Skip to Content

Man Dies After Catching Cancer From His Organ Donor

A tragic medical anomaly unfolded when a 69-year-old Arizona man died from cancer that was not originally his but had been transmitted through a liver transplant. While organ transplants are life-saving for many, they sometimes carry hidden and deadly risks, as demonstrated in this unprecedented case. Transmitted cancers via organ donation are exceedingly rare, making this particular instance both a medical curiosity and a cautionary tale. The incident sheds light on the critical importance of meticulous donor screening processes, underscoring the balance between the urgent need for organs and ensuring the safety of recipients.

Patient Background and Initial Health Challenges

Before undergoing the fateful transplant, the patient faced a dire battle with alcoholic cirrhosis and hepatocellular carcinoma (HCC), the most common type of liver cancer, typically linked to long-term liver damage from alcohol consumption. Diagnosed with these severe conditions, his medical team initially opted for minimally invasive procedures aimed at curing the cancer. 

Unfortunately, as his liver function continued to decline, it became evident that more aggressive treatment was necessary. His worsening condition urgently required a liver transplant, setting the stage for the unexpected complications that followed. The transition from managing his liver disease through standard medical interventions to the decision for a transplant underscores the complexities often involved in treating severe organ damage.

The Transplant and Subsequent Complications

At The Mayo Clinic in Phoenix, Arizona, doctors performed a liver transplant on the patient, aiming to replace his cancerous liver with a healthy one from a deceased donor. Initially, the surgery appeared successful, offering a glimmer of hope for his recovery. However, within six months, routine post-operative monitoring began to reveal troubling signs. An ultrasound identified two solid masses in the new liver four months after the procedure. These unexpected findings prompted further investigations. Subsequent imaging tests, including a CT scan and an MRI, uncovered additional masses, indicating a rapid and concerning progression. Each test revealed more about the aggressive nature of the new cancer, pointing to a serious and unusual complication from the transplant.

Discovery of Donor-Derived Cancer

Medical professionals at The Mayo Clinic faced a perplexing challenge when imaging tests detected new cancerous masses in the liver transplant recipient’s body. Initial biopsies of these masses revealed poorly differentiated carcinoma, a particularly aggressive form of cancer. As doctors delved deeper, employing a polymerase chain reaction-based assay, or PCR test, they made a startling discovery. The genetic makeup of the tumor cells in the patient’s liver matched that of the organ donor, not the recipient.

According to doctors: “To our knowledge, this is the only case in literature describing donor‐derived lung cancer in a liver graft without known malignancy in the donor.”

Further analysis confirmed that these were indeed cases of donor-derived cancer, a rare phenomenon where the transplanted organ carries malignant cells from the donor into the recipient. This case marked an extraordinary instance of lung cancer cells that had metastasized undetected to the donor’s liver, only to manifest aggressively within the recipient post-transplant. These findings underscored the critical need for meticulous screening and monitoring procedures in transplant medicine, highlighting a gap in current medical protocols that could bear severe consequences for transplant recipients.

Investigation into the Donor’s Medical History

Doctors initially believed the 50-year-old organ donor was cancer-free, which qualified his liver for transplant. He had a history of smoking but no medical records of lung tumors or other cancers. However, the aggressive cancer manifesting in the transplant recipient led to a reevaluation of the donor’s health status. Post-mortem examinations revealed that the donor had undiagnosed advanced lung cancer, which had metastasized to his liver.

In a patient’s case report published in The Oncologist, doctors wrote of the donor: ‘’Interestingly, although the donor had a history of smoking, he did not have any known history of malignancy. He was 50 years old and had developed cardiac arrest with unknown down time, leading to subsequent anoxic brain injury.’’

The Science Behind Donor-Derived Cancers

Cancers can be transmitted through organ transplants when the donated organ contains undetected malignant cells. These cases are rare but can occur under specific circumstances.
Metastatic cancer spreads from its original location to other parts of the body. Donors may have cancers that metastasized without being detected during screening. For instance, lung cancer cells could travel to the liver, as seen in rare donor-derived cancer cases. These cells remain dormant or unnoticed during routine evaluations, making detection challenging. Some donors may unknowingly harbor dormant cancer cells. These inactive cells may not form visible tumors during the donor’s lifetime. Once transplanted, immunosuppressive medications given to recipients reduce the immune system’s ability to eliminate these cells, allowing them to activate and grow.

