Screening and treatment of chagas disease in organ transplant recipients in the United States

Recommendations from the chagas in transplant working group

P. V. Chin-Hong, B. S. Schwartz, C. Bern, S. P. Montgomery, S. Kontak, B. Kubak, Michele I Morris, M. Nowicki, C. Wright, M. G. Ison

Research output: Contribution to journalArticle

83 Citations (Scopus)

Abstract

Donor-derived transmission of Trypanosoma cruzi, the etiologic agent of Chagas disease, has emerged as an issue in the United States over the past 10 years. Acute T. cruzi infection causes substantial morbidity and mortality in the posttransplant setting if not recognized and treated early. We assembled a working group of transplant infectious disease specialists, laboratory medicine specialists, organ procurement organization representatives and epidemiologists with expertise in Chagas disease. Based on review of published and unpublished data, the working group prepared evidence-based recommendations for donor screening, and follow-up testing and treatment of recipients of organs from infected donors. We advise targeted T. cruzi screening of potential donors born in Mexico, Central America and South America. Programs can consider transplantation of kidneys and livers from T. cruzi-infected donors with informed consent from recipients. However, we recommend against heart transplantation from infected donors. For other organs, we recommend caution based on the anticipated degree of immunosuppression. Our recommendations stress the need for systematic monitoring of recipients by polymerase chain reaction, and microscopy of buffy coat and advance planning for immediate antitrypanosomal treatment if recipient infection is detected. Data on management and outcomes of all cases should be collected to inform future guidelines and to assist in coordination with public health authorities.

Original languageEnglish
Pages (from-to)672-680
Number of pages9
JournalAmerican Journal of Transplantation
Volume11
Issue number4
DOIs
StatePublished - Apr 1 2011

Fingerprint

Chagas Disease
Trypanosoma cruzi
Tissue Donors
Transplants
Donor Selection
Central America
Tissue and Organ Procurement
South America
Heart Transplantation
Therapeutics
Mexico
Infection
Informed Consent
Liver Transplantation
Kidney Transplantation
Immunosuppression
Communicable Diseases
Microscopy
Public Health
Medicine

Keywords

  • Chagas disease
  • donor-derived infection
  • nonendemic countries
  • T. cruzi
  • transplant infectious disease

ASJC Scopus subject areas

  • Transplantation
  • Immunology and Allergy
  • Pharmacology (medical)

Cite this

Screening and treatment of chagas disease in organ transplant recipients in the United States : Recommendations from the chagas in transplant working group. / Chin-Hong, P. V.; Schwartz, B. S.; Bern, C.; Montgomery, S. P.; Kontak, S.; Kubak, B.; Morris, Michele I; Nowicki, M.; Wright, C.; Ison, M. G.

In: American Journal of Transplantation, Vol. 11, No. 4, 01.04.2011, p. 672-680.

Research output: Contribution to journalArticle

Chin-Hong, P. V. ; Schwartz, B. S. ; Bern, C. ; Montgomery, S. P. ; Kontak, S. ; Kubak, B. ; Morris, Michele I ; Nowicki, M. ; Wright, C. ; Ison, M. G. / Screening and treatment of chagas disease in organ transplant recipients in the United States : Recommendations from the chagas in transplant working group. In: American Journal of Transplantation. 2011 ; Vol. 11, No. 4. pp. 672-680.
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