Session Time: 6:00pm-7:00pm
Presentation Time: 6:00pm-7:00pm
Location: Hall C & D
*Purpose: Vigilance monitoring after organ transplantation includes Serious Adverse Events (SAE) and Serious Adverse Reactions (SAR). SAE describe findings in the donor after transplant that pose a risk of harm to the already transplanted recipients of the donor, e.g. malignancies. SAR refer to harm that has occurred to one or more recipients of the same donor and that is suspected of being associated with the donor organ, e.g. new tumor in liver graft after transplant. All SAE/SAR associated to deceased organ donors or organ recipients in Germany have to be reported to the national competent authority for vigilance monitoring.
*Methods: Analysis of all reported SAE/SAR related to malignant tumors from 7/2015 to 12/2017 in Germany
*Results: 17 donor neoplasms (SAE) were found (see below). 14 of them were detected in donor organs during preparation in the recipient center, after pathological examination of not transplanted organs and in donor autopsy. In 3 cases retrospective evaluation of donor history or imaging of the donor prior to death led to tumor diagnosis. 4 reported tumors resulted in preventive or therapeutic organ removal or partial resection in the recipient. One SAE tumor/pleuramesothelioma was transmitted to 2 recipients, both of them died. 11 SAR without previous SAE were reported 2 weeks -16 years after transplant. One known donor glioblastoma was transmitted to one recipient. He died 28 months after transplant. Donor origin of SAR was confirmed/probable for 10 recipient tumors, possible for 2 and excluded for 2 tumors. Additionally, 10 malignancy SAE/SARs related to foreign donors have been reported, none of them resulted in transmission to German recipients (see below).
*Conclusions: An occult donor pleuramesothelioma was transmitted to 2 recipients, a known donor glioblastoma to a third recipient. None of them survived. Comprehensive and detailed reporting of SAE/SAR and international data collection will provide a valuable resource for transmission risk assessment. These data are essential to minimize tumor transmission in the future.
|Donors in Germany||SAE n=17||5 renal cell carcinoma/RCC, 3 neuroendocrine tumor/NET,
2 lung cancer (1 plus prostate cancer), 2 plasmocytoma (one suspected), breast cancer, lymphoma, melanoma metastases, pleuramesothelioma, history of thyroid cancer
|SAR n=12||6 RCC, 2 multiple lung lesions, angiosarcoma, glioblastoma, lung cancer, liver metastases|
|Foreign donorsonors||SAE/SAR n=10||4 RCC, 2 angiosarcoma, choriocarcinoma, lymphoma, thyroid cancer, NET|
To cite this abstract in AMA style:Moench K, Rahmel A, Barreiros AP. Organ Vigilance in Germany: Malignancy Transmission from Organ Donor to Recipient [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/organ-vigilance-in-germany-malignancy-transmission-from-organ-donor-to-recipient/. Accessed January 25, 2021.
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