1887

Abstract

Approximately one-third of the world's population has infection, and one of the main routes of transmission is organ transplantation. The aim of this study was to evaluate the impact of infection on liver transplantation patients.

We searched PubMed, Lilacs, Medline, Science direct, Scielo, Ebsco, Springer, Wiley, Ovid and Google Scholar for reports published up to June 2017, and a systematic review was performed.

Twenty cases were analysed before and after liver transplantation. Primary and reactivated infections were investigated. Before transplantation, positive IgG antibodies were the predominant serological markers in donors and recipients: 40 % (D+/R−), 20 % (D+/R+) and 20 % (D/R+). IgM was present in only 5 % of the donors (D+/R−). In four cases, the serological markers were not specified or were negative (D?/R? or D?/R−). After transplantation, IgM anti- antibodies were found in 30 % of the recipients, and in 67 % of the seronegative recipients the presence of DNA or tachyzoites was reported, suggesting a primary infection. Clinical symptoms were meningitis, massive cerebral oedema, encephalitis and seizures. Treatment was administered in 70 % of the patients, and 40 % died after presenting symptoms associated with infection.

Although we review infection and liver transplantation cases, problems associated with the parasite may be greater than identified. Hence, follow-up studies on infection in liver transplantation patients are recommended.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000694
2018-04-01
2024-03-28
Loading full text...

Full text loading...

/deliver/fulltext/jmm/67/4/499.html?itemId=/content/journal/jmm/10.1099/jmm.0.000694&mimeType=html&fmt=ahah

