Objective Acute and severe liver failure progress rapidly with an extremely high mortality，while timely liver transplantation can save the patient's life. Due to the shortage of donors， patients often cannot match a suitable liver in time. Through the application of ABO-incompatible liver transplantation， the situation of liver shortage can be alleviated to a certain extent. Methods ABO-incompatible liver transplantation was performed on 3 patients with acute and severe liver failure. By adopting appropriate pretreatment methods， the postoperative complications and survival of the patients were observed. Results None of the 3 patients had acute rejection after the operation. Two patients survived for a long term. Among them，1 patient had biliary complications in the early stage and was treated in time， and 1 patient died due to severe infection. Conclusion For patients with acute and severe liver failure，emergency ABO-incompatible liver transplantation can also achieve good results. 

Objective There is a huge gap between organ demand and supply for patients with end-stagerenal disease. To increase the supply of kidneys，kidney transplantation is trying to break through ABO and human leukocyte antigen （HLA） incompatible barriers. ABO-incompatible kidney transplantation （ABOi-KT） increases the risk of antibody-mediated rejection, infection and death in recipients. We use plasma exchange and rituximab desensitization therapy before surgery in ABOi-KT recipients to reduce the incidence of rejection and improve graft and patient survival. Methods All recipients undergoing ABOi kidney transplantation in our center from 2020 to 2023 were included. Recipients underwent rituximab and plasma exchange therapy preoperatively, and ABO antibody titers were measured after each plasma exchange. Intravenous methylprednisolone was administered as induction therapy before transplantation. Oral prednisone，mycophenolate and tacrolimus were used as maintenance therapy. Results A total of6 cases of ABOi-KT were performed with an average follow-up of 412 days. One patient suffered from Klebsiella pneumoniae and Candida glabrata infection, and was cured after anti-bacterial and anti-fungal treatment. None of the 6 patients suffered from BK virus，cytomegalovirus，or herpes simplex virus infection. One patient had post-operative urine leakage from the graft kidney and underwent re-anastomosis of the transplanted ureter and bladder. The 1-year graft and patient survival rates were all 100%. Conclusion In our center's ABOi-KT，the risk of infectious complications was low，and graft and patient survival were good. 

Objective To evaluate the clinical outcomes of ABO-incompatible （ABOi） versus ABOcompatible/identical liver transplantation in pediatric patients. Methods This study conducted a retrospective analysis of clinical data from 49 pediatric patients who underwent liver transplantation at Hunan Children's Hospitalbetween May 23，2017， and April 30，2023. Patients were divided into the ABOi group （8 cases） and the non-ABOi group （41 cases） based on ABO blood type compatibility between donors and recipients. The study compared pre-operative scores， transplantation waiting times， urgency levels on the waiting list， postoperative complications， and survival rates between the two groups. Results Pre-operative PELD scores and urgency levels on the waiting list were significantly higher in the ABOi group compared to the non-ABOi group. However， there was no significant difference in postoperative complications and survival rates between the two groups （P ＞ 0.05）. The comparison of post-transplant survival rates between the ABOi and non-ABOi groups also showed no significant difference （P ＞ 0.05）. Conclusion This study supports the use of ABOi-LT as an effective strategy to expand the donor pool for pediatric liver transplantation， especially for patients withhigh urgency levels. 

Objective The objective of this study is to examine the clinical efficacy and prognosis of ABO incompatible live donor liver transplantation in children， thereby offering valuable insights for clinical practice in this particular area. Methods The data of 22 children who underwent living donor liver transplantation in the Department of Pediatric Surgery， the First Affiliated Hospital of Xinjiang Medical University from 2021 to 2023 were retrospectively analyzed. There were 16 cases in the ABO-identical （ABO Id） or ABO-compatible （ABO-C） group. There were 6 cases inthe ABO-incompatible （ABO-In） group. The general data， postoperative indicators，complications and survival of the twogroups were compared. Results There was no statistically significant difference between the two groups in transplant age， gender， operation history， PELD score， donor age， anhepatic phase， operation time， postoperative hospitalization duration， tacrolimus whole blood trough concentration， and serum creatinine value （P ＞ 0.05）. There was no significant difference in the overall cumulative survival rate between the two groups （P ＞ 0.05）. There was no significant difference in the incidence of postoperative pulmonary infection，cytomegalovirus infection， rejection and vascular complications between the two groups （P ＞ 0.05）. Conclusion ABO incompatible living donor liver transplantation in children is a safe andeffective treatment， which can increase the source of donor liver and save the lives of children. 

