Objective Examining the effects of donor-recipient age gap and donor liver weight-torecipient weight ratio on postoperative wound infection in recipients. Methods Clinical data of patients undergoing liver transplantation at Renmin Hospital of Wuhan University from June 1，2017 to September 1，2023 were retrospectively collected.Differences in donor infection rates between groups before and after propensity scoringwere analyzed by chi-square test. Results The donor-recipient age gap was greater than or equal to 10 yearsin 32 cases. A total number of 51 cases had a donor-recipient age gap less than 10 years. Pre-propensity score ：no difference in early infection rate. Late infection rate did not differ. The ratio of donor liver weight to recipient body weight was greater than 0.01 in 46 cases. The ratio of donor liver weight to recipient body weight was less thanor equal to 0.01 in 37 cases. Before propensity scoring ：early infection rate did not differ. Late infection rate didnot differ. A total number of 32 donor-recipients had an age difference greater than or equal to 10 years. Thirtytwo patients with a donor-recipient age gap less than 10 years were matched according to 1 ∶ 1. After propensityscoring ：early infection rates were statistically different（χ2 ＝ 4.27，P ＝ 0.04）. There was no difference in therate of late infection. A total number of 37 patients have a donor liver weight-to-recipient weight ratio less thanor equal to 0.01. A total number of 37 patients with a donor weight-to-recipient weight ratio greater than 0.01 were matched according to a 1 ∶ 1 ratio. After propensity scoring ：early infection rates were statistically different （χ2 ＝ 9.95，P ＜ 0.01）. There was no difference in the late infection rate. Conclusion Donor-recipient agegreater than 10 years and donor liver weight to recipient body weight ratio less than or equal to 0.01 were risk factors for early postoperative wound infection in recipients. 

Objective To investigate the effect of donor quality on the survival rate of liver transplantationrecipients after cardiac death organ donation（DCD）. Methods A retrospective analysis was performed on 100 patients who received DCD liver transplantation from January 2018 to January 2021. A 1-year follow-up survey was conducted after transplantation to observe the survival status of liver transplantation recipients and to analyze the risk factors affecting liver transplantation recipients. Results The mortality rate of liver transplantation recipientswas 3%（3/100）. The mortality factors were closely related to the donor cold ischemia time，donor fatty liver，intraoperative blood loss，donor albumin and total bilirubin levels，and hepatocyte edema（P ＜ 0.05）. MultivariateLogistic regression analysis showed that donor cold ischemia time ≥ 840 min and fatty liver were independent risk factors for survival status of liver transplantation recipients（P ＜ 0.05）. The postoperative infection rate of liver transplantation was 26%（26/100），and the postoperative infection rate was closely correlated with child-Pugh scoreof recipient，preoperative hemoglobin level，platelet count，intraoperative blood transfusion volume and postoperative intensive care unit（ICU）observation time（P ＜ 0.05）. Conclusion DCD donor quality has a significant impact on the survival rate of recipients after liver transplantation，and the donor cold ischemia time and fatty liver have an important impact on the survival status of recipients after liver transplantation，while the preoperative anemia level，intraoperative blood loss and postoperative ICU observation time of recipients are closely related to the incidence of postoperative infection. 

 Objective To explore the knowledge and understanding of relatives of potential organdonors in children about organ donation，and to analyze the influencing factors of their willingness to donate organs. Methods The data of 57 children eligible for organ donation and their relatives in the 900th Hospital of Logistic Support Forces from 2017 to 2021 were retrospectively analyzed.They were divided into the agree group（n ＝ 14）and the disagree group（n ＝ 43）according to whether they finally agreed to organ donation. The aim isto investigate the awareness and understanding of organ donation among children's relatives，and to analyze the influencing factors of organ donation willingness. Results Among the 14 children with organ donation，brain trauma，glioma and meningitis were the main causes，which accounted for 5（35.71%），4（28.57%）and 3（21.43%）cases. Three children's family members agreed to organ donation immediately after the first communication，six children's family members communicated twice，and five children's family members communicated more than twice. A total of 11 livers，10 pairs of kidneys，3 pairs of hearts，11 pairs of corneas and 1 gross organ were donated. Univariate analysis and Logistic multivariate analysis showed that religious belief（OR ＝ 2.916，95% CI ＝2.546 ～ 9.646），only child（OR ＝ 2.246，95% CI ＝ 1.536 ～ 6.347），less knowledge of organ donation（OR ＝2.578，95%CI ＝ 1.864 ～ 5.346），unwilling to give up treatment（OR ＝ 3.635，95%CI ＝ 2.835 ～ 11.536）were independent influencing factor of organ rejection by family members of children. Conclusion The decision of therelatives of potential organ donors is often affected by many factors. It is necessary to strengthen the publicity andeducation in daily public welfare publicity to improve the public's awareness and understanding of organ donation，this is conducive to improving the success rate of organ donation in children. 

