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Announcement on a Case of Organ Donation and Transplantation

The spokesperson of the Prince of Wales Hospital (PWH) made the following announcement today (27 August) regarding a case of organ donation and transplantation:

A patient suffering from acute stroke passed away in PWH on 25 August 2015 despite resuscitation. The deceased’s family gave consent to donate the kidneys, liver, heart and lungs. Hospitals concerned were informed and they proceeded to identify suitable patients for organ transplant.

A series of examinations including bronchoscopy, serology test, chest X-ray, renal ultrasound, urinalysis, echocardiogram and coronary angiogram were conducted according to the established protocol for brain stem death patients. Results were reviewed and the organs were considered suitable for donation.

The organ harvesting operations began at around 9:00am on 26 August 2015. Based on prevailing organ transplant procedures, doctors from the Queen Mary Hospital (QMH) harvested the organs in the order of heart, lungs and liver. The organs were then transported to QMH immediately for subsequent transplant to three patients.

At 2:55pm when PWH doctors harvested the kidneys, a mass of 1.5cm diameter was found on the posterior surface of the right kidney. The specimen was sent for urgent frozen section examination. PWH organ donation coordinator concurrently informed the related transplant teams of the findings at 3:00pm. It was understood that the heart and lungs transplantations at QMH were in progress.

Frozen section examination results available at 3:30pm confirmed the specimen as renal cell carcinoma. The transplant teams concerned were notified immediately. After thorough assessment, it was decided not to carry out the kidney transplantations. The QMH liver team also decided not to use the liver for transplant according to risk assessment.

QMH has explained to the families of the two heart and lungs recipients the risks and follow-up plans. The patients will be closely monitored, and necessary examinations will be arranged. The Hospital will also closely follow up their disease prognoses.

Early renal cell carcinoma does not come with obvious symptoms. It is usually found out incidentally during other examinations. Thorough investigations on the donor and recipients had been performed before the transplant operations according to the established guidelines to assess the condition of the organs, recipients’ clinical condition and overall risks. Explanations were given to the recipients and their family regarding all the known risks, including that the donor may have some asymptomatic diseases, and that there may be window period of infections or endured time is required for tests, making pre-transplant diagnosis of all occult diseases not feasible. The operations were performed after obtaining the informed consent from the respective patients.

According to the local experience of organ transplant, it is very rare for transplant recipients to get cancer from the transplanted organ. For this case, the expert assessment is that the risk of renal cell carcinoma metastasis to other organs is extremely low, and it is highly unlikely to have an impact on the two recipients.

The Hospital would like to express its gratitude to the donor’s family once again for their generous act in supporting organ donation which gives hope to patients in need.

PWH has reported the case to the Hospital Authority Head Office via the Advance Incident Reporting System.