Prevalence of Antibodies to Trypanosoma cruzi among Solid Organ Donors in Southern California: A Population at Risk

Abstract

Trypanosoma cruzi, a parasite that causes Chagas' disease, is endemic in parts of Mexico, South America, and Central America. Transmission of T. cruzi infection by solid organ transplantation has been reported in Latin America and recently in the United States. To determine the prevalence of T. cruzi antibodies in Southern California organ donors, 404 samples from deceased organ donors between May 2002 to April 2004 were screened using a qualitative enzyme-linked immunosorbent assay (EIA) and confirmed with an immunofluorescence assay (IFA) available through the Centers for Disease Control (CDC). Six donors were initially reactive by EIA. Three donors were repeatedly reactive after repeat testing and were sent to the CDC for confirmation. One donor (0.25%) had an IFA-confirmed reactivity to anti-T. cruzi antibodies. In areas where there is a high number of immigrants from T. cruzi endemic countries, screening for anti-T. cruzi donor antibodies may be beneficial.

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

“…A male donor was found to be positive, and the authorities were notified, but data regarding the recipients have not been published (269). In a similar study in a different area of the United States, no seropositive donors were found in a period of 6 1 ⁄2 years (50).…”

“…The risk of transmission of the infection after transfusion of a contaminated blood unit has been estimated to be around 20% (328). The first report of transmission via an infected blood transfusion was in Brazil in 1952, and since then, there have been at least 200 declared cases in Latin America (269,329). In 1989, a case of a renal transplant recipient who died due to acute Chagas ' disease infection was reported.…”

“…Based on the United Network for Organ Sharing data from 1988 to 2000, Shames et al (335a) reported that the prevalence of HTLV-1 infection in organ donors was 0.027% and that the prevalence of HTLV-2 was 0.064%. However, in another report, Nowicki et al (269) presented data accumulated during testing of all prospective 1,408 cadaveric organ donors between 2002 and 2003: there were 1.56% donors that were repeatedly reactive by HTLV-1/2 EIA (40% were African American, 20% were Hispanic, and 40% were Caucasian). Approximately 29% of EIA-reactive samples from donors were not confirmed by WB, and another 35% had indeterminate results.…”

Bioluminescent imaging of Trypanosoma cruzi infection

“…despite the optimistic nature of this statistic, the report also states that cases are now being identified outside the typical endemic regions due to increasing incidences of blood transmission (Kirchhoff et al, 2006) and organ transplantation (Nowicki et al, 2006). Chagas disease can occur in an acute phase, typically characterized by high parasitism, fever and lymphadenopathy, but more commonly progresses to a chronic phase where cardiac alterations or gastrointestinal disorders are observed.…”

Delayed Gastric Emptying for Semi-Solid Diets in Patients With Chagasic Megaesophagus

“…The condition can be transmitted by transfusion of blood and blood derivatives, organ transplantation, and orally; the disease may also be congenital. 7,8,9 About 30% of infected individuals develop the chronic symptomatic form of the disease, usually decades after the initial infection. 3,4,10 One complication of the disease is alteration of the upper gastrointestinal tract caused by destruction of the myenteric plexus 11 This results in delayed esophageal emptying secondary to dysfunction of the lower esophageal sphincter and esophageal body.…”