A recent report in the American Journal of Transplantation described a rare and “extraordinary” case in Europe, where donated organs from a 53-year-old woman spread breast cancer to four different transplant recipients.
According to the report, four recipients developed cancer years after their transplants, and three of the four eventually died. The donor died from bleeding in the brain; physical exams, lab testing, ultrasounds, and x-rays showed at the time that she had no troublesome medical history. Her organs – heart, lungs, liver, and kidneys – were transplanted into five individuals.
Only a few months after the transplant, the heart recipient died of sepsis, an immune response to infection.
The other recipients survived longer. However, in the six years following all of the transplants, all four of the recipients developed metastatic breast cancer. Metastatic is the kind of cancer that spreads to other organs in the body, which is more difficult to treat. Testing of the DNA cancer cells showed the cancer had come from the donor.
Further testing revealed the donor had breast cancer at the time of her death, but doctors were unaware. Otherwise, her organs would have been unable to be donated, as people with active or invasive cancers are unsuitable for organ donation, according to the authors of the study.
The recipients of the donor's liver, lung, and left kidney eventually died from their breast cancer. The recipient of the right kidney, a 32-year-old man, survived after having his donated kidney removed and undergoing chemotherapy. In 2012, he achieved complete remission and, as of his last follow up in 2017, he was still cancer-free and seeking a new kidney.
Cancer from a donated organ is incredibly rare
Although this isn't the first documented case of cancer from a donated organ spreading to a transplant recipient, this case is so notable because one donor spread cancer to four people. And, the authors add, it took a considerable amount of time for the cancer to grow and symptomize in the recipients' bodies.
According to the report, the risk of getting cancer from a donated organ is extremely low – between 0.01 and 0.05 percent.
It's not clear, however, why the donor's breast cancer wasn't detected before her organs were donated. The authors posited in their report that it's possible she had micrometastases, which are groups of cancer cells that split off the original tumor and spread to other parts of the body.
Micrometastases are too small to be detected on imaging tests. Additionally, transplant recipients must take drugs to suppress their immune systems, which lowers the risk of organ rejection – but can make it easier for cancer cells to survive.
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