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Incidental Schistosomiasis in Transplant Liver: A Case Report and Review of the Literature

Abstract

Ravi A Patel, Oscar W Cummings, Richard S Mangus, Parth M Patel, Santosh Nagaraju, A Joseph Tector and Jingmei Lin

Background: We report a rare case of incidental allograft liver schistosomiasis within the United States.

Methods: A 52-year-old Filipino female received a liver transplant for decompensated cirrhosis and hepatocellular carcinoma secondary to hepatitis B viral infection and alcoholic liver disease.

Results: Her posttransplant course was unremarkable. However, a protocol liver allograft biopsy revealed multiple dead and calcified Schistosoma eggs. The patient’s explant liver showed cirrhosis but no signs of Schistosoma. This finding of incidental hepatic schistosomiasis prompted a retrospective review of the donor’s profile. The donor had no history of liver disease, schistosomiasis, or any signs to suggest an active parasitic infection. It was elected to follow this patient without any empirical treatment. The patient was discharged on standard posttransplant immunosuppression. Currently after four months of followup she remains disease free.

Conclusions: With many immigrants migrating into the United States, plausible guidelines are necessary at large liver transplant centers in regard as screening donor livers and management for Schistosoma

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