Objective To explore a common cause of delayed graft function（DGF）and its diagnosis and treatment methods. Methods One patient after renal transplantation were reported，who experience hump shape change of urine up to 2 months，and the related literature of the disease were reviewed toanalyze the causes of DGF. Results The allograft kidney transplantation patient show a hump shape change of urine，and was treated by porcine immunoglobulin of anti-human T cells，and Danshen andChuanqongqin injection improving micro circulation. Regular hemodialysis was performed to remove the body of inflammatory mediators，and water， electrolyte and acid-base balance were maintained，and infection prevention and support treatment were done. Patient was discharged as urine output was gradually stabilized about 2 000 mL，and serum creatine around 130 μmol/LConclusion Full awareness of the common causes of DGF is helpful to reduce the incidence of DGF. In case of occurrence，early blood purification and auxiliary measures should be performed，and most DGF can recover.

Objective A method for interpretation of donor-specific antibody（DSA）when the donor human leukocyte antigen（HLA）typing information is unavailable but with suspected antibody-mediated rejection（AMR）was demonstrated，which may improve the accuracy of clinical diagnosis and treatment. Methods Fresh transplanted kidney tissues from two patients with suspected AMR were obtained and digested for total DNA extraction. Then HLA typings of the donor and recipient was conducted. The donor HLA typing was obtained by matching the total HLA typing information with the recipient peripheral blood HLA typing. HE staining and C4d immunohistochemistry staining of the paraffin-embedded tissues of the transplanted kidney were performed. DSA-mediated AMR wasdetermined based on the patient's clinical manifestations，pathological findings，recipient's peripheral blood HLAantibody test and HLA typing results of the donor and recipient. Results One case was diagnosed with DSA-mediated C4d-negative AMR and returned to dialysis after graft nephrectomy while the other case was not considered having DSA-mediated AMR. The patient’s condition improved after 3 d of high-dose prednisolone therapy. The patient was currently surviving with a well-functioning transplanted kidney. Conclusion The method of identifying DSA by the donor HLA typing results using the transplanted kidney biopsy tissues provides necessarytechnical support for the follow-up of kidney transplant recipients who seek care at different medical centers with unavailable donor HLA typing information. In patients with suspected AMR，HLA typing of donor and recipient，DSA interpretation，and pathological findings should be combined to make an accurate clinical diagnosis and to guide the precise treatment. 

Objective To investigate the current status of kinesiophobia in liver transplant recipients and to explore its influencing factors. Methods Liver transplant recipients who were hospitalized or followed up at theOrgan Transplantation Center of Jiangsu Province Hospital from January to September 2025 were selected by conveniencesampling. The 13-item Tampa Scale for Kinesiophobia （TSK-13）， Patient Health Questionnaire-9（PHQ-9）， FatigueSeverity Scale （FSS）， Sarcopenia-Five （SARC-F） questionnaire， and Health Literacy Scale for Chronic Patients were used for assessment. Univariate analysis， Pearson correlation analysis， and multiple linear regression analysis were performed to identify factors associated with kinesiophobia. Results The mean score of kinesiophobia among liver transplant recipients was （31.61±6.13）， and 37.6% of them had moderate-to-severe kinesiophobia. Univariate analysis showed that gender and living alone were significantly associated with kinesiophobia levels （P ＜ 0.05）. Pearson correlation analysis revealed that kinesiophobia scores were positively correlated with fatigue， sarcopenia， and depression scores （all P＜0.05）. Multiple linear regression analysis indicated that living alone， fatigue， and depression were independent influencing factorsof kinesiophobia （all P ＜ 0.05）. Conclusion Kinesiophobia is prevalent in postoperative liver transplant recipients，with nearly 40% experiencing moderate-to-severe levels. Living alone， fatigue， and depression are the main independent risk factors. Clinical medical staff should routinely screen for kinesiophobia and related risk factors， and implement comprehensive interventions for high-risk patients to effectively reduce kinesiophobia and improve long-term quality of life. 

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 investigate the clinical efficacy of peptide receptor radionuclide therapy （PRRT）in patients with recurrent neuroendocrine tumors （NETs） after liver transplantation. Methods A retrospective analysis was conducted on the clinical data of 5 patients with recurrent NETs after liver transplantation who underwent PRRT from April 2023 to May 2024 in Tianjin First Central Hospital. Adverse reactions and treatment efficacy were evaluated. Results The median follow-up was 15.6 months. Among the patients，1 achieved partial response （PR），3 had stable disease （SD）， and 1 experienced progressive disease （PD）. Liver function remained stable during treatment， and no rejection reactions occurred. Grade 3 neutropenia was observed in 2 cases， while grade 2 neutropenia occurred in 3 cases. Symptomatic treatment alleviated the condition in 4 cases， but 1 case had persistent severe neutropenia， leading to treatment discontinuation. Grade 1 ～ 2 proteinuria was observed in 2 cases. Conclusion PRRT is safe and effective for patients with recurrent NETs after liver transplantation. The main side effect is neutropenia， and PRRT can be considered as one of the multimodal treatment options. 

