Transplant Trial Watch

Donor-Transmitted Cancer in Orthotopic Solid Organ Transplant Recipients: A Systematic Review.

Greenhall, G. H. B., et al.

Transplant International 2021; 35: 10092.

This study aimed to synthesise the available evidence on donor-transmitted cancer (DTC) in orthotopic solid organ transplant recipients.

A literature search was performed on PubMed, EMBASE, MEDLINE, Scopus and Web of Science. Study selection and data extraction were carried out by two independent reviewers. The methodological quality of the included studies were assessed using tools published by the Joanna Briggs Institute (JBI).

58 studies were included in the review.

The main outcomes included patient death, cause of death, cancer remission and cancer recurrence (and time since remission).


CET Conclusions
The systematic review evaluated published evidence on donor transmitted cancer (DTC) in solid organ transplant recipients. The systematic review was registered with PROSPERO. A thorough bibliographic search was developed to identify relevant cohort studies, case-control studies, case series and case reports. Two independent reviewers screened search results, selected studies, extracted data and assessed the study quality. Fifty-eight studies met the inclusion criteria and reported on 73 cases of DTC in liver, lung and heart transplant recipients. Methodological quality of the included studies varied but was overall considered acceptable. Time from transplantation to the diagnosis of DTC ranged from 0 days to 6 years with 66% of cases diagnosed within 1 year and 82% of cases diagnosed within 2 years. The limited evidence showed that mortality was high. The authors make suggestions for clinical practice including surveillance of higher risk patients and management after DTC diagnosis.

Trial registration
PROSPERO - CRD42020165001

Funding source
Non-industry funded