Nontuberculous mycobacterial and Aspergillus infections among cadaveric lung transplant recipients in Japan.

Autor: Tachibana K; Department of Respiratory Medicine, National Hospital Organization, Kinki-Chuo Chest Medical Center, 1180 Nagasone-Cho, Kita-Ku, Sakai City, Osaka 591-8555, Japan., Okada Y; Department of Thoracic Surgery, Tohoku University, Sendai, Japan., Matsuda Y; Department of Thoracic Surgery, Tohoku University, Sendai, Japan., Miyoshi K; Department of Organ Transplant Center, Okayama University Graduate School of Medicine, Okayama, Japan., Oto T; Department of Organ Transplant Center, Okayama University Graduate School of Medicine, Okayama, Japan., Chen-Yoshikawa TF; Department of Thoracic Surgery, Kyoto University, Kyoto, Japan., Date H; Department of Thoracic Surgery, Kyoto University, Kyoto, Japan., Minami M; Department of General Thoracic Surgery, Osaka University, Suita, Japan., Okumura M; Department of General Thoracic Surgery, Osaka University, Suita, Japan., Iwasaki A; Department of General Thoracic, Breast, and Pediatric Surgery, Fukuoka University, Fukuoka, Japan., Shiraishi T; Department of General Thoracic, Breast, and Pediatric Surgery, Fukuoka University, Fukuoka, Japan., Maeda S; Department of Thoracic Surgery, Dokkyo Medical University, Mibu, Japan., Matsumura Y; Department of Thoracic Surgery, Dokkyo Medical University, Mibu, Japan., Nakajima T; Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan., Yoshino I; Department of General Thoracic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan., Hayashi S; Department of Respiratory Medicine, National Hospital Organization, Kinki-Chuo Chest Medical Center, 1180 Nagasone-Cho, Kita-Ku, Sakai City, Osaka 591-8555, Japan. Electronic address: shayashi@kch.hosp.go.jp.
Jazyk: angličtina
Zdroj: Respiratory investigation [Respir Investig] 2018 May; Vol. 56 (3), pp. 243-248. Date of Electronic Publication: 2018 Feb 04.
DOI: 10.1016/j.resinv.2017.12.010
Abstrakt: Background: Lung transplantation is an effective treatment modality for respiratory failure. Chronic lung infections, including infections caused by nontuberculous mycobacteria (NTM) and Aspergillus, are difficult to control, and uncontrolled infections are relative contraindications for lung transplantation. However, few reports have documented the incidence and outcome of these infections in lung transplant recipients.
Methods: To quantify the incidence and outcomes of colonization and disease caused by NTM and aspergillosis in recipients before and after lung transplantation, we reviewed the medical records and microbiology data from 240 consecutive cadaveric lung transplant recipients between 2000 and 2014.
Results: Before lung transplantation, NTM and Aspergillus species were isolated from five (2.1%) and six (2.5%) patients, respectively, out of the total 240 recipients. All patients with NTM infection received treatment, resulting in culture conversion. They had no recurrence after lung transplantation. All patients with aspergillosis received treatment, one of whom had recurrence after lung transplantation. Over a median follow-up period of 3.3 years, NTM species were isolated after transplantation from eight of 240 patients (3.3%). Five of these patients met the criteria for NTM disease, and four of them received treatment. Four patients survived without a worsening of NTM disease. Over the same median follow-up period, Aspergillus species were isolated from seven of 240 patients (2.9%), six of whom received treatment.
Conclusions: Isolation of NTM or Aspergillus species from lung transplant recipients is uncommon. Adequate pre-transplant control and post-transplant management of NTM and Aspergillus infections allows for safe lung transplantation.
(Copyright © 2018 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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