According to Dr. Luigi Marchionni, lead author of the paper “Donor-derived Acute Myeloid Leukemia in Solid Organ Transplantation,” the timing of donor-derived cancer development can vary significantly. As he explains: ”Donor-derived cancers can either develop early – i.e., during the first few weeks after transplantation – or at a later time. In the first instance, tumors are transplanted together with the organ, engrafting notwithstanding HLA mismatch, possibly due to recipient’s immunosuppression.”

How Are Organ Donors Screened?

Organ donors undergo comprehensive evaluations to ensure their organs are suitable for transplantation. These screenings identify health risks, including hidden cancers, to protect recipients.

Medical History Review: Medical professionals examine the donor’s history for risk factors like chronic illnesses, smoking, or family history of cancer. Certain conditions may disqualify individuals from donating, but incomplete or unavailable histories can limit the accuracy of assessments.

Physical Examination and Imaging: Doctors conduct thorough physical exams to detect signs of disease. Imaging tests, such as X-rays, CT scans, or ultrasounds, identify abnormalities in major organs. While these methods catch many issues, small or undetectable tumors can still be missed.

Laboratory Tests: Blood and biopsies are screened for used ones, organ function, and tumor markers, but they are ineffective in identifying dormant or early-stage cancers.

Post-Mortem Analysis: For deceased donors, detailed examinations, including tissue sampling, are performed. However, time constraints and limited access to medical records can hinder the thoroughness of this process.

Limitations and Challenges

  1. Undetected Cancers: Early-stage or dormant cancers often evade detection due to their small size or lack of symptoms.
  2. Time Constraints: Organ preservation requires swift decision-making, limiting the time available for exhaustive screenings.
  3. Technological Gaps: While advanced tools like genetic testing are available, they are not yet universally adopted, leaving gaps in donor evaluation.

Why Are Such Cases So Rare?

Donor-derived cancers occur in less than 0.05% of organ transplants. Rigorous medical protocols and screening measures ensure that most donors are free from malignancies. Medical teams review donor histories, conduct physical exams, and use imaging to detect underlying conditions, significantly reducing risks.

Due to advancements in immunosuppressive therapy and post-transplant monitoring, malignant cells rarely survive in recipients. Technological improvements like genetic testing further enhance screening accuracy, catching potential issues earlier. Millions of transplants are successful worldwide, with donor-derived cancer cases remaining isolated anomalies. Continuous innovations in diagnostics and safety protocols improve outcomes even further.

A 2013 review of these cases published in the Cold Spring Harbor Perspectives in Medicine states ‘’In view of the higher cancer incidence and poorer prognoses, prevention and screening may play an important role in reducing the burden of cancer in kidney transplant recipients. Routine cancer screening is recommended for all transplant individuals. Recommendations for cancer screening in transplant recipients are mostly extrapolated from the general populations and are consistent with screening guidelines in the general population, with the exception of cervical, skin, colorectal, and renal cancers.’’

This case also gained attention online, with Deborah Verran, a medical professional, noting on Twitter: “FYI this type of outcome is rare and has been the subject of a number of other publications in the scientific literature #cancer #organdonors”

Future Care

The tragic outcome of this case is a poignant reminder of the inherent risks associated with organ transplants and the complexities involved in donor screening. Modern transplantation faces growing challenges as organ demand increases with our aging population. Pressure to expand donor criteria creates new safety considerations for medical teams. Advanced screening methods must balance thorough disease detection against time-sensitive organ preservation.

Informed consent discussions now require careful consideration of rare but serious risks. Medical centers must communicate these possibilities without deterring patients from vital procedures. Solutions to these challenges will influence risk management across multiple medical specialties.

Patient outcomes drive improvements in transplant protocols, pushing medicine toward more precise and comprehensive screening methods. Each rare case adds vital knowledge to help protect future recipients while expanding access to life-saving organ donations.

This site uses Akismet to reduce spam. Learn how your comment data is processed.

This site uses Akismet to reduce spam. Learn how your comment data is processed.