References

  1. Brandon-Mong GJ, Che Mat Seri NA, Sharma RS, Andiappan H, Tan TC et al. Seroepidemiology of toxoplasmosis among people having close contact with animals. Front Immunol 2015; 6:143 [View Article][PubMed]
    [Google Scholar]
  2. Pereira KS, Franco RM, Leal DA. Transmission of toxoplasmosis (Toxoplasma gondii) by foods. Adv Food Nutr Res 2010; 60:1–19 [View Article][PubMed]
    [Google Scholar]
  3. Galván-Ramírez ML, Rincón Sánchez AR, Bernal Redondo RM. Chapter 10. Diagnostic of opportunistic parasites in liver transplantation. In Bruyn O, Peeters S. (editors) Parasitology Research Trends New York: Nova Science Publishers; 2010
    [Google Scholar]
  4. Siegel SE, Lunde MN, Gelderman AH, Halterman RH, Brown JA et al. Transmission of toxoplasmosis by leukocyte transfusion. Blood 1971; 37:388–394[PubMed]
    [Google Scholar]
  5. Galván Ramirez ML, Covarrubias X, Rodríguez R, Troyo R, Alfaro N et al. Toxoplasma gondii antibodies in Mexican blood donors. Transfusion 2005; 45:281–282 [View Article][PubMed]
    [Google Scholar]
  6. Foroutan-Rad M, Majidiani H, Dalvand S, Daryani A, Kooti W et al. Toxoplasmosis in blood donors: a systematic review and meta-analysis. Transfus Med Rev 2016; 30:116–122 [View Article][PubMed]
    [Google Scholar]
  7. el-On J, Peiser J. Toxoplasma and toxoplasmosis. Harefuah 2003; 142:1:48–55
    [Google Scholar]
  8. Ramos JM, Milla A, Rodríguez JC, Padilla S, Masiá M et al. Seroprevalence of Toxoplasma gondii infection among immigrant and native pregnant women in Eastern Spain. Parasitol Res 2011; 109:1447–1452 [View Article][PubMed]
    [Google Scholar]
  9. Derouin F, Pelloux H. ESCMID Study Group on Clinical Parasitology Prevention of toxoplasmosis in transplant patients. Clin Microbiol Infect 2008; 14:1089–1101 [View Article][PubMed]
    [Google Scholar]
  10. Aubert D, Foudrinier F, Villena I, Pinon JM, Biava MF et al. PCR for diagnosis and follow-up of two cases of disseminated toxoplasmosis after kidney grafting. J Clin Microbiol 1996; 34:1347[PubMed]
    [Google Scholar]
  11. de La Garza RG, Sarobe P, Merino J, Lasarte JJ, D'Avola D et al. Trial of complete weaning from immunosuppression for liver transplant recipients: factors predictive of tolerance. Liver Transpl 2013; 19:937–944 [View Article][PubMed]
    [Google Scholar]
  12. Chiquet C, Fleury J, Blanc-Jouvan M, Wallon M, Boibieux A. [Acquired ocular toxoplasmosis (panuveitis) after liver transplantation]. J Fr Ophtalmol 2000; 23:375–379[PubMed]
    [Google Scholar]
  13. Laibe S, Ranque S, Curtillet C, Faraut F, Dumon H et al. Timely diagnosis of disseminated toxoplasmosis by sputum examination. J Clin Microbiol 2006; 44:646–648 [View Article][PubMed]
    [Google Scholar]
  14. Ascher NL, Stock PG, Bumgardner GL, Payne WD, Najarian JS. Infection and rejection of primary hepatic transplant in 93 consecutive patients treated with triple immunosuppressive therapy. Surg Gynecol Obstet 1988; 167:474–484[PubMed]
    [Google Scholar]
  15. Ferreira MS, Borges AS. Some aspects of protozoan infections in immunocompromised patients- a review. Mem Inst Oswaldo Cruz 2002; 97:443–457 [View Article][PubMed]
    [Google Scholar]
  16. Garbino J, Romand JA, Pittet D, Giostra E, Mentha G et al. Infection and rejection in liver transplant patients: a 10-year Swiss single-centre experience. Swiss Med Wkly 2005; 135:587–593[PubMed]
    [Google Scholar]
  17. Batista MV, Pierrotti LC, Abdala E, Clemente WT, Girão ES et al. Endemic and opportunistic infections in Brazilian solid organ transplant recipients. Trop Med Int Health 2011; 16:1134–1142 [View Article][PubMed]
    [Google Scholar]
  18. Anthony CW. Disseminated toxoplasmosis in a liver transplant patient. J Am Med Womens Assoc 1972; 27:601–603
    [Google Scholar]
  19. Fernàndez-Sabé N, Cervera C, Fariñas MC, Bodro M, Muñoz P et al. Risk factors, clinical features, and outcomes of toxoplasmosis in solid-organ transplant recipients: a matched case-control study. Clin Infect Dis 2012; 54:355–361 [View Article][PubMed]
    [Google Scholar]
  20. Gourishankar S, Doucette K, Fenton J, Purych D, Kowalewska-Grochowska K et al. The use of donor and recipient screening for Toxoplasma in the era of universal trimethoprim sulfamethoxazole prophylaxis. Transplantation 2008; 85:980–985 [View Article]
    [Google Scholar]
  21. Kusne S, Dummer JS, Ho M, Whiteside T, Rabin BS et al. Self-limited toxoplasma parasitemia after liver transplantation. Transplantation 1987; 44:457–458[PubMed] [Crossref]
    [Google Scholar]
  22. Mayes JT, O'Connor BJ, Avery R, Castellani W, Carey W et al. Transmission of Toxoplasma gondii infection by liver transplantation. Clin Infect Dis 1995; 21:511–515 [View Article][PubMed]
