Rodríguez-Romo R, Morales-Buenrostro L E, Reyes P A, Gracida C, Medeiros M, Mancilla E, De Leo C, Alberú J
Departamento de Trasplantes, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, México.
Transpl Infect Dis. 2013 Dec;15(6):639-44. doi: 10.1111/tid.12122. Epub 2013 Aug 1.
Infectious diseases are common causes of morbidity and mortality among kidney transplant recipients. Chagas disease (CD) has been recognized as an emerging infectious complication of transplantation caused by the parasite Trypanosoma cruzi. CD is prevalent in Mexico, particularly in the southern coastal region. The impact on Mexican kidney transplant programs has not been previously studied prospectively. From 2009 through 2010, serum samples from 59 kidney transplant donors and 405 renal transplant recipients were screened for antibodies against T. cruzi. Serum was initially screened using a locally developed ELISA test; positive results were confirmed by an indirect immunofluorescense test, in accordance with Panamerican Health Organization/World Health Organization guidelines. None of the donors were seropositive for T. cruzi, while 8 (1.97%) kidney transplant recipients were confirmed to be seropositive for T. cruzi. None of them have developed clinical manifestations of CD, although specific screening of recipients was not performed. A prospective study is planned to define the epidemiology and outcome of CD among kidney transplant donors and recipients in Mexico more thoroughly.
传染病是肾移植受者发病和死亡的常见原因。恰加斯病（CD）已被确认为由克氏锥虫寄生虫引起的一种新出现的移植感染并发症。CD在墨西哥很普遍，尤其是在南部沿海地区。此前尚未对其对墨西哥肾移植项目的影响进行前瞻性研究。2009年至2010年，对59名肾移植供者和405名肾移植受者的血清样本进行了抗克氏锥虫抗体筛查。血清最初使用当地开发的酶联免疫吸附测定（ELISA）试验进行筛查；根据泛美卫生组织/世界卫生组织的指南，阳性结果通过间接免疫荧光试验进行确认。供者中没有克氏锥虫血清学阳性者，而8名（1.97%）肾移植受者被确认为克氏锥虫血清学阳性。尽管没有对受者进行特异性筛查，但他们均未出现CD的临床表现。计划开展一项前瞻性研究，以更全面地确定墨西哥肾移植供者和受者中CD的流行病学情况和结局。
