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.
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' diseasepatients: 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.
Authors: Rosália Morais Torres; Dalmo Correia; Maria do Carmo Pereira Nunes; Walderez O Dutra; André Talvani; Andréa Silvestre Sousa; Fernanda de Souza Nogueira Sardinha Mendes; Maurício Ibrahim Scanavacca; Cristiano Pisani; Maria da Consolação Vieira Moreira; Dilma do Socorro Moraes de Souza; Wilson de Oliveira Junior; Silvia Marinho Martins; João Carlos Pinto Dias Journal: Mem Inst Oswaldo Cruz Date: 2022-06-06 Impact factor: 2.747
Authors: Jefferson L Vieira; Maria G V Sobral; Francisco Y Macedo; Raquel S Florêncio; Germana P L Almeida; Glauber G Vasconcelos; Juliana R Fernandes; Laura L E Marinho; Daniel F M Trompieri; Tilak K R Pasala; Juan A C Mejia; João D Souza-Neto Journal: Transplant Direct Date: 2022-06-24
Authors: Elizabeth B Gray; Ricardo M La Hoz; Jaime S Green; Holenarasipur R Vikram; Theresa Benedict; Hilda Rivera; Susan P Montgomery Journal: Transpl Infect Dis Date: 2018-10-02 Impact factor: 2.228
Authors: Sarah Cristina Gozzi-Silva; Gil Benard; Ricardo Wesley Alberca; Tatiana Mina Yendo; Franciane Mouradian Emidio Teixeira; Luana de Mendonça Oliveira; Danielle Rosa Beserra; Anna Julia Pietrobon; Emily Araujo de Oliveira; Anna Cláudia Calvielli Castelo Branco; Milena Mary de Souza Andrade; Iara Grigoletto Fernandes; Nátalli Zanete Pereira; Yasmim Álefe Leuzzi Ramos; Julia Cataldo Lima; Bruna Provenci; Sandrigo Mangini; Alberto José da Silva Duarte; Maria Notomi Sato Journal: Trop Med Infect Dis Date: 2021-02-10