Influenza-Associated Hospitalizations in Pediatric Solid Organ Transplant Recipients
1Pediatric Infectious Diseases, Vanderbilt University Medical Center, Nashville, TN, 2Children's Hospital Association, Lenexa, KS, 3Pediatric Cardiology, Vanderbilt University Medical Center, Nashville, TN
Meeting: 2020 American Transplant Congress
Abstract number: 597
Keywords: Infection, Lung infection, Pediatric, Vaccination
Session Information
Session Time: 3:15pm-4:45pm
Presentation Time: 3:27pm-3:39pm
Location: Virtual
*Purpose: Pediatric solid organ transplant (pSOT) recipients are at high risk for severe influenza virus infection. Data regarding the incidence, morbidity, mortality, and economic burden of influenza infection in pSOT recipients are limited. We sought to define hospital-based resource utilization for influenza-associated hospitalization (IAH) in pSOT recipients using a linked administrative database.
*Methods: Using a unique linkage between the Pediatric Health Information Systems (PHIS) and Scientific Registry of Transplant Recipients (SRTR) databases, we identified pSOT recipients with emergency department encounters (EDE) or hospital admission encounters (HAE) who had associated with ICD-9/10 diagnosis codes for influenza after their initial pSOT transplantation. Patients undergoing heart, liver, lung, heart-lung, kidney, and small bowel transplants were included.
*Results: A total of 13,178 pSOT recipients are present within the linked dataset. Between 2002-2018, 1,187 influenza-associated EDE or HAE were identified in 1,115 individual pSOT recipients. Of these encounters, 885 (74.5%) were IAH, all of which were unique subjects. Of IAH in pSOT recipients, 35.1% occurred in liver transplant recipients and 33.4% occurred in kidney recipients, with 21.7%, 5.3%, and 4.2% occurring in heart, lung, and intestine recipients, respectively. Median time to IAH following transplantation was 1.8 years (IQR: 0.7-3.7 years) and 31.5% of IAH occurred in the first-year following transplant. Median duration of IAH was 3 days (IQR 2-6 days). Of pSOT recipients with IAH, 15.4% required intensive care, 7.5% required mechanical ventilation, 0.3% required ECMO, and 1.2% died during the hospitalization. Median cost of IAH was $9,653 (IQR $5,664 – $20,595). Influenza antivirals were administered in 73% and antibiotic therapy was administered in 87.6% of IAH episodes.
*Conclusions: IAH in pSOT recipients is associated with significant morbidity, mortality, antibiotic use, and economic burden, including years after pSOT. Future studies will determine the impact of IAH on late transplant outcomes using this unique linked database.
To cite this abstract in AMA style:
Haddadin Z, Probst V, Rahman H, Hall M, Thurm C, Halasa N, Godown J, Dulek DE. Influenza-Associated Hospitalizations in Pediatric Solid Organ Transplant Recipients [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/influenza-associated-hospitalizations-in-pediatric-solid-organ-transplant-recipients/. Accessed May 9, 2025.« Back to 2020 American Transplant Congress