Cerebral toxoplasmosis after combined liver-pancreas-kidney and liver-pancreas transplantation

Hommann, Merten; Schotte, U.; Voigt, R; Glutig, H; Grube, Thomas; Küpper, B.; Kornberg, Arno; Richter, Klaus; Scheele, J.

doi:10.1016/s0041-1345(02)03241-4

Cited by 18 publications

(17 citation statements)

References 11 publications

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“…A Medline search was performed using the terms ‘toxoplasmosis’ and ‘transplant.’ We encountered a total of 12 reported cases of toxoplasmosis in adult liver transplant recipients in the English literature from 1971 until November 2005 (Table 1) (5–7, 12–19). Included are 1 patient with combined liver/kidney/pancreas transplants and another with combined liver/pancreas (17).…”

Section: Literature Reviewmentioning

confidence: 99%

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Donor‐transmitted toxoplasmosis in liver transplant recipients: a case report and literature review

Assi

Rosenblatt

Marshall

2007

Transplant Infectious Dis

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Transmission of toxoplasmosis via liver transplantation is extremely uncommon. Here we report the case of a 52-year-old male liver transplant recipient who on day 32 post transplant developed pneumonia followed by respiratory failure. Donor-transmitted toxoplasmosis was confirmed as the etiology by both serologic and molecular testing. We also review all previously published cases of toxoplasmosis in the English-language adult liver transplant literature.

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Section: Literature Reviewmentioning

confidence: 99%

“…Seven of 12 patients died. Of those, only 3 were diagnosed and treated ante mortem (2 with pyrimethamine/sulfadiazine [7, 17] and 1 with pyrimethamine/clindamycin [16]). Only 3 of the reported cases were documented as primary infections transmitted from the donor livers (seropositive donor with seronegative recipient) (5–7).…”

Section: Literature Reviewmentioning

confidence: 99%

Donor‐transmitted toxoplasmosis in liver transplant recipients: a case report and literature review

Assi

Rosenblatt

Marshall

2007

Transplant Infectious Dis

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“…However, several conditions may appear later in life that impair the function of the immune system and its ability to control the reactivation of T. gondii tissue cysts. These include infectious diseases such as human immunodeficiency virus infection (28-30) and treatment with immunosuppressive and chemotherapeutic agents commonly given to transplant and cancer patients, respectively (3,18,22,27,32,45). Reactivation of tissue cysts in these individuals leads to the recrudescence of T. gondii infection (15), a life-threatening condition that in the long term responds poorly to therapy and often develops into encephalitis (16,19,26,28,30,42).…”

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confidence: 99%

Temporal and Spatial Distribution of Toxoplasma gondii Differentiation into Bradyzoites and Tissue Cyst Formation In Vivo

et al. 2008

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During Toxoplasma gondii infection, a fraction of the multiplying parasites, the tachyzoites, converts into bradyzoites, a dormant stage, which form tissue cysts localized mainly in brain, heart, and skeletal muscles that persist for several years after infection. At this stage the parasite is protected from the immune system, and it is believed to be inaccessible to drugs. While the long persistence of tissue cysts does not represent a medical problem for healthy individuals, this condition represents a major risk for patients with a compromised immune system, who can develop recrudescent life-threatening T. gondii infections. We have investigated for the first time the dynamics and the kinetics of tachyzoite-to-bradyzoite interconversion and cyst formation in vivo by using stage-specific bioluminescent parasites in a mouse model. Our findings provide a new framework for understanding the process of bradyzoite differentiation in vivo. We have also demonstrated that complex molecules such as D-luciferin have access to tissue cysts and are metabolically processed, thus providing a rationale for developing drugs that attack the parasite at this developmental stage.Toxoplasma gondii is transmitted to humans by the ingestion of either undercooked meat containing tissue cysts or poorly washed vegetables contaminated with oocysts from cat feces. The infection normally progresses as a mild, self-resolving disease. Initially T. gondii multiplies rapidly inside cells of different tissues and organs in the form of tachyzoites. Within 2 to 3 weeks, infected individuals develop a potent immune response that effectively controls the growth of the parasite. Before being eliminated by the immune system, some of the tachyzoites develop into a dormant stage, the bradyzoites, which multiply at a much lower rate than tachyzoites and become progressively enclosed in a dense matrix surrounded by a thick wall, the tissue cyst (11,33,46). At this stage the parasite is much less vulnerable to attack by the immune system. Tissue cysts can persist for several years in the brain, the heart, and the skeletal muscle of individuals who had been previously infected with T. gondii (34,46,49). Tissue cysts do not cause major pathological damage, and parasites are eventually released as result of stochastic reactivation of the bradyzoites (14) yet are promptly eliminated by the immune system. Therefore, in healthy individuals the persistence of T. gondii cysts in tissues and organs does not represent a cause for concern. However, several conditions may appear later in life that impair the function of the immune system and its ability to control the reactivation of T. gondii tissue cysts. These include infectious diseases such as human immunodeficiency virus infection (28-30) and treatment with immunosuppressive and chemotherapeutic agents commonly given to transplant and cancer patients, respectively (3,18,22,27,32,45). Reactivation of tissue cysts in these individuals leads to the recrudescence of T. gondii infection (15), a life-threatening co...

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“…It also has been reported with bone marrow (Ortonne., 2001), stem cell (Lopez-Duarte et al, 2003), liver (Barcan et al, 2002), kidney (Sukthana et al, 2001), simultaneous liver-pancreas, and liver-kidney-pancreas (Hommann et al, 2002) transplants. Transmission of the disease can occur with either blood transfusion or transplanted organs.…”

Section: Toxoplasmosismentioning

confidence: 99%

Infectious Complications in Kidney Transplantation

El‐Husseini¹,

Hassan²

2011

After the Kidney Transplant - The Patients and Their Allograft

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Cerebral toxoplasmosis after combined liver-pancreas-kidney and liver-pancreas transplantation

Cited by 18 publications

References 11 publications

Donor‐transmitted toxoplasmosis in liver transplant recipients: a case report and literature review

Donor‐transmitted toxoplasmosis in liver transplant recipients: a case report and literature review

Temporal and Spatial Distribution of Toxoplasma gondii Differentiation into Bradyzoites and Tissue Cyst Formation In Vivo

Infectious Complications in Kidney Transplantation

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