Each year 3-5 million people have severe cases and 250-500,000 die from complications of seasonal influenza world-wide. This year, the novel 2009 H1N1 (nH1N1) influenza, previously called swine flu, has reached pandemic status.
Since novel 2009 H1N1 is a viral infection of the respiratory tract, there are additional challenges for cardiopulmonary transplant recipients and donors, as well as for the healthcare workers involved in the transplant process. In an article published online today in the Journal of Heart and Lung Transplantation (www.jhltonline.org), physicians representing the International Society for Heart & Lung Transplantation (ISHLT) Infectious Disease Council issue an advisory for all programs in cardiothoracic transplantation.
Mandeep R. Mehra, MBBS, FACC, FACP, Editor-in-Chief, the Journal of Heart and Lung Transplantation observes, "Nowhere is the threat of H1N1 more real than in cardiopulmonary transplantation. The ISHLT's Infectious Disease Council has developed what is assuredly the most comprehensive and clinically relevant direction for prevention and management of H1N1 flu in donors, recipients, care providers and family members."
Recognition of the novel 2009 H1N1 influenza virus, aggressive diagnosis and early treatment need be paired with active preventative measures to stem the impact of infection in the transplant population. This special advisory addresses issues relevant to cardiothoracic transplant candidates, selection of donors, recipient management and patients with mechanical circulatory support devices. Since transplant recipients are treated with anti-rejection drugs, the advisory provides clear directions for specific dosing of antiviral drugs and management of the background immunosuppression. Specific guidelines for evaluation and management of post-surgical transplant patients are also given, as well as recommendations for how and when to administer vaccines. On the donor side, the advisory provides guidelines for how to evaluate and treat donors so that organs can be safely used and not wasted. Finally, it provides specific guidelines for the healthcare teams managing such patients.
Writing in the article, Lara A. Danziger-Isakov MD MPH, Cleveland Clinic Children's Hospital, states, "Interaction with organ procurement organizations for organ selection must take into account emerging data on the use of organs from patients infected and treated for the novel 2009 H1N1 Influenza virus. Improved diagnostic testing with shorter turnaround times is needed in donor evaluation. Individual patient education, prevention measures and treatment strategies will also require attention to the local patterns of infection, availability of the novel 2009 H1N1 Influenza virus vaccination, and emerging patterns of antiviral resistance. Finally, efforts to contain and prevent the novel 2009 H1N1 Influenza virus from spreading within the cardiothoracic transplant setting can be accomplished through infection control measures."
"This article is an initiative of the Infectious Disease (ID) council of ISHLT to provide timely practical guidance for cardiothoracic transplant programs facing a winter pandemic of novel 2009 H1N1 influenza," comments Dr Margaret M Hannan, Mater Misericordiae University Hospital, Dublin, Chairman of ID council for ISHLT. "Evolving diagnostic testing with limitations due to prolonged turnaround time and availability are considered in donor and recipient management. Ensuring that the most accurate diagnostic tests are being carried out in a timely and systematic manner will allow cardiothoracic transplant surgeons to make informed decisions in 'real time' and avoid waste of usable organs." Education of staff and patients in infection control and prevention is fundamental to successful management of this virus in the transplant recipient population.
The article is "The Novel 2009 H1N1 Influenza Virus Pandemic: Unique Considerations for Programs in Cardiothoracic Transplantation" by Lara A. Danziger-Isakov MD MPH, Shahid Husain MD MS , Martha L. Mooney MD FACP, Margaret M. Hannan MD for the ISHLT Infectious Diseases Council. DOI 10.1016/j.healun.2009.10.001. Following advance online publication on October 23, 2009, the article will appear in the Journal of Heart and Lung Transplantation, Volume 28, Issue 12 (December 2009) published by Elsevier.
Linda Gruner | EurekAlert!
Investigators may unlock mystery of how staph cells dodge the body's immune system
22.09.2017 | Cedars-Sinai Medical Center
Monitoring the heart's mitochondria to predict cardiac arrest?
21.09.2017 | Boston Children's Hospital
Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.
A warming planet
Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.
The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...
Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...
Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!
When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...
For the first time, physicists have successfully imaged spiral magnetic ordering in a multiferroic material. These materials are considered highly promising candidates for future data storage media. The researchers were able to prove their findings using unique quantum sensors that were developed at Basel University and that can analyze electromagnetic fields on the nanometer scale. The results – obtained by scientists from the University of Basel’s Department of Physics, the Swiss Nanoscience Institute, the University of Montpellier and several laboratories from University Paris-Saclay – were recently published in the journal Nature.
Multiferroics are materials that simultaneously react to electric and magnetic fields. These two properties are rarely found together, and their combined...
19.09.2017 | Event News
12.09.2017 | Event News
06.09.2017 | Event News
22.09.2017 | Life Sciences
22.09.2017 | Medical Engineering
22.09.2017 | Physics and Astronomy