World Health Organization, 2016. Chagas Disease (American Trypanosomiasis). Available at: http://www.who.int/chagas/disease/en/. Accessed February 1, 2017.
Robertson LJ, Devleesschauwer B, Alarcón de Noya B, Noya-González O, Torgerson PR, 2016. Trypanosoma cruzi: time for international recognition as a foodborne parasite. PLoS Negl Trop Dis 10: e4656.
Len O, Garzoni C, Lumbreras C, Molina I, Meije Y, Pahissa A, Grossi P; ESCMID Study Group of Infection in Compromised Hosts, 2014. Recommendations for screening of donor and recipient prior to solid organ transplantation and to minimize transmission of donor-derived infections. Clin Microbiol Infect 20 (Suppl 7 ): 10–18.
Chin-Hong PV, Schwartz BS, Bern C, Montgomery SP, Kontak S, Kubak B, Morris MI, Nowicki M, Wright C, Ison MG, 2011. Screening and treatment of Chagas disease in organ transplant recipients in the United States: recommendations from the Chagas in transplant working group. Am J Transplant 11: 672–680.
Salvador F, Len O, Molina I, Sulleiro E, Sauleda S, Bilbao I, Castells L, Pont T, Gavaldà J, Pahissa A, 2011. Safety of liver transplantation with Chagas disease-seropositive donors for seronegative recipients. Liver Transpl 17: 1304–1308.
Sousa AA, Lobo MC, Barbosa RA, Bello V, 2004. Chagas seropositive donors in kidney transplantation. Transplant Proc 36: 868–869.
Barcan L, Luna C, Clara L, Sinagra A, Valledor A, De Rissio AM, Gadano A, García MM, De Santibañes E, Riarte A, 2005. Transmission of T. cruzi infection via liver transplantation to a nonreactive recipient for Chagas’ disease. Liver Transpl 11: 1112–1116.
D’Albuquerque LA, Gonzalez AM, Filho HL, Copstein JL, Larrea FI, Mansero JM, Perón G Jr, Ribeiro MA Jr, Oliveira de Silva A, 2007. Liver transplantation from deceased donors serologically positive for Chagas disease. Am J Transplant 7: 680–684.
Riarte A, et al., 1999. Chagas’ disease in patients with kidney transplants: 7 years of experience 1989–1996. Clin Infect Dis 29: 561–567.
McCormack L, Quiñónez E, Goldaracena N, Anders M, Rodriguez V, Orozco Ganem F, Mastai RC, 2012. Liver transplantation using Chagas-infected donors in uninfected recipients: a single-center experience without prophylactic therapy. Am J Transplant 12: 2832–2837.
Piron M, Fisa R, Casamitjana N, López-Chéjade P, Puig L, Vergés M, Gascón J, Gómez i Prat J, Portús M, Sauleda S, 2007. Development of a real-time PCR assay for Trypanosoma cruzi detection in blood samples. Acta Trop 103: 195–200.
Cura CI, Lattes R, Nagel C, Gimenez MJ, Blanes M, Calabuig E, Iranzo A, Barcan LA, Anders M, Schijman AG, 2013. Early molecular diagnosis of acute Chagas disease after transplantation with organs from Trypanosoma cruzi-infected donors. Am J Transplant 13: 3253–3261.
Huprikar S, et al., 2013. Donor-derived Trypanosoma cruzi infection in solid organ recipients in the United States, 2001–2011. Am J Transplant 13: 2418–2425.
De Faria JB, Alves G, 1993. Transmission of Chagas’ disease through cadaveric renal transplantation. Transplantation 56: 1583–1584.
Centers for Disease Control and Prevention, 2002. Chagas disease after organ transplantation–United States, 2001. MMWR Morb Mortal Wkly Rep 51: 210–212.
Bern C, 2012. Chagas disease in the immunosuppressed host. Curr Opin Infect Dis 25: 450–457.
Pinazo MJ, et al., 2011. Recommendations for management of Chagas disease in organ and hematopoietic tissue transplantation programs in non-endemic areas. Transplant Rev (Orlando) 25: 91–101.
