Pandemic influenza (H1N1): impact on lung transplant recipients and candidates

J Heart Lung Transplant. 2010 Sep;29(9):1034-8. doi: 10.1016/j.healun.2010.05.007. Epub 2010 Jun 16.

Abstract

Background: The year 2009 was notable for the outbreak of a novel strain of influenza A (H1N1). We report the outcomes of H1N1 infection in a large cohort of lung transplant (LTx) recipients and candidates.

Methods: This was a retrospective review of 22 suspected cases of H1N1 influenza screened using real-time polymerase chain reaction from nasal secretions. There were 15 confirmed cases (10 LTx recipients, 5 LTx candidates).

Results: All patients were treated with oseltamivir at the time of the first clinical assessment. In the LTx recipients group, 7 of the 10 confirmed cases were treated at home with oseltamivir alone. Three patients were admitted with complications (2 pneumonia, 1 acute rejection). Two patients required mechanical ventilation. Two patients had prolonged viral shedding. No deaths occurred among the LTx recipients. In the 5 LTx candidates with confirmed H1N1, 2 deaths occurred from pneumonia and acute respiratory distress syndrome.

Conclusions: Influenza H1N1 had a significant complication rate amongst LTx recipients and a high mortality rate amongst LTx candidates.

MeSH terms

  • Adolescent
  • Adult
  • Antiviral Agents / therapeutic use
  • Child
  • Female
  • Humans
  • Influenza A Virus, H1N1 Subtype*
  • Influenza, Human / complications
  • Influenza, Human / drug therapy
  • Influenza, Human / epidemiology*
  • Influenza, Human / therapy
  • Israel / epidemiology
  • Lung Diseases / complications
  • Lung Diseases / surgery
  • Lung Diseases / virology
  • Lung Transplantation / adverse effects*
  • Male
  • Middle Aged
  • Oseltamivir / therapeutic use
  • Pandemics*
  • Patient Selection

Substances

  • Antiviral Agents
  • Oseltamivir