@booklet {1871,
	title = {Liver Transplantation Using Chagas-Infected Donors in Uninfected Recipients: A Single-Center Experience Without Prophylactic Therapy},
	volume = {12},
	year = {2012},
	note = {[Miscellaneous]; NLM Journal Code: 100968638},
	month = {October},
	abstract = {: Organ shortage is the first cause of death on liver transplant waiting lists. As a consequence, we recently decided to expand liver acceptance to those organs that could potentially transmit infectious diseases to their recipients. On January 2010, we initiated a prospective protocol using livers from Chagas-infected donors for transplanting uninfected recipients without using prophylactic therapy. During a 13-month period, 9 of 37 (24\%) liver transplants were performed within this protocol. After transplant, each recipient was sequentially and strictly monitored for infection transmission using the Strout method and promptly treated with benznidazole if this occurs. During follow-up, two patients died without Chagas infection and only two (donor-derived T. cruzi transmission rate: 2/9; 22\%) patients developed donor-derived Chagas transmission without clinical symptoms. The median follow-up time of the seven live patients was 15 months (range: 13-20). At present, all are symptoms-free with excellent allograft function and without evidence of Chagas disease. In conclusion, we consider that Chagas-infected donors are a promising source of liver grafts that could reduce the growing mortality on liver waiting lists in America. Relevant data from larger prospective studies are required to confirm these preliminary excellent results. Liver grafts from Chagas-infected donors can be safely used for transplanting uninfected recipients without the need of prophylactic therapy but under strict scheduled parasitological infection screening. Copyright (C) 2012 Blackwell Publishing Ltd.; References: 1. Durand F, Renz JF, Alkofer B, et al. Report of the Paris consensus meeting on expanded criteria donors in liver transplantation. Liver Transplant, 2008; 14: 1694-1707. 2. McCormack L, Gadano A, Lendoire J, et al. Model for end-stage liver disease exceptions committee activity in Argentina: Does it provide justice and equity among adult patients waiting for a liver transplant? HPB (Oxford), 2010; 12: 531-537. 3. McCormack L, Gadano A, Lendoire J, et al. Model for end-stage liver disease-based allocation system for liver transplantation in Argentina: Does it work outside the United States? HPB (Oxford), 2010; 12: 456-464. 4. McCormack L, Dutkowski P, El-Badry AM, Clavien PA. Liver transplantation using fatty livers: Always feasible? J Hepatol, 2011; 54: 1055-1062. 5. McCormack L, Quinonez E, Rios MM, et al. Rescue policy for discarded liver grafts: A single-centre experience of transplanting livers {\textquoteright}that nobody wants{\textquoteright}. HPB (Oxford), 2010; 12: 523-530. 6. Schwartz BS, Paster M, Ison MG, Chin-Hong PV. Organ donor screening practices for Trypanosoma cruzi infection among US Organ Procurement Organizations. Am J Transplant, 2011; 11: 848-851. 7. Kun H, Moore A, Mascola L, et al. Transmission of Trypanosoma cruzi by heart transplantation. Clin Infect Dis, 2009; 48: 1534-1540. 8. Bern C, Montgomery SP. An estimate of the burden of Chagas disease in the United States. Clin Infect Dis, 2009; 49: e52-e54. 9. Lescure FX, Le Loup G, Freilij H, et al. Chagas disease: Changes in knowledge and management. Lancet Infect Dis, 2010; 10: 556-570. 10. Barcan L, Luna C, Clara L, et al. Transmission of T. cruzi infection via liver transplantation to a nonreactive recipient for Chagas{\textquoteright} disease. Liver Transplant, 2005; 11: 1112-1116. 11. Casadei D. Chagas{\textquoteright} disease and solid organ transplantation. Transplant Proc, 2010; 42: 3354-3359. 12. Chagas disease after organ transplantation. United States, 2001. MMWR Morb Mortal Wkly Rep, 2002; 51: 210-212. 13. Chagas disease after organ transplantation. Los Angeles, California. MMWR Morb Mortal Wkly Rep, 2006; 55: 798-800. 14. Riarte A, Luna C, Sabatiello R, et al. Chagas{\textquoteright} disease in patients with kidney transplants: 7 years of experience 1989-1996. Clin Infect Dis, 1999; 29: 561-567. 15. D{\textquoteright}Albuquerque LA, Gonzalez AM, Filho HL, et al. Liver transplantation from deceased donors serologically positive for Chagas disease. Am J Transplant, 2007; 7: 680-684. 16. Salvador F, Len O, Molina I, et al. Safety of liver transplantation performed with Chagas seropositive donors to seronegative recipients. Liver Transplant, 2011; 17: 1304-1308. 17. Chin-Hong PV, Schwartz BS, Bern C, et al. Screening and treatment of chagas disease in organ transplant recipients in the United States: Recommendations from the chagas in transplant working group. Am J Transplant, 2011; 11: 672-680. 18. Sousa AA, Lobo MC, Barbosa RA, Bello V. Chagas seropositive donors in kidney transplantation. Transplant Proc, 2004; 36: 868-869. 19. Apt W, Zulantay I. Update on the treatment of Chagas{\textquoteright} disease. Rev Med Chil, 2011; 139: 247-257. 20. Bocchi EA, Higuchi ML, Vieira ML, et al. Higher incidence of malignant neoplasms after heart transplantation for treatment of chronic Chagas{\textquoteright} heart disease. J Heart Lung Transplant, 1998; 17: 399-405. 21. Schijman AG, Bisio M, Orellana L, et al. International study to evaluate PCR methods for detection of Trypanosoma cruzi DNA in blood samples from Chagas disease patients. PLoS Negl Trop Dis, 2011; 5: e931.},
	keywords = {Clinical Medicine., Extended donor criteria, infectious diseases, Liver, marginal donors, prophylaxis, transplantation.},
	issn = {1600-6135},
	doi = {10.1111/j.1600-6143.2012.04160.x},
	author = {McCormack,L. and Quinonez,E. and Goldaracena,N. and Anders,M. and Rodriguez,V. and Orozco Ganem,F. and Mastai,R. C.}
}
