Donor derived malignancy following transplantation: a review
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Donor derived malignancy following transplantation: a review Manish J. Gandhi Æ D. Michael Strong
Received: 25 January 2007 / Accepted: 12 February 2007 / Published online: 12 April 2007 Ó Springer Science+Business Media B.V. 2007
Abstract Organ and tissue transplant is now the treatment of choice for many end stage diseases. In the recent years, there has been an increasing demand for organs but not a similar increase in the supply leading to a severe shortage of organs for transplant resulted in increasing wait times for recipients. This has resulted in expanded donor criteria to include older donors and donors with mild disease. In spite of implementation of more stringent criteria for donor selection, there continues to be some risk of donor derived malignancy. Malignancy after transplantation can occur in three different ways: (a) de-novo occurrence, (b) recurrence of malignancy, and (c) donorrelated malignancy. Donor related malignancy can be either due to direct transmission of tumor or due to tumor arising in cells of donor origin. We will review donor related malignancies following solid organ transplantation and hematopoeitic progenitor cell transplantation. Further, we will briefly review the methods for detection and management of these donor related malignancies. M. J. Gandhi (&) Department of Pathology and Immunology, Washington University, 660 S Euclid Ave #8118, St Louis, MO 63110, USA e-mail: [email protected]; [email protected] D. M. Strong Puget Sound Blood Center, Seattle, WA, USA
Keywords Solid organ transplant Hematopoeitic progenitor cell transplant Stem cell transplant Bone marrow transplant Tumor transmission Donor derived malignancy Donor related malignancy Abbreviations AML Acute myeloid leukemia B-HCG B-human choroinic gonadotrophin CIS Carcinoma in situ CML Chronic myeloid leukemia CMV Cytomegalovirus CNS Central nervous system CTTR Cincinnati Transplant Tumor Registry EBV Epstein Barr Virus FISH Fluorescent in situ hybridization HBV Hepatitis B virus HCV Hepatitis C virus HHV-8 Human herpes virus 8 HPCT Hematopoeitic progenitor cell transplantation HPV Human papilloma virus HTLV Human T-lymphotropic virus IPTTR Israel Penn Transplant Tumor Registry MDS Myelodysplastic syndrome NHL Non-Hodgkin’s lymphoma OPTN Organ Procurement and Transplantation Network PTLD Post-transplant lymphoproliferative disorder
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RFLP SNP STR UNOS VNTR WHO
Cell Tissue Banking (2007) 8:267–286
Restriction fragment length polymorphism Single nucleotide polymorphism Repetitive sequence of 2–7 nucleotides long United Network of Organ Sharing Repetitive sequence of 9–45 nucleotides long World Health Organization
to transmission of oncogenic viruses like human papilloma virus (HPV), human T-lymphotropic virus (HTLV), hepatitis C virus (HCV), hepatitis B virus (HBV), human herpes virus 8 (HHV-8), Epstein-barr virus (EBV), cytomegalovirus (CMV), however, this issue will not be addressed in this review. Donor-related malignancy can be further classified into two broad categories: Tumor
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