Infections in heart transplant recipients in Brazil: the challenge of Chagas' disease

Infections in heart transplant recipients in Brazil: the challenge of Chagas' disease

Author Godoy, Henrique L. Autor UNIFESP Google Scholar
Guerra, Carla M. Autor UNIFESP Google Scholar
Viegas, Ruy F. Autor UNIFESP Google Scholar
Dinis, Rosiane Z. Autor UNIFESP Google Scholar
Branco, Joao N. Autor UNIFESP Google Scholar
Neto, Vicente A. Autor UNIFESP Google Scholar
Almeida, Dirceu R. Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract BACKGROUND: Despite the high incidence of infections after heart transplantation, there is limited information about its epidemiology in patients from countries where Chagas' disease is endemic.METHODS: We analyzed the occurrence of infections in 126 patients aged older than 18 years who underwent transplantation from 1986 through 2007 at a Brazilian University Hospital and who survived at least 48 hours.RESULTS: Heart failure diagnoses before transplantation were idiopathic dilated cardiomyopathy (38.6%), Chagas' disease (34.9%), coronary artery disease (19.8%), and others (6.3%). the respiratory tract was the most common site of infections (40.9%), followed by surgical wound site (18.1%). Trypanosoma cruzi reactivations occurred in, 38.8% of Chagas' disease patients: 47.0% had myocarditis, 23.5% had skin lesions, and 29.4% had both. New-onset ventricular dysfunction was observed in 47.0%, with complete response after specific treatment, and 41.0% were asymptomatic cases, diagnosed by routine endomyocardial biopsies. No patient died from such events. No differences in survival were found after 5 years of follow-up between recipients with and without Chagas' disease (p = 0.231).CONCLUSIONS: in a heart transplant population from a developing country, infectious complications occurred at a high rate. Tropical illnesses were uncommon, except for the high rate of Chagas' disease reactivations. Despite that, the overall outcome of these patients was similar to that of recipients with other cardiomyopathies. J Heart Lung Transplant 2010;29:286-90 (C) 2010 International Society for Heart and Lung Transplantation. All rights reserved.
Keywords Chagas' disease
Trypanosoma cruzi
immunosuppression
infections
allopurinol
Language English
Date 2010-03-01
Published in Journal of Heart and Lung Transplantation. New York: Elsevier B.V., v. 29, n. 3, p. 286-290, 2010.
ISSN 1053-2498 (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 286-290
Origin http://dx.doi.org/10.1016/j.healun.2009.08.006
Access rights Closed access
Type Article
Web of Science ID WOS:000276005200010
URI http://repositorio.unifesp.br/handle/11600/32333

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