Objective The purpose of this study is to summarize the situation of non-standard donor hearttransplantations（HTx）in Fuwai Hospital，and to compare the HTx outcomes between non-standard donors group and conventional donors group. Methods A retrospective analysis of HTx cases in Fuwai Hospital from January 2015 to December 2021 was conducted to summarize the use of non-standard donors; compare the clinical data of thetwo groups of recipients; analyze the postoperative survival of the two groups of recipients; explore the association between indicators of non-standard donors and postoperative 1-year mortality. Results A total of 616 HTx patients were analyzed，of which 456 were male（70.0%）and 160 were female（30.0%）. The average age was（46.0 ± 14.1）years. In these patients，330 patients were included in non-standard donor group，and 289 were included in conventional standard

donor group. Compared with the standard donor group，the non-standard donor group have longer cardiopulmonary bypass time，higher proportion of postoperative cardiac dysfunction，postoperative ECMO and IABP insertion and postoperative infection. Longer postoperative mechanical ventilation duration and ICU hospitalization duration，and higher serum creatinine before discharge（P ＜ 0.05）were also seen in the non-standard donor group. In terms of prognosis，the in-hospital mortality of the non-standard donor group was higher. Kaplan-Meier survival analysis showed that the one-year survival rate of the non-standard donor group was lower than that of the standard donor group（P ＜ 0.01），but there was no significant difference in the long-term survival rate of the patients who survived for one year after operation between thetwo groups（P ＝ 0.12）. After adjusting for recipient-related factors，multivariate analysis showed that donor coronaryartery abnormalities and donor high-dose positive inotropic drug support were independent risk factors for one-year mortality. Conclusion The application of non-standard donor heart can alleviate the shortage of donor heart resources，but it may increase post-transplant early mortality. Donor high-dose vasoactive drugs support and abnormal coronary artery of donor heart are risk factors of one-year mortality，so we should pay more attention to the management and assessment of donors before donation.

Objective To study the pathomorphological characteristics of extrahepatic portal vein wallthickening in children with biliary atresia, and to investigate the clinical significance and risk factors of the degree of extrahepatic portal vein wall thickening. Methods The clinicopathological data of 60 pediatric liver transplant recipients with biliary atresia from Children's Organ Transplantation Department of Tianjin First Central Hospital in June 2022 to December 2022 were analyzed. The pathomorphological changes of extrahepatic portal vein wall thickening in children with biliary atresia were observed. According to the median thickness of the total wall of extrahepatic portal vein, children with biliary atresia were divided into mild portal vein thickening group and severe portal vein thickeninggroup. The survival time of native liver after Kasai operation was compared between the two groups. Univariate and multivariate logistic regression were used to analyze the influencing factors of the degree of extrahepatic portal vein wallthickening. Results The wall of extrahepatic portal vein in children with biliary atresia was thickened to varyingdegrees， and the main pathological changes were interstitial edema under vascular endothelial cells， proliferation of fibers and fibroblasts， and a small amount of inflammatory cell infiltration. The intimal thickness of extrahepatic portal vein was 110（30 ～ 640）μm. Total wall thickness was 373（160~1320）μm. The ratio of portal vein intima thickness to total portal vein wall thickness was 0.341（0.105 ~ 0.636）. Biliary atresia patients were furhter grouped, total wall hickness ≤ 373 μm was defined as portal vein mild thickening group, total wall thickness ＞ 373 μm was defined as severe portal vein thickening group. The survival time of native liver in severe portal vein thickening group was significantly lowerthan that in mild portal vein thickening group （P ＜ 0.05）. Univariate analysis showed that Kasai operation history and cholangitis history were related factors affecting the degree of extrahepatic portal vein wall thickening in biliary atresia （P ＜ 0.05）. Multivariate analysis showed that the history of cholangitis was an independent risk factor for the degree ofextrahepatic portal vein wall thickening in biliary atresia （odds ratio ＝ 4.000, 95% confidence interval as 1.272 ~ 12.578, P ＜ 0.05）.Conclusion Extrahepatic portal vein wall thickening in children with biliary atresia was mainly characterized by interstitial edema under vascular endothelial cells, proliferation of fibers and fibroblasts, and a small amount of inflammatory cell infiltration. The degree of extrahepatic portal vein wall thickening in biliary atresia may affect the survival time of native liver after Kasai operation. Prevention and treatment of cholangitis could help to reduce the degree of portal vein wall thickening. 

