Objective To investigate the safety and efficacy of islet transplantation after failed pancreas transplantation， and to summarize the literature experience. Methods The clinical data of 3 patients with islettransplantation after failed pancreas transplantation in the first Affiliated Hospital of Sun Yat-sen University wereretrospectively analyzed and followed up for 6 months.Results In the 3 patients who received islet transplantation afterfailed pancreas transplantation， the islet function was good after operation， the level of fasting C-peptide was significantly improved compared with that before surgery. All patients stopped using exogenous insulin or reduced the dosage by morethan 2/3， and their blood glucose was stable. Conclusion islet transplantation after failed pancreas transplantation canbe a remedial treatment for diabetes mellitus with high efficacy and safety. 

 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 explore the clinical application value of extended release tacrolimus in longterm adult liver transplantation recipients with stable liver function. Methods The clinical data of long-termliver transplant recipients who were followed up in our hospital from January 2018 to January 2023 and converted to extended release tacrolimus were reviewed. The changes of liver function，renal function，tacrolimus drug concentration and CD4+ T cell count at different time points before and after the application of extended release tacrolimus were analyzed. Results A total of 21 patients were treated with extended release tacrolimus after liver transplantation. The male to female ratio was 13 ∶ 8. The average age was（60.07±8.24）years old. The conversion time（from liver transplantation surgery）was（28.85±49.47）months. The dose ratio of immediate- and extendedrelease tacrolimus was 1 ∶ 1.03. Compared with that before conversion，the levels of alanine aminotransferase （ALT），aspartate aminotransferase（AST），γ-glutamyl transpeptadase（GGT），alkaline phosphatase（ALP）， creatinine（Cre），bloodureanitrogen（BUN），as well as the number of CD4+ T cells and tacrolimus concentration were not statistically significant in 2，4，12 weeks after dressing change. Three patients showed slight fluctuations in liver function，and liver function returned to normal after adding extended release tacrolimus. Conclusion The adult liver transplantation patients with stable liver function were changed from immediate tacrolimus to extended release tacrolimus，the liver function was stable and the rejection rate was low，the renal function was not significantly improved. 

Objective The purpose of this study is to evaluate the potential effect of ischemia-free liver transplantation（IFLT）technology in reducing the recurrence of hepatocellular carcinoma（HCC）after liver transplantation，and to compare it with the outcomes of conventional liver transplantation（CLT）. Methods We conducted a retrospective cohort study，including 208 HBV-HCC patients who underwent liver transplantation at the First Affiliated Hospital of Sun Yat-sen University from January 1，2018，to May 31，2021. Among them，22 cases received IFLT，and the remaining 186 patients received CLT. Patients were divided into IFLT and CLT groups based on the type of surgery they received，and the tumor recurrence rate，early postoperative liver function indicators，incidence of complications，and other perioperative data were compared between the two groups. The primary endpoint was tumor recurrence，and secondary endpoints included early allograft dysfunction（EAD），andserum alanine aminotransferase（ALT）and aspartate aminotransferase（AST）levels. Results The recurrence-free survival period in the IFLT group was significantly higher than that in the CLT group（P ＝ 0.037）. The incidence of EAD in the IFLT group（4.5%）was significantly lower than that in the CLT group（26.3%，P ＝ 0.046）. The peak serum ALT and AST levels，as well as the peak total bilirubin levels，were all significantly lower in the IFLT group compared to the CLT group within seven days postoperatively. Conclusion IFLT technology helps avoid ischemiareperfusion injury（IRI）by maintaining the blood and oxygen supply to the liver graft，which reduces the risk of hepatocellular carcinoma（HCC）recurrence and improves the quality of the donor liver. IFLT is expected to become an effective strategy for reducing the recurrence of HCC after liver transplantation and improving patients' long-term prognosis.