Efficacy of pyrimethamine for the prevention of donor-acquired Toxoplasma gondii infection in heart and heart-lung transplant patients.
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.
Wreghitt
T G
TG
Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, UK.
Gray
J J
JJ
Pavel
P
P
Balfour
A
A
Fabbri
A
A
Sharples
L D
LD
Wallwork
J
J
D000293:Adolescent; D000328:Adult; D002648:Child; D016027:Heart Transplantation / Q000009:adverse effects*; D016041:Heart-Lung Transplantation / Q000009:adverse effects*; D006801:Humans; D008875:Middle Aged; D011739:Pyrimethamine / Q000627:therapeutic use*; D014019:Tissue Donors; D014123:Toxoplasmosis / Q000517:prevention & control*
D011739:Pyrimethamine