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Liver transplantation from deceased donors serologically positive for Chagas disease

L A C D'Albuquerque1, A M Gonzalez, H L V N Filho

  • 1Departments of General and Transplantation Surgery, Hospital Beneficência Portuguesa, São Paulo, SP, Brazil.

American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons
|January 16, 2007
PubMed

Insights

Liver transplantation using marginal livers from Chagas disease (CD) positive donors is a viable option for patients with severe liver disease. Prophylactic benznidazole treatment showed good tolerance and effectiveness in preventing CD transmission.

Area of Science:

  • Hepatology
  • Transplantation Immunology
  • Infectious Diseases

Background:

  • High mortality rates in liver transplant candidates necessitate the use of marginal donor organs.
  • Deceased donors with serological evidence of Chagas disease (CD) represent a potential source of marginal livers.

Purpose of the Study:

  • To evaluate the outcomes of orthotopic liver transplantation using CD-seropositive donor livers.
  • To assess the safety and efficacy of prophylactic benznidazole treatment in recipients.

Main Methods:

  • Six patients with severe liver disease (Child Pugh C) received liver transplants from CD-seropositive donors.
  • Patients underwent prophylactic treatment with benznidazole for 60 days post-transplantation.
  • Outcomes including technical success, side effects, and CD serology were monitored.

Main Results:

  • All transplantations were technically successful, and patients were discharged from the hospital.
  • Five patients tolerated prophylactic treatment without interruption; four remained clinically well over one year post-transplant.
  • Two patients died due to sepsis and tuberculosis complications, respectively; both were serologically negative for CD post-transplant.

Conclusions:

  • Liver transplantation from CD-seropositive donors, combined with benznidazole prophylaxis, is a valuable therapeutic option for severe liver disease.
  • This approach expands the donor pool and offers a chance for survival to critically ill patients.

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