Chagas disease in solid organ and heart transplantation

Kransdorf, E.; Zakowski, P.; Kobashigawa, Jon A.

doi:10.1097/qco.0000000000000088

Cited by 69 publications

(59 citation statements)

References 43 publications

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“…Additionally, there is the risk of re-activation of the infection as a result of the administration of immunosuppressive drugs. [130] Recurrent life-threatening ventricular arrhythmia that is refractory to all currently available treatments is a less common indication for cardiac transplantation in patients with Chagas cardiomyopathy. Monitoring of the reactivation of infection with T. cruzi after heart transplantation should be performed routinely.…”

Section: Heart Failure: Advances In Pharmacological Treatmentmentioning

confidence: 99%

Developments in the management of Chagas cardiomyopathy

Tanowitz

Machado

Spray

et al. 2015

Expert Review of Cardiovascular Therapy

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Over 100 years have elapsed since the discovery of Chagas disease and there is still much to learn regarding pathogenesis and treatment. Although there are antiparasitic drugs available, such as benznidazole and nifurtimox, they are not totally reliable and often toxic. A recently released negative clinical trial with benznidazole in patients with chronic Chagas cardiomyopathy further reinforces the concerns regarding its effectiveness. New drugs and new delivery systems, including those based on nanotechnology, are being sought. Although vaccine development is still in its infancy, the reality of a therapeutic vaccine remains a challenge. New ECG methods may help to recognize patients prone to developing malignant ventricular arrhythmias. The management of heart failure, stroke and arrhythmias also remains a challenge. Although animal experiments have suggested that stem cell based therapy may be therapeutic in the management of heart failure in Chagas cardiomyopathy, clinical trials have not been promising.

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Section: Heart Failure: Advances In Pharmacological Treatmentmentioning

confidence: 99%

Developments in the management of Chagas cardiomyopathy

Tanowitz

Machado

Spray

et al. 2015

Expert Review of Cardiovascular Therapy

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“…The infection may also occur in both areas that are endemic and nonendemic through blood transfusion (10), organ transplant (11), congenital transmission (12), and laboratory accidents (13), allowing the disease to spread to urbanized areas (14).…”

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confidence: 99%

Serological Diagnosis of Chronic Chagas Disease: Is It Time for a Change?

et al. 2016

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“…Además de la infección vectorial, puede transmitirse en forma vertical durante el embarazo, por transfusión sanguínea en ausencia de tamizaje, por órganos trasplantados o por ingestión de alimentos contaminados [2][3][4][5][6] . Esta infección ocurre sólo en el continente americano pero ha sido observada en otros continentes por migraciones humanas, trasplantes de órganos o donaciones de sangre 5,7 .…”

Section: Introductionunclassified

“…Esta infección ocurre sólo en el continente americano pero ha sido observada en otros continentes por migraciones humanas, trasplantes de órganos o donaciones de sangre 5,7 . En su fase aguda, la enfermedad de Chagas tiene tratamiento y en la fase crónica, donde se afectan el corazón (hasta en 30% de los casos) y el tubo digestivo (hasta 10%), este tratamiento también puede moldear su evolución.…”

Section: Introductionunclassified

Enfermedad de Chagas del sistema nervioso central en un paciente con SIDA demostrada por métodos cuantitativos moleculares

Fíca

Salinas

Jercic

et al. 2017

Rev. chil. infectol.

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Although infrequent, Trypanosoma cruzi reactivation is possible among patients with HIV/AIDS infection that develop a tumor-like or granulomatous lesion in the CNS. We report the case of a 60 years old male patient with HIV /AIDS and low CD4 lymphocytes count with cerebellar symptoms and mild paresis, associated to supra and infratentorial hypodense lesions and positive serology tests both to T. gondii and Trypanosoma cruzi. Empirical therapy against toxoplasmosis was prescribed together with antiretroviral therapy but without a favorable response. Brain Chagas disease was confirmed by quantitative PCR in the CSF but he died despite nifurtimox treatment. Despite its rare occurrence, Chagas disease affecting the CNS is possible among patients with HIV/AIDS infection. Epidemiological exposure, a positive Chagas serological test and the image pattern of brain lesions support the suspicion. Diagnosis can be confirmed by molecular test in CSF samples, including new quantitative methods. Despite an adverse prognosis, specific therapy can be attempted besides antiretroviral treatment.

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Chagas disease in solid organ and heart transplantation

Abstract: Transplant clinicians should exercise vigilance in surveillance for Chagas disease in both organ donors and recipients. Although Chagas disease may seem uncommon, it is pervasive in endemic and several nonendemic countries, including the United States and Spain.

Cited by 69 publications

References 43 publications

Developments in the management of Chagas cardiomyopathy

Developments in the management of Chagas cardiomyopathy

Serological Diagnosis of Chronic Chagas Disease: Is It Time for a Change?

Enfermedad de Chagas del sistema nervioso central en un paciente con SIDA demostrada por métodos cuantitativos moleculares

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