Leishmaniasis in transplant patients: what do we know so far?

Area of Science:

• * Infectious Diseases
• * Immunology
• * Transplantation

Background:

• * Visceral leishmaniasis (VL) cases in immunosuppressed non-HIV patients, particularly kidney transplant recipients, are increasing.
• * Transplant-associated immunosuppression is a significant risk factor for VL development and recurrence.

Purpose of the Study:

• * To review and update the latest developments in the diagnostic management, treatment, and follow-up of visceral leishmaniasis in transplant recipients.
• * To highlight the growing challenge of VL in the context of organ transplantation and immunosuppression.

Main Methods:

• * Comprehensive literature review of recent studies on visceral leishmaniasis in transplant recipients.
• * Analysis of current treatment guidelines and emerging diagnostic and prognostic markers.

Main Results:

• * Liposomal amphotericin B is the established first-line treatment for VL in transplant patients.
• * Recurrent infections are common due to ongoing immunosuppression.
• * Cellular immune response markers post-treatment show promise as biomarkers for cure, monitoring, and guiding secondary prophylaxis.

Conclusions:

• * There is a lack of consensus on donor/recipient screening protocols and indications for secondary prophylaxis.
• * Further research into novel biomarkers for cure assessment is crucial for managing VL in transplant recipients.
• * Biomarkers could aid in treatment monitoring and prophylaxis decisions in this vulnerable population.