Toxoplasmosis in Transplant Recipients, Europe, 2010–2014

• DOI: 10.3201/eid2408.180045
• Publication Date: 2018-06-27T14:20:27Z
• Authors: Florence Robert-G...; Valeria Meroni; Damien Dupont; Françoise Botterel; José M. Aguado Ga...; Marie-Pierre Bren...; Isabelle Accoceberry; Hamdi Akan; Isabella Abbate; Katia Boggian; Fabrizio Bruschi; Jordi Carratalà; Miruna David; Lubos Drgona; Olgica Djurković-...; Maria Carmen Farinas; Francesca Genco; Effrossyni Gkrani...; Andreas H. Groll; Edward Guy; Cédric Hirzel; Nina Khanna; Özgür Kurt; Lia Monica Junie; Tiziana Lazzarotto; Oscar Len; Nicolas J. Mueller; Patricia Munoz; Zoi Dorothea Pana; Emmanuel Roilides; Tijana Stajner; Christian van Delden; Isabelle Villena; Hervé Pelloux; Oriol Manuel
• Keywords: Adult; Paràsits; [SDV]Life Sciences [q-bio]; Antibiòtics; Infectious and parasitic diseases; RC109-216; parasites; Chemoprophylaxis; 03 medical and health sciences; transplant recipient; Antibiotics; Risk Factors; info:eu-repo/classification/ddc/617; Humans; Parasites; toxoplasma infection; hematopoietic stem cell transplant; cerebral toxoplasmosis; Retrospective Studies; Cerebral toxoplasmosis; Toxoplasma infection; Transplantation; 0303 health sciences; ddc:617; Research; chemoprophylaxis; R; Hematopoietic Stem Cell Transplantation; Organ Transplantation; Middle Aged; cotrimoxazole; Transplant Recipients; Europe; Toxoplasma; cerebral toxoplasmosis; chemoprophylaxis; cotrimoxazole; hematopoietic stem cell transplant; parasites; toxoplasma infection; transplant recipient; transplantation; Cotrimoxazole; 3. Good health; Europe; Medicine; Hematopoietic stem cell transplant; Europa; Toxoplasmosi gondii, prevention practices, prevalence, outcomes, hematopoietic stem cell transplant, solid organ transplant; Toxoplasma; Transplant recipient; Toxoplasmosis; transplantation

Transplantation activity is increasing, leading to a growing number of patients at risk for toxoplasmosis. We reviewed toxoplasmosis prevention practices, prevalence, and outcomes for hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT; heart, kidney, or liver) patients in Europe. We collected electronic data on the transplant population and prevention guidelines/regulations and clinical data on toxoplasmosis cases diagnosed during 2010-2014. Serologic pretransplant screening of allo-hematopoietic stem cell donors was performed in 80% of countries, screening of organ donors in 100%. SOT recipients were systematically screened in 6 countries. Targeted anti-Toxoplasma chemoprophylaxis was heterogeneous. A total of 87 toxoplasmosis cases were recorded (58 allo-HSCTs, 29 SOTs). The 6-month survival rate was lower among Toxoplasma-seropositive recipients and among allo-hematopoietic stem cell and liver recipients. Chemoprophylaxis improved outcomes for SOT recipients. Toxoplasmosis remains associated with high mortality rates among transplant recipients. Guidelines are urgently needed to standardize prophylactic regimens and optimize patient management.