Objective To analyze the long-term results after simultaneous pancreas-kidney transplantation at a single center． Methods A retrospective analysis of the survival rates of 58 recipients and transplanted organsfrom May 2010 to December 2019 was conducted in the Department of Organ Transplantation，923thHospital of PLA Joint Logistic Support Force．The causes of death and loss of graft function were analyzed.Results Recipient’s survival rates in the 1，3，5 and 8 years were 98.28%，98.28%，92.24% and 89.99%，respectively．The 1，3，5 and 8 year survival rates of pancreas grafts were 86.21%，84.48%，78.40% and 76.16%，and that of kidney grafts were 98.28%，98.28%，82.83% and 80.60%，respectively．The survival rates after bladder drainage（BD）procedure at 1，3，5 and 8 year was 96.15%、96.15%、 86.73% and 86.73% and the survival rates of enteric drainage（ED）procedure was 100%，100%，96.67% and 93.33% （P ＝ 0.187）. Conclusion Simultaneous pancreas-kidney transplantation has a good long-term effect on end-stage diabetic nephropathy. Surgical complications are the main factors affecting the long-term outcomes. ED procedure may have a betterlong-termprognosis. Infection，rejectionand recipient death are also important factors for graft functionloss.

Objective To summarize and analyze the clinical efficacy of simultaneous pancreaskidney transplantation（SPK）with different drainage methods in 53 patients with diabetic nephropathy. MethodsFrom May 2010 to December 2019, 53 simultaneous pancreas-kidney transplantation surgeries were completed at theTransplant Medical Center of The Second Affiliated Hospital of Guangxi Medical University. There were 22 cases in pancreatic fluid bladder drainage（BD）surgery group and 31 cases in pancreatic fluid jejunal drainage（ED）surgery group.The patients were treated with anti lymphocyte globulin or anti-CD25 monoclonal antibody during the operation，andtacrolimus，mycophenolate mofetil and glucocorticoid triple immunosuppressive regimen were used in the early stage. The 1-year survival rate，delayed recovery of pancreas function，incidence of delayed renal function recovery（DGF），operation time，pancreatic cold ischemia time，reoperation rate，intraoperative total blood transfusion，blood glucosechange trend inone month after operation，and other complications were compared between the two groups. Results A total number of 53 cases were operated successfully. All patients were followed up for 2 to 60 months. Among them，22 cases were performedwith pancreatic juice bladder drainage（BD）. One patient developed necrotizing pancreatitis，and the pancreas was resected. After 6 months，pancreas transplantation was successful. Three recipients had delayed recovery of renal allograft functionafter operation. One patient had delayed recovery of renal function. Bladder mucosal bleeding occurred after urination recovery. After three times of interventional embolization，pulmonary infection occurred and the patient died. Pancreatic andrenal functions were normal at the time of death. The rest of the patients survived and their fasting blood glucose returned to normal at（14.2 ± 5.1）d，（9.5 ± 4.2）d after surgery，and serum creatinine returned to normal after（10.4 ± 6.5）d. The average length of hospital stay was（21.4±7.3）d. Postoperative complications included 1 case of pancreatic incision infectionand 1 case of lymphatic leakage. Other complications included 1 case of urinary tract infection，2 cases of pancreatic vein thrombosis，1 case of tacrolimus poisoning and 1 case of acute rejection of transplanted kidney. Eleven patients were cured and discharged. In addition，31 cases recieved pancreatic juice jejunal drainage（ED）operation，fasting blood glucose returned to normal on（12.2 ± 5.1）d after operation，（7.3 ± 3.2）d after operation，and serum creatinine returned to normal after（11.2 ± 5.7）d. The average hospital stay was（18.6 ± 6.6）d. Two patients experienced postoperative thrombosis of transplanted pancreatic veins and underwent pancreatic resection. Two patients developed necrotizing pancreatitis and underwent pancreatic resection. Postoperative complications included pancreatic incision infection in 2 cases，lymphatic leakage in 2 cases，tacrolimus poisoning in 1case andacuterejection in2 cases. Thirty-one patients were cured and discharged. Conclusion Thesurvival rate of recipientsand grafts was not affected，andthe qualityof life of patients was higher than that of bladder drainage group. The application of donor organ function protection system and meticulous and individualized perioperative treatment plan can improve the efficacy and safety of pancreatico jejunal drainage. It isworthyof clinical promotion. 

