title: Transmission of T. cruzi infection via liver transplantation to a nonreactive recipient for Chagas' disease.
abstract: 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.
authors.affiliation: Infectious Disease Section, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. lbarcan@intramed.net.ar
authors.forename: Laura
authors.initials: L
authors.lastname: Barcán
authors.forename: Concepcion
authors.initials: C
authors.lastname: Luna
authors.forename: Concepción
authors.initials: C
authors.lastname: Lunaó
authors.forename: Liliana
authors.initials: L
authors.lastname: Clara
authors.forename: Angel
authors.initials: A
authors.lastname: Sinagra
authors.forename: Alejandra
authors.initials: A
authors.lastname: Valledor
authors.forename: Ana María
authors.initials: AM
authors.lastname: De Rissio
authors.forename: Ana María
authors.initials: AM
authors.lastname: De Rissioí
authors.forename: Adrian
authors.initials: A
authors.lastname: Gadano
authors.forename: Adrián
authors.initials: A
authors.lastname: Gadanoá
authors.forename: Myriam Martín
authors.initials: MM
authors.lastname: García
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Santibañes
authors.forename: Adelina
authors.initials: A
authors.lastname: Riarte
mesh_terms: 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