Objective The clinical effects of single lung transplantation （SLT）and bilateral lung transplantation（BLT）in the treatmentof end-stagepulmonaryfibrosiswere compared to provide a reference for the choice of clinical treatment. Methods Retrospectiveanalysisofpatients withpulmonaryfibrosis who underwent lung transplantation at Wuxi People's Hospital affiliated to Nanjing Medical University between February 2020 and December 2020 was performed，a total of 72 patients were included，and were divided into two groups based on the type of surgery, including single-lung transplantation group（24 cases）and bilateral-lung transplant transplantation group（48 cases）. Preoperative characteristics，intraoperative conditions，functional improvement andpostoperative complications between the two groups were analyzed retrospectively. Results TheageinSLT groupwas significantly older than the BLT group〔65（57，69.75）years vs 55（48，61.75）years，P ＜ 0.05〕，which was in consistent with the fact that single lung transplantation was mostly performed in the elderly patients in this center. The two groups were comparable in other preoperative clinical data（P ＞ 0.05）. The predicted value of FVC% and FEV1% in the BLT group were better than those in the SLT group（P ＜ 0.05）. However the cold ischemia timeand total operation time were shorter in the SLT group than in the BLT group，and the intraoperative blood loss was less in SLT group than that in the BLT group（P ＜ 0.05）. There were no significant differences between the twogroups in the incidence of bronchial stenosis，bronchial stenosis，bronchial stenosis and primary graft dysfunction （P＞0.05）. Conclusion BLT has advantages in treating patients with end-stage pulmonary fibrosis and can effectively improve postoperative lung function，but SLT should still be considered in some selected patients. 

Objective To analyze the recovery of renal function after kidney transplantationfrom different donors，to explore the difference of short-term effect between donation after cardiac death （DCD）and living-donor（LD）， and to evaluate the feasibility and safety of DCD kidney transplantation and make better use of DCD donor. Methods Participants who underwent kidney transplantation in Organ Transplantation Center，the Department of Urology，Linyi people’s Hospital from December 2017 to January 2023 were selected. According to the source of donors，they were divided into DCD group and LD group.Then the demographic distribution between the two groups was analyzed，and the serum creatinine（Scr）and postoperative complications of the two groups at different time were compared. Results A total number of 70 patients were enrolled，including 50 patients with DCD and 20 patients with LD. Within two weeks after operation，the Scr level decreased to below 200 μmol/L，but the Scr level in DCD group was higher than LD group on day 1 ～ 7 and 9 after operation，the difference was statistically significant（P ＜ 0.05）. Conclusion The effect of DCD renal transplantation is accurate，but there is a certain difference between the short-term renal function recovery after operation compared with LD donor kidney，therefore，preoperative evaluation should be strengthened. 

Objective To summarize the diagnostic methods，clinical manifestations and prevention andtreatment of recurrent human parvovirus B19（HPV-B19）infecton in realansantion recipients. Methods FroJune 2020 to May 2022，8 out of 37 recipients infected with HPV-B19 after renal transplantation at Organ Transplantation Center of Tongji Hospital Affiliated to Tongji Medical College，Huazhong University of Science and Technology were collected. The clinical manifestations，diagnosis and treatment measures，laboratory tests，and prognosis of these 8 patients were retrospectively analyzed and summarized. Results After multiple courses of intravenous immunoglobulin G（IVIG），conversion and reduction of immunosuppression and other comprehensive regimens，the anemia symptoms were improved and hemoglobin（Hb）level was stable in 8 patients. And the same treatment was effective when recurrent infections occur. Eight patients were followed up for one year after the last recurrence. There was no recurrence and the Hb level was stable〔（136.8±12.0）g/L〕，and renal function was stable throughout the infectionperiod. Conclusion Post-transplant recipients are susceptible to infection with HPV-B19 due to immunocompromise and are prone to reactive or recur many times. When patients are infected with HPV-B19，the levels of Hb and reticulocyte should be monitored regularly，especially in patients who have recovered from treatment. Once the progressive decline of Hb occurs again，attention should be paid immediately，and HPV-B19 DNA should be further tested by PCR to determine whether there is recurrence. Intravenous IVIG is the preferred treatment for HPV-B19 infection，and when the disease recurs，reapplication remains effective and reinforces the treatment effect. Combined with adjustment of immunosuppressive regimen，reduction of immunosuppression and other comprehensive regimens，the ideal curative effect can be achieved. 

