Strongyloides Pre-Transplant Screening in Solid Organ Transplantation (SOT): Single Center Analysis

M. Al-Obaidi,¹ K. Vigil,¹ R. Hasbun,¹ A. De Golovine,² V. Machicao,³ L. Ostrosky,¹ S. Bynon,⁴ M. Nigo.¹

¹Division of Infectious Diseases, UT McGovern Medical School, Houston
²Division of Renal Disease and Hypertension, UT McGovern Medical School, Houston
³Division of Gastroenterology, Hepatology and Nutrition, UT McGovern Medical School, Houston
⁴Division of Immunology and Organ Transplantation, UT McGovern Medical School, Houston.

Meeting: 2018 American Transplant Congress

Abstract number: C348

Keywords: Infection, Risk factors, Screening

Session Information

Session Name: Poster Session C: Transplant Infectious Diseases

Session Type: Poster Session

Date: Monday, June 4, 2018

Session Time: 6:00pm-7:00pm

Presentation Time: 6:00pm-7:00pm

Location: Hall 4EF

Background: Strongyloides stercoralis infects about 100 million persons worldwide. In SOT, the optimal pre-transplant (Tsp) screening method (universal versus targeted) is yet to be determined. We aim to study the epidemiology and risk factors for Strongyloides infection in the Houston,TX area.

Methods: Patients were identified from our transplant referral list (7/2012 – 6/2017). Data was collected including: demographics, Tsp type, pre-Tsp screening serologies, and laboratory results. For patients with a positive Strongyloides serology (PSS): country of origin, travel history, treatment, and stool ova and parasite (O&P) were collected.

Results: A total of 1741 (94% kidney, 3% liver, 3% others) patients underwent pre-Tsp Strongyloides serology screening. 173 patients (9.9 %) had PSS. Patients with PSS differed from negative Strongyloides serology (NSS) groups in regards to ethnicity/race (Hispanic 32.9% vs 27.9%, p=0.05, Asian 5.2% vs 2.7%, p=0.05), diabetes (62.4% vs. 53.8%, p=0.03), eosinophilia (19.1% vs 12.9%, p=0.02), positivity of tuberculosis screening (13.3 vs. 7.6%, p=0.02) and HSV I IgG (87.7% vs. 79.2%, p=0.01). Among PSS patients, 49% were foreign born (Mexico/Central America 26%, East/South Asia 7%) and 80% reported travel history (Mexico/Central America 50%). Of note, 22% of PSS were born in the US and did not have any travel history. 9.5% of PSS patients reported gastrointestinal symptoms. O&P detected Strongyloides in only one out of 42 patients (2%). Interestingly, 42 (6.2 %) out of 617 patients screened on multiple occasions became positive after previous NSS. Ivermectin was used for treatment, and no case of disseminated infection occurred during this period. Multivariate analysis revealed Asian race (odds ratio (OR) 2.7, p=0.02) and eosinophilia (OR 1.69, p=0.01) as independent factors associated with PSS.

Conclusion: The prevalence for strongyloides infection in our SOT population is 9.9%, and these patients were treated prior to transplantation with no episodes of dissemination. Universal Pre-tsp screening for Strongyloides should be considered in this population.

CITATION INFORMATION: Al-Obaidi M., Vigil K., Hasbun R., De Golovine A., Machicao V., Ostrosky L., Bynon S., Nigo M. Strongyloides Pre-Transplant Screening in Solid Organ Transplantation (SOT): Single Center Analysis Am J Transplant. 2017;17 (suppl 3).

To cite this abstract in AMA style:

Al-Obaidi M, Vigil K, Hasbun R, Golovine ADe, Machicao V, Ostrosky L, Bynon S, Nigo M. Strongyloides Pre-Transplant Screening in Solid Organ Transplantation (SOT): Single Center Analysis [abstract]. https://atcmeetingabstracts.com/abstract/strongyloides-pre-transplant-screening-in-solid-organ-transplantation-sot-single-center-analysis/. Accessed November 21, 2024.

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