Infectious Disease Section, Internal Medicine, Hospital Italiano, Buenos Aires, Argentina.
Transplantation. 2010 Dec 27;90(12):1458-62. doi: 10.1097/TP.0b013e3181fc09fe.
The 2009 novel influenza A/H1N1 virus pandemic did not spare solid organ transplant (SOT) recipients. We aimed to describe the behavior of pandemic influenza infection in a group of SOT recipients in Argentina.
Data from 10 transplant (Tx) centers were retrospectively collected for SOT that presented with a respiratory illness compatible with pandemic influenza A infection, between May and September 2009. Cases were defined as suspected, probable, or confirmed according to diagnostic method.
Seventy-seven cases were included. No significant differences in presenting symptoms, pulmonary infiltrates, and graft involvement were found among 35 suspected, 19 probable, and 23 confirmed cases. The 33 ambulatory cases had significantly more sore throat and headache when compared with 34 cases admitted to medical ward (MW) and 10 admitted to intensive care unit (ICU), 9 of whom required ventilatory support. MW and ICU cases had significantly more dyspnea, hypoxemia, pulmonary infiltrates, and graft dysfunction. Time from onset of symptoms to first visit and to treatment was significantly longer in MW and ICU cases (P=0.008). Coinfections were found in six cases. Most cases received oseltamivir for 5 to 10 days. Six patients (7.8%) died from viral infection at a median of 15 days from admission. No differences in outcome were seen related to the transplanted organ, the immunosuppressive regimen, time from Tx, or confirmation of diagnosis.
Mortality is higher in Tx recipients than in the general population. Poor outcome seems to be related to a delay in the beginning of treatment.
2009 年新型甲型 H1N1 流感病毒大流行并未放过实体器官移植（SOT）受者。我们旨在描述一组阿根廷 SOT 受者中大流行性流感感染的行为。
回顾性收集了 10 个移植（Tx）中心的数据，这些数据是在 2009 年 5 月至 9 月期间出现与大流行性甲型流感感染相符的呼吸道疾病的 SOT 患者。根据诊断方法将病例定义为疑似、可能或确诊。
共纳入了 77 例病例。在 35 例疑似病例、19 例可能病例和 23 例确诊病例中，未发现临床表现、肺部浸润和移植物受累存在明显差异。33 例门诊患者与 34 例住院于医疗病房（MW）和 10 例住院于重症监护病房（ICU）的患者相比，喉咙痛和头痛的发生率明显更高，其中 9 例需要呼吸机支持。MW 和 ICU 病例的呼吸困难、低氧血症、肺部浸润和移植物功能障碍的发生率明显更高。MW 和 ICU 病例从出现症状到首次就诊和开始治疗的时间明显更长（P=0.008）。在 6 例病例中发现了合并感染。大多数病例接受了 5 至 10 天的奥司他韦治疗。6 名患者（7.8%）在入院后 15 天内死于病毒感染。与移植器官、免疫抑制方案、Tx 时间或确诊诊断无关，预后未见差异。
Tx 受者的死亡率高于普通人群。不良预后似乎与治疗开始时间延迟有关。
