Parasitic Infections in Solid Organ Transplant Recipients

Donor‐transmitted malaria after heart transplant managed successfully with artesunate

“…SOT recipients may acquire malaria from the bite of the female Anopheles mosquito in endemic areas, from reactivation, or from transmission by infected blood transfusion or infected allografts . The plasmodia can survive over 24 h in blood at 4°C, and transplanted tissues are preserved for a shorter time than this .…”

“…Although testing for malaria infection in all donors with epidemiological risk is strongly recommended , screening tests for malaria are suboptimal . Malaria produces a degree of resistance to severe infection through successive exposure and through persistence of plasmodia in the liver, the microvasculature, and the bloodstream.…”

“…Most cases of malaria infection in SOT recipients usually occur in the early post‐transplant period . Clinical manifestations of malaria in SOT recipients can be nonspecific . Fever has been reported as the most frequent presenting symptom, but it does not always have the typical paroxysmal or cyclic pattern .…”

Incidental hepatic schistosomiasis in a liver transplant recipient

“…Organ transplant recipients may acquire schistosomiasis in 3 ways: (i) transmission through the graft (13), (ii) de novo infection (14, 15), or (iii) recrudescence or reactivation of dormant infection as a consequence of immunosuppression (4, 16). Recurrence of schistosomiasis has been described mostly after kidney transplantation (16), and reports after liver transplantation are rare (13, 16). Schistosomiasis does not appear to have a significant negative impact on allograft survival after kidney transplantation.…”

“…However, others have suggested that individuals from endemic areas, such as the Middle East, Africa, Latin America, and Asia, who are undergoing assessment for liver transplant should undergo stool screening for ova and parasites, and serological testing to determine schistosomiasis (4, 13, 21). If infection is detected, the transplant candidates need to be treated preoperatively even if they are asymptomatic, as the adult worms often live silently in the host for several years (16, 21, 22).…”