Background: Prevention of transmission of malignancy from donors to recipients is an aim of donor assessment. We report the most stringent interpretation of the Italian National Guidelines. Methods: A two- step ALERT process was used: ALERT1 consisting of clinical, radiological, and laboratory tests; ALERT2, consisting of intraoperative assessment in suspicious lesions. Results: Four hundred of 506 potential deceased donors entered the ALERT system. Forty- one of 400 (10%) donors were excluded due to unacceptable risk of transmission. Of the remaining 359 193 required histopathology, which excluded malignancy or determined acceptable risk in 161/193 (83%). Thirty- five malignancies were identified: 19 (54%) at ALERT1, four (11%) at ALERT2, nine (26%) picked up at ALERT1 and confirmed by ALERT2. Three (9%) were missed by ALERT and diagnosed at postmortem examination. Prostate (n=12%, 34%) and renal cell (n=7%, 20%) were the most frequent carcinomas. The majority (92%) of prostate adenocarcinomas were of low risk and donation proceeded compared to 43% of renal carcinomas. Four renal carcinomas, two breast carcinomas, and a single case of nine different malignancies excluded donation. Positive ALERT donors had statistically more malignant reports than negative ALERT donors (P=<.05). Conclusion: Histopathology is an essential component of the multidisciplinary assess-ment of donors.
Rapid screening for malignancy in organ donors: 15-year experience with the Verona "Alert" protocol and review of the literature / Eccher A, Cima L, Ciangherotti A, Montin U, Violi P, Carraro A, Tedeschi U, Nacchia F, Fior F, Rostand M, Boschiero L, D'Errico A, Scarpa A, Casartelli-Liviero M, Ferrari G, Rodini V, Tomaselli E, Zampicinini L, Vanzo F, Bovo C, Feltrin G, Neil D, Brunelli M.. - In: CLINICAL TRANSPLANTATION. - ISSN 1399-0012. - ELETTRONICO. - Sep;31:9(2017), pp. 1-10. [10.1111/ctr.13045]
Rapid screening for malignancy in organ donors: 15-year experience with the Verona "Alert" protocol and review of the literature.
D'Errico AMethodology
;
2017
Abstract
Background: Prevention of transmission of malignancy from donors to recipients is an aim of donor assessment. We report the most stringent interpretation of the Italian National Guidelines. Methods: A two- step ALERT process was used: ALERT1 consisting of clinical, radiological, and laboratory tests; ALERT2, consisting of intraoperative assessment in suspicious lesions. Results: Four hundred of 506 potential deceased donors entered the ALERT system. Forty- one of 400 (10%) donors were excluded due to unacceptable risk of transmission. Of the remaining 359 193 required histopathology, which excluded malignancy or determined acceptable risk in 161/193 (83%). Thirty- five malignancies were identified: 19 (54%) at ALERT1, four (11%) at ALERT2, nine (26%) picked up at ALERT1 and confirmed by ALERT2. Three (9%) were missed by ALERT and diagnosed at postmortem examination. Prostate (n=12%, 34%) and renal cell (n=7%, 20%) were the most frequent carcinomas. The majority (92%) of prostate adenocarcinomas were of low risk and donation proceeded compared to 43% of renal carcinomas. Four renal carcinomas, two breast carcinomas, and a single case of nine different malignancies excluded donation. Positive ALERT donors had statistically more malignant reports than negative ALERT donors (P=<.05). Conclusion: Histopathology is an essential component of the multidisciplinary assess-ment of donors.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
