What are the outcomes for lung transplants in patients with Nontuberculous Mycobacterial Infection?
For patients with nontuberculous mycobacterial (NTM) infection, lung transplantation can be a viable option, but outcomes depend on careful pre-transplant treatment and post-transplant monitoring. Studies show that with appropriate therapy, many patients do well, though NTM can still appear after transplant and may affect survival.
What the research says
A systematic review of cystic fibrosis patients with NTM undergoing lung transplantation found that NTM infection is a poor prognostic factor, but guidelines recommend it should not automatically preclude transplant 2. In a Japanese study of 240 cadaveric lung transplant recipients, all 5 patients with pre-transplant NTM received treatment and achieved culture conversion with no recurrence after transplant; however, 8 of 240 patients (3.3%) developed new NTM isolation post-transplant, and 5 of those met criteria for NTM disease 6. A case report of an HIV-positive patient with Mycobacterium kansasii colonization successfully underwent double lung transplantation; at 12 months post-transplant, the patient developed bronchiolitis obliterans syndrome, a form of chronic lung allograft dysfunction 8. Overall, pre-transplant NTM treatment appears to reduce recurrence risk, but post-transplant NTM remains a concern and may contribute to complications.
What to ask your doctor
- Should I complete treatment for NTM before being listed for lung transplant?
- What is the center's experience with lung transplant in NTM patients?
- How will I be monitored for NTM infection after transplant?
- What are the risks of NTM recurrence or new infection after transplant?
- Could NTM infection affect my long-term transplant outcomes, such as chronic lung allograft dysfunction?
This question is drawn from common patient questions about Pulmonology & Critical Care and answered using cited medical research. We do not provide individualized advice.