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Master of Public Health

Incidence of and Risk Factors for Influenza-Associated Hospital Encounters in Pediatric Solid Organ Transplant Recipients

AUTHORS

Haddadin Z , Spieker AJ , Amarin JZ , Hall M , Thurm C , Danziger-Isakov L , Godown J , Halasa NB , Dulek DE , . American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons. 2023 2 7; ().

ABSTRACT

Few studies have defined the incidence of and risk factors for influenza infection in pediatric solid organ transplant (SOT) recipients. We utilized a linkage between the Pediatric Health Information System (PHIS) and the Scientific Registry of Transplant Recipients (SRTR) databases to identify posttransplant influenza-associated hospital encounters (IAHEs) in pediatric SOT recipients of single-organ transplants. Among 7,997 unique pediatric SOT recipients transplanted between 1/1/2006 and 6/1/2016, estimated one- and three-year post-transplant cumulative incidence rates of IAHE were 2.7% (95% CI, 2.4-3.1%) and 7.4% (95% CI, 6.8-8.0%), respectively. One- and three-year cumulative incidence rates of severe IAHE were 0.3% (95% CI, 0.2-0.5%) and 0.9% (95% CI, 0.7-1.2%). Multivariable analysis showed that organ type (aSHR — Kidney: ref., Liver: 0.64 [95% CI 0.49-0.84], Heart 0.72 [95% CI 0.57-0.93]), race/ethnicity (aSHR – non-Hispanic White: ref, non-Hispanic Black: 1.63 [95% CI 1.29-2.07], Hispanic 1.57 [95% CI: 1.27-1.94]) and increasing age at transplant (aSHR 0.93 [95% CI 0.91-0.94]) were significantly associated with IAHE occurrence. Heart transplant recipients had a near statistically significant increase in hazard for severe IAHE (aSHR 1.96 [0.92-3.49]. Our findings may help guide future influenza prevention efforts and facilitate intervention impact assessment measurement in pediatric solid organ transplant recipients.

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