Overview

Transplantation has become a new transmission modality for this parasitic disease. Diagnosis of the infection has reached a state of maturity: besides parasitic diagnosis and serological tests we now have molecular testing and quantification of parasites. Still in the process of being studied is the real value of the parasite load from a clinical point of view. Solid organ receptors can either be infected; receive an organ from an infected donor or more rarely can be both: infected and receive an organ from an infected donor. Solid organ recipients are studied in different groups: Infected recipients, heart recipients and infected donors. Kidney: The vast majority of the data come from infected kidney recipients and this is how we learnt to establish sequential guidelines and how to use laboratory and trypanocidal treatment. Liver transplant was way behind but is now coming in full force. Heart transplant has been there for a while and data on this procedure are quite interesting: receptors are younger, not sick in any other capacity and tend to do quite well when compared to other heart transplant recipients. With an infected donor diagnosis before or immediately after distribution is essential so sequential monitoring can be established. Relationship with immunosuppression needs further study as also relationship with anti –rejection treatment and with maintenance immunosuppression. 

Objectives

At the end of this session the attendees should be able to answer:

1. Which recipient/donor pairs should be evaluated for Chagas disease

2. How often do you need to monitor and for how long.

3. When can you be safe from Chagas disease

4. Is it safe to use organs from infected donors