Objective To summary the application value of pulmonary sequestration，anesthesia management and extracorporeal membrane oxygenation（ECMO）during lung transplantation anesthesia. Methods Clinical data of 330 cases of lung transplant recipients were collected，age 51.4±9.6 yearsold，ASA grade Ⅲ or Ⅳ . All patients were treated with preoperative oxygen clinotherapy，including 6 cases with tracheotomy and 12 cases with tracheal intubation and respiratory support. During the surgery, all patients were treated by intravenous injection of midazolam 0.05-0.1 mg/kg，fentanyl 4 μg/kg，etomidate 0.2-0.4 mg/kg and vecuronium 0.1 mg/kg. A double lumen bronchial tube，a single chamber double balloon catheter（Univent tube） or a bronchial obstruction wasselected according to the need of operation. Ventilation mode was used in pressure control，and the parameters were adjusted according to the blood gas index and vital signs，manual ventilation if necessary. ECMO was used in patients who could not tolerate single lung ventilation and cardiac dysfunction during surgery. Results 132 patients underwent single lung transplantation patients，121 of them were treated with non operative side double lumenbronchial tube ；3 patients were treated with tracheotomy before operation and 6 cases were treated with bronchial obstruction. 2 of them were treated with short stature and Univent tube. There were 198 patients underwent bilateral lung transplantation，187 cases of them applied the left double lumen endobronchial tube，among which 5 cases replaced the tube due to surgical operation punctured the cuff，7 cases applied the left bronchial anastomosis return tube ；6 patients underwent Univent tube ；5 cases used endobronchial blocker. 5 cases of bronchiectasis patients and 3 idiopathic pulmonary fibrosis（IPF）patients had sputum obstruction after induction of anesthesia，4 cases turnedbetter after treatment，1 case died due to continuous hypoxemia. ECMO was used in 148 cases，including 69 cases of pulmonary hypertension，17 cases of cardiac insufficiency，57 cases of hypoxia and 5 cases of hypercapnia. 133 cases immediately removed ECMO after surgery，15 patients continued to use ECMO due to the hemodynamic instability and poor postoperative oxygenation. Conclusion Rational application of pulmonary sequestration technology is the premise of the completion of lung transplantation anesthesia ；The effective management of respiratory and circulation in the patients during the perioperative period is the basis of ensuring the success of operation ；ECMO is an effective method for lung transplantation，which can improve the success rate of anesthesia in lung transplantation.

Objective To evaluate the effects of propofol on brain during pediatric parent livertransplantation. Methods 40 pediatric patients in Tianjin First Central Hospital with congenital biliary atresia wereprepared to do elective parent liver transplantation. There was no gender perference，age from six to nine months，their weight was from 6 to 9.5 kg，and ASA classification was Ⅲ or Ⅳ grade. They were randomly divided into two groups （n ＝ 20）：propofol group（P group）and control group（C group）. Their vein were opened after entering into operating room. They were injected with atropine 0.01 mk/kg，midazolam 0.10-0.15 mg/kg，etomidate 0.2-0.3 mg/kg，fentany 2-5 μg/kg and vecuronium 0.8-1.0 mg/kg through the venous pathway. They were carried out endotrachealintubation and mechanical ventilation after induction of anesthesia. Propofol were continuously pump-injected9-15 mg/（kg·h）until the end of the surgery in P group. 1%-2% sevoflurane were continuously inhaled in C group. Their blood samples were collected from central venous at the time of operation began（T0），30 min after anhepatic phase（T1），3 hours after hepato-reperfusion（T2），24 hours after hepato-reperfusion（T3）. S100-β expression and neuron-specific enolase（NSE）were detected. Results There were no significant difference in basic information of pediatric patients（age，weight，anhepatic phase，anesthsic time，operationtime，transfusion volume and urine volume）. Compared with T0，the concentration of S100-βand NSE were in serum increased at T1，T2 in P and C groups〔C group，S100-β（ng/ml）：11.29±3.45、8.66±1.57 vs. 5.26±0.94，P ＜ 0.05，NSE（ng/ml）：26.92±4.43、24.57±4.12 vs. 20.68±2.94，P ＜ 0.05 ；P group ：S100-β（ng/ml）：9.28±1.85、6.47±0.86 vs. 4.91±1.25，P ＜ 0.05，NSE（ng/ml）：24.50±3.26、22.23±3.07 vs. 19.89±4.40，P ＜ 0.05〕. Compared with C group，the concentration of serum S100-βand NSE were decreased in P group at T1-T3〔S100-β（ng/ml）：9.28±1.85 vs. 11.29±3.45、6.47±0.86 vs. 8.66±1.57、5.49±0.79 vs. 6.36±1.42，P ＜ 0.05 ；NSE（ng/ml）：24.50±3.26 vs. 26.92±4.43、22.23±3.07 vs. 24.57±4.12、20.04±20.71 vs. 21.94±3.07，P ＜ 0.05〕. Conclusion Propofol can alleviate brain injury during pediatric parent liver transplantation.

