TOXOPLASMOSIS IN HEART-TRANSPLANT RECIPIENTS

In cardiac transplant recipients, infection with Toxoplasma gondii may be transmitted with the transplanted organ to immunosuppressed recipi ents or may be due to reactivation under immunosuppression in cases of pretransplant infection, In the present study the incidence of infect ion with Toxoplasma gondii and the clinical presentation of the infect ion in 121 consecutive heart transplant recipients were investigated, Data on IgG and IgM antibodies for Toxoplasma gondii measured by a sem iquantitative microparticle immunoassay of donors and recipients were collected prospectively in 121 patients, Infection with Toxoplasma gon dii was defined as IgM seroconversion with proven pretransplant serone gativity (primary infection) or at least a fourfold increase of IgG an tibodies (reactivation), Infection with Toxoplasma gondii occurred in 16 of 121 patients (13%), whereas overt clinical disease occurred in 5 of 121 patients (4%), Organ-transmitted infection was more frequent ( 11/18, 61%) and more often associated with acute disease than reactiva tion of latent infection (5/69 patients, 7%) (p < 0.01), although one case of Toxoplasma retinochoroiditis occurred in a patient with recrud escence of latent pretransplant infection, Treatment with pyrimethamin e and sulfadiazine was efficient in all patients with acute disease an d in controlling disease in patients with evidence of acute infection.