title: Efficacy of pyrimethamine for the prevention of donor-acquired Toxoplasma gondii infection in heart and heart-lung transplant patients.
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.
authors.affiliation: Clinical Microbiology and Public Health Laboratory, Addenbrooke's Hospital, Cambridge, UK.
authors.forename: T G
authors.initials: TG
authors.lastname: Wreghitt
authors.forename: J J
authors.initials: JJ
authors.lastname: Gray
authors.forename: P
authors.initials: P
authors.lastname: Pavel
authors.forename: A
authors.initials: A
authors.lastname: Balfour
authors.forename: A
authors.initials: A
authors.lastname: Fabbri
authors.forename: L D
authors.initials: LD
authors.lastname: Sharples
authors.forename: J
authors.initials: J
authors.lastname: Wallwork
mesh_terms: 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*
chemical_list: D011739:Pyrimethamine