- Organs from a single donor spread breast cancer to four transplant
recipients, according to a new report in the American Journal of
- Three of the four recipients died because of the cancer.
- But the risk of getting cancer from a donated organ is very
low, the report’s authors wrote.
Donated organs from one woman spread breast cancer to four
different transplant recipients, according to a new report
authored by a team of doctors in the Netherlands. It’s a case the
authors described as “extraordinary.”
The report was published in the July issue in American Journal of
Transplantation, LiveScience reported Saturday.
The donor was a 53-year-old woman who died from bleeding in
the brain. At the time, a physical exam, lab testing,
x-rays, and ultrasounds showed that the woman had no problematic
medical history. Her heart, lungs, liver, and kidneys were then
transplanted into five individuals.
The heart recipient died of sepsis — a life-threatening
immune response to infection — just a few months after the
transplant, the report said.
The recipients of the right kidney, left kidney, lungs, and liver
all survived longer. But in the 16 months to 6 years following
transplantation, all four developed metastatic breast cancer — the
type that spreads to other organs in the body, making it far more
difficult to treat. Testing of the cancer cells’ DNA revealed
that they had come from the donor.
It turned out that the donor had breast cancer at the time of
donation, but it was unknown to doctors. Otherwise, her organs
wouldn’t have been given to other people. People with active or
invasive cancers considered “unsuitable for organ
donation,” the authors wrote.
The liver, lung, and left-kidney recipients eventually died
because of their donor-derived breast cancer. The right-kidney
recipient, a 32-year-old man, survived after removal of the
donated kidney and chemotherapy treatment. He achieved complete
cancer remission in 2012. At his last follow-up in the spring of
2017, he was still cancer-free and ready to seek another new
kidney, the report said.
Getting cancer from a donated organ is extremely rare
This is not the first-ever case of cancer spreading to a
transplant recipient through a donated organ. The authors wrote
there have been “many” reports of the phenomenon before. What
makes this case unique, they added, is that one donor spread
breast cancer to four people — and that it took so long for the
transmitted cancer to grow and cause symptoms in the recipients’
But overall, the risk of getting donor-derived cancer after an
organ transplant is very low — between 0.01% and 0.05% per organ
transplant, according to the report.
“The organ supply is incredibly
Lewis Teperman, director of
organ transplantation at Northwell Health, who was not involved
in the case, told LiveScience. But he added that it’s “impossible
to screen for everything,” and there remains a very small chance
that a donor could transmit a hidden disease.
It’s not clear why testing missed the donor’s breast
It’s not clear why the donor’s breast cancer wasn’t caught
before her organs were donated, but it’s possible that she had
micrometastases, or groups of
cancers cells that split off the original tumor and spread to
other parts of the body but are too small to be seen by imaging
tests, the authors wrote. Transplant recipients must also take
drugs that suppress their immune system, which lowers the risk of
organ rejection but may make it easier for cancer
cells to survive, LiveScience reported.
It’s also unclear whether a full-body CT scan — an imaging
test that provides more detail than normal
x-rays — may have caught the donor’s cancer. But the authors
wrote that screening every potential organ donor with this test
may catch “irrelevant” issues that thin out the already scarce
supply of organs. For now, they concluded, the extremely low risk
of getting cancer from an organ donor suggests current screening
practices are “effective.”
Study co-author Dr. Frederike J. Bemelman did not immediately
respond to INSIDER’s request for comment.