To the Editor.
—Dr Loh and colleagues1 carefully documented a devastating complication of orthotopic cardiac transplantation: donor-derived transmission of malignancy. It is remarkable that their report of prostate cancer transmission is the only one known, since prostate cancer is the most common malignancy of men in the countries where most transplants are performed.Our interest is not only the medicolegal issues that may arise after organ transplants, but the potential to avoid them. The incidence of melanoma, one of the first tumors reportedly involved in donor transmission of cancer,2 is increasing,3 and it characteristically metastasizes widely throughout the donor's body. Recently, Ciaran et al4 described a very sensitive nuclear scan for melanoma using a radiolabeled benzamide. Such a scan performed on potential organ donors would be likely to detect clinically significant melanoma with potential to metastasize to a transplantable organ.The logistics of transplanting organs, as well summarized by
Pretorius HT, Wurnig PN. Prostate Cancer Transmitted in an Orthotopic Heart Transplant. JAMA. 1997;277(17):1355. doi:10.1001/jama.1997.03540410033021