Unexpected transmission of donor-derived diseases, including infections and malignancies, through organ transplantation are occasionally observed and reported. Subclinical, or otherwise undiagnosed, hematological malignancies in potential donors are rare events and typically not identifiable via standard donor evaluation or laboratory testing. Flow cytometric crossmatching (FCXM) is a specialized assay routinely performed in clinical histocompatibility laboratories for the evaluation of immunological compatibility between the recipients and the organ donors through the detection of donor-specific antibodies. Here, we report three unusual cases of undiagnosed hematological malignancies in the organ donors that were identified during routine pre-transplant FCXM evaluation through abnormalities observed in the lymphocyte staining profile, size and relative cell events which effectively prevented potential transmission of such donor-derived malignancies to the immunocompromised recipients.
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