223: Use of an Immune Monitoring Assay To Distinguish between Fungal Colonization and Fungal Disease in Lung Transplant Recipients

infrequently isolated from the airways of patients preand post-lung transplantation. However, the clinical importance of NTM colonization and infection in this population is unknown. Our objectives were to characterize the clinical significance of NTM isolation preand post-lung transplantation and to determine if pre-transplant isolation of NTM predicted post-transplant colonization or disease. Methods and Materials: Patients who underwent lung transplantation in British Columbia between May 1989 and October 2006 were studied. Data obtained from the British Columbia Centre for Disease Control / TB Control database was used to identify lung transplant recipients who had ever had a positive isolate for NTM. Charts were then reviewed for demographics, pulmonary function, treatment course for NTM, and clinical outcomes for these patients. Results: 146 patients who underwent single (86), double (46) or heart-lung (14) transplantation were studied. Indications for lung transplantation included COPD (36%), CF/bronchiectasis (25%), pulmonary fibrosis (24%), and other (15%). 28 patients were positive for NTM, 11 pre-transplant and 17 post-transplant. Only one patient who grew NTM pre-transplant had NTM post-transplant. No patients were treated for NTM infection prior to transplant. 6 patients with NTM pre-transplant underwent double lung transplant. 39% of NTM was identified in recipients with COPD, 29% with CF/bronchiectasis, 18% with pulmonary fibrosis and 14% with other disease. 2 of 17 patients developed clinical disease related to NTM infection in the post-transplant group. 5-year survival rates were similar between recipients with and without identification of NTM preor post-transplant. Conclusions: NTM isolation is common in the preand post-lung transplantation population. Isolation of NTM pre-transplant did not predict post-transplant isolation. NTM did not commonly cause clinical disease and did not affect survival. Treatment of NTM positive patients without clinical disease may be unnecessary.