Objective To summarize the clinical effect and prognosis of liver transplant in children with hepatoblastoma（HB）. Methods A retrospective analysis was performed on 8 cases of liver transplantation（LT）with HB in Department of Hematology and Oncology of Shanghai Children’s Hospital from January 2014 to December 2020. Results Eight patients underwent LT，accounting for 12.1% of HB patients during the same period，there were 3 males and 5 females，with a median age of 54（30 ～ 130）months，the median age at transplant was 67.5（36 ～ 175）months. According to PRETEXT stage ：3 patients were in stage Ⅲ and 5 in stage Ⅳ，with 1 involving hepatic vein and4 involving portal vein. Lung metastasis was found in 2 cases. According to POST-TEXT stage ：6 patients were in stage Ⅲ and 2 in stage Ⅳ . The median AFP value was 55 450（23 950 ～＞ 121 000）ng/ml at diagnosis and 242（6.78 ～ 58025）ng/ml before LT，respectively. The median declines in AFP was 99.7%（52.0% ～ 99.9%），and The median AFP value was 6.02（3.58 ～ 15 015）ng/ml after LT. All patients were treated with chemotherapy with a median course of 6 course before LT and 3 courses after LT. The median follow-up time was 10.5（1 ～ 42）months，CR occurred in 6 cases，PR occurred in 1 case and 1 patient died. The mean survival time was（36.9±4.8）months.The overall survival rate was 87.5%. Conclusion The treatment of pediatric hepatoblastoma is a comprehensive treatment mode. Total liver resection combined with LT can achieve satisfactory results，but refractory HB and recurrence are still the difficulties in the current treatment.

Objective To investigate the effects of donor body mass index （BMI） and percentage body fat （PBF） on early postoperative recovery of liver function in children undergoing living donor livertransplantation. Methods Thirty-two patients（21 males and 11 females）who received living liver transplantationin Beijing Friendship Affiliated to Capital Medical University from December 2019 to April 2021 were selected fora retrospective study. The mean age of recipients was（42.3±42.2）months. Postoperative alanine aminotransferase （ALT）downward trend was analyzed. Results There were 19 cases in the normal BMI group. The mean value of ALT downward trend was -89.41±80.18. There were 13 cases in the abnormal BMI group. The mean value of ALT downward trend was -81.37±61.42，P ＝ 0.751. There were 26 cases in the non-obese group. The mean value of ALT downward trend was -89.59±79.92. There were 6 cases in the obese group. The mean value of ALT downward trend was -71.23±5.93，P ＝ 0.583. There were no statistically significant differences（P ＞ 0.05）. Conclusion Mild abnormalities of donor BMI and BFR in pediatric living liver transplantation have no significant influence on the recovery of liver function in the early postoperative period. In clinical donor selection，we can select the donors whose BMI and PBF above normal values.

 Objective To explore the clinical value of self-made retrieval bag during retroperitoneal laparoscopicleft live donor nephrectomy. Methods The clinical data of 66 donors from January 2020 to June 2021 were retrospectivelyanalyzed，including 27 men and 39 women with an average age of（58.3 ± 7.8）years old. Self-made retrieval bag was applied for extraction of kidney in 41 cases（retrieval bag group），and was not used in other 25 cases（no retrieval bag group）.The donor ages，gender，body mass index（BMI），long diameter and the width of the kidney graft，length of incision and warm ischemia time of kidney graft were compared. Results The two groups were matched for the following ：thedonor ages，gender，body mass index（BMI），long diameter and the width of the kidney graft. The length of incision in retrieval bag group and no retrieval bag group were（62.4±5.3）mm and（79.5±6.8）mm，respectively（P ＜ 0.001）. The warm ischemia time of kidney in retrieval bag group and no retrieval bag group were（153±54）s and（165±71）s （P ＝ 0.441）. Conclusion During retroperitoneal laparoscopic live left donor nephrectomy，application of self-made retrieval bag for extraction of kidney could reduce the length of incision and did not increase organ warm ischemia time.

Objective As a promising non-invasive biomarker，graft-derived cell-free DNA（GcfDNA）has been proved to be useful in detecting graft rejection in a series of studies. However，there has been no report on programmed detection of GcfDNA after renal transplantation. Whether GcfDNA monitoring during the follow-up period can guide clinical work is unknown. Methods The copy number and percentage of GcfDNA were prospectively collected from live donor kidney transplant recipients and cadaver kidney transplant recipients on day 10（D10），month 1（M1），month 3（M3），and month 6（M6）after surgery，and the clinical data of recipients were collected simultaneously for cohort study. Results A total of 87 recipients were enrolled，and the copy number of GcfDNA on D10 was 0.70 cp/ml，which was significantly higher than that on M1（0.40 cp/ml）. The percentage of GcfDNA onM1 was 0.5%，which was significantly higher than that on M3（0.3%）. However，there were no significant differences in creatinine and glomerular filtration rate at different time points. Group comparison showed that the GcfDNA copynumber on D10 was lower in the live donor transplantation group than in the cadaver transplantation group（0.45 cp/ml vs. 0.90 cp/ml，P ＜ 0.05）. There was no significant difference in the percentage of GcfDNA between the two groups on D10. Regression analysis of GcfDNA copy number and percentage with serum creatinine showed a non-linear correlation. Conclusion GcfDNA copy number and percentage of GcfDNA are independent indicators of renal function compared with creatinine or pathological biopsy，and GcfDNA levels are in consistent with pathological biopsy results. The effect of ischemia reperfusion injury on GcfDNA can last for more than 10 days，so we recommendinitiating programmed detection 10 days after surgery.

