ABSTRACT
In late March 2009, an outbreak of influenza A virus infection was detected in Mexico with subsequent cases observed in many other countries. The pandemic was caused by an H1N1 virus that represents a quadruple reassortment of 2 swine strains, 1 human strain, and 1 avian strain of influenza. Until February 1, 2010, a total of 47 cases of influenza A (Inf A) were recorded by the Spanish Society of Nephrology in kidney transplant recipients. Herein we have reported our 3 cases (6.4%) in this registry. A 17-year-old girl with hepatorenal polycystosis received a liver and kidney transplant at 37 months previously. She displayed high fever and mild respiratory symptoms that resolved without treatment. A 38-year-old woman with chronic renal failure (CRF) of undetermined etiology received a kidney transplant 9 months previously. She was admitted with a 5-day history of febrile syndrome and respiratory symptoms, with extensive bilateral pneumonia and acute severe respiratory failure that required admission to the intensive care unit. Her evolution was satisfactory. A 38-year-old woman with CRF of undetermined etiology received a kidney transplant 2.5 months previously. She was admitted in November 2009 with a 2-week history of fever, myalgia, general malaise, cough, and expectoration. Her course was satisfactory. In these cases we determined H1N1 Inf A pandemic variant by detection of Inf A Matrix Protein 2 gene M2 and the specific H1 gene for influenza pandemic H1N1 2009 with reverse transcriptase polymerase chain reaction Inf A/H1N1 (Roche). The 3 cases of Inf A in kidney transplant recipients recorded in the province of Almeria occurred in young women shortly after kidney transplantation, and with no other risk factors apart from those associated with the transplantation itself. From the consideration of respiratory and renal situations, their courses were satisfactory.