Objective A human liver model with disease was constructed based on normothermic machineperfusion. Methods A cirrhotic liver from a liver transplant patient was studied. Hepatic artery and portal vein were connected to life-X100 technology for normothermic machine perfusion. We continuously monitored the pressure of the flow and blood gas analysis from the perfusate and analyzed the function of the liver. Liver tissue was stained with H&E before and after perfusion. Results We succeeded in making perfusion for 100 h to preserve diseased liver, with stable perfusion parameters, and the blood gas of perfusate maintained within the physiological range. Continuous bile production during perfusion indicates good biliary function. Conclusion We have preliminarily established a human liver model of liver cirrhosis in vitro, which is the first human model for whole liver disease. It has set up a suitable platform for the research of organ medicine. 

Objective Donation after circulatory death（DCD）is considered a way to alleviate organ shortage，which increases the mortality of patients waiting for organ transplantation. After the withdrawal of life-sustained therapy，a series of pathological changes in the donor organ may impact graft outcome. This study is to investigate the ischemic pathophysiology of donor's liver after circulatory death in porcine model. Methods Sixteen Bama minipigs（8 females，8 males，45 ~ 55 kg）were used in this study. A porcine DCD model was created by the asphyxia method. Hemodynamic changes after ventilation withdrawal were recorded，and pathological changes in the donor's liver during warm ischemia time（WIT）were assessed. Results The average survival duration was 17.94 min. Systolic and diastolic blood pressures increased in the first 5 minutes，then decreased continuouslyafterward. Central venous pressure increased in the first 10 minutes and then decreased continuously afterward. Simultaneously，PaO2 dropped sharply to 0 in the first 10 minutes，and PaCO2 gradually rose to a stable level of 100 mmHg（1 mmHg ＝ 0.133 kPa）. The histological assessment indicated that warm ischemic injury on livertissue aggravated gradually as time progressed. In subcellular observation，ischemic injury within 30 minutes of WITseemed to be reversible，but longer WIT caused irreversible degeneration. Conclusion Through the porcine ventilation withdrawal model，the circulatory death in the clinical setting could be simulated. Damage to graft tissues was positively correlated with WIT. 30 minute WIT after confirmation of circulatory death with the asphyxia method appeared to be a limit for a desirable organ quality. 

Objective Preliminary study on the repair effect of normothermic mechine perfusion（NMP）on acute kidney injury（AKI）of kidneys from cardiac death donors. Methods In vitro continuousNMP was used for cardiac-death pig kidneys . The blood gas biochemical indexes of the perfusion fluid and urine as well as the kidney pathological indexes during perfusion were recorded and analyzed. Results Ten pig kidneys were perfused with NMP in this study，of which 9 were perfused with single kidney，and 1 was perfused combined with liver. After the perfusion started，the kidneys were filled quickly and the surface tension was rich. About 5 min after the perfusion，the kidneys became bright red. The urine output of the kidneys increased at the initial stage of perfusion，reached the extreme value at（3.2±1.5）h on average after perfusion，and then decreased slowly. About 6 h later，the appearance of the kidneys turned dull color. The cross-section of the kidneys showed obvious hemorrhage in the renal pelvis and calyx，and the renal cortex and medulla were slightly bloody with soft and loose appearance. The normal perfusion flow rate increased gradually，reached peak after 2 ~ 3 hours of perfusion，and then maintained at a stable level. PaO2 was basically maintained in the range of 350 ~ 450 mmHg（1 mmHg ＝ 0.133 kPa）；PaCO2 varied greatly among the groups，mostly fluctuating at 15 ~ 60 mmHg，while each of perfusion individuals maintained a relatively stable level. The Na+ concentration fluctuated slightly in the early process of perfusion，and reached a stable level after about 3 ~ 4 h and was close to the normal value range. The K+ and Ca2+ concentrations were fluctuated within the physiological range. The lactic acid level of single-kidney perfusion increased progressively，while the lactic acid level of kidney-liver combined perfusion gradually decreased and then stabilized at a low level. The cross-section of the kidneys showed no obvious bleeding in the renal pelvis and calyx after 9 h of liver-kidney combined perfusion，and the renal cortex and medulla were bloodless and normal in appearance. The H&E pathological results showed that the damage of the globules and tubules gradually and slowly increased during the perfusion process，which suggested that the Normothermic Mechine Perfusion might delay the progress of the globular and tubule damage. Conclusion NMP can provide an environment close to the physiological state for isolated kidneys，and may have a certain repair effect on AKI. Therefore，NMP is expected to expand the source of donor kidneys and increase the rate of kidney transplantationin patients with end-stage renal disease for better prognosis and quality of life. In addition，liver-kidney combinedperfusion had better renal appearance and lactic acid levels than single-kidney perfusion，but no advantage in perfusion time，urine output，and pathological results. Above conclusions need to be supported by further large sample research.

