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Recipient Outcomes in U.S. Cases of Post-Donation Living Donor Malignancy.

A. Wilk,1 S. Taranto,1 M. Nalesnik.3

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).

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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 May 10, 2025.

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