Managing Thyroid Nodules in Brain-Dead Donors: Our Experience and a Review of the Literature.

neck surgery thyroid cancer thyroid nodules thyroidectomy transplantation

Journal

Head & neck
ISSN: 1097-0347
Titre abrégé: Head Neck
Pays: United States
ID NLM: 8902541

Informations de publication

Date de publication:
06 Oct 2024
Historique:
revised: 31 07 2024
received: 17 06 2024
accepted: 18 09 2024
medline: 7 10 2024
pubmed: 7 10 2024
entrez: 7 10 2024
Statut: aheadofprint

Résumé

Thyroid nodules are common findings during the diagnostic work-up in potential organ donors. A fast yet thorough assessment to rule out cancer is mandatory but their management remains heterogeneous among hospitals and the evidence in this field is scarce. We present our institutional experience and review the most recent literature on this topic. Retrospective case series and systematic review of the literature. In the years 2000-2023, 47 total thyroidectomies were performed on potential brain-dead donors. Intraoperative frozen section (FS) revealed 6 cases (13.9%) of papillary carcinoma that led to organ discarding in 3 cases (6.9%). The mean operative time of the procedures was 42.75 min and no procurement-delaying complications were registered. Total thyroidectomy with an intraoperative FS is a sound method for assessing suspicious nodules before organ harvesting. Future randomized studies comparing its performance against fine needle aspiration biopsy are needed to define the most cost-effective and time-saving strategy.

Sections du résumé

BACKGROUND BACKGROUND
Thyroid nodules are common findings during the diagnostic work-up in potential organ donors. A fast yet thorough assessment to rule out cancer is mandatory but their management remains heterogeneous among hospitals and the evidence in this field is scarce. We present our institutional experience and review the most recent literature on this topic.
METHODS METHODS
Retrospective case series and systematic review of the literature.
RESULTS RESULTS
In the years 2000-2023, 47 total thyroidectomies were performed on potential brain-dead donors. Intraoperative frozen section (FS) revealed 6 cases (13.9%) of papillary carcinoma that led to organ discarding in 3 cases (6.9%). The mean operative time of the procedures was 42.75 min and no procurement-delaying complications were registered.
CONCLUSION CONCLUSIONS
Total thyroidectomy with an intraoperative FS is a sound method for assessing suspicious nodules before organ harvesting. Future randomized studies comparing its performance against fine needle aspiration biopsy are needed to define the most cost-effective and time-saving strategy.

Identifiants

pubmed: 39370689
doi: 10.1002/hed.27946
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024 Wiley Periodicals LLC.

