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To the Editor: Organ transplantation in patients with Chagas disease is one of the issues addressed by Dr Bern and colleagues¹ in their comprehensive review of Chagas disease in the United States. For the last 20 years, this has been a challenge for transplant teams from endemic areas. In Argentina, more than 150 transplants have been performed in recipients with Chagas disease during this period. There are no data regarding the effect of transplantation on the development of chronic Chagas disease (Chagas myocardiopathy) in long-term follow-up.

However, with systematic monitoring it has been possible to establish the diagnosis and the incidence of reactivation in organ recipients with Chagas disease: 9% to 16% in kidney,² 50% to 100% in heart transplantations,³ and 17% and 40% in autologous and allogeneic hematopoietic cell transplantation.⁴ It has also been possible to show that clinical reactivation is preceded, with some exceptions, by patent parasitemia as . . . [Full Text of this Article]

Javier D. Altclas, MD
jaltclas@fibertel.com.ar
Department of Infectious Diseases and Infection Control
Sanatorio de la Trinidad Mitre

Laura Barcan, MD
Infectious Diseases Section
Hospital Italiano

Claudia Nagel, MD
Epidemiology and Infectious Diseases Department
Fundación Favaloro

Roberta Lattes, MD
Infectious Diseases Section
Transplant Department
Instituto de Nefrología Buenos Aires

Adelina Riarte, MD
Department of Clinical Pathology and Treatment
Instituto Nacional de Parasitología "Dr M. Fatala Chaben"
Buenos Aires, Argentina

RELATED ARTICLE

Evaluation and Treatment of Chagas Disease in the United States: A Systematic Review
Caryn Bern, Susan P. Montgomery, Barbara L. Herwaldt, Anis Rassi, Jr, Jose Antonio Marin-Neto, Roberto O. Dantas, James H. Maguire, Harry Acquatella, Carlos Morillo, Louis V. Kirchhoff, Robert H. Gilman, Pedro A. Reyes, Roberto Salvatella, and Anne C. Moore
JAMA. 2007;298(18):2171-2181.
ABSTRACT | FULL TEXT  

RELATED LETTER

Organ Transplantation and Chagas Disease—Reply
Caryn Bern, Anne Moore, Anis Rassi, Jr, Jose Antonio Marin-Neto, and James H. Maguire
JAMA. 2008;299(10):1134-1135.
EXTRACT | FULL TEXT