Four organ recipients developed cancer after doctors did not detect breast cancer in an organ donor.
The 53-year-old female donor died in 2007 after a stroke, according to the case study published in the American Journal of Transplantation. Her lungs, kidneys, liver and heart were transplanted into five different patients.
Four of them developed breast cancer between 16 months and 6 years after the transplant. Three of those who developed breast cancer have now died. The fifth patient – who received the donor's heart – died from complications after the transplant, unrelated to cancer.
One of the transplant patients, a 42-year-old woman, presented with cancer affecting the lungs, bones and liver. Genetic testing revealed that the tumours had originated from cancerous cells from the transplanted lungs she had received. The remaining patients who had received organs from that donor were warned about the risks and kept under observation, as none of them appeared to have cancer at the time.
However, in 2011 a 59-year-old woman who had received the donor's liver and a 62-year-old woman who had received a kidney both developed cancer. Both died shortly afterwards.
A 32-year-old man who had also received a kidney from the donor underwent surgery to remove the affected kidney once cancer was detected in the tissue, five years after the transplant. After receiving chemotherapy, he has been cancer-free to date.
The authors note that storing the warm organs without blood supply might have aided the spread of metastatic cancer cells. However, using a CT scan on every organ donor to prevent similar cases would be impractical, and a relatively high rate of false positives might 'shrink the already small donor pool', they concluded.
The case study seems to be the first to report an organ donor transmitting cancer to several different organ recipients. Contracting cancer from an organ transplant is extremely rare, with a risk of 0.01 to 0.005 percent, as organs and organ donors are given thorough medical exams before the organs are transplanted into patients.
Dr Yvette Matser, lead author of the study from the VU University Medical Centre in the Netherlands, said: 'The extremely low rate of transmission of malignancies during transplantation proves the efficiency of the current guidelines.'