Objective To investigate the effects of outpatient nursing interventions on blood glucose levelsin patients with simultaneous pancreas-kidney transplantation. Methods A total number of 28 patients undergoing simultaneous pancreas-kidney transplantation in the Department of Urology，8th Medical Center of PLA General Hospital were divided into an observation group and a control group，with 14 patients in each group. The control group received routine nursing care and health education during outpatient follow-up，while the observation group received outpatient nursing intervention.After 6 months，the dietary compliance，exercise habits，adherence to lifestyle changes，disease knowledge，and blood glucose control level were evaluated in both groups. The satisfaction with nursing services was also compared between the two groups. Results The observation group showed better dietary compliance，exercise habits，adherence to lifestyle changes，and disease knowledge compared to the control group. Additionally，the blood glucose levels in the observation group were lower than those in the control group. The patients in the observation group expressed higher satisfaction with nursing services compared to the control group. These differences were statistically significant （all P ＜ 0.05）. Conclusion Outpatient nursing intervention can effectively improve blood glucose levels in patients undergoing simultaneous pancreas-kidney transplantation. It also enhances patients' self-care abilities，adherence to medical recommendations，and satisfaction with nursing services. Therefore，outpatient nursing intervention is worthy of clinical promotion and application. 

Objective To analyze the recovery of renal function after kidney transplantationfrom different donors，to explore the difference of short-term effect between donation after cardiac death （DCD）and living-donor（LD）， and to evaluate the feasibility and safety of DCD kidney transplantation and make better use of DCD donor. Methods Participants who underwent kidney transplantation in Organ Transplantation Center，the Department of Urology，Linyi people’s Hospital from December 2017 to January 2023 were selected. According to the source of donors，they were divided into DCD group and LD group.Then the demographic distribution between the two groups was analyzed，and the serum creatinine（Scr）and postoperative complications of the two groups at different time were compared. Results A total number of 70 patients were enrolled，including 50 patients with DCD and 20 patients with LD. Within two weeks after operation，the Scr level decreased to below 200 μmol/L，but the Scr level in DCD group was higher than LD group on day 1 ～ 7 and 9 after operation，the difference was statistically significant（P ＜ 0.05）. Conclusion The effect of DCD renal transplantation is accurate，but there is a certain difference between the short-term renal function recovery after operation compared with LD donor kidney，therefore，preoperative evaluation should be strengthened. 

Objective This study aimed to compare and analyze the efficacy and safety of T-cellpolyclonal antibody and basiliximab in deceased donor kidney transplants. Methods This study wasaretrospective，single center，controlled study. The clinical data of 402 adult kidney transplant recipients who met the inclusion criteria at Kunming First People's Hospital from August 20，2015 to February 28，2020 were retrospectively analyzed. Patients were placed into rabbit anti-human thymocyte immunoglobulin（rATG）group （147 patients，group A），anti-human T lymphocyte rabbit immunoglobulin （ATG-F）group（177 patients，group B），and basiliximab

（78 patients，group C）group. The incidences of acute rejection（AR），delayed graft function（DGF），lung infection，bone marrow suppression，cytomegalovirus（CMV）infection were retrospectively analyzed. Results The total incidences of AR in groups A，B and Cpost-transplantation within one year were 32.65%，16.94% and 26.92%，respectively（group B vs. group C ：χ2 ＝ 4.30，P ＜ 0.05）. The proportion of DGF in the three groups was 25.17%，12.42% and 17.9%，respectively. The durations of DGF in each group were （14.86±6.15）d，（15.63±4.56）d and（13.7±4.24）d，respectively. There were no significant differences among three groups. The serum creatinine（SCr）levels of patients with DGF one month after transplantation was（223.39±129.18）μmol/L，（225.62±182.97）μmol/L，（170.76±50.30）μmol/L，respectively. The incidence of bone marrow suppression one year after surgery was 8.8%（13/147），6.8%（12/177），2.6%（2/78）. There were no statistically significant differences among groups. The prevalence of pulmonary infection in each group was 11.56%，7.9%，2.6%，respectively. The incidence rate of group A was higher than that of group C（P ＜ 0.05）. The incidence of CMV infection in both groups A and group B were higher than that in group C（P ＜ 0.01）. Conclusion Both T-cell polyclonal antibodies and basiliximab can be safely and effectively used in the induction therapy of DDkidneytransplantation. Compared with basiliximab，T-cell polyclonal antibodies can increase the risk of pneumonia and CMV infection. 

