Objective To investigate the current status of medication compliance and analyze its influencing factors in liver transplant recipients. Methods A questionnaire survey was conducted on the liver transplant recipients using the demographic information and Morisky Medication Compliance Scale.Results A total of 204 liver transplant recipients were enrolled in this study，52 cases（25.5%）of which werelower compliance，105 cases（51.5%）were moderate compliance and 47 cases（23%）were high compliance. Marital status，type of daily medication and the level of understanding in the medication were influencing factors in themedication compliance of the liver transplant recipients（P ＜ 0.05）. Conclusion The medication compliance ofliver transplant recipients remains to be improved. It is necessary to strengthen the recipient's own attention on the medicine. The regular follow-up and necessary medical intervention will be the key to long-term survival.

Objective To investigate the usage of immunosuppressive agents after liver retransplantation.Methods The clinical data of 54 adult liver retransplantation patients were retrospectively analyzed. According to the application of immunosuppressive regimen，the patients were divided into 4 groups ：①corticosteroid + basiliximab + tacrolimus + mycophenolic acid（MPA）quadruple immunosuppressive regimen ；② corticosteroid + basiliximab + tacrolimus triple immunosuppressive regimen ；③ basiliximab + tacrolimus + MPA triple immunosuppressive regimen ；④ basiliximab + tacrolimus two immunosuppressive regimen. Cases of acute rejection and infection were calculated andprognosis was

recorded. Results Among 54 patients who underwent liver retransplantation，15 patients died in 1 year after surgery，and the remaining 39 patients survived for a long time. There were 9 cases（16.7%）with acute rejection and 34 cases（63.0%）with infection with in 1 year after operation. Among them，there were 31 patients in protocol 1，and 4 out of 31 had acute rejection（12.9%），20 cases had postoperative infections（64.5%）. There were 15 patients in protocol 2，and 3 out of 15 hadacute rejection（20.0%）and 10 cases had postoperative infections（66.7%）; There were only 1 case in protocol 3，there was no acute convulsion（0%），1 case had postoperative infection（100%）; And there were 7 patients in protocol 4，2 out of 7 had acute rejection（28.6%），3 cases occurred postoperative infection（42.9%）. All the cases with acute rejection were relieved after increasing the dose of tacrolimus or the treatment with methylprednisolone. A total number of 12 infected patients died of infection，and the remaining 22 patients improved after anti-infective treatment. Conclusion The immune status of patients after liver retransplantation is complicated，and individualized immunosuppressive therapy is essential.

Objective To investigate the risk factors for the prognosis of liver retransplantation.Methods The clinical data of patients undergoing liver retransplantation from January 2000 to December 2015 were retrospectively analyzed. The risk factors related to survival were analyzed by binary logisticregression. Results The 1，3 and 5 years overall cumulative survival rates were 63%，52.4% and 51.6%，respectively. There were significant correlations between the survival rates and the factors such as operation years，preoperative bilirubin level，intraoperative blood transfusion volume，and post-operative intensive care unit（ICU）detention time. When grouped by operation years，the early group was established from 2000 to 2004，and thematurity group was established from 2005 to 2015. The 1，3 and 5 years cumulative survival rates in the early groupwere 41.7%，28.6% and 28.6%，respectively，while those in the maturity group were 65.5%，56.1% and 54.4%，respectively. Conclusion The prognostic factors of retransplantation were closely related to preoperative bilirubinlevel，surgical complexity and surgical experience. 

Objective To summarize therapeutic experience of liver retransplantation for early graft nonfunction. Methods Six cases of liver retransplantation for early graft nonfunction were analyzed retrospectivelyand surgical related indicators were compared with first liver transplantation. Results Operations weresuccessfully performed in all 6 cases and 3 out of 6 patients died during early postoperative period. The model for end-stage liver disease（MELD）scores before second operation were higher than their first operation（scores ：34.67±5.64 vs. 20.67±8.29，P ＜ 0.05）. The operation time of second operation was longer than that of first operation（min ：388.33±64.47 vs. 474.83±76.41，P ＜ 0.05）. The volume of blood transfusion in second operation was more than that in first operation（ml ：4 631.25±1 393.19 vs. 3 739.58±1 930.82，P ＜ 0.05）. There was nosignificant difference in anhepatic phase between second and first operation. The rate of post-operative infection after retransplantation was 66.7%（4/6）.Conclusion Liver retransplantation is the effective treatment for early graft nonfunction but with high risk.

Objective To analyze the safety of renal transplant from donors with primary central nervoussystem（CNS）tumors. Methods We retrospectively analyzed the clinical data of 21 donors with primary CNS tumors and the 28 corresponding renal recipients and 2 stimultaneous pancreas-kidney transplantation（SPK）between Apr 2014 and Jun 2018 in The Third Medical Center of the PLA General Hospital. Results The average age was（25.8 ± 16.7）years，including 13 males and 8 females. Nine donors underwent surgical tumor resection before donation. The pathological classification of these tumors included ：pineal benign tumor，spinal benign tumor，craniopharyngioma benign tumor，astrocytoma grade Ⅱ and grade Ⅲ，meningioma grade Ⅰ. Two patients underwent simultaneous pancreas-kidney transplantation，one patient recovered smoothly，splenic venous thrombosis was found in the other patient on the first day after surgery，and embolectomy was performed. The postoperative recovery was

