Transmission of T. cruzi infection via liver transplantation to a nonreactive recipient for Chagas' disease

✍ Scribed by Laura Barcán; Concepción Lunaó; Liliana Clara; Angel Sinagra; Alejandra Valledor; Ana María De Rissioí; Adrián Gadanoá; Myriam Martín García; Eduardo de Santibañes; Adelina Riarte

• Publisher: John Wiley and Sons
• Year: 2005
• Tongue: English
• Weight: 78 KB
• Volume: 11
• Category: Article
• ISSN: 1527-6465
• DOI: 10.1002/lt.20522

✦ Synopsis

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 trans

plants 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 84th 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. (Liver Transpl 2005;11:1112-1116.)

C hagas' disease is an endemic zoonosis of South America, although the parasite exists from the south of the United States to the southernmost end of Argentina. Ninety million people are estimated to live in endemic areas at risk for infection, and 25% of them are considered to be infected.