Case Report: Successful Lung Transplantation from a Donor Seropositive for Trypanosoma cruzi Infection (Chagas Disease) to a Seronegative Recipient

Fernando Salvador Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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Adrián Sánchez-Montalvá Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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Elena Sulleiro Department of Microbiology, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain;

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Cristina Berastegui Department of Pulmonology and Lung Transplant Unit, Vall d’Hebron University Hospital, Barcelona, Spain;

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Alberto Jauregui Department of Thoracic Surgery and Lung Transplant Unit, Vall d’Hebron University Hospital, Barcelona, Spain;

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Teresa Pont Department of Organ and Tissue Procurement for Transplantation, Hospital Universitari Vall d’Hebron, Barcelona, Spain

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Ibai Los-Arcos Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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Óscar Len Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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Joan Gavaldà Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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Israel Molina Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain;

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The increasing shortage of organs for transplantation has prompted transplant programs to investigate the use of extended criteria donors, such as those with transmissible infectious diseases. Successful cases of organ transplantation (mostly kidney and liver) from Trypanosoma cruzi seropositive donors to seronegative recipients have been reported. We present a case of lung transplantation from a donor serologically positive for Chagas disease to a seronegative recipient, and provide a review of the literature. Left single lung transplantation was performed in a 44-year-old Spanish woman presenting with interstitial lung disease in February 2016. The deceased donor was a Colombian immigrant living in Spain who was serologically positive for Chagas disease. Oral administration of 5 mg/kg/day benznidazole divided in three doses for 60 days was given for specific Chagas disease prophylaxis after transplantation. Periodic follow-up with serological reverse transcription polymerase chain reaction to detect T. cruzi DNA were performed until 6 months after the end of treatment. All results were negative, indicating that transmission of T. cruzi had not occurred. In a review of the literature, two similar cases were identified in Argentina and the United States. In both cases T. cruzi infection was detected posttransplant in the recipients, after which they were treated with benznidazole. The course of the patient described herein confirms that lungs from donors with chronic T. cruzi infection can be used successfully as allografts, and that posttransplant prophylaxis with benznidazole may reduce the probability of transmission of T. cruzi to the recipient.

Author Notes

Address correspondence to Israel Molina, Infectious Diseases Department, Vall d’Hebron University Hospital, Passeig Vall d’Hebron 119-129, 08035 Barcelona, Spain. E-mail: imolina@vhebron.net

Authors’ addresses: Fernando Salvador, Adrián Sánchez-Montalvá, Ibai Los-Arcos, Óscar Len, Joan Gavaldà, and Israel Molina, Department of Infectious Diseases, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona, Barcelona, Spain, E-mails: fmsalvad@vhebron.net, adsanche@vhebron.net, ilosarco@vhebron.net, olen@vhebron.net, jgavalda@vhebron.net, and imolina@vhebron.net. Elena Sulleiro, Department of Microbiology, Vall d’Hebron University Hospital, PROSICS Barcelona, Barcelona, Spain, E-mail: esulleir@vhebron.net. Cristina Berastegui, Department of Pulmonology and Lung Transplant Unit, Vall d’Hebron University Hospital, Barcelona, Spain, E-mail: cberaste@vhebron.net. Alberto Jauregui, Department of Thoracic Surgery and Lung Transplant Unit, Vall d’Hebron University Hospital, Barcelona, Spain, E-mail: ajauregui@vhebron.net. Teresa Pont, Department of Organ and Tissue Procurement for Transplantation, Hospital Universitari Vall d’Hebron, Barcelona, Spain, E-mail: tpont@vhebron.net.

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