Dataset Information

Toxoplasmosis in Transplant Recipients, Europe, 2010-2014.

ABSTRACT: Transplantation activity is increasing, leading to a growing number of patients at risk for toxoplasmosis. We reviewed toxoplasmosis prevention practices, prevalence, and outcomes for hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT; heart, kidney, or liver) patients in Europe. We collected electronic data on the transplant population and prevention guidelines/regulations and clinical data on toxoplasmosis cases diagnosed during 2010-2014. Serologic pretransplant screening of allo-hematopoietic stem cell donors was performed in 80% of countries, screening of organ donors in 100%. SOT recipients were systematically screened in 6 countries. Targeted anti-Toxoplasma chemoprophylaxis was heterogeneous. A total of 87 toxoplasmosis cases were recorded (58 allo-HSCTs, 29 SOTs). The 6-month survival rate was lower among Toxoplasma-seropositive recipients and among allo-hematopoietic stem cell and liver recipients. Chemoprophylaxis improved outcomes for SOT recipients. Toxoplasmosis remains associated with high mortality rates among transplant recipients. Guidelines are urgently needed to standardize prophylactic regimens and optimize patient management.

SUBMITTER: Robert-Gangneux F

PROVIDER: S-EPMC6056100 | biostudies-literature | 2018 Aug

REPOSITORIES: biostudies-literature

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Toxoplasmosis in Transplant Recipients, Europe, 2010-2014.

Robert-Gangneux Florence F Meroni Valeria V Dupont Damien D Botterel Françoise F Garcia José M Aguado JMA Brenier-Pinchart Marie-Pierre MP Accoceberry Isabelle I Akan Hamdi H Abbate Isabella I Boggian Katia K Bruschi Fabrizio F Carratalà Jordi J David Miruna M Drgona Lubos L Djurković-Djaković Olgica O Farinas Maria Carmen MC Genco Francesca F Gkrania-Klotsas Effrossyni E Groll Andreas H AH Guy Edward E Hirzel Cédric C Khanna Nina N Kurt Özgür Ö Junie Lia Monica LM Lazzarotto Tiziana T Len Oscar O Mueller Nicolas J NJ Munoz Patricia P Pana Zoi Dorothea ZD Roilides Emmanuel E Stajner Tijana T van Delden Christian C Villena Isabelle I Pelloux Hervé H Manuel Oriol O

Emerging infectious diseases 20180801 8

Transplantation activity is increasing, leading to a growing number of patients at risk for toxoplasmosis. We reviewed toxoplasmosis prevention practices, prevalence, and outcomes for hematopoietic stem cell transplant (HSCT) and solid organ transplant (SOT; heart, kidney, or liver) patients in Europe. We collected electronic data on the transplant population and prevention guidelines/regulations and clinical data on toxoplasmosis cases diagnosed during 2010-2014. Serologic pretransplant screeni ...[more]

PMID: 30014843

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Project description:BackgroundSolid organ transplant recipients have an elevated risk of cancer. Quantifying deaths attributable to cancer can inform priorities to reduce cancer burden.MethodsLinked transplantation and cancer registry data were used to identify incident cancers and deaths among solid organ transplant recipients in the United States (1987-2014). Population-attributable fractions (PAFs) of deaths due to cancer and corresponding cancer-attributable mortality rates were estimated using Cox models.ResultsAmong 221,962 solid organ transplant recipients, 15,012 developed cancer. Approximately 13% of deaths (PAF, 13.2%) were attributable to cancer, corresponding to a cancer-attributable mortality rate of 516 per 100,000 person-years. Lung cancer was the largest contributor to mortality (PAF, 3.1%), followed by non-Hodgkin lymphoma (NHL; PAF, 1.9%), colorectal cancer (PAF, 0.7%), and kidney cancer (PAF, 0.5%). Cancer-attributable mortality rates increased with age at transplantation, reaching 1229 per 100,000 person-years among recipients aged ≥65 years. NHL was the largest contributor among children (PAF, 4.1%) and lung cancer was the largest contributor among recipients aged ≥50 years (PAFs, 3.7%-4.3%). Heart recipients had the highest PAF (16.4%), but lung recipients had the highest cancer-attributable mortality rate (1241 per 100,000 person-years). Overall, mortality attributable to cancer increased steadily with longer time since transplantation, reaching 15.7% of deaths (810 per 100,000 person-years) at ≥10 years after transplantation. Comparison of cancer-attributable mortality rates with specified causes of death indicated that some deaths recorded as other causes might instead be caused by cancer or its treatment.ConclusionsCancer is a substantial cause of mortality among solid organ transplant recipients, with major contributions reported from lung cancer and NHL. Cancer-attributable mortality increases with age and time since transplantation, and therefore cancer deaths will become an increasing burden as recipients live longer.

Dataset Information

Toxoplasmosis in Transplant Recipients, Europe, 2010-2014.

Publications

Toxoplasmosis in Transplant Recipients, Europe, 2010-2014.

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