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September 25, 2018

An ‘extraordinary’ case: 1 donor. 5 transplant patients. And 4 cases of cancer.

Daily Briefing

    Editor's note: This popular story from the Daily Briefing's archives was republished on Dec. 6, 2018.

    Four transplant patients developed cancer after receiving organs from a donor whose breast cancer had gone undetected by multiple pre-transplant tests, in what researchers have called an "extraordinary" case, Caroline Kee writes for BuzzFeed News.

    Here are 5 key tactics to attract and retain transplant patients

    One organ donor: Four new cancer patients

    According to the case report, published earlier this year in the American Journal of Transplantation, the donor was a 53-year-old woman who died of a stroke. A physical exam, X-rays, and lab tests conducted before the transplant showed no sign of malignancy, and the organs were cleared for donation.

    Five people received transplants from this donor. One patient, a heart recipient, died of sepsis five months after transplantation. The remaining four all developed cancer anywhere from 16 months to six years after transplantation. Three of those patients died after the cancer metastasized.

    The first patient, a 42-year-old woman who had received a double-lung transplant, was diagnosed with cancer in 2008. Testing detected cancer in her lymph nodes and a DNA test showed the cancer came from her organ donor. She died a year later.

    The other three recipients were warned about the prospect of cancer, and two of the three later died of cancer as well, Kee writes. A 62-year-old woman who received a kidney and a 59-year-old woman who received the liver. Both died, in 2013 and 2014, respectively.

    One patient, a 32-year-old man who received a kidney, also developed cancer but has survived, according to the case report. Doctors treated the cancer by removing the kidney, stopping immunosuppression drugs, and starting the patient on chemotherapy. As of 2017, the patient was cancer-free and waiting on another kidney transplant.

    A rare case

    Previous reports have shown that cancer cells can be transmitted during a transplant, Kee writes, but that risk is extremely low—between just 0.01 and 0.05% for each transplant.

    According to the report, this is the first time cancer cells have been transmitted during an organ transplant to four patients receiving organs from one donor.

    However, the report noted, once cancer is transmitted to an organ recipient, it's exceedingly difficult to treat and comes with a high mortality rate (Kee, BuzzFeed News, 9/20).

    Here are 5 key tactics to attract and retain transplant patients

    Download this briefing to learn how to expand the pipeline of potential transplant patients and engage them across the care pathway.

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