Donor-Transmitted Cancer in Orthotopic Solid Organ Transplant Recipients: A Systematic Review.
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Authors
Greenhall, George H B
Ibrahim, Maria
Dutta, Utkarsh
Doree, Carolyn
Brunskill, Susan J
Johnson, Rachel J
Callaghan, Chris J
Watson, Christopher J E
Publication Date
2021-01-01Journal Title
Transplant international : official journal of the European Society for Organ Transplantation
ISSN
0934-0874
Volume
35
Language
eng
Type
Article
This Version
VoR
Metadata
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Greenhall, G. H. B., Ibrahim, M., Dutta, U., Doree, C., Brunskill, S. J., Johnson, R. J., Tomlinson, L. A., et al. (2021). Donor-Transmitted Cancer in Orthotopic Solid Organ Transplant Recipients: A Systematic Review.. Transplant international : official journal of the European Society for Organ Transplantation, 35 https://doi.org/10.3389/ti.2021.10092
Abstract
Donor-transmitted cancer (DTC) has major implications for the affected patient as well as other recipients of organs from the same donor. Unlike heterotopic transplant recipients, there may be limited treatment options for orthotopic transplant recipients with DTC. We systematically reviewed the evidence on DTC in orthotopic solid organ transplant recipients (SOTRs). We searched MEDLINE, EMBASE, PubMed, Scopus, and Web of Science in January 2020. We included cases where the outcome was reported and excluded donor-derived cancers. We assessed study quality using published checklists. Our domains of interest were presentation, time to diagnosis, cancer extent, management, and survival. There were 73 DTC cases in liver (n = 51), heart (n = 10), lung (n = 10) and multi-organ (n = 2) recipients from 58 publications. Study quality was variable. Median time to diagnosis was 8 months; 42% were widespread at diagnosis. Of 13 cases that underwent re-transplantation, three tumours recurred. Mortality was 75%; median survival 7 months. Survival was worst in transmitted melanoma and central nervous system tumours. The prognosis of DTC in orthotopic SOTRs is poor. Although re-transplantation offers the best chance of cure, some tumours still recur. Publication bias and clinical heterogeneity limit the available evidence. From our findings, we suggest refinements to clinical practice. <b>Systematic Review Registration:</b> https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020165001, Prospero Registration Number: CRD42020165001.
Keywords
Cancer, Heart transplantation, Liver transplantation, Lung transplantation, Deceased Organ Donors, Donor-transmitted Disease, Humans, Neoplasm Recurrence, Local, Organ Transplantation, Transplants, Tissue Donors, Transplant Recipients
Identifiers
35185366, PMC8842379
External DOI: https://doi.org/10.3389/ti.2021.10092
This record's URL: https://www.repository.cam.ac.uk/handle/1810/335393
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