Is Organ Transplantation from Trypanosoma cruzi-Infected Donors Safe? An Autopsy-Based Study of Parasite Persistence in Chronic Chagasic Patients
Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Meeting: 2015 American Transplant Congress
Abstract number: A63
Session Information
Session Name: Poster Session A: Donor Management: All Organs
Session Type: Poster Session
Date: Saturday, May 2, 2015
Session Time: 5:30pm-7:30pm
Presentation Time: 5:30pm-7:30pm
Location: Exhibit Hall E
Introduction: Chagas' disease, endemic in Latin America, is caused by infection with the protozoan Trypanosoma cruzi. The disease can affect the heart and/or the gastrointestinal tract, but around 70% of infected individuals remain asymptomatic in the indeterminate form of the chronic phase. Organ transplantation from T. cruzi-infected donors is controversial, because Chagas' disease can be transmitted to the recipient. However, the real risk of infection is unknown. We investigated the persistence of T. cruzi in organs of chronic chagasic patients to evaluate the potential of disease transmission by solid organ transplantation.
Methods: Samples of the heart, lung, liver, kidney and pancreas of 15 patients with chronic Chagas' disease were obtained at autopsy, fixed in buffered formalin and paraffin-embedded. Histological sections were evaluated by microscopy, searching for parasites and pathological lesions. Parasite persistence was investigated through qualitative polymerase chain reaction for T. cruzi DNA.
Results: The mean age of the patients was 54.0 ± 13.0 years and 11/15 (73.3%) were male. Chagas' disease affected the heart and the gastrointestinal tract (megaesophagus/megacolon) in 14/15 (93.3%) and 4/15 (26.7%) patients, respectively. Chronic lymphocytic myocarditis was present in 12/15 (80%) patients. The lung and liver exhibited chronic congestion. We succeeded to obtain DNA from 64/75 (85.3%) samples. PCR for T. cruzi DNA was positive in 10/14 (71.4%) heart samples; T. cruzi parasites were detected by microscopy in one of them (Figure). No samples of the lung, liver, kidney or pancreas presented parasites at microscopy or tested positive for T. cruzi DNA.
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Conclusion: The heart, but not the lung, liver, kidney or pancreas presents a high rate of T. cruzi persistence in chronic chagasic patients. Although this rate can be overestimated for individuals in the indeterminate form of disease, our results reinforce the notion that the heart should be discarded, but the other solid organs of T. cruzi-infected donors can be considered for transplantation.
To cite this abstract in AMA style:
Benvenuti L, Roggério A. Is Organ Transplantation from Trypanosoma cruzi-Infected Donors Safe? An Autopsy-Based Study of Parasite Persistence in Chronic Chagasic Patients [abstract]. Am J Transplant. 2015; 15 (suppl 3). https://atcmeetingabstracts.com/abstract/is-organ-transplantation-from-trypanosoma-cruzi-infected-donors-safe-an-autopsy-based-study-of-parasite-persistence-in-chronic-chagasic-patients/. Accessed November 21, 2024.« Back to 2015 American Transplant Congress