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Nontuberculous mycobacteria and transplantation

Question
Hello,

I have CF and I have been colonized with Mycobacterium abscessus for the past three years.
I have been previously told that M. abscessus colonization was a contra-indication to transplantation. Why?
Recently, more and more centers accept to perform lung transplantation in patients colonized with M. abscessus. What has changed during recent years? Is there any statistics related to post-transplant survival under these circumstances?
Answer
Hello,
Colonization with M. Abscessus is generally considered a relative contra-indication to lung transplantation because of the description of severe infection (lung and skin abscesses, bacteremia) related to M.abscessus during the post tranplant period. Initially, several cases of death related to these infections were reported. More recently, some transplantations were successful. It is possible that these successful outcomes were related to better utilization of antibiotic combinations and/or to infection with less virulent strains of M. abscessus. There is no reliable statistic on this topic due to the small number of subjects who had been transplanted under these circumstances.
Dr Pierre-Régis Burgel
11.09.2012