Association of Organ Donor's Prostate Cancer With Kidney Graft and Recipient Survival

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Abstract

Introduction

Prostate cancer positive (CaP+) donors are not commonly accepted as extended criteria donors category. In Eurotransplant zone and Poland more than 50% of actual donors are males, whereof approximately 48% are aged above 50 years. Demographic prognosis heralded that European populations life expectancy will be prolonged. In other words, increasing proportion of CaP (+) donors rate should be anticipated. Based on five years experience with CaP (+) kidney transplantations preliminary results indicate possibility to increase donor pool without increase of donor's related risk for recipients.

Aim

Evaluation of influence of organ donor's CaP on kidney graft and patients’ survival.

Methods

Prospective analysis of allograft and recipient survival based on analysis of non-immunological donor’s factors

Results

Survey group consisted from 191 cadaveric kidney recipients (71% males), 28 (15%) of them received graft from CaP positive donor. Mean time of post transplant observation reached 33 months (SD 18.6). During analyzed time any clinical or laboratory signs of CaP had been established amongst patients. Analysis of non-immunological factors (tab.1) revealed association between donor age and histological neoplasm diagnosis. Mean age in CaP(+)/CaP(−) group was 57 and 45 years, respectively (p<0.0001). Hazard ratio (HR) of graft lose in CaP(+) vs CaP(−) group reached 1.27 (95%CI: 0.432-3.775), p=0.65. Hazard ratio for donor age reached 1.036 (95%CI: 1.001-1.073) per each year of donor's life (p=0.044).

Conclusion

Graft loss is associated with older donor age but neither graft loss nor recipient survival are associated with donor prostate cancer positivity. (fig1,2).

References

1. Deceased donors used in 2016, by donor country, by characteristic. Eurotransplant - statistic report library. Accesed 21.04.2017.

References

2. Bell K.J.L, Del Mar Ch., Wright G. et al. Prevalence of incidental prostate cancer: A systematic review of autopsy studies. Int J Cancer. 2015 Oct 1; 137(7): 1749–1757.

References

3. Pabisiak K, Ostrowski M, Kram A, Safranow K, Słojewski M, Ciechanowski K. Prostate Specific Antigen-Positive Deceased Organ Donor: A Pathologist Is Indispensable. Transplant Proc. 2016 Sep;48(7):2450–2453.

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