Objective To analyze the changes of perioperative blood transfusion and laboratory test results of kidney transplantation patients，and to provide the basis for clinical judgment of perioperativeblood transfusion strategy of kidney transplantation patients. Methods The perioperative blood transfusion of 330 patients with kidney transplantation in 8th Medical Center of PLA General Hospital from 2016 to 2022 was retrospectively analyzed. The difference of preoperative routine blood test indexes between 237 patients without blood transfusion and 93 patients with blood transfusion during perioperative period of kidney transplantation were analyzed and compared. The immune rejection and nosocomial infection after kidney transplantation between perioperative blood transfusion patients and without blood transfusion patients were analyzed and compared. Results The proportion of perioperative blood transfusion in 330 kidney transplantation patients was 28.18%（93/330）. There were statistically significant differences in intraoperative blood loss，operation duration，preoperative hemoglobin， hematocrit，prothrombin activity and other indexes between patients without blood transfusion and with blood transfusionduring the perioperative period of kidney transplantation（P ＜ 0.05）. The incidence of nosocomial infection was 4.55%（15/330）in 330 patients with kidney transplantation，and 9.68%（9/93）in 93 patients with perioperative blood transfusion，which was significantly higher than that in 237 patients without blood transfusion（2.53%，6/237）（P ＜ 0.05）. The incidence of immune rejection in 330 patients with kidney transplantation was 9.39%（31/330），including 12.9%（12/93）in patients with perioperative blood transfusion was，and 8.02%（19/237）in patients without blood transfusion. There was no significant difference between the two groups（P ＞ 0.05）. Conclusion It is necessary to strengthen the monitoring of perioperative coagulation function of kidney transplantation patients，actively preoperative anemia treatment and coagulation level regulation，minimize intraoperative blood loss and shorten operation duration，rationally utilize blood resources，improve the transfusion efficacy of kidney transplantation patients are necessary to improve the prognosis of patients. 

Objective To summarize the diagnostic methods，clinical manifestations and prevention andtreatment of recurrent human parvovirus B19（HPV-B19）infecton in realansantion recipients. Methods FroJune 2020 to May 2022，8 out of 37 recipients infected with HPV-B19 after renal transplantation at Organ Transplantation Center of Tongji Hospital Affiliated to Tongji Medical College，Huazhong University of Science and Technology were collected. The clinical manifestations，diagnosis and treatment measures，laboratory tests，and prognosis of these 8 patients were retrospectively analyzed and summarized. Results After multiple courses of intravenous immunoglobulin G（IVIG），conversion and reduction of immunosuppression and other comprehensive regimens，the anemia symptoms were improved and hemoglobin（Hb）level was stable in 8 patients. And the same treatment was effective when recurrent infections occur. Eight patients were followed up for one year after the last recurrence. There was no recurrence and the Hb level was stable〔（136.8±12.0）g/L〕，and renal function was stable throughout the infectionperiod. Conclusion Post-transplant recipients are susceptible to infection with HPV-B19 due to immunocompromise and are prone to reactive or recur many times. When patients are infected with HPV-B19，the levels of Hb and reticulocyte should be monitored regularly，especially in patients who have recovered from treatment. Once the progressive decline of Hb occurs again，attention should be paid immediately，and HPV-B19 DNA should be further tested by PCR to determine whether there is recurrence. Intravenous IVIG is the preferred treatment for HPV-B19 infection，and when the disease recurs，reapplication remains effective and reinforces the treatment effect. Combined with adjustment of immunosuppressive regimen，reduction of immunosuppression and other comprehensive regimens，the ideal curative effect can be achieved. 