Objective To investigate the possibility of stroke volume variation （SVV）in guiding intraoperative volume management of renal transplantation which used the donor after cardial death （DCD）. Methods 60 patients scheduled for DCD renal transplantation in Tianjin First Center Hospital fromSeptember 2013 to June 2014 were enrolled and randomly divided into two groups ：30 patients in SVV-guided group and 30 patients in central venous pressure（CVP）-guided group. Electrocardiograph（ECG），pulse oxygen saturation（SpO2），invasive arterial blood pressure and CVP were monitored during the operation in two groups. In addition，SVV and cardiac output（CO）were monitored by FloTrac/Vigileo in SVV-guided group. Ringer's solution or polygeline were given〔2-5 ml/（kg·h）〕. In CVP-guided group，in accordance with the rehydration principleof Miller's Anesthesia（seventh edition），we maintained CVP within the range of 10-15 mmHg by regulating the infusion speed. Dynamic parameters，duration of operation，blood loss，infusion volume，inotropic medicines used intraoperatively and their dosage were monitored intraoperative. The time of seeing urine，intraoperative urinary volume，postoperative 24 h urinary volume，postoperative complication，postoperative ICU stay time，renal allograft function and postoperative hospital stay in two groups were also recorded. Results No significant difference was observed between patients during hospitalization and the survival rate of renal allograft. The dynamic parametersof SVV-guided group was more stable，while the infusion volume and postoperative ICU residence time were less than CVP-guided group〔infusion volume（ml）：3 327±205 vs. 3 550±229，P ＜ 0.01，ICU residence stay（h）：6.4±2.3 vs. 18.1±2.7，P ＜ 0.05〕. There were no significant differences in two groups of patients with intraoperative urinary volume，postoperative 24h urinary volume，postoperative adverse events，renal allograft function and postoperative hospital stay. Conclusion Compare with CVP，SVV can reflect circulatory volume status more accurately and predict fluid responsiveness of renal transplantation patients. SVV can conduct intraoperative fluidvolume for renal transplantation patients，reduce intraoperative infusion volume and postoperative ICU residence time.

Objective To study long-term effects of anti-HLA and anti-major histocompatibility complexclass I chain-related molecule A（MICA）antibodies after kidney transplantation on renal allograft . Methods A total number of 78 cases in Beijing Friendship Hospital，Capital Medical University which can be traced were selected after renal transplantation in October 2014. Panel reactive antibody（PRA）and MICA antibodies were detected. Serum creatinine and blood urea nitrogen test data were provided by the clinical laboratory. Results Among these78 cases of patients，Anti-HLA antibody and MICA antibodies were positive in 62 cases，There were 14 patients with normal renal function，the decrease graft function or graft loss were observed in 48 patients ；There were 16 cases of Anti-HLA and MICA negative patients，of which 5 cases in patients with normal renal function, and patients withdecrease graft function or graft loss were 11 cases. Conclusion Anti-HLA and MICA antibodies were importantfactors affecting the long-term survival of transplanted kidney.

Objective To explore the changes of the inflammatory mediators and myocardial injury duringthe hepato-reperfusion in patients undergoing liver transplantation. Methods A total number of 24 recipients who underwent liver transplantation received general anesthesia. Blood samples were collected from central veinbefore skin incision（T0 baseline），at 1 min of hepato-reperfusion（T1），2 h of neohepatic stage（T2），the end of surgery（T3）and four hours after surgery（T4），24 h after operation（T5）. Concentration of TNF-α，IL-6，cardiac troponin I（cTnI），creatine kinase MB（CK-MB）and lactate dehydrogenase（LDH）activity were detected in blood serum. Results All patients completed surgery successfully. Hemodynamic changed obviously during the anhepaticphase and hepato-reperfusion. The serum TNF-α，IL-6，cTnI and CK-MB concentrations and LDH activity at T2-T5 increased significantly compared with the baseline at T0〔TNF-α（ng/L）：182±29、89±22、71±26、28±13 vs. 21±8，IL-6（ng/L）：1751±255、1420±251、947±219、417±97 vs. 70±18，cTnI（μg/L）：0.126±0.045、0.215±0.065、0.252±0.055、0.198±0.045 vs. 0.042±0.018，CK-MB（μg/L）：5.1±1.7、10.3±2.2、15.2±2.5、10.3±2.2 vs. 1.6±0.5，LDH（U/L）：547±216、620±251、751±255、417±97 vs. 170±58，P ＜ 0.05 or P ＜ 0.01）〕. Conclusion To some degree，myocardial injury could be found during the neohepatic stage in patients undergoing liver transplantation，which may be associated with a great deal of inflammatory mediatorsreleasing. 

Objective To analyze the psychologic status and influence factors of the DCD preoperativetransplant patients，provide the basis for implementing psychological intervention，improve patients' unhealthy emotions for improving the preoperative patients' understanding of disease and treatment，let them treat the disease in a positive emotion，make the treatment smooth，guarantee the postoperative life quality of patients. Methods Questionnaire survey was applied to 108 registered patients from January 2014 to June 2014. The patients were divided into control group with regular nursing and experiment group with nursing intervention. SAS，SDS，MuIs-A and self-design psychological effect factor survey had been used to evaluate the psychological status and factor analysis. After intervention for half year，the same survey was applied and evaluated again. Results With the extension of thewaiting time, the patient will gradually exhibit a variety of emotional disorders. 70% of them show anxiety，the reason for 40% of those anxious patient was related to long-time disease，long waiting time，financial burden，repeatedly matching failure，unpredictability of transplantation，uncomprehensive understanding of disease. After nursingintervention，the situation of anxiety，depressed and uncertainty in illness in control and experiment group had improved （P ＜ 0.05）. Conclusion Taking nursing intervention according to influence factors can dramatically improve thepatient’s understanding and cooperation.