Vilchez Regis A, McCurry Kenneth, Dauber James, Lacono Aldo, Griffith Bartley, Fung John, Kusne Shimon
Department of Medicine, University of Pittsburgh Medical Center, PA 15213, USA.
Am J Transplant. 2002 Mar;2(3):287-91. doi: 10.1034/j.1600-6143.2002.20315.x.
Solid organ transplant (SOT) recipients have been reported to be more susceptible to influenza virus. However, little is known about the clinical epidemiology and the implications of influenza viral infection among SOT recipients.
Cohort study of influenza viral infection in SOT recipients at the University of Pittsburgh Medical Center.
Between November 1990 and April 2000, 30 cases of influenza were diagnosed in SOT recipients at our center, including influenza A (n = 22) and influenza B (n = 8). These included recipients of lung (n = 19), liver (n = 5) and kidney (n = 6) transplants. The incidence of influenza viral infection was 41.8 cases/1,000 person years (PYs), 2.8 cases/1000 PYs and 4.3 cases/ 1,000 PYs among lung, liver and renal transplant patients, respectively (p <0.0001). Symptoms were reported in all patients and included malaise, myalgia/ arthralgia, fever, cough, and shortness of breath. Secondary bacterial pneumonia occurred in five patients (17%). Other complications were seen in three SOT recipients (2 liver and 1 kidney) and included: myocarditis, myositis, and bronchiolitis obliterans. Biopsy of the transplanted organ was performed in 21 SOT recipients (18 lung, 1 liver and 2 kidney) at the time of influenza viral infection. Overall, 62% (13/21) showed variable degrees of acute allograft rejection, and included 61% (11/18) of lung, and 100% (2/2) of kidney transplant recipients.
Influenza infection is associated with significant morbidity in different groups of SOT recipients. Studies are needed to determine if yearly chemoprophylaxis with antiviral drugs might benefit this patient population.
据报道，实体器官移植（SOT）受者更容易感染流感病毒。然而，关于SOT受者中流感病毒感染的临床流行病学及其影响知之甚少。
对匹兹堡大学医学中心的SOT受者进行流感病毒感染队列研究。
1990年11月至2000年4月期间，我们中心诊断出30例SOT受者感染流感，其中甲型流感22例，乙型流感8例。这些受者包括肺移植受者19例、肝移植受者5例和肾移植受者6例。肺、肝和肾移植患者中流感病毒感染的发病率分别为41.8例/1000人年、2.8例/1000人年和4.3例/1000人年（p<0.0001）。所有患者均出现症状，包括不适、肌痛/关节痛、发热、咳嗽和呼吸急促。5例患者（17%）发生继发性细菌性肺炎。3例SOT受者（2例肝移植和1例肾移植）出现其他并发症，包括心肌炎、肌炎和闭塞性细支气管炎。21例SOT受者（18例肺移植、1例肝移植和2例肾移植）在流感病毒感染时进行了移植器官活检。总体而言，62%（13/21）表现出不同程度的急性移植物排斥反应，其中肺移植受者为61%（11/18），肾移植受者为100%（2/2）。
流感感染与不同组别的SOT受者的显著发病率相关。需要进行研究以确定每年使用抗病毒药物进行化学预防是否对该患者群体有益。
