Objective To analyze the diversify trend characteristics and implication of dendritic cells（DCs）and its subsets myeliod DC（mDC）and plasmacytoid DC（pDC）in peripheral blood of transitional cell carcinoma after kidney transplantation，and to confer the profile of DCs and subsets in de novo malignant tumor after kidney transplantation. Methods White blood cell（WBC）and mononuclear cell（PBMNC）in peripheral blood of 9 transitional cell carcinoma patients after kidney transplantation were measured before and 1 day after tumorectomy. DCs' quantity，subsets and mDC/pDC were detected using flow cytometry. 7 renal transplantation patients who had been survived over two years and 30 patients with transitional cell carcinoma of bladder were included in this research as long term control and common tumor control. 15 volunteers（control group）were studied as healthy controls. Results The levels of DCs of all the patients groups were lower than healthy people control group，the total mDC level of long term survival group was the lowest（P＜0.05）. Compared with long term survival group， there was no difference in DCs with two subset of tumor groups（all P＞0.05）. The pDC level of the transitional cellcarcinoma patients after kidney transplantation was decreased and the ratio of mDC/pDC was significantly higher than other groups（all P＞0.05）. Different from carcinoma after kidney transplantation，mDC in patient with transitional cell carcinoma of bladder were decreased significantly and pDC level decreased slightly. After tumorectomy，mDC and pDC levels in both groups were increased with different extent. Conclusions Changes in DCs and their subsets were different between the carcinoma patients after kidney transplantation and common transitional cell carcinoma of bladder. This difference suggested that disequilibrium of immune system of kidney transplant recipient should be response to carcinoma after kidney transplantation. Monitoring the level of DCs and subsets is helpful for the forecast of tumor immunity surveillance and cancer relapse.

Objective To detect risk factors for early acute renal failure（ARF）after orthotopic liver transplantation（OLT）. Methods 189 patients who underwent liver transplantation in our center were analyzed retrospectively. They were divided into ARF and non-ARF groups according to serum creatinine level early after OLT. Peri-operative clinical and laboratory variables of these two groups were compared with univariate analysis，and then variables with significantly statistic difference were further studied with logistic regression analysis. Results 68 （36.0%）of the 189 patients develop post-OLT early ARF. Age，body mass index（BMI），pre-OLT serum creatinine，model for end-stage liver disease（MELD）score，minimum mean arterial pressure during operation，low blood pressure duration，blood products transfusion volume，urine output during operation were significantly different between these two groups with univariate analysis（all P＜0.05）. Logistic regression analysis showed low bloodpressure time during operation and urine output were independent risk factors for development of early ARF after OLT（both P＜0.05）. In patients with early ARF，the duration of mechanical ventilation was prolonged，length of stay in the transplant intensive care unit（TICU）was longer than that in non-ARF group（both P＜0.05）. Conclusions Patients with early ARF had prolonged duration of mechanical ventilation and longer stay in TICU. Low blood pressure during operation and urine output are independent risk factors for development of early ARF after OLT.

Objective To evaluate efficacy and safety of long-acting or intermediate-acting insulin combined with oral hypoglycemic drug in treatment of patients with high blood sugar early after kidney transplantation. Methods 45 cases at 1 month after kidney transplantation with high blood glucose were divided into three groups according to insulin used，insulin detemir group（A），insulin glargine group（B）and Novolin N group（C），and 15 patients in each group. The original oral acarbose dose was maintained，and each group of patients received 1 dose a day injections of insulin for 4 weeks. Blood glucose and incidence of hypoglycemia were monitored. Results Fasting blood glucose and post prandial blood sugar after treatment of three groups were significantly decreased，with most

significantly decreased in the A group ；and A，B groups decreased more than C group〔fasting blood glucose （mmol/L）：3.08±0.51，2.86±0.58 vs. 0.92±0.34 ；post prandial blood sugar（mmol/L）：4.38±1.19，4.18±1.22 vs. 2.34±0.77〕，the difference was statistically significant（all P＜0.05）；A，B groups of hypoglycemia events were obviously less than group C（6%，13% vs. 26%）. Conclusions In patients early after kidney transplantation with high blood glucose and cannot be controlled well by acarbose，treatment with addition of long-acting or intermediate- acting insulin can decrease the level of blood glucose obviously. Insulin detemir is effective and gentle for control forblood glucose with less incidence of hypoglycemia，which is a more ideal physiological simulated insulin secretion.

