Prevalence of Chagas disease in deceased donors from Argentina
Ariel Antik2, Gabriela Hidalgo1, Margarita Anders4, Federico Piñero3, Daniela Hansen Krogh2, Viviana Tagliafichi2, Marcelo Silva3, Manuel Mendizabal3, Florencia Antinucci4, Julia Brutti4, Liliana Bisigniano2.
1Medical Direccion, Incucai, Buenos Aires, Argentina; 2Scientific and Technical Direction, Incucai, Buenos Aires, Argentina; 3Liver Trasplant Unit, Hospital Austral, Buenos Aires, Argentina; 4Trasplante Unit, Hospital Alemán, Buenos Aires, Argentina
Background & Aims: Argentina is an endemic area of Chagas disease, estimating that there are around 2 million infected. However, the real prevalence of the disease is unknown. Thus, the aim of this study is to evaluate the prevalence and utilization of donors with Chagas disease in Argentina.
Methods: We performed a cross-sectional study to analyze data from the National Procurement of Transplantation (INCUCAI) in Argentina from 2006 to 2020. We included data from all donors, including effective organ donors (those for whom transplantation was effectively done), non-effective organ donors, and tissue only donors that were discarded. Chagas serologic tests included Immunoagglutination, enzyme-linked immunosorbent assays and complement fixation. These tests were performed in all donors during the procurement process. A donor was considered positive when at least two of the three tests turned positive. A stratified analysis according to the type of donor and Chagas status was done.
Results: Overall, 16140 deceased donors were included. Organ donors 8627 (55%), and 7513 (46%) tissue donors. Demographic characteristics age 42 ± 18 years and male/female ratio was 1.59/1. Overall serologic tests showed that the prevalence of Chagas disease in deceased donors was 3.27% (n=528). The highest prevalence was found in the provinces of Chaco (11.7%), Santiago del Estero. (10.7%) and Formosa (8.6.%). Prevalence ratio per periods among Chagas + donors showed that the highest prevalence was observed in 2010 (5%) and the lowest prevalence in 2020 (1,8%). The percentage of effective donors among those with positive Chagas was 85%, lower than the effective donors chagas negative which is 90% (p 0.001). The solid organ transplants performed using chagas positive donors were 234 kidneys and 87 livers.
Conclusions: The prevalence of Chagas in deceased donor in Argentina is high, especially in the northeast region. Since the probability of being a donor is random, the prevalence in this population could be close to the real one in the country. A lower percentage of effective organ donors chagas positive is observed, so these type of organ donors could be optimized.
