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Transplantation for Chagas' disease: an overview of immunosuppression and reactivation in the last two decades


, : Transplantation for Chagas' disease: an overview of immunosuppression and reactivation in the last two decades. Clinical Transplantation 24(2): E29-E34

Over the last 20 yr, the immunosuppression protocols in chagasic heart-transplanted patients have gone through three phases, and we have identified several changes and discoveries about Chagas' disease reactivation, mortality, and neoplasia development. The first phase was especially important because until that time, Chagas' disease was an absolute contraindication for transplantation. The second phase started when an adjustment was made to the immunosuppression protocol, a lower dosage being adopted to avoid adverse effects, especially neoplasias and reactivation episodes. Currently, strategies to change the immunosuppression, especially replacement of mycophenolate mofetil by azathioprine or low doses of mycophenolate in this special situation, have been shown to be effective in reducing Chagas' disease reactivation. Cardiac transplantation for Chagas' disease is a reality. Although patients with Chagas' disease may experience particular complications when undergoing transplantation compared with transplantation for other etiologies, these difficulties are well known, and treatment and preventive strategies are also better established. In other organs and tissues, transplantation in patients with Chagas' disease also has good outcomes. Blood monitoring for parasitemias is mandatory as is the institution of therapy in the case of a reactivation diagnosis. Acute Chagas' disease may occur in patients who received organs from donors with Chagas' disease.

US$19.90

PMID: 20088914

DOI: 10.1111/j.1399-0012.2009.01202.x


Other references

Alieva, I.B.; Berezinskaya, T.; Borisy, G.G.; Vorobjev, I.A., 2016: Centrosome nucleates numerous ephemeral microtubules and only few of them participate in the radial array. It is generally accepted that long microtubules (MTs) grow from the centrosome with their minus ends anchored there and plus ends directed towards cell membrane. However, recent findings show this scheme to be an oversimplification. To further ana...

Magalhaes, M.; Ghorab, Z.; Morneault, J.; Akinfolarin, J.; Bradley, G., 2015: Age-related Epstein-Barr virus-positive mucocutaneous ulcer: a case report. Key Clinical Message The oral manifestations of EBV-positive mucocutaneous ulcers have a worrisome clinical appearance but relatively benign clinical course, responding well to conservative treatment. Elderly patients who develop an unexplained, p...

West L.J.; Huang Y.; Handley K., 2001: Dependence of sandstone dielectric behaviour on moisture content and lithology. Proceedings - Symposium on the Application of Geophysics to Engineering and Environmental Problems (SAGEEP) 2001(2001

Hirose, S.; Komoike, Y.; Higashinakagawa, T., 2006: Identification of a nuclear localization signal in mouse polycomb protein, M33. The mouse Polycomb group (PcG) protein M33 forms nuclear complexes with the products of other PcG members and maintains repressed states of developmentally important genes, including homeotic genes. In this context, nuclear localization is a prer...

Price Neville J.; Hancock Paul L., 1972: Development of Fracture Cleavage and Kindred Structures. Closely spaced fractures including fracture cleavage in Devonian rocks in Wales and lower Tertiary rocks in southern Pyrenees, analysis of deformation history.

Borders, S.E.; Fronek, A.; Kemper, W.S.; Franklin, D., 1978: Ultrasonic energy backscattered from blood. An experimental determination of the variation of sound energy with hematocrit. To determine how the ultrasonic energy scattered from flowing blood depends on the hematocrit, the rms amplitude of the audio Doppler signal from a range gated, pulsed Doppler ultrasonic flowmeter was measured for hematocrits ranging from 0.01-80%...

Davis, D., L.; Soldin, S., J., 2000: An immunophilin-binding assay for sirolimus. Objective: This review examines the performance of 4 assays for sirolimus in terms of their ability to meet 6 guidelines determined by a panel of experts. Background: Four methods have been described to date for the analysis of sirolimus concentra...

Tang, F.L.; Xu, W.J.; Feng, N., 2003: Micro determination of acrylonitrile in ambient air by gas chromatography. Acrylonitrile in ambient air was collected by Tenax GC and then thermo-desorbed. It was separated on GDX-502 chromatographic column from other pollutants and determined by flame-ion ization detector. The minimum detectable concentration was 0.01 m...

Tanner, Wilmer W., 1990: Thamnophis rufipunctatus (Cope). Narrow-headed garter snake. Catalogue of American Amphibians and Reptiles, 505: 1-2

Mihalco, F.; Mitrică, N., 1965: Simple methods for the specific determination of antistreptolysins "O" in serum gamma globulins. Their interpretation. Archives Roumaines de Pathologie Experimentales et de Microbiologie 24(4): 985-992