Influenza treatment study gives hope to transplant patients

Rachel Singer

FLU FIGHTERS Dr. Deepali Kumar’s research focuses on improving flu treatments for transplant patients who are usually more susceptible to viruses.

Transplant patients have weaker immune systems than normal, but University of Alberta research has taken step towards helping them combat the flu. The research, done by Dr. Deepali Kumar, has won this year's Gold Medal in Medicine from the Royal College of Physicians and Surgeons of Canada.

Each year, a single medical specialist in Canada is awarded the gold medal and only four other researchers from Alberta have ever received the award.

"I was floored to get the email and this is the most important award I have ever gotten. The Royal College is an organization that all the specialist physicians in Canada are part of, so to get an award from [them] is amazing," Kumar said.

Kumar, an associate professor in the Department of Medicine, received the award for her research on the effects of the H1N1 influenza virus on transplant patients. She had noticed that some of the transplant patients who got the flu became very sick and ended up in critical care, while others were fine. Kumar contacted her fellow colleagues in North America and Europe to see if they had noticed the same thing.

"It was interesting because they were all thinking the same thing. So we got together and we got information on all the patients everybody was seeing, and the U of A was the central site. All the information came to the U of A and I put it into a database and I analyzed the information," Kumar explained.

From the analysis, which involved information from 237 patients, Kumar found that patients who received antiviral treatment within 48 hours of flu symptoms fared much better and were less likely to end up in critical care, compared to those who received no treatment or who received treatment after the first 48 hours. The problem with starting antiviral therapy within the 48 hour time period is that doctor's usually test if a patient has the flu first, which takes time to confirm.

Kumar suggested that doctors should use antiviral treatment the moment they suspect a transplant patient has the flu. This would ensure that doctors would not miss the time period that could prevent a transplant patient from ending up in critical care. If the test confirms a patient does not have the flu then the doctor can quickly take the patient off the treatment, with little to no side effects.

Kumar pointed out that flu shots don't work very well in transplant patients, as they try and boost the immune system, which is usually suppressed in these patients to prevent rejection of new organs. A flu shot is much more likely to work at least six months after the transplant date, when the post-operation medication has been reduced. One of the studies she recently finished looked at whether the flu shot under the skin is more effective in transplant patients than into the muscle which is normally done. The results have not been analyzed yet, but Kumar hopes to look at them this fall.