Management of nontuberculous mycobacteria in lung transplant cases: an international Delphi study.

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 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. 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, 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.

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Déclaration de conflit d'intérêts

Conflict of interest: H. Asif, A. Ohsumi, J. Philley, A. Emtiazjoo, T. Hirama, C-C. Shu, F. Silveira, V. Poulin, M. Nagao, P-R. Burgel, S. Hays, T. Kawasaki, C. Dela Cruz, S. Aliberti, T. Nakajima, S. Ruoss, T.K. Marras and G.I. Snell have no conflict to report. F.F. Rahaghi has received research grants, paid to his institution, from Mallinckrodt, outside the submitted work; and payment or honoraria for lectures, presentations, consultation fee events from United Therapeutics, Mallinckrodt and Actelion Pharma, outside the submitted work. P. Rizzuto has received research grants, paid to his institution, from Insmed, regarding the submitted work. T. Aksamit has received payment or honoraria for lectures, presentations, consultation fee events from Advanced Respiratory, Inc., outside the submitted work. A.W. Baker has received research grants, paid to his institution, from NIH/NIAID, Insmed and CDC's Prevention Epicenters Program outside the submitted work. K. Winthrop has received restricted research grants, paid to his institution, from E.R Squibb & Sons, Regeneron Pharm and Gentech, outside the submitted work; and payment or honoraria for lectures, presentations, consultation fee events from Insmed, AbbVie, Eli Lilly and WhiteHall, outside the submitted work. M. Mirsaeidi has received research grants, paid to his institution, from Boehringer Ingelheim, Ashvattha and Mallinckrodt, outside the submitted work.