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 evaluate the clinical efficacy and prognosis of liver transplantation for langerhans cell histiocytosis（LCH）in children with liver cirrhosis. Methods The clinical data and treatment experience of 10 cases of liver transplantation for LCH in children with liver cirrhosis in the Tianjin First Central Hospital were descriptively analyzed. Results All children were in decompensated stage of liver cirrhosis caused by LCH before liver transplantation. Among the 10 LCH patients，7 patients underwent cadaveric liver transplantation，3 patients underwent living donor liver transplantation. The type of graft was left lateral lobe in 7 cases，whole liver in 2 cases，and right hemi-liver in 1 case. The graft to recipient weight ratio ranged from 1.41% to 4.53%. The valuesof alanine transaminase（ALT），aspartate aminotransferase（AST），and total bilirubin（TBil）started to decreasefrom the first postoperative day and continued with a downward daily trend in most recipients. The median followup time was 12.11 months. Two patients presented with extrahepatic recurrence and were well-controlled after theadministration of chemotherapy and targeted drugs. The survival rate of the patients after liver transplantation was90%. Conclusion Liver transplantation is an effective treatment for the decompensated stage of liver cirrhosis caused by LCH in children，a better survival outcome may be achieved. 

Objective To explore the therapeutic benefit of liver transplantation（LT）on congenital bile acid synthesis disorder（CBAS）. Methods The clinical data of 5 cases with CBAS who underwent liver transplantation at Huashan Hospital affiliated to Fudan University from October 2015 to December 2022，were analyzed retrospectively. Among them，there was 1 patient with CBAS type 1，2 patients with CBAS type 2 and 2 patients with cerebrotendinous xanthomatosis（CTX）. There were 3 males and 2 females. The median age was 9（7 ~ 12）months. There were 4 cases of living donor liver transplantation and 1 case of donation after citizen's death（DCD）liver transplantation. The median follow-up time after surgery was 74（60 ~ 84）months. The preoperative clinical characteristics，intraoperative conditions，postoperative follow-up data of the children were analyzed to evaluate the efficacy of liver transplantation. Results All the surgeries were completed successfully，and one child had rejection，one child had chyllesomerhea，and two children were infected with hepatitis B virus（HBV）. After surgery，one child died due to lung infection，and the remaining 4 children recovered their liver function welland survived normally. Symptoms suchasjaundice and itching subsided，and their growth and development improved. Conclusion Liver transplantation is aneffective treatment for children withCBAS whodo notrespond well to medicaltreatment. 

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 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.

Objective To explore the establishment of standardized samples collection， storage，management and service system with complete facilities and information exchange for blood diseases， so as to achieve the standardized storage of a full range of hematological living cells and related blood components， and to provide resources for clinical research and transformation application. Methods The blood biobank was integrated with collection and processing， quality control， gene analysis and function identification， and has an independent storage area. It also has an integrated information management system connected with clinical diagnosis， treatment data and omics information. Characterized by the preservation of bone marrow living cells for blood diseases， standardized samplecollection， processing， storage and use procedures are established， and regular quality control testing is carried out. A comprehensive sharing mechanism and operational model was established. Results The blood biobank has stored a total of more than 400000 samples of hematological living cells and other related blood components， which has achieved full coverage of samples for all clinical diagnosis and treatment of disease types， and it has established more than 700 strains of disease derived iPSC. Six fresh and frozen samples， were randomly selected，and all of them were qualified， providing sample support for the high-quality scientific research output of the institute. Conclusion Standardized collection，preparation， storage and use of hematologic pathological living cells and related components can be achieved through the whole process control， an upgraded version of physical and virtual integration biobank that integrates biological samples，clinical diagnosis and treatment data， bioinformatics and other biomedical information and resources can be established. 