Références

C. Durante, G. Grani, L. Lamartina, S. Filetti, S. J. Mandel, and D. S. Cooper, “The Diagnosis and Management of Thyroid Nodules: A Review,” JAMA 319, no. 9 (2018): 914–924.
M. Pizzato, M. Li, J. Vignat, et al., “The Epidemiological Landscape of Thyroid Cancer Worldwide: GLOBOCAN Estimates for Incidence and Mortality Rates in 2020,” Lancet Diabetes and Endocrinology 10, no. 4 (2022): 264–272.
D. W. Chen, B. H. Lang, D. S. McLeod, K. Newbold, and M. R. Haymart, “Thyroid Cancer,” Lancet 401, no. 10387 (2023): 1531–1544.
R. Vanholder, B. Domínguez‐Gil, M. Busic, et al., “Organ Donation and Transplantation: A Multi‐Stakeholder Call to Action,” Nature Reviews Nephrology 17 (2021): 554–568, https://doi.org/10.1038/s41581‐021‐00425‐3.
A. Eccher, I. Girolami, A. D'Errico, et al., “Management of Thyroid Nodules in Deceased Donors With Comparison Between Fine Needle Aspiration and Intraoperative Frozen Section in the Setting of Transplantation,” Progress in Transplantation 29, no. 4 (2019): 316–320.
N. Ahmed and D. Cheng‐Robles, “Damage Control Surgery Prior to Organ Harvesting,” Journal of Trauma 61, no. 4 (2006): 981–983. (discussion 943–944), https://doi.org/10.1097/01.ta.0000238617.17538.b3.
N. A. Fainberg, W. E. Morrison, S. West, R. Hasz, and M. P. Kirschen, “Organ Donation From Patients on Extracorporeal Membrane Oxygenation at the Time of Death,” Critical Care Explorations 4, no. 12 (2022): e0812, https://doi.org/10.1097/CCE.0000000000000812.
P. Bruzzone and S. Venettoni, “Legal Aspects of Organ Transplantation in Italy,” Transplantation Proceedings 40, no. 6 (2008): 1818–1819, https://doi.org/10.1016/j.transproceed.2008.05.004.
M. J. Page, J. E. McKenzie, P. M. Bossuyt, et al., “The PRISMA 2020 Statement: An Updated Guideline for Reporting Systematic Reviews,” British Medical Journal 372 (2021): n71.
N. R. Haddaway, M. J. Page, C. C. Pritchard, and L. A. McGuinness, “PRISMA2020: An R Package and Shiny App for Producing PRISMA 2020‐Compliant Flow Diagrams, With Interactivity for Optimised Digital Transparency and,” Open Synthesis Campbell Systematic Reviews 18 (2022): e1230, https://doi.org/10.1002/cl2.1230.
J. T. Adler, H. Yeh, G. Barbesino, and C. C. Lubitz, “Reassessing Risks and Benefits of Living Kidney Donors With a History of Thyroid Cancer,” Clinical Transplantation 31, no. 11 (2017): e13114, https://doi.org/10.1111/ctr.13114.
H. M. Kauffman, M. A. McBride, W. S. Cherikh, P. C. Spain, W. H. Marks, and A. M. Roza, “Transplant Tumor Registry: Donor Related Malignancies,” Transplantation 74 (2002): 358–362, https://doi.org/10.1097/00007890‐200208150‐00011.
L. A. Georgieva, E. M. Gielis, R. Hellemans, et al., “Single‐Center Case Series of Donor‐Related Malignancies: Rare Cases With Tremendous Impact,” Transplantation Proceedings 48, no. 8 (2016): 2669–2677, https://doi.org/10.1016/j.transproceed.2016.07.014.
R. Desai, D. Collett, C. J. Watson, P. Johnson, T. Evans, and J. Neuberger, “Cancer Transmission From Organ Donors‐Unavoidable But Low Risk,” Transplantation 94, no. 12 (2012): 1200–1207, https://doi.org/10.1097/TP.0b013e318272df41.
D. Malvi, A. Eccher, and L. Novelli, “Valutazione dell'idoneità del donatore in relazione a patologie neoplastiche (tumori solidi),” Version 2024.3, National Transplant Center (CNT), The Italian National Institute of Health and Italian Ministry of Health, accessed April 4, 2024, in ITALIAN only, https://www.trapianti.salute.gov.it/imgs/C_17_cntPubblicazioni_619_allegato.pdf.
D. Malvi, F. Vasuri, E. Albertini, et al., “Donors Risk Assessment in Transplantation: From the Guidelines to Their Real‐World Application,” Pathology, Research and Practice 255 (2024): 155210, https://doi.org/10.1016/j.prp.2024.155210.
S. Z. Ali, Z. W. Baloch, B. Cochand‐Priollet, F. C. Schmitt, P. Vielh, and P. A. VanderLaan, “The 2023 Bethesda System for Reporting Thyroid Cytopathology,” Thyroid 33, no. 9 (2023): 1039–1044, https://doi.org/10.1089/thy.2023.0141.
