A deceased woman whose organs were transplanted into four other people had a cancerous growth in her pancreas, doctors said this week. The transplant recipients will now be subject to comprehensive medical supervision to determine whether they contracted cancer from the donor.
The woman, a 40-year-old resident of a southern community, died of a heart disorder two weeks ago at Be'er Sheva's Soroka Medical Center. After her family agreed to donate her organs, her pancreas was taken to Tel Aviv's Ichilov Hospital.
Medical staff led by Dr. Mendy Ben-Haim noticed that it appeared to be infected. After a biopsy revealed low-level cancerous growths, doctors recommended the pancreas transplant be canceled.
By then, four of the woman's other organs already had been transplanted into other patients. Two recipients - men ages 38 and 60 - underwent kidney transplants at Beilinson Hospital in Petah Tikva. Over the next few days, medical teams will determine whether the organs need to be removed due to risks that they also may contain cancerous growth, which could infect the patients' other organs.
The two other patients - a 34-year-old lung recipient and 60-year-old liver recipient - remain hospitalized at Jerusalem's Hadassah University Hospital, Ein Karem and will undergo similar tests.
Charges of negligence in the case appear unlikely. The incident is the first in Israel in which an organ donor was found to have cancer after the transplant was performed. Experts believe that worldwide, 0.1 percent of organs harvested contain undetected cancer cells.
The Health Ministry said yesterday in a statement, "The transfer of diseases from donor to recipient is well-known throughout the world ... These organ recipients will be placed under special medical supervision."
Ministry officials said the organs transplanted at Beilinson and Hadassah Ein Karem had been subjected to the required pre-transplant tests, and that no cancerous growths had been detected. The pre-donation tests commonly in use today, however, cannot identify the entire spectrum of cancerous growth without a comprehensive examination like the one that was performed on the pancreas.
Prof. Refael Beyar, chairman of the National Transplant Center and director general of Rambam, said yesterday, "Medical tests are conducted when organs are donated, but no test, even the most advanced imaging methods, can ensure that there will be no part of the body with a cancerous growth.
"In the current case, the organ transplant documentation was entirely sound, and all of the organs except for the pancreas were suitable for donation. Tests for determining the nature of the growth are continuing, but we must remember that these patients essentially received donations to save their lives."
Dr. Hadar Merhav, director of the transplant department at Hadassah Ein Karem, said the liver transplant recipient had been slated to be released from hospital, but remained in the surgery ward after doctors were informed that the donor had been found to have cancer.
Merhav added that because two weeks had passed since the transplant, he has decided not to remove the organ, which would require a replacement transplant and could kill the patient.
Every organ recipient is required to undergo supervision to ensure his or her body does not reject the transplant. Merhav noted, however, that the patient "will have to undergo more comprehensive monitoring than other recipients who have not undergone these complications."
Merhav said the cancer could have spread already to other parts of the recipient's body. "We will consult with additional experts and draft a monitoring and treatment regimen with the patient and his family," he said.
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