Transfusion-Associated Babesiosis after Heart Transplant

Lux, Joseph Z.; Weiss, Don; Linden, Jeanne V.; Kessler, Debra; Herwaldt, Barbara L.; Wong, Susan J.; Keithly, Jan S.; Della‐Latta, Phyllis; Scully, Brian E.

doi:10.3201/eid0901.020149

Cited by 46 publications

(50 citation statements)

References 19 publications

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“…To date, only four cases of B. microti infection have been described in the context of SOT, and in all of those cases, the mechanism of transmission was attributed to a transfusion of infected blood at the time of transplantation (150,232,288,344). Three cases occurred in renal transplant patients, and one occurred following a heart transplant.…”

Section: Other Parasitic Infectionsmentioning

confidence: 99%

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Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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Section: Other Parasitic Infectionsmentioning

confidence: 99%

“…It is a virus that exhibits T-cell tropism, causes the proliferation of T cells, and has a tendency to produce persistent infection. HTLV-1 and -2 infections are lifelong infections (232).…”

Section: Viral Infections Infections Caused By Htlv-1/2mentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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“…The risk of developing severe babesiosis also increases with age, with individuals over the age of 50 years being predisposed to severe symptoms (263,334,389). Other groups predisposed to a severe, potentially lethal form of babesiosis include those with HIV (198,214,592), those receiving immunosuppressive therapy (including transplant patients), those with leukocyte malignancies, and those without a spleen (226,331,333,366,389,574). The predisposition of splenectomized humans to a more severe form of disease is a feature that is also common to malaria parasites.…”

Section: Babesia Sppmentioning

confidence: 99%

“…Small mammals (235,307,492,539,574) and ruminants (275,354,501,542,574) serve as reservoirs for Babesia spp., and humans usually become infected after an infected Ixodes tick takes a blood meal. However, transmission via blood transfusion has also been widely reported (50,86,246,272,366,379).…”

Section: Babesia Sppmentioning

confidence: 99%

Importance of Nonenteric Protozoan Infections in Immunocompromised People

et al. 2010

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SUMMARY There are many neglected nonenteric protozoa able to cause serious morbidity and mortality in humans, particularly in the developing world. Diseases caused by certain protozoa are often more severe in the presence of HIV. While information regarding neglected tropical diseases caused by trypanosomatids and Plasmodium is abundant, these protozoa are often not a first consideration in Western countries where they are not endemic. As such, diagnostics may not be available in these regions. Due to global travel and immigration, this has become an increasing problem. Inversely, in certain parts of the world (particularly sub-Saharan Africa), the HIV problem is so severe that diseases like microsporidiosis and toxoplasmosis are common. In Western countries, due to the availability of highly active antiretroviral therapy (HAART), these diseases are infrequently encountered. While free-living amoebae are rarely encountered in a clinical setting, when infections do occur, they are often fatal. Rapid diagnosis and treatment are essential to the survival of patients infected with these organisms. This paper reviews information on the diagnosis and treatment of nonenteric protozoal diseases in immunocompromised people, with a focus on patients infected with HIV. The nonenteric microsporidia, some trypanosomatids, Toxoplasma spp., Neospora spp., some free-living amoebae, Plasmodium spp., and Babesia spp. are discussed.

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“…However, there have been at least three cases of babesiosis in recipients of solid-organ transplants (two renal and one cardiac) that were not directly attributable to the transplanted organ (43,82,96,113). In two of these cases, blood transfusions at the time of transplantation or shortly thereafter were implicated as the source of the Babesia infection, while the other organ recipient, who was asplenic, was likely infected naturally after experiencing multiple tick bites during a camping trip in Wisconsin 18 years after receiving a renal transplant (113).…”

Section: Routes Of Transmissionmentioning

confidence: 99%

Transfusion-TransmittedBabesiaspp.: Bull's-Eye onBabesia microti

2011

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SUMMARY Babesia spp. are intraerythrocytic protozoan parasites of animals and humans that cause babesiosis, a zoonotic disease transmitted primarily by tick vectors. Although a variety of species or types of Babesia have been described in the literature as causing infection in humans, the rodent parasite Babesia microti has emerged as the focal point of human disease, especially in the United States. Not only has B. microti become established as a public health concern, this agent is increasingly being transmitted by blood transfusion: estimates suggest that between 70 and 100 cases of transfusion-transmitted Babesia (TTB) have occurred over the last 30 years. A recent upsurge in TTB cases attributable to B. microti , coupled with at least 12 fatalities in transfusion recipients diagnosed with babesiosis, has elevated TTB to a key policy issue in transfusion medicine. Despite clarity on a need to mitigate transmission risk, few options are currently available to prevent the transmission of B. microti by blood transfusion. Future mitigation efforts may stress serological screening of blood donors in regionalized areas of endemicity, with adjunct nucleic acid testing during the summer months, when acute infections are prevalent. However, several hurdles remain, including the absence of a licensed blood screening assay and a thorough cost-benefit analysis of proposed interventions. Despite current obstacles, continued discussion of TTB without proactive intervention is no longer a viable alternative.

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Transfusion-Associated Babesiosis after Heart Transplant

Cited by 46 publications

References 19 publications

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Importance of Nonenteric Protozoan Infections in Immunocompromised People

Transfusion-TransmittedBabesiaspp.: Bull's-Eye onBabesia microti

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