title: ClinicalTrypanosoma cruziDisease after Cardiac Transplantation in a Cynomolgus Macaque (Macaca fascicularis).
abstract: A cynomolgus macaque received a heterotopic cardiac allograft as part of a transplant study, with monoclonal antibodies targeted to specific immune costimulation molecules (CD154, CD28) but no traditional immunosuppressive therapy after surgery. Clinical anemia was detected on postoperative day (POD) 35 and had worsened (Hgb, 2.3 g/dL; Hct = 7.3%) by POD 47, despite type-matched whole-blood transfusions. After a total of 4 blood transfusions, hematologic parameters were improved (Hgb, 5.9 g/dL; Hct, 18.7%). On POD 50, a peripheral blood smear revealed trypomastigotes, and qualitative RT-PCR of whole blood identified the organism as Trypanosoma cruzi. Although clinically stable initially, the macaque soon developed sufficient weight loss to necessitate euthanasia on POD 64. The final diagnosis was clinical anemia due to T. cruzi infection. This study represents the first reported case of Chagas disease after heart transplant in a NHP.
authors.affiliation: Department of Surgery First Equine, Dover, Delaware, Banfield Pet Hospital, Laurel, Maryland.
authors.forename: Elana R
authors.initials: ER
authors.lastname: Rybak
authors.affiliation: Department of Surgery and Comparative Medicine Program and Veterinary Resources, University of Maryland School of Medicine, Baltimore, Maryland; Division of Laboratory Animal Medicine, University of North Carolina, Chapel Hill, North Carolina; These authors contributed equally to the study.
authors.forename: Steve
authors.initials: S
authors.lastname: Shipley
authors.affiliation: Department of Surgery and Comparative Medicine Program and Veterinary Resources, University of Maryland School of Medicine, Baltimore, Maryland;, Email: itatarov@smail.umaryland.edu.
authors.forename: Ivan
authors.initials: I
authors.lastname: Tatarov
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Tianshu
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Wenji
authors.initials: W
authors.lastname: Sun
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Braileanu
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Lars
authors.initials: L
authors.lastname: Burdorf
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Sievert
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Agnes M
authors.initials: AM
authors.lastname: Azimzadeh
authors.affiliation: Comparative Medicine Program and Veterinary Resources, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Louis J
authors.initials: LJ
authors.lastname: DeTolla
authors.affiliation: Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland.
authors.forename: Richard N
authors.initials: RN
authors.lastname: Pierson
mesh_terms: D000740:Anemia / Q000150:complications / Q000209:etiology / Q000662:veterinary*; D000818:Animals; D001803:Blood Transfusion; D014355:Chagas Disease / Q000150:complications / Q000473:pathology / Q000662:veterinary*; D004804:Eosinophils / Q000276:immunology; D005260:Female; D006321:Heart / Q000469:parasitology; D016027:Heart Transplantation / Q000009:adverse effects / Q000662:veterinary*; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008252:Macaca fascicularis; D008297:Male; D008992:Monkey Diseases / Q000473:pathology; D014349:Trypanosoma cruzi / Q000276:immunology*
chemical_list: D007166:Immunosuppressive Agents