ATC Abstracts

American Transplant Congress abstracts

  • Home
  • Meetings Archive
    • 2022 American Transplant Congress
    • 2021 American Transplant Congress
    • 2020 American Transplant Congress
    • 2019 American Transplant Congress
    • 2018 American Transplant Congress
    • 2017 American Transplant Congress
    • 2016 American Transplant Congress
    • 2015 American Transplant Congress
    • 2013 American Transplant Congress
  • Keyword Index
  • Resources
    • 2021 Resources
    • 2016 Resources
      • 2016 Welcome Letter
      • ATC 2016 Program Planning Committees
      • ASTS Council 2015-2016
      • AST Board of Directors 2015-2016
    • 2015 Resources
      • 2015 Welcome Letter
      • ATC 2015 Program Planning Committees
      • ASTS Council 2014-2015
      • AST Board of Directors 2014-2015
      • 2015 Conference Schedule
  • Search

Short Tandem Repeat (STR) Analysis Identifies a Cancer Transmitted from an Organ Donor to 4 Transplant Recipients

M. Park1, J. Van Ziffle1, E. Collisson1, J. Grenert1, S. Behr1, A. Gonzalez1, J. Chou1, S. Maisel1, T. Friedlander1, C. Freise1, J. Shoji1, T. Semrad2, P. Chin-Hong1, C. Atreya1

1UCSF, San Francisco, CA, 2Gene Upshaw Memorial Tahoe Forest Cancer Center, Truckee, CA

Meeting: 2020 American Transplant Congress

Abstract number: D-018

Keywords: Donors, marginal, Donors, unrelated, Informed consent, Post-transplant malignancy

Session Information

Session Name: Poster Session D: Kidney Deceased Donor Selection

Session Type: Poster Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:00pm

 Presentation Time: 3:30pm-4:00pm

Location: Virtual

*Purpose: Organ donors are systematically screened for infection, while screening for malignancy is less rigorous. The true incidence of donor-transmitted malignancies is unknown due to lack of universal tumor testing post-transplant. We describe the transmission of a gastrointestinal (GI) adenocarcinoma from one donor to four transplant recipients. The donor was a 34-year-old overweight, nonverbal man living in a group home with no prior h/o malignancy. Cause of death was recorded as anoxia due to cardiac arrest attributed to polypharmacy. Four recipients received his organs (Table 1); all developed adenocarcinoma.

*Methods: IRB approval for chart review was obtained. Records pertaining to the Donor and Heart Recipient (deceased) were obtained from the UNOS OPTN online database, UNet. The other 3 organ recipients provided individual research consent for chart review and molecular profiling. Short Tandem Repeat (STR) genotyping of each recipient’s tumors was performed using the AmpFlSTR Identifiler Kit, followed by capillary electrophoresis. Tumor and germline DNA were subjected to next generation sequencing (NGS) of 479 genes.

*Results: Donor origin was established by STR analysis, with tumors showing high levels of donor alleles. In the Liver and Right KP recipients, 15 of 15 STR loci were amplified by PCR, with tumors showing high levels of donor alleles in 13 and 14 loci. Human Leukocyte Antigen (HLA) typing and NGS also demonstrated that tumors in the Left Kidney Recipient and the Right KP Recipient were donor-transmitted. Tumors from the Liver, Left Kidney, and Right KP Recipients were all poorly differentiated adenocarcinoma with signet ring features and stained positive for markers consistent with a GI primary, while markers for melanoma, breast, lung, and gynecologic cancers were negative. Based on the immunohistochemical profile and NGS data, the stomach was considered the most probable organ of origin.

*Conclusions: To improve patient safety, Short Tandem Repeat (STR) testing should be standard immediately upon diagnosis of cancer in any organ transplant recipient. Utilization of new screening methods of organ donors for malignancy may also be warranted. While other methods can be used for molecular identity testing (e.g., HLA typing and NGS described here), STR analysis is cost and time efficient, with easily interpretable results. One patient remains alive and without evidence of cancer following prompt organ explant.

Recipient Characteristics
Heart Liver Left kidney Right kidney-pancreas (KP)
Description 69 yo man; ischemic cardiomyopathy 54 yo man; alcoholic cirrhosis 63 yo man; multifocal urothelial carcinoma in situ, s/p bilateral nephroureterectomy 41 yo woman; type 1 diabetes mellitus
Vital status Died post-transplant day (PTD) 143 Died PTD 293 Died PTD 812 Alive

  • Tweet
  • Email
  • Print

To cite this abstract in AMA style:

Park M, Ziffle JVan, Collisson E, Grenert J, Behr S, Gonzalez A, Chou J, Maisel S, Friedlander T, Freise C, Shoji J, Semrad T, Chin-Hong P, Atreya C. Short Tandem Repeat (STR) Analysis Identifies a Cancer Transmitted from an Organ Donor to 4 Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/short-tandem-repeat-str-analysis-identifies-a-cancer-transmitted-from-an-organ-donor-to-4-transplant-recipients/. Accessed May 11, 2025.

« Back to 2020 American Transplant Congress

Visit Our Partner Sites

American Transplant Congress (ATC)

Visit the official site for the American Transplant Congress »

American Journal of Transplantation

The official publication for the American Society of Transplantation (AST) and the American Society of Transplant Surgeons (ASTS) »

American Society of Transplantation (AST)

An organization of more than 3000 professionals dedicated to advancing the field of transplantation. »

American Society of Transplant Surgeons (ASTS)

The society represents approximately 1,800 professionals dedicated to excellence in transplantation surgery. »

Copyright © 2013-2025 by American Society of Transplantation and the American Society of Transplant Surgeons. All rights reserved.

Privacy Policy | Terms of Use | Cookie Preferences