A 5-year single-center review of Strongyloides seropositivity in cardiac transplant candidates in Central Texas.

BACKGROUND

Strongyloides stercoralis is a parasitic nematode that chronically infects an estimated 30 to 100 million individuals worldwide. In solid organ transplant recipients, Strongyloides can cause disseminated disease or hyperinfection, both with a high mortality rate. The American Society of Transplantation recommends serologic screening for all potential transplant donors and recipients with risk factors.

METHODS

This single-center, retrospective chart review involved patients aged 18 or older who underwent evaluation for cardiac transplant and serologic Strongyloides screening at Baylor Scott & White Medical Center in Temple, Texas, between March 2019 and March 2024. A total of 259 patients underwent screening for Strongyloides as part of a broader evaluation for cardiac transplant candidacy. Data were collected and managed using REDCap hosted at our institution. Bivariate analyses were completed to test the association between the Strongyloides seropositive and seronegative groups. All statistical analyses were performed in SAS 9.4.

RESULTS

Of 259 patients, 11.58% tested positive or equivocal for Strongyloides. All seropositive or serology equivocal patients received appropriate treatment.

CONCLUSION

Based on our results, targeted screening may miss many seropositive patients. Given the lack of epidemiological risk factors within our seropositive population, we recommend consideration of universal screening for solid organ transplants for Strongyloides.