Fate of a renal tubulopapillary adenoma transmitted by an organ donor

Organ transplantation from cadaveric donors has a risk of cancer transmissi on. However, some reports indicate that kidneys bearing small carcinomas ca n be safely transplanted, as can other organs harvested from the same donor . We report herein the case of two allograft recipients (left kidney and he art with no evidence of tumor) who developed a renal carcinoma soon after t ransplantation. The initial tumor of the donor was a 17-mm tubulopapillary adenoma found on the right kidney, which was not transplanted. The left kid ney recipient rejected all residual tumoral cells after graft removal and i mmunosuppression discontinuation. The heart recipient died 7 months after t ransplantation from metastasis of a renal carcinoma. This strongly suggests that circulating carcinoma cells were present at the time of organ retriev al and that they were not cleared by in situ perfusion. In contrast with th e literature data, this report indicates that patients with small renal tub ulopapillary tumors should not be considered for organ donation.