Serological study of Toxoplasma gondii in kidney recipients

Abstract

Toxoplasma gondii IgG antibodies were determined in 200 kidney recipients by the Sabin-Felmand dye test. Twenty-two (11%) cases were positive for antibody detection. There was a statistically significant difference in the history of taking under-cooked meat, between the number of sero-positive cases and that of sero-negative subjects (63.6% vs 28.8%, p = 0.02). No such significant difference was evident regarding cat ownership (13.6% vs 22.0%, p = 0.3). Sixteen (72.6%) of the 22 subjects with positive T.gondii antibody had undergone kidney transplantation less than one year ago during which a high dose of immunosuppressive drugs were prescribed. The remaining six (27.3%) cases had had transplantation more than one year ago and were on a lower dosage of immunosuprresants. Toxoplasma reactivation seemed to be higher in the former group, which should thus be closely followed-up. Preventive chemoprophylaxis should be considered if there is any indication of toxoplasma reactivation. Since there have been occasional reports of donor-to-host transmission of toxoplasmosis in kidney transplant recipients, serological screening of toxoplasma antibody in kidney donors is advisable. Potential donors with positive toxoplasma antibody should be rejected; but if that is unavoidable, 6-week prophylactic treatment of primary infection in kidney recipients should be administered.