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从原发性颅内恶性肿瘤的已故供者中移植器官的安全性如何?对英国注册处数据的分析。

How safe is it to transplant organs from deceased donors with primary intracranial malignancy? An analysis of UK Registry data.

机构信息

University Department of Surgery, Addenbrooke's Hospital, Cambridge and the NIHR Cambridge Biomedical Research Centre, Cambridge, UK.

出版信息

Am J Transplant. 2010 Jun;10(6):1437-44. doi: 10.1111/j.1600-6143.2010.03130.x. Epub 2010 May 10.

Abstract

Patients dying from primary intracranial malignancy are a potential source of organs for transplantation. However, a perceived risk of tumor transfer to the organ recipient has limited their use. We evaluated the risk of tumor transmission by reviewing the incidence in patients transplanted in the UK. Information from the UK Transplant Registry was combined with that from the national cancer registries of England, Wales and Northern Ireland to identify all organ donors between 1985 and 2001 inclusive with a primary intracranial malignancy and to identify the occurrence of posttransplant malignancy in the recipients of the organs transplanted. Of 11,799 organ donors in the study period, 179 were identified as having had a primary intracranial malignancy, including 33 with high-grade malignancy (24 grade IV gliomas and 9 medulloblastomas). A total of 448 recipients of 495 organs from 177 of these donors were identified. No transmission of donor intracranial malignancy occurred. Organs from patients dying from primary intracranial malignancy, including those with high-grade tumors, should be considered for transplantation and the small risk of tumor transmission should be balanced against the likely mortality for potential recipients who remain on the transplant waiting list.

摘要

死于原发性颅内恶性肿瘤的患者可能成为器官移植的供体来源。然而,人们担心肿瘤会转移到器官受者体内,从而限制了其使用。我们通过回顾英国的移植病例,评估了肿瘤传播的风险。英国移植登记处的信息与英格兰、威尔士和北爱尔兰国家癌症登记处的信息相结合,以确定 1985 年至 2001 年期间所有原发性颅内恶性肿瘤的供体,并确定移植器官受者中发生的移植后恶性肿瘤。在研究期间的 11799 名器官供体中,有 179 名被确定患有原发性颅内恶性肿瘤,其中 33 名患有高级别恶性肿瘤(24 名 4 级神经胶质瘤和 9 名髓母细胞瘤)。共确定了来自 177 名供体的 495 个器官的 448 名受者。没有供体颅内恶性肿瘤的传播。应考虑将死于原发性颅内恶性肿瘤的患者的器官,包括患有高级别肿瘤的患者的器官用于移植,并且应该权衡肿瘤传播的小风险与可能因在移植等待名单上而死亡的潜在受者的预期死亡率。

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