Nontuberculous mycobacterial disease is not a contraindication to lung transplantation in patients with cystic fibrosis: a retrospective analysis in a Danish patient population

Transplant Proc. Jan-Feb 2013;45(1):342-5. doi: 10.1016/j.transproceed.2012.02.035. Epub 2012 Aug 30.

Abstract

Whether nontuberculous mycobacterial (NTM) disease is a contraindication to lung transplantation remains controversial. We conducted a nationwide study to evaluate the clinical importance of NTM infection among lung transplant patients with cystic fibrosis (CF) in Denmark and to determine if NTM infection poses a contraindication to lung transplantation. All CF patients with current or prior NTM who had undergone lung transplantation were identified. Out of 52 lung transplant patients with CF 9 (17%) had NTM disease. Five patients had known infection at the time of transplantation. Two of these died of non-NTM-related causes whereas two developed deep Mycobacterium abscessus wound infections and one was transiently culture negative until M abscessus was reactivated. One patient was subsequently cured; the other two remained on therapy with good performance status. The study supports the contention that CF patients with prior or active NTM can undergo lung transplantation although postoperative complications can be expected.

MeSH terms

  • Adolescent
  • Adult
  • Bronchoalveolar Lavage Fluid
  • Child
  • Cystic Fibrosis / complications*
  • Cystic Fibrosis / therapy*
  • Denmark
  • Female
  • Humans
  • Lung Transplantation / methods*
  • Male
  • Mycobacterium Infections, Nontuberculous / complications*
  • Mycobacterium Infections, Nontuberculous / diagnosis*
  • Nontuberculous Mycobacteria
  • Retrospective Studies
  • Sputum / metabolism
  • Time Factors
  • Treatment Outcome
  • Wound Infection
  • Young Adult