancy. [abstract]. Am J Transplant. 2016; 16 (suppl 3). https://atcmeetingabstracts.com/abstract/recipient-outcomes-in-u-s-cases-of-post-donation-living-donor-malignancy/. Accessed November 22, 2024.« Back to 2016 American Transplant Congress