Objective To assessthe risk factorsfor early thrombosis after pancreatic transplantation. Methods We selected 46 recipients of simultaneous pancreas-kidney transplantation（SPK）from donation after brain death（DBD） donors in the 923 Hospital of the People's Liberation Army Joint Support Force from January 2015 to August 2019， and 30 SPK recipients of DBD donors in the Second Affiliated Hospital of Guangxi Medical University from November 2019 to July 2023 were collected. They were divided into thrombotic group and non thrombotic group based on whether thrombosis had occurred. A retrospective study was conducted on two groups of recipients to evaluate the ch

aracteristics of donors and recipients and the risk factors for early thrombosis after pancreatic transplantation. Results The age of the donor and recipient was not significantly related to pancreatic thrombosis（P ＞ 0.05）. The recipient body mass index（BMI）was closely related to the formation of transplanted pancreatic thrombosis（P ＝ 0.01）.The choice ofdrainage method for pancreatic exocrine fluid had little effect on transplanted pancreatic thrombosis（P ＝ 0.49）. The

use of arteries or veins to extend the donor pancreatic vein was associated with thrombosis after pancreatic transplantation （P ＝ 0.02）. The incidence of thrombosis in recipients who received heparin and received sequential aspirin was lower than those who received aspirin alone（P ＝ 0.04）. The change of donor amylase was a risk factor for pancreatic graft thrombosis（P ＝ 0.04）. The change of D-dimer（D-D）on the 7th day after surgery in the recipient suggested the formation of transplanted pancreatic thrombosis. Conclusion The recipient's BMI，arterial or venous extension of the donor pancreatic vein，use of heparin，and changes in donor amylase are risk factors for early thrombosis after pancreatic transplantation. 

Objective To investigate the effect of cold ischemic time（CIT）on liver transplantation functionin the early stage after orthotopic liver transplantation（OLT）for critical liver disease. Methods From January 1，2015 to June 25，2019，the clinical data of 59 critically ill liver patients undergoing OLT at the Third Medical Center ofChinese PLA General Hospital were collected and analyzed. The clinical data were divided into group A（CIT ≤ 8 h，n ＝ 35），group B（8 h ＜ CIT ≤ 10 h，n ＝ 16），and group C（CIT ＞ 10 h，n ＝ 8）. Blood samples were collected preoperatively and 1，7，14，30，60 d after OLT to detect the dynamic changes of alanine aminotransferase（ALT），aspartate transaminase（AST），prothrombin time international normalized ratio（PT-INR）and prothrombin time activity （PTA）. Results Comparing the levels of ALT and AST in each group at the early postoperative stage，the levels of ALT and AST in all three groups reached the peak on the first day after OLT，and then gradually decreased. Both ALT and AST were equivalent between groups A and B on the 14th day，and the two indices were equivalent among group A，B and C on the 30th day. Correlation analysis demonstrated that the length of CIT was positively correlated with the peak value of ALT on the first day after OLT. Postoperative PT-INR and PTA of recipients in each group were significantly lower thanthose before OLT，and the difference within each independent sample were statistically significant. Conclusion Early recovery of liver function in patients with critical liver disease after OLT was affected by CIT significantly，and the ideal CITwas less than 8 ～ 10 h. 

Objective Hepatocellular carcinoma（HCC）is a leading cause of cancer mortality worldwide. This study was aimed atexploring the prognosis predictive ability of ferroptosis-related genes in HCC and constructing a reliable risk model for clinical management. The expression of ferroptosis-related genes in ischemia-reperfusion injury after liver transplantation was preliminarily studied. Methods Bioinformatics analysis of transcription data obtained from Therapeutically Applicable Research to Generate Effective Treatments（TARGET）was utilized in this study. COX regression and consensus clustering were performed to identify two molecular subgroups based on ferroptosis related to the prognosis of HCC patients. Furthermore，we explored the underlying mechanism of ferroptosis involved in the prognosis of HCC through the pathway analysis of the differentially expressed genes of the two molecular subsets. We then performed LASSO-COX regression analysis to build the risk model and visualize the model using a nomogram graph. Transcription data obtained from the GEO database was used to preliminarily explore the expression of ferroptosis-related genes in ischemiareperfusion injury after liver transplantation. Results We identified two molecular subgroups with distinct overall survival based on the different expression profiles of differentially expressed ferroptosis-related genes. Pathways analysisshowed 

differentially expressed immune and bile acid metabolism related genes between the two molecular subgroups. Finally，we established a risk model based on six ferroptosis-related genes KLF2，MYCN，FZD7，PRDX6，HILPDA，and SLC7A11. The nomogram established with the six genes performed reliable predictive ability of HCC prognosis. In addition，ferroptosis-related genes'expression was significantly changed in ischemia-reperfusion injury after liver transplantation. Conclusion The risk model developed based on the expression of ferroptosis related genes could act as a potent predictor of HCC prognosis.