Department of Pathology and Diagnostics, Pathology Unit, University and Hospital Trust of Verona, P.le Stefani n. 1, 37126, Verona, Italy.
National Health Institute, Rome, Italy.
J Nephrol. 2019 Apr;32(2):323-330. doi: 10.1007/s40620-018-00573-z. Epub 2019 Jan 2.
Guidelines for donor selection have changed to expand the donor pool, considering potential donors affected by a neoplasm. Aim of this retrospective study is to look at the use of organs from donors with a current or history of neoplasm within the Italian Transplant Network. Data, collected and validated by Italian National Health Institute for the time interval 2006-2015, have been reviewed retrospectively by mean of multivariable pivot tables. Donors with neoplasia represented about 5% of all donors, resulting in about 4% of all transplants. Donors presented a benign neoplasm in 29.08% of cases, a malignancy with variable risk of transmission in 69.75% while in 1.34% the nature of neoplasm could not be assessed. Considering all procedures, rate of transmission of a malignancy was 0.03% (10 cases) of all 29858 transplants of the time interval. Notably, cases of transmission were not from donors of this pool, but from donors that, according to our protocols, had no elements of suspect at time of donation. As recipient safety is always the priority and as guidelines have set exclusion criteria for donors with some specific types of malignancy, these results show that use of this type of donors is safe and improve organ pool. Furthermore represent basis for improvement and standardization of donor assessment protocols suggesting that efforts in data collection systems, to produce complete and homogeneous data, are mandatory.
供者选择指南已经发生改变，以扩大供者库，将潜在供者中受肿瘤影响的供者也纳入考虑。本回顾性研究旨在观察意大利移植网络中使用当前或有肿瘤病史的供者器官的情况。意大利国家卫生研究所于 2006 年至 2015 年期间收集和验证的数据，通过多变量枢轴表进行了回顾性分析。有肿瘤的供者约占所有供者的 5%，导致约 4%的所有移植。良性肿瘤供者占 29.08%，恶性肿瘤供者中存在不同传播风险的肿瘤占 69.75%，而 1.34%的肿瘤性质无法评估。考虑所有手术，在所研究的 29858 例移植中，恶性肿瘤传播率为 0.03%（10 例）。值得注意的是，传播病例并非来自该供者库，而是来自根据我们的方案在供者捐献时没有可疑因素的供者。由于受者安全始终是首要任务，并且指南为具有某些特定类型恶性肿瘤的供者制定了排除标准，这些结果表明使用此类供者是安全的，并且可以改善器官库。此外，这些结果还为改进和标准化供者评估方案提供了依据，表明必须努力建立数据收集系统，以生成完整和同质的数据。