smooth. The pancreas and kidney functions of the two patients were normal. Among twenty-eight kidney transplant recipients，one patient suffered from DGF after operation，the kidney function recovered after dialysis，one patient had urinary leakage and was cured by operation. One patient with lupus nephritis underwent kidney transplantation 8 years ago，and now lupus nephritis recurred，the donor was a 7-year-old boy who was diagnosed with brain stem glioma and no craniotomy was performed，lupus nephritis recurred again after 1 year，and dialysis was restored. Other patients recovered smoothly. At present，The renal function of 27 recipients was normal and no CNS recurrence was found in the follow-up. Conclusion Tumor transmission of renal allograft from donors with primary CNS tumors was inevitable but with low risk，this kind of donors could be used with careful assessment and it could effectively expand the source of kidney，reduce patient waiting time and mortality，but the donor kidney should be carefully evaluated and screened.

Objective To explore the effect of the holistic care on the quality of life assessment systemin patients with postoperative infection after kidney transplantation. Methods The clinical data of 92 patients with infection after renal transplantation in our hospital from January 2017 to December 2017, were analysed retrospectively. The patients were divided into nursing group（observation group）and routine nursing（controlgroup），according to different nursing plans，each group has 46 patients. The nursing quality were compared between the two groups，mainly on the scores of the nursing quality，survival quality score，anxiety score，compliance evaluation，physical comfort，environmental comfort ratings，and patient satisfaction. Results The comprehensive nursing quality（education，nursing attitude，nursing skills，ward management）in the observation group were significantly higher than that in the control group，and the difference were statistically significant（χ2 ＝ 14.286，P ＝ 0.003 ；χ2 ＝ 16.331，P ＝ 0.003 ；χ2 ＝ 19.247，P ＝ 0.002 ；χ2 ＝ 18.295，P ＝ 0.003）. The survival quality score in the observation group was significantly higher than that in thecontrol group，and the difference was statistically significant（t ＝ 4.672，P ＝ 0.002）. Anxiety scores in the observation group were significantly lower than that in the control group，and the difference was statistically significant（t ＝ -4.855，P ＝ 0.003）.The compliance score，physiological comfort score and environmental comfortscore in the observation group were significantly higher than those in the control group，and the difference werestatistically significant（t ＝ -19.218，P ＝ 0.002 ；t ＝ -14.821，P ＝ 0.003 ；t ＝ -16.115，P ＝ 0.002）.Nursing satisfaction in observation group was significantly higher than that in control group，and the difference was statistically significant（χ2 ＝ 4.873，P ＝ 0.001）Conclusion “The holistic care”intervention could reduce the psychologicalburden of patients and their families as well as relieve the pain on the body，mind and spirit in all aspects. This method could also improve the quality of patients' lives along with the quality of nursing work. It has important guidingsignificance for clinical management of infection after renal transplantation and related nursing work.

Objective To observe the changes of erythrocyte immune function and CD4，CD8 lymphocytenumber during perioperative period in renal transplant recipients. Methods A total of 25 recipients withkidney transplantation during January 2013 and March 2017 were chosen as the observation group，and 25 healthycontrols taking physical examinations were chosen as the control group. The erythrocyte immune function and the number of CD4，CD8 lymphocytes before and on the 3 d，7 d，14 d，1 month and 3 months after the transplantation was detected so as to observe the changes of immune function of red blood cells and the number of CD4，CD8 lymphocytes. Results The red cell rosette in the observation group were lower than those in the control group，the CD35，CD58，CD59 expressions before the transplantation in the observation group were lower than those in thecontrol group. The number of CD4，CD8 lymphocytes were slightly lower than the control group. Red cell rosette and the number of CD4 and CD8 lymphocytes decreased at first，and then gradually recovered. The surface CD35 dropped at first after the operation，and the CD58 and CD59 showed a slight increase after the operation，and then gradually recovered. Conclusion The immune function of erythrocyte was weak in recipients before transplantation，but the function can be recovered after transplantation. Its changes were basically consistent with lymphocytechanges，the erythrocytes immunity was involved in the regulation of immune function of lymphocytes and renaltransplant recipients.

Objective To investigate the effect of cardiac death organ donation（DCD）for kidneytransplantation in mesangial immunoglobulin A（IgA）deposition. Methods We retrospectively reviewed the renal donation by DCD in Zhengzhou People’s hospital between June 2015 and June 2017. Donors underwentpathological biopsy before surgery. The renal function and graft survival time were compared in mesangial IgA deposition group（IgA DCD group，n ＝ 24）and mesangial no IgA deposition group（no IgA DCD group，n ＝ 68）.Results In 92 cases, IgA deposition was found in 24 cases of mesangial area of donor kidney by pathological before operation. The mean serum creatinine levels at 12th month，24th month after operation were（92.48±9.70）μmol/Land（89.64±7.61）μmol/L in mesangial IgA deposition group，（93.77±8.82）μmol/L and（90.95±7.71）μmol/L in non-mesangial IgA deposition group，respectively. The mean Scr levels in patients at different time points two years after transplantation in two groups were no significantly different. After 12 ～ 36 months of follow-up，Kaplan-meier analysis showed no significant difference in survival rate between two groups. Conclusion There was no significantdifference between two groups on the short-term renal allograft function and allograft survival. The glomerular mesangial IgA deposition in kidney from DCD donors can be used as donor kidney source.