Objective To assess the safety and effectiveness of direct antiviral drugs（DAAs）in hepatitis C virus（HCV）infected patients who underwent kidney transplantation with HCV IgG antibodies positive and HCV infected kidney grafts. Methods A tobal number of 12 patients were retrospectively enrolled，9 patients with HCV underwent kidney transplantation. 1 patient received HCV IgG positive kidney and oral sofobuvir plus vertapavir antiviral therapy，2 patients received kidneys infected with type 6 a HCV，oral anti-viral treatment with sofosbuvir plus vertapavir was given. All patients were regularly reviewed for trough concentration of immunosuppressiveagents in the blood，serum transaminase levels，creatinine level and serum HCV RNA level to assess the efficacy and safety of DAAs treatment. Results Patients with HCV infection achieved a sustained virological response （SVR）after kidney transplantation. Patients receiving HCV IgG antibody positive kidney had negative expression of HCV RNA and HCV IgG. Postoperative review showed positive expression of HCV IgG，HCV RNA continued to be negative during 12 weeks follow-up time in patients who received HCV-infected kidneys. In addition to pulmonary infection in one patient during treatment，the remaining patients had stable creatinine level and blood concentration of immunosuppressive agents，and serum transaminase levels were lower than before treatment during follow-up， the adverse effect was dizziness in 1 case. Conclusion Under close supervision，patients with hepatitis C were safe and reliable to use DAAs after renal transplantation. It is safe to use HCV IgG positive kidney and HCV infected kidney as donor grafts under the premise of effective antiviral therapy.

Objective To investigate the effect and intervention strategy of adopting elderly donor liver on graft function and survival rate of recipients after liver transplantation. Methods The patients who underwent liver transplantation from January 2016 to June 2017 were paired selected and divided into two groups based on the age of donors ≥ or ＜ 60 years old ：the elderly donor（ED，n ＝ 74）group and the non-elderly donor（NED，n ＝ 74） group. The recovery of liver function，complications，graft and recipient survival rate were compared. Results The incidence of early allograft dysfunction and biliary complications in the ED group were 47.3% and 21.6%， significantly higher than those in the NED group which were 28.4% and 9.5%（P ＝ 0.018，P ＝ 0.041）. The survival rate of grafts was significantly lower in the NED group compared with ED group（P ＝ 0.023）. In ED group， the incidence of early allograft dysfunction was 70.6% in patients with cold ischemia time ＞ 12 h，significantly higher than 40.4% in patients with cold ischemia time ＜ 12 h（P ＝ 0.003）.Conclusion The application of elderlydonor liver will influence the early functional recovery and survival rate of the graft. Shortening CIT could significantly reduce the incidence of early allograft dysfunction and improve the prognosis of the recipient.

Objective To investigate the effect of vascular interventional therapy on transplanted renal arterial stenosis（TRAS）. Methods The patients with concurrent TRAS among 513 patients with renal transplantation were retrospectively enrolled. The changes of creatinine，blood pressure and hemodynamic index of transplanted renal hemography in patients 1 week，1 month，3 months，and 6 months after treatment were compared. Results Of the 513 patients with kidney transplantation，9 experienced concurrent TRAS，with an incidence rate of 1.75%. The 9 patients were treated with vascular interventional treatment，8 patients received simple balloon expansion and 1 patient was implanted with vascular stents after balloon expansion. In patients with cystic dilation，3 cases recurred within 2 months of surgery，with a secondary stenosis rate of 33.3%，and the secondary cystic dilation was successful. All patients were followed up for 6 months，and one patient died of lung infection 4 months after vascular intervention therapy. Blood creatinine in pre-treatment patients was（142.3±59.6）μmol/L，and were （133.5±57.2）μmol/L，（131.8±35.6）μmol/L，（127.0±29.9）μmol/L，（125.7±37.1）μmol/L at 1 week，1 month， 3 months，6 months after treatment，respectively. Although there is no statistical difference，there is a downward trend after treatment. Pre-treatment systolic pressure was（149.7±19.3）mmHg（1 mmHg ＝ 0.133 kPa），the value were（131.3±4.1）mmHg，（136.2±7.9）mmHg，（128.5±6.6）mmHg，（127.1±3.6）mmHg at 1 week，1 month，3 months，6 months after treatment. Systolic pressure was significantly reduced compared with pre-treatment level. The Pre-treatment transplanted renal aortic peak systolic velocity（PSV）was（297.2±105.3）cm/s，the velocity were （171±56.3）cm/s，（185.8±64.8）cm/s，（197.5±69.1）cm/s，（178.8±75.4）cm/s at 1 week，1 month，3 months， 6 months after treatment, There are statistical differences compared with pre-treatment. The interfolate arterial PSV， interfolate artery resistance index were similar at 1 week，1 month，3 months，6 months after treatment compared to preoperative levels. Conclusion Vascular interventional therapy is effective in improving the transplanted kidney function of TRAS patients.

