Objective To compare and analyze the hemoglobin，platelet levels and hepatorenal and kidney function of lung transplant recipients who underwent V-V and V-A transfer within 7 d after surgery. Methods Thestudy retrospectively analyzed the recipients who have undergone ECMO after lung transplantation from April 2021 to December 2022 at the Affiliated Wuxi People's Hospital of Nanjing Medical University. The patients were divided into three groups according to whether they received ECMO or not and how they were rerouted ：non-ECMO group （n ＝ 19），V-V ECMO group（n ＝ 107）and V-A ECMO group（n ＝ 18）. Results Compared with the non-ECMO treatment group，the hemoglobin was lower in V-V ECMO and V-A ECMO groups on the first postoperative day，and the platelet level of the V-V ECMO group was lower on the 2nd day after surgery. V-A ECMO group have a lower platelet level on the 2nd to 4th day. There was no significant difference in hemoglobin and platelet levels between V-V ECMO and V-A ECMO groups within 7 d after surgery（P ＞ 0.05）. Compared with the nonECMO group，the creatinine was lower in the V-V ECMO group on the 2nd day after surgery，and was lower in the V-A ECMO group within the 3 d after surgery，with no significant difference between the groups on the 4th to 7th day after surgery. Compared with the V-V ECMO group，V-A ECMO have a lower creatinine level on the 3rd to 4th days. There were no significant differences in glomerular filtration rates between the non-ECMO group and V-V ECMO within 7 d after surgery. Compared with the V-A ECMO group，the glomerular filtration rate in non-ECMO group was lower within 4 d after surgery. The glomerular filtration rate in V-V ECMO group was lower within 7 d after surgery. In addition，The V-A ECMO group have a higher bilirubin level than non-ECMO group. Conclusion This study found that ECMO treatment has certain effects on the platelet level and glomerular filtration rate of patients after surgery，and the postoperative prognostic indicators of patients with V-A bypass are better than those with V-V bypass. 

Objective To explore the effects of different pulmonary hypertension on mechanicalventilation time and extracorporeal membrane oxygenation （ECMO） of patients after lung transplantation. Methods A retrospective analysis was conducted on 101 patients with lung transplantation admitted to the Department of Critical Care Medicine，Wuxi People's Hospital Affiliated to Nanjing Medical University from June 2nd，2018 to May 5th，2020. According to the different degrees of pulmonary hypertension after lung transplantation，the patients were divided into 62 patients with mild pulmonary hypertension group（≤ 49 mmHg，1 mmHg ＝ 0.133 kPa）and 39 patients with moderate and severe pulmonary hypertension group（≥ 50 mmHg）. Cox proportional risk model was used to analyze the effects of pulmonary hypertension on mechanical ventilationtime and ECMO after lung transplantation. The 30 d Kaplan-Meiers survival curve was used to analyze theeffects of different pulmonary hypertension groups on ECMO time and mechanical ventilation time of patients after lung transplantation. Results There were significant differences in age，primary disease，pulmonary hypertension value，ECMO mode and hemoglobin between mild and moderate to severe pulmonary hypertension groups （P ＜ 0.05）. The mechanical ventilation time and ECMO time of the two groups were compared according to the 30 d postoperative survival（P ＜ 0.05）. Univariate Cox regression analysis showed that the mechanical ventilation time and ECMO time of the two groups had statistically significant effects on the survival time after lung transplantation. Multivariate Cox regression analysis showed that the effect of mechanical ventilation time on survival time of patients after lung transplantation was statistically significant. Conclusion Patients with moderate and severe pulmonary hypertension after lung transplantation need longer ECMO time and mechanical ventilation time. 