Requena-Méndez A, Albajar-Viñas P, Angheben A, Chiodini P, Gascón J & Muñoz J ; Chagas Disease COHEMI Working Group, 2014. Health policies to control Chagas disease transmission in European countries. PLoS Negl Trop Dis 8: e3245.
Schmunis GA, Yadon ZE, 2010. Chagas disease: a Latin American health problema becoming a world health problem. Acta Trop 115: 14–21.
Salvador F, et al., 2014. Trypanosoma cruzi infection in a non-endemic country: epidemiological and clinical profile. Clin Microbiol Infect 20: 706–712.
Basile L, et al., 2011. Chagas disease in European countries: the challenge of a surveilllance system. Euro Surveill 16: 19968.
Pinazo MJ, Espinosa G, Cortés-Lletget C, Posada E, Aldasoro E, Oliveira I, Muñoz J, Gállego M, Gascón J, 2013.Immunosuppression and Chagas disease: a management challenge. PLoS Negl Trop Dis 7: e1965.
Salvador F, Sánchez-Montalvá A, Valerio L, Serre N, Roure S, Treviño B, Pou D, Sulleiro E, Bocanegra C, Molina I, 2015. Immunosuppression and Chagas disease; experience from a non-endemic country. Clin Microbiol Infect 21: 854–860.
World Health Organization Expert Committee, 2002. Control of Chagas disease. World Health Organ Tech Rep Ser 905: 1–109.
Maldonado C, Albano S, Vettorazzi L, Salomone O, Zlocowski JC, Abiega C, Amuchastegui M, Córdoba R, Alvarellos T, 2004. Using polymerase chain reaction in early diagnosis of re-activated Trypanosoma cruzi infection after heart transplantation. J Heart Lung Transplant 23: 1345–1348.
Schijman AG, Vigliano C, Burgos J, Favaloro R, Perrone S, Laguens R, Levin MJ, 2000. Early diagnosis of recurrence of Trypanosoma cruzi infection by polimerasa chain reaction after heart transplantation of a chronic Chagas’ heart disease patient. J Heart Lung Transplant 19: 1114–1117.
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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.
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.
World Health Organization, 2016. Chagas Disease (American Trypanosomiasis). Available at: http://www.who.int/chagas/disease/en/. Accessed February 1, 2017.
Robertson LJ, Devleesschauwer B, Alarcón de Noya B, Noya-González O, Torgerson PR, 2016. Trypanosoma cruzi: time for international recognition as a foodborne parasite. PLoS Negl Trop Dis 10: e4656.
Len O, Garzoni C, Lumbreras C, Molina I, Meije Y, Pahissa A, Grossi P; ESCMID Study Group of Infection in Compromised Hosts, 2014. Recommendations for screening of donor and recipient prior to solid organ transplantation and to minimize transmission of donor-derived infections. Clin Microbiol Infect 20 (Suppl 7 ): 10–18.
Chin-Hong PV, Schwartz BS, Bern C, Montgomery SP, Kontak S, Kubak B, Morris MI, Nowicki M, Wright C, Ison MG, 2011. Screening and treatment of Chagas disease in organ transplant recipients in the United States: recommendations from the Chagas in transplant working group. Am J Transplant 11: 672–680.
Salvador F, Len O, Molina I, Sulleiro E, Sauleda S, Bilbao I, Castells L, Pont T, Gavaldà J, Pahissa A, 2011. Safety of liver transplantation with Chagas disease-seropositive donors for seronegative recipients. Liver Transpl 17: 1304–1308.
Sousa AA, Lobo MC, Barbosa RA, Bello V, 2004. Chagas seropositive donors in kidney transplantation. Transplant Proc 36: 868–869.
Barcan L, Luna C, Clara L, Sinagra A, Valledor A, De Rissio AM, Gadano A, García MM, De Santibañes E, Riarte A, 2005. Transmission of T. cruzi infection via liver transplantation to a nonreactive recipient for Chagas’ disease. Liver Transpl 11: 1112–1116.
D’Albuquerque LA, Gonzalez AM, Filho HL, Copstein JL, Larrea FI, Mansero JM, Perón G Jr, Ribeiro MA Jr, Oliveira de Silva A, 2007. Liver transplantation from deceased donors serologically positive for Chagas disease. Am J Transplant 7: 680–684.