Objective To evaluate the efficacy and safety of bicyclol treatment in drug-induced liver injuryafter renal transplantation. Methods A retrospective analysis was performed on 36 cases of renal transplantation， who experienced drug-induced liver injury 3 months after transplantation from January 2010 to August 2013 in Second People's Hospital of Shanxi Province. 22 cases from October 2011 to August 2013 were served as test group （treated with bicyclol 25 mg/50 mg）, while 14 cases from January 2010 to September 2011 as control group（treated with capsule of Gan Caosuaneran 150 mg）. The patients in two groups received treatment 3 times per day for 4 weeks.Before and 4 weeks after treatment, the changes in alanine aminotransferase（ALT）, aspartateaminotransferase （AST）, total bilirubin（TBil）and serum creatinine（SCr）were recorded，as well as 50% decreased time and restore tonormal time of ALT. Adverse reaction induced by drugs was observed. Results ALT，AST and TBil after treatment in both groups were significantly lower than those before treatment（all P ＜ 0.05），but there was no significant change in SCr. There were no significant differences in above indexes before and after treatment between two groups （all P ＞ 0.05）. The average time of 50％ decrease in ALT and the time of return to normal in test group were significantly shorter than those in control group〔time of decreased 50％（days）：5.30±2.26 vs. 11.00±5.36，timeof return to normal（days）：7.60±4.71 vs. 16.00±9.71，both P ＜ 0.05〕. During treatment，there was no rejectionor drug-related adverse reaction in both groups. Conclusion The efficacy of bicyclol treatment on drug-induced liver injury after renal transplantation is precise，safe，and easy to use。

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 optimize triple immunosuppressive dose in renal transplantation. Methods According to the dose of triple combined immunosuppressive regimen，200 patients were divided into conventional dose group（n＝145）and low-dose group（n＝128）. The dose of immunosuppressive regimen at two，four weeks， two，three and six months post-transplantation，the incidences of acute rejection，pulmonary infection and patient/graft survival rate were compared respectively between the two groups. Results The dose of triple immunosuppressive agents in the low-dose group was significantly lower than that in conventional dose group at six months post-transplantation. During the first six months post-transplantation，acute rejection including biopsy-proven and clinical presumed acute rejection occurred in 24 of 145 patients（16.5%）in the conventional dose group，and in 24 of 128 patients（18.7%）in the low-dose group（P＞0.05）. At six months post-transplantation，pulmonary infection， especially severe pulmonary infection，had a significantly higher occurrence in the conventional dose than in the low-dose group（30.4% vs 10.2% and 22.1% vs 4.7% respectively，both P＜0.01）. At 12 months，patient survival rate was 89.7% and 98.4%（P＜0.01），while the graft survival rate was 86.9% and 96.9%（P＜0.01）in the conventional dose group and low-dose group respectively. Excluding the death caused by infection with normal renal function，no significant difference was noted between the two groups（P＞0.05）. Conclusion The low-dose combination of triple immunosuppressive agents post-transplantation can significantly reduce the pulmonary infection and mortality without increasing the incidence and severity of acute rejection and subclinical rejection.

Objective To investigate the significance of color doppler ultrasound for detecting hepatic arteryin pediatric liver transplantation. Methods Application of color doppler ultrasound to observe the hepatic artery in57 pediatric after liver transplantation，observe whether the signal of blood flow，systolicvelocity（S），diastolic velocity （D）and S/D. The minimum follow-up time is 2 months，the longest is 9 months. All patients with artery detection data were collected for analysis. Results No obvious abnormality of hepatic artery was observed in 52 cases with colordoppler ultrasound. Arterial flow signal could not be detected in 5 patients 5-8 days after transplantation and hepaticartery thrombosis was considered，in which 3 cases were confirmed by digital subtraction angiography（DSA），1 case by contrast-enhanced ultrasound and CT，and 1 case was confirmed to be ultrasonic false positive with DSA showedno obvious abnormal hepatic artery. Diagnosis coincidence rate of color doppler ultrasound in hepatic artery detection was 98%. Conclusion Color Doppler ultrasound provides an important basis for hepatic artery monitoring and early diagnosis of complication after liver transplantation.