LIVER GRAFT-TRANSMITTED GLIOBLASTOMA-MULTIFORME - A CASE-REPORT AND EXPERIENCE WITH 13 MULTIORGAN DONORS SUFFERING FROM PRIMARY CEREBRAL NEOPLASIA

The transmission of donor-related malignancies by organ transplantatio n is a rather rare event. There has only been one report on the develo pment of a brain tumor metastasis in liver transplantation. From Septe mber 1988 to January 1993, 342 donor hepatectomies with subsequent tra nsplantation were performed at our center. The main donor diagnoses in cluded subarachnoidal bleeding (n = 128; 37.4 %), isolated head injury (n = 114; 33.3 %), multiple injuries (n = 55; 16.1 %), primary cerebr al neoplasia (n = 13; 3.8 %), and other (n = 32; 9.4 %). Primary cereb ral neoplasia included glioblastoma (n = 4), meningioma (n = 3), astro cytoma (n = 2), angioma (n = 2), neurocytoma (n = 1), and ependymoma ( n = 1). In the group of donors suffering from primary cerebral neoplas ia, procured organs other than the liver included kidneys (n = 20), co mbined kidneys and pancreata (n = 1), pancreata (n = 2), hearts (n = 8 ), combined hearts and lungs (n = 1), and single lungs (n = 1). Follow -up of the respective graft recipients ranged from 28 to 68 months (me dian 43 months). Recurrent malignancy was observed once, in a liver gr aft recipient. The donor, a 48-year-old female, had undergone surgical resection of an intracerebral multiform glioblastoma and died 4 month s later of a relapse in the brain stem. The 28-year-old female recipie nt had undergone transplantation for an autoimmune-hepatitic cirrhosis . Four months later, histopathological examination of an intraperitone al and intrahepatic mass revealed a poorly differentiated, small-cell pleomorphic cancer, identified as a glioma metastasis by S100- and gli al fibrillary acidic protein immunohistochemical staining. The patient died 6 months post-transplantation. On autopsy, no further neoplastic lesions were detected. Our review adds a second reported case of a li ver graft-transmitted brain tumor to the literature and the fourth don or-related malignancy after hepatic transplantation in general.