Objective To evaluate the effect of individualized comprehensive management model on the compliance and quality of life of kidney transplant recipients. Methods A total of 220 recipients who underwent allogeneic kidney transplantation at the Second People's Hospital of Shanxi Province from May 1，2020 to April30，2024 and were followed up in our hospital were selected as the research subjects and randomly divided into the observation group and the control group，with 110 cases in each group. The Basel Assessment of Adherence to Immunosuppressive Therapy in Transplantation（BAASIS）questionnaire was used to assess the complianceof the recipients，the Short Form 36 Health Survey（SF-36）was used to evaluate their health status，the Patient Health Questionnaire-9（PHQ-9）was used for self-assessment of depression in the recipients，and the Health Literacy Questionnaire（HLQ）was used to assess the recipients'ability to obtain，understand and apply health information. Results A total of 220 recipients were included in this study，with 110 recipients in the experimental group and 110 recipients in the control group. During the follow-up period，2 patients were lost to follow-up in the experimental group，with a loss to follow-up rate of 1.82%，while 6 patients were lost to follow-up in the control group，with a loss to follow-up rate of 5.45%. The loss to follow-up rate in the experimental group was 3.63% lower than that in the control group，but the difference was not statistically significant（P＝0.18）. Ultimately，212 patients completed the questionnaire and were included in the statistical analysis. The compliance rate of immunosuppressive drugs after kidney transplantation in the experimental group was 88.0%，which was higher than 68.3%（71/104）in the control group，and the difference was statistically significant（P＝0.03）. The scores of all SF-36 items in the experimental group were significantly higher than those in the control group，and the differences were statistically significant（P＜0.05）. The PHQ-9 questionnaire in the experimental group showed that the proportion of recipients without depression and with mild depression was higher，and the differences were statistically significant（P＜0.05）. The scores of all HLQ items in the experimental group were significantly higher than those in the control group，and the differences were statistically significant（P＜0.05）. Conclusion Compared with the conventional follow-up model，the individualized comprehensive management model has certain advantages in improving patients'compliance and enhancing their mental and physical health.

Objective To analyze the clinical effect of fertility follow-up management in 15 female renal transplant recipients，summarize appropriate follow-up strategies，and provide practical evidence for improving maternal and infant outcomes and ensuring the survival of transplanted kidneys. Methods A retrospective analysis was conducted on the clinical data of 15 female renal transplant recipients who received fertility followup management in Shaanxi Provincial People's Hospital and Tangdu Hospital from January 2018 to December 2024.The key measures of the whole-course follow-up management（pre-pregnancy，pregnancy，and post-partum）were summarized. Results The time from post-transplantation to preparation for pregnancy in the 15 female renal transplant recipients ranged from 24 to 64 months，with an average of（41 .67 ±11.03）months; the average age at delivery was（30 .13 ±3.14）years. The main immunosuppressant regimen during pregnancy was tacrolimus+azathioprine+methylprednisolone/prednisone（9 cases），and the blood drug concentrations were all up to standard. The average gestational week at termination of pregnancy was（34 .03 ±3.18）weeks，14 cases gave birth to live infants（live birthrate 93.33%），including 4 cases of full-term delivery（28 .57%）and 10 cases of premature delivery（71 .43%）. The main reasons for termination of pregnancy were preeclampsia（4 cases）and deterioration of renal function（3 cases）， and the main mode of delivery was cesarean section（13 cases，92.86%）. No severe congenital malformations were found in neonates，and their growth and development were normal during follow-up. Two cases had deterioration of renal function after delivery and required hemodialysis. Conclusion The implementation of a multidisciplinary follow-up program of "pre-pregnancy evaluation—precise pregnancy monitoring—post-partum continuous management" for female renal transplant recipients can effectively improve the full-term delivery rate and ensure maternal and infant safety as well as the long-term stability of transplanted kidneys.

Objective To systematically summarize the long-term follow-up strategy for pediatric liver transplantation constructed by Tianjin First Central Hospital，analyze its application effects in ensuring patient survival，improving follow-up adherence，and accurately detecting complications，so as to provide a replicable practical reference for clinical follow-up management after pediatric liver transplantation. Methods A retrospective study was conducted，including 1 967 pediatric liver transplant patients in Tianjin First Central Hospital from 2013 to 2024. A long-term follow-up strategy of“standardized follow-up procedure + multidisciplinary team（MDT）+ information platform”was established. Kaplan-Meier method was used to calculate patient and graft survival rates，and Logistic regression analysis was performed to identify factors influencing follow-up status. Results The1-year，5-year and 10-year patient survival rates were 95.6%、94.1% and 93.8%，respectively，while the 1-year，5-year and 10-year graft survival rates were 94.4%，92.6% and 90.2%，respectively. The regular follow-up rate was91.68%，the pure loss to follow-up rate was 2.07%，and 96 .4% of patients from other provinces received standardized follow-up through the information platform. Multivariate Logistic regression analysis showed that only "postoperativefollow-up time" was an independent risk factor affecting follow-up status（OR＝1.433，95% CI＝1.208～1.700， P＜0.001）. Conclusion The long-term follow-up strategy of "standardized follow-up procedure + MDT + information platform" constructed by our center can effectively ensure long-term patient survival，improve follow-up adherence，and accurately identify late high-risk complications. It is particularly suitable for the clinical situation in China with a high proportion of remote patients，and has important clinical promotion value.

