Objective To study the therapeutic effect of avatrombopag on severe thrombocytopenia（TCP）in patients waiting for liver transplantation. Methods This study was conducted by analyzing the clinical data of67 patients waiting for liver transplantation with severe TCP in the First Affiliated Hospital of Zhengzhou Universityfrom February 2021 to October 2022. The general information of patients and their platelet count before and afteravatrombopag treatment were collected in this study. Patients were divided into two groups for further analysisaccording to whether recombinant human thrombopoietin（rhTPO）was used at same time. Platelet count no less than 50×109 /L after treatment of avatrombopag was considered as effective response. Results The platelet count of67 patients waiting for liver transplantation with severe TCP was significantly elevated after using avatrombopag（P＝ 0.001）. Moreover，the platelet counts of 89.55%（60/67）patients were higher than 50×109 /L and there was no significant difference in the effective rate between different thrombocytopenia groups（P ＝ 0.373）. Furtheranalysis showed that combined therapy group（avatrombopag and rhTPO）acquired significant higher platelet count than monotherapy group（P ＝ 0.002）with similar basal count level before treatment（P＝ 0.064）. Furthermore，the percentage of patients whose platelet counts were more than 50×109 /L had no significant difference（P ＝ 0.228）between avatrombopag group 85.00%（34/40）and combined group 96.30%（26/27）. Conclusion Avatrombopag could increase the platelet level in severe TCP patients waiting for liver transplantation. Avatrombopag combined with rhTPO may have better therapeutic effect. 

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 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 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 investigate the effect of polymorphisms of CYP3A5 gene mutation on the metabolism of tacrolimus in renal transplantation recipients after surgery，and to compare the differences in followup parameters of patients with different metabolic function genotypes after kidney transplantation. Methods The recipients who received allograft kidney transplantation from January 2016 to December 2018 were selectedconsecutively，and the data of each follow-up in the perioperative period of kidney transplantation and the electronicmedical record system after the operation were sorted out，mainly including the general information before the operation，the dose of tacrolimus taken at each follow-up time point（the second week，one month，three months，six months，one year and two years after the operation），the concentration-dose ratio，liver and kidney functionpostoperative complications. CYP3A5 genotype was determined by PCR-SSP method before surgery，and kidney transplant recipients were divided into CYP3A5*1 expression group（AA，AG，28 cases in total）and CYP3A5*1 non-expression group（GG，124 cases in total）according to different genotypes. The differences of clinical indicators between the two groups during the follow-up period were compared and systematically analyzed. Results In this study，a total of 152 recipients of kidney transplantation were included according to the above criteria，including 30 recipients of living donor transplants from relatives and 122 recipients of DCD transplants. There were 52 females（34.21%）with an average age of（43.90±10.81）years and an average weight of（65.51±12.02）kg. Patients were divided into groups according to the difference of CYP3A5 expression，and the preoperative basic data of CYP3A5*1 expression group（AA，AG）and non-expression group（GG）were analyzed. The results showed that there was no statistical difference in the basic demographic clinical characteristics between the two groups. The C0/D value of tacrolimus in the CYP3A5*1 expression group was significantly lower than that in the CYP3A5*1 non-expression group at week 2，month 1，3，6，year 1 and year 2 after renal transplantation（P ＜ 0.01）. Thedaily tacrolimus dose of the CYP3A5*1 expression group was also significantly lower than that of the CYP3A5*1non-expression group at each of the above follow-up time points（P ＜ 0.01）. At the 1st month and 2nd year of follow-up after kidney transplantation，the serum trough concentration of tacrolimus in CYP3A5*1 expression group was significantly lower than that in CYP3A5*1 non-expression group（P ＜ 0.01）. There was no significant difference in blood tacrolimus concentration between the two groups at the follow-up time points of 2 weeks，3 months，6 months and 1 year（P ＞ 0.05）. There were no significant differences in serum creatinine，transaminase，hemoglobin， blood glucose levels，renal biopsy pathological types and postoperative complications between the two groups at each follow-up time point（P ＞ 0.05）. Conclusion Compared with CYP3A5*1 non-expression group，patients in CYP3A5*1 expression group metabolized tacrolimus faster after taking tacrolimus，and higher tacrolimus dose is usually required to reach the target blood concentration range after transplantation. The differences of CYP3A5 gene polymorphism among different renal transplant recipients have no significant negative effects on postoperative liver and kidney function，blood glucose level，graft rejection，graft survival and adverse events. 

