Vincent Liew was a 37-year-old diabetic man from Singapore who waited five years for a kidney transplant. He had to go through dialysis three times a week and thought his wish for a more fulfilling life had come true when he received a kidney in February 2002 from a seemingly healthy 50-year-old woman who died suddenly from a stroke. An autopsy several days after the woman’s death, however, revealed what no doctor caring for her or the kidney expected – she had uterine cancer.
Vincent Liew was informed of this problem about 6 weeks later in April of 2002. According to testimony at a malpractice suit regarding his case, his surgeon noted that the best prevention would be to remove the kidney, though that the risk of the transplant spreading the cancer to him, let alone a kidney having uterine cancer in a man, was 99.9% not possible. Approximately 1% of transplants are estimated to spread illness, mostly chronic viral infections missed by screening procedures or the short time frame for organ turnaround. MSNBC quoted the Centers for Disease Control and Prevention that approximately 23 cases of disease via transplantation (including 12 deaths) occurred in 2007 out of nearly 28,000 transplant procedures, with cancer listed among the diseases transmitted.
But cancer of the uterus in a man? And on a kidney? That would be highly unusual, and unexpected. According to the Women’s Cancer Center, the cancer would first metastasize to the other female reproductive organs in the lower abdomen, and then to the bladder, and then to the abdominal organs, including the kidneys. The donor’s cancer would have to have metastasized, and likely been more noticeable and diagnosed, if it was going to be present in the kidney tissue.
Liew decided to keep the kidney and was reportedly tested for signs of cancer with none found from April to August. At that time though, severe back pain caused them to pursue removal of the transplanted kidney, which doctors noted was covered in tumors originating from female cells. Three weeks later, in September 2002, Vincent Liew died. Because of the differentiation state of the cancer cells, they were not able to tell for certain that they were uterine, but many who have reviewed the case have settled on the diagnosis of uterine cancer of the kidney.
Liew’s widow filed a malpractice suit against the doctors and hospital, but a jury found in May 2010 that they were not at fault (see TechJackal). Two other recipients of organs from the same donor have also reportedly died of cancer. Experts agree that the case was wholly unexpected and reaches into the realm of what is unknown about cancer, particularly its spread between individuals.
More than 107,000 people are on the United States transplant waiting list alone, many of whom will die without the transplant, including 900 already in 2010. Because of the lack of viability outside the human body, organs have a very short timeframe to be tested, and some conditions and diseases simply cannot be detected. Many have to choose between inevitably dying sooner without the organ, and the small chance of dying because of it.