With transplantation becoming an increasingly routine form of treatment for diverse populations, and with international travel becoming ever more accessible and affordable, the danger of transplantation-mediated helminth infections, exacerbated by coincident immunosuppression, must be considered. In this Review, we attempt to catalogue all clinically-relevant helminthiases that have been reported to coincide with transplantation, whether by transplantation-mediated transmission, reactivation of latent infections in an immunosuppressed context, or possible de-novo infection during the immunosuppressed peritransplant period. Helminthiasis has been reported in cases of kidney, liver, bowel, pancreas, heart, lung, and stem-cell transplant, and blood transfusion. For each helminthiasis, known risk factors, symptoms, and suggested options for screening and treatment are given. We conclude that helminths are a small but important and potentially severe source of disease after transplantation, and, with options for diagnosis and treatment, these pathogens warrant greater consideration during organ implantation. The achievement of immunological tolerance using helminth-derived products is also an exciting future prospect.

Helminths in organ transplantation

Introduction. The immunosuppression used after transplantation (Tx) is associated with an increased risk of opportunistic infections. In Europe, parasitic infections after Tx are much less common than viral, bacterial and fungal ones. However, diseases caused by parasites are very common in tropical countries. In the last years the number of travellers with immunosuppression visiting tropical countries has increased. Methods. We performed a literature review to evaluate a risk of parasitic infections after Tx in Europe. Results. There is a real risk of parasitic infection in patients after Tx travelling to tropical countries. Malaria, leishmaniasis, strongyloidiasis and schistosomiasis are the most dangerous and relatively common. Although the incidence of these tropical infections after Tx has not increased, the course of disease could be fatal. There are also some cosmopolitan parasitic infections dangerous for patients after Tx. The greatest threat in Europe is toxoplasmosis, especially in heart and bone marrow recipients. The most severe manifestations of toxoplasmosis are myocarditis, encephalitis and disseminated disease. Diarrhoea is one of the most common symptoms of parasitic infection. In Europe the most prevalent pathogens causing diarrhoea are Giardia duodenalis and Cryptosporidium. Conclusions. Solid organ and bone marrow transplantations, blood transfusions and immunosuppressive treatment are associated with a small but real risk of parasitic infections in European citizens. In patients with severe parasitic infection, i.e., those with lung or brain involvement or a disseminated disease, the progression is very rapid and the prognosis is bad. Establishing a diagnosis before the patient’s death is challenging.

https://www.mdpi.com/1648-9144/54/2/27/pdf

Parasitic Infections Associated with Unfavourable Outcomes in Transplant Recipients.

Zoonotic helminths of three rodent species, Bandicota indiaca, Bandicota savilei, and Leopoldamys edwardsi, were investigated in Vientiane capital, Lao PDR. A total of 310 rodents were infected with 11 species of helminth parasites. There were 168 (54.2%) of 310 rodents infected with zoonotic helminths. From our results, there are six recorded zoonotic helminth species, and the highest prevalence was exhibited by Raillietina sp. (30.7%), followed by Hymenolepis diminuta (17.7%), Hymenolepis nana (2.6%), Echinostoma ilocanum (1.9%), Echinostoma malayanum (1.3%), and Angiostrongylus cantonensis (1%). This is the first study of zoonotic helminths in L. edwardsi and the first report of H. diminuta, H. nana, E. ilocanum, and E. malayanum in Bandicota indica and B. savilei, and the first demonstration of A. cantonenensis in B. indica in Lao PDR. From our results, these three rodents are potentially important reservoir hosts of zoonotic helminths. Thus, effective control programs should be considered for implementation to prevent the transmission of these zoonoses in this area.

Zoonotic Helminthiases in Rodents (Bandicota indica, Bandicota savilei, and Leopoldamys edwardsi) from Vientiane Capital, Lao PDR.

Pathogenic Intestinal Parasites in Transplant Recipients

In this study, we report the potential rodent-borne zoonotic helminths in wild-caught murid rodents from four categorized habitats—forest, nonflooded land, irrigated land, and human settlement in seven localities of Thailand, Cambodia, and Lao PDR. Out of 2478 rodent samples, 735 (29.7%) were infected by at least one of the following zoonotic helminth species: Echinostoma malayanum, Echinostoma ilocanum, Plagiorchis muris, Raillietina spp., Hymenolepis diminuta, Hymenolepis nana, Cyclodontostomum purivisi, and Moniliformis moniliformis. Raillietina spp. showed the highest prevalence (13.8%), followed by H. diminuta (8.6%), H. nana (6.7%), and C. purvisi (1.0%). Habitat affected the intensity of helminth infection in murid rodent hosts. Specific habitats favoring each zoonotic helminth species are discussed in relation to the risk of human infection. Season and host maturity influenced intensity of total zoonotic helminths, but there was no influence of host gender. However, in terms of individual...

/pdf/potentially-zoonotic-helminthiases-of-murid-rodents-from-the-2mxpzldxsh.pdf

Potentially zoonotic helminthiases of murid rodents from the Indo-Chinese peninsula: impact of habitat and the risk of human infection.

A case of hymenolepiasis in a renal transplant recipient. Issues discussed include the benefit of anti-parasitic agents as well as the preventive measures.

/pdf/hymenolepis-nana-in-a-renal-transplant-recipient-to-treat-or-1stqad99xv.pdf

Hymenolepis nana in a renal transplant recipient: to treat or not to treat?

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Hymenolepis nana in a renal transplant recipient: to treat or not to treat?