Objective To observe the high-flow nasal cannulae can reduce the rates of reintubation of patients with acute respiratory failure after the lung transplantation in intensive care unit（ICU）. Methods A total number of 18 cases of patients after lung transplantation with aute respiratory failure in the ICU after extubation were divided into two groups，control group of 9 patients，9 cases of observation group patients. Compareing the reintubation rates between control group patients using non-invasive mechanical ventilation and observation group of patients using HFNC. Results Observation group of reintubation rate was 22.22% ，the control group was 55.55%， reintubation rate difference of two groups of patients were statistically significant（P ＜ 0.05）. Conclusion HFNC can reduce the postoperative extubation in patients with acute respiratory failure after lung transplantation.

Objective To summarize the methods and key points of nutritional treatment for the lungtransplant patients at the different stages of peri-operation period and analyze the prognosis. Methods Through retrospective method，information of ten cases of lung-transplant patients was analyzed，of which，eight male and two female patients，age ranged 27 to 65 years old（average 45.0±12.8），five cases were pulmonary fibrosis，four cases were Silicosis，and one was COPD. Six cases received nutritional interfering before operation，but the rest did not due to emergency operation or other reasons. All of the ten cases were taken cared by clinical nutritionists and physicians for their nutritional treatment after operation. Results All of the ten cases received lung transplant successfully and survived longer than one month，but two cases died on 31st and 36th post-operation day due to multiple system organ failure and pulmonary infection respectively. The average post-operation hospital stay was（29.5±6.4）days（ranged 23-44 days）. Conclusion During peri-operation period，lung-transplant patients need to receive normative nutritional treatment carried out by professional nutritionist，who could solve the under-nutrition problem，which could further help the patients overcome the infection and transplant rejection，and improve their prognosis.

Objective To explore and summarize the therapeutic effect of cytomegalovirus（CMV）infection with valganciclovir prophylaxis after lung transplantation. Methods A retrospective analysis of 11 cases of lung transplantation in patients with clinical data in Henan Provincial People's Hospital from September 2015 to April 2017. We summarized the experience of treatment with valganciclovir prophylaxis after lung transplantation CMV infection. Results 11 cases of patients after lung transplantation were started oral valganciclovir oral 900 mg/d， 3 months of therapy，including 1 cases of postoperative 37 days due to liver and kidney failure，bronchial anastomotic fistula infection 1 cases death loss prevention were lost. The remaining 9 cases had not yet found signs of giant cell virus infection. Effect of CMV infection in lung transplantation. Conclusion Prevention valganciclovir 3 months after the standard is exact and it helps to reduce postoperative complications.

Objective To investigate the risk factors of recurrent ventricular fibrillation in patients with silicosis and hyperthyroidism during and after lung transplantation, for its effective intervention and reducing the risk of operation. Methods Methods The clinical data of one patient with silicosis and hyperthyroidism who underwent recurrent ventricular fibrillation during and after lung transplantation was analyzed retrospectively, and the relevant literatures were reviewed. Results Male 69 years old, he needed lung transplantation because of respiratory failure with silicosis, but diagnosed with hyperthyroidism preoperatively. After standardized treatment in department of endocrinology, lung transplantation was performed after hyperthyroidism was well controlled. However, recurrent ventricular fibrillation occurred during and after the operation and successfully discharged after active rescue. Postoperative follow-up was conducted for three months，the patient recovered well. Conclusion For lung transplant patients with hyperthyroidism, we must actively intervene and regularly review the thyroid function and cardiac involvement. However, there will still be fatal arrhythmias during and after the operation.

Objective To investigate the risk factors of recurrent ventricular fibrillation in patients with silicosis and hyperthyroidism during and after lung transplantation, for its effective intervention and reducing the risk of operation. Methods Methods The clinical data of one patient with silicosis and hyperthyroidism who underwent recurrent ventricular fibrillation during and after lung transplantation was analyzed retrospectively, and the relevant literatures were reviewed. Results Male 69 years old, he needed lung transplantation because of respiratory failure with silicosis, but diagnosed with hyperthyroidism preoperatively. After standardized treatment in department of endocrinology, lung transplantation was performed after hyperthyroidism was well controlled. However, recurrent ventricular fibrillation occurred during and after the operation and successfully discharged after active rescue. Postoperative follow-up was conducted for three months，the patient recovered well. Conclusion For lung transplant patients with hyperthyroidism, we must actively intervene and regularly review the thyroid function and cardiac involvement. However, there will still be fatal arrhythmias during and after the operation.

Objective To investigate the application of immunosuppresive protocol during perioperative period of heart transplantaion. Methods A total number of 25 patients accepted allogaft heart transplantation from March，2014 to December，2016. The immunosuppresive protocol included Basiliximab + Tacrolimus（Tac）+ Mycophenolate mofetil（MMF）. After operation the patients were followed-up and we observed complications，severe infection incidence，the rejection rate，etc. Results A total number of 25 patients recovered smoothly. Acute renal failure occurred in 3 cases，one patient was discharged from the hospital after dialysis，one patient died after intestinal obstruction，and one died of respiratory failure. there was no acute rejection reaction，and the mortality rate within one month was 0.04%，and the survival rate within 3 months was 88%，1 year survival rate was 84%，and the average of the last follow-up was（2.89±0.85）mg/d. Conclusion The immunosuppresive protocol based on tacrolimus can effectively prevent rejection after heart transplantation.

Objective To invenstigate the clinical situation of donation after citizen's death（DCD）donor liver in adult recipients and to analyze the hemodynamic changes after transplantation. Methods Three successful DCD donor child-to-adult liver transplantations have reviewed since 2014 in Shanxi Provincial People's hospotal. All the three donors were male，with an average age of 7 years. All of them suffered with brain benign tumor. All recipients were female，they suffered from liver cirrhosis after hepatitis C or B. Ratio of donor liver volume to recipient standard liver volume（GV/SLV）were separately 45%，60% and 62%. Ratio of donor liver weight to recipient weight（GRWR） were separately 1%，1.4% and 1.4%. The patient accepted the orthotopic liver transplantation. Intraoperative ligation of spleen artery was done and T tube was placed into bile duct. Postoperative range of alanine aminotransferase（ALT）， bile flow，total bilirubin（TBiL）were observed，and color Doppler ultrasound monitored portal vein and hepatic arterial blood flow. After one year of follow-up visit，the recipient recovered smoothly. Results The change of ALT was stable after operation，and 1 weeks after operation，the patients recovered to normal. TBiL rised rapidly in the postoperative，reached the peak after 24 h，and decreased significantly after 72 h. After 72 h，bile fiow increased significantly. After the first day of the portal vein flow reached the peak，then the flow gradually slowed，and the tend was stable. The trend of the changes of hepatic artery resistance index was similar to that of vein. Conclusion DCD child-to-adult liver transplantation should only be used for comparatively matched donor and recipient. It is safe aneffective and alleviate the problem of insufficient donor liver. In order to prevent SFSS and biliary stricture，partial ligation of splenic artery and placement of T tube should be done.