Cancer Diagnosis During Kidney Donor Evaluation

Area of Science:

• Medical Diagnostics
• Oncology
• Transplant Surgery

Background:

• Donor evaluation is critical for preventing the transmission of life-threatening diseases, particularly cancer, to recipients.
• Standard pre-transplant assessments, including blood/urine biochemistry and imaging, may not detect all potential malignancies.
• Early cancer detection in donors is essential for recipient safety.

Purpose of the Study:

• To report a case where standard donor evaluation failed to detect a malignancy.
• To emphasize the diagnostic value of endoscopic procedures in identifying occult cancers during donor screening.
• To advocate for the integration of endoscopic techniques into routine donor evaluation protocols.

Main Methods:

• A comprehensive donor evaluation was performed, including blood and urine biochemistry analysis.
• Renal ultrasonography and renal artery computed tomography (CT) were conducted to assess kidney health.
• Endoscopic analysis of the anal verge and positron emission tomography (PET) were utilized for further investigation.

Main Results:

• Standard biochemical and imaging tests showed no abnormalities in the donor.
• Endoscopic examination revealed a significant protruding mass at the anal verge (22-25 cm).
• Positron emission tomography confirmed liver metastasis, indicating advanced cancer.

Conclusions:

• Endoscopic techniques are highly valuable for detecting cancers that may be missed by conventional donor evaluation methods.
• The case underscores the limitations of standard screening and the importance of advanced diagnostic tools.
• Medical centers should consider incorporating endoscopic examinations into their donor evaluation procedures to enhance patient safety.