Severe novel H1N1 influenza A infection in the immediate postoperative period of a liver transplant patient

Zapata, Rodrigo; Uribe, Mario; Martínez, Waldo; Andrade, Alejandro; Leal, José Luis; Gómez, Fernando

doi:10.1002/lt.22013

Cited by 4 publications

(3 citation statements)

References 11 publications

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“…Hospital‐acquired seasonal influenza in SOTR has been documented [22]. Within the recent pandemic, hospital‐acquired cases of influenza were reported in immunocompromised patients [23], and isolated cases were described in SOTR [24,25]. In the same way, we found that 8% of the pandemic influenza cases were hospital‐acquired.…”

Section: Discussionsupporting

confidence: 70%

Pandemic influenza A(H1N1) virus infection in solid organ transplant recipients: impact of viral and non-viral co-infection

Cordero

Pérez‐Romero

Moreno

et al. 2012

Clinical Microbiology and Infection

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Solid organ transplant recipients (SOTR) are at risk of serious influenza-related complications. The impact of respiratory co-infection in SOTR with 2009 pandemic influenza A(H1N1) is unknown. A multicentre prospective study of consecutive cases of pandemic influenza A(H1N1) in SOTR was carried out to assess the clinical characteristics and outcome and the risk factors for co-infection. Overall, 51 patients were included. Median time from transplant was 3.7 years, 5.9% of the cases occurred perioperatively and 7.8% were hospital-acquired. Pneumonia was diagnosed in 15 (29.4%) patients. Ten cases were severe (19.6%): 13.7% were admitted to intensive care units, 5.9% suffered septic shock, 5.9% developed acute graft rejection and 7.8% died. Co-infection was detected in 15 patients (29.4%): eight viral, six bacterial and one fungal. Viral co-infection did not affect the outcome. Patients with non-viral co-infection had a worse outcome: longer hospital stay (26.2 ± 20.7 vs. 5.5 ± 10.2) and higher rate of severe diseases (85.7% vs. 2.3%) and mortality (42.8% vs. 2.3%). Independent risk factors for non-viral co-infection were: diabetes mellitus and septic shock. Other factors associated with severe influenza were: delayed antiviral therapy, diabetes mellitus, time since transplantation <90 days and pneumonia. In conclusion, pandemic influenza A can cause significant direct and indirect effects in SOTR, especially in the early post-transplant period, and should be treated early. Clinicians should be aware of the possibility of non-viral co-infection, mainly in diabetic patients and severe cases. An effort should be made to prevent influenza with immunization of the patient and the environment.

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Section: Discussionsupporting

confidence: 70%

Pandemic influenza A(H1N1) virus infection in solid organ transplant recipients: impact of viral and non-viral co-infection

Cordero

Pérez‐Romero

Moreno

et al. 2012

Clinical Microbiology and Infection

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“…However, this patient had other possible causes of rejection, such as low immunosuppressive drug levels. In addition, episodes of acute allograft rejection and permanent graft dysfunction have also been related to seasonal and pandemic influenza virus infection [5,29,30].…”

Section: Discussionmentioning

confidence: 99%

Influenza vaccination during the first 6 months after solid organ transplantation is efficacious and safe

Pérez‐Romero

Bulnes-Ramos

Torre-Cisneros

et al. 2015

Clinical Microbiology and Infection

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Preventing influenza infection early after transplantation is essential, given the disease's high mortality. A multicentre prospective cohort study in adult solid organ transplant recipients (SOTR) receiving the influenza vaccine during four consecutive influenza seasons (2009-2013) was performed to assess the immunogenicity and safety of influenza vaccination in SOTR before and 6 months after transplantation. A total of 798 SOTR, 130 of them vaccinated within 6 months of transplantation and 668 of them vaccinated more than 6 months since transplantation. Seroprotection was similar in both groups: 73.1% vs. 76.5% for A/(H1N1)pdm (p 0.49), 67.5% vs. 74.1% for A/H3N2 (p 0.17) and 84.2% vs. 85.2% for influenza B (p 0.80), respectively. Geometric mean titres after vaccination did not differ among groups: 117.32 (95% confidence interval (CI) 81.52, 168.83) vs. 87.43 (95% CI 72.87, 104.91) for A/(H1N1)pdm, 120.45 (95% CI 82.17, 176.57) vs. 97.86 (95% CI 81.34, 117.44) for A/H3N2 and 143.32 (95% CI 103.46, 198.53) vs. 145.54 (95% CI 122.35, 174.24) for influenza B, respectively. After adjusting for confounding factors, time since transplantation was not associated with response to vaccination. No cases of rejection or severe adverse events were detected in patients vaccinated within the first 6 months after transplantation. In conclusion, influenza vaccination within the first 6 months after transplantation is as safe and immunogenic as vaccination thereafter. Thus, administration of the influenza vaccine can be recommended as soon as 1 month after transplantation.

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“…신종인플루엔자 A의 증상은 대부분 전형적인 인플루 엔자 유사질환(influenza-like illness, ILI)의 양상으로 젊 은 성인이나 소아에서 호발하지만, 증상이 경하고 합병증 이 적으나 노인(65세 이상), 임산부, 면역이 저하된 환자 나 만성적 호흡기질환, 신질환, 심질환이 있는 환자는 합 병증 발병이 높은 고위험군이다 (3)(4)(5). 또한, 이식환자에 서 매년 인플루엔자 감염은 폐렴을 흔히 유발하며 급성 거부반응을 일으키기도 한다 (6).…”

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Swine Influenza A (H1N1) Infection in Renal Transplant Recipients

Lee

Kim

et al. 2010

Korean J Transplant

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Background: Novel H1N1 influenza A was a pandemic disease in 2009. However, limited data are available on renal transplant recipients undergoing long-term immunosuppression who contracted novel H1N1 influenza A. Methods:We analyzed 2,345 patients who had been tested with H1N1 swab real-time reverse transcriptase-polymerase chain reaction test (rRT-PCR) between May 2009 and February 2010. Of them, 30 were kidney recipients who underwent kidney transplantation between April 1979 and 2, May 2009 before the first diagnosis of H1N1 influenza A in Korea. The clinical characteristics, treatment, and outcome of renal transplant recipients with confirmed H1N1 influenza were reviewed retrospectively.Results: A total of 1,543 (66.7%) general patients were swine influenza A confirmed. Of the 30 transplant patients, 19 (63.3%) were confirmed with swine influenza A. The mean age of the general patients at diagnosis of swine influenza A was younger than that of renal recipients (16.5±16.1 vs. 39.7±11.5 years, P＜0.0001). More patients died in the transplant group than in the general patient group even after oseltamivir (Tamiflu) treatment. When comparing the cured group with the dead group of transplant patients, the dead group had a longer duration between symptom manifestation and the beginning of treatment than the cured group (7 [5-7] vs. 2 [1-14] days, P=0.007). The dead group presented more complications such as pneumonia (P=0.009).Conclusions: H1N1 influenza A can cause severe illness in kidney transplant recipients. We suggest that early diagnosis and treatment with an antiviral agent produces good results in kidney transplant recipients as in the general population.

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Severe novel H1N1 influenza A infection in the immediate postoperative period of a liver transplant patient

Cited by 4 publications

References 11 publications

Pandemic influenza A(H1N1) virus infection in solid organ transplant recipients: impact of viral and non-viral co-infection

Pandemic influenza A(H1N1) virus infection in solid organ transplant recipients: impact of viral and non-viral co-infection

Influenza vaccination during the first 6 months after solid organ transplantation is efficacious and safe

Swine Influenza A (H1N1) Infection in Renal Transplant Recipients

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