Successful bilateral lung transplantation in a patient with end-stage lung disease and positive novel influenza virus (H1N1).
In 2009, a pandemic novel influenza virus (H1N1) outbreak was declared by the World Health Organization and resulted in significant worldwide illness. This report describes a 50-year-old male with end-stage lung disease secondary to alpha(1)-anti-trypsin deficiency and chronic obstructive pulmonary disease. He was admitted for potential bilateral lung transplantation when suitable organs became available. Incidentally, he was found to have some non-specific symptoms, including malaise and myalgias. These findings were attributed to killed-virus H1N1 vaccine given 48 hours earlier. However, as a safety measure, a nasopharyngeal swab was taken, and anti-viral therapy with oseltamivir (Tamiflu) was started empirically. He underwent bilateral lung transplantation on the same day of admission. In the immediate post-operative period his nasopharyngeal swab came back positive for H1N1 influenza virus. Then, post-operatively, two consecutive bronchoalveolar lavage samples from the transplanted lungs were found to be positive for H1N1 virus. He received three-weeks of antiviral treatment post-operatively and he had uneventful procedure with favorable outcome.
Division of Cardiac Surgery, Heart and Lung Transplantation, University of Alberta, Edmonton, Alberta, Alberta, Canada. alaklabi@ualberta.ca
Mohammed M
MM
Al Aklabi
Justin G
JG
Weinkauf
Atul
A
Humar
Nitin
N
Ghorpade
D000998:Antiviral Agents / Q000627:therapeutic use; D018893:Bronchoalveolar Lavage; D006801:Humans; D033162:Incidental Findings; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D008168:Lung / Q000382:microbiology / Q000601:surgery; D016040:Lung Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D053139:Oseltamivir / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000601:surgery*; D016896:Treatment Outcome
D000998:Antiviral Agents; D053139:Oseltamivir