Toxoplasma gondii infection in feline renal transplant recipients: 24 cases (1998-2018).

ABSTRACT

OBJECTIVE: To evaluate the effects of Toxoplasma gondii infection in feline renal transplant recipients with a preoperative seronegative or unknown serostatus (SN-UNK) for T gondii and the efficacy of lifelong prophylactic treatment of T gondii infection in feline renal transplant recipients with a preoperative seropositive serostatus (SP) for T gondii. ANIMALS 24 cats with various serostatuses for T gondii before undergoing renal transplantation. PROCEDURES Medical records of cats that had undergone renal transplantation from 1998 through 2018 were reviewed. Two groups of cats were identified. Before renal transplantation, the SN-UNK group cats were seronegative for T gondii (n = 4) or serostatus for T gondii was unknown (4). The SN-UNK group cats received immunosuppressive therapy but were not maintained on prophylactic treatment of T gondii infection. The SP group cats were seropositive for T gondii (n = 16) prior to initiation of immunosuppressive therapy and renal transplantation and were managed after surgery with prophylactic treatment of T gondii infection. RESULTS: All 8 SN-UNK group cats developed T gondii infections after initiation of immunosuppressive therapy and renal transplantation; T gondii infections were fatal in 6 cats. Of 16 SP group cats, 1 developed a nonfatal T gondii infection resulting in an allograft rejection episode. No SP group cats, which were managed postoperatively with prophylactic treatment, developed a fatal T gondii infection. CONCLUSIONS AND CLINICAL RELEVANCE T gondii infection resulted in morbidity and death in immunosuppressed cats not receiving prophylactic treatment of T gondii infection after renal transplantation. Seropositive cats were acceptable candidates for renal transplantation when lifelong prophylactic treatment of T gondii infection was provided.