Objective To report the preliminary application of an optimized method for detecting donor derived cell-free DNA（dd-cfDNA）according to the characteristics of single nucleotide polymorphisms（SNP）in theChinese population. Methods A dd-cfDNA detection method（Panel HX-8）formed by the optimized selectionof 8 SNP was used to test the preserved blood samples from kidney transplant recipients，and the clinical data of therecipients were retrospectively analyzed. These recipients were divided into five groups ：immediate graft function （IGF），slow graft function（SGF），delayed graft function（DGF），serum creatinine elevation（CE）and active antibody mediated rejection（ABMR）. Results A total of 330 blood samples from 87 recipients were tested. In 84 of these recipients，both serum creatinine（Scr）and dd-cfDNA in the IGF group（n ＝ 73）decreased exponentially while Scr reached a trough plateau value（116.2±33.7）μmol/L by postoperative day 7（POD7）and dd-cfDNA reached an early trough plateau value（0.8%±1.5%）at POD5. The dd-cfDNA on POD1 in the SGF group（n ＝ 4）and the DGF group（n ＝ 2）was both higher than that in the IGF group（28.5%±38.8 % vs. 4.0%±3.3 %，P ＝ 0.003 ；9.9%±1.8 % vs. 4.0%±3.3%，P ＝ 0.083）. The Scr in the CE group rose from （118.6±22.0）μmol/L （POD7）to （150.8±25.9）μmol/L（POD12），while mean dd-cfDNA rose earlier from 1.4%±0.9%（POD5）to 5.4%±9.6% （POD7）. ABMR occurred in 3 other recipients，with a mean dd-cfDNA of 4.2%±2.0% vs. 0.6%±0.1% before and after treatment（P ＝ 0.399）. Conclusion The Panel HX-8 method for detecting dd-cfDNA has high clinical utility and dd-cfDNA may be a more sensitive indicator of transplant kidney graft health than Scr. The widespread use of Panel HX-8 in clinical practice awaits follow-up studies to further clarify the clinical value of detecting dd-cfDNA in renal transplant recipients.

Objective To investigate the significance of serum C-reactive protein（CRP）in predicting liver cancer recurrence after liver transplantation. Methods Retrospective analysis was performed on the clinical data of 65 patients undergoing liver transplantation for liver cancer from March 2013 to March 2019. The patientswere divided into positive group（CRP ≥ 8 mg/L）and the negative group（CRP ＜ 8 mg/L）. The collected data were statistically analyzed. Results Of the 65 patients，45（75.0%）met milan criteria and 32（49.2%）had a history of pre-transplant treatment. In the multivariate analysis，serum CRP ≥ 8 mg/L was an independent risk factors for HCC recurrence. The 2-year recurrence rates of the two groups were 74.3% and 14.8%，respectively（HR ＝ 10.36，95% CI ＝ 3.89 ～ 27.61，P ＝ 0.000）. There was also a statistically significant difference in overall survival between the positive group and the negative group（P ＝ 0.000）. Conclusion Preoperative test of CRP can predict the recurrence of liver cancer after liver transplantation and predict the prognosis of patients.

Objective To analyze the clinical characteristics and early diagnosis methods of pulmonarytuberculosis infection after renal transplantation in order to offer assistances for the early diagnosis of pulmonary tuberculosis. Methods A retrospective study was performed on 6 cases of patients with pulmonary tuberculosiswho were admitted from 2005 to 2020. Results The incidence of pulmonary tuberculosis after kidney transplantation in our hospital was 0.6%. Most of the patients had fever as the first or only manifestation，mainly low fever. Only 2 cases of them had respiratory symptoms. Of all the patients，only 2 cases had typical pulmonarytuberculosis imaging changes，and the other 4 cases had no specific imaging performances. Only one of 6 patients was positive for acid fast staining from sputum smear，and mycobacterium tuberculosis was found in peripheral blood samples by mNGS. And only 1 patient was PPD positive，four patients were T-SPOT positive，and one patient was finally confirmed by lung biopsy. Conclusion Pulmonary tuberculosis infection after renal transplantation was increasing in recent years. Due to the influences of immunosuppressive agents，most patients with pulmonary tuberculosis after renal transplantation have atypical clinical symptoms or signs，these patients may lack of respiratory symptoms and specificity in imaging results，they may have high false negative rate of traditional PPD test and low detection rate of mycobacterium tuberculosis. These features lead to difficulties in early diagnosis. IGRA test and mNGS are relatively new detection methods with high sensitivity and specificity，which are conducive to the early diagnosis of tuberculosis. And regular，repeated，multiple joint comprehensive detection is conducive to the early diagnosis of tuberculosis.