Objective To assessthe risk factorsfor early thrombosis after pancreatic transplantation. Methods We selected 46 recipients of simultaneous pancreas-kidney transplantation（SPK）from donation after brain death（DBD） donors in the 923 Hospital of the People's Liberation Army Joint Support Force from January 2015 to August 2019， and 30 SPK recipients of DBD donors in the Second Affiliated Hospital of Guangxi Medical University from November 2019 to July 2023 were collected. They were divided into thrombotic group and non thrombotic group based on whether thrombosis had occurred. A retrospective study was conducted on two groups of recipients to evaluate the ch

aracteristics of donors and recipients and the risk factors for early thrombosis after pancreatic transplantation. Results The age of the donor and recipient was not significantly related to pancreatic thrombosis（P ＞ 0.05）. The recipient body mass index（BMI）was closely related to the formation of transplanted pancreatic thrombosis（P ＝ 0.01）.The choice ofdrainage method for pancreatic exocrine fluid had little effect on transplanted pancreatic thrombosis（P ＝ 0.49）. The

use of arteries or veins to extend the donor pancreatic vein was associated with thrombosis after pancreatic transplantation （P ＝ 0.02）. The incidence of thrombosis in recipients who received heparin and received sequential aspirin was lower than those who received aspirin alone（P ＝ 0.04）. The change of donor amylase was a risk factor for pancreatic graft thrombosis（P ＝ 0.04）. The change of D-dimer（D-D）on the 7th day after surgery in the recipient suggested the formation of transplanted pancreatic thrombosis. Conclusion The recipient's BMI，arterial or venous extension of the donor pancreatic vein，use of heparin，and changes in donor amylase are risk factors for early thrombosis after pancreatic transplantation. 

Objective To improve the management of individualized drug therapy and drug safety inpregnancy patients after kidney transplantation，and to reduce maternal and fetal adverse events. Methods Toformulate individualized medication regimen and provide medication education from the aspects of adjustment ofimmunosuppressants，optimization of antihypertensive drugs，supplementation of folic acid，selection and monitoring ofanticoagulant drugs，monitoring of high uric acid and lactation were conducted. Results First trimester : The blood HCGinspection was positive indicating pregnancy .The patient's medication regimens were adjusted to the immunosuppressanttacrolimus capsule（5 mg Bid），hypotensor nifedipine controlled release tablets（30 mg QD），folic acid tablets（5 mg QD），dydrogesterone table（10 mg Q12 h）. Second trimester ：anticoagulant therapy of dapheparin sodium injection（5000 U/d）was given. At the same time，oral tacrolimus（5 mg Bid）was continued to maintain immunotherapy，and nifedipinecontrolled release tablet（30 mg QD）was used to reduce blood pressure. Perinatal period ：dexamethasone intramuscular（6 mg Q12 h）injection was given to promote fetal lung maturation and reduce lung complications of premature newborns.To prevent infection，Ceftazidime injection（2 g Bid）and metronidazole sodium chloride injection（100 ml Qd）weregiven for 5 d . Leonurus intramuscular injection was 1 ml to promote uterine contraction，in the meantime, the patients continueto take tacrolimus to maintain immunotherapy and nifedipine to reduce blood pressure. Conclusion The cooperation amongphysicians，pharmacists and nurses could provide whole-process management for kidney transplantation patients and improvetreatment effect. Meanwhile，pharmacists can effectively improve clinical dialectical thinking and evidence-based thinking throughparticipating in the whole process of treatment practice，laying a foundation for improving the level of pharmaceutical care.

Objective To evaluate the significance of detecting cytomegalovirus antigenemia in thediagnosis of cytomegalovirus infection in renal transplant patients. Methods From September 2021 to December2021，a total number of 110 blood samples from 90 renal transplant patients in The First Hospital of Kunming were collected.The CMV pp65 antigenemia test was compared with the results of IgG antibody and CMV DNA. The correlation betweenthe CMV pp65 antigenemia results and creatinine，tacrolimus（tacrolimus，Tac/FK506）concentration，lymphocyte subsetswas evaluated. Results The consistency between CMV pp65 antigenemia results and CMV DNA results was 65.5%，the difference was statistically significant（P ＜ 0.05）. The consistency between the CMV pp65 antigenemia test resultsand the CMV IgG antibody test results was 57.3%，the difference was not statistically significant（P ＞ 0.05）. There wasno significant difference between CMV pp65 antigenemia results and creatinine as well as FK506 drug concentrations（P ＞ 0.05）. In the comparison between CMV pp65 antigenemia results and lymphocyte subsets，there was only astatistically significant difference between CMV pp65 and NK cell absolute value（P ＜ 0.05）. Conclusion Theconsistency between CMV pp65 antigen and CMV IgG antibody was 57.3%. The consistency between CMV pp65 antigenand CMV DNA was 65.5%. The combined detection of CMV pp65 antigen and CMV DNA has certain significance inimproving the accuracy of clinical diagnosis of CMV infection. There was no statistically significant difference in the serumcreatinine level and the whole blood FK506 drug concentration between the CMV pp65 antigen negative group and thepositive group. The absolute value difference of NK cells was statistically significant. The probability of CMV infection inrenal transplant patients with high absolute value of NK cells was low.