Objective To summarize the application of early exercise combined with respiratory rehabilitation in two cases of heart-kidney transplantation，and to provide clinical practice theory for patients withheart-kidney transplantation. Methods From November 2020 to March 2021，two patients who underwentearly exercise combined with respiratory rehabilitation after heart-kidney transplantation in transplantationmedicine Center，the Second Affiliated Hospital of Guangxi Medical University were selected. The clinical and follow-up data of the patients were collected and analyzed，and the anxiety and depression score，muscle strength score，nutrition score，thrombus score，blood gas analysis index and postoperative follow-up pulmonaryinfection index were analyzed. Results The scores of anxiety and depression were significantly decreased，the scores of muscle strength， nutrition and thrombosis were significantly improved，PaO2 （arterial partial pressure of oxygen），SaO2 （arterial oxygen saturation）were increased and PaCO2 （partial pressure of carbon dioxide）was decreased in two patients who underwent early exercise combined with respiratory rehabilitation after heart-kidney transplantation. No pulmonary infection occurred during two years of follow-up. Conclusion Early exercise combined with respiratory rehabilitation can provide theoretical guidance and improve the psychological state，blood gas analysis index and exercise endurance of patients with heart-kidney combined transplantation. 

Objective To investigate the clinical characteristics and treatment plans of anemia causedby human parvovirus B19V infection after kidney transplantation. Methods A total number of 5 patients with refractory anemia who underwent kidney transplantation surgery at the Organ Transplantation Center of the 924th Hospital of the Joint Logistics Support Force of the People's Liberation Army of China were observed. Laboratorytests showed small cell hypochromic anemia，and after ruling out common causes of anemia，blood metagenomic next-generation sequencing（mNGS）testing showed positive for human parvovirus B19V. Treatment includederythropoietin，oral iron，intravenous injection of human immunoglobulin（400 mg/kg，d 1 ～ 5），adjusting theimmunosuppressive regimen（partially reducing the dose of tacrolimus，partially adjusting tacrolimus to cyclosporine） and other comprehensive treatments. Results After comprehensive treatment，4 cases among the 5 patients （80%）showed significant improvement in their conditions，1 case experienced recurrence，which was improved after intravenous injection of human immunoglobulin again. During treatment，1 case developed acute rejection reaction. Conclusion After kidney transplantation，patients with unexplained anemia and progressive exacerbationshould be alert to the possibility of human parvovirus B19V infection. Intravenous injection of human immunoglobulin is the preferred treatment method for pure red blood cell aplastic anemia caused by human parvovirus B19V infection after kidney transplantation. For recurrent patients，reapplication is still effective. Combined adjustment of immunosuppressive regimens and other comprehensive treatments can achieve ideal therapeutic effects. During thetreatment period，it is also necessary to closely monitor the functional status of the transplanted kidney to prevent rejection reactions. 

Objective To investigate the main causes of kidney transplantation graft loss，and analyze independent risk factors for loss of graft by chronic rejection. Methods The prognosis of all kidney transplantrecipients from January 2015 to January 2023 was retrospectively analyzed. A total number of 14 recipients with renal graft loss due to chronic rejection were selected as the case group，and 56 recipients corresponding to 28 donors without donor kidney loss were selected as the control group. Clinical data of the two groups of recipients and corresponding donors were retrospectively analyzed，and logistic regression analysis was carried out. Results Inthe past 8 years，147 cases experienced renal graft loss，including 67 cases of renal graft dysfunction and 80 cases of death. The top three causes of renal graft dysfunction were chronic rejection，vascular embolism and relapse of nephropathy. The top three causes of death in transplant patients were infection，cardiovascular accidents and digestive complications. Multivariate logistic regression analysis showed that there was a statistically significant difference in donor age between the case group and the control group（P ＝ 0.012）. Conclusion In our center， chronic rejection was the main cause of renal graft failure. The leading causes of death in kidney transplant patients are infection and cardiovascular problems. Age of the donors is the independent risk factor for renal graft loss bychronic rejection. 

