Retransplantation of a cardiac allograft inadvertently harvested from a donor with metastatic melanoma

Transplantation. 2003 Aug 27;76(4):741-3. doi: 10.1097/01.TP.0000080561.31826.FE.

Abstract

Donor-derived melanoma is easily transmitted through organ transplants and is highly aggressive in transplant recipients. The best treatment-withdrawal or reduction of immunosuppression-permits tumor rejection but risks allograft rejection. In recipients of nonrenal allografts, the prognosis is particularly grim, with transmission rates and mortality approaching 100%. Retransplantation has been proposed as a possible strategy but has never been performed for a cardiac allograft. This is the first report of cardiac retransplantation and only the second case of retransplantation of any nonrenal organ. Our patient received a heart transplant from a donor found to have occult metastatic melanoma at autopsy. He underwent retransplantation 17 days later. Close clinical and radiographic follow-up reveal no evidence of melanoma 22 months after transplantation. Based on the rapid development of donor-derived melanoma in previous reports, our patient is likely to remain free of donor cancer. Retransplantation and low-dose immunosuppression may have been lifesaving.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Heart Neoplasms / secondary*
  • Heart Transplantation*
  • Humans
  • Male
  • Melanoma / secondary*
  • Middle Aged
  • Reoperation
  • Tissue Donors*
  • Transplantation, Homologous