title: Management of influenza infection in solid-organ transplant recipients: consensus statement of the Group for the Study of Infection in Transplant Recipients (GESITRA) of the Spanish Society of Infectious Diseases and Clinical Microbiology (SEIMC) and the Spanish Network for Research in Infectious Diseases (REIPI).
abstract: BACKGROUND
  Solid organ transplant (SOT) recipients are at greater risk than the general population for complications and mortality from influenza infection.
  
  
  METHODS
  Researchers and clinicians with experience in SOT infections have developed this consensus document in collaboration with several Spanish scientific societies and study networks related to transplant management. We conducted a systematic review to assess the management and prevention of influenza infection in SOT recipients. Evidence levels based on the available literature are given for each recommendation. This article was written in accordance with international recommendations on consensus statements and the recommendations of the Appraisal of Guidelines for Research and Evaluation II (AGREE II).
  
  
  RESULTS
  Recommendations are provided on the procurement of organs from donors with suspected or confirmed influenza infection. We highlight the importance of the possibility of influenza infection in any SOT recipient presenting upper or lower respiratory symptoms, including pneumonia. The importance of early antiviral treatment of SOT recipients with suspected or confirmed influenza infection and the necessity of annual influenza vaccination are emphasized. The microbiological techniques for diagnosis of influenza infection are reviewed. Guidelines for the use of antiviral prophylaxis in inpatients and outpatients are provided. Recommendations for household contacts of SOT recipients with influenza infection and health care workers in close contact with transplant patients are also included. Finally antiviral dose adjustment guidelines are presented for cases of impaired renal function and for pediatric populations.
  
  
  CONCLUSIONS
  The latest scientific information available regarding influenza infection in the context of SOT is incorporated into this document.
authors.affiliation: Unidad de Enfermedades Infecciosas, Hospital Universitario 12 de Octubre, Instituto de Investigación Biomédica 12 de Octubre (i+12), Departamento de Medicina, Universidad Complutense, Madrid, Spain. Electronic address: flmedrano@yahoo.es.
authors.forename: Francisco
authors.initials: F
authors.lastname: López-Medrano
authors.forename: Elisa
authors.initials: E
authors.lastname: Cordero
authors.forename: Joan
authors.initials: J
authors.lastname: Gavaldá
authors.forename: Josep M
authors.initials: JM
authors.lastname: Cruzado
authors.forename: M Ángeles
authors.initials: MÁ
authors.lastname: Marcos
authors.forename: Pilar
authors.initials: P
authors.lastname: Pérez-Romero
authors.forename: Nuria
authors.initials: N
authors.lastname: Sabé
authors.forename: Miguel Ángel
authors.initials: MÁ
authors.lastname: Gómez-Bravo
authors.forename: Juan Francisco
authors.initials: JF
authors.lastname: Delgado
authors.forename: Evelyn
authors.initials: E
authors.lastname: Cabral
authors.forename: Jordi
authors.initials: J
authors.lastname: Carratalá
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D003428:Cross Infection / Q000517:prevention & control / Q000635:transmission; D003937:Diagnosis, Differential; D019468:Disease Management; D024882:Drug Resistance, Viral; D015707:HN Protein / Q000187:drug effects; D006801:Humans; D009980:Influenza A virus / Q000187:drug effects / Q000302:isolation & purification; D009981:Influenza B virus / Q000187:drug effects / Q000302:isolation & purification; D007252:Influenza Vaccines / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology; D007251:Influenza, Human / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control / Q000635:transmission; D007297:Inpatients; D007674:Kidney Diseases / Q000150:complications; D016377:Organ Transplantation; D053139:Oseltamivir / Q000008:administration & dosage / Q000627:therapeutic use; D010045:Outpatients; D011014:Pneumonia / Q000175:diagnosis; D011183:Postoperative Complications / Q000175:diagnosis / Q000188:drug therapy* / Q000517:prevention & control; D015163:Superinfection / Q000188:drug therapy / Q000517:prevention & control; D053243:Zanamivir / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D000998:Antiviral Agents; D015707:HN Protein; D007252:Influenza Vaccines; D053139:Oseltamivir; D053243:Zanamivir
keywords: Consenso; Consensus; Gripe; Influenza; Profilaxis; Prophylaxis; Transplantation; Trasplante; Tratamiento; Treatment; Vaccination; Vacunación