Doctors in the Netherlands and Germany have reported a rare case of cancer transmission through organ transplants. Four patients suffered metastatic breast cancer, and three of them died after receiving transplants from the same donor, in which no evidence of the disease had been found.
One donor transmitted cancer to four recipients
In 2007, a 53-year-old woman died of a stroke. Routine medical check-ups after her death did not detect any tumor markers in the patient. Her kidneys, lungs, liver, and heart were transplanted to other patients.
After 16 months, the 42-year-old woman who had received both lungs from the donor suffered a breast tumor which metastasized. Several DNA analyses showed that the tumour cells came from the donor.
Since then, two other patients have died of cancer, first the recipient of the left kidney in 2013 and then the recipient of the liver in 2014. The latter was alerted to the presence of the tumor in 2011 but refused to have the organ removed.
The recipient of the other kidney, a 32-year-old man, was alerted, then he got the transplanted organ removed, and he was successfully treated for cancer.
In all patients, DNA markers were detected in the tumor cells that matched the donor’s genetic profile.
Finally, the recipient of the donor’s heart died five months after the operation from an infection.
This case is the first of its kind in the medical history
“This is the first case of breast cancer transmission as a result of a single-patient organ transplant involving four recipients,” said those responsible for the study, led by Frederike Bemelman, a kidney transplant specialist at the University of Amsterdam Medical Center. “No previous study had detected such a long interval between the transplant and the manifestation of the tumor,” the scientists added.
The donor had “micrometastasis” in each of the donated organs that went unnoticed by medical check-ups, the study’s report says. People who received one of those organs also received drugs that suppress their immune system to prevent rejection. That made it easier for cancer cells to spread and cause metastasis.
These cases do not imply a failure of the transplant system or of the medical controls, the authors of the study and the independent experts consulted point out.