Abstract:
BACKGROUND:Conflicting data have been reported about the effect of Toxoplasma serostatus on mortality after heart transplantation. Either a positive or a negative recipient Toxoplasma serostatus was found to be associated with increased mortality. METHODS:We evaluated the effects of T. gondii infection on survival of our 582 cardiac allograft recipients operated upon between June 1984 and July 2011. RESULTS:The 258 Toxoplasma seronegative and 324 seropositive recipients differed in age, pretransplantation diagnosis, ischemia time, renal function, donor Toxoplasma serology, and maintenance immunosuppression. After a median follow-up time of 8.3 years (range, 0-26 years), 117 (45%) seronegative and 219 (67%) seropositive patients died. No difference was found in deaths due to cardiac allograft vasculopathy. After adjustment for all relevant clinical characteristics, the recipient Toxoplasma serostatus was not associated with mortality (hazard ratio, 1.21; 95% confidence interval [CI], 0.95-1.54). With the Toxoplasma serostatus combination donor negative/recipient negative as a reference, univariate hazard ratios for the Toxoplasma serostatus combinations were D+/R- 0.52 (95% CI, 0.37-0.73), D-/R+ 0.65 (95% CI, 0.40-1.05), and D+/R+ 0.78 (95% CI, 0.57-1.07). Multivariate analysis, however, showed that donor Toxoplasma serostatus was not independently associated with mortality. CONCLUSIONS:The Toxoplasma serostatus of both the recipient and donor appeared not to be independent risk factors for mortality after heart transplantation.
journal_name
Transplantationjournal_title
Transplantationauthors
van Hellemond JJ,van Domburg RT,Caliskan K,Birim O,Balk AHdoi
10.1097/TP.0b013e3182a9274asubject
Has Abstractpub_date
2013-12-27 00:00:00pages
1052-8issue
12eissn
0041-1337issn
1534-6080journal_volume
96pub_type
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