{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T08:13:03Z","timestamp":1788941583327,"version":"build-2803163510"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Single-center studies suggest that solid-organ transplant recipients (SOTRs) with nontuberculous mycobacterial disease (NTM-D) face increased mortality, particularly in the presence of comorbidities such as chronic lung disease. Large-scale studies are needed to quantify the risk of NTM-D and its impact on mortality in this population.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare the risk of NTM-D between the general population and SOTRs, stratified by lung and nonlung transplants, and to assess whether NTM-D is associated with increased mortality risk in SOTRs.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This population-based cohort study was conducted in Ontario, Canada, from April 1, 2002, to December 31, 2018. Adult SOTRs were matched 1:10 with general population controls by age, sex, and region. Analyses were conducted from January 2024 to March 2025.<\/jats:p><\/jats:sec>Exposure<\/jats:title>Solid-organ transplantation.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcome was NTM-D, defined as isolation of NTM from blood, tissues, or respiratory samples (\u22652 sputum cultures with the same species or 1 bronchoscopic or lung biopsy culture). The secondary outcome was all-cause mortality in the SOTR cohort at 1 year and by the end of follow-up (March 31, 2021). Cox proportional hazard models were used to estimate the risk of outcomes.<\/jats:p><\/jats:sec>Results<\/jats:title>The study included 138\u202f175 individuals (49\u202f611 female [35.9%]; mean [SD] age, 51.87 [12.99] years), comprising 12\u202f564 SOTRs (7674 kidney, 2419 liver, 1257 lung, 584 heart, 563 kidney-pancreas, and 67 multiorgan recipients) and 125\u202f611 matched controls. During the study period, 368 SOTRs (2.92%) and 127 controls (0.10%) developed NTM-D. Receipt of a lung transplant (adjusted hazard ratio [aHR], 177.34; 95% CI, 79.65-394.82) or other solid-organ transplant (aHR, 8.89; 95% CI, 5.90-13.40) were both associated with increased risk of NTM-D compared with controls. NTM-D by Mycobacterium avium <\/jats:italic>complex (MAC) and rapidly growing mycobacteria (RGM) were associated with significant long-term mortality in lung SOTRs (MAC aHR, 1.66; 95% CI, 1.35-2.04; RGM aHR, 2.33; 95% CI, 1.59-3.39) and nonlung SOTRs (MAC aHR, 2.12; 95% CI, 1.36-3.29; RGM aHR, 2.25; 95% CI, 1.07-4.74).<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>In this cohort study of SOTRs and the general population, both lung transplantation and other solid-organ transplantation were associated with a significantly elevated risk of NTM-D, which was linked to a higher mortality risk. These findings highlight the need for preventive and screening strategies.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2025.31563","type":"journal-article","created":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T15:30:33Z","timestamp":1757691033000},"page":"e2531563","source":"Crossref","is-referenced-by-count":3,"title":["Nontuberculous Mycobacterial Disease in Solid-Organ Transplant Recipients and the General Population"],"prefix":"10.1001","volume":"8","author":[{"given":"Seyed M.","family":"Hosseini-Moghaddam","sequence":"first","affiliation":[{"name":"ICES, Toronto, Ontario, Canada"},{"name":"Transplant-Oncology Infectious Diseases, Ajmera Transplant Program, University Health Network, Toronto, Ontario, Canada"},{"name":"Division of Infectious Diseases, Department of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Fridman","sequence":"additional","affiliation":[{"name":"ICES, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samantha S. 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