Objective To investigate the observation and management of blood coagulation function inpatients with severe hepatitis during perioperative period of liver transplantation. Methods The blood coagulation functions of 39 patients with severe hepatitis who underwent allogeneic liver transplantation in our hospital fromJanuary 2018 to March 2021 were retrospectively analyzed. Blood coagulation markers, such as thrombin time（PT），prothrombin time activity（PTA），international standardized ratio（INR），platelet count（PLT），thrombin time（TT）， fibrinogen（FIB）and activated partial thromboplastin time（APTT）, were measured before transplantation（T0），3 hours after transplantation（T1），24 hours after operation（T2）and 72 hours after operation（T3）. The dosage of clotting substance，operation time，volume of blood loss and volume of blood products during liver transplantationwere recorded. Results Compared with preoperative values，the values of PT and APTT decreased gradually afterthe use of coagulant substances（P ＜ 0.05），and returned to normal 72 hours after operation. The values of PTA and FIB gradually increased into the normal range after the use of coagulant substances（P ＜ 0.05）. Conclusion Thecoagulation function of the patients with severe hepatitis is poor，and the operation time of livertransplantation islong and complicated. It is of great significance to closely observe the bleeding of the patients，monitor the bloodcoagulation function and supplement the corresponding coagulation substances in time to ensure the smooth progress of the operation. 

Objective The aim of this study is to analyze and summarize the markers，characteristics and causes of common critical values in renal transplant recipients during the perioperative period. Methods The data of gender，age，primary disease，transplantation time，critical values，complications and corresponding treatments as well as blood concentrations of immunosuppressive agents after transplantation were collected and analyzed in 283 cases of renal transplant recipients who presented with critical values between January 2018 and November 2020. Results The most common preoperative critical value of renal transplant recipients was highserum creatinine（62.7%，69/110），followed by electrolyte and acid-base disorders（27.3%，30/110）. And the most common postoperative critical value of renal transplant recipients was electrolyte and acid-base disorders（39.9%，69/173），followed by microbial isolation or culture positivity（22.0%，38/173）and abnormal bloodroutine test（15.0%，26/173）. The preoperative and postoperative mean age of patients presented with critical values were（39.3 ±12.5）years old and（45.4 ±11.6）years old（P ＜ 0.001），

respectively. And the ratio of male to female were statistically significant（78.2% vs 21.8% preoperatively and 62.4% vs 37.6% postoperatively，P ＜ 0.05）. Conclusion Renal transplant recipients are in the end stage of renal disease before transplantation，and critical values mostly occur in patients with irregular or inadequate dialysis，as well as in those with irregular follow-up. Therefore，attention should be paid to education and follow-up for the patients waiting for transplantation，to ensure regular dialysis and visits. The early emergence of critical values in renal transplant recipients is mainly dueto the changes of internal environment，electrolyte imbalance caused by polyuria or diuresis，delayed graft function，acute rejection and drug interaction. Therefore，it is necessary to strengthen monitoring and timely adjustment for postoperative patients. 

Objective To investigate the characteristics and predictive value of ultrasound（US），color doppler flow imaging（CDFI）and contrast-enhanced ultrasonography（CEUS）examinations in recipients with donationafter cardiac death（DCD）donor kidney and living donor kidney（LDK）transplantation. Methods Allogeneickidney transplantation was performed in Organ Transplantation Center of Sichuan Provincial Academy of Medical Sciences and Sichuan Provincial People's Hospital from December 2017 to January 2020. Twenty one recipients were enrolled in the DGF group，and 39 recipients with clinically confirmed normal renal function were selected as the immediate graft function group. Recipients underwent renal grayscale ultrasound，color doppler and contrast-enhanced ultrasound on the first day after renal transplantation. In the DGF group and the transplanted kidney function recovery group（IGF），the renal artery resistance index，cortical time difference，vertebral body time difference，cone peak time，cortical peak intensity and cold ischemia time were recorded to evaluate thefeasibility of these values in predicting early DGF after renal transplantation. Results In this observationalstudy，a total of 60 allogeneic kidney transplant recipients met the criteria for inclusion. Among them，21 patients developed DGF after operation. The renal artery resistance index RI，the time of transplanted renal cortex，the peak time of transplanted kidney cone，the peak intensity of transplanted renal cortex，the difference of cortical cone arrival time and cold ischemia time were combined and analyzed by logistic regression. The index value is calculated as（3.471×main renal artery resistance index +0.157×cortical time difference T1 + 0.120×cone time difference - 0. 105×cortical peak intensity + 0.005×cone peak time + 0.550×cold ischemia time）. The area under the ROC curve of the composite index value was 0.901（P ＜ 0.001），the 95% confidence interval for the composite index value was（0.822，0.978），and the diagnostic threshold for the composite index value was 8.8158，and the sensitivity was 85.70. %，the specificity was 84.62%，the positive predictive value was 72%，the negative predictive value was 91.42%，the positive likelihood ratio was 4.77，and the negative likelihood ratio was 0.174. In addition，a large area of perirenal hematoma was found in the early stage of the study，1 case of renal artery stenosis，and 2 cases of renal allograft rejection. Conclusion The study found that the combination of renal artery motility index，transplantation renal cortex time difference，transplantation renal cortex imaging peak intensity，transplantation renal cortex pyramidal imaging time difference，transplanted kidney cold ischemia time can be early and timely predictive markers of delayed graft dysfunction. It has high sensitivity and specificity. This study also found that CEUS has a greater diagnostic value in the detection of early complications of transplanted kidneys，and can promptly detect peri-renal hematomas，stenosis of the transplanted renal arteries，and acute rejection of the transplanted kidneys. 

