नेफ्रोलॉजी और थेरेप्यूटिक्स जर्नल

Visceral Leishmaniasis in Renal Transplant Recipients: Study of 30 Cases

Abstract

Alves Da Silva A *,Barros da Silva DM ,Chaves RV ,Cintra Sesso R ,Pacheco-Silva A ,Oliveira CMC ,Fernandes PFCBC ,Oliveira RA ,Esmeraldo RM ,Andrade JX ,Costa CHN

Introduction: Visceral leishmaniasis is a disease caused by the protozoan Leishmania sp. and is transmitted by Lutzomyia longipalpis (sand fly). In renal transplant recipients, Visceral Leishmaniasis causes severe damage to the liver, spleen, and hematopoietic system as well as poor outcomes for patients and transplanted kidneys. This study describes the largest series of cases of this disease in renal transplant recipients, providing important information about the diagnostic routines and therapeutic strategies in this patient population. Methods: A retrospective, descriptive study was performed to analyze the distribution and evaluate the extent of the epidemiologic, clinical, diagnostic, and therapeutic aspects of 30 renal transplant recipients from endemic regions who presented with Visceral Leishmaniasis in the post-transplantation period. Results: In this study, Visceral Leishmaniasis was more frequent in men (80%); the mean age of presentation was 40±10.5 years. The majority (66.7%) of patients worked in urban areas. Most of the patients (90%) cohabitated with domestic animals and were from low-income households. In 73.3% of cases, diagnosis was made by direct isolation of Leishmania forms. The drug chosen for treatment was liposomal amphotericin, resulting in a high degree of disease remission (80%). Conclusion: This study describes the largest series of Visceral Leishmaniasis in renal transplant recipients and expands clinical-epidemiological knowledge for transplantation teams to perform adequate disease management for this specific patient population