Objective To explore the risk factors of cytomegalovirus（CMV）infection after liver transplantation by analyzing the difference of clinical characteristics and the intrapatient variability（IPV）intacrolimus of the recipients after liver transplantation. Methods A retrospective cohort study was conducted inpatients who underwent liver transplantation in the Liver transplantation center of the First Affiliated Hospital of Xi'an Jiaotong University from January 2015 to December 2019. Among the patients of tacrolimus-based immunosuppressionregiments，290 cases were included according to inclusion and exclusion criteria，and were divided into infection group and control group according to the occurrence for CMV infection. Tacrolimus IPV expressed as the coefficientof variation（CV）was calculated from at least 3 tacrolimus trough levels obtained between months 2 and 6 after liver transplantation，P ＜ 0.05 was considered statistically significant. Results As of December 31 2021，290 liver transplant recipients included in the study，the follow-up ranged from 6 to 83 months. The survival time of recipients in CMV infection group was shorter than that in control group〔（1 707.08±225.96）d vs.（2 214.16±45.03）d，P＜0.05〕.The clinical data of recipients in the CMV infection group and the control group included basic characteristics of donor and recipient，operation-related data，postoperative complications，and the tacrolimus C0 of 2 to 6 months after surgery，there were no significant differences（P ＞ 0.05）. However，the incidence of severe infection and acute rejection in CMV infection group were higher than that in control group（31.58% vs. 4.43%，15.79% vs. 0.74%， P ＜ 0.05）. The influence of some variables on the occurrence of CMV infection after liver transplantation was analyzed by the Cox proportional hazards model analyzed. The results showed that the recipients with high tacrolimus CV had a significantly increased risk of CMV infection after liver transplantation（P ＜ 0.05）. Furthermore，the results showed that CMV-IgM positivity before of liver transplantation，postoperative ICU stay time and tacrolimus CV within 2 to 6 months were an independent risk factors for CMV infection after liver transplantation（all P ＜ 0.05）. Conclusion The preoperative CMV-IgM in liver transplant recipients，the time of ICU stay and the high tacrolimus IPV（CV ≥ 34.36%）within 2 to 6 months after surgery were significantly associated with CMV infection after liver transplantation. CMV infection may lead to an increased incidence of severe infection and acute rejection after livertransplantation. 

Objective To retrospectively analyze the safety，efficacy of target dose candesartan in the treatment of chronic heart failure（CHF）and the factors affecting the target dose. Methods From March 2018 toDecember 2020，CHF patients with clinically stable NYHA Ⅱ - Ⅲ receiving candesartan in the outpatient departmentwere enrolled. Demographic data，drug combination therapy，echocardiographic parameters（UCG），NT-proBNP，serum creatinine and potassium were collected. According to the dose of candesartan，these patients were divided into candesartan target group（32 mg）and less than 32 mg group. Pair t-test was used to compare the difference of efficacy between groups before and after treatment. Logistic regression analysis was used to analyze the factors affecting candesartan to reach thetarget dose. Results A total of 79 patients were included in this study. The median follow-up time was 11 months. A total number of 40 patients（50.6%）reached the target dose of candesartan. The average candesartan dose of the other39 patients（49.4%）was 18.8±7.6 mg. A total of 60 patients with left ventricular ejection fraction（LVEF）less than 50% were included in this study（35 cases in the standard group and 25 cases in the substandard group）. After the candesartan treatment，the level of LVEF increase 30.7% significantly（P ＜ 0.001），and a significantly decrease of left ventricular end-diastolic diameter〔LVEDD，（67.7±9.3）mm vs（62.2±10.3）mm，P ＜ 0.01〕and left atrial diameter〔LAD，（46.2±7.3）mm vs（43.0±5.4）mm，P ＜ 0.05〕was observed in the target group. In the substandard group，LVEF increased by 15.1% comparing with the baseline（P ＜ 0.01），while the diameters of LVEDD and LAD were not significantly improved （P ＞ 0.05）. A total of 19 CHF patients with LVEF ≥ 50%（HFpEF）were included in this study. The diameters of LVEDD，LVEF，LAD，and the level of NT-proBNP improved after treatment but failed to reach the statistical significance（P ＞ 0.05）. Multivariate analysis showed that the etiology of dilated cardiomyopathy，LVEF ＜ 40% and high LAD diameter were the favorable factors for reaching the target dose of candisartan. The high level of NT-proBNP and the combined application of spironolactone negatively affected the dose reaching the standard. The diastolic blood pressure decreased significantly after treatment both in the standard group〔（83.4±12.4）mmHgvs（77.4±13.5）mmHg，P ＜ 0.05）〕and thenon-standard group〔（79.4±12.9）mmHg vs（74.2±13.1）mmHg，P ＜ 0.05）〕，while the systolic blood pressure did not decrease significantly（P ＞ 0.05）.1 patient was newly diagnosed of renal insufficiency in the standard group with creatinine of 115 μmol/L（normal value ＜ 104 μmol/L）and 4 in the substandard group（creatinine 143 μmol/L）. In the substandard group，the systolic blood pressure decreased below 90 mmHg in 1 patient. There was no hyperkalemia in both groups. Conclusion Thetarget dose of candesartan is more effective in the treatment of CHF，And the safety is satisfactory. A high level of NT-proBNPrather thana lowlevelof LVEF isthe limiting factor for candesartan toreach the targetdose

