Objective Donor-derived infection （DDI） caused by carbapenem-resistant Gram-negative bacilli （CRGNB） leads to severe clinical consequences. This study aimed to investigate the antibacterial effect of colistimethate sodium （CMS） on four CRGNB strains when added to organ preservation solution after pretreatment on four CRGNB strains， and to provide a theoretical basis for CMS application in in vitro decontamination of preservation solution . Methods The clinical decontamination process was simulated. Bacterial suspensions of four CRGNB strains were added to organ preservation solution to evaluate whether CMS and amikacin （AK） could eliminate the bacteria. Furthermore， the elimination ability of CMS with different concentrations， CMS treated with different water bath temperatures and different heating durations against CRGNB were explored. Results At low temperature （4℃）， CMS at standard concentration and AK showed poor antibacterial efficacy. Compared with the AK group， the bacterial load of CRGNB contamination was significantly decreased in the CMS group with 4-fold concentration CMS group 〔（86.14±20.37）% vs（29.77±5.67）%，P ＝ 0.002〕. In addition， after pretreatment such as water bath heatingand prolonged time， the bacterial load was significantly reduced in the 60℃ +15 min group and 60℃ +30 min group 〔（0.78±0.159） CFU/g vs（0.56±0.458） CFU/g，P＝ 0.002〕， after pretreatment, such as water bath heating and prolonged time，with no statistical difference between the two groups . Conclusion CMS has poor antibacterial activity against CRGNB at low temperature， and it is difficult to achieve clinically satisfactory antibacterial efficacy even with a greatly increased concentration. Pretreatment can endow CMS with extremely strong decontamination ability， which can effectively prevent CRGNB contamination of grafts even at low temperatures. 

Objective To investigate the application effects of the centralized donor maintenance model inorgan donation. Methods This study collected information on potential organ donors maintained in our hospital's Organ Procurement Organization （OPO） from August 1，2023， to March 31，2024. The subjects were grouped according to the maintenance model: the control group used a decentralized maintenance model Except Donor Intensive Care Unit（DICU），while the experimental group used a centralized maintenance model （in the DICU）. The effectiveness was evaluated using indicators such as organ yield， organ utilization rate， donor maintenance time， cold ischemia time of transplanted organs， and postoperative complication rates. Results The overall organ yield and utilization rates in the experimental group were higher than those in the control group， but the differences were not statistically significant （P ＝ 0.067，0.204， respectively）. The donor maintenance time in the experimental group was longer than in the control group （P ＜ 0.001）， and the cold ischemia time for donated kidneys and livers were shorter in the experimental group than in the control group （P ＜ 0.001）. There were no statistically significant differences in the incidence of common postoperative complications between the two groups （P ＞ 0.05）. Conclusion The centralized donor maintenance model can prolong donor maintenance time， shorten the cold ischemia time of kidneys and livers， and is expected to improve the quality of donated organs. It is worth promoting and applying. 

Objective To investigate the correlation between quantitative contrast-enhanced ultrasound （CEUS） parameters of donor livers and pathological features， and to evaluate their predictive value for early posttransplant complications. Methods Between October 20th，2021， and November 29th，2024，127 liver donors and 89 recipients was enrolled at our center. Potential donors underwent liver CEUS examination before procurement with quantitative parameters analysis，such as wash in slope （WIS）， rise time （RT）， mean transit time （MTT）， and Time from Peak to 1/2（T1/2）. During procurement， donor livers were biopsied and grouped according to the scheuer score to explore the correlation between CEUS parameters and pathological features. Recipient clinical data was collected 6 months posttransplantation to further investigate the relationship between these parameters and early post-transplant complications. Results Prolonged MTT （OR ＝ 1.122，95%CI ＝ 1.008 ～ 1.250，P ＝ 0.036） and shortened T1/2（OR ＝ 0.749，95%CI ＝ 0.584-0.961，P ＝ 0.023） were risk factors for liver inflammation and fibrosis. WIS correlated positively with portal inflammation， hepatocyte hydropic degeneration， and inflammatory activity （P ＜ 0.05）， while negatively correlated

with microvesicular hepatic steatosis （P ＜ 0.05）. Early allograft dysfunction occurred in 24.72% of recipients， with no significant difference in CEUS parameters compared to the normal group. Acute rejection occurred in 10.11%. Compared to the non-rejection group， these recipients were younger （P ＝ 0.004） and had longer MTT （P ＝ 0.036） and RT （P ＝0.039）. The AUC value was 0.776 when combining recipient age， MTT， and RT predicted acute rejection （sensitivity55.6%， specificity 95.0%）. Conclusion CEUS quantitative parameters show significant correlation with donor liver pathological features， demonstrating potential for noninvasive assessment of graft quality and prediction of acute rejectionafter transplantation. 

