Evidence of Trypanosoma cruzi Infection (Chagas’ Disease) Among Patients Undergoing Cardiac Surgery

Background—Trypanosoma cruzi, the agent of Chagas’ heart disease, is transmitted by triatomine insects and by blood transfusion. The emigration of several million people from T cruzi–endemic countries to the United States has raised concerns regarding a possible increase in cases of Chagas’ heart disease here, as well as an increased risk of transfusion-transmitted T cruzi. To investigate these 2 possible outcomes, we tested a repository of blood specimens from multiply transfused cardiac surgery patients for antibodies to T cruzi. Methods and Results—Postoperative blood specimens from 11 430 cardiac surgery patients were tested by enzyme immunoassay, and if repeat-reactive, were confirmed by radioimmunoprecipitation. Six postoperative specimens (0.05%) were confirmed positive. Corresponding preoperative specimens, available for 4 of these patients, were also positive. The other 2 patients had undergone heart transplantations. Tissue samples from their excised hearts were tested for T cruzi by polymerase ...