Objective To explore the effect of surgical method selection on prognosis of lung re-transplantation. Methods A retrospective cohort study was conducted on patients（n ＝15）who chose re-transplantation due to chronic lung allograft dysfunction（CLAD）at Wuxi Lung Transplant Center from January 1，2015 to December 31，2021.We analyzed the indications for re-transplantation，intraoperative conditions，perioperative and longterm survival rates，and compared them within groups based on the choice of surgical methods. Results In the 15 CLADpatients，the survival rate of patients who chose right single lung and double lung re-transplantation was better than that of left single lung re-transplantation，while double lung re-transplantation was not better than right single lung transplantation. Conclusion The choice of surgical method for the recipient of secondary lung transplantation affects the prognosis of patients . Further exploration is needed to select reasonable surgical methods according to different indications of patients. 

 Objective The incidence，pathological changes and differential diagnosis of commoncomplications after liver transplantation have been studied，through a retrospective analysis of the pathological dataof 209 liver transplant biopsy tissues from a single center. Methods A total of 209 biopsies were performed in145 patients with liver transplantation from August 2013 to April 2023, at the Organ Transplantation Center of the First Hospital of Jilin University. The liver tissues were fixed with 4% neutral formaldehyde solution， embedded in paraffin and sectioned continuously， routinely HE staining， Masson， D-PAS， reticular fiber histochemical staining， CK7， CMV， C4dimmunohistochemical staining and EBER in situ hybridization were performed. Results Acute T cell-mediated rejection （TCMR） was the most common （36.84%） complication， followed by drug-induced liver injury（DILI）（23.44%） and biliary complications （14.35%）， others include Hepatitis B and Hepatitis C virus infection or recurrence，ischemia-reperfusion injury， cytomegalovirus infection， chronic rejection， plasma cell-rich rejection， vascular complications， recurrent primary disease， primary graft dysfunction， and difficult-to-diagnose liver morphology. The diagnosis of acute T cell-mediated rejection was based on portal inflammation， bile duct inflammation and venous endothelial inflammation. In 58.44% cases of TCMR， the classic“Triad” of portal area was found. In DILI， there were swelling or ballooning degeneration of hepatocytes around central vein， steatosis with different degrees， cholestasis in hepatocytes and bile canaliculi. Biliary complication was characterized by cholestasis in hepatocytes and bile canaliculi， proliferation of small bile ducts along the interface of the portal tract，and interstitial edema.Conclusion The pathological diagnosis should be made after comprehensive analysisof the clinical manifestation， laboratory examination， imaging data and medication history. 

