Helminthic therapy and organ transplantation

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    Pathogenic helminths may present a risk for organ transplant patients, and three possible scenarios are mentioned in the literature.

    • a helminth infection acquired from the donated organ, [1]
    • a latent helminth infection reactivated as a result of post-transplantation immunosuppression, [2]
    • a new helminth infection acquired during the immunosuppressed post-transplantation period.

    However, it appears unlikely that hosting any of the currently available therapeutic helminths will present a threat to a transplant recipient.

    … regardless of whether the transplanted organ was the point of entry of the helminth into the recipient or the helminthiasis was a consequence of the subsequent immunosuppression, only those helminths capable of multiplying in human beings—thus increasing their number—and able to invade various organs and tissues are, in my opinion, relevant and deserve special attention. Therefore, in this sense, the only helminthiasis that constitutes a serious threat to transplant recipients is strongyloidiasis. The only other helminth capable of multiplying in people is the tapeworm Hymenolepis nana but, unlike Strongyloides stercoralis, H. nana is exclusively an intestinal parasite that does not reach any other location. [3]

    Moreover, it is possible that a therapeutic helminth infection might assist in suppressing rejection of a transplanted organ.

    The results show that helminth-derived products can powerfully induce regulatory immunological mechanisms in the presence of a fully allogeneic transplant. Identification of the specific mechanisms involved in suppression of allograft rejection by helminth parasites could lead towards development of safe and effective novel therapeutic strategies. [4]

    Helminths may also provide protection against graft-versus-host disease following bone marrow transplantation. [5]