Jorge Reyes, MD, chief of transplant surgery at Seattle-based UW Medicine, shared several steps the health system takes to lower the risk of cancer transmission through transplanted organs, after the news of a European organ donor whose undetected breast cancer was transmitted to four other individuals via transplants.
Here are four things to know:
1. Among all U.S. organ transplant surgeries, cancer transmission affects less than 1 percent of recipients.
2. To limit the chance of transmission, UW Medicine rejects organ donation offers from recipients with a history of cancer.
"It's not unusual for us to get [organ] offers from a prospective donor who has a history of breast cancer, and we reject them every time," said Dr. Reyes in a news release. "Breast cancer, melanoma and certain brain cancers are the three tumor types we reject every time it is part of a donor’s medical history, no matter how far in the past."
3. Prior to transplantation, all organ donors are also subject to a comprehensive physical exam and medical record review. Testing donors for potential bacterial and viral infections that could be spread to the recipient is a top priority. However, a "head-to-toe, behind-the-ears" exam of the donor may not be prioritized, according to Dr. Reyes
"About 10 percent of the time we're confronted with unknowns," he said. "For instance, we had a prospective lung donor, and our team ordered a CT scan to check for infection, pulmonary edema and nodules. This showed masses in the spleen, which led to a second CT scan and questions about whether the donor could have lymphoma or another cancer. So we withdrew from that offer. But if the lungs had not been involved in the original donation, the CT wouldn't have been done. Then it would've been up to the surgeon doing the procurement, in their exam of the donor's abdomen, to recognize any visual clues that might be there."
4. Dr. Reyes said a checklist, similar to ones clinicians use before surgeries, could be used to improve the organ donor screening process.