The frequency and clinical characteristics of plasmodium infection wer
e reported in 420 renal transplant recipients who were followed in the
Transplantation Unit and Out-Patient Clinic of the Medical School of
Istanbul. Plasmodium infection was diagnosed in eleven (9 male, 2 fema
le) of the 420 patients (2.6%). Ten of the patients were transplanted
in India, and one in our institution. The mean duration between the tr
ansplantation and the diagnosis of malaria was 21.7 + 44.4 days in pat
ients who were transplanted in India. All of the patients were taking
triple immunosuppressive drugs (CsA, AZA PRED). Plasmodium falciparum
was diagnosed in 6 patients, P vivax in 1 patient and P malariae in 1
patient. Also mixed infection with P falciparum and P malariae was dia
gnosed in 3 patients. After definite diagnosis, the patients were hosp
italized. Chloroquine phosphate plus primaquine phosphate was administ
ered for P vivax infection, whereas chloroquine phosphate alone was gi
ven for P falciparum and P malariae infection as a first line antimala
rial therapy. As a result of therapy, infection improved clinically an
d the plasmodia disappeared rapidly from the thick blood film in 10 of
the patients. Severe hemolysis and acute renal failure developed in o
ne patient, who improved after hemodialysis therapy and exchange trans
fusions. It was concluded that malaria is quite a frequent infection o
f transplant recipients who get their allografts from donors living in
high-risk areas, and all transplant recipients having this kind of tr
ansplantations should be suspected and examinedfor malaria. This may h
elp to diagnose and treat the complication in the early period, thus r
esulting in an improved prognosis for this potentially life-threatenin
g complication of the posttransplant period.