Donors With a Prior History of Cancer: Factors of Non-Utilization of Kidneys for Transplantation

Wai H Lim; Eric Au; Armando Teixeira-Pinto; Esther Ooi; Helen Opdam; Jeremy Chapman; David W Johnson; John Kanellis; Christopher E Davies; Germaine Wong

doi:10.3389/ti.2023.11883

Donors With a Prior History of Cancer: Factors of Non-Utilization of Kidneys for Transplantation

Transpl Int. 2023 Oct 31:36:11883. doi: 10.3389/ti.2023.11883. eCollection 2023.

Authors

Wai H Lim^{1

2}, Eric Au³, Armando Teixeira-Pinto^{4

5}, Esther Ooi^{1

6}, Helen Opdam^{7

8}, Jeremy Chapman⁹, David W Johnson^{10

11

12}, John Kanellis^{13

14}, Christopher E Davies^{15

16}, Germaine Wong^{3

4

5}

Affiliations

¹ Medical School, University of Western Australia, Perth, WA, Australia.
² Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia.
³ Department of Renal Medicine, Westmead Hospital, Sydney, NSW, Australia.
⁴ Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
⁵ Centre for Kidney Research, Kids Research Institute, The Children's Hospital at Westmead, Sydney, NSW, Australia.
⁶ School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia.
⁷ DonateLife, Organ and Tissue Authority, Canberra, NSW, Australia.
⁸ Department of Intensive Care, Austin Health, Melbourne, VIC, Australia.
⁹ Centre for Transplant and Renal Research, Westmead Hospital, Sydney, NSW, Australia.
¹⁰ Princess Alexandra Hospital, Metro South Integrated Nephrology and Transplant Services, Brisbane, QLD, Australia.
¹¹ Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia.
¹² Translational Research Institute, Brisbane, QLD, Australia.
¹³ Department of Nephrology, Monash Health, Melbourne, VIC, Australia.
¹⁴ Centre for Inflammatory Disease, Monash University, Melbourne, VIC, Australia.
¹⁵ Australia and New Zealand Dialysis and Transplant Registry, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
¹⁶ Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.

Abstract

Cancer transmission from deceased donors is an exceedingly rare but potentially fatal complication in transplant recipients. We aimed to quantify the likelihood of non-utilization of kidneys for transplantation from donors with a prior cancer history. We included all intended and actual deceased donors in Australia and New Zealand between 1989 and 2017. Association between prior cancer history and non-utilization of donor kidneys was examined using adjusted logistic regression. Of 9,485 deceased donors, 345 (4%) had a prior cancer history. Of 345 donors with a prior cancer history, 197 (57%) were utilized for transplantation. Donor characteristics of age, sex and comorbidities were similar between utilized and non-utilized donors with prior cancer. The time from cancer to organ donation was similar between utilized and non-utilized donors, irrespective of cancer subtypes. Donors with a prior cancer history were less likely to be utilized [adjusted OR (95% CI) 2.29 (1.68-3.13)] than donors without prior cancer. Of all actual donors, the adjusted OR for non-utilization among those with prior cancer was 2.36 (1.58-3.53). Non-melanoma skin cancer was the most frequent prior cancer type for utilized and non-utilized potential donors. Donors with prior cancers were less likely to be utilized for transplantation, with no discernible differences in cancer characteristics between utilized and non-utilized donors.

Keywords: allograft failure; donor cancer; kidney donation; registry-based study; utilization.

MeSH terms

Humans
Kidney
Kidney Transplantation*
Neoplasms*
Tissue Donors
Tissue and Organ Procurement*

Grants and funding

DJ is supported by a National Health and Medical Research Council (NHMRC) Practitioner Fellowship. GW is supported by an NHMRC Career Development Fellowship. EO is supported by a Heart Foundation Future Leader Fellowship (Award ID: 102538).