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Efficacy of pyrimethamine for the prevention of donor-acquiredToxoplasma gondiiinfection in heart and heart-lung transplant patients

✍ Scribed by T. G. Wreghitt; J. J. Gray; P. Pavel; A. Balfour; A. Fabbri; L. D. Sharples; J. Wallwork

Book ID: 104727956
Publisher: Springer
Year: 1992
Tongue: English
Weight: 433 KB
Volume: 5
Category: Article
ISSN: 0934-0874
DOI: 10.1007/bf00336069

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✦ Synopsis

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.

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