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Heart transplantation for chronic Chagas' heart disease

E A Bocchi1, G Bellotti, A O Mocelin

  • 1Heart Institute, São Paulo University Medical School, Brazil.

The Annals of Thoracic Surgery
|June 1, 1996
PubMed

Insights

Heart transplantation is viable for Chagas' heart disease. Lower immunosuppression doses improved survival and reduced Chagas' disease reactivation in heart transplant recipients.

Area of Science:

  • Cardiology
  • Infectious Diseases
  • Transplantation Immunology

Background:

  • Chagas' disease historically contraindicated heart transplantation due to potential Trypanosoma cruzi recurrence.
  • End-stage Chagas' heart disease necessitates advanced treatment options.

Purpose of the Study:

  • To evaluate the outcomes of orthotopic heart transplantation in patients with end-stage Chagas' heart disease.
  • To assess the impact of modified immunosuppression protocols on post-transplant outcomes.

Main Methods:

  • Retrospective analysis of 22 heart transplant recipients with Chagas' heart disease.
  • Patients divided into two groups based on transplantation period (1985-1991 and 1991-1995).
  • Comparison of outcomes between a standard cyclosporine group and a lower-dose cyclosporine group.

Main Results:

  • Overall 24-month survival was 60%, significantly better in the lower-immunosuppression group (80% vs. 33%).
  • Chagas' disease reactivation occurred less frequently in the lower-immunosuppression group (1 vs. 5 patients).
  • Neoplasia incidence was lower in the second group (1 vs. 5 patients).

Conclusions:

  • Cardiac transplantation can achieve satisfactory outcomes in selected Chagas' heart disease patients.
  • Lowering immunosuppression may reduce Chagas' disease reactivation and improve survival post-transplantation.
  • Further research is needed to optimize heart transplantation protocols for Chagas' disease.
Abstract

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