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Corneal Transplantation from Donors Serologically Positive for Trypanosoma cruzi
Rachel A. Lieberman, MD, Daniel G. Kulman, BS, Brian Philippy, BChE, BS, CEBT, Mark M. Fernandez, MD, Mark A. Pavilack, MD, Charles D. Reilly, MD, Susan P. Montgomery, DVM, MPH
Chagas disease, corneal transplant, DSAEK, endothelial keratoplasty, penetrating keratoplasty, Trypanosoma cruzi
Introduction: Chagas disease, caused by infection with Trypanosoma cruzi (T. cruzi), can be transmitted by solid organ transplantation but risk of transmission by corneal tissue is undefined.
Objectives: The primary objective in this study is to describe patient cases following corneal transplantation at risk for T. cruzi transmission and summarize the outcomes.
Methods: This retrospective case series describes four patients who received corneal transplants from donors found to be serologically positive for T. cruzi only after corneal transplantation of donated tissue had been performed. In 2011, two Descemet’s Stripping Automated Endothelial Keratoplasties (DSAEK) were performed using corneas from a single donor. In 2018, corneas from a second positive donor were used for a DSAEK and a penetrating keratoplasty (PK) in two other patients. The patient with a PK elected for a repeat transplant, while those with DSAEKs did not undergo further transplant.
Results: None of the recipients developed signs or symptoms of ocular or systemic Chagas disease. All laboratory testing for evidence of infection yielded negative results.
Conclusion: These cases suggest that the risk of Chagas disease transmission is low in corneal transplants, including both DSAEK and PK.