Status:
Ready to upload
Record number:
1466
Adverse Occurrence type:
MPHO Type:
Estimated frequency:
Before this manuscript, only 4 liver transplant patients with grafts infected by schistosoma had been reported; all the recipients were adults, and they received their grafts from deceased donors.
Time to detection:
N/A
Alerting signals, symptoms, evidence of occurrence:
Schistosoma spp granulomas found in the liver biopsy tissue of 6 asymptomatic living donors; donors had no evidence of active schistosomal infection, with normal liver function tests, normal abdominal ultrasound and negative stool test. Recipients remained asymptomatic without evidence of infection at 3 years of follow up.
Demonstration of imputability or root cause:
IWDT (intervention without documented transmission). Praziquantel given to donors. Recipients remained asymptomatic without evidence of infection (negative liver biopsy). No praziquantel given to recipients as drug acts against adult form.
Groups audience:
Keywords:
References:
Reference attachment:
Suggest references:
Vincenzi et al, Schistosoma mansoni Infection in the Liver Graft: The Impact on Donor and Recipient Outcomes After Transplantation, LIVER TRANSPLANTATION 17:1299-1303, 2011
Note:
This manuscript adds more data to consider liver infected with schistosomiasis eggs as sure enough to perform the transplantation without any kind of treatment.
Expert comments for publication:
Hepatic damage in chronic schistosomiasis is caused not by adult worms but by the eggs trapped in the liver tissue. Progression to severe forms of the disease requires sustained heavy infection or re-infection with continued egg production. The adult worms remain in the mesenteric vein. Therefore, it seems safe to transplant livers infected with schistosoma eggs as the symptomatic infection is due to the adult form.