Donor-transmitted cancer in kidney transplant recipients: a systematic review.Eccher, A., et al.
Journal of Nephrology 2020 [record in progress].
The aim of this study was to summarize all evidence that has been published on donor-related cancer transmission among renal transplant patients.
Electronic databases including Scopus, PUBMED and the Cochrane Library were searched up to August 2019. Searches were also conducted in the NOTIFY library. Study screening, data extraction and quality assessment were performed by two reviewers.
128 articles were included in the review.
The primary outcomes included the overall survival of the transplant patients following the diagnosis of transmitted cancer and the time to cancer diagnosis posttransplant. The secondary outcomes were the distribution of the types of cancer, the frequency of malignancies and recipient treatment/management.
This systematic review looks at case reports and series of donor-derived malignancy transmitted through transplantation. The authors report on frequency of reporting of transmission of different malignancies, and prognosis in the recipient. They found lymphoma and melanoma to be the most frequently reported and challenging to detect and prevent, with metastasis outside the graft the worst prognostic indicator. Methodology and reporting are excellent, with search and screening strategies reported and quality assessment of included articles detailed. There are some limitations – it is not entirely clear how the authors dealt with potential duplication (e.g. case reports that may also have appeared in registry data), and as there is no denominator, overall risk of transmission for each cancer type cannot be derived. There was a large amount of missing data, with all relevant information found in only 1/3 cases.