Rapid subacute myelopathy following kidney transplantation from HTLV-1 donors: role of immunosuppresors and failure of antiretrovirals

Roc, L. ; de Mendoza, C. ; Fernandez-Alonso, M. ; Reina, G. ; Soriano, V. ; Rodriguez, C. ; Vera, M. ; del Romero, J. ; Marcaida, G. ; Ocete, M.D. ; Caballero, E. ; Molina, I. ; Aguilera, A. ; Rodriguez-Calvino, J.J. ; Navarro, D. ; Rivero, C. ; Vilarino, M.D. ; Benito, R. (Universidad de Zaragoza) ; Algarate, S. ; Gil, J. ; de Lejarazu, R.O. ; Rojo, S. ; Eiros, J.M. ; San Miguel, A. ; Manzardo, C. ; Miro, J.M. ; Garcia, J. ; Paz, I. ; Poveda, E. ; Calderon, E. ; Escudero, D. ; Trigo, M. ; Diz, J. ; Garcia-Campello, M. ; Rodriguez-Iglesias, M. ; Hernandez-Betancor, A. ; Martin, A.M. ; Ramos, J.M. ; Gimeno, A. ; Gutierrez, F. ; Rodriguez, J.C. ; Sanchez, V. ; Gomez-Hernando, C. ; Cilla, G. ; Perez-Trallero, E. ; Lopez-Aldeguer, J. ; Fernandez-Pereira, L. ; Niubo, J. ; Hernandez, M. ; Lopez-Lirola, A.M. ; Gomez-Sirvent, J.L. ; Force, L. ; Cifuentes, C. ; Perez, S. ; Morano, L. ; Raya, C. ; Gonzalez-Praetorius, A. ; Perez, J.L. ; Penaranda, M. ; Hernaez-Crespo, S. ; Montejo, J.M. ; Martinez-Sapina, A. ; Viciana, I. ; Cabezas, T. ; Lozano, A. ; Fernandez, J.M. ; Garcia-Bermejo, I. ; Gaspar, G. ; Garcia, R. ; Gorgolas, M. ; Vegas, C. ; Blas, J. ; Miralles, P. ; Valeiro, M. ; Aldamiz, T. ; Margall, N. ; Guardia, C. ; do Pico, E. ; Polo, I. ; Aguinaga, A. ; Ezpeleta, C. ; Sauleda, S. ; Piron, M. ; Gonzalez, R. ; Barea, L. ; Jimenez, A. ; Blanco, L. ; Suarez, A. ; Rodriguez-Avial, I. ; Perez-Rivilla, A. ; Parra, P. ; Fernandez, M. ; Trevino, A. ; Requena, S. ; Benitez-Gutierrez, L. ; Cuervas-Mons, V. ; Barreiro, P. ; Corral, O. ; Gomez-Gallego, F.

Resumen: Two kidney transplant recipients from a single donor became infected with HTLV-1 (human T-lymphotropic virus type 1) in Spain. One developed myelopathy 8 months following surgery despite early prescription of antiretroviral therapy. The allograft was removed from the second recipient at month 8 due to rejection and immunosuppressors discontinued. To date, 3 years later, this patient remains infected but asymptomatic. HTLV-1 infection was recognized retrospectively in the donor, a native Spaniard who had sex partners from endemic regions. Our findings call for a reappraisal of screening policies on donor-recipient organ transplantation. Based on the high risk of disease development and the large flux of persons from HTLV-1 endemic regions, pre-transplant HTLV-1 testing should be mandatory in Spain.

Idioma: Inglés

DOI: 10.1177/2049936119868028

Año: 2019

Publicado en: Therapeutic Advances in Infectious Disease 6 (2019), 1-8
ISSN: 2049-9361

Tipo y forma: Article (Published version)

Área (Departamento): Área Microbiología (Dpto. Microb.Med.Pr.,Sal.Públ.)