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The liver as an organ at risk for Toxoplasma transmission during transplantation: myth or reality?
  1. Brice Autier1,
  2. Sarah Dion2,3,
  3. Florence Robert-Gangneux1,2,3
  1. 1 Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Rennes, Rennes, France
  2. 2 Institut de recherche en santé, environnement et travail, Inserm U0185, Rennes, France
  3. 3 Université Rennes 1, Rennes, France
  1. Correspondence to Professor Florence Robert-Gangneux, Laboratoire de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Rennes, F-35033, France; florence.robert-gangneux{at}


Aim Toxoplasmosis following liver transplant with donor–recipient mismatch is rare, but is often life-threatening. However, there are no data on the frequency of cyst carriage in the liver, nor consensual chemoprophylaxis guidelines. This study aimed at describing frequency and localisation of Toxoplasma cysts in the liver in a mouse model of chronic infection to predict the risk in liver transplantation.

Methods Heart, brain and liver lobes of 21 mice chronically infected with Toxoplasma were collected for DNA extraction and amplification of Toxoplasma gondii rep529 sequence by real-time PCR.

Results Parasite DNA was detected in the liver of 19/21 mice (90.5%), with no preferential anatomical localisation, but with higher parasite loads in the papillary process. Parasite loads in the liver were far lower than in brain and heart. The number of infected lobes was inversely correlated to the total liver weight, but was independent of the brain parasite load and of the parasite strain.

Conclusions The liver is a frequent site of cyst carriage, confirming that transplantation of an organ from a seropositive donor to seronegative recipient is at high risk for acquired toxoplasmosis. Systematic serological screening prior to transplantation and chemoprophylaxis in patients at risk are fully justified.

  • toxoplasma
  • transplantation
  • liver
  • infections

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  • Handling editor Tony Mazzulli.

  • Contributors FRG and SD designed the study. FRG performed mouse dissection. BA, SD and FRG realised samples collection and storage and wrote the manuscript. BA performed DNA extraction and real-time PCR. BA and FRG analysed the results.

  • Funding The Centre Hospitalier Universitaire de Rennes supports the animal facility for its routine use for toxoplasmosis diagnosis. Molecular analyses were funded by a grant of the European Society of Clinical Microbiology & Infectious Diseases, Study Group of Clinical Parasitology (ESGCP)(#P307-09).

  • Competing interests None declared.

  • Ethics approval Animal experiment was approved by the local Ethics Committee and the Ministère de l’Enseignement Supérieur et de la Recherche (agreement no 2016121517337913).

  • Provenance and peer review Not commissioned; externally peer reviewed.