Transmission of T. cruzi infection via liver transplantation to a nonreactive recipient for Chagas' disease.
Chagas' disease is an endemic zoonosis of South America caused by a protozoan parasite Trypanosoma cruzi. About 30% of infected people develop the disease. This disease is known to reactivate in immunocompromised hosts, such as patients with acquired immunodeficiency syndrome, leukemia, and transplantation. There is some experience with transplantation of infected renal grafts into negative recipients, resulting in an index of transmission of 35%. No cases have been reported involving other organ transplants up to 2002, when the Centers for Disease Control and Prevention reported 3 cases of Chagas' disease transmission to 3 recipients (liver, kidney, and pancreas-kidney) from a single chagas infected donor. Here we report on a case of orthotopic liver transplant from a chagas infected donor into a negative recipient in clinical emergency status. The recipient was monitored by direct parasitological Strout method and serological tests with detection of transmission on the 84 th day by both studies, without clinical signs. The patient was put on benznidazole with rapid clearance of the parasitemia. However, we propose that chagas infected donors may be accepted for liver transplant recipients only in emergency status.
Barcán
Laura
L
Infectious Disease Section, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. lbarcan@intramed.net.ar
Luna
Concepcion
C
Lunaó
Concepción
C
Clara
Liliana
L
Sinagra
Angel
A
Valledor
Alejandra
A
De Rissio
Ana María
AM
De Rissioí
Ana María
AM
Gadano
Adrian
A
Gadanoá
Adrián
A
García
Myriam Martín
MM
de Santibañes
Eduardo
E
Riarte
Adelina
A
D000328:Adult; D000818:Animals; D014355:Chagas Disease / Q000209:etiology / Q000635:transmission*; D018562:Disease Transmission, Infectious; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016031:Liver Transplantation / Q000009:adverse effects*; D014019:Tissue Donors; D014349:Trypanosoma cruzi