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Background: Nontuberculous mycobacteria (NTM) infection is an important issue after lung transplantation, but the incidence and mortality data are insufficient. We present our experience with pulmonary NTM infection after lung transplantation. Methods: We retrospectively evaluated the lung transplant recipients between January 2013 and December 2018 in a referral hospital of South Korea. Bronchoscopies were performed according to the surveillance protocol and clinical indications. The diagnosis of pulmonary NTM colonization was defined by a positive NTM culture in a bronchoalveolar lavage specimen or at least two separate sputum samples. NTM pulmonary disease (NTM-PD) was diagnosed according to the American Thoracic Society/Infectious Disease Society of America 2007 guidelines. Log-rank test and Cox regression models were used to assess the relationship between NTM and all-cause mortality. Results: A total of 210 recipients were enrolled. The median age at transplantation was 56 (Interquartile range, IQR 45-63) years, and 61% were males. Fourteen (7%) patients were diagnosed with NTM colonization at a median of 11.8 (IQR 1.7-22.2) months after transplantation. Nine (4%) patients were diagnosed with NTM-PD, and the incidence of NTM-PD was 2,219/100,000 person-year. Mycobacterium abscessus (56%) was the most common species in NTM-PD, followed by M. avium (22%) and M. intracellulare (22%). NTM colonization group had better survival after transplantation (Log-rank P = 0.02) and showed decreased the risk of allcause mortality (HR 0.22, 95% CI 0.06-0.91, P=0.037). NTM-PD group showed no difference in mortality. Conclusions: The incidence of NTM-PD is considerable in lung transplantation recipients. NTM colonized patients had better survival outcomes than the control group after lung transplantation.

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complications were hemorrhage and pneumothorax. Hemorrhage rate in re-biopsy, male was 18.5% (10/54), and female was 3.4% (2/59). Re-biopsy needle size 17G (Angiotech 17G coaxial trocar together with Biopince 18G automatic biopsy needle) was 5.7% (5/87), and needle size 18G (18G Angiotech soft biopsy needle) was 26.9% (7/26). The mean frequency of intraoperative needle adjustment with and without hemorrhage was 3.3±1.8 vs 2.2±1.6. The mean distance (cm) of pleurato-target in with and without hemorrhage was 3.7±1.5 vs 2.3±1.9. High rate of pneumothorax for needle through interlobular septal puncture in re-biopsy, 62.5% (5/8). CT-guided percutaneous transthoracic needle re-biopsy of NSCLC was showed in Figure . Conclusion: First biopsy and re-biopsy complications were similar. Both of hemorrhage and pneumothorax were acceptable. CT-guided percutaneous transthoracic needle re-biopsy of NSCLC showed safe and feasible.