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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2016;69:1160-6 - Vol. 69 Num.12 DOI: 10.1016/j.rec.2016.04.059

Toxoplasma Gondii Serostatus in Heart Transplant Recipients: Is It an Independent Prognostic Factor?

Eduardo Barge-Caballero a,b,, Cayetana Barbeito-Caamaño a,b, Gonzalo Barge-Caballero a,b, David Couto-Mallón a,b, María J. Paniagua-Martín a,b, Raquel Marzoa-Rivas a,b, Miguel Solla-Buceta b,c, Francisco Estévez-Cid b,d, José M. Herrera-Noreña b,d, José J. Cuenca-Castillo b,d, José M. Vázquez-Rodríguez a,b, María G. Crespo-Leiro a,b

a Servicio de Cardiología, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
b Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain
c Servicio de Medicina Intensiva, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain
d Servicio de Cirugía Cardiaca, Complejo Hospitalario Universitario A Coruña, A Coruña, Spain

Keywords

Heart transplant. Toxoplasma gondii. Outcomes. Survival.

Abstract

Introduction and objectives

To assess the potential association between recipient Toxoplasma gondii serostatus and outcomes after heart transplant (HT).

Methods

We conducted a retrospective single-center study of 657 HT recipients from 1991 to 2015. Survival and the incidence of adverse clinical events of T. gondii-seropositive (n = 481) vs T. gondii-seronegative (n = 176) recipients were compared by means of 2 different multivariable Cox regression models. Model 1 included solely age and sex, and model 2 included other potential confounders.

Results

Over a median follow-up of 2903 days (interquartile range: 898-4757), 250 seropositive recipients (52%) and 72 seronegative recipients (41%) died. Univariable analysis showed increased posttransplant mortality among T. gondii-seropositive recipients (hazard ratio [HR] = 1.31; 95% confidence interval [95%CI], 1,00-1.70). After multivariable adjustment, the statistical significance of this association was lost (model 1: HR = 1.09; 95%CI, 0.83-1.43; model 2:HR = 1.12; 95%CI, 0.85-1.47). Recipient T. gondii seropositivity was independently associated with an increased risk of acute rejection (model 1: HR = 1.36; 95%CI, 1.06-1.74; model 2: HR = 1.29; 95%CI, 1.01-1.66). Multivariable models showed no statistically significant impact of recipient T. gondii serostatus on the incidence of infection, malignancy, coronary allograft vasculopathy, or the composite outcome of cardiac death or retransplant. No significant association was found between donor-recipient T. gondii serostatus matching and posttransplant outcome.

Conclusions

In this study, recipient T. gondii serostatus was not an independent predictor of long-term post-HT outcome.

1885-5857/© 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved