Int J Infect Dis. 2016 Oct;51:19-21. doi: 10.1016/j.ijid.2016.08.014.

Donor-derived Strongyloides stercoralis hyperinfection syndrome after simultaneous kidney/pancreas transplantation.

Galiano A1, Trelis M2, Moya-Herráiz Á3, Sánchez-Plumed J4, Merino JF5.
1 Department of Pharmacy and Pharmaceutical Technology and Parasitology, Faculty of Pharmacy, University of Valencia, Spain.
2 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.
3 Hepatobiliopancreatic Surgery and Transplantation Unit, Department of General Surgery, La Fe University and Polytechnic Hospital, Valencia, Spain.
4 Department of Nephrology, La Fe University and Polytechnic Hospital, Valencia, Spain.
5 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.

 

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.Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

KEYWORDS:

Donor-derived; Hyperinfection; Kidney; Pancreas; Strongyloides; Transplant

PMID: 27590562

 

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