title: Donor-derived Strongyloides stercoralis hyperinfection syndrome after simultaneous kidney/pancreas transplantation.
abstract: Most cases of strongyloidiasis associated with solid organ transplantation have been due to the reactivation of a latent infection in the recipient as a result of the immunosuppressive therapy; however, donor-derived infections are becoming increasingly frequent. The case of a patient who nearly died of a Strongyloides stercoralis hyperinfection after receiving simultaneous kidney/pancreas transplants is described herein. No specific parasitological tests were performed pre-transplantation, despite the fact that both the recipient and the donor originated from endemic areas. Serological analysis of the donor's serum performed retrospectively revealed the origin of the infection, which if it had been done beforehand would have prevented the serious complications. Current practice guidelines need to be updated to incorporate immunological and molecular techniques for the rapid screening of Strongyloides prior to transplantation, and empirical treatment with ivermectin should be applied systematically when there is the slightest risk of infection in the donor or recipient.
authors: Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Spain.
authors: A
authors: A
authors: Galiano
authors: Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Spain; Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, Valencia, Spain. Electronic address: maria.trelis@uv.es.
authors: M
authors: M
authors: Trelis
authors: Hepatobiliopancreatic Surgery and Transplantation Unit, Department of General Surgery, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors: Á
authors: Á
authors: Moya-Herráiz
authors: Department of Nephrology, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors: J
authors: J
authors: Sánchez-Plumed
authors: Joint Research Unit on Endocrinology, Nutrition and Clinical Dietetics, University of Valencia-Health Research Institute La Fe, Valencia, Spain; Department of Endocrinology and Nutrition, La Fe University and Polytechnic Hospital, Valencia, Spain.
authors: J F
authors: JF
authors: Merino
mesh_terms: D000328:Adult; D000818:Animals; D006801:Humans; D007165:Immunosuppression Therapy / Q000009:adverse effects; D007559:Ivermectin / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D016035:Pancreas Transplantation / Q000009:adverse effects*; D017171:Strongyloides stercoralis; D013322:Strongyloidiasis / Q000175:diagnosis / Q000209:etiology*; D014019:Tissue Donors
chemical_list: D007559:Ivermectin
keywords: Donor-derived; Hyperinfection; Kidney; Pancreas; Strongyloides; Transplant