Objective To evaluate the long-term efficacy and neurological outcomes of liver transplantation in patients with decompensated liver cirrhosis complicated by hepatic myelopathy. Methods This single-center retrospective case analysis included 9 patients with decompensated liver cirrhosis and hepatic myelopathy who underwent liver transplantation at Tianjin First Central Hospital between January 2014 and March 2025 and were followed up long-term. Baseline characteristics，surgical data，and follow-up information were collected. Neurological disability and activities of daily living were assessed using the modified rankin scale（MRS）and the Modified Barthel Index（MBI），respectively. The Wilcoxon signed-rank test was employed to compare score differences before and after surgery. Results All 9 male patients were followed up，with a mean age of（46 .8 ±7.8）years. At the final postoperative follow-up，the median MRS score was significantly lower than the preoperative score〔3 .0（2 .0，4.0）vs.4.0（4 .0～4.0），P＝0.034〕. The median MBI score was hig her than the preoperative level〔92 .0（85 .0～100.0） vs. 86.0（58 .0～87.0），P＝0.075〕；although this difference did not reach statistical significance，it indicated a clear trend towards improvement. Case analysis suggests that patients with a shorter disease course may benefitmore. Conclusion Liver transplantation can significantly improve neurological disability in patients with hepatic myelopathy and shows a trend towards enhancing their activities of daily living，proving to be an effective treatment for myelopathy and shows a trend towards enhancing their activities of daily living，proving to be an effective treatment for this condition. Early intervention with liver transplantation may lead to optimal neurological outcomes.

Objective To establish a follow-up system for postoperative patients of pancreatic cancer undergoing radical resection combined with intestinal autotransplantation，in order to provide reference for standardizing hospital follow-up management，improving follow-up efficiency，and promoting self-management of patients at home. Methods Establish an integrated follow-up team of medical care，the construction of a three-dimensional structured follow-up list of "physiology—psychology—behavior"，and the establishment of an information-based follow-up platform based on patient-reported outcomes，the follow-up files of patients'continuous care were improved，and the standardized follow-up after discharge was implemented. Results From November2024 to August 2025，a total of 178 systematic follow-up visits were completed for 27 patients，and the followup compliance was 100%. Patients received 234 adjuvant treatments，and the treatment compliance was 99.6 %. The follow-up team solved 33 difficult problems and needs of patients，and the average score of patient satisfaction evaluation was 98.3 points. Conclusion This system base on collaborative healthcare partnerships，uses a unified follow-up checklist to ensure the comprehensiveness and scientific nature of the content. The information-basedfollow-up platform built by integrating patient report outcomes can provide patients with individualized symptom intervention，psychological support and rehabilitation guidance，tracking to improve postoperative survival，followup efficiency and continuous care level.

Objective To investigate the role of senescent proximal tubular epithelial cells（sPTECs） in predicting renal outcomes in living-related kidney transplant recipients. Methods In this single center retrospective cohort study，135 recipients were divided into stable（n＝83）and deteriorating graft function（n＝52） groups. Donor kidneys and posttransplant biopsies（3，6，12，18 months）from the deterioration group were assessed for tubular atrophy（TA）and interstitial fibrosis（IF），along with senescence markers（γ-H2AX，P21，P 16），to analyze their association with adverse renal repair. Results Compared with donor baseline，TA and IF areas increased progressively from 12 months posttransplant（P＜0.05）. Expression of γH2AX，P21，and P 16 increased earlier，showing significant differences from 6 months（P＜0.001）. All senescence markers positively correlated with TA and IF extent. Conclusion PTEC senescence is positively correlated with the degree of chronic renal histopathological injury in living-related transplant recipients and occurs earlier than structural changes. sPTECs mayserve as a potential biomarker for evaluating renal prognosis in this population.

