Objective To improve the accuracy and clinical interpretability of recurrence prediction after liver transplantation in patients with hepatocellular carcinoma（HCC），and to explore the potential application of explainable machine learning models in integrating multimodal data. Methods This study included data from 138 liver transplant patients with liver cancer at the Third Medical Center of the Chinese People's Liberation Army General Hospital from December 2018 to December 2021. Preoperative contrast-enhanced CT radiomics features and clinical variables were extracted. Predictive models were developed using four machine learning methods ：LASSO regression，random forest，support vector machine（SVM），and neural network. Importance of variate was employed to identify key predictive factors. Model performance was evaluated using area under the receiver operating characteristiccurve（AUC），Brier score，and calibration curves. A nomogram was ultimately constructed based on important variables. Results The AUCs for the random forest model in predicting recurrence at 1，2，and 3 years were 0.881，0.906，and 0.915，respectively，significantly outperforming other models. The importance analysis identified five key imaging features，and the nomogram model combining these with clinical variables demonstrated good consistency and predictive capability. Conclusion Explainable machine learning models based on multimodal data can effectively improve the accuracy and transparency of recurrence prediction following liver transplantation in HCC patients. These models have strong clinical applicability and provide valuable support for individualized preoperative risk assessmentand treatment decision-making. 

Objective Split liver transplantation （SLT） is an important innovative technique in transplant surgery that addresses the shortage of donor livers and expands the source of donor organs. Currently， the number of hepatocellular carcinoma patients undergoing SLT is increasing year by year， but its impact on the occurrence of complications and prognosis in hepatocellular carcinoma recipients compared with whole liver transplantation （WLT） remains unclear. This study aims to explore the differences in the occurrence of complications and prognosisbetween WLT and SLT recipients with hepatocellular carcinoma， and to construct a prognostic prediction model forhepatocellular carcinoma recipients underwent SLT by analyzing the prognostic factors. Methods A retrospective selection of 3 773 adult recipients with hepatocellular carcinoma who underwent WLT and SLT registered in the ChinaLiver Transplant Registry （CLTR） from January 2015 to December 2023 was conducted. Clinical data of donors and recipients were collected to compare the clinicopathological characteristics of donors and recipients， the occurrence ofcomplications and prognosis of recipients between the two surgical methods was evaluated. Propensity score matching （PSM） at a 2 ：1 ratio was used to match the baseline clinical data with differences between the WLT and SLT groups，and the incidence of complications and prognosis in the two groups were analyzed. Univariate and multivariate analyses were performed to screen for risk factors related to the prognosis of SLT recipients， and then a prognostic prediction model

was constructed. Results There was no significant difference in the overall survival rate and recurrence-free survival rate between SLT recipients and WLT recipients （P ＞ 0.05）. However， the incidence of postoperative biliary leakage，portal vein embolism， and new-onset diabetes after surgery in SLT recipients were significantly higher than those in theWLT group （postoperative biliary leakage，P ＝ 0.0010 ； portal vein embolism，P ＝ 0.0044 ； new-onset diabetes after surgery，P ＝ 0.036）. Univariate and multivariate analyses of the prognosis of SLT recipients found that donor-recipient

ABO blood type incompatibility， recipient alpha-fetoprotein （AFP）＞ 100 ng/ml， and cumulative tumor diameter ≥ 8 cm were independent risk factors for the prognosis of SLT hepatocellular carcinoma recipients （all P ＜ 0.05）. A prognostic prediction model for SLT recipients was constructed based on the above risk factors， with AUC values of 0.561，0.698， and 0.687 for 1-year，3-year， and 5-year survival rates， respectively. Conclusion The incidence of some postoperative complications in SLT recipients is higher than that in WLT recipients， but the clinical prognosis is similar. Among them，donor-recipient ABO blood type incompatibility， recipient AFP ＞ 100 ng/ml， and cumulative tumor diameter ≥ 8 cm areindependent risk factors affecting the prognosis of SLT hepatocellular carcinoma recipients. The prediction model establishedon this basis has good predictive value for the survival rate of recipients. 

Objective To explore the association between immune therapy and the risk of rejection after liver transplantation in patients with hepatocellular carcinoma （HCC）. Methods A retrospective analysis was conducted on 11 HCC patients who received immune therapy before transplantation at Beijing Friendship Hospital from 2019 to 2025， and 70 cases reported in the literature were included. The incidence of rejection and influencing factors were analyzed. Results The rejection rate in our center's cohort was 9.1% （1/11）， which was lower than that in theneoadjuvant therapy cohort （25.0%）and the post-transplantation cohort （30.8%）in the literature. The rejection rate was significantly reduced when the interval between the last dose of immune therapy and transplantation was more than two halflives. The expression of programmed death ligand 1（PD-L1）in the graft may be related to the risk of rejection and could serve as a potential biomarker for predicting rejection. Conclusion It is recommended to wait at least 8 weeks （two halflives）after immune therapy before liver transplantation. The expression levels of programmed death receptor 1（PD-1）/PDL1 in the graft tissue can be used as potential biomarkers， but further research is needed to explore the mechanism and safe time intervas. 

