Prostate-Specific Antigen: Nonspecific in Deceased Organ Donors

• The prostate-specific antigen (PSA)-positive donor should not be disqualified on the basis of a laboratory test result alone
• Increased PSA levels mostly do not correspond to prostate cancer in donors aged <60 years
• The length of a catheterization was inversely correlated with PSA concentration
• There is no correlation between PSA values and occurrence of prostate carcinoma in organ donors

Currently, there is no clear position regarding the donation of organs from donors with prostate carcinoma (CaP) in European countries, except Italy. The lengthening of life expectancy increases the probability of prostate cancer among potential organ donors. The concentration of prostate-specific antigen (PSA) >2 ng/mL at 60 years of age is related to the increasing possibility of identifying an advanced form of CaP. In recent years in Poland, the recommendation has been to determine tumor markers in potential donors. In the first year of the recommendation, 10% of potential male cadaveric donors were disqualified in West Pomerania, Poland, on the basis of elevated PSA levels (>10 ng/mL). To avoid reduction of the actual donor pool, each potential male donor reported to the center since January 2010 undergoes a routine histologic evaluation of the whole prostate, regardless of the PSA level, before organ implantation. In the study group (N = 52), histopathologic evaluation revealed 6 cases of CaP (12%). In CaP positive group Gleason score range from 2+2 to 3+4. In CaP donors PSA level have been noticed in range 1.79 ng/mL – 7.66 ng/mL. There was no correlation between histologically confirmed CaP and the PSA level.