Serological study of Toxoplasma gondii in kidney recipients.
Toxoplasma gondii IgG antibodies were determined in 200 kidney recipients by the Sabin-Felmand dye test. Twenty-two (11%) cases were positive for antibody detection. There was a statistically significant difference in the history of taking under-cooked meat, between the number of sero-positive cases and that of sero-negative subjects (63.6% vs 28.8%, p = 0.02). No such significant difference was evident regarding cat ownership (13.6% vs 22.0%, p = 0.3). Sixteen (72.6%) of the 22 subjects with positive Tgondii antibody had undergone kidney transplantation less than one year ago during which a high dose of immunosuppressive drugs were prescribed. The remaining six (27.3%) cases had had transplantation more than one year ago and were on a lower dosage of immunosuprresants. Toxoplasma reactivation seemed to be higher in the former group, which should thus be closely followed-up. Preventive chemoprophylaxis should be considered if there is any indication of toxoplasma reactivation. Since there have been occasional reports of donor-to-host transmission of toxoplasmosis in kidney transplant recipients, serological screening of toxoplasma antibody in kidney donors is advisable. Potential donors with positive toxoplasma antibody should be rejected; but if that is unavoidable, 6-week prophylactic treatment of primary infection in kidney recipients should be administered.
Sukthana
Y
Y
Department of Protozoology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Chintana
T
T
Damrongkitchaiporn
S
S
Lekkla
A
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D002415:Cats / Q000469:parasitology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008403:Mass Screening; D008460:Meat / Q000469:parasitology; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D014019:Tissue Donors; D014122:Toxoplasma / Q000276:immunology; D014123:Toxoplasmosis / Q000097:blood / Q000453:epidemiology / Q000209:etiology* / Q000276:immunology / Q000469:parasitology / Q000635:transmission
D000913:Antibodies, Protozoan; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents