Pandemic influenza (H1N1): impact on lung transplant recipients and candidates.
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.
Fox
Benjamin Daniel
BD
Pulmonary Institute, Rabin Medical Center, Beilinson Campus, Petach Tiqwa, Israel.
Raviv
Yael
Y
Rozengarten
Dror
D
Rusanov
Viktoria
V
Bakal
Ilana
I
Kramer
Mordechai R
MR
D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002648:Child; D005260:Female; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype; D007251:Influenza, Human / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy; D007557:Israel / Q000453:epidemiology; D008171:Lung Diseases / Q000150:complications / Q000601:surgery / Q000821:virology; D016040:Lung Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D053139:Oseltamivir / Q000627:therapeutic use; D058873:Pandemics; D018579:Patient Selection
D000998:Antiviral Agents; D053139:Oseltamivir