Chagas' disease in patients with kidney transplants: 7 years of experience, 1989-1996

Chagas' disease was present in 17.22% of persons undergoing kidney transpla ntation in an Argentine Hospital. The criterion for attributing reactivatio n of chronic Chagas' disease and transmission of Trypanosoma cruzi to graft s was detection of parasites in blood (patent parasitemia) or tissues. Reac tivation was diagnosed in 5 (21.7%) of 23 recipients. Ten (43.4%) of 23 cha gasic recipients without reactivation of chronic Chagas' disease had abroga tion of serological reactivity. T. cruzi infection was transmitted to 3 (18 .7%) of 16 non-chagasic recipients. Reactivation and infection were diagnos ed by patent parasitemia or cutaneous panniculitis. For diagnosis, detectio n of parasites in blood and tissues had more relevance than serology. Seque ntial monitoring detected early reactivation and infection, permitting appl ication of preemptive or therapeutic therapy with benznidazole, thus inhibi ting, in all patients, severe clinical disease produced by a progressive an d systemic replication of the parasite.