Donor transmitted malignancy is a real disastrous risk when dealing with expanded criteria donors. As donor age is increasing, guidelines for cancer screening of the elderly brain dead organ donors must be evidence-based but systematic review of such is sparse. Based on a review of published liteature and ur 20 years  experience, we propose a new series of guidelines concerning screening for the four most common malignancies: breast colon, lung and prostate cancer. Prospective testing of the efficacy of such protocol will then follow.

Keywords: cancer transmission, brain dead organ donors, Transplantation