Schistosomiasis and renal transplantation

Area of Science:

• Nephrology
• Infectious Diseases
• Transplantation Immunology

Background:

• Schistosomiasis is a parasitic disease prevalent in endemic areas.
• Renal transplantation involves careful donor and recipient evaluation.
• The impact of schistosomiasis on renal transplant outcomes requires investigation.

Observation:

• Schistosomiasis was detected in 4 of 67 live-related renal transplant recipients and 12 donors.
• All infected individuals received preoperative anti-schistosomal chemotherapy.
• Recipients showed no post-transplant complications, including those with bladder calcifications.

Findings:

• Cystoscopy with biopsy offers superior schistosomiasis detection compared to imaging or urinalysis.
• Excretory urography is essential for assessing structural urinary tract changes.
• One donor experienced reinfection and ureteral dilatation after returning to an endemic region.

Implications:

• Schistosomiasis is not an absolute contraindication for renal transplantation.
• Live kidney donors with pre-existing anatomical urinary tract abnormalities due to schistosomiasis should be excluded.
• Careful screening and management are crucial for schistosomiasis-positive individuals undergoing renal transplantation.