Fatal Chagas Disease Among Solid- Organ Transplant Recipients in

Chagas disease continues to cause substantial morbidity and mortality in endemic areas in Latin America. Although there have been somewell documented successes in halting the trans-mission of Chagas disease through preventive interventions to decrease vector-borne and blood-transfusion cases, this para-sitic infection continues to be transmitted through these routes in some areas as well through perinatal and foodborne routes. In addition, transmission through solid-organ transplantation has been described in nonendemic settings due to the increas-ing globalization of Chagas disease to the United States of America, Europe, and other areas. Because there has been a concomitant increase in the number of solid-organ transplan-tations performed in Latin American settings endemic for American trypanosomiasis, there is increasing concern for the potential reactivation of Trypanosoma cruzi in a previously infected recipient and as a result of aggressive immunosuppres-sion; or via transmission from organs donated by a latently in-fection donor transplanted onto an uninfected recipient. In this study, we report 2 cases of Chagas disease reactivation in 2 solid-organ transplant recipients in Northeastern Colombia, and we discuss the implications for screening as a crucial strat-egy for preventing transmission in endemic settings