Single-lung Transplant in a Patient with Mycobacterium avium Pulmonary Disease Successfully Treated with Amikacin...

Area of Science:

• Pulmonology
• Infectious Diseases
• Transplantation

Background:

• Idiopathic pulmonary fibrosis (IPF) is a progressive lung disease.
• Mycobacterium avium complex (MAC) pulmonary disease can complicate IPF, posing treatment challenges.
• Lung transplantation is a potential option for advanced IPF.

Purpose of the Study:

• To report a case of successful treatment of MAC pulmonary disease in an IPF patient using amikacin liposome inhalation suspension (ALIS).
• To evaluate the efficacy and safety of ALIS in the context of lung transplantation.

Main Methods:

• A 55-year-old male IPF patient with refractory MAC pulmonary disease received standard antimycobacterial therapy without achieving sputum conversion.
• Amikacin liposome inhalation suspension (ALIS) was initiated, leading to sputum conversion.
• The patient subsequently underwent single-lung transplantation and continued ALIS therapy.

Main Results:

• ALIS administration resulted in sputum conversion, enabling the patient to proceed with lung transplantation.
• Post-transplant ALIS therapy was maintained for 15 months without recurrence of MAC disease.
• No adverse events related to ALIS were reported during the follow-up period.

Conclusions:

• ALIS is an effective treatment option for MAC pulmonary disease in IPF patients, even in the context of lung transplantation.
• Sustained ALIS therapy post-transplant appears to prevent MAC recurrence.
• This case highlights the potential role of ALIS in managing complex pulmonary infections in immunocompromised patients.