Objective To investigate the preparation method of tacrolimus/mycophenolate mofetil dualdrug nanoparticles supported by PEG-PLGA and its application value in immunosuppression. Methods Tacrolim us/mycophenolate mofetil supported PEG-PLGA nanoparticles were prepared by phacoemulsification - solvent evaporation method. Their morphology was observed by transmission electron microscopy， and their particle size and distribution were detected by Malvern particle size analyzer. The successful synthesis of nanoparticles was verified by infrared spectroscopy. Furthermore， the immunosuppressive effects of different drug ratios were evaluated in an in vitro T cell activation and proliferation model. Results The prepared dual-drug nanoparticles were in regular spherical shape， with an average particle size of approximately 258 nm and uniform dispersion. Infrared spectroscopy confirmed the successful binding of the drug to the carrier. Cell experiments have shown that the inhibitory effect on T cell proliferation is the best when thedual-drug ratio （tacrolimus ：mycophenolate mofetil） is 1 ：3.5. Meanwhile， this dual-drug nanoparticle can significantly down-regulate the expression of activation markers of T cells， and its inhibitory effect is superior to that of the singledrug nanoparticles of each component. Conclusion PEG-PLGA-loaded tacrolimus/mycophenolate mofetil dual-drug nanoparticles have good physicochemical properties and significant immunosuppressive activity. They are expected to beused as candidate preparations for hormone reduction and discontinuation and long-term immune maintenance therapy after liver transplantation， and have important clinical application prospects. 

Objective The incidence and assessment of metabolic associated fatty liver disease （MAFLD） in liver transplantation （LT） recipients is not well studied. This study aimed to investigate the incidence of MAFLD， in LT recipients， and to evaluate the diagnostic potency of different criteria of MAFLD including VCTE， BMI， waisthip ratio and somatotype in a large LT center in China. Methods LT recipients regularly followed up at the Affiliated Hospital of Qingdao University from March 2021 to April 2021 were included. Demographic characteristics and clinical information were collected. Vibration-controlled transient elastography （VCTE） and bioelectrical impedance analysis techniques were used. Diagnostic potency of VCTE， body mass index （BMI）， waist-hip ratio and somatotype for MAFLD were evaluated， respectively. Results A total of 101 LT recipients were finally enrolled and 34 cases （33.7%） were diagnosed with MAFLD. LT recipients with MAFLD had significantly higher BMI， waist-hip ratio， visceral fat index， and controlled attenuation parameter （CAP） value than those without MAFLD. The optimal cutoff CAP value （233 dB/m） for diagnosing MAFLD obtained the sensitivity and specificity of 76.47% and 92.54% with an AUROC value of 0.883（95% CI＝0.804 ～ 0.938）. BMI （＞ 26 kg/m2 ） and waist-hip ratio （＞ 0.88） were inferior to CAP value in the diagnostic potency，but they both had higher sensitivity （85.29%）. Conclusion The incidence of MAFLD in LT recipients is 33.7%. BMI，waist-to-hip ratio， visceral fat index and CAP had their own advantages in assessing MAFLD in adult LT recipients. 