Objective Gene detection and immune microenvironment detection in liver cancer can guideanti-tumor therapy，but there are few studies on gene detection and microenvironment detection in liver cancer. In this study，we reported the results of two cases of hepatic carcinoma，one is hepatocellular carcinoma and the other is intrahepatic cholangiocarcinoma，and provided preliminary insightsfor the treatment of hepatic carcinoma in the future. Methods In this study，thetumorspecimensoftwopatientsweretestedby multipleximmunohistochemistry/immunofluorescence techniques and tumor gene sequencing. Both patients were under follow- up observation. Results Both patients were belonged to immune non-response type. The overall results showed that the effect of single drug immunotherapy may not be ideal. Partial gene detection results suggested that immune checkpoint blockade may be effective for both patients . Neither patient received immunotherapy. Conclusion The results of these two patients suggested that the effect of immunotherapy is not satisfactory. But immunotherapy is a promisingtreatment for cancerat present, and combinedimmunotherapy maybe helpful for liver cancer. 

Objective A method for interpretation of donor-specific antibody（DSA）when the donor human leukocyte antigen（HLA）typing information is unavailable but with suspected antibody-mediated rejection（AMR）was demonstrated，which may improve the accuracy of clinical diagnosis and treatment. Methods Fresh transplanted kidney tissues from two patients with suspected AMR were obtained and digested for total DNA extraction. Then HLA typings of the donor and recipient was conducted. The donor HLA typing was obtained by matching the total HLA typing information with the recipient peripheral blood HLA typing. HE staining and C4d immunohistochemistry staining of the paraffin-embedded tissues of the transplanted kidney were performed. DSA-mediated AMR wasdetermined based on the patient's clinical manifestations，pathological findings，recipient's peripheral blood HLAantibody test and HLA typing results of the donor and recipient. Results One case was diagnosed with DSA-mediated C4d-negative AMR and returned to dialysis after graft nephrectomy while the other case was not considered having DSA-mediated AMR. The patient’s condition improved after 3 d of high-dose prednisolone therapy. The patient was currently surviving with a well-functioning transplanted kidney. Conclusion The method of identifying DSA by the donor HLA typing results using the transplanted kidney biopsy tissues provides necessarytechnical support for the follow-up of kidney transplant recipients who seek care at different medical centers with unavailable donor HLA typing information. In patients with suspected AMR，HLA typing of donor and recipient，DSA interpretation，and pathological findings should be combined to make an accurate clinical diagnosis and to guide the precise treatment. 

Objective To describe the level of medication adherence and the occurrence of symptoms distress after taking immunosuppressant medication in liver transplantation recipients and explore the relationship between them. Methods A total number of 80 recipients who received liver transplantation from January 2019 to December 2019 in an organ transplantation center of the First Affiliated Hospital of Sun Yat-sen University were included by convenient sampling. The basel assessment scale for immunosuppressive medication adherence and the modified transplant symptom occurrence and symptomdistress scale（MTSOSD）were used to investigate medication adherence，symptom occurrence and disturbance. Results The symptom occurrence score of MSSOSD was 0 ~135（23.38±21.65），and the symptom disturbance score was 0 ~ 134（14.87±22.27）. Difficulties in falling asleep and fatigue were the first and second in the degree of occurrence and disturbance. A total number of 8 cases（10%）of liver transplantation recipients had poor drug compliance. Medication adherence in liver transplantation recipients was associated with the occurrence of immunosuppressant symptoms（P ＝ 0.013，OR ＝ 0.97）. Conclusion Drug-related side effectsare common in liver transplantation recipients taking immunosuppressive medication，and the occurrence of these symptoms affects the medication adherence. The knowledge of drug and compliance should be strengthened in the follow-up of livertransplantation recipients，especially for recipients more than 3 months after operation. It is important to pay attention tothe symptoms of immunosuppressant in liver transplantation recipients and to give timely treatment to improve medication compliance and reduce the occurrence of rejection. 

Objective To investigate the status quo of readiness for return-to-work among patients afterkidney transplantation and to analyze its influencing factors. Methods By using the general data questionnaire，Chinese version of the readiness for return-to-work scale（RRTW），brief illness perception questionnaire（BIPQ）and the general self-efficacy scale（GSES），a total of 241 respondents from transplantation clinics of two teaching affiliated hospitals in Wuhan were investigated. Results The rate of return-to-work among kidney transplant recipients was 50.2%，and the mean return time was（8.57±7.09）months after surgery. Patients who did not return-to-work accounted for the highest proportion in intention stage（43.3%）. Meanwhile，the proportion of patients who had returned to work in active maintenance stage was 71.7%. The average score was（38.21±8.95）points for illness perception，（23.53±4.44）points for self-efficacy. Renal function，whether having children，illness perception and self-efficacy were the influencing factors of readiness for return-to-work among kidney transplant recipients（all P ＜ 0.05）. Conclusion Kidney transplant patients' readiness for return-to-work is at a moderate level. Medical workers should pay attention to postoperative health follow-up of patients and provide targeted interventions to helpthem return to work and improve their readiness for return to work.