Objective To analyze the causes and characteristics of death of kidney transplant recipients. Methods "Kidney transplantation" "death" and "cause" were searched in the retrieval system of China Biomedical Literature Database，China National Knowledge Network and Wanfang Medical network，and the 15 literatures included were statistically analyzed. Results A total of 18 070 kidney transplant recipients from 1977 to 2018 were included，and 2 286 of them died，with the mortality rate ranging from 2.0% to 35.7%，and the overall mortality rate was 12.6%（2 286/18 070）. The causes of death included 810 cases（35.4%）of infection，787 cases（34.4）of cardiovascular and cerebrovascular diseases，344 cases（15.1%）of liver failure，73 cases（3.2%）of gastrointestinal diseases，69 cases（3.0%）of tumor，19 cases（0.8%）of accidental death，10 cases（0.5%）of economic factors，and 174 cases of other causes（7.6%）. Conclusion Infection and cardiovascular and cerebrovascular diseases were the main causes of death in kidney transplant recipients，liver failure was the secondarycause，and gastrointestinal diseases and tumors were the rare causes，and other causes were rare. 

Objective Hepatocellular carcinoma（HCC）is a leading cause of cancer mortality worldwide. This study was aimed atexploring the prognosis predictive ability of ferroptosis-related genes in HCC and constructing a reliable risk model for clinical management. The expression of ferroptosis-related genes in ischemia-reperfusion injury after liver transplantation was preliminarily studied. Methods Bioinformatics analysis of transcription data obtained from Therapeutically Applicable Research to Generate Effective Treatments（TARGET）was utilized in this study. COX regression and consensus clustering were performed to identify two molecular subgroups based on ferroptosis related to the prognosis of HCC patients. Furthermore，we explored the underlying mechanism of ferroptosis involved in the prognosis of HCC through the pathway analysis of the differentially expressed genes of the two molecular subsets. We then performed LASSO-COX regression analysis to build the risk model and visualize the model using a nomogram graph. Transcription data obtained from the GEO database was used to preliminarily explore the expression of ferroptosis-related genes in ischemiareperfusion injury after liver transplantation. Results We identified two molecular subgroups with distinct overall survival based on the different expression profiles of differentially expressed ferroptosis-related genes. Pathways analysisshowed 

differentially expressed immune and bile acid metabolism related genes between the two molecular subgroups. Finally，we established a risk model based on six ferroptosis-related genes KLF2，MYCN，FZD7，PRDX6，HILPDA，and SLC7A11. The nomogram established with the six genes performed reliable predictive ability of HCC prognosis. In addition，ferroptosis-related genes'expression was significantly changed in ischemia-reperfusion injury after liver transplantation. Conclusion The risk model developed based on the expression of ferroptosis related genes could act as a potent predictor of HCC prognosis.

Objective To investigate the effect of donor quality on the survival rate of liver transplantationrecipients after cardiac death organ donation（DCD）. Methods A retrospective analysis was performed on 100 patients who received DCD liver transplantation from January 2018 to January 2021. A 1-year follow-up survey was conducted after transplantation to observe the survival status of liver transplantation recipients and to analyze the risk factors affecting liver transplantation recipients. Results The mortality rate of liver transplantation recipientswas 3%（3/100）. The mortality factors were closely related to the donor cold ischemia time，donor fatty liver，intraoperative blood loss，donor albumin and total bilirubin levels，and hepatocyte edema（P ＜ 0.05）. MultivariateLogistic regression analysis showed that donor cold ischemia time ≥ 840 min and fatty liver were independent risk factors for survival status of liver transplantation recipients（P ＜ 0.05）. The postoperative infection rate of liver transplantation was 26%（26/100），and the postoperative infection rate was closely correlated with child-Pugh scoreof recipient，preoperative hemoglobin level，platelet count，intraoperative blood transfusion volume and postoperative intensive care unit（ICU）observation time（P ＜ 0.05）. Conclusion DCD donor quality has a significant impact on the survival rate of recipients after liver transplantation，and the donor cold ischemia time and fatty liver have an important impact on the survival status of recipients after liver transplantation，while the preoperative anemia level，intraoperative blood loss and postoperative ICU observation time of recipients are closely related to the incidence of postoperative infection. 

