Toxoplasma gondii Monitoring in Liver Transplantation Patients: A Single Center Cross-Sectional Study in an Italian Hospital
Open Access
- 7 May 2020
- Vol. 9 (5), 354
- https://doi.org/10.3390/pathogens9050354
Abstract
Toxoplasma gondii (TG) is one of the most widespread intracellular parasites in the world, despite the slight declining trend in industrialized countries. Whilst the infection is often asymptomatic in immunocompetent hosts, in immunocompromised patients such as organ transplant recipients it can have important clinical sequels with even fatal consequences. We retrospectively reviewed 568 primary liver transplants (LT) from deceased donors from 2012 to 2017. Data were analyzed adjusting for year, gender, and age. The study objective was to assess the incidence of post-transplant TG infection and adherence to international guidelines for primary chemoprophylaxis. Prior to transplantation, 42.4% of recipients tested seronegative and 56.5% seropositive, while 36.6% of donors were seropositive and 40.4% showed undetermined serology. Anti-TG antibody titer was higher in patients born abroad (71.4%) versus Italy (54.8%). Among recipients at high risk of post-transplant TG infection, 82.7% of them received chemoprophylaxis, while in 17.3% of cases no prophylaxis was administered. At a mean (SD) follow-up of 21.2 (12.4) months no case of TG infection has been observed. Despite the low rate of adherence to recommendations, prophylaxis of high-risk LT recipients provides control of post-transplant TG infection risk. Review of current guidelines is warranted for low-risk populations.This publication has 46 references indexed in Scilit:
- A 4-year evaluation of toxoplasmosis seroprevalence in the general population and in women of reproductive age in central ItalyEpidemiology and Infection, 2012
- Decreased prevalence and age-specific risk factors for Toxoplasma gondii IgG antibodies in The Netherlands between 1995/1996 and 2006/2007Epidemiology and Infection, 2010
- Myeloablative Conditioning Predisposes Patients forToxoplasma gondiiReactivation after Allogeneic Stem Cell TransplantationClinical Infectious Diseases, 2010
- Prevention of toxoplasmosis in transplant patientsClinical Microbiology & Infection, 2008
- Incidence and diagnosis of active toxoplasma infection among liver transplant recipients in Western TurkeyLiver Transplantation, 2008
- The Use of Donor and Recipient Screening for Toxoplasma in the Era of Universal Trimethoprim Sulfamethoxazole ProphylaxisTransplantation, 2008
- Fatal disseminated toxoplasmosis in a cardiac transplantation with seropositive match for Toxoplasma: Should prophylaxis be extended?Transplant Immunology, 2007
- First Case of Toxoplasmosis Following Small Bowel Transplantation and Systematic Review of Tissue-Invasive Toxoplasmosis Following Noncardiac Solid Organ TransplantationTransplantation, 2006
- Pretransplant Evaluation for Infections in Donors and Recipients of Solid OrgansClinical Infectious Diseases, 2001
- Toxoplasmosis in heart transplant recipientsEuropean Journal of Clinical Microbiology & Infectious Diseases, 1996