Toxoplasmosis in Transplant Recipients, Europe, 2010-2014
Journal Paper/Review - Aug 1, 2018
Robert-Gangneux Florence, Meroni Valeria, Dupont Damien, Botterel Françoise, Garcia José M Aguado, Brenier-Pinchart Marie-Pierre, Accoceberry Isabelle, Akan Hamdi, Abbate Isabella, Boggian Katia, Bruschi Fabrizio, Carratala Jordi, David Miruna, Drgona Lubos, Djurković-Djaković Olgica, Farinas Maria Carmen, Genco Francesca, Gkrania-Klotsas Effrossyni, Groll Andreas H, Guy Edward, Hirzel Cédric, Khanna Nina, Kurt Özgür, Junie Lia Monica, Lazzarotto Tiziana, Len Oscar, Mueller Nicolas J, Munoz Patricia, Pana Zoi Dorothea, Roilides Emmanuel, Stajner Tijana, Van Delden Christian, Villena Isabelle, Pelloux Hervé, Manuel Oriol
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.