Among 27 heart transplanted patients, 4 had chagasic cardiomiopathy. They were male, with ages from 28 to 43 years, 3 in the NYHA class IV and 1 in class II, but with refractory arrhythmias. The immunosuppressive protocol included cyclosporin and steroids in the first patient and cyclosporin, azathioprine and steroids in the last. Three patients had one or more rejection episodes and 1 had no episode. Usual complications were observed and in 1 patient a lymphoproliferative intestinal disease occurred. Three patients had a new acute phase of Chagas disease in the 59th, 81rst and 420th postoperative days with fever, skin lesions and myocarditis. Trypanosoma cruzi were found in skin lesion in all 3 patients and in myocardial byopsies in 2 patients. The laboratory tests were not the expected for the acute phase. All the alterations were reversed by specific therapy in a few days. One patient died in the 197th postoperative day due to rejection; the immunosuppression regimen had been diminished due to the lymphoproliferative disease; the others were well 107, 160 and 500 days, respectively, after the transplant.
heart transplantation; chagasic cardiomiopathy