Riarte A, et al., 1999. Chagas’ disease in patients with kidney transplants: 7 years of experience 1989–1996. Clin Infect Dis 29: 561–567.
McCormack L, Quiñónez E, Goldaracena N, Anders M, Rodriguez V, Orozco Ganem F, Mastai RC, 2012. Liver transplantation using Chagas-infected donors in uninfected recipients: a single-center experience without prophylactic therapy. Am J Transplant 12: 2832–2837.
Piron M, Fisa R, Casamitjana N, López-Chéjade P, Puig L, Vergés M, Gascón J, Gómez i Prat J, Portús M, Sauleda S, 2007. Development of a real-time PCR assay for Trypanosoma cruzi detection in blood samples. Acta Trop 103: 195–200.
Cura CI, Lattes R, Nagel C, Gimenez MJ, Blanes M, Calabuig E, Iranzo A, Barcan LA, Anders M, Schijman AG, 2013. Early molecular diagnosis of acute Chagas disease after transplantation with organs from Trypanosoma cruzi-infected donors. Am J Transplant 13: 3253–3261.
Huprikar S, et al., 2013. Donor-derived Trypanosoma cruzi infection in solid organ recipients in the United States, 2001–2011. Am J Transplant 13: 2418–2425.
De Faria JB, Alves G, 1993. Transmission of Chagas’ disease through cadaveric renal transplantation. Transplantation 56: 1583–1584.
Centers for Disease Control and Prevention, 2002. Chagas disease after organ transplantation–United States, 2001. MMWR Morb Mortal Wkly Rep 51: 210–212.
Bern C, 2012. Chagas disease in the immunosuppressed host. Curr Opin Infect Dis 25: 450–457.
Pinazo MJ, et al., 2011. Recommendations for management of Chagas disease in organ and hematopoietic tissue transplantation programs in non-endemic areas. Transplant Rev (Orlando) 25: 91–101.
Requena-Méndez A, Albajar-Viñas P, Angheben A, Chiodini P, Gascón J & Muñoz J ; Chagas Disease COHEMI Working Group, 2014. Health policies to control Chagas disease transmission in European countries. PLoS Negl Trop Dis 8: e3245.
Schmunis GA, Yadon ZE, 2010. Chagas disease: a Latin American health problema becoming a world health problem. Acta Trop 115: 14–21.
Salvador F, et al., 2014. Trypanosoma cruzi infection in a non-endemic country: epidemiological and clinical profile. Clin Microbiol Infect 20: 706–712.
Basile L, et al., 2011. Chagas disease in European countries: the challenge of a surveilllance system. Euro Surveill 16: 19968.
Pinazo MJ, Espinosa G, Cortés-Lletget C, Posada E, Aldasoro E, Oliveira I, Muñoz J, Gállego M, Gascón J, 2013.Immunosuppression and Chagas disease: a management challenge. PLoS Negl Trop Dis 7: e1965.
Salvador F, Sánchez-Montalvá A, Valerio L, Serre N, Roure S, Treviño B, Pou D, Sulleiro E, Bocanegra C, Molina I, 2015. Immunosuppression and Chagas disease; experience from a non-endemic country. Clin Microbiol Infect 21: 854–860.
World Health Organization Expert Committee, 2002. Control of Chagas disease. World Health Organ Tech Rep Ser 905: 1–109.
Maldonado C, Albano S, Vettorazzi L, Salomone O, Zlocowski JC, Abiega C, Amuchastegui M, Córdoba R, Alvarellos T, 2004. Using polymerase chain reaction in early diagnosis of re-activated Trypanosoma cruzi infection after heart transplantation. J Heart Lung Transplant 23: 1345–1348.
Schijman AG, Vigliano C, Burgos J, Favaloro R, Perrone S, Laguens R, Levin MJ, 2000. Early diagnosis of recurrence of Trypanosoma cruzi infection by polimerasa chain reaction after heart transplantation of a chronic Chagas’ heart disease patient. J Heart Lung Transplant 19: 1114–1117.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
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