Objective To explore the application of metagenomic next-generation sequencing（mNGS）ofpathogens in the detection of pathogenic microorganisms in organ donors，and to provide a basis for targeted treatmentof anti-infective drugs after organ transplantation. Methods A retrospective analysis was conducted on the clinical cases of 142 organ donors at Central South Hospital of Wuhan University from August 2021 to June 2023. Bloodsamples from donors were collected for mNGS testing and pathogen culture testing，and the results were analyzed and compared. Results Pathogenic microorganisms were detected in 98 out of 142 donors with mNGS，the positivedetection rate was 69.01%. Among them，59 cases（60.20%）were simple viral infections，12 cases（12.24%）were simple bacterial infections，4 cases（4.08%）were simple fungal infections，and 23 cases（23.47%）were mixed infections. A total of 173 strains of pathogenic microorganisms were detected. Among them，there were 125 strains of viruses（72.25%），40 strains of bacteria（23.12%），and 8 strains of fungi（4.62%）. Blood samples from donors were sent for mNGS testing and microbial culture testing. Among 142 donors，20 cases（14.08%）detected pathogenicmicroorganisms in blood culture，and a total of 21 strains of pathogenic microorganisms were detected，of which20 cases（95.24%）had bacteria and 1 case（4.76%）had fungal infection. Two cases（1.40%）of pathogenicmicroorganisms were found in organ preservation solution. Conclusion The detection rate of pathogenic microorganisms by mNGS is higher than that by microbial blood culture detection. The difference between mNGS detection and blood culture pathogen detection in bacterial diagnosis is not significant，but there is statistical significance when detecting fungi and viruses. Moreover，mNGS detection can significantly shorten the testing timecompared to blood culture pathogen detection. 

Objective To explore the clinical application value of extended release tacrolimus in longterm adult liver transplantation recipients with stable liver function. Methods The clinical data of long-termliver transplant recipients who were followed up in our hospital from January 2018 to January 2023 and converted to extended release tacrolimus were reviewed. The changes of liver function，renal function，tacrolimus drug concentration and CD4+ T cell count at different time points before and after the application of extended release tacrolimus were analyzed. Results A total of 21 patients were treated with extended release tacrolimus after liver transplantation. The male to female ratio was 13 ∶ 8. The average age was（60.07±8.24）years old. The conversion time（from liver transplantation surgery）was（28.85±49.47）months. The dose ratio of immediate- and extendedrelease tacrolimus was 1 ∶ 1.03. Compared with that before conversion，the levels of alanine aminotransferase （ALT），aspartate aminotransferase（AST），γ-glutamyl transpeptadase（GGT），alkaline phosphatase（ALP）， creatinine（Cre），bloodureanitrogen（BUN），as well as the number of CD4+ T cells and tacrolimus concentration were not statistically significant in 2，4，12 weeks after dressing change. Three patients showed slight fluctuations in liver function，and liver function returned to normal after adding extended release tacrolimus. Conclusion The adult liver transplantation patients with stable liver function were changed from immediate tacrolimus to extended release tacrolimus，the liver function was stable and the rejection rate was low，the renal function was not significantly improved. 

Objective To analyze the causes and characteristics of death of kidney transplant recipients. Methods "Kidney transplantation" "death" and "cause" were searched in the retrieval system of China Biomedical Literature Database，China National Knowledge Network and Wanfang Medical network，and the 15 literatures included were statistically analyzed. Results A total of 18 070 kidney transplant recipients from 1977 to 2018 were included，and 2 286 of them died，with the mortality rate ranging from 2.0% to 35.7%，and the overall mortality rate was 12.6%（2 286/18 070）. The causes of death included 810 cases（35.4%）of infection，787 cases（34.4）of cardiovascular and cerebrovascular diseases，344 cases（15.1%）of liver failure，73 cases（3.2%）of gastrointestinal diseases，69 cases（3.0%）of tumor，19 cases（0.8%）of accidental death，10 cases（0.5%）of economic factors，and 174 cases of other causes（7.6%）. Conclusion Infection and cardiovascular and cerebrovascular diseases were the main causes of death in kidney transplant recipients，liver failure was the secondarycause，and gastrointestinal diseases and tumors were the rare causes，and other causes were rare. 

Objective To investigate the expression and scientific significance of PBRM1 in renal transplantation ischemia reperfusion injury（IRI）. Methods Three groups of kidney tissues（5 cases in eachgroup）were selected and divided into normal kidney group（Control），stable allograft function（STA group），and ischemia injury（IRI group）. The expression of polybromo 1（PBRM1）in the three groups was detected by immunohistochemistry. The expression of PBRM1 after renal IRI was analyzed with Gene Expression Omnibus（GEO）data set and its mechanism was discussed. Finally，the expression of Pbrm1 in Th17 cells was verified in vitro. Results Immunohistochemical staining showed that the expression of PBRM1 in IRI group was significantly higher than that in the other two groups. GSE180420 database analysis showed that PBRM1 expression was significantly increased in IRI group compared with Control，and GSEA results suggested that PBRM1 could promote the function of Th17 cells. In vitro experiments confirmed that the transcription level of Pbrm1 was significantly increased in Th17cells compared with Th0 cells. Conclusion The expression of PBRM1 was significantly increased after renal IRI transplantation. PBRM1 may aggravate renal IRI by affecting the function of Th17 cells.