Chagas' disease in patients with kidney transplants: 7 years of experience 1989-1996.
Chagas' disease was present in 17.22% of persons undergoing kidney transplantation in an Argentine Hospital. The criterion for attributing reactivation of chronic Chagas' disease and transmission of Trypanosoma cruzi to grafts was detection of parasites in blood (patent parasitemia) or tissues. Reactivation was diagnosed in 5 (21.7%) of 23 recipients. Ten (43.4%) of 23 chagasic recipients without reactivation of chronic Chagas' disease had abrogation of serological reactivity. T. cruzi infection was transmitted to 3 (18.7%) of 16 non-chagasic recipients. Reactivation and infection were diagnosed by patent parasitemia or cutaneous panniculitis. For diagnosis, detection of parasites in blood and tissues had more relevance than serology. Sequential monitoring detected early reactivation and infection, permitting application of preemptive or therapeutic therapy with benznidazole, thus inhibiting, in all patients, severe clinical disease produced by a progressive and systemic replication of the parasite.
Riarte
A
A
Instituto Nacional de Parasitologia Dr. Mario Fatala Chabén, the Hospital Dr. Cosme Argerich, Municipalidad de la Ciudad de Buenos Aires, Argentina. ade@inscha.gov.ar
Luna
C
C
Sabatiello
R
R
Sinagra
A
A
Schiavelli
R
R
De Rissio
A
A
Maiolo
E
E
Garcìa
M M
MM
Jacob
N
N
Pattin
M
M
Lauricella
M
M
Segura
E L
EL
Vázquez
M
M
D000293:Adolescent; D000328:Adult; D001118:Argentina / Q000453:epidemiology; D014355:Chagas Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D016867:Immunocompromised Host; D015994:Incidence; D016030:Kidney Transplantation / Q000009:adverse effects* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D015996:Survival Rate