Objective To explore the risk factors for recurrent （≥ 2 times） pneumonia in elderlykidney transplant recipients after surgery. Methods Retrospective analysis was performed from the clinical data of 119 elderly kidney transplant recipients who underwent kidney transplantation at the Eighth Medical Center of the People's Liberation Army General Hospital from January 2010 to January 2024. According to whether pneumonia occurs repeatedly （≥ 2 times） after kidney transplantation， elderly recipients were divided into two groups， with 11 cases in the recurrent pneumonia group and 108 cases in the non-recurrent pneumonia group. Relevant clinical data were compared between the two groups， including the general basic information of the recipient （gender， age， height， weight， smoking history，etc.）， as well as the relevant clinical data （the time of dialysis before kidney transplantation， the maintenance treatment plan of immunosuppressant after surgery， whether there was delayed recovery of kidney function after transplantation， whether there was a decrease in white blood cells after transplantation， serum creatinine level at discharge， whether there was diabetes before and after surgery， and whether there was viral hepatitis B infection， etc.）. We conducted univariate analysis and multivariate logistic regression analysis to explore the risk factors for recurrent pneumonia in elderly kidneytransplant recipients after surgery. Results The incidence of recurrent pneumonia in elderly kidney transplant recipientsafter surgery was 9.24% （11/119）， and one patient in the case group died from severe pneumonia， with a mortality rate of 9.1% （1/11）. Smoking history （OR ＝ 13.15，95% CI ＝ 2.406 ～ 71.91，P ＝ 0.003） and postoperative leukopenia （OR ＝ 6.050，95% CI ＝ 1.248 ～ 29.32，P ＝ 0.025） were risk factors for recurrent pneumonia in elderly kidney transplant recipients. Conclusion Smoking history and postoperative leukopenia increase the risk of recurrent pneumonia in elderly kidney transplant recipients. So we should strengthen postoperative health education for elderly kidney transplant recipients， encourage smoking cessation， and prevent and treat postoperative leukopenia. 

Objective To explore whether temperature changes at different times in the perioperative period correlate with the incidence of early allograft dysfunction（EAD）. Methods Recipients who underwent liver transplantation in the Eastern Theater General Hospital between December 1，2020， and November 30，2023 wereselected， and perioperative clinical data and temperature data at different times of the recipients were collected， andmeaningful body temperature was identified by propensity score matching with other general information data to analyze the correlation of early graft insufficiency with temperature changes. Results There were 86 cases of EAD among 272 recipients， with an incidence of 31.2%. After 1 ：1 propensity score matching， a total of 56 pairs of recipients were matched: divided into the EAD group （n ＝ 56 cases）， and the NO-EAD group （n ＝ 56 instances）. The temperature change 1 h after the opening of the inferior vena cava in the neo-hepatic phase （△ T4 ） was significantly different between the two groups （t ＝ 2.382，P ＝ 0.019）， and with the optimal truncation value of the ROC curve 0.45 ℃， it was foundthat the incidence of EAD in recipients with △ T4lower than 0.45℃ was 2.901 times higher than that higher than 0.45℃（95% CI ＝ 1.181 ～ 7.125，P ＝ 0.020）. Conclusion Temperature change 1 h after opening of the inferior vena cava in the anhepatic phase has a certain correlation with the early graft insufficiency， and the faster the body temperatureincreases， the earlier the early graft function recovers. The quicker the body temperature rises to its normal temperature，the lower the incidence of early graft insufficiency. Intraoperative temperature changes can reflect the recovery of newliver function at an early stage， and the poor rise of body temperature in the new liver stage should arouse the vigilance of clinicians. 

