Prostate cancer in deceased organ donors: A review

Objective: To estimate the risk of prostate cancer transmission in relation with organ procurement. Methods: A literature search from the Medline database using the following keywords—transplantation, prostate cancer, organ procurement, donor transmitted malignancies, disease transmission, staging, evaluation, and PSA—was conducted to select 16 articles written in English and French over the last 15 years. Results: The incidence of prostate cancer in deceased organ donors (DOD) has been estimated to be between 3% and 18.5%. There were more than 120 solid-organ transplantations performed with organs coming from DOD with a proven prostate cancer without any case of cancer transmission or death related to malignancy and only 1 case of transmission by the donor after a heart transplant has been described. Conclusion: Transmission of prostate cancer by a transplanted organ seems incidental. When PSA is measured, it should be suspected only if the value is beyond 20 ng/ml and in all cases, should be interpreted taking digital rectal examination (DRE) into account. Organs from a DOD with a DRE proving a T3–T4 prostate cancer should not be procured. Suspect iliac lymph nodes during the preparation of the vessels for cannulation must lead to the discontinuation of the procurement or a histological analysis.