Travel Practices and Associated Risks in Thoracic Transplant Recipients: A Monocentric Survey

Abstract

Little is known regarding the travel practices of thoracic organ transplant recipients and their potential associated morbidity. A questionnaire was distributed to thoracic organ transplant recipients in the transplant clinic at a single French center between October, 2015, and October, 2018. Questions addressed demographics, transplant history, current immune suppression, knowledge regarding vaccination status, past history of travel (any destination outside metropolitan France), including pre-travel advice, health issues during travels outside Europe, and travel intentions during the following year. 117 patients completed the survey (82 lung, 14 heart and 21 heart-lung transplant recipients). Mean age was 49.4 years, 61.5% were female. 19 patients (17%) were born outside metropolitan France. At the time of survey completion, 70%, 68%, 96% and 12% of patients were receiving steroids, mycophenolate, calcineurin inhibitors, and mTOR inhibitors, respectively. 36%, 16%, and 10% of respondents considered that being a transplant recipient increased their risk of travel-related health issues mildly, moderately, and greatly, respectively. 58 patients (50%) had traveled outside metropolitan France after transplant (mean number of travels=7; mean number of destinations=3.3). Among 34 subjects who had traveled outside Europe in the last 5 years, 23 had received pre-travel advice, predominantly by their transplant physician. Among 41 respondents having traveled outside metropolitan France, 6 (15%) had experienced health issues (all outside Europe), which led to consultation and hospitalization in 3 and 1 cases, respectively. No immunosuppressives shortage was reported. Among 102 respondents, 61 (60%) intended to travel within the following year, and 50 (82%) to sought medical advice before departure, predominantly from their transplant physician (50 patients, including 17 in combination with a general practitioner or a travel medicine center). These data highlight the significant number of international travels undertaken by thoracic transplant recipients, and a relatively low travel-associated morbidity. As very few patients intend to seek advice from travel medicine specialists, transplant physicians are expected to be the major players of pre-travel counselling in this specific population.