Objective To evaluate the clinical safety of the steroid withdrawal strategy in patients with endstage diabetic kidney disease（ESDN）after simultaneous pancreas-kidney transplantation（SPKT）. Methods A retrospective analysis was conducted on 81 ESDN patients who underwent SPKT at the Second Affiliated Hospital of Guangzhou Medical University from January 2020 to January 2022. The patients were divided into the early withdrawal group（discontinued within 3 months after surgery，n＝29），the non-early withdrawal group（discontinued between3 and 10 months after surgery，n = 22），and the steroid maintenance group（long-term low-dose maintenance， n＝30）. The functional indicators of the transplanted pancreas and kidneys，as well as the survival rates of the recipients and grafts，were compared among the different withdrawal strategies. The occurrence of postoperative complications was also analyzed. Results Within 1 year of follow-up，the survival rates of the recipients and their transplanted pancreas and kidneys were all 100%. The fasting blood glucose，glycosylated hemoglobin，and serumcreatinine levels at different time points after surgery showed a similar distribution，and there were no statistically significant differences among the groups. The incidence of various postoperative complications also showed no significant difference（P＞0.05）. Conclusion With the support of standardized immunization induction and maintenance of immunosuppressive regimens，the implementation of steroid withdrawal after SPKT in ESDN patients did not increase the short-term graft dysfunction，rejection reactions，or infection-related risks，suggesting that this strategy has good safety in the short-term follow-up.

Objective To analyze the clinical efficacy，timing of transplantation，prognosis and comprehensive management strategies of liver transplantation for langerhans cell histiocytosis（LCH）in children. Methods A case of liver transplantation for langerhans cell histiocytosis in children was analyzed. Databases of CNKI，Wanfang，VIP，PubMed and Web of Science（as of August 31，2025）were retrieved to collect the case reports on liver transplantation for langerhans cell histiocytosis（LCH）in children，and the main clinical data of the patients were analyzed descriptively. Results In Shanghai Children’s Hospital，a male patient with multisystem involvement LCH received chemotherapy and liver transplantation，experiencing no complications and achieving complete remission for over six years. A comprehensive literature review encompassed 15 studies， involving 39 patients in total. The male-to-female ratio was 0.95：1. The median age at LCH diagnosis was 22（6～48）months，and the median age at liver transplantation was 50（14～204）months. All patients exhibited liver involvement，with the skin being the most commonly affected site（71 .8%）. Thirty-two patients had involvementof three or more organs. Pathological confirmation of LCH was obtained for all cases，with skin biopsy representing the most frequent diagnostic method（59 .0%）. The median follow-up duration was 20 months（9 d～88 months）. Among the 39 patients，recurrence was observed in 7 cases，death occurred in 4 cases，vascular complications were reported in 2 cases，and the most prevalent infection was cytomegalovirus infection（33 .3%）. Conclusion Liver transplantation is an effective treatment for end-stage liver disease related to Langerhans cell histiocytosis in children. To ensure sustained complete remission，this approach should be integrated with chemotherapy，targeted therapy， and meticulous follow-up protocols.

Objective To investigate the predictive value of systemic immune-inflammation index（SII）for postoperative adverse outcomes in heart transplant recipients. Methods A retrospective analysis was conducted on the clinical data of 64 heart transplant recipients at Central China Fuwai Hospital of Zhengzhou University from April 1，2018，to December 10，2024. The patients were stratified into a favorable-prognosis group and an adverse-prognosis group based on the occurrence of postoperative adverse outcomes. Logistic regression analysis was used to identify risk factors for adverse outcomes，and the receiver operating characteristic（ROC）curve was employed to determine the area under the curve（AUC）of SII in predicting adverse outcomes. According to the optimal cutoff value，the64 patients were stratified into high-SII and low-SII groups，and their perioperative data were compared. Results SII and cardiopulmonary bypass time were identified as risk factors for postoperative adverse outcomes. The AUC of SII for predicting adverse outcomes was 0.793，with an optimal cutoff value of 765.5，yielding a sensitivityof 80.0% and a specificity of 74.1%. When the patients were divided into high- and low-SII groups based on the cutoff value，the high-SII group exhibited a significantly higher postoperative ECMO utilization rate（31 .8% vs.4.8%，P＝0.006）and incidence of adverse outcomes（36 .4% vs. 4.8%，P＝0.02）compared to the low-SII group. Additionally，the duration of postoperative mechanical ventilation（h）was longer in the high-SII group〔72 .5（48 .0，141.5）h vs. 42.0（23 .0，84.5）h，P＝0.02〕. Conclusion As a simple and readily available biomarker，SII has certain predictive value for adverse outcomes in heart transplant recipients. When SII exceeds 765.5，there may be an increased risk of adverse postoperative events.