RT Journal Article
SR Electronic
T1 H1N1 influenza in lung transplant patients: A follow up after one year
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p3079
VO 38
IS Suppl 55
A1 Harish Seethamraju
A1 Bindu Akkanti
A1 Amit Parulekar
A1 Goutham Dronavalli
A1 Matthias Loebe
A1 Saverio LaFrancesca
A1 George Noon
A1 Karolina Chmielowiec
A1 Pawel Kolodziejski
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p3079.abstract
AB The 2009 outbreak of H1N1 caused significant morbidity and mortality. Long term outcome of H1N1 in lung transplant (LT) patients have not been well characterized.We did a retrospective study of LT patients diagnosed with H1N1 between July and November 2009. Data pertaining to LT, history of influenza, admission information, pulmonary function, radiograph, computer tomography scans, and echocardiograms were identified.Among 181 LT patients, there were 10 PCR confirmed cases of H1N1. Patients had a median of 4 months time since LT to infection, received immunosuppressive therapy, and had not received vaccination against H1N1. 60% of patients presented with fever and cough, others had non-pulmonary complaints and all received oseltamivir upon diagnosis. Consolidation was seen by imaging in 60% of patients. Median FEV1 decreased and remained low over a one-year follow up period (1.72 – 1.51 – 1.54) despite clinical improvement. Two patients progressed to respiratory failure and severe LV dysfunction (EF 20-30%) despite previous normal LV function. These patients were on ECMO and had improvement in cardiac and respiratory status but developed gangrene, vascular necrosis, sepsis, and died. One patient developed acute rejection and two patients developed chronic rejection with one retransplanted in February 2010.LT patients contracting H1N1 infection have significant morbidity ranging from mild disease to severe respiratory failure with cardiac dysfunction. Rapidly deteriorating patients had developed myocardial dysfunction, but continued to decline even when this dysfunction resolved. Increased incidence of chronic rejection and extended decreased pulmonary function is seen among LT patients infected with H1N1.