Prostate Cancer in Deceased Organ Donors: Loss of Organ or Transplantation With Active Surveillance

Prostate cancer has become an important clinical issue within deceased organ donors. There is still a considerable number of undiagnosed cancers, especially in early stage, despite frozen section analysis. The aim of the study was to evaluate outcomes of orthotopic liver transplants (OLTx) with organs from donors with prostate cancer.

A retrospective analysis was performed in deceased liver donors whose prostate glands were harvested for histologic examinations because of prostate cancer suspicion. The study group consisted of 72 men reported as potential liver donors between 2011 and November 2017. Prostate glands were primarily assessed by frozen sections and afterward in routine examination. Generally cancer diagnosed in frozen specimen was not considered for OLTx. Recipients who received an organ from the donor with prostate cancer were actively surveilled.

There were 19 cases (26.40%) of prostate cancer diagnosed among the study group. In 12 cases diagnosis was made by frozen section assessment, of which 11 organs were disqualified from OLTx and 1 was transplanted. In 7 cases prostate cancer was diagnosed after OLTx in final routine histologic examination. Finally, 8 recipients (5 men and 3 women) received a new organ. Only 1 died during the perioperative period. In the remaining 7 patients the perioperative period was uneventful and no disease transmission was observed during follow-up.

Diagnosis of prostate cancer in donors should not be treated as a contraindication for OLTx because the risk of disease transmission is low. Potential recipients must be fully informed and kept under oncological surveillance.