Patients with Primary Brain Tumors as Organ Donors

Organ transplant is now the treatment of choice for many end-stage diseases. The success of solid organ transplantation is accompained by a severe shortage of available organs for those currently awaiting transplantation. In recent years, there has been an increasing demand for organs, but not a similar increase in the supply leading to a severe shortage of organs for transplant that resulted in increasing waiting times for recipients. This has resulted in expanded donor criteria to include older donors and donors with mild diseases. Malignancy is considered a contra-indication to organ donation, with a few possible exceptions. There is a significant controversy in the transplant literature around the use of organs from donors with primary brain tumors (PBT). While case reports and registry data have certainly documented transmission of PBT with resultant morbidity and even mortality, the loss of quality and quantity of life by those on the waiting list remains a staggering and sobering reality. Ultimately the decision regarding transplantation from such donors lies with the transplanting team that should weigh the risk of donor tumor transmission against the risk of their patient dying on the waiting list.