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Evaluation of Trypanosoma cruzi persistence and load in transplantable solid organs, digestive system and adrenal gland of chronic chagasic patients


The persistence of Trypanosoma cruzi in the chronic phase of Chagas' disease has been demonstrated in the myocardium, where is associated with high-grade myocarditis, and in some parts of the digestive system, the traditional target-organs of the disease. These organs, and also the adrenal gland would be the reservoirs of the T. cruzi in the chronic phase, responsible for the origin of the parasites in cases of reactivation of the disease, which can occur after immunosupression of chronic chagasic patients. Beyond its importance in the pathogenesis of the chronic phase, the matter of the persistence and parasitic load of T. cruzi in chronic chagasic individuals is very important for the selection of donors for organ transplantation. Due to previous sporadic reports of transmission of Chagas disease by organ transplantation, the usage of such organs is debatable. We propose to evaluate the parasitic persistence and load of T. cruzi in transplantable solid organs (heart, lung, liver, kidney and pancreas) of chronic chagasic patients; the results of this study can be useful to establish the real risk of Chagas disease transmission by organ transplantation, and contribute to define criteria for usage of such organs. From 20 necropsies of chronic chagasic patients, previously performed at InCor, we will select paraffin blocks containing only myocardium, lung, kidney, pancreas, digestive organs (esophagus or colon) and adrenal gland. The parasitic persistence will be evaluated by direct detection of parasite amastigotes, immunohistochemistry for T. cruzi antigens and polymerase chain reaction (PCR) for T. cruzi DNA in serial sections of the paraffin-embedded tissue. The parasitic load will be evaluated through real-time PCR. The parasitic persistence and load of the samples of lung, liver, kidney and pancreas will be compared to the parasitic persistence and load of the samples of the target-organs of the disease (heart and digestive system) and adrenal gland (putative natural reservoir of the parasite). (AU)

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(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
BENVENUTI, LUIZ A.; ROGGERIO, ALESSANDRA; CAVALCANTI, MARTA M.; NISHIYA, ANNA S.; LEVI, JOSE E.. An autopsy-based study of Trypanosoma cruzi persistence in organs of chronic chagasic patients and its relevance for transplantation. TRANSPLANT INFECTIOUS DISEASE, v. 19, n. 6, . (14/04691-0)

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