Cite Score:
0.65
ELSEVIER SCOPUS

Screen of Uremic Patients for Toxoplasmosis Before Kidney Transplantation

AUTHORS

Fatemeh Hayati 1 , * , Shokouh Shayanpour 1

AUTHORS INFORMATION

1 Department of Internal Medicine, Chronic Renal Failure Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran

ARTICLE INFORMATION

Shiraz E-Medical Journal: 16 (3); e26226
Published Online: March 31, 2015
Article Type: Letter
Received: December 19, 2014
Accepted: February 16, 2015
Crossmark

Crossmark

CHEKING

READ FULL TEXT

Keywords

Kidney Transplantation Toxoplasmosis Toxoplasma Antibodies

Copyright © 2015, Shiraz University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

Dear Editor,

With interest, we read the article by Beladi Mousavi and Faramarzi (1) entitled “Do we Need to Screen Uremic Patients for Toxoplasmosis before Kidney Transplantation” in your journal. In a cross sectional study, the author evaluated 22 patients with end stage renal disease (ESRD) candidate for kidney transplantation and 30 donors for toxoplasmosis before transplantation in Khuzestan province, Iran. The results of this study showed that about a half of donors and recipients candidate for kidney transplantation in the Khuzestan province of Iran had Toxoplasma IgG antibody and therefore exposure to the infection. In the end of the study, they suggested that both the recipient and the donor should be routinely tested for toxoplasmosis before transplantation to avoid kidney donation from seropositive donor to seronegative recipient (1). The results of the study are interesting, but it is limited due to short duration and small number of patients enrolled in the study and therefore multicenter clinical trials with long duration and larger number of patients are needed for better evaluation of this suggestion. Although the results of the study are limited, we agree with the author for this suggestion. Toxoplasmosis is an opportunistic pathogen among immunocompromised patients including solid organ transplant recipients and it has been recognized as a potential donor-to-host transmission infection after transplantation (2-5). It can contribute in increment of morbidity and mortality in these patients (6-13).

The transmission of infection occurs mainly in seronegative heart transplant recipients from seropositive donors. It is also suggested that the myocardium is one of the sites, which the cysts of Toxoplasma gondii are located and therefore the transmission of infection occurs after heart transplantation from seropositive donors to seronegative recipients (14). Transmission of infection from seropositive donors to seronegative recipients has been described infrequently after liver transplantation (15). The transmission of infection from seropositive donors to seronegative recipients is also infrequent after renal transplantation; however, the mortality of this complication is high among renal transplant recipient and as 50% based on some studies; therefore, efforts to identify patients at risk or to avoid kidney donation from seropositive donors are required (16).

Screening recipient candidate for solid organ transplantation for IgM and IgG anti-toxoplasma antibodies before transplantation is also helpful for better follow-up of seropositive recipients for reactivation of latent tissue cysts following immunosuppressive treatments (17). It has been reported that immunosuppressive treatments after transplantation could reactivate latent tissue cysts to active toxoplasmosis (18).

Acknowledgements
Footnote
References
  • 1. Beladi Mousavi SS, Faramarzi M. Do we Need to Screen Uremic Patients for Toxoplasmosis before Kidney Transplantation? Shiraz E-Med J. 2013; 14(4)
  • 2. Velimirovic B. Toxoplasmosis in immunosuppression and AIDS. Infection. 1984; 12(5) : 315 -7 [PubMed]
  • 3. Montoya JG, Liesenfeld O. Toxoplasmosis. Lancet. 2004; 363(9425) : 1965 -76 [DOI][PubMed]
  • 4. Engstrom RJ, Holland GN, Nussenblatt RB, Jabs DA. Current practices in the management of ocular toxoplasmosis. Am J Ophthalmol. 1991; 111(5) : 601 -10 [PubMed]
  • 5. Gharavi MJ, Oormazdi H, Roointan ES. A Comparative Study on Sensitivity and Specificity of Conventional and Unconventional IgG and IgM Assays for Diagnosis of Toxoplasmosis. Iran J Public Health. 2008; 37(4) : 42 -5
  • 6. Beladi Mousavi SS, Alemzadeh Ansari MJ, Cheraghian B. Outcome of patients on haemodialysis in Khuzestan, Iran. NDT plus. 2011; 4(2) : 143 -4
  • 7. Beladi-Mousavi SS, Alemzadeh-Ansari MJ, Alemzadeh-Ansari MH, Beladi-Mousavi M. Long-term survival of patients with end-stage renal disease on maintenance hemodialysis: a multicenter study in Iran. Iran J Kidney Dis. 2012; 6(6) : 452 -6 [PubMed]
  • 8. Hebraud B, Kamar N, Borde JS, Bessieres MH, Galinier M, Rostaing L. Unusual presentation of primary toxoplasmosis infection in a kidney-transplant patient complicated by an acute left-ventricular failure. NDT Plus. 2008; 1(6) : 429 -32 [DOI][PubMed]
  • 9. Beladi Mousavi SS, Sametzadeh M, Hayati F, Fatemi SM. Evaluation of acquired cystic kidney disease in patients on hemodialysis with ultrasonography. Iran J Kidney Dis. 2010; 4(3) : 223 -6 [PubMed]
  • 10. Robin P, Carlos VP. Infections in solid-organ transplant recipients. Clin Mic Rev. 1997; 10(107)
  • 11. Beladi-Mousavi SS, Beladi-Mousavi M, Hayati F, Talebzadeh M. Effect of intranasal DDAVP in prevention of hypotension during hemodialysis. Nefrologia. 2012; 32(1) : 89 -93 [PubMed]
  • 12. Trikha I, Wig N. Management of toxoplasmosis in AIDS. Indian J Med Sci. 2001; 55(2) : 87 -98 [PubMed]
  • 13. Beladi Mousavi SS, Tavazoe M, Hayati F, Sametzadeh M. Arterio-Venous Fistula Recirculation in Hemodialysis: Causes and Prevalences. Shiraz E-Med J. 2010; 11(4)
  • 14. Orr KE, Gould FK, Short G, Dark JH, Hilton CJ, Corris PA, et al. Outcome of Toxoplasma gondii mismatches in heart transplant recipients over a period of 8 years. J Infect. 1994; 29(3) : 249 -53 [PubMed]
  • 15. Mayes JT, O'Connor BJ, Avery R, Castellani W, Carey W. Transmission of Toxoplasma gondii infection by liver transplantation. Clin Infect Dis. 1995; 21(3) : 511 -5 [PubMed]
  • 16. Gharavi MJ, Jalali S, Khademvatan S, Heydari S. Serological evaluation of anti-toxoplasma IgM and IgG antibodies in renal transplant recipient's before and after transplant by ELFA, ELISA and ISAGA methods. koomesh. 2012; 13(2) : 177 -82
  • 17. Vejdani M. Evaluation of Toxoplasma antibody levels in 50 kidney donors and recipients. J Kermanshah Univ Med Sci. 2008; 13(1)
  • 18. Seong DC, Przepiorka D, Bruner JM, Van Tassel P, Lo WK, Champlin RE. Leptomeningeal toxoplasmosis after allogeneic marrow transplantation. Case report and review of the literature. Am J Clin Oncol. 1993; 16(2) : 105 -8 [PubMed]
  • COMMENTS

    LEAVE A COMMENT HERE: