Transplant International (Oct 2023)

Donors With a Prior History of Cancer: Factors of Non-Utilization of Kidneys for Transplantation

  • Wai H. Lim,
  • Wai H. Lim,
  • Eric Au,
  • Armando Teixeira-Pinto,
  • Armando Teixeira-Pinto,
  • Esther Ooi,
  • Esther Ooi,
  • Helen Opdam,
  • Helen Opdam,
  • Jeremy Chapman,
  • David W. Johnson,
  • David W. Johnson,
  • David W. Johnson,
  • John Kanellis,
  • John Kanellis,
  • Christopher E. Davies,
  • Christopher E. Davies,
  • Germaine Wong,
  • Germaine Wong,
  • Germaine Wong

DOI
https://doi.org/10.3389/ti.2023.11883
Journal volume & issue
Vol. 36

Abstract

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Cancer transmission from deceased donors is an exceedingly rare but potentially fatal complication in transplant recipients. We aimed to quantify the likelihood of non-utilization of kidneys for transplantation from donors with a prior cancer history. We included all intended and actual deceased donors in Australia and New Zealand between 1989 and 2017. Association between prior cancer history and non-utilization of donor kidneys was examined using adjusted logistic regression. Of 9,485 deceased donors, 345 (4%) had a prior cancer history. Of 345 donors with a prior cancer history, 197 (57%) were utilized for transplantation. Donor characteristics of age, sex and comorbidities were similar between utilized and non-utilized donors with prior cancer. The time from cancer to organ donation was similar between utilized and non-utilized donors, irrespective of cancer subtypes. Donors with a prior cancer history were less likely to be utilized [adjusted OR (95% CI) 2.29 (1.68–3.13)] than donors without prior cancer. Of all actual donors, the adjusted OR for non-utilization among those with prior cancer was 2.36 (1.58–3.53). Non-melanoma skin cancer was the most frequent prior cancer type for utilized and non-utilized potential donors. Donors with prior cancers were less likely to be utilized for transplantation, with no discernible differences in cancer characteristics between utilized and non-utilized donors.

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