Whole Body CT Imaging in Deceased Donor Screening

J. W. Mensink¹, R. A. Pol.², W. N. Nijboer¹, J. de Jonge³, K. M. Ooms - de Vries⁴, M. F. van der Jagt⁵, M. C. van de Poll⁶, I. P. Alwayn¹, A. E. Braat¹

¹Department of Surgery
Division of Transplantation, Leiden University Medical Center, Leiden, Netherlands, ²Department of Surgery
Division of Transplantation, University Medical Center Groningen, Groningen, Netherlands, ³Department of Surgery
Division of Transplantation, Erasmus Medical Center, Rotterdam, Netherlands, ⁴Dutch Transplant Foundation, Leiden, Netherlands, ⁵Department of Surgery
Division of Transplantation, University Medical Center St. Radboud, Nijmegen, Netherlands, ⁶Department of Surgery and Department of Intensive Care, Maastricht University Medical Center, Maastricht, Netherlands

Meeting: 2019 American Transplant Congress

Abstract number: D333

Keywords: Donors, marginal, Elderly patients, Malignancy, Safety

Session Information

Session Name: Poster Session D: PTLD/Malignancies: All Topics

Session Type: Poster Session

Date: Tuesday, June 4, 2019

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall C & D

*Purpose: Using older (extended criteria) donors to increase the donor pool increases the risk of malignancies in the donor. Our aim was to analyze the effect of a preoperative computed tomography (CT) scan on identifying malignancies and to perform a systematic literature search on radiologic screening of deceased organ donors.

*Methods: We included all reported deceased organ donors in the Netherlands from 2013-2016. Donor reports were analyzed to identify results of radiologic investigations or (suspected) malignancies found during the organ retrieval procedure. Secondly, we compared retrieval outcomes between conventionally screened deceased donors and deceased donors who have had a CT-scan.

*Results: Chest or abdominal CT-scans were performed in 16% and 18% of the 1322 reported donors respectively. Screening by chest CT-scan versus chest X-ray resulted in 1.3% vs no thoracic malignancies found. During retrieval no more malignancies were found in the CT group; an additional 0.2% malignancies were found in the chest X-ray group. Screening by abdominal CT-scan resulted in 0.4% malignancies, compared to 0.1% in the abdominal ultrasound group. During retrieval, an additional 0.9% and 1.6% malignancies were found respectively. Our literature search rendered 3 articles. Two studies evaluated CT-scanning in deceased donor screening. The whole body CT reports described in 8% and 11% of the cases (possible) malignancies in these two studies. In 4% and 11% of the cases the retrieval was canceled because of an active malignancy. The third study evaluated diagnostic imaging of potential lung donors and its clinical relevance. In 7% of the patients a (possible) malignancy was reported.

*Conclusions: CT-scanning decreases perioperative detection of tumors, from 0.2% to 0% for thoracic imaging and from 1.6% to 0.9% for abdominal imaging. CT scanning could prevent 2-3 futile organ retrieval procedures annually in the Netherlands and probably will decrease the risk of donor derived malignancies.

To cite this abstract in AMA style:

Mensink JW, Pol RA, Nijboer WN, Jonge Jde, Alwayn IP, Braat AE. Whole Body CT Imaging in Deceased Donor Screening [abstract]. Am J Transplant. 2019; 19 (suppl 3). https://atcmeetingabstracts.com/abstract/whole-body-ct-imaging-in-deceased-donor-screening/. Accessed November 22, 2024.

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