Objective To investigate the effect of tacrolimus on intestinal flora in donation after circulatorydeath（DCD）rats with acute rejection after liver transplantation. Methods To establish a stable normothermic machine perfusion（NMP）system. The thoracic aorta of Lewis rats was clamped for 30 minutes to obtain the DCD livers. The acute rejection model of orthotopic liver transplantation was established with brown norway（BN）rats as recipients. According to different treatment methods of liver，BN rats were divided into the following three groups ：sham operation（Sham）group，simple NMP（NMP）group and NMP combined with postoperative tacrolimus（FMP）group，with 6 rats in each group. Blood，liver and intestinal content samples were collected 14 days after operation. The liver function of blood samples was detected，the histological changes of liver were observed by HE staining，and the rejection activity index （RAI）was calculated. The intestinal contents were detected by 16SrDNA，and the changes of intestinal florastructure，diversity and function in each group were observed. Results The survival timeof ratsin FMP group（median survival time ＞ 60 d）was longer than that in NMP group（median survival time ＝ 16.5 d），and the liver function and liverhistopathology were significantly improved than those in NMP group（P ＜ 0.05）. The results of RAI showed that FMP group（2.00±1.23）was significantly lower than NMP group（7.60 ± 1.14）（P ＜ 0.05）. Compared with the NMP group，the abundance of intestinal flora in the FMP group was significantly decreased（P ＜ 0.05），and there were significant differences between the two groups. FMP group was rich in Firmicutes，Akkermansiaceae andLachnospiraceae，as well as the other glycan degradation and sphingolipid metabolism pathways.Conclusion Tacrolimus can improve liver injuryin rats withacute rejection after transplantation，andregulate the structure of intestinal flora and metabolic pathway. 

Objective To summarize the genotype and phenotype characteristics of children with coenzyme Q8B（COQ8B）-associated nephropathy and the prognosis related to kidney transplantation，in order to provide reference for the diagnosis and treatment of patients with COQ8B-associatednephropathy. Methods The genotypes，phenotypes and prognosis of children with COQ8B-relatednephropathy who underwent kidney transplantation in the First Affiliated Hospital of Sun Yat-sen University from 2017 to 2022 were retrospectively analyzed. The inclusion criteria of the patients were carriers of pathogenic mutation of COQ8B detected by next-generation sequencing（NGS）. Results A total number of18 children with COQ8B-associated nephropathy were included in the study，including 13 children with compound heterozygous mutation of COQ8B and 5 with homozygous mutation of COQ8B，c.748G ＞ C was the most commonmutation in this cohort. The average age of disease onset was（9.09±2.57）years，and the average age of reaching end-stage renal disease was（9.72±2.84）years. Among the 18 cases，15 cases showed isolated nephropathy and3 cases had extrarenal organ involvement. The average follow-up time was 31.7 months，during the follow-up period，only one patient had rejection，and there was no recurrence of primary nephropathy and renal allograft failure. Thegrowth of the children was improved after operation. The median height-for-age z-score（HAZ）before operation was -1.47（-1.95，-0.9），the median HAZ one year after operation was -1.25（-1.77，-0.7），and the median HAZ of the second year after operation was -0.91（-1.24，-0.34）. Conclusion COQ8B-associated nephropathy is characterized by isolated nephrotic syndrome and less involvement of extrarenal organs. Kidney transplantation is a safe and effective treatment for children who are already in the stage of advanced nephropathy.

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 investigate non-HLA antibodies characteristics and its relationship with graft pathology after renal transplantation. Methods Non-HLA antibody data of 444 recipients after renal transplantation from 2016 to 2022 were retrospectively analyzed， the recipients were divided into rejection group （47 cases）， nonrejection group （61 cases）， and stable renal function group （336 cases） according to the pathological diagnosis of grafts. GraphPad Prism 9.0 was used to analyze the characteristics of non-HLA antibodies after kidney transplantation， the correlation between non-HLA antibodies and HLA antibodies， and the relationship between non-HLA antibodies and thepathological state of the renal allograft. Results Among the 444 recipients，310 cases （69.8%） were positive for nonHLA antibodies， which was positively correlated with HLA antibodies （r ＝ 0.606，P ＜ 0.001）. The median of MFIvalue and the median multiple of the threshold value of non-HLA antibodies in recipients with positive HLA antibodies was higher than that in recipients with negative HLA antibodies post-transplant. There were differences in common nonHLA antibodies among rejection group， non-rejection group and renal function stable group. Non-HLA antibodies were positively correlated with chronic glomerulopathy （r ＝ 0.186，P ＝ 0.033） and interstitial fibrosis （r ＝ 0.265，P ＝ 0.002）. Receiver operating characteristic curve （ROC） analysis showed that non-HLA antibodies were highly predictive of allograft arteritis （AUC ＝ 0.771）and chronic nephropathy （AUC ＝ 0.741）， but were not good at predicting rejection （AUC ＝0.605）. ConclusionThe positive rate of non-HLA antibodies was higher after renal transplantation. The common non-HLA antibodies in recipients with rejection， non-rejection and stable renal allograft function are different. Non-HLAantibodies are closely related to the chronic disease of graft kidney， and their predictive value for graft arteritis and chronic graft nephropathy is higher than that for rejection. 