Objective To explore the application value of the ultrasonic attenuation coefficient（ATT）combined with elastography to quantitatively evaluate the steatosis degree of donor liver. Methods We collected 27 cases of brain death donors. Ultrasound examination was performed for all donor livers before operation. Measurement parameters include young's modulus（E），shear wave velocity（Vs），index of fibrosis（F index），index of activity（A index）and ultrasonic ATT for donor liver. During the operation，liver tissue was taken for pathological examination to observe whether the liver tissue had steatosis change. According to the pathological results，the donors were divided into the fatty liver group and the non-fatty liver group，the difference of ultrasound parameters between the two groups was compare. Results In this study，there were 27 brain-death donors，7 were pathologically diagnosed with fatty liver and 20 without. ATT in the fatty liver group（0.54±0.06）was significantly higher than that in the non-fatty liver group（0.45±0.07）（P ＜ 0.05），and there was no significant difference in other parameters （V，A，Vs，F）between the two groups（P ＞ 0.05）. Moreover，ATT was significantly positively correlated with whether the donor liver is fatty liver or not（r ＝ 0.54，P ＜ 0.05），while other parameters have no significantly correlation with the pathological diagnosis of fatty liver（P ＞ 0.05）. ROC curve was performed to analyze thediagnostic efficiency of ATT，the area under the curve，sensitivity and specificity of ATT in diagnosing steatotic change of donor liver were 0.868，85.7% and 85.0%，respectively. Conclusion ATT can quantitatively evaluatewhether the donor liver has steatosis or not，it has certain clinical value. 

Objective To study and analyze the clinical features and risk factors of lung infection afterkidney transplantation. Methods A retrospective analysis of 162 patients undergoing kidney transplantation inour hospital from January 2015 to December 2019 was performed. Patients were divided into three groups based on whether they had pulmonary fungal infection within 6 months after operation，the patients with pulmonary fungal infection after operation were included in the fungal infection group，those with pulmonary bacterial infection were included in the bacterial infection group，and those without pulmonary infection were included in the non-infected group. The clinical data of the three groups of patients were analyzed and the risk factors affecting lung infection after kidney transplantation were investigated. Results Of the 162 kidney transplant patients，46（28.39%）had lung infections. Bacterial infection patients accounted for 52.17%（24/46），fungal infection patients accounted for 41.30%（19/46），and no pathogen was detected in 1 patient. Fungal infections were mainly Candida albicans，Aspergillus，Candida，and Pneumocystis. Its clinical symptoms were mainlyfever，cough，sputum expectoration，dyspnea，and blood in sputum. CT manifestations were complex andchangeable，showing a variety of properties and morphological changes. The results of multivariate analysis showed that age ≥ 60 years，delayed postoperative renal function recovery，acute rejection，white blood cell（WBC）＜ 3.5×109/L，and albumin（ALB）＜ 40 g/L were risk factors for lung infection after kidney transplantation（P＜0.05）. Conclusion The proportion of fungal infections in the lungs after kidney transplantation is similar as that of bacterial infections. The clinical manifestations and CT manifestations of patients with fungal infection are non-specific. Therefore，the diagnosis of fungal infection after kidney transplantation relies on thecombination of clinical manifestations of the patient，microbiology，CT imaging and pathology.Patients withadvanced age，delayed postoperative renal function recovery，acute rejection，WBC ＜ 3.5×109/L，and ALB ＜40 g/L are high-risk groups of lung infection after kidney transplantation. These people should be closely monitored after surgery to reduce the chance of infection.