Objective To investigate the current status of kinesiophobia in liver transplant recipients and to explore its influencing factors. Methods Liver transplant recipients who were hospitalized or followed up at theOrgan Transplantation Center of Jiangsu Province Hospital from January to September 2025 were selected by conveniencesampling. The 13-item Tampa Scale for Kinesiophobia （TSK-13）， Patient Health Questionnaire-9（PHQ-9）， FatigueSeverity Scale （FSS）， Sarcopenia-Five （SARC-F） questionnaire， and Health Literacy Scale for Chronic Patients were used for assessment. Univariate analysis， Pearson correlation analysis， and multiple linear regression analysis were performed to identify factors associated with kinesiophobia. Results The mean score of kinesiophobia among liver transplant recipients was （31.61±6.13）， and 37.6% of them had moderate-to-severe kinesiophobia. Univariate analysis showed that gender and living alone were significantly associated with kinesiophobia levels （P ＜ 0.05）. Pearson correlation analysis revealed that kinesiophobia scores were positively correlated with fatigue， sarcopenia， and depression scores （all P＜0.05）. Multiple linear regression analysis indicated that living alone， fatigue， and depression were independent influencing factorsof kinesiophobia （all P ＜ 0.05）. Conclusion Kinesiophobia is prevalent in postoperative liver transplant recipients，with nearly 40% experiencing moderate-to-severe levels. Living alone， fatigue， and depression are the main independent risk factors. Clinical medical staff should routinely screen for kinesiophobia and related risk factors， and implement comprehensive interventions for high-risk patients to effectively reduce kinesiophobia and improve long-term quality of life. 

Objective To review pediatric liver transplantation cases in our hospital and explore factors influencing the duration of invasive mechanical ventilation via endotracheal intubation. Methods Clinical data from 34 pediatric patients who underwent liver transplantation at the First Affiliated Hospital of Xinjiang Medical Universityfrom January 2023 to October 2024 were collected. Survival rates and complication rates were calculated， and the impact of intraoperative factors on postoperative ventilation duration was analyzed. Results The survival rate for pediatric livertransplantation in our hospital was 85.3%， with a complication rate of 23.3%. Intraoperative factors，such as liver coldischemia time， warm ischemia time， anhepatic phase， intraoperative blood transfusion volume， blood loss， and urine output showed no significant effect on postoperative ventilation duration. Conclusion The success rate of pediatric liver transplantation in our hospital is relatively high， with a low complication rate. However， further studies with more cases are needed to investigate the factors influencing the duration of endotracheal intubation. 

Objective To explore the therapeutic characteristics of human-parvovirus B19（HPV-B19）infection after renal transplantation. Methods Clinical data of patients infected with HPV-B19 after renal transplantation at the Organ transplant Center of Jiangxi Provincial People's Hospital from January 2018 to December2023 were retrospectively collected， and the patients were divided into Successful Group and Unsuccessful Group according to whether they had recurred after treatment. Important parameters，such as the difference of treatment regimen， hemoglobin count， hemoglobin count rise ratio， red blood cell count， red blood cell count rise ratio， serum creatinine rise ratio， serum creatinine rise ratio and the occurrence of rejection after treatment regimen change were compared. Results A total of 41 patients were included in the study， including 19 successful patients （SG） and 22 unsuccessful patients （USG）. Acute rejection （clinical diagnosis） occurred in 3 cases， of which 1 case in SG and 2 cases in USG. In the SG，16 cases were treated with dual immunosuppression regimen （13 cases were treated with cyclosporin A regimen and 3 cases were treated with tacrolimus regimen）. In the USG，7 patients received the dual immunosuppressiveregimen （4 patients received cyclosporine A and 3 patients received tacrolimus）. IVIG+RIS regimen was used in 13 patients in both the SG and the USG. There was a significant difference in hemoglobin on day 21 of treatment. On the 7thday of treatment， hemoglobin and red blood cell count increased significantly. There was no significant difference in serumcreatinine at 0，7，14 and 21 days of treatment. There was no significant difference in renal function regardless of whether the treatment was successful or not. After treatment， serum creatinine decreased to varying degrees without significantly increasing the incidence of rejection. Conclusion The dual immunosuppressive regimen combined with IVIG has the best therapeutic effect on HPV-B19 infection after renal transplantation， and does not significantly increase the incidence of rejection. Serum creatinine decreases to varying degrees after treatment， which also indicates that the treatment of HPV-B19 has a protective effect on renal function. Higher hemoglobin level on the 21st day of treatment， lower hemoglobin rise ratio and red blood cell count rise ratio on the 7th day of treatment are negatively correlated with the recurrence of infection， which have certain predictive value for the evaluation of infection recurrence.