Our blood supplier is now testing for Chagas and AABB recommends recipient notification.

Living in an area with a high seropositive population, I have received my first batch of confirmed positives. Does anyone have a form letter or pamphlet for recipient's information? Any comments are welcomed....

I have asked a similar question about Chagas testing on the AABB site. I haven't chosen to begin testing yet. This test is a big can of worms. I understand that Quest has a confirmatory test. Does your supplier also do a confirmatory test?

If we do institute T. cruzi testing (which we will not unless it becomes mandatory), I am going to suggest that the donor come in for a heart and colon biopsy. I will train my phlebotomists to perform this procedure. It can't be any worse than sticking a 16-gauge needle in a 17-gauge vein. This mess is going to scare the living hell out of donors and recipients alike. Sounds like we have another anti-HBc-like test: good for nothing except unnecessarily deferring donors and generally causing confusion and angst.

BC

Our supplier has contracted testing to be performed at another collection facility. These tests are RIPA confirmed, which is supposed to be the most sensitive test out there; However, I'm not sure it is currently licensed for this use (at least as of Dec 06-it was not-I'll be looking into it). I would definitely wait to initiate testing and as you stated ala Hep C-we will all be re-informing the public yet again...Yippeee! I haven't talked to risk management yet about legal ramifications for prior vs post transfusion infections???

Sure hope they fast track that processfor altering blood types to O...we're going to need it!

I am sitting on almost 100 type B units in my inventory. I could certainly use that conversion process. It seems simple enough- cleave the last sugar off the antigen. However, I remember a similar attempt with type B blood created more problems than it solved.

I have loosely followed the quest for a T. cruzi antigen test. I have worked with T. cruzi in a pure research setting. Those little buggers can change their coat in an instant. Genetically, IIRC, they can shed their coat 12 times, thus confounding the best immune system (as well as an antigen detection test). Antibody tests are worthless (witness the anti-HBc and anti-HCV tests). So, it has taken many moons to develop an antigen test. I am not ready to trust it.

BC

Has anyone come up with an answer to the Chagas Lookback dilemma? And more importantly, does anyone have a Chagas Lookback letter? Please let me know.

I am also looking for an answer to the Chagas Lookback dilemma. This is not currently an FDA requirement is it? Just an AABB recommendation? Has anyone got a Chagas Lookback letter they would like to share? Thanks!

My medical director, who is as skeptical as I am about the vaidity of Chagas testing, suggested a letter along the lines of the following:

Dear Donor,

You have tested positive in a screening test for a South American parasite that has never been proven to manifest itself inside the United States. There is no licensed confirmatory blood test for this parasite. We recommend that you present this information to your personal physician so that your health may be followed more closely should you be truly infected with this parasite, Trypanosoma cruzi. If you have any questions, please contact me at the number below.

Sincerely,

Sol Solly, MD

Phone: BR-549

If you choose to offer the RIPA, then you can ask the donor to come in for that test at no charge to the donor.

BC