Scientific publications
Preoperative Toxoplasma gondii serostatus does not affect long-term survival of cardiac transplant recipients. Analysis of the Spanish Heart Transplantation Registry
Barge-Caballero E (1), Almenar-Bonet L (2), Crespo-Leiro MG (3), Brossa-Loidi V (4), Rangel-Sousa D (5), Gómez-Bueno M (6), Farrero-Torres M (7), Díaz-Molina B (8), Delgado-Jiménez J (9), Martínez-Sellés M (10), López-Granados A (11), De-la-Fuente-Galán L (12), González-Costello J (13), Garrido-Bravo IP (14), Blasco-Peiró T (15), Rábago-Juan-Aracil G (16), González-Vílchez F (17).
BACKGROUND:
It's unclear whether pre-transplant T. gondii seropositivity is associated with impaired survival in heart transplant recipients.
OBJECTIVES:
To test the above-mentioned hypothesis in the Spanish Heart Transplantation Registry.
METHODS:
Post-transplant outcomes of 4048 patients aged >16years who underwent first, single-organ heart transplantation in 17 Spanish institutions from 1984 to 2014 were studied. Long-term post-transplant survival and survival free of cardiac death or retransplantation of 2434 (60%) T. gondii seropositive recipients and 1614 (40%) T. gondii seronegative recipients were compared.
RESULTS:
T. gondii seropositive recipients were older, had higher body mass index, and presented higher prevalence of hypertension, hypercholesterolemia, COPD and Cytomegalovirus seropositivity than T. gondii seronegative recipients.
In univariable analysis, pre-transplant T. gondii seropositivity was associated with increased post-transplant all-cause mortality (non-adjusted HR 1.15; 95% CI 1.04-1.26). However, this effect was no longer statistically significant after multivariable adjustment by recipient's age and sex (adjusted HR 1.01, 95% CI 0.92-1.11).
Extended multivariable adjustment by other potential confounders showed similar results (adjusted HR 0.99, 95% CI 0.89-1.11). T. gondii seropositivity had no significant effect on the composite outcome cardiac death or retransplantation (non-adjusted HR 1.08, 95% CI 0.95-1.24, p=0.235). The distribution of the causes of death was comparable in T. gondii seropositive and T. gondii seronegative recipients. No statistically significant impact of donor's T. gondii serostatus or donor-recipient T. gondii serostatus matching on post-transplant survival was observed.
CONCLUSIONS:
Our analysis did not show a significant independent effect of preoperative T. gondii serostatus on long-term outcomes after heart transplantation.
CITATION Int J Cardiol. 2018 Jan 1;250:183-187. doi: 10.1016/j.ijcard.2017.09.215. Epub 2017 Oct 7
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