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Adverse Occurrence type:
Transmission rates without recipient chemoprophylaxis is in the order of 18 to 22% according to different cases series.
Time to detection:
36 - 98 days
Alerting signals, symptoms, evidence of occurrence:
Study from Argentina, describing T. cruzi surveillance in seronegative recipients of SOT from seropositive donors. Four donors and 8 recipients (D+/R-) were included in this work. Clinical details not described in the paper but as treatment was pre-emptive, it is assumed there were no symptoms when benznidazole was started. Parasiteamia detected through surveillance testing by quantitative real time PCR of T. cruzi satellite DNA in PBMC. Donor 1 donared lungs, liver and one kidney. Lung recipient: PCR positive on day +72, Strout test became positive on post transplant day +119 and seroconversion documented on day +210. Liver recipient also became infected and 1 kidney recipient did not develop any evidence of infection at follow up > day +429. Both liver and lung recipients responded to Benznidazole 5mg/kg/d for 6 days, with control of parasitaemia and negative PCR in whole blood.
Demonstration of imputability or root cause:
Donors known to be seropositive for T. cruzi. Real time PCR surveillance for T. cruzi satellite DNA in PBMC of matching seronegative recipients. Same pattern of RFLP demonstrated TcV in more than one recipient from a common donor. Recipients also seroconverted.
Cura CI, Lattes R, Nagel C, Gimenez MJ, Blanes M, Calabuig E, et al. Early molecular diagnosis of acute Chagas disease after transplantation with organs from Trypanosoma cruzi-infected donors. American journal of transplantation; 2013;13(12):3253-61.