Objective To investigate the effects of dexmedetomidine intervention on procalcitonin（PCT）， tumor necrosis factor - α（TNF - α）， helper T cell （Th17） levels， and cognitive function in patientswith decompensated cirrhosis undergoing liver transplantation surgery. Methods A total number of 72 patientswho underwent liver transplantation surgery due to decompensated cirrhosis and were treated in Shenzhen Third People's Hospital from November 2022 to November 2023 were randomly divided into a study group （D group，n ＝ 36） and a control group （NS group，n ＝ 36）. The D group received intravenous infusion of dexmedetomidine loading dose after entering theroom and maintained it until the end of the surgery， while the NS group received an equal dose of physiological saline. Basic vital signs， including mean blood pressure （MAP）， heart rate （HR），pulse oxygen saturation（SPO2 ），cardiac output（CO），and central venous pressure （CVP），5 mins before anesthesia （T1 ），5 mins after tracheal intubation （T2 ），5 mins before surgery （T3 ），5 mins before anhepatic phase （T4 ），5 mins before anhepatic phase （T5 ），5 mins before new liver phase （T6 ）， 5 mins after new liver phase （T7 ）， and at the end of surgery （T8 ）. Changes in PCT， TNF - α， and Th17 levels between two groups of patients at 24 h before surgery，24 h after surgery， and 72 h after surgery， as well as the incidence of secondary infections at 15 d after surgery were compared. At the same time， the cognitive function of the two groups of patients was evaluated using the Montreal Cognitive Assessment Scale （MMSE）24 h before and 72 h after surgery， and the total amount of vasoactive drugs during surgery，intensive care unit （ICU） stay time after surgery， and total length of hospital stay after surgery were compared between the two groups of patients. Results Compared with the NS group， there was no significant difference in basic vital signs at all time points in the D group. The PCT and Th17 levels were lower in the D group at 24 and 72 h after surgery （P ＜ 0.05）. The level of TNF - α was lower at 24 h postoperatively （P ＜ 0.05）， but there was no difference at 72 h. On postoperative day 15， there was no significant difference in the incidence of secondary infections between group D （5/36，13.89%） and group NS （7/36，19.44%）（P ＞ 0.05）. In terms of cognitive function assessment， there was no significant difference in MMSE scores between the two groups before surgery （P ＞ 0.05），and the MMSE score in group D was higher than that in group NS at 72 h after surgery （P ＜ 0.05）. Concusion The use of dexmedetomidine during general anesthesia can effectively reduce the levels of PCT， TNF - α， and Th17 after liver transplantation in patients with decompensated cirrhosis， and alleviate inflammatory reactions. Meanwhile，dexmedetomidine can also improve postoperative cognitive function. These results suggest that dexmedetomidine has potential clinical value in the prognosis of liver transplantation in the decompensated phase of hepatitis cirrhosis.

Objective To investigate the care burden of family caregivers of liver transplant recipients andto explore its influencing factors. Methods Convenience sampling method was used to select the family caregivers of liver transplant recipients who visited the Organ Transplantation Center of Qingdao University Affiliated Hospital from June 2022 to December 2022 as the research subjects. A total of 205 family caregivers of adult liver transplant recipients wereselected by convenience sampling method and investigated with the General Information Questionnaire ： Zarit CaregiverBurden Interview（ZBI）. Results The score of caregiver burden of liver transplant recipients was （28.84±14.33）， and67.8% of them had moderate and severe level of caregiver burden. Univariate analysis showed that there were statisticallysignificant differences in the level of care burden between liver transplant recipients with postoperative complications and their self-care ability， family caregivers with other diseases， family monthly income， daily care time and total caring time （P ＜ 0.05）. Multiple linear regression results showed that the self-care ability of liver transplant recipients and whetherfamily caregivers had other diseases were the influencing factors of care burden （P ＜ 0.05）. Conclusion The familycaregivers of liver transplant recipients have a certain degree of care burden. While providing nursing care for recipients，medical staff should also pay attention to their family caregivers and take timely targeted interventions to reduce the careburden and improve the overall quality of life. 

Objective To investigate the predictive value of arterial alveolar oxygen partial pressure ratio in prolonged mechanical ventilation （PMV） after lung transplantation and to construct a predictive model. Methods Aretrospective analysis was conducted on the clinical data of 152 patients who underwent their first lung transplant and received intravenous venous extracorporeal membrane oxygenation support surgery at the Affiliated Wuxi People's Hospitalof Nanjing Medical University from January 2022 to December 2022. According to the duration of invasive mechanical ventilation after operation， all recipients were divided into the PMV group （ventilation duration ＞ 48 h，n ＝ 91） and control group （ventilation duration ≤ 48 h，n ＝ 61）. Perioperative indexes were compared between two groups，includingintraoperative indexes（operation time ， operation methods and cold ischemia time of donor lung）and postoperative indexes〔Hb， PaCO2， HCO3 - ， lactate， P（A-a）O2，P（a/A）O2，and PaO2/FiO2at 0，8，24 h and 48 h after operation， mechanical ventilation time and intensive care unit（ICU） hospitalization time〕. Receiver operating characteristic（ROC） curve，Pearson correlation analysis and multivariate logistic regression analysis were used to analyze the outcomevariables. Results ① There was a significant positive correlation between P（a/A）O2and PaO2/FiO2 （P ＜ 0.001）. ② P（a/A）O2at 8 h after ICU had a good predictive ability for PMV after lung transplantation（sensitivity and specificity were 0.750 and 0.700，AUC was 0.77）. ③ PaO2/FiO2immediately after ICU admission， PaCO2at 8 h after ICU admission，actual HCO3 - ，lactate and P （a/A） O2were independent risk factors for PMV after lung transplantation. Conclusion P （a/A） O2is an independent risk factor for PMV after lung transplantation， and the dynamic changes of P （a/A） O2 should not be ignored. Continuous monitoring of P （a/A） O2is helpful to guide clinical evaluation of prolonged mechanicalventilation after lung transplantation.