Intestinal parasites including Cryptosporidium, Cyclospora, Giardia, and Microsporidia, Entamoeba histolytica, Strongyloides, Schistosomiasis, and Echinococcus: Guidelines from the American Society of Transplantation Infectious Diseases Community of Practice

Clin Transplant. 2019 Sep;33(9):e13618 doi: 10.1111/ctr.13618.
Abstract

These updated guidelines from the Infectious Diseases Community of Practice of the American Society of Transplantation review the diagnosis, prevention, and management of intestinal parasites in the pre- and post-transplant period. Intestinal parasites are prevalent in the developing regions of the world. With increasing travel to and from endemic regions, changing immigration patterns, and the expansion of transplant medicine in developing countries, they are increasingly recognized as a source of morbidity and mortality in solid-organ transplant recipients. Parasitic infections may be acquired from the donor allograft, from reactivation, or from de novo acquisition post-transplantation. Gastrointestinal multiplex assays have been developed; some of the panels include testing for Cryptosporidium, Cyclospora, Entamoeba histolytica, and Giardia, and the performance is comparable to conventional methods. A polymerase chain reaction test, not yet widely available, has also been developed to detect Strongyloides in stool samples. New recommendations have been developed to minimize the risk of Strongyloides donor-derived events. Deceased donors with epidemiological risk factors should be screened for Strongyloides and recipients treated if positive as soon as the results are available. New therapeutic agents and studies addressing the optimal treatment regimen for solid-organ transplant recipients are unmet needs.

Metadata
Organisation: La Hoz, R M. Division of Infectious Diseases and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, TX. Morris, M I. Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL.
Funding: american society of transplantation
Publication type: Guideline
Organ: Kidney; Liver; Heart; Lung; Pancreas; Intestine; Simultaneous Kidney/Pancreas; Heart/Lung; Various
Language: English
MeSH terms: Animals; Anthelmintics; Cryptosporidiosis; Cryptosporidium; Cyclospora; Cyclosporiasis; Donor Selection; Echinococcosis; Echinococcus; Entamoeba histolytica; Entamoebiasis; Giardia; Giardiasis; Helminths; Humans; Intestinal Diseases, Parasitic; Microsporidia; Microsporidiosis; Organ Transplantation; Practice Guidelines as Topic; Schistosoma; Schistosomiasis; Societies, Medical; Strongyloides; Strongyloidiasis; Tissue Donors; Transplant Recipients; Entamoeba Histolytica; 0 (Anthelmintics); Heart Transplantation; Kidney Transplantation; Liver Transplantation; Heart-Lung Transplantation; Lung Transplantation; Pancreas Transplantation