Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Treating Mycobacterium avium complex (MAC) infection pre-lung transplant (LT) can be challenging to treat, given prolonged therapy and side effects. The impact of pre-transplant MAC treatment on recurrence and outcomes post-LT remains unclear, especially in patients with interstitial lung disease (ILD) who have a median survival of less than 2 years. METHODS: We performed a retrospective cohort study of adult LT patients at the Mayo Clinic who had positive MAC sputum cultures pre-LT. The cohort was stratified and compared based on the type of treatment (complete, partial, or no treatment) for MAC pulmonary infection. The primary outcome was MAC recurrence post-LT, and secondary outcomes were mortality, FEV-1, and FVC at 1-year post-LT. RESULTS: Among the cohort of 47 patients, 9 (19.1%) were partially treated and 11 (23.4%) were completely treated for MAC infection pre-LT. Post-transplant MAC pulmonary infection recurrence occurred in eight (17%) of the total cohort, with four (14.8%) in the non-treated, four (44.4%) in the partially-treated, and none (0%) in the completely treated patients (p = 0.026). There was no difference in mortality in patients who had MAC recurrence post-transplantation (13% vs. 9.7%, p > 0.9) and those who were completely or partially treated, compared to non-treated (0% vs. 13% vs. 13%, p > 0.9). The FEV1 and FVC at 1-year post-LT did not differ by the pre-transplant treatment or post-transplant MAC recurrence status. CONCLUSION: The role of treatment for MAC infection pre-transplant is questionable, especially in patients with diseases like ILD who may not have enough wait time to complete therapy.
Source: Transplant Infectious Disease
DOI: 10.1111/tid.70129
Authors: Prasanth Balasubramanian, Aditya Khanijo, Brad A. White, Rosa Corro, Francisco Alvarez, Tathagat Narula, Remzi Bag, Kelly Pennington, Mathew Thomas, John Haney, Ian Makey, Wendelyn Bosch, Lisa Brumble, Margaret Johnson, Sadia Z. Shah, Maher A. Baz
Institutions: Mayo Clinic in Florida, Mayo Clinic
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4415881689