MEDICINE: Unwelcome Transmission

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Science  18 Apr 2003:
Vol. 300, Issue 5618, pp. 395c
DOI: 10.1126/science.300.5618.395c

Improvements in immunosuppressive drugs and organ storage technology have enhanced the success rate of organ transplantation, but these surgeries still place recipients at elevated risk of certain malignancies, including Kaposi sarcoma (KS). Because KS is caused by human herpesvirus type 8 (HHV-8), development of this tumor in the transplant setting has been attributed to activation of latent virus in the host or transmission of free virus from the donor organ.

In a small study of kidney transplant recipients, Barozzi et al. present highly suggestive evidence that KS can also arise through transmission and engraftment of donor tumor cells or their progenitors. Presumably such cells would normally be eliminated by immune surveillance, but the immunosuppressed state of the organ recipients may allow their uncontrolled proliferation. This finding not only underscores the importance of screening donor organs for HHV-8 but it is likely also to renew interest in earlier speculations that sexual transmission of KS in AIDS patients may sometimes occur through direct transfer of shed tumor cells.—PAK

Nature Med. 10.1038/nm862 (2003).

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