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Kidney donation from a patient with cardiac myxoma: a case report
A Hałoń1, D J Patrzałek, M Boratyńska
1Department of Pathological Anatomy, Medical University of Wrocław, Wrocław, Poland. ahalon@anpat.am.wroc.pl
Introduction:
Renal transplantation has still become the preferred method to treat end-stage renal failure. The majority of organs are obtained from individuals with irreversible central nervous system injury. This group is nowadays unsatisfactory and small relative to the needs. A significant percentage of donors may be found among patients primarily suffering from benign neoplasms whose nature does not show malignant potential and do not metastasize. To date, there have been no reports about successful organ transplantation from an organ donor with cardiac myxoma.
Aim:
The aim of this report was to present a successful transplantation of cadaveric kidney grafts from a 61-year-old female donor with a left atrial cardiac myxoma, which initially appeared as an embolic cerebral infarct. The kidney graft recipients were a 51-year-old woman and a 57-year-old man with long-lasting histories of chronic renal failure under treatment by hemodialysis. The transplant function of both kidneys has been satisfactory with a 5-year follow-up. For the present, apart from single event of acute rejection in a male recipient, the patients have maintained stable renal function. Routine accessory examinations did not reveal any changes within the kidney or other organs. To date, a renal biopsy has not been taken. Both recipients are undergoing special follow-up.
Conclusion:
Patients with myxoma should be accepted as donors, since the risk of dying on the waiting list is greater than the tumor transfer risk. Exclusion of these potential donors decreases the donor pool and unnecessarily wastes valuable organs.
Insights
Patients with cardiac myxoma can be successful organ donors, as the risk of tumor transfer is low. Accepting these donors expands the organ supply for kidney transplantation, saving lives.
Area of Science:
- Nephrology
- Cardiology
- Transplantation Immunology
Background:
- End-stage renal failure necessitates renal transplantation, with organ shortages being a critical issue.
- Current donor pools are insufficient, highlighting the need to consider alternative donor sources.
- Benign neoplasms, such as cardiac myxoma, represent a potential, yet largely untapped, donor population.
Observation:
- A case report details successful kidney transplantation from a 61-year-old female donor with a left atrial cardiac myxoma.
- The myxoma initially presented as an embolic cerebral infarct.
- Kidney grafts were transplanted into a 51-year-old woman and a 57-year-old man undergoing long-term hemodialysis.
Findings:
- Both kidney grafts demonstrated satisfactory function over a 5-year follow-up period.
- Recipients maintained stable renal function with one instance of acute rejection.
- Routine examinations revealed no significant changes in the transplanted kidneys or other organs.
Implications:
- Cardiac myxoma patients should be considered viable organ donors.
- Excluding such donors unnecessarily reduces the organ pool and increases mortality risk for transplant candidates.
- Accepting myxoma donors balances the risk of tumor transmission against the certainty of death on the waiting list.
Related Concept Videos
01:28Kidney Transplant I: Introduction
01:26Kidney Transplant II: Surgical Procedure