02670nas a2200193   4500008004100000022004200041245005000083210005000133250001000183260000800193300001300201490000600214520213300220653002702353653002402380653001102404100001702415856004402432       2004                        eng d  a1304-0855 (Print) 1304-0855 (Linking)00aParasitic infections in organ transplantation0 aParasitic infections in organ transplantation  a38472  cDec  a258 - 670 v23 aMore than 340 parasitic species infect more than 3 billion people worldwide with varying morbidity and mortality. The Tropics constitute the main reservoir of infection with the highest clinical impact, owing to favorable ecological factors. Acquisition of infection, clinical severity, and outcome of a parasitic disease depend on innate and acquired host immunity as well as the parasite's own immune response against the host when infection is established. Organ transplant recipients may acquire significant parasitic disease in 3 ways: transmission with the graft, de novo infection, or activation of dormant infection as a consequence of immunosuppression. Malaria, Trypanosoma, Toxoplasma, and Leishmania are the principal parasites that may be transmitted with bone marrow, kidney, or liver homografts, and microsporidia with xenotransplants. De novo infection with malaria and kala-azar may occur in immunocompromised travelers visiting in endemic areas, while immunocompromised natives are subject to superinfection with different strains of endemic parasites, reinfection with schistosomiasis, or rarely, with primary infections such as acanthamoeba. The list of parasites that may be reactivated in the immunocompromised host includes giardiasis, balantidiasis, strongyloidiasis, capillariasis, malaria, Chagas' disease, and kalaazar. The broad clinical syndromes of parasitic infection in transplant recipients include prolonged pyrexia, lower gastrointestinal symptoms, bronchopneumonia, and meningoencephalitis. Specific syndromes include the hematologic manifestations of malaria, myocarditis in Chagas' disease, acute renal failure in malaria and leishmaniasis, and the typical skin lesions of Chagas' and cutaneous leishmaniasis. Many antiparasitic drugs have the potential for gastrointestinal, hepatic, renal, and hematologic toxicity, and may interact with the metabolism of immunosuppressive agents. It is recommended that transplant clinicians have a high index of suspicion of parasitic infections as an important transmission threat, as well as a potential cause of significant posttransplant morbidity.10a*Organ Transplantation10a*Parasitic Diseases10aHumans1 aBarsoum, R S  uhttps://notifylibrary.org/reference/142