Toxoplasma-Positive Kidney Donors No Longer Shunned! Relief for Transplant Patients

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The availability of donor kidneys can be enhanced! This is the outcome of a recent investigation conducted by UC Davis Health.

Transplant recipients who are given kidneys infected with the toxoplasma parasite experience similar outcomes as those recipients who receive organs free from toxoplasma infection. Despite the ongoing apprehensions, recipients of kidneys from donors who tested positive for toxoplasma antibodies (TPDs) exhibited almost similar rates of mortality and organ rejection. This study was published in Transplant International ().

‘Did You Know?
Toxoplasmosis is an infection caused by a parasite known as Toxoplasma gondii. It is the primary cause of deaths associated with foodborne illnesses in the United States. #toxoplasma #kidneytransplant #medindia’

"Organs from donors who were positive for toxoplasma did just as well as organs from those who were negative, both for survival of the patients and survival of the kidneys," said Lavjay Butani, chief of pediatric nephrology. He co-authored the paper with Daniel Tancredi, professor of pediatrics. "This is quite encouraging."

Differences in Approach Amongst the Centers

Toxoplasma is a common parasite that usually does not harm healthy individuals. However, those with weak immune systems, like kidney transplant recipients, are at higher risk. Toxoplasmosis has a potential to be transmitted via the transplanted kidney, potentially reactivating a dormant infection in the kidney recipient.

There is significant inconsistency among transplant centers regarding the acceptance of TPD kidneys, with some centers accepting them while others choose to reject them.

"We conducted this study because, about a year ago, there was a positive donor and the team did not want to use that kidney for one of our pediatric patients, so we didn't accept it," Butani said. "But we realized, we just didn't have the data to know if that was the correct decision."

Comparing Rejection Rates and Graft Failure Between the Two Types of Donors

The research evaluated 51,000 transplant cases sourced from the Organ Procurement and Transplantation Network database. Among these, 4,300 were classified as TPD. The findings showed that the rates of rejection and graft failure were identical at 5%, for both TPD and non-TPD kidneys. Other metrics showed comparable results, suggesting that TPD kidneys did not present any extra risk.

The authors are confident in the safety of transplanting TPD kidneys; however, they recommend close monitoring of the patient. Transplant recipients usually receive Bactrim, which helps reduce the risk of toxoplasma, and this treatment may be extended for TPD patients. The authors hope this research will help standardize TPD policies at transplant centers. UC Davis Health is developing new protocols for pediatric transplants, which could improve access to vital organs for patients who are in need.

"In transplants, kidneys are the greatest need," Butani said. "Because of increased diabetes, high blood pressure and other conditions, the wait list just gets progressively longer. We hope these findings will help increase the supply of donor kidneys."

Reference:

1. Outcomes of Kidney Transplants From Toxoplasma-Positive Donors: An Organ Procurement and Transplant Network Database Analysis - (https:www.frontierspartnerships.org/articles/10.3389/ti.2024.13203/full)

Source: Medindia