tetano
Editor, Senior Moderator
Am J Transplant. 2011 Feb 7. doi: 10.1111/j.1600-6143.2010.03422.x. [Epub ahead of print]
The Impact of Pandemic Influenza A H1N1 2009 on Australian Lung Transplant Recipients.
Ng BJ, Glanville AR, Snell G, Musk M, Holmes M, Chambers DC, Hopkins PM.
Queensland Centre for Pulmonary Transplantation and Vascular Disease, The Prince Charles Hospital, Brisbane, Queensland, Australia The Lung Transplant Unit, St.Vincent's Hospital, Sydney, NSW, Australia Heart and Lung Transplant Unit, The Alfred Hospital, Melbourne, Victoria, Australia Western Australian Lung Transplant Unit, Royal Perth Hospital, Perth, Western Australia, Australia South Australian Lung Transplant Services, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Abstract
Influenza A H1N1 2009 led to 189 deaths during the Australian pandemic. Community-acquired respiratory viruses not only can cause prolonged allograft dysfunction in lung transplant recipients but have also been linked to bronchiolitis obliterans syndrome (BOS). We report the impact of the 2009 H1N1 pandemic on Australian lung transplant recipients. An observational study of confirmed H1N1 cases was conducted across five Australian lung transplant programs during the pandemic. An electronic database collected patient demographics, clinical presentation, management and outcomes up to a year follow-up. Twenty-four H1N1 cases (mean age 43 ? 14 years, eight females) were identified, incidence of 3%. Illness severity varied from upper respiratory tract symptoms only in 29% to lung allograft dysfunction (≥10% decline FEV1) in 75% to death in 5 (21%) cases (pre-existing BOS grade 3, n = 4). Treatment with oseltamivir occurred in all but one case confirmed after death, reduced immunosuppression, n = 1, augmented corticosteroid therapy, n = 16, and mechanical/noninvasive ventilation, n = 4. There was BOS grade decline within a year in six cases (32%). In conclusion, Australian lung transplant recipients were variably affected by the H1N1 pandemic mirroring the broader community with significant morbidity and mortality. After initial recovery, a considerable proportion of survivors have demonstrated BOS progression.
?2011 The Authors Journal compilation?2011 The American Society of Transplantation and the American Society of Transplant Surgeons.
PMID: 21299829 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21299829
The Impact of Pandemic Influenza A H1N1 2009 on Australian Lung Transplant Recipients.
Ng BJ, Glanville AR, Snell G, Musk M, Holmes M, Chambers DC, Hopkins PM.
Queensland Centre for Pulmonary Transplantation and Vascular Disease, The Prince Charles Hospital, Brisbane, Queensland, Australia The Lung Transplant Unit, St.Vincent's Hospital, Sydney, NSW, Australia Heart and Lung Transplant Unit, The Alfred Hospital, Melbourne, Victoria, Australia Western Australian Lung Transplant Unit, Royal Perth Hospital, Perth, Western Australia, Australia South Australian Lung Transplant Services, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Abstract
Influenza A H1N1 2009 led to 189 deaths during the Australian pandemic. Community-acquired respiratory viruses not only can cause prolonged allograft dysfunction in lung transplant recipients but have also been linked to bronchiolitis obliterans syndrome (BOS). We report the impact of the 2009 H1N1 pandemic on Australian lung transplant recipients. An observational study of confirmed H1N1 cases was conducted across five Australian lung transplant programs during the pandemic. An electronic database collected patient demographics, clinical presentation, management and outcomes up to a year follow-up. Twenty-four H1N1 cases (mean age 43 ? 14 years, eight females) were identified, incidence of 3%. Illness severity varied from upper respiratory tract symptoms only in 29% to lung allograft dysfunction (≥10% decline FEV1) in 75% to death in 5 (21%) cases (pre-existing BOS grade 3, n = 4). Treatment with oseltamivir occurred in all but one case confirmed after death, reduced immunosuppression, n = 1, augmented corticosteroid therapy, n = 16, and mechanical/noninvasive ventilation, n = 4. There was BOS grade decline within a year in six cases (32%). In conclusion, Australian lung transplant recipients were variably affected by the H1N1 pandemic mirroring the broader community with significant morbidity and mortality. After initial recovery, a considerable proportion of survivors have demonstrated BOS progression.
?2011 The Authors Journal compilation?2011 The American Society of Transplantation and the American Society of Transplant Surgeons.
PMID: 21299829 [PubMed - as supplied by publisher]
http://www.ncbi.nlm.nih.gov/pubmed/21299829