Division of Pulmonary and Critical Care Medicine, University of North Carolina, Chapel Hill, NC 27599, USA.
Clin Transplant. 2013 Jul-Aug;27(4):523-9. doi: 10.1111/ctr.12140. Epub 2013 May 26.
Mycobacterium abscessus in cystic fibrosis (CF) patients is considered a contraindication to lung transplantation. We examine the post-transplant outcomes of CF patients with M. abscessus pre-transplant.
CF patients transplanted at the University of North Carolina from 1992 to 2012 were retrospectively examined. Patients with at least one respiratory sample positive for M. abscessus prior to transplantation were included. Data collected included age, FEV1, body mass index (BMI), systemic steroid use, diabetes mellitus, ventilatory assistance, co-existent CF pathogens, imaging, post-transplant complications, and survival. RESULTS (N = 13): At transplant, mean age was 24.6 yr, mean BMI was 18.1 kg/m(2), six had 3+ positive smears for M. abscessus, and three were ventilator dependent. All met American Thoracic Society microbiological criteria for disease pre-transplant. Three patients developed M. abscessus-related complications, with clearance of the organism following treatment. Survival post-transplant shows 77% alive at one yr, 64% at three yr, and 50% at five yr; none died of M. abscessus. The survival data showed no statistically significant difference (p = 0.8) compared with a contemporaneously transplanted population of CF patients without M. abscessus (n = 154).
Lung transplantation, with favorable survival, is possible in CF patients with M. abscessus. Even if M. abscessus recurs, local control and clearance is possible.
囊性纤维化（CF）患者中的脓肿分枝杆菌被认为是肺移植的禁忌症。我们检查了移植前存在脓肿分枝杆菌的 CF 患者的移植后结果。
回顾性检查了 1992 年至 2012 年期间在北卡罗来纳大学接受移植的 CF 患者。包括至少有一个呼吸道样本阳性的患者脓肿分枝杆菌在移植前。收集的数据包括年龄、FEV1、体重指数（BMI）、全身类固醇使用、糖尿病、通气辅助、并存 CF 病原体、影像学、移植后并发症和生存率。结果（N=13）：移植时，平均年龄为 24.6 岁，平均 BMI 为 18.1kg/m2，6 例有 3+阳性分枝杆菌脓肿杆菌涂片，3 例依赖呼吸机。所有患者均符合美国胸科学会移植前疾病的微生物学标准。3 例患者发生脓肿分枝杆菌相关并发症，经治疗后清除了病原体。移植后生存显示，1 年时存活率为 77%，3 年时存活率为 64%，5 年时存活率为 50%；无一例因脓肿分枝杆菌死亡。与同时期未感染脓肿分枝杆菌的 CF 患者（n=154）相比，移植后生存数据无统计学差异（p=0.8）。
脓肿分枝杆菌的 CF 患者进行肺移植是可行的，生存率良好。即使脓肿分枝杆菌复发，也可以进行局部控制和清除。
