TY - JOUR T1 - Management of nontuberculous mycobacteria in lung transplant cases: an international Delphi study JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.00377-2022 VL - 9 IS - 2 SP - 00377-2022 AU - Huda Asif AU - Franck F. Rahaghi AU - Akihiro Ohsumi AU - Julie Philley AU - Amir Emtiazjoo AU - Takashi Hirama AU - Arthur W. Baker AU - Chin-Chung Shu AU - Fernanda Silveira AU - Vincent Poulin AU - Pete Rizzuto AU - Miki Nagao AU - Pierre-Régis Burgel AU - Steve Hays AU - Timothy Aksamit AU - Takeshi Kawasaki AU - Charles Dela Cruz AU - Stefano Aliberti AU - Takahiro Nakajima AU - Stephen Ruoss AU - Theodore K. Marras AU - Gregory I. Snell AU - Kevin Winthrop AU - Mehdi Mirsaeidi Y1 - 2023/03/01 UR - http://openres.ersjournals.com/content/9/2/00377-2022.abstract N2 - Rationale Nontuberculous mycobacterial (NTM) diseases are difficult-to-treat infections, especially in lung transplant (LTx) candidates. Currently, there is a paucity of recommendations on the management of NTM infections in LTx, focusing on Mycobacterium avium complex (MAC), M. abscessus and M. kansasii.Methods Pulmonologists, infectious disease specialists, LTx surgeons and Delphi experts with expertise in NTM were recruited. A patient representative was also invited. Three questionnaires comprising questions with multiple response statements were distributed to panellists. Delphi methodology with a Likert scale of 11 points (5 to −5) was applied to define the agreement between experts. Responses from the first two questionnaires were collated to develop a final questionnaire. The consensus was described as a median rating >4 or <−4 indicating for or against the given statement. After the last round of questionnaires, a cumulative report was generated.Results Panellists recommend performing sputum cultures and a chest computed tomography scan for NTM screening in LTx candidates. Panellists recommend against absolute contraindication to LTx even with multiple positive sputum cultures for MAC, M. abscessus or M. kansasii. Panellists recommend MAC patients on antimicrobial treatment and culture negative can be listed for LTx without further delay. Panellists recommend 6 months of culture-negative for M. kansasii, but 12 months of further treatment from the time of culture-negative for M. abscessus before listing for LTx.Conclusion This NTM LTx study consensus statement provides essential recommendations for NTM management in LTx and can be utilised as an expert opinion while awaiting evidence-based contributions.Experts recommend performing sputum cultures and a chest CT scan for NTM screening in lung transplant candidates. They recommend against absolute contraindication to lung transplantation even with multiple positive sputum cultures for NTM. https://bit.ly/3WaSwLe ER -