Mrzljak Anna, Novak Rafaela, Pandak Nenad, Tabain Irena, Franusic Lucija, Barbic Ljubo, Bogdanic Maja, Savic Vladimir, Mikulic Danko, Pavicic-Saric Jadranka, Stevanovic Vladimir, Vilibic-Cavlek Tatjana
Department of Medicine, Merkur University Hospital, Zagreb 10000, Croatia.
School of Medicine, University of Zagreb, Zagreb 10000, Croatia.
World J Transplant. 2020 Mar 31;10(3):47-63. doi: 10.5500/wjt.v10.i3.47.
Zoonoses represent a problem of rising importance in the transplant population. A close relationship and changes between human, animal and environmental health ("One Health" concept) significantly influence the transmission and distribution of zoonotic diseases. The aim of this manuscript is to perform a narrative review of the published literature on emerging and neglected zoonoses in the transplant population. Many reports on donor-derived or naturally acquired (re-)emerging arboviral infections such as dengue, chikungunya, West Nile, tick-borne encephalitis and Zika virus infection have demonstrated atypical or more complicated clinical course in immunocompromised hosts. Hepatitis E virus has emerged as a serious problem after solid organ transplantation (SOT), leading to diverse extrahepatic manifestations and chronic hepatitis with unfavorable outcomes. Some neglected pathogens such as lymphocytic choriomeningitis virus can cause severe infection with multi-organ failure and high mortality. In addition, ehrlichiosis may be more severe with higher case-fatality rates in SOT recipients. Some unusual or severe presentations of borreliosis, anaplasmosis and rickettsioses were also reported among transplant patients. Moreover, toxoplasmosis as infectious complication is a well-recognized zoonosis in this population. Although rabies transmission through SOT transplantation has rarely been reported, it has become a notable problem in some countries. Since the spreading trends of zoonoses are likely to continue, the awareness, recognition and treatment of zoonotic infections among transplant professionals should be imperative.
人畜共患病在移植人群中是一个日益重要的问题。人类、动物和环境卫生之间的密切关系及变化（“同一健康”概念）显著影响人畜共患病的传播和分布。本文的目的是对已发表的关于移植人群中新兴和被忽视的人畜共患病的文献进行叙述性综述。许多关于供体来源或自然获得的（再）出现的虫媒病毒感染的报告，如登革热、基孔肯雅热、西尼罗河病毒、蜱传脑炎和寨卡病毒感染，都显示了免疫功能低下宿主中不典型或更复杂的临床病程。戊型肝炎病毒在实体器官移植（SOT）后已成为一个严重问题，导致多种肝外表现和慢性肝炎，预后不佳。一些被忽视的病原体，如淋巴细胞性脉络丛脑膜炎病毒，可导致严重感染，出现多器官功能衰竭和高死亡率。此外，埃立克体病在SOT受者中可能更严重，病死率更高。移植患者中也报告了一些莱姆病、无形体病和立克次体病的不寻常或严重表现。此外,弓形虫病作为感染并发症在该人群中是一种公认的人畜共患病。虽然通过SOT移植传播狂犬病的报道很少，但在一些国家已成为一个显著问题。由于人畜共患病的传播趋势可能会持续下去，移植专业人员对人畜共患感染的认识、识别和治疗应势在必行。
