Efficacy of pyrimethamine for the prevention of donor-acquired Toxoplasma gondii infection in heart and heart-lung transplant patients |
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Authors: | T G Wreghitt J J Gray P Pavel A Balfour A Fabbri L D Sharples J Wallwork |
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Institution: | (1) Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, CB22QQ Cambridge, UK;(2) The Transplant Unit, Papworth Hospital, Papworth Everard, CB3 8RE Cambridge, UK;(3) Toxoplasma Reference Laboratory, Public Health Laboratory, Bridle Path, York Road, LS15 7TR Leeds, UK |
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Abstract: | Seven (11%) of the first 65 patients who received heart transplants at Papworth Hospital were mismatched for Toxoplasma gondii. Of these, four (57%) experienced T. gondii infection and two died. The remaining two had severe symptoms and received anti-T-gondii chemotherapy for a year after transplantation. In an attempt to reduce the impact of donor-acquired T. gondii in our heart transplant recipients, we decided in April 1984 to give prophylactic pyrimethamine to all T. gondii-mismatched patients. In this study, 7 years later, we review the efficacy of this policy. Five of 37 (14%) patients given prophylactic pyrimethamine acquired T. gondii infection; only one was symptomatic, and none died. This compares with 100% symptomatic infection in the pre-1984 patients, who did not receive prophylactic pyrimethamine. We believe that our experience has shown that pyrimethamine is effective in reducing the incidence and severity of primary donor-acquired T. gondii infection in mismatched heart and heart-lung transplant recipients. |
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Keywords: | Pyrimethamine prophylaxis Heart transplantation Toxoplasma gondii Toxoplasma gondii in heart transplantation |
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