Paediatric lung transplant outcomes vary withMycobacterium abscessuscomplex species: Table 1–

Abstract

To the Editor: Mycobacterium abscessus complex species are rapid-growing non-tuberculous mycobacteria (NTM) with multiple drug resistance profiles [1]. Increasing prevalence in cystic fibrosis (CF) subjects [1] may reflect several factors, including improved detection and increased CF survival. Persistent NTM infection post-transplantation is associated with poorer outcome [2], and the risk is highest with M. abscessus [3]. However, recent small case series have suggested improved short-term post-transplantation outcomes may be achievable despite pre-transplantation M. abscessus infection [3]. The current approach to listing varies markedly across transplant centres and refusal to consider transplantation in those with active infection is common. Recent data have suggested a stratified approach to transplant listing for CF subjects with Burkholderia cepacia complex may be appropriate, as poor outcomes were attributable to genomovar III ( B. cenocepacia ) alone [4]. Recently, M. abscessus has been recognised to be a complex of three closely related species: M. abscessus ( sensu stricto ), hereafter referred to as M. abscessus , M. massiliense and M. bolletii , which are collectively termed M. abscessus complex [5]. The transplantation literature to date has not examined the impact of M. abscessus species type on outcome. In this case series we describe experience at a single paediatric lung transplant centre (Great Ormond Street Hospital, London, UK) with subjects infected with M. abscessus complex pre-transplantation and provide pilot data suggesting post-transplantation outcome may be influenced by the particular M. abscessus complex species encountered. Five subjects have been transplanted since 2003 …