2009 H1N1 influenza in hospitalized transplant recipients

Background. The 2009 H1N1 influenza virus was first identified in April 2009 and rapidly evolved into a pandemic. There are limited reports of 2009 H1N1 influenza in transplant recipients. We report on our experience with hospitalized transplant recipients with 2009 H1N1 influenza virus. Methods. Ongoing review of hospitalized 2009 H1N1 influenza cases identified six patients who had received transplants. Clinical characteristics and outcomes were abstracted from the medical record. Results. Between April 27 and November 30, 2009, 29 patients with influenza A virus were admitted to the Mayo Clinic Hospital. Six of the 29 patients were transplant recipients; 4 were confirmed to have 2009 H1N1 influenza virus. Most patients presented with an acute febrile respiratory illness. Duration of antiviral treatment was 5 to 7 days except for one patient who was treated for 11 days until withdrawal of care. Prolonged viral shedding was not noted, and the patients recovered promptly except for a patient with recalcitrant multiple myeloma who died because of the disease. Conclusion. 2009 H1N1 influenza disease in this cohort of hospitalized transplant recipients was relatively mild. The majority of the patients improved promptly, and prolonged viral shedding was not noted.