Potential for overlooked melanoma in solid organ donors with a severely dysplastic nevus

Current or recent malignancy is a contraindication to organ donation because of the risk of transmission. Given the profound organ shortage in the United States, transplant surgeons frequently consider potential deceased organ donors with a remote history of malignancy. However, a diagnosis of melanoma, at any time, is an absolute contraindication to organ donation.1 Melanoma is one of the cancers most commonly transmitted from donor to recipient, which is likely related to its pathophysiology. The behavior of melanoma can be modulated by immunity; melanoma can remain dormant in the donor and then reactivate in the recipient because of the intense immunosuppression required to prevent rejection.