343.1: Liver transplantation from donors with a past history of malignancy.

Abstract

Background: The demand for transplantable organs exceeds donor organ supply. Transplantation of organs from donors with a history of malignancy remains controversial and the transmission of cancer in liver transplant recipients has not been sufficiently examined. Methods: From 2002 until 2017, 83 livers from donors with a history of malignancy were transplanted at the University Hospital Essen, Germany. Donor and recipient data, type of malignancy, tumor-free interval at organ procurement and follow-up data were analyzed. Results: Nine different tumor sites (central nervous system (n=27), genitourinary (n=24), breast (n=10), skin (n=8), colorectal (n=5), lung (n=3), hemato-oncological (n=3), thyroid (n=2), larynx (n=1)) were detected in 83 donors. The majority (58%) of donors had tumor-free intervals of less than 5 years vs. 19% of 6-10 years vs. 23% over 10 years. The risk of tumor transmission from donors was assessed as low in 44 (53%), intermediate in 28 (34%) and high in 11 (13%) cases. During median follow-up of 19.9 [0-155] months, none of the recipients developed donor-transmitted malignancy. Conclusions: Liver transplantation with organs from donors with a medical history of malignancy is feasible and the risk of donor-transmitted malignancy appears to be low in this single center analysis. A careful selection of donors remains mandatory and can expand the donor pool.