Objective To observe the efficacy and survival status of single donor kidney transplantation with high Remuzzi score at zero-point biopsy. Methods A retrospective analysis was conducted on 178 recipients of single donor kidney transplantation who received deceased organ donation at the Second People's Hospital of Shanxi Province from January 2018 to January 2021. The donor kidneys underwent zeropoint biopsies and were evaluated with pathological Remuzzi scoring. The recipients were divided into high scoring group（≥ 4 and ≤ 6）and low scoring group（≤ 3）. The occurrence of delayed graft function of transplanted kidneys，postoperative renal function，occurrence of proteinuria，and survival of recipients and transplantedkidneys in both groups were observed with a follow-up time of 36 months. Results There were no statisticallysignificant differences（P ＞ 0.05）in gender ratio，body mass index，human leukocyte antigen（HLA）mismatch number，and donor kidney cold ischemia time between the two groups of recipients; there was no statistically significant difference in baseline blood creatinine and glomerular filtration rate before surgery（P ＞ 0.05）. A total number of 21 cases（23.6%）in the high scoring group experienced delayed graft function of transplanted kidneys after surgery，while 6 cases（6.7%）in the low scoring group experienced delayed graft function. The difference between the two groups was statistically significant（P ＜ 0.05），24 cases（27%）in the high scoring group developed proteinuria after surgery，while 9 cases（10.1%）developed proteinuria in the low scoring group. Through multiple factor analysis，it was found that the occurrence of proteinuria after kidney transplantation and the addition of mTOR immunosuppressants after surgery （OR ＝ 4.52， P ＜ 0.05）were related to thepreoperative Remuzzi score（OR ＝ 1.46，P ＜ 0.05）. At a follow-up of 36 months，the high scoring group had a blood creatinine level of（131.3±5.53）μmol/L and an eGFR level of（62.9±2.02）ml/（min · 1.73 m2 ）， while the low scoring group had a blood creatinine level of（121.3±2.18）μmol/L and an eGFR level of（65.0± 1.24）ml/（min·1.73 m2 ）. There was no statistically significant difference between the two groups（P ＞ 0.05）. Thesurvival rate of recipients in the high scoring group 36 months after surgery was 95.5%（85 cases），and the survival rate of transplanted kidneys was 95.5%（85 cases）. The survival rate of recipients in the low scoring group was 95.5% （85 cases），and the survival rate of transplanted kidneys was 97.7%（87 cases），with no statistically significant difference（P ＞ 0.05）. Conclusion Single kidney transplantation with a pre-transplant renal biopsy score of 6 ≥ Remuzzi ≥ 4 can achieve good long-term kidney survival and is worthy of clinical implementation. 

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

Objective To explore the clinical effects of retroperitoneal laparoscopic donor nephrectomy and open donor nephrectomy. Methods The clinical data of donors from January 2023 to April 2024 were analyzed retrospectively， including 46 males and 93 females， with an average age of （54.21±6.52） years. Retroperitoneal laparoscopic nephrectomy was used in 99 cases and open nephrectomy was used in 40 cases. Data of donor's past history，kidney position， donor's renal artery length， kidney dimension， number of arteries， operation time， intraoperative bloodloss， surgical incision length， postoperative maximum creatinine， postoperative maximum urea nitrogen， postoperative hospitalization days， postoperative total drainage， donor's renal artery length after removal， warm ischemia time， intraoperative peritoneal damage and fat adhesion， and complications were collected and analyzed. Results Comparedwith the open operation group， the incision of laparoscopic operation was significantly reduced， the amount of bleeding and postoperative drainage were significantly reduced， the hospital stay of donors was significantly shortened （P ＜ 0.05），and the warm ischemia time was significantly prolonged （P ＜ 0.05）. Male， larger body mass index， previous smoking history， trauma history， larger kidney dimension， excessive bleeding during operation， peritoneal damage and fat adhesion significantly increased the operation time （P ＜ 0.05）. Conclusion On the premise of ensuring the quality of the kidney， laparoscopic operation has the advantages of small incision， less bleeding and quick recovery.