{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T01:19:21Z","timestamp":1787015961361,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T00:00:00Z","timestamp":1745366400000},"content-version":"vor","delay-in-days":53,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Chagas disease is a relevant cause of heart transplantation. The risk of reactivation is a potential concern. This study aimed to describe the reactivation of\n                      <jats:italic>Trypanosoma cruzi<\/jats:italic>\n                      in the central nervous system (CNS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a retrospective study of all heart transplants for Chagas disease undertaken between 2006 and 2023 at a single institution in Brazil to define the prevalence of neurological reactivation and reviewed clinical characteristics and outcomes associated with CNS\n                      <jats:italic>T. cruzi<\/jats:italic>\n                      involvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 187 Chagas disease recipients, 11 episodes of neurologic reactivation were identified in nine patients, at a median of 160 days after transplant. Two patients had a relapse more than a year after the first episode. Three patients died and the remaining six had neurological sequelae. Of the 11 episodes of CNS reactivation, eight were confirmed based on finding\n                      <jats:italic>T. cruzi<\/jats:italic>\n                      parasites or DNA in cerebrospinal fluid or brain tissue biopsy, the remaining three episodes were considered probable by demonstrating parasites in blood and other tissues. Focal neurological manifestations (8 of 11 episodes) and a single lesion with the predominant involvement of white matter (6 of 11 episodes) were the most common features. Brain biopsy was the gold standard tool, detecting five of seven CNS reactivation.\n                      <jats:italic>T. cruzi<\/jats:italic>\n                      PCR in cerebrospinal fluid confirmed two of three cases, and direct examination has a low diagnostic yield, detecting only one of six episodes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Neurological Chagas reactivation is a rare and severe posttransplant complication that should be considered in any at\u2010risk heart recipient.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tid.70021","type":"journal-article","created":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T10:27:55Z","timestamp":1745404075000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Reactivation of Chagas Disease in the Central Nervous System Among Heart Transplant Recipients: A Clinical Series From Brazil, 2006\u20132023"],"prefix":"10.1111","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9845-9826","authenticated-orcid":false,"given":"Jacqueline Ferreira de","family":"Oliveira","sequence":"first","affiliation":[{"name":"Division of Internal Medicine Transplant Infectious Diseases Service Hospital das Cl\u00ednicas Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Luiza","family":"Barbosa","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine Transplant Infectious Diseases Service Hospital das Cl\u00ednicas Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gl\u00e1ucia","family":"Cota","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine Transplant Infectious Diseases Service Hospital das Cl\u00ednicas Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F\u00e1bio Morato","family":"de Castilho","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Heart Transplantation Hospital das Cl\u00ednicas Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvio Amadeu","family":"de Andrade","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Heart Transplantation Hospital das Cl\u00ednicas Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guilherme Ferraz Messina","family":"de P\u00e1dua Andrade","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Heart Transplantation Hospital das Cl\u00ednicas Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juliana Rodrigues Soares","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Heart Transplantation Hospital das Cl\u00ednicas Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paulo Pereira","family":"Christo","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital das Cl\u00ednicas Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Breno Franco Silveira","family":"Fernandes","sequence":"additional","affiliation":[{"name":"Department of Neurology Hospital das Cl\u00ednicas Federal University of Minas Gerais  Belo Horizonte Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodrigo Santiago","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Neurology 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