Objective To investigate factors affecting medication adherence of patients who take immunosuppressive agents after kidney transplantation and to evaluate the effectiveness of specific nursing interventions. Methods A questionnaire survey was conducted in patients and nurses to find out the factors that affect medication compliance，and targeted nursing intervention methods were proposed. A total of 100 renal transplant patients in 2017 were collected and divided into intervention group and control group. The intervention group were subdivided into 4 groups，3 received single intervention seperately，the comprehensive intervention group received all of the intervention. The effect were evaluated with modified Morisky Medication Adherence Evaluation Scale，and the results were just good or not good. Chi-square test was used to analyze difference between groups. Results Factors that affect medication adherence were：① insufficient knowledge about the importance of taking medicine under order. ② Problem concerning medicine management. ③ Inadequate management of patients after discharge. Rate of good adherence in all intervention groups was 84%，that is higher than 60% in the control group（P ＜ 0.05）. The rate of good adherence in comprehensive intervention group was 91.3% which was significantly higher than the control group （P ＜ 0.05）. Comparison between other groups didn’t show any statistical difference. Conclusion Our studyexplored several important factors that affect medication adherence of patients who take immunosuppressive agents after kidney transplantation. Interventions focusing on these factors improve medication adherence. Comprehensive intervention was more effective than applying single intervention method

Objective To analyze the correlation between biomarkers in Lifeport perfusion solution and delayed graft function（DGF）after deceased donor（DD）renal transplantation. Methods The parameters of Lifeport perfusion maintenance，biomarkers of perfusion fluid and clinical data of 43 renal transplantation recipients during the period from 1 June 2019 to 31 August 2019 at the first affiliated Hospital of Xi'an Jiaotong University were prospective collected. The incidence of DGF and the recovery time of renal function were summarized and analyzed by statistical methods. Results In this study，the incidence of DGF was 18.6%，and the recovery time of renal function was（11.7 ±10.6）d. The recovery time of renal function in DGF group〔（30.8±22.7）d〕was significantly longer than that in NO-DGF group〔（6.8±7.0）d〕（P ＜ 0.001）. Multivariate logistic regression analysis showed thatterminal resistance（OR ＝ 1.879，95%，CI ＝ 1.145 ～ 3.56）and perfusion marker glutathione S-transferase（GST） （OR ＝ 1.62，95% CI ＝ 1.23 ～ 2.46）were independent risk factors for DGF. Comparing with ROC area under curve （AUC）, the accuracy of prediction was significantly higher when GST combined with terminal resistance prediction than that of terminal resistance prediction alone（P ＝ 0.023）. Conclusion Perfusion parameters（terminal resistance）combined with the biomarker of perfusion fluid（GST）can improve the ability of predicting DGF.

Objective To explore the application of standardized nursing procedures management inimproving nursing quality and patient satisfaction in kidney transplantation department. Methods The nursingwork defect rate，nursing quality and patient satisfaction in kidney transplantation department before and after theimplementation of standardized nursing procedures were statistically analyzed. Results After the implementationof standardized nursing procedures，the nursing work defect rate was 4.88%，far lower than that before theimplementation（24.39%）. The scores of 5 aspects of nursing quality were all higher than before implementation，P ＜ 0.05. The score of patient satisfaction in 4 aspects was higher than that before implementation，and the differencewas statistically significant. Conclusion The implementation of standardized nursing procedures can improve thequality of nursing in kidney transplantation department，improve the satisfaction of patients，and reduce or even avoidthe occurrence of adverse nursing events.