Chagas' Disease in Patients with Kidney Transplants: 7 Years of Experience, 1989–1996

• Published in: Clinical infectious diseases Vol. 29; no. 3; pp. 561 - 567
• Main Authors: Riarte, A., Luna, C., Sabatiello, R., Sinagra, A., Schiavelli, R., Rissio, A. De, Maiolo, E., García, M. M., Jacob, N., Pattin, M., Lauricella, M., Segura, E. L., Vàzquez, M.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.09.1999; University of Chicago Press
• Subjects: Adolescent; Adult; Argentina - epidemiology; Biological and medical sciences; Chagas disease; Chagas Disease - diagnosis; Chagas Disease - drug therapy; Chagas Disease - epidemiology; Chagas Disease - etiology; Chronic diseases; Clinical Articles; Evaluation Studies as Topic; Female; Follow-Up Studies; Graft Rejection; Graft Survival; Human protozoal diseases; Humans; Immunocompromised Host; Incidence; Infections; Infectious diseases; Kidney diseases; Kidney transplantation; Kidney Transplantation - adverse effects; Kidney Transplantation - immunology; Kidneys; Male; Medical sciences; Middle Aged; Parasitemia; Parasitic diseases; Protozoal diseases; Risk Factors; Survival Rate; Transplantation; Tropical medicine; Trypanosomiasis; Argentina; Kinetoplastida; Human; Protozoa; Protozoal disease; Reactivation; Chagas disease; Transplantation; Parasitosis; Medical screening; Homotransplantation; Kidney; Trypanosoma cruzi; Infection; Microbiological investigation; Donor; Surgery; Complication; Diagnosis; Parasitemia; Trypanosomiasis
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/598634

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.