Toxoplasma gondii Serostatus Is Not Associated With Impaired Long-Term Survival after Heart Transplantation

Hellemond, Jaap J. van; Domburg, Ron T. van; Çalışkan, Kadir; Birim, Özcan; Balk, A. H. M. M.

doi:10.1097/tp.0b013e3182a9274a

Cited by 20 publications

(21 citation statements)

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“…Both CMV serology donor–recipient mismatch and the occurrence of CMV disease were not significantly different between the two cohorts. Furthermore, we previously established that the Toxoplasma gondii sero‐status was not associated with long‐term survival after HT .…”

Section: Resultsmentioning

confidence: 99%

Improved long-term survival in Dutch heart transplant patients despite increasing donor age: the Rotterdam experience

et al. 2015

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SummaryOver the past decades donor and recipient characteristics and medical management of heart transplantation (HT) patients have changed markedly. We studied the impact of these changes on long-term clinical outcome. Data of all consecutive HT recipients in our center have been collected prospectively. Cohort A (n = 353) was defined as the adult pts transplanted between 1984 and 1999 and was compared with cohort B (n = 227) transplanted between 2000 and 2013. Compared with cohort A, recipients in cohort B had older donors (mean age 29 vs. 43 years, donors aged >50 year: 2% vs. 33%, respectively). Survival at 1 and 10 years in cohort A vs. B was 89% vs. 86% and 53% vs. 68%, respectively (P = 0.02). Cohort B pts were treated more often with tacrolimus-based immunosuppression (77% vs. 22%; P = <0.0001) and early statins post-HT (88% vs. 18%; P = 0.0001), while renal function was better conserved at 5 and 10 years (P = 0.001 and 0.02). Multivariate analysis showed significant reduction in 10-year mortality with tacrolimus-based immunosuppression (HR 0.27 and 95% CI 0.17-0.42), hypertension post-HT (HR 0.5, 95% CI 0.36-0.72), and revascularization (HR 0.28, 95% CI 0.15-0.52). In spite of the use of much older donors, the long-term outcome after HT has improved considerably in the last decade, probably due to the introduction of newer treatment modalities.

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Section: Resultsmentioning

confidence: 99%

Improved long-term survival in Dutch heart transplant patients despite increasing donor age: the Rotterdam experience

et al. 2015

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“…At the time of the study, our results showed that none of our patients who received chemoprophylaxis with TMP/SMX developed T gondii infection. Although prophylactic antibiotic regimen is recommended for all patients who receive heart transplant, it could negatively affect the patient's outcome by its side effects 16 . There are some alternatives for TMP/SMX such as pyrimethamine‐sulphadoxine which is preferred in some centers as it can be administered weekly.…”

Section: Discussionmentioning

confidence: 99%

Comparison of serologic status of Toxoplasma gondii infection in pre‐ and post‐heart transplantation in a pediatric population: A preliminary study

Orang

Sayyahfar

Mahdavi

et al. 2020

Transplant Infectious Dis

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Background Toxoplasmosis is an important opportunistic infection in immunocompromised children, especially in heart transplant recipients. This study aimed to investigate pre‐ and post‐transplant serology for toxoplasmosis along with post‐transplant PCR in pediatric heart transplant patients. Methods This cross‐sectional study was performed on 38 heart transplant recipients aged 1‐17 years, by the end of 2018. Pre‐ and post‐transplant IgM and IgG titrations were measured using ELISA method. Nested PCR of B1 gene was performed to identify Toxoplasma gondii (T gondii) infection after transplant. Results Totally, 11.4% of patients had positive IgG and 91.4% had negative IgM for toxoplasmosis before heart transplantation. The mean of pre‐transplant IgG titration for seropositive and seronegative patients was 22.32 ± 15.30 IU/mL and 1.49 ± 1.15 IU/mL, respectively (P < .001). All cases were on chemoprophylaxis with trimethoprim‐sulfamethoxazole (TMP/SMX). The mean of post‐transplant IgG titration was 1.62 ± 1.87 IU/mL, which was negative for all cases. Investigating pre‐transplant, IgM titration, 5.7% were positive, 91.4% were negative, and 2.9% were borderline. All cases were post‐transplant IgM negative. The mean of post‐transplant IgG titrations was significantly higher in the first 6 months (3.26 ± 2.68 IU/mL) compared to 6‐12 (1.30 ± 1.34 IU/mL; P = .039) and > 12 months (1.07 ± 1.27 IU/mL; P = .004) time periods. The result of PCR for B1 gene in all cases was negative. Conclusions Chemoprophylaxis with TMP/SMX seems to be effective in prevention of T gondii infection or reactivation among pediatric heart transplantation population. Anti‐T. gondii‐IgG level alone may not be sensitive enough for evaluation of the infection at least after 6 months post‐transplantation.

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“…reviewed their experience at Erasmus Medical Center in The Netherlands of the 582 heart transplant recipients transplanted between the inception of the program in 1986 and 2011 (1). With a median follow-up of 8.3 years, the authors demonstrate that Toxoplasma-seronegative recipients had mortality rate of 35% compared with 65% for Toxoplasmaseropositive recipients.…”

mentioning

confidence: 93%

Toxoplasma gondii Exposure in the Heart Transplant Recipient

Kittleson¹,

Kobashigawa²

2013

Transplantation

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Toxoplasma gondii Serostatus Is Not Associated With Impaired Long-Term Survival after Heart Transplantation

Cited by 20 publications

References 21 publications

Improved long-term survival in Dutch heart transplant patients despite increasing donor age: the Rotterdam experience

Improved long-term survival in Dutch heart transplant patients despite increasing donor age: the Rotterdam experience

Comparison of serologic status of Toxoplasma gondii infection in pre‐ and post‐heart transplantation in a pediatric population: A preliminary study

Toxoplasma gondii Exposure in the Heart Transplant Recipient

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