Objective To explore the physiological and psychological factors affecting pulmonary infection in kidney transplant recipients and to construct a risk prediction model. Methods The clinical and follow-updata of 327 recipients undergoing kidney transplantation in Shandong Provincial Qianfoshan Hospital from January2019 to January 2024 were retrospectively analyzed. The recipients were divided into pulmonary infection group（102 cases）and non-pulmonary infection group（225 cases）according to whether pulmonary infection occurred after kidney transplantation. The data of the two groups of recipients was analyzed with multivariate regression analyze，theprediction model of pulmonary infection of kidney transplant recipients was constructed，and the receiver operatingcharacteristic（ROC）curve was used to verify the predictive value. Results The rate of pulmonary infection within 1 years after kidney transplantation was 31.19%. Age，blood glucose，insomnia severe index，use of cyclosporine and mycophenolate mofetil were independent risk factors for pulmonary infection. While white blood cell count on postoperative day 5 and positive psychological capital were independent protective factors（P ＜ 0.05）.The areaunder curve（AUC）of the constructed model equation for predicting the risk of pulmonary infection was 88.7% with a Kappa value of 0.66（P ＜ 0.05）. Conclusion The prediction model of pulmonary infection in kidney transplant recipients constructed based on physiological and psychological factors has a good predictive value. 

Objective To investigate the clinical efficacy of peptide receptor radionuclide therapy （PRRT）in patients with recurrent neuroendocrine tumors （NETs） after liver transplantation. Methods A retrospective analysis was conducted on the clinical data of 5 patients with recurrent NETs after liver transplantation who underwent PRRT from April 2023 to May 2024 in Tianjin First Central Hospital. Adverse reactions and treatment efficacy were evaluated. Results The median follow-up was 15.6 months. Among the patients，1 achieved partial response （PR），3 had stable disease （SD）， and 1 experienced progressive disease （PD）. Liver function remained stable during treatment， and no rejection reactions occurred. Grade 3 neutropenia was observed in 2 cases， while grade 2 neutropenia occurred in 3 cases. Symptomatic treatment alleviated the condition in 4 cases， but 1 case had persistent severe neutropenia， leading to treatment discontinuation. Grade 1 ～ 2 proteinuria was observed in 2 cases. Conclusion PRRT is safe and effective for patients with recurrent NETs after liver transplantation. The main side effect is neutropenia， and PRRT can be considered as one of the multimodal treatment options. 

Objective To explore the molecular mechanisms and potential inflammation-related biomarkers of hepatic ischemia reperfusion injury（HIRI）process using bioinformatics techniques. Methods HIRI datasets GSE12720 and GSE14951 were obtained. Differential expressed genes（DEGs）were analyzed for functional enrichment and pathway enrichment. Hub genes were obtained using protein interactions analysis，and the correlationbetween Hub genes and inflammatory genes was calculated to finalize the key genes. The biological processes involved in these key genes were explored using GSEA analysis，and the expression of key genes was verified by mouse HIRI model. Finally，miRNAs of the key genes were predicted. Results Signaling pathways such as TNF，IL-17，MAPK and NF-κB were involved in inflammatory and immune processes during HIRI，and five key genes were closely related to inflammatory responses and their expressions are upregulated after HIRI. Conclusion This studyconfirms the central role of the inflammatory response in the process of HIRI and provides new perspectives for the discovery of the pathogenesis and potential therapeutic targets of HIRI. 

Objective Urological complications such as urinary leakage and ureteral stenosis following transplantation significantly impact the efficacy of renal transplantation surgery. Ureteral stent placement is currently the most common method for reducing ureteral complications; however， the optimal duration for stentindwelling remains controversial. This study aimed to investigate the impact of ureteral stent indwelling time on postoperative outcomes in renal transplant recipients， and to provide clinical evidence for optimal stent removal timing. Methods A prospective cohort study was conducted involving 100 patients who underwent their first allogeneic renal transplantation in Organ Transplant Department，the Second Affiliated Hospital of Guangzhou Medical University between October 2020 and October 2022. Patients were divided into two groups: the stent-on-string group （n ＝ 50）and the conventional stent group （n ＝ 50）. In the stent-on-string group， the stent was removed via the string at 1 week postoperatively. In the conventional stent group， stents were removed via ureteroscopy at 1 month postoperatively. Theincidence of delayed graft function （DGF）， incidence of urological complications， length of hospital stay （LOS）， and renal function during the stable postoperative period were compared between the two groups. Results The stent-on-string group demonstrated a significantly shorter hospital stay and significantly lower incidences of urinary tract infections （UTIs）and BK viremia at 1 month postoperatively compared to the conventional stent group （P ＜ 0.05 for all comparisons）. Conclusion Removal of the ureteral stent at 1 week post-transplantation significantly reduces the incidence of UTIs and BK viremia without increasing the risk of ureteral complications. The use of a stent-on-string avoids patient discomfort which is associated with cystoscopy or ureteroscopy stent removal. Therefore， a stent-on-string should be placed andremoved at 1 week postoperatively when no significant lesions are present in the donor ureter or recipient bladder. 

