Transplant infectious disease experts provide pandemic guidance

December 03, 2009

Surgeons and other healthcare professionals specialising in solid organ transplants have been issued with expert advice to guide them through the complex clinical issues posed by the global H1N1 (swine flu) pandemic.

The paper, published online by the American Journal of Transplantation, also urges them to stay alert to the significant concerns that swine flu could combine with seasonal flu, and possibly even bird flu (H5N1), to develop into a strain with unpredictable virulence.

"The current virus pandemic can cause severe disease in transplant patients and could be transmitted from donors" explains assistant professor Dr Deepali Kumar, an expert in transplant-related infectious diseases from the University of Alberta, Canada. "This has major implications for donor selection and transplant management and care."

Dr Kumar has teamed up with infectious disease experts from across Canada and the USA to discuss the solid organ transplant guidance issued as part of the wider H1N1 guidelines produced by the American Society of Transplantation (AST) and The Transplantation Society (TTS), which are updated online as new information emerges.

The article, fast-tracked for online publication, has been produced on behalf of both societies and carries the additional endorsement of the Canadian Society of Transplantation.

It includes discussions about clinical presentation, diagnosis, therapy and prevention, specifically addressing areas such as chemoprophylaxis, immunization and donor-derived infection.

"Reaction to this novel respiratory virus in the transplant community has been swift, as clinicians have real concerns about the prevention, diagnosis and treatment of the flu virus as public health data mounts and the course of the pandemic evolves" says Dr Kumar.

"The International Society for Heart and Lung Transplantation has already developed guidelines for heart and lung transplant recipients in the pandemic setting, raising concerns about transmission from donors to recipients.

"However, autopsy studies suggest that other organs, such as the brain, kidney, pancreas, spleen, liver and heart, can also become infected. This pandemic has important clinical implications for all stages of the solid organ transplant process."

Key points raised by the discussion document include:"As new information emerges about novel H1N1, updates will be made to the electronic guidance document posted on the AST and TTS websites so regular visits are recommended" stresses Dr Kumar.
-end-
The paper is available free online at: http://www3.interscience.wiley.com/cgi-bin/fulltext/123198716/HTMLSTART

Notes to editors

Guidance on Novel Influenza A/H1N1 in Solid Organ Transplant Recipients. Kumar et al on behalf of the AST Infectious Diseases Community of Practice and Transplant Infections Diseases Section of TTS. American Journal of Transplantation. Online publication ahead of print (December 2009). doi: 10.1111/j.1600-6143.2009.02960.x Available free online at: http://www3.interscience.wiley.com/cgi-bin/fulltext/123198716/HTMLSTART

American Journal of Transplantation is the leading, most authoritative source for current clinical and research results on all aspects of transplantation. As the official publication of the American Society of Transplantation and the American Society of Transplant Surgeons, the American Journal of Transplantation serves as a forum for debate and reassessment, an agent of change, and a major new platform for promoting understanding, improving results, and advancing science in organ and tissue transplantation. For more information, please visit www.amjtrans.com.

Wiley-Blackwell is the international scientific, technical, medical, and scholarly publishing business of John Wiley & Sons, with strengths in every major academic and professional field and partnerships with many of the world's leading societies. Wiley-Blackwell publishes nearly 1,500 peer-reviewed journals and 1,500+ new books annually in print and online, as well as databases, major reference works and laboratory protocols. For more information, please visit www.wileyblackwell.com or www.interscience.wiley.com

Wiley

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