Patients with primary brain tumors as organ donors: Case report and review of the literature
Patients with primary brain tumors as organ donors: Case report and review of the literature
复制标题
原发性脑肿瘤患者作为器官捐献者：病例报告及文献复习
作者：
A. Punnett;L. Mccarthy;P. Dirks;C. Hawkins;E. Bouffet
除少数可能的例外情况外，移植被认为是器官捐献的禁忌症。我们提出的情况下，致命的颅内出血的儿童原发性脑肿瘤（PBT）的器官被拒绝移植后恢复。我们回顾了文献中的器官捐献者与PBTs在当前器官短缺的背景下，并讨论了实践肿瘤学家的影响。已经有文献记录了供体脑肿瘤向器官接受者的传播，但发病率似乎非常低。肿瘤传播的风险因素包括潜在的供体肿瘤组织学、开颅术和/或分流术放置史、全身化疗和放疗的使用以及捐献前疾病的持续时间。国家登记处正在进行的数据收集将提供更多关于器官接受者潜在风险的信息。在某些情况下，似宜扩大捐助者的范围，将具有建设和平能力的捐助者包括在内。移植团队最终决定使用特定捐赠者的器官。即使实体器官移植被禁止，许多家庭也会感谢捐赠特定组织的机会。© 2004 Wiley利斯公司
Malignancy is considered a contra‐indication to organ donation, with a few possible exceptions. We present the case of a child with fatal intracranial hemorrhage from a primary brain tumor (PBT) whose organs were denied for transplant after recovery. We review the literature of organ donors with PBTs in the context of the current organ shortage and discuss the implications for the practicing oncologist. Transmission of donor brain tumor to organ recipients has been documented but the incidence appears to be very low. Risk factors for tumor transmission include underlying donor tumor histology, history of craniotomy and/or shunt placement, use of systemic chemotherapy and radiation therapy, and duration of disease prior to donation. Ongoing data collection by national registries will provide more information on the potential risk to organ recipients. It may be appropriate to expand the donor pool to include donors with PBTs in certain situations. The transplantation team ultimately decides upon the use of organs from specific donors. Many families will appreciate the opportunity to donate specific tissues even if solid organ transplantation is prohibited. © 2004 Wiley‐Liss, Inc.