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• W2000513945 abstract "La enfermedad de Chagas es un problema de salud pública en América Latina con repercusión mundial por la globalización. Presentar la experiencia acumulada después de 25 años de un único centro con trasplante cardíaco en la cardiomiopatía chagásica. De 417 pacientes sometidos a trasplante cardíaco desde marzo de 1985 hasta marzo de 2010, 111 (26,6%) eran portadores de cardiomiopatía chagásica: 77 (69,3%) estaban en clase funcional IV; 34 (30,6%) usaban agentes vasopresores y 17 (15,3%) recibían asistencia circulatoria mecánica. La mortalidad hospitalaria fue 17,1% (19 casos), por infección en 6 (31,5%) casos, disfunción del injerto en 6 (31,5%), rechazo en 4 (21,1%) y muerte súbita en 2 (10,5%) casos, y debido a la falta de coincidencia ABO en 1 (5,3%) caso. la mortalidad tardía fue de 24,3% (26), distribuidos así: 6 (22,2%) por rechazo, 6 (22,2%) por infección, 4 (14,8%) por linfoma; 2 (7,4%) por Kaposi, 2 (7,4%) por pericarditis constrictiva y 1 (7,1%) por reactivación de la enfermedad del sistema nervioso central. El trasplante cardíaco es el único tratamiento actual eficaz de tratamiento de la enfermedad de Chagas en fase terminal. La reactivación de la enfermedad es un problema real que es fácilmente revertido con la introducción de la terapéutica farmacológica específica, restaurando los padrones histológicos del miocardio sin dejar secuelas. La inmunosupresión, en especial los corticoides, predisponen al desarrollo de neoplasias y a la reactivación de la enfermedad, exigiendo una atención especial su interrupción o reducción precoz. Chagas’ disease is a public health problem in Latin America and with universal repercussions by globalization. To show the accumulated experience after 25 years with heart transplantation in Chagas’ disease in a single center. From 417 patients underwent to heart transplantation since March 1985 to March 2010, 111 (26.6%) patients had Chagas’ disease and formed the current study group: 77 (69.3%) were in functional class IV, 34 (30.6%) in use of vasopressor agents of which 17 (15.3%) were under mechanical circulatory support. Hospital mortality was 17.1% (19 cases) due to the infection in 6 cases (31.5%), graft dysfunction in 6 (31.5%), rejection in 4 (21.1%), sudden death 2 (10.5%), and due to ABO mismatch in 1 (5.3%) case. Late mortality was in 24.3% (26 cases) during study period: 6 (22.2%) due to rejection, 6 (22.2%) infection, 4 (14.8%) lymphoma, 2 (7.4%) Kaposi, 2 (7.4%) constrictive pericarditis, and 1 (7.1%) for Chagas’ disease reactivation into central nervous system. Heart transplantation is unique form to modify the natural evolution of the terminal chagasic cardiomyopathy; however, the operation is faced with peculiar problems that differ others patients by possibility of the disease reactivation and increase of neoplasias. The reactivation of the disease is a real problem which is easily reversed by introduction of specific pharmacological therapy, restoring the normal histological patterns without myocardial sequelae. immunosuppression, especially steroids, predisposes to neoplasias and reactivation of the disease, thus requiring special attention as to its use." @default.
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• W2000513945 date "2011-07-01" @default.
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• W2000513945 title "Trasplante cardíaco en pacientes con enfermedad de Chagas. Experiencia de un único centro" @default.
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