Donor With Occult Breast Cancer: The Fate of Multiple Organ Recipients: A Case Report And Review of the Literature

Abstract

We present the outcomes of organ recipients from a 69-year-old female donor diagnosed with occult breast cancer. The donor had no relevant medical history nor aberrant finding or sings of malignancy at the time of organ procurement. The organ donation encompassed the right kidney, liver, lungs, and corneas, which were thereafter transplanted. The left kidney of the donor was not accepted due to macroscopic features of chronic injury. Routine histopathological examination disclosed microscopic metastasis of lobular breast carcinoma. Consequently, given the elevated risk of transmission, the following interventions were implemented: the kidney recipient underwent nephrectomy followed by the discontinuation of immunosuppression; the liver recipient was administered letrozole and subsequently underwent liver retransplantation 3 months later; the lung recipient received a therapeutic regimen consisting of goserelin and letrozole; and the cornea recipient received nonvascular tissues. At the most recent follow-up in October 2024 (13 months post-transplantation), all recipients were reported to be in good health and free from disease. This remarkable case underscores that even an exhaustive evaluation of the donor may not unveil the presence of malignancy. Appropriate logistical and therapeutic strategies are crucial in preventing the transmission of cancer. Although the risk of malignancy transmission remains low, it is still present, necessitating that patients remain under vigilant medical supervision.