Donating the Gift of Life
Donating blood and tissues after cancer is gaining acceptance.
[While going through treatment, did family and friends donate blood or platelets for you?
Do you hope to return the favor one day?]
The criteria for blood donation varies from center to center, and even patient to patient, so the only sure way to know if you qualify is to call your local blood bank and ask. Donors who have solid tumors can usually donate corneas—and about 18.5 percent of donations to eye banks in the U.S. come from people with a history of cancer, according to the Eye Bank Association of America. As with other tissue donations, however, people with leukemia, lymphoma and myeloma are excluded. For organ donation, decisions are often made at the time an organ becomes available and are based on the health status of both donor and recipient. “There are not good guidelines because there are not a lot of data,” says Thomas Gross, a pediatric hematologist and oncologist, and chief of the transplant program at Nationwide Children’s Hospital in Columbus, Ohio. “Certainly there are cases of cancer transmitted through donated organs. Most of the time when that was found to be the case, the cancer was not known to the donor.”
Cancer can be transmitted when a donated organ contains the seeds of cancer that remained undetected while the donor was alive. Doctors also have concerns about whether tumor cells circulating in the blood might have lodged silently in a donated organ. Once organs are transplanted, a recipient would be extremely vulnerable to undiscovered cancer cells because immunosuppression, which could impair the ability to destroy microscopic cancer, is part of organ transplantation.
The risks are more than theoretical, and, while rare, cases of donor-transmitted cancer have occurred. As a result, doctors have traditionally been very wary about the idea of transplanting donated organs from cancer survivors, researchers in Britain pointed out in 2011 in an editorial in the American Journal of Transplantation. However, “given the severe shortage of organs for transplantation, such a cautious approach may no longer be appropriate, at least not in all cases. There is an increasing need to balance the risk of using organs from donors where there may be a low or even intermediate risk of disease transmission, against the likelihood of death on the transplant waiting list.”