Extracranial glioblastoma in transplant recipients

Traditionally, gliomas are considered to be confined to the central nervous system. The shortage of solid donor organs resulted in consideration of organs from patients with primary malignancy such as glioblastoma multiforme (GBM) for transplantation into patients suffering from end-stage organ disease. We performed a PubMed search including all studies that documented patient demographics, pre- and post-transplantation conditions as well as time to metastasis and overall survival in recipients of organ transplants from donors suffering from GBM. A total of 11 studies with 11 patients were included in this review. Three patients had liver, three had kidney, and five had lung transplantation. For kidney transplants, average time to metastasis was 17.3 months post-surgery. The average follow-up time was 32.3 months, and all patients were doing well. All liver transplant recipients succumbed due to GBM metastasis. The average survival was 7 months for all three patients. For lung-receiving patients, two patients died at an average of 9.5 months post-transplantation, with a mean time to metastasis of 9 months. Two patients were doing well at 17- and 20-month follow-up. One patient was diagnosed with metastasis 12 months after transplantation, but no follow-up data were provided. These studies emphasize the disadvantage of transplanting an organ of an individual with GBM. However, it should be noted that these cases do not make up a large percentage of overall transplantations, and donors with primary central nervous system malignancies also do not represent the whole pool of organs available.