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  • Title: Retransplantation of a cardiac allograft inadvertently harvested from a donor with metastatic melanoma.
    Author: Loren AW, Desai S, Gorman RC, Schuchter LM.
    Journal: Transplantation; 2003 Aug 27; 76(4):741-3. PubMed ID: 12973122.
    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.
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