Article Dans Une Revue Transplant Infectious Disease Année : 2021

Microsporidiosis after liver transplantation: A French nationwide retrospective study

Jérôme Dumortier
Sylvie Radenne
Filomena Conti
  • Fonction : Auteur
Armand Abergel
Audrey Coilly
Claire Francoz
  • Fonction : Auteur
Pauline Houssel-Debry
Claire Vanlemmens
  • Fonction : Auteur
Noémie Laverdure
Christophe Duvoux
  • Fonction : Auteur
Marc Thellier
Adela Angoulvant
Nicolas Argy
Brice Autier
Anne‐Pauline Bellanger
Françoise Botterel
Cyril Garrouste
Meja Rabodonirina
  • Fonction : Auteur
Philippe Poirier

Résumé

Abstract Background Microsporidiosis has been largely reported in patients with acquired immunodeficiency syndrome, but emerged as a cause of persistent diarrhea in solid organ transplant patients. Methods Through the French Microsporidiosis Network and the Groupe français de recherche en greffe de foie, we collected all microsporidiosis cases identified in liver transplant patients between 1995 and 2020 in France. Results We identified 24 liver transplant recipients with microsporidiosis. Sex ratio was balanced and median age was 58.8 (3.5‐83.5) years (there were 4 children). Microsporidiosis occurred at a median time of 3.9 (0.1‐18.9) years post‐transplant. Median duration of diarrhea before diagnosis was 22 days (12‐45). Therapeutic care included immunosuppressive therapy changes in 20 patients, as follows: stop cyclosporine or tacrolimus (n = 2), dose reduction of cyclosporine or tacrolimus (n = 12), stop MMF (n = 5), and dose reduction of corticosteroids (n = 1). In addition, 15 patients received specific therapy against microsporidiosis: fumagillin (n = 11) or albendazole (n = 4). Median duration of treatment was 14 days (8‐45 days). Finally, 7 patients had immunosuppressive treatment tapering only. Microsporidiosis was complicated by renal failure in 15 patients, requiring dialysis in one case. Two patients had infection relapse. No patient presented proven rejection within the 3 months after microsporidiosis. None of the patients died within the 3 months after microsporidiosis. Conclusions Microsporidiosis is a very rare infection after liver transplantation but can induce severe dehydration and renal failure. Therefore, it must be systematically sought in any case of persistent diarrhea after first line screening of frequent infectious causes.

Dates et versions

hal-04313099 , version 1 (29-11-2023)

Identifiants

Citer

Jérôme Dumortier, Sylvie Radenne, Nassim Kamar, Filomena Conti, Armand Abergel, et al.. Microsporidiosis after liver transplantation: A French nationwide retrospective study. Transplant Infectious Disease, 2021, 23 (4), ⟨10.1111/tid.13665⟩. ⟨hal-04313099⟩
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