Department of Zoology, School of Natural Sciences, Trinity College, Dublin, Ireland.
Nuffield Department of Surgical Sciences and Oxford Transplant Centre, University of Oxford and Oxford University Hospitals NHS Trust, Oxford, UK.
Lancet Infect Dis. 2017 Jun;17(6):e166-e176. doi: 10.1016/S1473-3099(16)30533-3. Epub 2017 Feb 21.
With transplantation becoming an increasingly routine form of treatment for diverse populations, and with international travel becoming ever more accessible and affordable, the danger of transplantation-mediated helminth infections, exacerbated by coincident immunosuppression, must be considered. In this Review, we attempt to catalogue all clinically-relevant helminthiases that have been reported to coincide with transplantation, whether by transplantation-mediated transmission, reactivation of latent infections in an immunosuppressed context, or possible de-novo infection during the immunosuppressed peritransplant period. Helminthiasis has been reported in cases of kidney, liver, bowel, pancreas, heart, lung, and stem-cell transplant, and blood transfusion. For each helminthiasis, known risk factors, symptoms, and suggested options for screening and treatment are given. We conclude that helminths are a small but important and potentially severe source of disease after transplantation, and, with options for diagnosis and treatment, these pathogens warrant greater consideration during organ implantation. The achievement of immunological tolerance using helminth-derived products is also an exciting future prospect.
随着移植术成为治疗各种人群的一种越来越常规的治疗方法，以及国际旅行变得更加便捷和负担得起，必须考虑到移植介导的寄生虫感染的危险，这种感染会因同时存在免疫抑制而加剧。在这篇综述中，我们试图列出所有与移植术同时发生的临床相关的寄生虫病，无论是通过移植介导的传播、在免疫抑制背景下潜伏感染的重新激活，还是在免疫抑制移植期间可能发生的新感染。在肾、肝、肠、胰腺、心脏、肺和干细胞移植以及输血的病例中都有寄生虫病的报道。对于每种寄生虫病，我们给出了已知的危险因素、症状以及筛查和治疗的建议。我们得出结论，寄生虫是移植后疾病的一个虽小但重要且潜在严重的来源，并且由于有诊断和治疗的选择，这些病原体在器官植入时值得更多的考虑。利用寄生虫衍生产品实现免疫耐受也是一个令人兴奋的未来前景。
