A history of cancer does not automatically disqualify an individual from being an organ donor. Every potential donor’s medical history is evaluated case-by-case at the time of death to determine the suitability of organs and tissues. The transplant community encourages everyone to register their decision to donate, regardless of past health concerns, as few conditions result in automatic exclusion. A rigorous screening process ensures the organs used are safe for the recipient, balancing the need for a transplant with the risk of disease transmission.
The Basic Eligibility Standard
The fundamental principle guiding organ donation eligibility is the health and function of the organ itself and the potential for transmitting any disease to the recipient. The assessment focuses on whether the organs are viable for transplant and if the donor’s medical history presents an unacceptable risk. This evaluation is a detailed review of the entire medical profile, not a blanket judgment based on a single past diagnosis. Specialists review the complete medical records, imaging studies, and pathology reports of the potential donor upon their death. This comprehensive review determines which organs or tissues can be successfully used.
Cancer History That Disqualifies Organs
The primary concern leading to the disqualification of solid organs is the risk of transmitting malignant cells to the recipient. Active cancer, which is currently growing or undergoing treatment, generally makes an individual ineligible for organ donation. The most significant disqualifying factor is metastatic cancer, where the disease has spread from its original site to other parts of the body. This systemic spread increases the likelihood that cancer cells are present within the organs intended for transplant.
Hematological Malignancies
Cancers of the blood, known as hematological malignancies, also typically exclude a person from solid organ donation. These include active forms of leukemia, lymphoma, and multiple myeloma, which involve the body’s circulatory system and immune cells. Using organs from a donor with these cancers carries a high risk of passing on the malignancy. Since the recipient’s immune system is suppressed after a transplant, they are particularly vulnerable to any transmitted cancer cells.
Cancers That Permit Donation
A history of cancer often permits donation when the disease was localized and successfully treated, especially after a significant period of remission. Transplant teams generally accept organs from individuals who had early-stage cancers that were removed and did not spread. Examples include certain low-grade prostate, cervical, or breast cancers that were organ-confined.
Non-Melanoma Skin Cancers
Non-melanoma skin cancers, such as Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC), are almost always acceptable and do not prevent organ donation. These cancers are usually localized to the skin and have a low risk of systemic spread. The time elapsed since treatment is a major factor, with many centers preferring a cancer-free period of several years to confirm the disease is cured. Even if solid organs are deemed unsuitable, corneas and certain tissues can often still be donated.
How Transplant Teams Assess Risk
The assessment of a potential donor with a cancer history is a multi-step process conducted by a specialized transplant team. This evaluation begins with reviewing the donor’s complete medical record, including pathology reports and diagnostic imaging studies, to understand the cancer type, stage, and treatment history. The final decision rests with the specific transplant surgeon and is made in consultation with the potential recipient’s medical team.
Weighing Risk vs. Need
Specific testing is often performed immediately prior to organ retrieval to confirm viability and safety. This can include targeted biopsies of the organs if there is suspicion of residual malignancy or damage. The team weighs the small chance of donor tumor transmission, which occurs in approximately 1 out of 3,000 transplants, against the certain risk of the recipient dying without a transplant. This is known as “informed risk,” where the recipient is made fully aware of the history before consenting to receive the organ. The ongoing shortage of organs necessitates this careful balancing of risk.