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 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 To understand the status and hot spots of the research on the health management of kidney transplantation recipients in China，to discuss the research deficiencies and development trends，andto provide reference for the development of this field. Methods The relevant literatures were retrieved from CNKI，Wanfang，Weipu and China Biomedical database on August 8，2023，and visualized with CiteSpace and VOSviewer. Results A total of 678 Chinese literatures were retrieved，the number of which showed anincreasing trend. The published journals were concentrated，and the cooperation between authors and institutions was limited and regional. Research hotspots included medication compliance，self-management，quality of life，social support，the frontier areas include telemedicine，life-cycle follow-up management，and evidence-based nursing. Conclusion The study on the health management of kidney transplant recipients has gradually changed from passive health education to active health promotion，but the research force still needs to be strengthened. It is recommended to apply telemedicine and evidence-based concepts，improve the follow-up management system，andstrengthen the follow-up management of the whole life cycle. 

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 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 Establish model of abdominal heterotopic heart transplantation in mice and summarize the experience to provide animal model support for further study of organ transplantation immunology. Methods Inbred BALB/c（n ＝ 30）and C57BL/6（n ＝ 30）mice were selected as donors，and inbred BALB/c（n ＝ 60）mice were used as recipients. The ascending aorta of the donor was anastomosed to the abdominal aorta of the recipient，and the pulmonary artery of the donor was anastomosed to the inferior vena cava of the recipient respectively to establish the heterotopic heart transplantation model. The survival time and the rejection of grafts were observed postoperatively. Results The successful rate of transplantation was 85%（51/60）. The donoroperation time was（7.0±1.0）min，and the recipient operation time was（60±10）min. The vascular anastomosis time was（25±3.0）min. After the transplantation，no immunosuppressive agent was used，and the survival time of the graft was（7.6±0.9）d. The graft on the fifth day，the seventh day showed typical rejection by histopathology. Conclusion Skilled microsurgical techniques and timely management of surgical complications are key to the successful establishment of abdominal heterotopic heart transplantation in mice. 

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 Post-renal transplantation anemia（PTA）occurs frequently in kidney transplant recipients，significantly impacting their quality of life and graft loss. Currently，effective methods to predictthe risk of persistent PTA early post-transplantation are lacking. This study aimed to develop a nomogram prediction model for early persistent PTA specifically tailored to kidney transplant recipients. Methods Using the electronic medical record system of Southern Hospital of Southern Medical University，patient data from January 1，2020 to December 31，2022 were obtained，and 245 subjects were ultimately selected as the research subjects. Among these，85% were randomly selected as the training set for model development，and the remaining 15% constituted the testing set. Using the Least Absolute Shrinkage and Selection Operator（Lasso）regression model，variables potentially affecting early persistent PTA were screened to identify predictive factors.A logistic regression analysis was employed to establish the prediction model. Model performance was assessed using Receiver operating characteristic（ROC）curves，area under the curve（AUC），Calibration plots，and decision Curve Analysis（DCA）. Results Identified predictive factors after screening included recipient's preoperative body mass index，preoperative serum albumin level，preoperative hemoglobin level，preoperative mean corpuscular volume，perioperative use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers，exogenous iron supplementation，and exogenous erythropoietin supplementation. The model demonstrated good discriminativeability with an AUC of 0.87 for the training set and 0.75 for the testing set，indicating robust predictive performance. Calibration and DCA further confirmed the accuracy and clinical utility of the model. Conclusion This nomogram prediction model utilizes early recipient information，including demographic characteristics，laboratory data，and medication regimens，to accurately predict individualized risk of early persistent PTA in kidney transplant recipients. This provides a basis for early clinical intervention，potentially improving patient prognosis and quality of life. 

Objective To investigate the role of fission protein 1 （FIS1） in affecting renal ischemiareperfusion injury by regulating mitochondrial division and apoptosis. Methods Probing FIS1 expression levels and apoptosis levels were measured at different times in the renal tubular epithelial cell（ HK-2）with hypoxiareoxygenation（ HR）model and mouse renal ischemia-reperfusion（ IR） model. Cell lines with FIS1 knockdown and overexpression were constructed，changes in the degree of mitochondrial division were observed using mitochondrial probes，and changes in the level of apoptosis were detected with flow cytometry. Results FIS1 knockdown/ overexpression had essentially no effect in normal cells. After HR， knockdown of FIS1 inhibited mitochondrial division and reduced apoptosis levels， and vice versa after overexpression of FIS1. Conclusion In IRI， Inhibition of FIS1 expression reduces mitochondrial division and reduces the level of apoptosis， which is expected to be a potential therapeutic target for IRI. 

Objective To establish an ex situ machine perfusion（MP）system for long-term liverperfusion using normothermic machine perfusion（NMP）technology. Methods A porcine liver was connectedto the Life-X100 perfusion system for normothermic machine perfusion. Perfusion parameters and perfusate blood-gas analysis results were continuously monitored during the perfusion process to assess the ex situ liverfunction. Results The porcine liver was successfully perfused ex situ for 138 hours，with stable perfusionparameters and well-maintained liver function. Conclusion We have preliminarily established an ex situ longterm liver perfusion system. This system can be used for the ex situ maintenance of human livers in the future and can serve as a basis for various exploratory studies to advance medical development in our country. 

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.