Table 1– Pre- and post-transplantation course, microbiology and anti-non-tuberculous mycobacteria treatment

	Case 1	Case 2	Case 3	Case 4	Case 5
Pre-transplantation course
Age at transplant years	10.6	14.5	16.2	15.1	14.1
Sex	Female	Female	Female	Female	Female
Chronically infected with	S. aureus A. fumigatus Candida	S. aureus A. fumigatus S. maltophilia	S. aureus A. fumigatus	S. maltophilia P. aeruginosa	P. aeruginosa S. aureus A. fumigatus Coliforms
1st NTM growth, time prior to transplant	∼2 years	∼3 years	∼5 years	∼4 years	∼3 years
M. abscessus complex species	M. bolletti	M. massiliense	M. abscessus (sensu stricto)	M. abscessus (sensu stricto)	M. abscessus (sensu stricto)
Colony morphotype	Smooth	Rough	Rough	Rough	Smooth
Duration NTM treatment pre-transplant	>12 months p.o. Rifampicin p.o. Ethambutol p.o. Clarithromycin	7 months p.o. Rifampicin p.o. Isoniazid p.o. Clarithromycin Neb. Amikacin	>3 years Neb. Amikacin p.o. Clarithromycin p.o. Ciprofloxacin	>3 years Neb. Amikacin p.o. Clarithromycin p.o. Ciprofloxacin p.o. Septrin	15 months Neb. Amikacin p.o. Ciprofloxacin p.o. Clarithromycin
Smear positive at referral	Yes	No	Yes	Yes	Yes
Smear positive at transplant	Yes	No	No	Yes	No
Most recent sputum culture pre-transplant at GOSH	6 months prior; smear and culture positive	3 months prior; smear negative, culture positive	3 months prior; smear negative, culture positive	3 months prior; smear and culture positive	15 days prior; smear and culture negative
Post transplantation course
Transplant type	HLT	BSSLT	BSSLT	BSSLT	BSSLT
CMV mismatch	Yes	Yes	Yes	Yes	No
Histological evidence of active NTM in explanted lung	Yes	Yes	Yes	No
NTM re-isolation	No	No	Yes	Yes	No
M. abscessus complex species			M. abscessus (pleural fluid)	M. abscessus (BAL, post mortem lung, trachea and pleura)
Perioperative Antibiotic treatment	Amikacin Clarithromycin Cefoxitin, Ceftazidime Teicoplanin	Amikacin Clarithromycin Ciprofloxacin Teicoplanin Co-trimoxazole	Amikacin Clarithromycin Ciprofloxacin Tigecycline Ceftazidime	Amikacin Clarithromycin Ciprofloxacin Tigecycline Imipenem Teicoplanin Co-trimoxazole	Amikacin Clarithromycin Ciprofloxacin Tigecycline Teicoplanin Colistin
i.v. antibiotics duration	4 weeks	4 weeks	Amikacin 10 weeks tigecycline 17 months		Tigecycline and amikacin 14 weeks
ICU stay days	5	7	11	21	11
Day of extubation	2	2	1	N/A	1
Inpatient stay days	29	43	68	N/A	Day 18 transfer to local hospital
Acute issues	Prolonged pleural effusions	ARF GORD (Nissens) Mild rejection at 1 month	Prolonged pleural effusions ARF PRES Paraspinal fungal abscess	ARDS DIC Severe pulmonary haemorrhage	Recurrent seizures GORD Hiatus hernia Unexplained transient limb weakness
BOS	No	No^#	No^#	N/A	No
Long term anti-NTM antibiotic treatment	p.o. clarithromycin p.o. ciprofloxacin Neb. amikacin	p.o. clarithromycin p.o. ciprofloxacin Neb. amikacin	p.o. clarithromycin p.o. ciprofloxacin Neb. amikacin p.o. linezolid	N/A	p.o. clarithromycin p.o. ciprofloxacin Neb. amikacin
Side effects of NTM treatment	Bilateral SNHL	Bilateral SNHL	Bilateral SNHL	N/A	None
Side effects of NTM treatment	Amikacin ceased	Amikacin weaned	CRF
Survival	7.5 years	28 months^# (7 years to date)	39 months^# (4.3 years to date)	21 days	30 months

NTM: non-tuberculous mycobacterium; GOSH: Great Ormond Street Hospital; CMV: cytomegalovirus; ICU: intensive care unit; BOS: bronchiolitis obliterans syndrome; p.o.: by mouth; Neb.: nebuliser; HLT: heart lung transplant; BSSLT: bilateral sequential single lung transplant; BAL: bronchoalveolar lavage; ARF: Acute renal failure; ARDS: acute respiratory distress syndrome; GORD: gastro-oesophageal reflux disease; DIC: disseminated intravascular coagulation; PRES: posterior reversible encephalopathy syndrome; SNHL: sensorineural hearing loss; CRF: chronic renal failure. ^#: at transition to adult services.