Objective To explore the key points and difficulties in the ethical review of pediatric livingdonor liver transplantation by analyzing the data and process of ethical review. Methods A retrospective analysis of 937 cases of pediatric living donor liver transplantation in our hospital in recent 5 years . Results In 937 cases, 936 cases passed and 1 failed. Conclusion According to the regulations on Human Organ Transplantation andseveral regulations of the Ministry of Health on Regulating Living Organ Transplantation, the review procedure should be strictly implemented to fully evaluate and weigh the risks of surgery, so as to ensure the safety and full knowledge of the donor while saving the life of the child, and to maximize the role of ethical review.

Objective To observe the efficacy and safety of T lymphocyte polyclonal antibody in deceased donor （DD）kidney transplantation. Methods The clinical data of 324 renal transplant recipients who met the research criteria from August 20，2015 to February 28，2020 in our hospital were retrospectively analyzed. They were divided into two groups. A total number of 147 patients were treated with rabbit anti humanthymocyte immunoglobulin（rATG）（group A）. 177 patients were treated with anti human T lymphocyte rabbit immunoglobulin （ATG-Fresenius）（group B）. The acute rejection （AR）， delayed graft function （DGF），lung infection， bone marrow suppression and cytomegalovirus （CMV） infection were compared between the two groups. Results The incidence of AR in group A and group B was 32.65% and 16.94% respectively （P ＜ 0.05）. There were 17 cases of AR in group A（17/48）and 23 cases in group B（23/30）within one month after operation（χ2 ＝ 12.573 7，P ＜ 0.01）. The incidence of AR in group A was lower than that in group B （P ＜ 0.01）. Theincidence of DGF was 25.17% （37/147）in group A and 12.42% （22/177）in group B （P ＜ 0.01）. Thirty days after operation，the incidence of DGF in group A was lower than that in group B（P ＜ 0.01）.There was no significant difference in the adverse events of bone marrow suppression，pulmonary infection andCMV infection（P ＞ 0.05）. Conclusion In our hospital，both rATG and ATG-F can be safely and effectively used in the induction and postoperative treatment of DD renal transplantation. The rATG has a better performance in correcting the DGF and reducing the incidence of AR in DD kidney transplantation.

Objective To investigate the ultrasound imaging characteristics and risk factors of lower extremity deep vein thrombosis（DVT）formation after liver transplantation. Methods A total of 141 patients who underwent liver transplantation in our hospital were selected，all of them received lower extremity veins examination by ultrasonography before operation，and the presence or absence of DVT was recorded. The occurrence of DVT at 1，7，and 14 d after operation was monitored. The sex，age，hypertension，diabetes mellitus，tumor history，history of long-term alcohol consumption，cholesterol concentration，triglyceride concentration，HDLconcentration，LDL concentration，D-dimer concentration，history of lower extremity deep venipuncture tube placement，total operation time，duration of anhepatic phase，intraoperative blood loss and blood transfusion，MELD score were analyzed. Results DVT was not detected before transplantation; DVT was detected in 33 cases after operation，and the overall incidence of DVT was 23.4%. All occurred within 7 d after operation. Univariateregression analysis showed that there were significant differences in total cholesterol concentration，high density lipoprotein concentration，D-dimer concentration，intraoperative bleeding and blood transfusion，MELD score，tumor history and lower extremity deep vein puncture and catheterization between patients wito or without DVT （P ＜ 0.05）. Logistic multivariate regression analysis showed that the history of lower extremity deep vein puncture，high MELD score and high D-dimer concentration were the risk factors of DVT after liver transplantation（P ＜ 0.05）. Conclusion Ultrasound can clearly diagnose the formation of lower limb DVT after liver transplantation. Totalcholesterol concentration，high density lipoprotein concentration，D-dimer concentration，intraoperative bleeding and blood transfusion，MELD score，tumor history and lower limb deep vein puncture and catheterization history are important factors for the formation of DVT. Ultrasound monitoring should be focused on patients with the above high-risk factors.

