駭人：癌症細胞竟隨器官移植傳播

近日，有外媒報道，美國一名女性中風去世後，有五個人接受了她的器官移植，結果除了一名不久後離世的病人，其他四個人先後患上乳腺癌，最後只有一人治癒癌症活了下來。經證實，乳腺癌細胞都來自被捐贈的器官。

Photo: 1662222/Pixabay An extraordinary and terrifying medical case revealed in the July issue of the American Journal of Transplantation proves that organ transplants can pass not only certain infectious diseases to recipients, but in rare cases, also cancer.

《美國移植雜誌》七月刊披露的一個離奇駭人的病例證實，器官移植不但會把某些傳染性疾病傳給器官接受者，在極少數情況下還會把癌症傳給接受者。

Patients known to have malignant tumors are often not able to donate their organs, but that was not the case of a 53-year-old woman who died of a stroke in 2007. She had no known conditions that could prevent doctors from transplanting her organs, and repeated tests revealed no sign of cancer. The woman’s kidneys, lungs, liver and heart were transplanted into donor recipients, but instead of saving their lives, they infected four of the five recipients with cancer, while the fifth died of unrelated causes shortly after the transplant.

已知患有惡性腫瘤的病人通常不能捐獻自己的器官，但2007年死於中風的一名53歲女性並不屬於這種情況。她沒有任何已知的病症阻止醫生移植她的器官，而反覆的檢查也沒有顯示出癌症的跡象。這名女性的腎、肺、肝及心臟被移植給了幾個器官接受者，結果非但沒有救這些人的命，反而讓五個接受者中的四人都染上了癌症，而第五個人在接受器官移植後不久就因其他原因去世。

The four organ recipients had recovered well after the transplants, but 16 months later, the woman who had received the donor’s lung fell ill and was subsequently diagnosed with cancer in the lymph nodes in her chest. Unfortunately, we live in an age when someone is diagnosed with cancer every couple of minutes, but what made this case remarkable was that tests showed the cancerous cells were actually breast cancer cells. Further DNA analysis revealed that they had come from the organ donor.

四個器官接受者在接受移植後一開始都恢復得不錯，但16個月之後，接受肺移植的女性就病倒了，隨後被診斷出胸部的淋巴結有癌細胞。不幸的是，我們生活在一個每幾分鐘就有人被診斷出癌症的年代，但這個病例的離奇之處在於，測試結果顯示，這些癌細胞實際上是乳腺癌細胞。進一步的DNA分析揭示，乳腺癌細胞來自器官捐贈者。

The lung recipient’s cancer spread and she died about a year after her disease was discovered. At the time, the remaining three organ recipients were notified that the deceased had become infected with cancer from the organ she had received, and advised to get themselves tested regularly just to make sure the same thing doesn’t happen to them. Unfortunately, that wasn’t enough…

接受肺移植女性的癌細胞擴散，並在發現癌症一年後去世。此時醫院告知其餘三位器官接受者，逝者的癌症來自她被移植的器官，並建議他們定期做檢查，確保他們不會同樣染上癌症。不幸的是，這樣的防範還不夠……

In 2011, four years after the transplant, the liver recipient was diagnosed with breast cancer cells in her liver. She was given the option of undergoing another transplant, but she refused for fear of potential complications. She opted for radiation treatment, which proved successful at first, but the cancer returned, and she died in 2014.

2011年，在接受器官移植四年後，接受肝移植的人被診斷出肝臟中有乳腺癌細胞。醫生給她的選擇是再一次接受肝移植，但她因擔心出現潛在併發症拒絕了。她選擇接受放射療法，一開始還比較成功，但後來癌症復發，她於2014年去世。

The person who had received the left kidney in 2007, was diagnosed with cancer in 2013, six years after the transplant. The disease had already spread to several organs when it was discovered, and the patient passed away two months later.

2007年接受左腎移植的人於2013年，也就是移植6年後，被診斷出癌症。發現癌症時癌細胞已經擴散到幾個器官，病人於兩個月後離世。

The right kidney was transplanted into a 32-year-old man. In 2011, tests revealed breast cancer cells in his transplanted organ, but he underwent another surgery to have the kidney removed, underwent chemotherapy and stopped taking medicine that suppressed his immune system. He has been cancer free for 10 years.

右腎被移植到一個32歲的男子身上。2011年，檢查結果顯示，在他被移植的器官內發現了乳腺癌細胞，但他做了一個摘除腎臟的手術，接受了化療，並停服抑制免疫系統的藥物。如今距離他癌症痊癒已有十年。

"Many reports have shown that cancer transmission can occur in solid organ transplantation,” the authors of the recently published case note wrote. “However, this is the first report describing breast cancer transmission after a multi-organ procedure from one donor to four recipients.”

最近這篇病例解析報告的作者寫道：“許多報告顯示，癌症傳播可能在實體器官移植中發生。不過，這是首份描述一對四多器官移植中乳腺癌傳播的病例報告。”

It’s worth pointing out that while terrifying, this case is incredibly rare. Dr. Lewis Teperman, director of organ transplantation at Northwell Health in New Hyde Park, New York, writes that passing cancer through organ donation is “very uncommon”, with chances varying between 0.01 and 0.05 percent.

值得指出的是，儘管很駭人，這種情況還是十分罕見的。位於紐約新海德公園的諾斯維爾保健集團器官移植中心主任路易斯·塔伯曼醫生寫道，通過器官移植傳播癌症“很不尋常”，機率只有0.01%到0.05%之間。

It’s not clear exactly how the breast cancer remained undetected during the screening performed before the transplants, or how it was able to grow in each of the four patients. Researchers believe that the donor may have had “micro metastases”, groups of cells too small to be detected by imaging tests, and that immunosuppressant drugs played a part in helping the cancer spread. Such drugs are taken by organ recipients so that their bodies don’t reject the new organs, but that means that the cancer cells aren’t rejected either.

目前還不清楚爲什麼器官移植前的篩查沒有檢測出乳腺癌細胞，以及癌細胞爲什麼會在四個接受者體內生長。研究人員認爲，捐贈者身上的癌細胞也許有過“微轉移”，只是細胞羣太小，影像學檢查檢測不到。此外，器官接受者服用的免疫抑制劑也有助於癌細胞擴散。接受者服用這種藥物是爲了讓身體不排斥新器官，不過這意味着癌細胞也不受排斥。

"This extraordinary case points out the often fatal consequences of donor-derived breast cancer,” researchers concluded, “and suggests that removal of the donor organ and restoration of immunity can induce complete remission.”

研究人員得出結論說：“這個離奇病例說明，源於捐贈者的乳腺癌通常是致命的，並指出，摘除捐贈移植的器官、恢復免疫系統的正常運轉可以免受其害。”