tetano
Editor, Senior Moderator
Transplantation. 2010 Sep 1. [Epub ahead of print]
Pandemic (H1N1) 2009 Infection in Adult Solid Organ Transplant Recipients in Singapore.
Low CY, Kee T, Chan KP, Oon LL, Tan CK, Tee NW, Tan BH.
1Department of Infectious Diseases, Singapore General Hospital, Singapore. 2Department of Renal Medicine, Singapore General Hospital, Singapore. 3Department of Pathology, Singapore General Hospital, Singapore. 4Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore. 5Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore.
Abstract
BACKGROUND.: Influenza can produce significant complications in immunocompromised persons. METHODS.: We studied the effects of the pandemic (H1N1) 2009 (pH1N1) infection on solid organ transplant recipients in our hospital, with emphasis on clinical information, duration of viral culture positivity, polymerase chain reaction positivity, effects of oseltamivir therapy, and graft status at 6 months of follow-up. RESULTS.: Twenty-two cases of pH1N1 infection involving 18 renal, two lung, one heart, and one liver transplant recipients were seen from July 14 to September 8, 2009. Their median age was 50.5 years (range 20-70 years); 64% were women, and median time posttransplant was 40 months (range 6-204 months). Common symptoms were fever (86%), cough (77%), sore throat (55%), phlegm (32%), and myalgia (27%). The median duration of symptoms (n=21) and duration of polymerase chain reaction positivity (n=15) were 7 (range 4-13 days) and 8 days (range 4-16 days), respectively. Mean (+/-SD) duration of symptom resolution (7.4+/-3.0 vs. 7.8+/-3.0 days, P=0.76) and viral culture positivity (5.3+/-2.8 vs. 4.3+/-3.2 days, P=0.65) did not differ between those who received a 5-day (n=9) or 10-day (n=12) course of oseltamivir. Five patients (22.7%) developed pneumonia with three needing intensive care. Mortality rate was 4.5% (1/22). At 6 months, three graft rejections involving two renal and one lung developed. CONCLUSIONS.: Our findings indicate that the pH1N1 infection in solid organ transplant recipients is associated with some degree of morbidity and may affect the function of the transplanted organ. In this nonrandomized comparison, patients treated with 5 days of oseltamivir did not fare worse compared with those who received 10 days.
PMID: 20814355 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20814355
Pandemic (H1N1) 2009 Infection in Adult Solid Organ Transplant Recipients in Singapore.
Low CY, Kee T, Chan KP, Oon LL, Tan CK, Tee NW, Tan BH.
1Department of Infectious Diseases, Singapore General Hospital, Singapore. 2Department of Renal Medicine, Singapore General Hospital, Singapore. 3Department of Pathology, Singapore General Hospital, Singapore. 4Department of Gastroenterology and Hepatology, Singapore General Hospital, Singapore. 5Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore.
Abstract
BACKGROUND.: Influenza can produce significant complications in immunocompromised persons. METHODS.: We studied the effects of the pandemic (H1N1) 2009 (pH1N1) infection on solid organ transplant recipients in our hospital, with emphasis on clinical information, duration of viral culture positivity, polymerase chain reaction positivity, effects of oseltamivir therapy, and graft status at 6 months of follow-up. RESULTS.: Twenty-two cases of pH1N1 infection involving 18 renal, two lung, one heart, and one liver transplant recipients were seen from July 14 to September 8, 2009. Their median age was 50.5 years (range 20-70 years); 64% were women, and median time posttransplant was 40 months (range 6-204 months). Common symptoms were fever (86%), cough (77%), sore throat (55%), phlegm (32%), and myalgia (27%). The median duration of symptoms (n=21) and duration of polymerase chain reaction positivity (n=15) were 7 (range 4-13 days) and 8 days (range 4-16 days), respectively. Mean (+/-SD) duration of symptom resolution (7.4+/-3.0 vs. 7.8+/-3.0 days, P=0.76) and viral culture positivity (5.3+/-2.8 vs. 4.3+/-3.2 days, P=0.65) did not differ between those who received a 5-day (n=9) or 10-day (n=12) course of oseltamivir. Five patients (22.7%) developed pneumonia with three needing intensive care. Mortality rate was 4.5% (1/22). At 6 months, three graft rejections involving two renal and one lung developed. CONCLUSIONS.: Our findings indicate that the pH1N1 infection in solid organ transplant recipients is associated with some degree of morbidity and may affect the function of the transplanted organ. In this nonrandomized comparison, patients treated with 5 days of oseltamivir did not fare worse compared with those who received 10 days.
PMID: 20814355 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/20814355