Laboratory markers of toxoplasmosis in heart recipients

Abstract

BACKGROUND. The number of organ transplantation surgeries is growing every year, including heart transplantion. The full spectrum of infections in heart transplant recipients is not well understood. One of the infectious agents that is particularly difficult to recognize is Toxoplasma gondii (T. gondii).

AIM: This work determines the informative value of detecting laboratory markers of toxoplasmosis in patients after heart transplantation to identify active forms of invasion.

MATERIALS AND METHODS: This investigation studied 121 heart recipients (95 men and 26 women) at different times after transplantation (several days to 12 years). Markers of Toxoplasma invasion were determined in blood sera, namely antibodies of the IgG, IgM, and IgA classes to T. gondii, avidity index of IgG antibodies to T. gondii, and DNA of the pathogen.

RESULTS: In 60 patients (49.6±4.5%) after heart transplantation, markers of Toxoplasma invasion were identified. In 20 (16.5±3.6%) cases, markers of active invasion were revealed, namely IgM and IgA antibodies to T. gondii in six and 11 patients, respectively, low-grade IgG antibodies to T. gondii in three patients, and DNA of the pathogen in two cases. Based on the totality of studies, it was determined that the disease activity in 75% of cases was due to its reactivation, whereas in the other cases, it was a recent infection. Laboratory signs of toxoplasmosis reactivation occurred mainly during the first year after transplantation, which was probably associated with the intensity of immunosuppressive therapy.

CONCLUSIONS: It was revealed that the most compelling studies indicating early signs of toxoplasmosis reactivation include detection of IgA antibodies to T. gondii and DNA of the pathogen. Further joint research is required by clinicians, epidemiologists, and laboratory diagnostics specialists to study the aspects of toxoplasmosis and disease diagnostics and preventionin patients after heart transplantation.

Keywords

toxoplasmosis / Toxoplasma gondii / heart transplantation / recipient / reactivation / immunosuppression

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