Original clinical sciencePandemic influenza (H1N1): Impact on lung transplant recipients and candidates
Section snippets
Rabin Medical Center Lung Transplantation Program
Rabin Medical Center (RMC) is a major tertiary medical facility in central Israel and is the only national center offering LTx. Since its inception, RMC has performed more than 314 LTx, and in recent years has performed between 40 and 50 LTx annually.
All LTx recipients were advised to obtain seasonal and H1N1 influenza vaccinations from their family doctor. Furthermore, we emphasized to the LTx recipient cohort the importance of urgent attendance for medical care in the case of influenza
General information
At the official start of the H1N1 pandemic, 190 allograft recipients were alive. There were 19 transplant procedures during the study period. There was 1 peri-transplant death, and 9 existing allograft recipients died of non-H1N1 causes. H1N1 evaluations in 17 LTx recipients during the study period confirmed 10 cases (5% of cohort at start of the pandemic). Amongst the 60 LTx candidates on the waiting list, 5 confirmed cases were identified (8% at start of the pandemic). Confirmed cases of H1N1
Discussion
We present a single-center experience of the effect of H1N1 pandemic influenza on patients before and after LTx. We monitored 10 LTx recipients and 5 LTx candidates who presented to our center with confirmed H1N1 and observed a significant incidence of complications. No deaths occurred amongst the LTx recipients, although 2 patients required mechanical ventilation and 2 patients had prolonged illness with shedding of H1N1 in nasal secretions.
This is the first case series that we are aware of
Disclosure statement
None of the authors has a financial relationship with a commercial entity that has an interest in the subject of the presented manuscript or other conflicts of interest to disclose.
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Cited by (23)
Respiratory Viral Infections in Solid Organ and Hematopoietic Stem Cell Transplantation
2017, Clinics in Chest MedicineCitation Excerpt :Recommended duration of treatment is 5 days in immunocompetent children and adults. In general, treatment recommendations and practice in SOT patients with influenza are for 5 days of oseltamivir as well.105,106 Although 5 days of oseltamivir is the typical treatment duration, there are reports of treatment for 10 days or longer in patients with persistent symptoms.107
Respiratory Viruses: Influenza, RSV, and Adenovirus in Kidney Transplantation
2016, Seminars in NephrologyCitation Excerpt :In general, oseltamivir has been well tolerated. Shedding may be prolonged and, as a result, longer courses than the usual 5-day course likely are required in transplant recipients.4,69 Most experts recommend treating until eradication of replication is confirmed.18,66,70
The impact of influenza A(H1N1)pdm09 infection on immunosuppressed patients
2012, Enfermedades Infecciosas y Microbiologia ClinicaPandemic 2009 H1N1 influenza virus vaccination in lung transplant recipients: Coverage, safety and clinical effectiveness in the Zurich cohort
2011, Journal of Heart and Lung TransplantationCitation Excerpt :A small proportion (2 of 7) of the H1N1 infections showed prolonged viral shedding. This observation is in line with other reports.10,16 Vaccination by a dedicated team, close follow-up at a single outpatient clinic, documentation of any vaccine-related symptom in all patients, and frequent testing with viral swabs for flu-like symptoms (average 3.5 per patient) are among the strengths of this study.
Peri-operative novel 2009 H1N1 influenza virus infection successfully treated with oseltamivir and zanamivir in a lung transplant recipient
2011, Journal of Heart and Lung TransplantationThe impact of pandemic influenza A H1N1 2009 on Australian lung transplant recipients
2011, American Journal of Transplantation