A Rare Case: Liver Transplant Recipient Dies from Donor’s Undetected Cancer

In 2001, a 41-year-old man from California, suffering from chronic liver disease, received a liver transplant from a deceased donor. Later, it was discovered that the donor had undiagnosed lung cancer at the time of the donation. Less than a year after the transplant, the recipient developed an aggressive and advanced cancer unrelated to his initial liver condition, leading to his death.

Why Was the Cancer Not Detected Before the Transplant?

Cancer transmission through organ transplants is extremely rare, with an estimated incidence of 0.01% to 0.05%. Donor evaluation protocols include physical exams, medical history reviews, and laboratory tests to detect infections and malignancies. However, certain cancers in early or subclinical stages can go undetected using standard screening methods. In this case, the donor’s lung cancer was not identified during the pre-transplant evaluation, resulting in the inadvertent transmission of cancer cells to the recipient.

Have Similar Cases Occurred?

Although infrequent, other cases of cancer transmission through organ transplants have been documented. For example, in 2007, a 53-year-old woman who died of a stroke in the Netherlands donated her organs to several recipients. Four of them later developed metastatic breast cancer derived from the donor, and three of them died from the disease.
These cases highlight the challenges of detecting hidden cancers during donor evaluations and underscore the need to improve screening methods.

Measures to Prevent Cancer Transmission in Transplants

To minimize the risk of cancer transmission, the following measures have been implemented:

• More Rigorous Evaluations: Advanced imaging studies and biopsies in suspicious cases to detect hidden malignancies.
• Detailed Medical Histories: Comprehensive reviews of the donor’s medical history can reveal cancer risk factors or past malignancies that might contraindicate donation.
• Exclusion Criteria: Donors with a history of certain cancers or suspicious findings during evaluation are excluded from the donation process to ensure recipient safety.

Conclusion

Although cancer transmission through organ transplants is rare, documented cases highlight the importance of thorough donor evaluations. Continuous improvements in screening protocols and the implementation of advanced technologies are essential to minimize these risks and ensure the safety of organ recipients.