HTLV-1 infection in solid organ transplant donors and recipients in Spain
Abstract Background HTLV-1 infection is a neglected disease, despite infecting 10–15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely consider...
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doaj-870f10ae33b341978347e68ba08be5912020-11-25T03:12:00ZengBMCBMC Infectious Diseases1471-23342019-08-011911510.1186/s12879-019-4346-zHTLV-1 infection in solid organ transplant donors and recipients in SpainCarmen de Mendoza0Lourdes Roc1Rafael Benito2Gabriel Reina3José Manuel Ramos4Cesar Gómez5Antonio Aguilera6Manuel Rodríguez-Iglesias7Juan García-Costa8Miriam Fernández-Alonso9Vicente Soriano10on behalf of the Spanish HTLV NetworkHospital Universitario Puerta de Hierro-MajadahondaHospital Miguel ServetHospital Lozano BlesaClínica Universitaria de NavarraHospital General UniversitarioComplejo HospitalarioHospital Conxo-CHUSHospital Puerta del MarComplejo Hospitalario UniversitarioClínica Universitaria de NavarraUNIR Health Sciences School and Medical CentreAbstract Background HTLV-1 infection is a neglected disease, despite infecting 10–15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. Methods All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. Results A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. Conclusion The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy.http://link.springer.com/article/10.1186/s12879-019-4346-zHTLV-1TransplantationScreeningTropical spastic paraparesisAdult T-cell leukaemiaImmunosuppression |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Carmen de Mendoza Lourdes Roc Rafael Benito Gabriel Reina José Manuel Ramos Cesar Gómez Antonio Aguilera Manuel Rodríguez-Iglesias Juan García-Costa Miriam Fernández-Alonso Vicente Soriano on behalf of the Spanish HTLV Network |
spellingShingle |
Carmen de Mendoza Lourdes Roc Rafael Benito Gabriel Reina José Manuel Ramos Cesar Gómez Antonio Aguilera Manuel Rodríguez-Iglesias Juan García-Costa Miriam Fernández-Alonso Vicente Soriano on behalf of the Spanish HTLV Network HTLV-1 infection in solid organ transplant donors and recipients in Spain BMC Infectious Diseases HTLV-1 Transplantation Screening Tropical spastic paraparesis Adult T-cell leukaemia Immunosuppression |
author_facet |
Carmen de Mendoza Lourdes Roc Rafael Benito Gabriel Reina José Manuel Ramos Cesar Gómez Antonio Aguilera Manuel Rodríguez-Iglesias Juan García-Costa Miriam Fernández-Alonso Vicente Soriano on behalf of the Spanish HTLV Network |
author_sort |
Carmen de Mendoza |
title |
HTLV-1 infection in solid organ transplant donors and recipients in Spain |
title_short |
HTLV-1 infection in solid organ transplant donors and recipients in Spain |
title_full |
HTLV-1 infection in solid organ transplant donors and recipients in Spain |
title_fullStr |
HTLV-1 infection in solid organ transplant donors and recipients in Spain |
title_full_unstemmed |
HTLV-1 infection in solid organ transplant donors and recipients in Spain |
title_sort |
htlv-1 infection in solid organ transplant donors and recipients in spain |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2019-08-01 |
description |
Abstract Background HTLV-1 infection is a neglected disease, despite infecting 10–15 million people worldwide and severe illnesses develop in 10% of carriers lifelong. Acknowledging a greater risk for developing HTLV-1 associated illnesses due to immunosuppression, screening is being widely considered in the transplantation setting. Herein, we report the experience with universal HTLV testing of donors and recipients of solid organ transplants in a survey conducted in Spain. Methods All hospitals belonging to the Spanish HTLV network were invited to participate in the study. Briefly, HTLV antibody screening was performed retrospectively in all specimens collected from solid organ donors and recipients attended since the year 2008. Results A total of 5751 individuals were tested for HTLV antibodies at 8 sites. Donors represented 2312 (42.2%), of whom 17 (0.3%) were living kidney donors. The remaining 3439 (59.8%) were recipients. Spaniards represented nearly 80%. Overall, 9 individuals (0.16%) were initially reactive for HTLV antibodies. Six were donors and 3 were recipients. Using confirmatory tests, HTLV-1 could be confirmed in only two donors, one Spaniard and another from Colombia. Both kidneys of the Spaniard were inadvertently transplanted. Subacute myelopathy developed within 1 year in one recipient. The second recipient seroconverted for HTLV-1 but the kidney had to be removed soon due to rejection. Immunosuppression was stopped and 3 years later the patient remains in dialysis but otherwise asymptomatic. Conclusion The rate of HTLV-1 is low but not negligible in donors/recipients of solid organ transplants in Spain. Universal HTLV screening should be recommended in all donor and recipients of solid organ transplantation in Spain. Evidence is overwhelming for very high virus transmission and increased risk along with the rapid development of subacute myelopathy. |
topic |
HTLV-1 Transplantation Screening Tropical spastic paraparesis Adult T-cell leukaemia Immunosuppression |
url |
http://link.springer.com/article/10.1186/s12879-019-4346-z |
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