Objective To investigate the clinical outcomes and prognosis of ABO incompatible livertransplantation in children. Methods A retrospective analysis of clinical data from 1607 pediatric liver transplant recipients at the Pediatric Organ Transplantation Department of Tianjin First Central Hospital between January 1， 2014， and December 31，2022 was performed. Recipients were categorized into three groups based on ABO blood typecompatibility with donors ： Group A （ABO-identical，1077 cases）， Group B （ABO-compatible，288 cases）， and Group C（ABO-incompatible，242 cases）. Postoperative complications， patient survival rates， and graft survival rates were observed and compared among the three groups. Results The overall 1，3， and 5 year survival rates of the 1，607 recipients were 95.7%，94.6%， and 94.0%， respectively， with no significant differences （P ＝ 0.797）. Similarly， there were no significant differences in graft survival rates at 1，3， and 5 years among the three groups （P＝ 0.366）. However， there were significant differences in the incidence of postoperative complications， including cellular rejection （P ＜ 0.001）， biliary stricture （P ＝0.016）， and hepatic artery thrombosis （P ＝ 0.030）， among the three groups. Conclusion Pediatric ABO incompatibleliver transplantation is safe and feasible， effectively expanding the donor pool and benefiting more pediatric patients. 

Objective To analyze the effect of pre-transplant donor kidney hemodialysis on the prognosisof recipients and grafts. Methods The clinical data of 289 donors who underwent organ donation in the Departmentof Organ Transplantation of Renmin Hospital of Wuhan University from January 2020 to June 2023 were collected and a retrospective cohort study was conducted. A total of 21“Chinese Class Ⅲ” donors who underwent preoperative hemodialysisand 40 corresponding recipients were included in the study. Propensity score near matching method was used to select nondialysis donors and their corresponding donors as controls according to the ratio （number of recipients receiving dialysis donors ：number of recipients receiving non-dialysis donors）＝（1 ：2）. Clinical data were collected and analyzed. Clinicaldata of the corresponding donors and recipients were collected and analyzed. Clinical data of corresponding recipients

were collected and analyzed. The general data of dialysis and non-dialysis donors and their corresponding recipients werecompared to analyze the prognosis of recipients. Results According to the propensity score， a total of 57 recipientswho received non-dialysis donor kidneys during the same period were matched， and their corresponding donors were50. There was no significant difference in baseline data between the two groups after matching （P ＞ 0.05）. There weresignificant differences in serum creatinine， urea nitrogen， estimated glomerular filtration rate （EGFR）and AKI positive rate between non-dialysis donors and dialysis donors before donation （P ＜ 0.001，P ＝ 0.013，P ＜ 0.001，P ＜ 0.001）. The difference in serum creatinine level on the first day after transplantation between the two groups was statistically significant （P ＝ 0.019）， while the incidence of delayed graft function （DGF） was not statistically significant （P ＝ 0.289）. There were13 cases of DGF （13/40 ；13/57）， and no PNF occurred. Conclusion There is no direct correlation between temporarydialysis before transplantation and DGF after transplantation. It can be considered as a marginal donor kidney in clinical application. 

Objective To explore the clinical effects of retroperitoneal laparoscopic donor nephrectomy and open donor nephrectomy. Methods The clinical data of donors from January 2023 to April 2024 were analyzed retrospectively， including 46 males and 93 females， with an average age of （54.21±6.52） years. Retroperitoneal laparoscopic nephrectomy was used in 99 cases and open nephrectomy was used in 40 cases. Data of donor's past history，kidney position， donor's renal artery length， kidney dimension， number of arteries， operation time， intraoperative bloodloss， surgical incision length， postoperative maximum creatinine， postoperative maximum urea nitrogen， postoperative hospitalization days， postoperative total drainage， donor's renal artery length after removal， warm ischemia time， intraoperative peritoneal damage and fat adhesion， and complications were collected and analyzed. Results Comparedwith the open operation group， the incision of laparoscopic operation was significantly reduced， the amount of bleeding and postoperative drainage were significantly reduced， the hospital stay of donors was significantly shortened （P ＜ 0.05），and the warm ischemia time was significantly prolonged （P ＜ 0.05）. Male， larger body mass index， previous smoking history， trauma history， larger kidney dimension， excessive bleeding during operation， peritoneal damage and fat adhesion significantly increased the operation time （P ＜ 0.05）. Conclusion On the premise of ensuring the quality of the kidney， laparoscopic operation has the advantages of small incision， less bleeding and quick recovery.