ObjectiveTo analyze the independent risk factors for achieving a textbook outcome （TO） inliver transplant （LT） surgery for patients with hepatocellular carcinoma. MethodsRetrospective analysis of clinical diagnosis and treatment data of patients with HCC who underwent LT in the Liver Transplantation Department of Sun Yatsen Memorial Hospital， Sun Yat-sen University from June 2019 to December 2022 was performed. A total of 134 patients were included， including 124 males and 10 females， with a median age of 54（47 ～ 60） years. According to whether TO was achieved， they were divided into the TO group （n ＝ 41） and the non-TO group （n＝ 93）. Univariate and multivariatelogistic regression analyses were used to identify independent factors affecting TO. ResultsApproximately one-third（30.6%） of hepatocellular carcinoma patients achieved tumor obliteration （TO） after liver transplantation （LT）. Multivariate analysis showed that preoperative bilirubin ≥ 54.1 mmol/L （OR ＝ 9.75，95% CI ＝ 2.01 ～ 47.28，P ＝ 0.005） and biliary stasis in donor liver （OR ＝ 2.93，95% CI ＝ 1.21 ～ 7.13，P ＝ 0.018） were independent risk factors for achieving TO. Further analysis revealed no statistical difference in long-term survival rates between the TO group and non-TO group （χ2 ＝ 1.127，P ＝ 0.288）. ConclusionPreoperative high serum bilirubin and cholestasis in the donor liver areindependent risk factors for achieving TO after liver transplantation in patients with hepatocellular carcinoma. Currently， no differences have been found in the long-term survival rates between different groups. As a comprehensive indicator of shortterm prognosis，TO can be used to compare the quality of nursing among different centers after liver transplantation.

Objective Examining the effects of donor-recipient age gap and donor liver weight-torecipient weight ratio on postoperative wound infection in recipients. Methods Clinical data of patients undergoing liver transplantation at Renmin Hospital of Wuhan University from June 1，2017 to September 1，2023 were retrospectively collected.Differences in donor infection rates between groups before and after propensity scoringwere analyzed by chi-square test. Results The donor-recipient age gap was greater than or equal to 10 yearsin 32 cases. A total number of 51 cases had a donor-recipient age gap less than 10 years. Pre-propensity score ：no difference in early infection rate. Late infection rate did not differ. The ratio of donor liver weight to recipient body weight was greater than 0.01 in 46 cases. The ratio of donor liver weight to recipient body weight was less thanor equal to 0.01 in 37 cases. Before propensity scoring ：early infection rate did not differ. Late infection rate didnot differ. A total number of 32 donor-recipients had an age difference greater than or equal to 10 years. Thirtytwo patients with a donor-recipient age gap less than 10 years were matched according to 1 ∶ 1. After propensityscoring ：early infection rates were statistically different（χ2 ＝ 4.27，P ＝ 0.04）. There was no difference in therate of late infection. A total number of 37 patients have a donor liver weight-to-recipient weight ratio less thanor equal to 0.01. A total number of 37 patients with a donor weight-to-recipient weight ratio greater than 0.01 were matched according to a 1 ∶ 1 ratio. After propensity scoring ：early infection rates were statistically different （χ2 ＝ 9.95，P ＜ 0.01）. There was no difference in the late infection rate. Conclusion Donor-recipient agegreater than 10 years and donor liver weight to recipient body weight ratio less than or equal to 0.01 were risk factors for early postoperative wound infection in recipients. 

Objective To analyze the long-term results after simultaneous pancreas-kidney transplantation at a single center． Methods A retrospective analysis of the survival rates of 58 recipients and transplanted organsfrom May 2010 to December 2019 was conducted in the Department of Organ Transplantation，923thHospital of PLA Joint Logistic Support Force．The causes of death and loss of graft function were analyzed.Results Recipient’s survival rates in the 1，3，5 and 8 years were 98.28%，98.28%，92.24% and 89.99%，respectively．The 1，3，5 and 8 year survival rates of pancreas grafts were 86.21%，84.48%，78.40% and 76.16%，and that of kidney grafts were 98.28%，98.28%，82.83% and 80.60%，respectively．The survival rates after bladder drainage（BD）procedure at 1，3，5 and 8 year was 96.15%、96.15%、 86.73% and 86.73% and the survival rates of enteric drainage（ED）procedure was 100%，100%，96.67% and 93.33% （P ＝ 0.187）. Conclusion Simultaneous pancreas-kidney transplantation has a good long-term effect on end-stage diabetic nephropathy. Surgical complications are the main factors affecting the long-term outcomes. ED procedure may have a betterlong-termprognosis. Infection，rejectionand recipient death are also important factors for graft functionloss.