Where do Trypanosoma cruzi go? The distribution of parasites in blood components from fractionated infected whole blood.

Background: Platelets (PLTs) are the blood component most frequently involved in Trypanosoma cruzi transfusion transmission cases reported in the literature, although whole blood (WB) and red blood cells (RBCs) have also been incriminated. However, there is little knowledge of the parasite distribution among blood components.

Study Design And Methods: The aim of this study was to investigate in which blood component T. cruzi parasites concentrate the most, after fractionating artificially T. cruzi-infected WB. The T. cruzi parasite load was studied by a specific quantitative real-time polymerase chain reaction (qPCR) in WB, buffy coat (BC), PLT concentrates, RBCs before and after leukoreduction, and plasma (PL).

Results: The parasite load in WB experimentally infected with 1.5 × 10(6) parasites (2.78 × 10(3) parasite equivalents/mL) was unevenly distributed among the separated blood components. The highest level was found in the BC (6.94 × 10(3) parasite equivalents/mL) and RBCs before leukoreduction by filtration (2.51 × 10(3) parasite equivalents/mL), after which RBCs presented a 99.9% reduction in parasite levels. Both PL and PLTs, partially leukoreduced by centrifugation but nonfiltered, had low parasite levels, the lowest concentration being in PL.

Conclusions: The highest parasite concentration was detected in the BC, followed by RBCs before leukoreduction. There is a notable risk of transfusion-transmitted Chagas disease associated with nonleukoreduced RBCs. Leukoreduction may be an effective prevention strategy for transfusion-transmitted T. cruzi infection, especially in endemic countries and in nonendemic countries with a high rate of immigration from Latin America.