    [Google Scholar]
  23. Singh N, Gayowski T, Wagener M. Pneumotis in a liver transplant recipient: implications for diagnostic. Liver Transpl Surg 1996; 4:299–300 [Crossref]
    [Google Scholar]
  24. Wendum D, Carbonell N, Svrcek M, Chazouilléres O, Fléjou JF. Fatal disseminated toxoplasmosis in a toxoplasma seropositive liver transplant recipient. J Clin Pathol 2002; 55:637 [View Article][PubMed]
    [Google Scholar]
  25. Barcán LA, Dallurzo ML, Clara LO, Valledor A, Macías S et al. Toxoplasma gondii pneumonia in liver transplantation: survival after a severe case of reactivation. Transpl Infect Dis 2002; 4:93–96 [View Article][PubMed]
    [Google Scholar]
  26. Salt A, Sutehall G, Sargaison M, Woodward C, Barnes ND et al. Viral and Toxoplasma gondii infections in children after liver transplantation. J Clin Pathol 1990; 43:63–67 [View Article][PubMed]
    [Google Scholar]
  27. Botterel F, Ichai P, Feray C, Bouree P, Saliba F et al. Disseminated toxoplasmosis, resulting from infection of allograft, after orthotopic liver transplantation: usefulness of quantitative PCR. J Clin Microbiol 2002; 40:1648–1650 [View Article][PubMed]
    [Google Scholar]
  28. Hommann M, Schotte U, Voigt R, Glutig H, Grube T et al. Cerebral toxoplasmosis after combined liver-pancreas-kidney and liver-pancreas transplantation. Transplant Proc 2002; 34:2294–2295 [View Article][PubMed]
    [Google Scholar]
  29. Vaessen N, Verweij JJ, Spijkerman IJ, van Hoek B, van Lieshout L. Fatal disseminated toxoplasmosis after liver transplantation: improved and early diagnosis by PCR. Neth J Med 2007; 65:222[PubMed]
    [Google Scholar]
  30. Miltgen G, Paillot J, Vanlemmens C, di Martino V, Heyd B et al. Fatal acute respiratory distress by Toxoplasma gondii in a toxoplasma seronegative liver transplant recipient. New Microbiol 2016; 39:160–162[PubMed]
    [Google Scholar]
  31. Lappalainen M, Jokiranta TS, Halme L, Tynninen O, Lautenschlager I et al. Disseminated toxoplasmosis after liver transplantation: case report and review. Clin Infect Dis 1998; 27:1327–1328 [View Article][PubMed]
    [Google Scholar]
  32. Assi MA, Rosenblatt JE, Marshall WF. Donor-transmitted toxoplasmosis in liver transplant recipients: a case report and literature review. Transpl Infect Dis 2007; 9:132–136 [View Article][PubMed]
    [Google Scholar]
  33. Singer MA, Hagler WS, Grossniklaus HE. Toxoplasma gondii retinochoroiditis after liver transplantation. Retina 1993; 13:40–45 [View Article][PubMed]
    [Google Scholar]
  34. Blanc-Jouvan M, Boibieux A, Fleury J, Fourcade N, Gandilhon F et al. Chorioretinitis following liver transplantation: detection of Toxoplasma gondii in aqueous humor. Clin Infect Dis 1996; 22:184–185 [View Article][PubMed]
    [Google Scholar]
  35. Galván Ramírez ML, Castillo-de-León Y, Espinoza-Oliva M, Bojorques-Ramos MC, Rodríguez-Pérez LR et al. Acute infection of Toxoplasma gondii and cytomegalovirus reactivation in a pediatric patient receiving liver transplant. Transpl Infect Dis 2006; 8:233–236 [View Article][PubMed]
    [Google Scholar]
  36. Caner A, Döşkaya M, Karasu Z, Değirmenci A, Guy E et al. Incidence and diagnosis of active Toxoplasma infection among liver transplant recipients in Western Turkey. Liver Transpl 2008; 14:1526–1532 [View Article][PubMed]
    [Google Scholar]
  37. Webb GJ, Shah H, David MD, Tiew S, Beare N et al. Post-prophylaxis Toxoplasma chorioretinitis following donor-recipient mismatched liver transplantation. Transpl Infect Dis 2016; 18:805–808 [View Article][PubMed]
    [Google Scholar]
  38. Green S. Systematic reviews and meta-analysis. Singapore Med J 2005; 46:270–274[PubMed]
    [Google Scholar]
  39. Clarke M. Systematic reviews and the Cochrane Collaboration. Br J Surg 2007; 94:391–392 [Crossref]
    [Google Scholar]
  40. Ali-Heydari S, Keshavarz H, Shojaee S, Mohebali M. Diagnosis of antigenic markers of acute toxoplasmosis by IgG avidity immunoblotting. Parasite 2013; 20:18 [View Article][PubMed]
    [Google Scholar]
  41. Uçkay I, Wunderli W, Giostra E, Majno P, Mentha G et al. False serologic evidence for acute primary toxoplasmosis during liver transplantation for fulminant hepatitis B: a case report. Transplant Proc 2009; 41:4425–4427 [View Article][PubMed]
    [Google Scholar]
  42. Bretagne S. Molecular diagnostics in clinical parasitology and mycology: limits of the current polymerase chain reaction (PCR) assays and interest of the real-time PCR assays. Clin Microbiol Infect 2003; 9:505–511 [View Article][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.000694
Loading
/content/journal/jmm/10.1099/jmm.0.000694
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error