Y. C. Chan, C. L. Chen, C. C. Lin, et al., “Impact of Thyroid Incidentaloma on Liver Transplant: A Study of 1010 Recipients at a Single Center,” Annals of Transplantation 27 (2022): e934988, https://doi.org/10.12659/AOT.934988.
T. M. Cotton, J. Xin, J. Sandyhya, et al., “Frozen Section Analysis in the Post‐Bethesda Era,” Journal of Surgical Research 205, no. 2 (2016): 393–397, https://doi.org/10.1016/j.jss.2016.06.072.
C. A. Bollig, J. B. Jorgensen, R. P. Zitsch, and L. M. Dooley, “Utility of Intraoperative Frozen Section in Large Thyroid Nodules,” Otolaryngology and Head and Neck Surgery 160, no. 1 (2019): 49–56, https://doi.org/10.1177/0194599818802183.
G. F. Huber, P. Dziegielewski, T. W. Matthews, et al., “Intraoperative Frozen‐Section Analysis for Thyroid Nodules: A Step Toward Clarity or Confusion?,” Archives of Otolaryngology – Head & Neck Surgery 133, no. 9 (2007): 874–881, https://doi.org/10.1001/archotol.133.9.874.
J. Huang, J. Luo, J. Chen, et al., “Intraoperative Frozen Section Can Be Reduced in Thyroid Nodules Classified as Bethesda Categories V and VI,” Scientific Reports 7 (2017): 5244, https://doi.org/10.1038/s41598‐017‐05459‐x.
Z. Mao, Y. Ding, L. Wen, et al., “Combined Fine‐Needle Aspiration and Selective Intraoperative Frozen Section to Optimize Prediction of Malignant Thyroid Nodules: A Retrospective Cohort Study of More Than 3000 Patients,” Frontiers in Endocrinology 14 (2023): 1091200, https://doi.org/10.3389/fendo.2023.1091200.
J. P. Almeida, S. D. Couto Netto, R. P. Rocha, E. G. Pfuetzenreiter, Jr., and R. A. Dedivitis, “The Role of Intraoperative Frozen Sections for Thyroid Nodules,” Brazilian Journal of Otorhinolaryngology 75, no. 2 (2009): 256–260, https://doi.org/10.1016/s1808‐8694(15)30787‐4.
A. Sanabria, M. Zafereo, L. D. R. Thompson, et al., “Frozen Section in Thyroid Gland Follicular Neoplasms: It's High Time to Abandon It!,” Surgical Oncology 36 (2021): 76–81, https://doi.org/10.1016/j.suronc.2020.12.005.
Y. Kim, K. Kim, and I. Jang, “Analysis of Mortality Prognostic Factors Using Model for End‐Stage Liver Disease With Incorporation of Serum‐Sodium Classification for Liver Cirrhosis Complications: A Retrospective Cohort Study,” Medicine (Baltimore) 98, no. 45 (2019): e17862, https://doi.org/10.1097/MD.0000000000017862.
G. Van den Berghe, “Non‐Thyroidal Illness in the ICU: A Syndrome With Different Faces,” Thyroid 24, no. 10 (2014): 1456–1465, https://doi.org/10.1089/thy.2014.0201.
M. G. Ison and M. A. Nalesnik, “An Update on Donor‐Derived Disease Transmission in Organ Transplantation,” American Journal of Transplantation 11, no. 6 (2011): 1123–1130.
P. Fiaschetti, R. Pretagostini, D. Stabile, et al., “The Use of Neoplastic Donors to Increase the Donor Pool,” Transplantation Proceedings 44, no. 7 (2012): 1848–1850, https://doi.org/10.1016/j.transproceed.2012.06.030.
T. Benkö, D. P. Hoyer, F. H. Saner, J. W. Treckmann, A. Paul, and S. Radunz, “Liver Transplantation From Donors With a History of Malignancy: A Single‐Center Experience,” Transplantation direct 3, no. 11 (2017): e224.
A. Eccher, L. Lombardini, I. Girolami, et al., “How Safe Are Organs From Deceased Donors With Neoplasia? The Results of the Italian Transplantation Network,” Journal of Nephrology 32 (2019): 323–330.
Z. W. Baloch, S. L. Asa, J. A. Barletta, et al., “Overview of the 2022 WHO Classification of Thyroid Neoplasms,” Endocrine Pathology 33, no. 1 (2022): 27–63.
K. P. Croome, A. S. Barbas, B. Whitson, et al., “American Society of Transplant Surgeons Recommendations on Best Practices in Donation After Circulatory Death Organ Procurement,” American Journal of Transplantation 23 (2023): 171–179.
E. A. Engels, G. Haber, A. Hart, et al., “Predicted Cure and Survival Among Transplant Recipients With a Previous Cancer Diagnosis,” Journal of Clinical Oncology 39, no. 36 (2021): 4039–4048, https://doi.org/10.1200/JCO.21.01195.
