To the Editor.
—The article by Dr Loh and colleagues1 addressed tumors arising after organ transplantation and the consequences of transplantation prior to a final diagnosis of the donor's cause of death. This article and the accompanying Editorial by Dr Gazdar2 were of considerable interest based on a personal case with similar implications several years ago.3 My experience caused me, as coroner, to require that all solid organ donors undergo a complete autopsy following harvest, a policy I still believe is appropriate.The case involved a 47-year-old man who presented with severe headache due to intracranial bleeding, which progressed to hemiparesis and coma. Family members decided to donate his kidneys and corneas for transplantation. Review of x-ray films during the preparation of the death note on the first postmortem day showed an osteolytic lesion of the fourth rib, which prompted an autopsy (initially refused by the next
Kohr RM. Prostate Cancer Transmitted in an Orthotopic Heart Transplant. JAMA. 1997;277(17):1354. doi:10.1001/jama.1997.03540410032019