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Cryptosporidium spp. Infection in Solid Organ Transplantation: The Nationwide "TRANSCRYPTO" Study.

Abstract：

BACKGROUND:Diarrhea is a frequent complication of solid organ transplantation. Cryptosporidiosis is classically reported in patients with acquired immunodeficiency syndrome and emerged as a cause of persistent diarrhea in solid organ transplant patients. METHODS:Through the ANOFEL Cryptosporidium National Network and the French Transplantation Society, we collected all cryptosporidiosis cases identified in solid organ transplanted patients between 2006 and 2010 in France. RESULTS:We reported 47 solid organ transplant recipients (41 kidneys) with cryptosporidiosis, mostly men (68%), with a median age of 52 (6-70) years old. Five patients had additional immunodepression favoring cryptosporidiosis (CD40 ligand deficiency [n = 1], human immunodeficiency virus infection [n = 4]). Cryptosporidiosis occurred at a median time of 3.4 (0-19.8) years posttransplant. Exposure to environmental risk factors was found before infection onset in 18 patients. Time between first symptoms and diagnosis was 10 (2-110) days. Four patients had associated extraintestinal location (biliary tract [n = 3] and lung [n = 1]). Thirty-five patients received specific therapy against cryptosporidiosis ie nitozoxanide, 25 in monotherapy, and 10 in association with azithromycin, 13 in association with immunosuppression (IS) reduction. Four patients were cured with IS treatment tapering only. The others patients had neither IS reduction nor specific therapy against cryptosporidiosis. Cryptosporidiosis was complicated by renal failure in 15 patients. Symptoms resolved after a median of 10 days of treatment. Six patients relapsed and 3 died, 1 with evolutive infection. CONCLUSIONS:Cryptosporidiosis is a late posttransplant infection that disseminated to biliar duct or lung in 9% of patients. When limited to digestive tract, infection may resolve without IS reduction.

journal_name

Transplantation

journal_title

Transplantation

authors

Lanternier F,Amazzough K,Favennec L,Mamzer-Bruneel MF,Abdoul H,Tourret J,Decramer S,Zuber J,Scemla A,Legendre C,Lortholary O,Bougnoux ME,ANOFEL Cryptosporidium National Network and Transplant Cryptosporidium Study Group.

doi

10.1097/TP.0000000000001503

subject

Has Abstract

pub_date

2017-04-01 00:00:00

pages

826-830

issue

eissn

0041-1337

issn

1534-6080

journal_volume

101

pub_type

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Cryptosporidium spp. Infection in Solid Organ Transplantation: The Nationwide "TRANSCRYPTO" Study.