According to the European Union Tissues and Cells Directives donation of tissue is contraindicated in the presence of or a previous history of malignant disease, with the exception of cutaneous
basal cell carcinoma.
Skin cancer is the most common
cancer. Due to ultraviolet light exposure and increasing life expectancy an increasing prevalence of malignant or premalignant skin lesions is observed, which may result in a decline of the availability of skin for
transplantation. A risk assessment based on published studies and expert opinion was performed in order to investigate the risk of transmitting malignant or premalignant skin lesions through
tissue transplantation, and more particular through
skin transplantation. The scarcity of data concerning
cancer transmission in
tissue transplantation was challenging. Circumstantial evidence, available for
organ transplantation, was used to develop the following policy proposal for
skin transplantation and cutaneous tumours.
Malignant melanoma is an absolute
contraindication for the donation of skin and also of other tissues, whereas, non-lesional skin and other tissues of a donor with non-
melanoma skin cancer (basal cell and
squamous cell carcinoma) or with a premalignant skin lesion can be considered for
transplantation. The above mentioned protocol proposal might serve as a prototype for analogous protocols for non-cutaneous
malignancies.