Donate organs not malignancies: postoperative small cell lung carcinoma in a marginal living kidney donor

A widening gap between supply and demand for transplantable kidneys has led to increasing use of marginal living donors from an elderly population in kidney transplantation programs. Although the graft survivals of these marginal organs are comparable with those of standard donors, the attendant risk of transmission of malignancy from older donors is high, given that aging is a risk factor for malignancy. Herein we have highlighted a case of small cell carcinoma developing in a marginal elderly donor at 10 months after kidney donation. The recipient remains free of malignancy at 36 months after transplantation. The exhaustiveness of tests for screening of elderly living donors for malignancy as well as the surveillance of recipients at high risk of developing donor-derived malignancy remain uncertain.