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Retransplantation of a cardiac allograft inadvertently harvested from a donor with metastatic melanoma.

Abstract
Donor-derived melanoma is easily transmitted through organ transplants and is highly aggressive in transplant recipients. The best treatment-withdrawal or reduction of immunosuppression-permits tumor rejection but risks allograft rejection. In recipients of nonrenal allografts, the prognosis is particularly grim, with transmission rates and mortality approaching 100%. Retransplantation has been proposed as a possible strategy but has never been performed for a cardiac allograft. This is the first report of cardiac retransplantation and only the second case of retransplantation of any nonrenal organ. Our patient received a heart transplant from a donor found to have occult metastatic melanoma at autopsy. He underwent retransplantation 17 days later. Close clinical and radiographic follow-up reveal no evidence of melanoma 22 months after transplantation. Based on the rapid development of donor-derived melanoma in previous reports, our patient is likely to remain free of donor cancer. Retransplantation and low-dose immunosuppression may have been lifesaving.
AuthorsAlison W Loren, Shashank Desai, Robert C Gorman, Lynn M Schuchter
JournalTransplantation (Transplantation) Vol. 76 Issue 4 Pg. 741-3 (Aug 27 2003) ISSN: 0041-1337 [Print] United States
PMID12973122 (Publication Type: Case Reports, Journal Article, Research Support, U.S. Gov't, P.H.S.)
Topics
  • Heart Neoplasms (secondary)
  • Heart Transplantation
  • Humans
  • Male
  • Melanoma (secondary)
  • Middle Aged
  • Reoperation
  • Tissue Donors
  • Transplantation, Homologous

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