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 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 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 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 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 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 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 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 study the safety and efficacy of retroperitoneal laparoscopic living donor nephrectomy after freeing subcostal nerve. Methods The clinical data of 126 donors who underwent retroperitoneoscopic living donor nephrectomy in the department of urology，the First Affiliated Hospital of Anhui Medical University from January 2016 to January 2019 were retrospectively analyzed. The donors were divided into two groups depending on whether the subcostal nerve was freed during donor kidneyharvesting，there were 74 donors in the traditional surgery group and 52 donors in the modified surgery group with freeing subcostal nerve. The donor’length of incision，surgery time，intraoperative blood loss，the length of hospitalization，kidney warm ischemia time and visual analogue scale（VAS）at 12 h，24 h and 48 h after surgery were compared between the two groups. Results All patients（n ＝ 126）finished thenephrectomy successfully，and none was transferred to open surgery. The differences in the length of incision，surgery time，kidney warm ischemia time and intraoperative blood loss between the two groups had no statistical significance（P ＞ 0.05）. The postoperative hospital stay was（6.6 ± 1.7）d in the traditional surgery group and（4.8 ± 1.7）d in the modified surgery group，and the difference between the two groups had statistical significance（P ＜ 0.001）. The VAS scores at 12 h，24 h and 48 h after operation in the modified operation group were significantly lower than those in the traditional surgery group，and the differences were statistically significant （P ＜ 0.001）. Conclusion Compared with traditional retroperitoneoscopic surgery，retroperitoneal laparoscopic donor nephrectomy with freeing subcostal nerves is safe and feasible，it can completely preserve the subcostal nerves and shorten the length of hospital stay and short-term postoperative pain.

Objective A survey was conducted to get some knowledge about the health related quality of life among the population of living donors of liver transplantation. And comparing them with healthypopulation. Methods Cross-sectional survey design was adopted. The questionnaire was developed based onthe European quality of life five-dimension questionaire（EQ-5D-5L），and the data were collected and statistically analyzed. The specific methods were the rank sum test（Kruskal-Wallis H）of multiple independent samples and the non-parametric test（Mann-Whitney U rank sum test）of two independent samples. Results There were totally 77 cases of donors recruited in this study，of which the proportion of males was 23.4%，while the one of female was76.6%. The average height was（161.9±9.0）cm. There were problems on the dimension of anxiety/depression， and the percentage was 68.8%. Followed by pain/discomfort，with the percentage of 32.5. The least problem was the dimension of self-care，only showing a proportion of 1.3%. The average score of VAS was 77.97±17.78. The variable of marriage showed significant difference on the dimension of self-care. The variable of gender showed significant difference on the dimension of anxiety/depression. With the comparison between the donors and healthy population， the dimension of pain/discomfort，anxiety/depression and VAS have statistical difference. Conclusion The healthrelated QOL of donors was relatively well. The gender and marriage were the impact factors. Comparing to the healthypopulation，some dimension of QOL has big space to improve. 

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 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 summarize the application and management of ECMO in 9 patients with lungtransplantation during perioperative period. Methods The data of ECMO assisted lungtransplantation patients who have been hospitalized in the thoracic surgery Department of Thoracic Surgery of the First Affiliated Hospital of Xi'an Jiaotong University since October 2022 were collected，and theirclinical characteristics and managementexperience were retrospectively analyzed.Results Of the9 patients，6 received VA-ECMO，2receivedVV-ECMO，and1 receivedVAV-ECMO. The VA intubation method is the axillary artery femoral vein method，the VV intubation method is the femoral vein internal jugular vein method，and the VAV intubation method is the femoral vein internal jugular vein ascending aorta intubation method. The main complications were hemorrhage and renal injury，and most of them were successfully removedfrom the machine. Conclusion ECMO technology is a safe and effective support tool during the perioperative period of lung transplantation，and its circulation and intubation methods，removal timing，complications management，and other issues need to be carefully managed.