@article {590,
	title = {Infections in heart transplant recipients in Brazil: the challenge of Chagas{\textquoteright} disease},
	journal = {J Heart Lung Transplant},
	volume = {29},
	year = {2010},
	note = {Godoy, Henrique L Guerra, Carla M Viegas, Ruy F Dinis, Rosiane Z Branco, Joao N Neto, Vicente A Almeida, Dirceu R United States The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation J Heart Lung Transplant. 2010 Mar;29(3):286-90. Epub 2009 Sep 26.},
	month = {Mar},
	pages = {286 - 90},
	edition = {40085},
	abstract = {BACKGROUND: Despite the high incidence of infections after heart transplantation, there is limited information about its epidemiology in patients from countries where Chagas{\textquoteright} disease is endemic. METHODS: We analyzed the occurrence of infections in 126 patients aged older than 18 years who underwent transplantation from 1986 through 2007 at a Brazilian University Hospital and who survived at least 48 hours. RESULTS: Heart failure diagnoses before transplantation were idiopathic dilated cardiomyopathy (38.6\%), Chagas{\textquoteright} disease (34.9\%), coronary artery disease (19.8\%), and others (6.3\%). The respiratory tract was the most common site of infections (40.9\%), followed by surgical wound site (18.1\%). Trypanosoma cruzi reactivations occurred in 38.8\% of Chagas{\textquoteright} disease patients: 47.0\% had myocarditis, 23.5\% had skin lesions, and 29.4\% had both. New-onset ventricular dysfunction was observed in 47.0\%, with complete response after specific treatment, and 41.0\% were asymptomatic cases, diagnosed by routine endomyocardial biopsies. No patient died from such events. No differences in survival were found after 5 years of follow-up between recipients with and without Chagas{\textquoteright} disease (p = 0.231). CONCLUSIONS: In a heart transplant population from a developing country, infectious complications occurred at a high rate. Tropical illnesses were uncommon, except for the high rate of Chagas{\textquoteright} disease reactivations. Despite that, the overall outcome of these patients was similar to that of recipients with other cardiomyopathies.},
	keywords = {*Endemic Diseases, *Heart Transplantation / immunology / mortality, Adult, Brazil / epidemiology, Cardiomyopathy, Dilated / surgery, Chagas Disease / *epidemiology / immunology / parasitology, Coronary Artery Disease / surgery, Female, Follow-Up Studies, Heart Failure / *surgery, Humans, Immunosuppressive Agents / therapeutic use, Incidence, Male, Middle Aged, Opportunistic Infections / epidemiology / immunology / parasitology, Postoperative Complications / *epidemiology / parasitology, Retrospective Studies, Survival Rate, Trypanosoma cruzi / physiology},
	issn = {1557-3117 (Electronic) 1053-2498 (Linking)},
	doi = {S1053-2498(09)00632-9 [pii] 10.1016/j.healun.2009.08.006},
	author = {Godoy,H. L. and Guerra,C. M. and Viegas,R. F. and Dinis,R. Z. and Branco,J. N. and Neto,V. A. and Almeida,D. R.}
}