C. Webb, P. Cronin, N. Gupta, et al., “Is Thyroid Cancer Prognosis Affected by Solid Organ Transplantation?,” Surgery 169, no. 1 (2021): 58–62, https://doi.org/10.1016/j.surg.2020.06.044.
A. E. Grulich, M. T. van Leeuwen, M. O. Falster, and C. M. Vajdic, “Incidence of Cancers in People With HIV/AIDS Compared With Immunosuppressed Transplant Recipients: A Meta‐Analysis,” Lancet 370, no. 9581 (2007): 59–67.
Y. Inamoto, N. N. Shah, B. N. Savani, et al., “Secondary Solid Cancer Screening Following Hematopoietic Cell Transplantation,” Bone Marrow Transplantation 50, no. 8 (2015): 1013–1023, https://doi.org/10.1038/bmt.2015.63.
W. P. Kluijfhout, F. T. Drake, J. D. Pasternak, et al., “De Novo Thyroid Cancer Following Solid Organ Transplantation—A 25‐Year Experience at a High‐Volume Institution With a Review of the Literature,” Journal of Surgical Oncology 115, no. 2 (2017): 105–108, https://doi.org/10.1002/jso.24495.
E. A. Engels, R. M. Pfeiffer, J. F. Fraumeni, et al., “Spectrum of Cancer Risk Among US Solid Organ Transplant Recipients,” Journal of the American Medical Association 306, no. 17 (2011): 1891–1901, https://doi.org/10.1001/jama.2011.1592.
D. Karamchandani, R. Arias‐Amaya, N. Donaldson, J. Gilbert, and K. M. Schulte, “Thyroid Cancer and Renal Transplantation: A Meta‐Analysis,” Endocrine‐Related Cancer 17, no. 1 (2010): 159–167, https://doi.org/10.1677/ERC‐09‐0191.
C. M. Kitahara, E. L. Yanik, P. W. Ladenson, et al., “Risk of Thyroid Cancer Among Solid Organ Transplant Recipients,” American Journal of Transplantation 17, no. 11 (2017): 2911–2921, https://doi.org/10.1111/ajt.14310.
M. Veroux, G. Giuffrida, S. Lo Bianco, et al., “Thyroid Disease and Cancer in Kidney Transplantation: A Single‐Center Analysis,” BMC Surgery 18, no. Suppl 1 (2019): 80, https://doi.org/10.1186/s12893‐018‐0408‐1.
J. Lee, J. J. Jeong, Y. S. Lee, et al., “Incidence and Clinical Behavior of Papillary Thyroid Carcinoma in Renal Allograft Recipients: A Single Center Experience,” Transplantation Proceedings 40 (2008): 3751–3754.
L. Hu, Y. Wu, F. Ju, Y. Zhang, and W. Wang, “Effects of Solid Organ Transplantation on the Risk of Developing Thyroid Cancer: A Systematic Review and Meta‐Analysis,” Gland Surgery 11, no. 4 (2022): 710–719, https://doi.org/10.21037/gs‐22‐137.
L. Hu, Y. Wu, F. Ju, Y. Zhang, and W. Wang, “Analysis of Clinicopathological Features of Papillary Thyroid Carcinoma in Solid Organ Transplant Recipients: A Retrospective Study,” Gland Surgery 11, no. 8 (2022): 1404–1414, https://doi.org/10.21037/gs‐22‐431.
H. Tisset, N. Kamar, I. Faugeron, et al., “Is Thyroid Cancer Recurrence Risk Increased After Transplantation?,” Journal of Clinical Endocrinology and Metabolism 98, no. 10 (2013): 3981–3988, https://doi.org/10.1210/jc.2013‐1357.
A. J. Mowery, M. J. Conlin, and D. R. Clayburgh, “Elevated Incidence of Head and Neck Cancer in Solid Organ Transplant Recipients,” Head & Neck 41 (2019): 4009–4017, https://doi.org/10.1002/hed.25937.

Auteurs

Luca Giovanni Locatello (LG)

Department of Otorhinolaryngology, Academic Hospital "Santa Maria Della Misericordia," Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.

Nicole Caiazza (N)

Department of Otorhinolaryngology, Academic Hospital "Santa Maria Della Misericordia," Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.

Federico Cavallo Ronchi (F)

Department of Otorhinolaryngology, Academic Hospital "Cattinara," Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy.

Anna Maria Bergamin-Bracale (AM)

Department of Otorhinolaryngology, Academic Hospital "Santa Maria Della Misericordia," Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.

Cesare Miani (C)

Department of Otorhinolaryngology, Academic Hospital "Santa Maria Della Misericordia," Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy.
Department of Medicine (DMED), University of Udine, Udine, Italy.

Classifications MeSH