Organ donors with malignant gliomas: an update.

The escalating shortage of organs motivates frequent reconsideration of concepts that guide the decision to accept or decline organs from donors with central nervous system (CNS) malignancy. Currently, a minority of patients who die annually of CNS malignancies are organ donors. Specifically, the organs of less than 0.5% of the 13 000 patients dying from glioma are procured and transplanted every year in the United States. This review seeks to clarify the risk of cancer transmission from transplantation of organs from donors with glioma. After considering historical precedence, we will systematically outline the clinical features of a potential organ donor with glioma that might reflect upon the risk of cancer transmission. We will then present recent knowledge regarding basic glioma biology that speaks to their metastatic potential and suggest rational strategies for the post-transplant management of recipients of organs from donors with glioma.