Efficacy of pyrimethamine for the prevention of donor-acquired Toxoplasma gondii infection in heart and heart-lung transplant patients.

Abstract

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.

• Authors: T G Wreghitt, J J Gray, P Pavel, A Balfour, A Fabbri, L D Sharples, J Wallwork
• Journal: Transplant international : official journal of the European Society for Organ Transplantation (Transpl Int) Vol. 5 Issue 4 Pg. 197-200 (Sep 1992) ISSN: 0934-0874 [Print] Switzerland
• PMID: 1418309 (Publication Type: Journal Article)

Chemical References

• Pyrimethamine

Topics

• Adolescent
• Adult
• Child
• Heart Transplantation (adverse effects)
• Heart-Lung Transplantation (adverse effects)
• Humans
• Middle Aged
• Pyrimethamine (therapeutic use)
• Tissue Donors
• Toxoplasmosis (prevention & control)