Probable transmission of Toxoplasma gondii by organ transplantation

Two heart transplant recipients developed toxoplasmosis shortly after surgery. As neither recipient had serologic evidence of exposure to Toxoplasma gondii before transplantation, infection was acquired from an exogenous source. Of the possible modes of transmission of Toxoplasma to the recipients, infection by the oral route or through transfusion of blood or blood products seems remote. Since both heart donors had serologic evidence of recently acquired toxoplasma infection at the time of transplantation and the myocardium is known to be infected with the organism during acute infection, we considered these facts to be a strong implication that the donors' hearts were the most likely source of toxoplasma infection in the recipients.