Objective Through a retrospective analysis of clinical data of patients after lung transplantation，the correlation between tacrolimus trough concentration and early prognosis after lung transplantationwas analyzed. Methods From January 1，2017 to December 1，2020，the clinical data of 64 patients with good earlyprognosis of lung transplantation surgery（survival at 30 d）and 36 patients with poor prognosis in the early stage of lung transplantation surgery（30 d of non-survival）were admitted to the Department of Critical Care Medicine of Wuxi People'sHospital. According to the tacrolimus trough concentration on the first day after surgery，the patients were divided into low tacrolimus group（＜ 10 ng/ml）and high tacrolimus group（≥ 10 ng/ml）for prognostic analysis. The efficacy of tacrolimus and other clinical factors in predicting patients after lung transplantation outcomes were determined using univariate and multivariate Cox proportional hazard analyses. Results There was a significant difference in survival at30 days after lung transplantation between the high and low tacrolimus group（P ＜ 0.05）. According to the 30 d survival group comparison，there were significant statistical differences（P ＜ 0.05）in preoperative alanine aminotransferase，aspartate aminotransferase，tacrolimustrough concentration on the first postoperative day，acute renal insufficiency，postoperative time of mechanical ventilation，number of days in intensive care uint and primary graft dysfunction（PGD），and univariate Cox regression analysis showed that preoperative alanine aminotransferase，glutamate aminotransferase. The effect of tacrolimus trough concentration on survival time on the first postoperative day was statistically significant. Multivariate Cox regressionanalysis showed that tacrolimus trough concentration on the first postoperative day was not an independent risk factor for survival time. Conclusion Tacrolimus concentration hassome value in the early prognosis of patients after lung transplantation. 

Objective To analyze the clinical and pathological characteristics ofpost-transplantlymphoproliferative disorder （PTLD） in children after liver transplantation， and to provide reference for diagnosis and treatment. Methods The clinical and pathological data of PTLD patients after liver transplantation were collected from May 2020 to May 2022 in the Pediatric Liver Transplantation Department of Tianjin First Central Hospital. The gender， age， surgical method， postoperative immunosuppression regimen， PTLD treatment regimen， prognosis， clinical manifestations，liver function， plasma EBV-DNA， and imaging examination results were included. Pathological classification and immunohistochemical staining results were analyzed according to WHO classification of lymphoid tissue tumors in 2016. The clinical， pathological and prognostic features of the patients were analyzed retrospectively. Results There were 8 patients with pathologically diagnosed PTLD after liver transplantation， including 4 males and 4 females， aged 1 ～ 4 years. All the 8 patients had biliary atresia as the primary disease and underwent living donor liver transplantation （LDLT）. In this group，5 cases had lymph node enlargement，5 cases had digestive system symptoms （including abdominal pain，intestinal obstruction， ascites， and abdominal distension），4 cases had liver dysfunction，3 cases had fever， and 1 case had abnormal liver and kidney function. The mean plasma EBV-DNA was 46072copies/ml. The non-destructive， pleomorphic and monomorphic cases accounted for 12.5% （1/8），25% （2/8） and 62.5% （5/8）， respectively. Burkitt lymphoma， diffuselarge B-cell lymphoma and mature T-cell lymphoma accounted for 60% （3/5），20% （1/5） and 20% （1/8） of monomorphic PTLD， respectively. After diagnosis， tacrolimus was tapered or discontinued. Six patients received chemotherapy and2 patients received hemodialysis. Two cases of local space occupying operation was performed. Of the 8 patients，7 caseshad remission and 1 died. Conclusion The early diagnosis of PTLD and the selection of reasonable treatment planaccording to pathological classification can improve the prognosis of patients. Children receiving chemotherapy should be alert to tumolysis syndrome and be given active and effective intervention in time.