Objective To analyze the correlation between pneumocystis pneumonia infection and cellular immune function. Methods From April 2019 to March 2020, 134 patients with renal transplantation in our department were diagnosed with Pneumocystis pneumonia, 54 of them were diagnosed as pneumocystis pneumonia.The number of CD4 cells was detected to reflect the cellular immune function of patients. The correlation between the incidence rate of pneumocystis pneumonia and cellular immune function was analyzed. Then the CD4 cell count was divided into three groups. The t-test was used to analyze the related indexes of the hospitalization days, the number of oxygen inhalation days, the number of days of pulmonary inflammatory absorption, and so on, and to explore the relationship between CD4 cell count and the prognosis of pneumocystis pneumonia and the prognosis of every two groups. Results Among 134 cases, 53 patients were infected with pneumocystis pneumonia. The prevalence rates of the three groups were 0.237, 0.720 and 0.813，respectively.  According to the grouping, the time of hospitalization,the time of oxygen inhalation and the time of focus absorption were analyzed by t-test. The P values were 0.667, 0.517,0.779, 0.335, 0.863, 0.150, 0.404, 0.139 and 0.405 respectively. The results showed that there was no statistical difference. Conclusion The incidence rate of pneumocystis pneumonia in renal transplant recipients increased withthe decrease of CD4 cell count, but CD4 cell count was not significantly associated with disease prognosis.

Objective Summarize the correlation between the detection of CYP3A5 polymorphism and tacrolimus neurotoxicity after renal transplantation. Methods A total number of 116 patients who received tacrolimus after renal transplantation in our hospital from 2017 to 2020 were analyzed retrospectively. Direct DNA sequencing was used to detect CYP3A5 polymorphism, and tacrolimus concentrations and neurotoxicity were observed in patients with different genes at different time points after surgery. Results The incidence of neurotoxicity inpatients receiving tacrolimus after renal transplantation was 38% , and in 116 renal transplant patients,the plasma concentrations of tacrolimus in patients with CYP3A5 * 3/* 3 genotype were lower than those with CYP3A5 * 1/* 1 and CYP3A5 * 1/* 3 genotypes within 2 weeks postoperatively, but higher than those with CYP3A5 * 1/* 1 and CYP3A5 * 1/* 3 genotypes at 2 weeks postoperatively and in the long term, there’s also a higher chance of neurotoxicity. Conclusion The concentration of tacrolimus in blood is an important factor of early neurological complications after renal transplantation. Patients with the CYP3A5 * 3/* 3 genotype were metabolizing slowly and had a higher probability of neurotoxicity. Blood concentrations of tacrolimus in patients with the CYP3A5 * 3/* 3 genotype were higher than the patients with other two genotypes with the same dose at two weeks after transplant, and the required dose should be reduced. 

Objective This paper aimed at investigating the current status of post-traumatic growth andits influencing factors among parents of pediatric renal transplantation recipients. Methods A total number of 84 parents of pediatric renal transplantation recipients were enrolled into this research，and their data were collected and analyzed using a set of general info questionnaires，as post-traumatic growth inventory（PTGI），family function assessment scale（FACES Ⅱ），and zarit caregiver burden interview（ZBI）. Results The parents scored an average of（63.21±17.37）on post-traumatic growth，which was found to be influenced by religions and beliefs，marital status，the pediatric renal transplantation recipients postoperative complications，frequency of postoperative follow-up visits，and family closeness. Also，the regression model of these factors turned out to be able to explain 61.06% of the total variance. Conclusion The general status of post-traumatic growth among the parents of pediatric renal transplantation recipients can be deemed as moderate. In light of the findings，it is suggested that medical staff should encourage self-disclosure on these group of parents，help them build a good social relationship，as well as be more proactive at guiding these parents and other family members，so as to increase the likelihood of post-traumatic growth among them.

Objective To analyze the cognitive level of children 5 years after living liver transplantation，and also to study the related factors affecting the cognitive level of children，so as to provide a scientific basis for the care of children after living liver transplantation and to strengthen their cognitive level. Methods A total of 37 random children who underwent living donor liver transplantation in a hospital was used as the study population，and the Montreal Cognitive Assessment Scale was selected to investigate the cognitive level of children after living donor liver transplantation. A questionnaire with demographic and sociological data was used to study the factors affecting the cognitive level of children after living donor liver transplantation. Excel spreadsheet was used to input data one by one and establish database. SPSS 23.0 statistical software was used for analysis. Results The study showed that the total score of cognitive level after liver transplantation in children was（26.46±2.43）scores，there was no significant difference in the total cognitive level of children with different methods of liver transplantation, years of liver transplantation, blood type, education level and gender. Conclusion It was found that children's cognitive level 5 years after living donor liver transplantation was at a low level and that different years of liver transplantation，gender，blood group，and literacy did not have an effect on children's cognitive level 5 years after living donor liver transplantation.