癌症传播是器官移植受者所面临的已知风险。很多人等待合适的移植物已经等了很久，但有些人可能永远没有机会接受移植。虽然患有脑肿瘤的病人可以捐赠器官，但人们对于捐赠的风险意见不一。本研究的主要目的是确定来自在世脑肿瘤患者的器官移植与癌症传播的风险，其次目标则是研究捐献者脑肿瘤与器官使用和移植后存活之间的关系。 本研究为英格兰和苏格兰的队列研究，从2000年1月1日至2016年12月31日进行，后续调查到2020年12月31日。本研究使用了来自英国移植登记处、英格兰国家癌症登记与分析服务以及苏格兰癌症登记处的有效国家身份证号的死亡捐赠者和实心器官移植受者的链接数据。次要分析中，对比组匹配了可能影响器官使用或移植失败概率的因素。本研究的数据统计分析从2021年10月1日至2022年5月31日进行。 本研究通过疾病代码在全部三个数据来源中确定了器官捐献者的原发性脑肿瘤史。本研究的主要结果为，来自器官捐赠者的脑肿瘤传播到移植受者的情况很少见。次要结果为器官使用（即接受提供的器官的移植），以及肾脏、肝脏、心脏和肺移植及其受者的存活。捐献者中的主要协变量为肿瘤等级和治疗史。 本研究共纳入了282位捐献者（年龄中位数[IQR]为42[33-54]岁；女性154位[55%]）及其887个移植，其中778个（88%）参与了主要结果的分析。这些移送来自262位高级别捐献者以及494位之前进行过神经外科手术或放射治疗的捐献者。移植受者的中位（IQR）年龄为48（35-58）岁，其中476（61%）为男性。在79位接受来自脑肿瘤患者捐赠的移植物的移植受者中，68位在6（3-9）年中出现了83个移植后恶性肿瘤（不包括非黑色素皮肤癌），但没有发现与捐献者脑肿瘤组织类型相匹配的恶性肿瘤。移植存活率与比较组相当。与比较组相比，肾脏、肝脏和肺器官使用率较低。 本队列研究的结果表明，来自原发性脑肿瘤死亡捐献者的器官移植传播癌症的风险比先前预估的要低，即使是来自高危捐献者的情况也一样。长期移植结果是有利的。这些结果表明，可能可以安全地扩展这些捐献者群体的器官使用。

Cancer transmission is a known risk for recipients of organ transplants. Many people wait a long time for a suitable transplant; some never receive one. Although patients with brain tumors may donate their organs, opinions vary on the risks involved.To determine the risk of cancer transmission associated with organ transplants from deceased donors with primary brain tumors. Key secondary objectives were to investigate the association that donor brain tumors have with organ usage and posttransplant survival.This was a cohort study in England and Scotland, conducted from January 1, 2000, to December 31, 2016, with follow-up to December 31, 2020. This study used linked data on deceased donors and solid organ transplant recipients with valid national patient identifier numbers from the UK Transplant Registry, the National Cancer Registration and Analysis Service (England), and the Scottish Cancer Registry. For secondary analyses, comparators were matched on factors that may influence the likelihood of organ usage or transplant failure. Statistical analysis of study data took place from October 1, 2021, to May 31, 2022.A history of primary brain tumor in the organ donor, identified from all 3 data sources using disease codes.Transmission of brain tumor from the organ donor into the transplant recipient. Secondary outcomes were organ utilization (ie, transplant of an offered organ) and survival of kidney, liver, heart, and lung transplants and their recipients. Key covariates in donors with brain tumors were tumor grade and treatment history.This study included a total of 282 donors (median [IQR] age, 42 [33-54] years; 154 females [55%]) with primary brain tumors and 887 transplants from them, 778 (88%) of which were analyzed for the primary outcome. There were 262 transplants from donors with high-grade tumors and 494 from donors with prior neurosurgical intervention or radiotherapy. Median (IQR) recipient age was 48 (35-58) years, and 476 (61%) were male. Among 83 posttransplant malignancies (excluding NMSC) that occurred over a median (IQR) of 6 (3-9) years in 79 recipients of transplants from donors with brain tumors, none were of a histological type matching the donor brain tumor. Transplant survival was equivalent to that of matched controls. Kidney, liver, and lung utilization were lower in donors with high-grade brain tumors compared with matched controls.Results of this cohort study suggest that the risk of cancer transmission in transplants from deceased donors with primary brain tumors was lower than previously thought, even in the context of donors that are considered as higher risk. Long-term transplant outcomes are favorable. These results suggest that it may be possible to safely expand organ usage from this donor group.