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SUGGESTIONS FOR CLINICAL CARE (Suggestions are based on Level III and IV evidence)

By No Level and I Ii

Abstract

Cancer is transmissable through organ donation and the risk of transmission, although in the order of 0.015%, cannot be fully eliminated. Deceased and living donors under the age of 50 years should have prior and current cancer excluded by clinical history and clinical examination. Female donors of reproductive age with death due to intra-cerebral haemorrhage should be screened for metastatic choriocarcinoma by testing serum b-HCG concentration. Skin, breast and large colon cancer are the commonest cancers in the general population under 50 years of age and should be specifically considered. Deceased and living donors over the age of 50 years should have prior and current cancer excluded by clinical history and clinical examination. Investigations should include Prostate Specific Antigen testing in males. Cancer of the prostate in males, breast in females, large bowel, lung, melanoma, stomach, pancreas, kidney and bladder, lymphoma and leukaemias are the commonest cancers in the general population aged over 50 years, and should be specifically considered. A donor will be excluded if they are confirmed or suspected to have, or have had a diagnosis of cancer which may be transmitted to the recipient. Donors and organs should be examined thoroughly at the time of retrieval and frozen sections taken of any suspect lesions. A formal post-mortem is desirable in all cases. Exceptions to the above may be made in the case of: – non-metastatic, non-melanoma skin cancer – carcinoma in situ of the cervix – other cancers known to have been fully eradicated from the donor

Year: 2004
OAI identifier: oai:CiteSeerX.psu:10.1.1.362.8743
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