Objective To investigate the protective effect of berberine pretreatment on liver injury in rats undergoing autogenous orthotopic liver transplantation and its related mechanism. Methods Twenty-four cleangrade healthy male Sprague-Dawley rats were divided into 3 groups（n ＝ 8）. They were sham operation group（S group），model group（AT group）and berberine pretreatment group（B group）. The weight was 250 ～ 280 g. In S group，the abdomen was opened，the corresponding blood vessels and ligaments were isolated，and the abdomen wasclosed. Rat models of liver injury after orthotopic liver transplantation were prepared in both AT and B groups，andberberine〔200 mg/（kg·d）〕was given by gavage 1 week before surgery in B group. Rats were anesthetized at 6 h after reperfusion，and the serum and liver tissues were collected. The serum levels of alanine aminotransferase（ALT）and aspartate aminotransferase（AST）were detected，the contents of serum high mobility group box-1 protein（HMGB1）（by enzyme-linked immunosorbent assay），and the expression of peroxisome proliferator activated receptor（PPARγ） and nuclear transcription factor-κB（NF-κB）（by immunohistochemistry）were determined. The expressions of ASC，NLRP3 and Pro-caspase1（by Western blot）were detected. Results Compared with S group，the levelsof serum ALT and AST and the contents of HMGB1 were significantly increased. The expression of PPARγin liver was down-regulated and the expression NF-κB、ASC、NLRP3 and Pro-caspase1 in liver was up-regulated，and histopathological injury of liver was significantly aggravated in AT and B groups（P ＜ 0.05）. Compared with AT group，the levels of serum ALT and AST and the contents of HMGB1 were significantly decreased. The expression of PPARγin liver was up-regulated and the expression NF-κB、ASC、NLRP3 and Pro-caspase1 in liver wasdown-regulated in liver tissue（P ＜ 0.05），and liver histopathological damage was significantly improved in B group. Conclusion Pretreatment of berberine can inhibit the expression of NF-κB by activating PPARγand then inhibiting the pyroptosis pathway，thus play a protective role against liver injury induced by liver transplantation in rats. 

Objective To investigate the promoting effect of human umbilical cord mesenchymal stem cells（hUC-MSCs）on long-term cultured human islets. MethodsThe hUC-MSCs were divided into three groups according to different cell concentrations ：group 104 ，group 105 and group106 . Each group was inoculated into 12-well plates in three parallel wells. After culturing for 24 h，150 IEQ human islets cultured for 17 d were added to each well and the group cultured without hUC-MSCs was a control. After culturing at 37℃ and 5% CO2 for 24 h，the islet shape，activity and static glucose-stimulated insulinreleaseindex（GSI）werecomparedindifferent groups.Results After culture，the shapes islets ineach group were compac，and there were somedeadcellsfloating in the culture medium of group 106 . Theactivity ofisletsingroup105 was significantly higher than that in the control group（P ＜ 0.01），and the activity of islets in group 106 was relatively poor（P ＜ 0.01）. The glucose stimulation GSI of pancreatic islets in group 105 was significantly higher than that of the control group（3.63±0.16 vs. 2.52±0.10，P ＜ 0.01）. There was no significant difference in the GSI of human pancreatic islets between the other two groups and the control group. ConclusionhUC-MSCs canimprove the in vitro activity and function of human pancreaticislet cell mass after long-term culture，but it is related to the concentration ofMSCs. 

Objective To investigate the cognition and attitude of medical staff towards organ donation and to provide reference for standardized organ donation. Methods A self-made questionnaire was used for the investigation. Meanwhile，an explanation toward the assessment items was given by the trained staff. Thequestionnaires were taken back after the survey immediately. Results All 1 197 questionnaires sent out weretaken back with 100% effective rate. Among them714 medical staff were willing to donate organs after death，while 415 were not sure and 68 were unwilling. A total number of 715 medical staff supported family members to donateorgans after death，400 had an uncertain attitude，and 82 did not agree to donate their family members’organs. The medical staff have a low cognition especially in questions like "citizens at any age are eligible to donate organs"，"manwith disease cannot donate organs or tissues"，"a certain organ donor can donate only one organ". As for the ways of acquiring knowledge about organ donation，more people obtained relevant information from the internet（80.37%），the government，the Red Cross and medical institutions（78.36%）. Conclusion The medical staff of the top threehospital hold a positive attitude towards organ donation，but they lack relevant knowledge.