Objective To observe the safety and effectiveness of elcatonin in prevention of femoral headnecrosis after kidney transplantation. Methods 235 cases of kidney transplantation patients from the Second People's Hospital of Shanxi kidney dialysis center from January 2006 to December 2008 were enrolled. 59 cases of kidney transplantation patients from January 2008 to December 2008 were assorted into experimental group，while 176 cases of kidney transplantation patients from January 2006 to December 2007 as control. Patients in the experimental group started intramuscular injection of elcatonin one week after kidney transplantation with 20 U，1-2 times a week， for three consecutive months as a course. Thereafter the treatment course was repeated every three other months for3 courses，during which oral calcium carbonate D3 tablets was taken orally ，600-1 200 mg/d. Elcatonin was not used in control，while calcium carbonate D3 tablets，600-1 200 mg/d，and active vitamin D3 capsule were orally taken. The observation last to 18 to 30 months after operation. Results No case of femoral head necrosis or elcatonin related adverse reactions was happened in experimental group during the observation period. There were 5 cases（2.84%）of femoral head necrosis happened in 176 cases of patients in the control，and all occurred 6 to 18 months after operation，which were statistically significant between the two groups（P＜0.05）. Conclusions The quality of life of uremic patients can be improved with kidney transplantation，but preoperative concurrent renal bone disease and postoperative long-term use of corticosteroids are both important factors leading to femoral head necrosis，in turn produces more severe，irreversible damage，affecting the quality of life and long-term survival of patients.Elcatonin injection postoperation can significantly reduce the incidence of femoral head necrosis. It is a safe andeffective prevention measure，and can significantly improve the quality of survivors through clinical observation.

Objective To explore the influence of preoperative panel reactive antibody（PRA）levels on kidney transplantation rate and long-term outcome after transplantation. Methods Clinical data of 7 123 cases of uremia patients in the First Affiliated Hospital of Sun Yat-sen University were collected between January 1998 and June 2012. According to the preoperative PRA levels，the patients were divided into five groups. Group A 6 124cases，PRA negative. Group B 160 cases，PRA ＜10%. Group C 261 cases，PRA 10%-29%. Group D 374 cases， PRA 30%-80%. Group E 204 cases，PRA ＞80%. The kidney transplantation rate was compared among these five groups，and the human leukocyte antigen（HLA）mismatched，patients and grafts survival，estimated glomerularfiltration rate（eGFR）levels 1 year after transplantation，and incidences of complications after operation，such asdelayed graft function（DGF），acute rejection，chronic rejection and infection were also compared. Results Thekidney transplantation rate in group A was 31.9%. The kidney transplantation rate reduced significantly with theelevation of PRA levels，while in group E was 7.3%（P＜0.05）. The HLA mismatched loci decreased significantly with the elevation of PRA levels. The incidences of acute rejection and chronic rejection were significantly lower in group A and B compared to group E（all P＜0.05）. There were no differences in DGF and infection among the groups（all P＞0.05）. The long-term graft survival（1 year ：96.4% vs. 89.5%，5 years ：76.8% vs. 63.4%，10 years ：59.7% vs. 47.3%，all P＜0.05）and 1-year eGFR level（66.7 mL/min vs. 45.3 mL/min，P＜0.05）werebetter in group A compared to group E. However，there was no difference in patient's survival among the groups（all P＞0.05）. Conclusion With the elevation of preoperative PRA levels，the kidney transplantation rate decrease， the risk of acute rejection and chronic rejection increase，and the long-term outcomes of kidney grafts become worse.