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Donors and  Chagas Disease 11 th  Congress of the  International Society for  Organ Donation and Procurement  Buenos Aires – Argentina  27-30 Nov 2011
Disclosures No conflict of interest Roberta Lattes [email_address] Instituto de Nefrología/Nephrology Buenos Aires – Argentina
Chagas disease
Chagas disease ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Key questions   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
-   PCR PCR
C hagas Disease: S ero-testing ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
PCR ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
26 labs in 16 countries  70 samples checked   Inter-lab evaluation Intra-lab evaluation PCR kDNA (330 bp) Highly repetitive sequences: Detection of low parasitic loads  Useful for chronic infection  diagnosis Early detection of  reactivation and transmission PCR satellite (180 bp ) Nuclear DNA 50.000-100.000 p/parasite Kinetoplast DNA 40.000-80.000 p/parasite 2011;5(1):e931
Chagas disease:  Transmission from donors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Chagas infected donors Effective infected donors in Argentina Source: INCUCAI 2011 Not all Tx teams accept infected donors 3.7 5.1 4.6 4.6 2.5 5.7
Kidney transplant: outcome Total Kidney Tx R-/D+ (n=56) 2.6% Infection Transmission  (day +35 to 165 ) 12.5% Diagnosis Hospital Argerich 650 27 4 Strout 1 Strout + fever 2 Strout+ Paniculitis 1 INBA 1019 27 2 Strout 1 PCR+Strout 1 Fundación Favaloro 478 2 1 PCR
Non kidney Tx: outcome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Recommendations ,[object Object],[object Object],[object Object],[object Object],[object Object],Kotton C, Lattes R. Parsitic infections in solid organ transplant recipients  AST Infectious diseases guidelines   AJT 2009;9(54) S4:S234-S251 The Chagas’ Disease Argentine Collaborative Transplant Consortium et al Transpl Proc 2010; 42:3354-3359  Chin-Hong et al “The Chagas in transplant working group”  AJT 2011;11:672-680
Guidelines ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Clinical Case ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Conclusions   ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Collaborators ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Roberta Lattes - Argentina - Tuesday 29 - Donor Risk

  • 1. Donors and Chagas Disease 11 th Congress of the International Society for Organ Donation and Procurement Buenos Aires – Argentina 27-30 Nov 2011
  • 2. Disclosures No conflict of interest Roberta Lattes [email_address] Instituto de Nefrología/Nephrology Buenos Aires – Argentina
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  • 6. - PCR PCR
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  • 9. 26 labs in 16 countries 70 samples checked Inter-lab evaluation Intra-lab evaluation PCR kDNA (330 bp) Highly repetitive sequences: Detection of low parasitic loads Useful for chronic infection diagnosis Early detection of reactivation and transmission PCR satellite (180 bp ) Nuclear DNA 50.000-100.000 p/parasite Kinetoplast DNA 40.000-80.000 p/parasite 2011;5(1):e931
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  • 11. Chagas infected donors Effective infected donors in Argentina Source: INCUCAI 2011 Not all Tx teams accept infected donors 3.7 5.1 4.6 4.6 2.5 5.7
  • 12. Kidney transplant: outcome Total Kidney Tx R-/D+ (n=56) 2.6% Infection Transmission (day +35 to 165 ) 12.5% Diagnosis Hospital Argerich 650 27 4 Strout 1 Strout + fever 2 Strout+ Paniculitis 1 INBA 1019 27 2 Strout 1 PCR+Strout 1 Fundación Favaloro 478 2 1 PCR
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