Non-tuberculous Mycobacterial Infections in Thoracic Transplant Candidates and Recipients

Current Infectious Disease Reports
Mana Rao, Fernanda P Silveira

Abstract

To review and discuss the epidemiology, risk factors, clinical presentation, diagnosis, and treatment of non-tuberculous mycobacteria (NTM) in thoracic transplantation. Non-tuberculous mycobacteria are ubiquitous but are an uncommon cause of disease after solid organ transplantation. The incidence of infection is higher in thoracic transplant recipients than in abdominal transplant recipients, with most cases seen after lung transplantation. It is associated with increased morbidity and, occasionally, mortality. Infection in the pre-transplant setting can occur in lung transplant candidates, often posing a dilemma regarding transplant listing. Disease manifestations are diverse, and pulmonary disease is the most common. Diagnosis requires a high index of suspicion. Treatment requires a multiple-drug combination and is limited by drug-drug interactions and tolerability. Mycobacterium abscessus is a challenge in lung transplant recipients, due to its intrinsic resistance and propensity to relapse even after prolonged therapy. Mycobacterium chimaera is an emerging pathogen associated with contamination of heater-cooler units and is described to cause disease months after cardiothoracic surgery. NTM infections in thoracic organ tra...Continue Reading

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Citations

Feb 12, 2020·Transplant Infectious Disease : an Official Journal of the Transplantation Society·Dima KabbaniShahid Husain
May 25, 2021·Seminars in Respiratory and Critical Care Medicine·Daniel Z P Friedman, Karen Doucette
May 29, 2021·ERJ Open Research·Paola FaverioStefano Aliberti

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