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1、CASEREPORTTransmissionofbreastcancerbyasinglemultiorgandonorto4transplantrecipientsLiteraturesSourceAmericanjournaloftransplantationYvetteA.H.Matser1
2、 MattyL.Terpstra2
3、 SilvioNadalin3
4、 GeorgeD.Nossent4
5、JandeBoer5
6、 BarbaraC.vanBemmel6
7、 SusannevanEeden7
8、
9、KlemensBudde8
10、SusanneBrakemeier8
11、 FrederikeJ.Bemelman2AuthorIF:6.49321、INTRODUCTIONThiscasereportdescribesthetransmissionofbreastcancerfromasingleorgandonorto4recipientsmanyyearsafterdonation.Atthetimeofdonation,itwasunknownthatthedonorsufferedfromamali
12、gnancy.32、CASEREPORTThe53-year-olddonorinthiscasehadnorelevantmedicalhistoryanddonatedherkidneys,lungs,liver.Theother4recipientsdevelopeddonor-derivedbreastcancer(provenbyDNAmicrosatellite)within16monthsto6yearsaftertransplantation.Unfortunately,thedoub
13、le-lungrecipient,left-kidneyrecipient,andliverrecipientdiedduetothedonor-derivedbreastcancer.Theright-kidneyrecipientremainsalive.Afterthediagnosisofbreastcancerinthetransplantedkidney,thepatientunderwenttransplantnephrectomy,hisimmunosuppressionwasstop
14、ped,chemotherapywasinitiated,andheachievedcompleteremissiondespitewidelymetastasizeddisease.FIGURE115①、Double-lungrecipientThelungswereallocatedtoa42-year-oldfemalewhosufferedfromend-stagelungdiseaseduetosarcoidosiswithremittingpneumothoraces.InAugust20
15、08(16monthsaftertransplantation),thepatientwasadmittedtothehospitalbecauseoftransplantdysfunction.AchestX-rayshowedmediastinallymphadenopathy.Amediastinallymphnodebiopsyshowedestrogenreceptorandprogesterone-receptorpositive(ER+,PR+)adenocarcinoma.TheFES
16、-PETscanrevealedabnormalitiesinthelungsandbones.Thepatient’simmunosuppressionwasreduced.InSeptember,aCTscanshowedlesionsintheliverandbonesthatwerecompatiblewithmetastases.Sixmonthslater,shepresentedwithincreasingthoracicpain,hypercalcemia,andrenalinsuff
17、iciency.InAugust2009,palliativecarewasstarted,andafterafewdays,thepatientpassedaway.Extensiveresearchwith5independentDNAmicrosatellitemarkersrevealedthatthisbreastcancerwasdonorderived.6②、Left-kidneyrecipienTheleft-kidneyrecipien
