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TUMORS IN KIDNEY DONORS – ETHIC DILEMMA IN TRANSPLANTATION MEDICINE

MARKO BANIĆ ; University of Zagreb, School of Medicine and Zagreb University Hospital Centre, Division of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb, Croatia
ALAN HORVAT ; University of Zagreb, School of Medicine and Zagreb University Hospital Centre, Division of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb, Croatia
LEA KATALINIĆ ; Zagreb University Hospital Centre, Department of Urology, Zagreb, Croatia
VESNA FURIĆ-ČUNKO ; Zagreb University Hospital Centre, Department of Urology, Zagreb, Croatia
IVANA JURIĆ ; Zagreb University Hospital Centre, Department of Urology, Zagreb, Croatia
TVRTKO HUDOLIN ; University of Zagreb, School of Medicine and Zagreb University Hospital Centre, Division of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb, Croatia
ŽELJKO KAŠTELAN ; University of Zagreb, School of Medicine and Zagreb University Hospital Centre, Division of Nephrology, Arterial Hypertension, Dialysis and Transplantation, Zagreb, Croatia
NIKOLINA BAŠIĆ-JUKIĆ orcid.org/0000-0002-0221-2758 ; University of Zagreb, School of Medicine and Zagreb University Hospital Centre, Division of Nephrology, Arterial Hypertension, Dialysis and Transplantation and Zagreb University Hospital Centre, Department of Urology, Zagreb, Croatia

Abstract

It is known that the incidence of malignant diseases is increased 3 to 4 times when the population of solid organs recipients is observed. Apart from the tumours developed from one's own tissues, tumour recipients may develop a malignant tumour related to the donated organ. The chance of developing such a disease is far smaller than the one of developing a malignant disease originating from one's own tissues but the chance is not non-existant. It is necessary to examine whether such a risk is worth taking and whether the donated organ should be explanted in the case of discovering a malignancy in donor. Another problem is the fact that a portion of such tumours is discovered not before the deceased donor's obduction. Acorrding to researches outside of Croatia, 0,01-0,05% of kidney recipients develop a malignancy transmitted from the donor. In Croatian terms, that would be equivalent to 0,02-0,1 persons per year. Increased risk groups would be donors over the age of 45 and donors with a history of malignant disease. There are no clear guidelines developed yet but there are some widely-accepted procedures in certain situations. Each patient must be individually evaluated and cost-benefit analysis must be taken into account. Four cases occured in the Hospital University Center Zagreb when the autopsy discovered a malignancy in kidney donors.

Keywords

HIV; kidney transplantation; outcome; kidney transplantation; kidney donor; tumour; kidney recipient; ethics

Hrčak ID:

230108

URI

https://hrcak.srce.hr/230108

Publication date:

5.12.2019.

Article data in other languages: croatian

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