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Abstract:

Heart transplantation is contraindicated as an effective treatment for end-stage Chagas' heart disease because of post-operative recurrence of Trypanosoma cruzi infection and reactivation of disease after immunosupression. In a follow-up study of a heart transplanted patient with Chagas' disease, we prospectively evaluated the usefulness of the polymerase chain reaction (PCR) for early diagnosis of reactivation. We monitored post-operative recurrence of Trypanosoma cruzi infection with microscopic observation of the parasite in peripheral blood (Strout's method), endomyocardial biopsies (EMBs), skin lesions, and 2 PCR assays, based on the amplification of specific T cruzi kinetoplastid and nuclear DNA sequences. During follow-up, parasite DNA was amplified in blood samples and EMB sections 41 days before we observed patent parasitemia and cutaneous manifestations of reactivation, proving that PCR is much more sensitive than direct microscopic observation for early diagnosis of disease reactivation in heart-transplanted Chagas' disease patients.

Registro:

Documento: Artículo
Título:Early diagnosis of recurrence of Trypanosoma cruzi infection by polymerase chain reaction after heart transplantation of a chronic chagas' heart disease patient
Autor:Schijman, A.G.; Vigliano, C.; Burgos, J.; Favaloro, R.; Perrone, S.; Laguens, R.; Levin, M.J.
Filiación:Instituto De Investigaciones En Ingeniería Genética Y Biología Molecular, Buenos Aires, Argentina
Instituto De Cardiología Y Cirugía Cardiovascular, Fundación Favaloro, Buenos Aires, Argentina
Instituto De Investigaciones En Ingeniería Genética Y Biología Molecular, Vuelta de Obligado 2490, Buenos Aires, 1428, Argentina
Palabras clave:article; case report; Chagas disease; heart muscle biopsy; heart transplantation; human; human tissue; polymerase chain reaction; priority journal; recurrent infection; Trypanosoma cruzi; trypanosomiasis; Animals; Biopsy; Chagas Cardiomyopathy; Endocardium; Female; Follow-Up Studies; Graft Rejection; Heart Transplantation; Humans; Middle Aged; Myocardium; Polymerase Chain Reaction; Postoperative Complications; Predictive Value of Tests; Prospective Studies; Recurrence; Trypanosoma cruzi
Año:2000
Volumen:19
Número:11
Página de inicio:1114
Página de fin:1117
DOI: http://dx.doi.org/10.1016/S1053-2498(00)00168-6
Título revista:Journal of Heart and Lung Transplantation
Título revista abreviado:J. Heart Lung Transplant.
ISSN:10532498
CODEN:JHLTE
Registro:https://bibliotecadigital.exactas.uba.ar/collection/paper/document/paper_10532498_v19_n11_p1114_Schijman

Referencias:

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  • De Carvalho, V.B., Sousa, E.F., Vila, J.H., Heart transplantation in Chagas' disease. 10 Years after the initial experience (1996) Circulation, 94 (8), pp. 1815-1817
  • Bocchi, E.A., Bellotti, G., Mocelin, A.O., Heart transplantation for chronic Chagas' heart disease (1996) Ann Thorac Surg, 61 (6), pp. 1727-1733
  • Riarte, A., Luna, C., Sabatiello, R., Chagas' disease in patients with kidney transplants: 7 Years of experience. 1989-1996 (1999) Clin Infect Dis, 29 (3), pp. 561-567
  • Billingham, M.E., Cary, N.R.B., Hammond, M.E., A working formulation for the standardization of nomenclature in the diagnosis of heart and lung rejection. Heart Rejection Study Group (1990) J Heart Transplant, 9, pp. 587-593
  • Avila, H.A., Sigman, D.S., Cohen, L.M., Millikan, R.C., Simpson, L., Polymerase chain reaction amplification of Trypanosoma cruzi kinetoplast minicircle DNA isolated from whole blood lysates: Diagnosis of chronic Chagas' disease (1991) Mol Biochem Parasitol, 48 (2), pp. 211-221
  • Brandariz, S., Schijman, A., Vigliano, C., Detection of Trypanosoma cruzi DNA from archival heart tissue of a chronic Chagas' disease reference case (1995) Lancet, 346, pp. 1370-1371
  • Gonzalez, A., Prediger, E., Huecas, M.E., Nogueira, N., Lizard, P.M., Minichromosomal repetitive DNA in trypanosoma cruzi. Its use in a high-sensitivity parasite detection assay (1984) Proc Natl Acad Sci USA, 81, pp. 3356-3360

Citas:

---------- APA ----------
Schijman, A.G., Vigliano, C., Burgos, J., Favaloro, R., Perrone, S., Laguens, R. & Levin, M.J. (2000) . Early diagnosis of recurrence of Trypanosoma cruzi infection by polymerase chain reaction after heart transplantation of a chronic chagas' heart disease patient. Journal of Heart and Lung Transplantation, 19(11), 1114-1117.
http://dx.doi.org/10.1016/S1053-2498(00)00168-6
---------- CHICAGO ----------
Schijman, A.G., Vigliano, C., Burgos, J., Favaloro, R., Perrone, S., Laguens, R., et al. "Early diagnosis of recurrence of Trypanosoma cruzi infection by polymerase chain reaction after heart transplantation of a chronic chagas' heart disease patient" . Journal of Heart and Lung Transplantation 19, no. 11 (2000) : 1114-1117.
http://dx.doi.org/10.1016/S1053-2498(00)00168-6
---------- MLA ----------
Schijman, A.G., Vigliano, C., Burgos, J., Favaloro, R., Perrone, S., Laguens, R., et al. "Early diagnosis of recurrence of Trypanosoma cruzi infection by polymerase chain reaction after heart transplantation of a chronic chagas' heart disease patient" . Journal of Heart and Lung Transplantation, vol. 19, no. 11, 2000, pp. 1114-1117.
http://dx.doi.org/10.1016/S1053-2498(00)00168-6
---------- VANCOUVER ----------
Schijman, A.G., Vigliano, C., Burgos, J., Favaloro, R., Perrone, S., Laguens, R., et al. Early diagnosis of recurrence of Trypanosoma cruzi infection by polymerase chain reaction after heart transplantation of a chronic chagas' heart disease patient. J. Heart Lung Transplant. 2000;19(11):1114-1117.
http://dx.doi.org/10.1016/S1053-2498(00)00168-6