Objective To analyze the research hotspots and development trends of artificial intelligencein the field of organ transplantation. Methods Literatures on the application of artificial intelligence inthe field of organ transplantation from January 2004 to June 2024 were retrieved from the Web of ScienceCore Collection and China National Knowledge Infrastructure database. CiteSpace 6.2.R6 software was used for visual analysis. Results A total of 728 relevant literatures were retrieved，559 English literatures and 143 Chinese literatures were included after screening. The number of literatures published in the early stage was small，while the number of literatures published in recent years has increased significantly. The country with the largest number of articles was the United States，followed by China. The top three institutions in terms of foreignpublications were Mayo Clinic，University of Toronto and Harvard University. Zhejiang University，Peking UnionMedical College and the First Affiliated Hospital of Sun Yat-sen University were the most active institutions in China. The authors who have published the most articles in English were Cheungpasitporn Wisit and Thongprayoon Charat，and the author who has published the most articles in Chinese was Ren Bin. The main high-frequency keywords in English were machine learning，survival，artificial intelligence，liver transplantation，kidney transplantation，mortality，risk，model，outcome and deep learning. The main high-frequency keywords in Chinese were machine learning， liver transplantation， kidney transplantation， deep learning， artificial intelligence， hepatocellular carcinoma，radiomics，liver cancer，prognosis and tacrolimus. The first emergent keywords in English were artificial neural networks，data mining and survival analysis，and the most recent were predictive model and kidney transplant. The first emergent keywords in Chinese were neural networks，cyclosporine A，and blood concentration，and the most recent were deep learning and machine learning. Conclusion The application of artificial intelligence in thefield of organ transplantation is increasing significantly. The use of machine learning and deep learning to construct prediction models and to analyze the survival of various organ transplantation patients is a current research hotspots. In the future，exchanges and cooperation between countries and disciplines can be strengthened to promote the study and application of advanced AI technologies，so as to further promote the development of this field. 

Objective Maintaining stable concentrations of anti-rejection drugs represents a critical facetof post-kidney transplantation patient care; however，achieving personalized and precise management for each patient remains challenging. This study leverages an artificial intelligence-based deep learning framework to develop a machine learning predictive model for tacrolimus concentration，with the objective of recommending optimal dosing regimens for individual kidney transplant recipients. Methods Fifty kidney transplant recipients who underwentsurgery at the Urology Department of Beijing Friendship Hospital，Capital Medical University，between January 2024 and April 2025，were enrolled in this study. Drawing on prior experience in tacrolimus dosing，we collected data on patients' gender，age，weight，comorbidities，CYP3A5 metabolic phenotypes，initial tacrolimus（Tac）doses，and FK506 levels measured on postoperative days 7，9，11，13，and 15，with subsequent dosage adjustments made according to each concentration measurement. A LightGBM regression model was employed to predict and optimize tacrolimus dosing regimens. Results Among the 50 kidney transplant recipients enrolled in this study，none developed severe complications，including delayed recovery of graft function，postoperative infections，or bleedingThe dataset was partitioned into training and validation sets using a five-fold cross-validation approach. The final model demonstrated robust predictive performance in the test set，with a mean absolute error（MAE）of 0.166，root mean square error（RMSE）of 0.227，mean absolute percentage error（MAPE）of 7.035%，P20 of 0.935，P30 of 0.97，and a coefficient of determination（R-squared）of 0.932. Conclusion The LightGBM regression model exhibited excellent performance，providing a novel and effective strategy for personalized tacrolimus dosage adjustment in kidney transplant recipients. 

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 analyze the fluid management plan and early clinical outcomes of patients after heart transplantation. Methods The clinical data of 121 heart transplant recipients were retrospectively analyzed in Chinese Academy of Medical Sciences Fuwai Hospital. The data on early fluid usage of the patients were sorted out and analyzed. Meanwhile， the occurrence and clinical outcomes of the main early complications of heart transplant patients after surgery were summarized and described. Results The negative fluid balance on the day after surgery was （1729.5±861.8） ml. The negative fluid balance from the 1st to the 3rd day after surgery was （1138.6±805.2） ml，（696.7±779.2） ml， and （527.1±694.3） ml respectively. The amount of colloid used on the day after surgery was 826.4±503.0 ml， and the average venous pressure was （3.0±2.0） mmHg. A total of 4 patients died in the hospital. Postoperative blood transfusion accounted for 14.9%， postoperative application of CRRT accounted for 5.0%， and secondary thoracotomy exploration accounted for 5.8%. Conclusion For heart transplant patients after surgery， the early management was guided by central venous pressure， in addition to floating catheter parameters， and through multiparameter guided dynamic fluid management. The risk of in-hospital death and the incidence of major complications of hearttransplant patients after surgery were at a relatively low level. 

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.