Pediatric lung transplantation is currently the only effective treatment for children with end-stage lung disease. In recent years, with the continuous advancement of organ donation and transplantation in China, the number of pediatric lung transplant procedures has gradually increased. However, given the relatively late initiation of pediatric lung transplantation in China, the development across centers remains uneven, clinical outcomes vary significantly, and unified professional consensus and management standards are lacking. To address these challenges, this guideline was developed through extensive discussion and evidence-based analysis by a multidisciplinary panel of experts. It focuses on key aspects of pediatric lung transplantation and proposes scientific and standardized principles for clinical practice, with the aim of improving both short- and long-term survival in pediatric recipients and promoting the normalization, standardization, and high-quality development of pediatric lung transplantation in China.

Primary graft dysfunction (PGD) is the most common and challenging early complication after lung transplantation, with a profound impact on both short- and long-term outcomes. To standardize and optimize the diagnosis and management of PGD and improve the prognosis of lung transplant recipients, the Lung Transplantation Group, Chinese Society of Organ Transplantation, Chinese Medical Association and China Quality Management and Control Center for Lung Transplantation convened a multidisciplinary working group. This group comprised experts from lung transplantation, intensive care medicine, respiratory and critical care medicine, cardiothoracic surgery and rehabilitation medicine. Drawing on recent evidence-based findings and the clinical practice experience of lung transplantation in China, the group developed the Guidelines for the Diagnosis and Management of Primary Graft Dysfunction After Lung Transplantation. The guideline addresses risk factors, diagnostic criteria, therapeutic strategies and prognosis of PGD, and provides a series of scientifically sound and standardized recommendations aimed at optimizing the comprehensive management of PGD in China.

Organ donation and transplantation in China have developed rapidly, ranking second in the world in terms of both donation and transplantation volume. However, both the quantity and quality of organ transplants remain to be further improved to satisfy the demands of the vast number of recipients awaiting transplantation. Artificial intelligence (AI) facilitates the integration, analysis, and application of multi-source clinical big data. It is capable of assisting in expanding the pool of available donor organs and enhancing graft quality, thereby providing a novel technological foundation for alleviating the imbalance between the supply and demand of transplant organs. To standardize the auxiliary application of AI throughout the entire process of organ donation and transplantation in China, a team of multidisciplinary experts were convened to formulate the Chinese Expert Consensus on AI-Assisted Clinical Decision-Making in Organ Transplantation. By establishing unified requirements for data and models, this consensus forms a technical framework covering clinical scenarios across the entire workflow of organ donation and transplantation, including donor assessment and maintenance, organ matching, organ preservation and transport, transplant surgery, and post-transplant recipient management. Furthermore, it clarifies ethical and regulatory constraints as well as the boundaries of responsibility subjects. The aim is to further enhance the standardization and safety of AI-assisted organ donation and transplantation, ultimately promoting the high-quality development of this field in China.

Autologous hematopoietic stem cell transplantation (auto-HSCT) is a crucial therapeutic modality for high-risk or relapsed lymphoma in adults with HIV infection. However, compared with Europe and American countries, China still faces significant gaps in the standardized and specialized management of auto-HSCT for HIV-positive patients. To address this issue, the National Clinical Research Center for Infectious Diseases, National Medical Center for Infectious Diseases, Yangtze River Delta Collaborative Group for Diagnosis and Treatment of Vulnerable Population with HIV/AIDS, AIDS Group, Society of Tropical Diseases and. Parasitology, Zhejiang Medical Association, jointly with experts from relevant fields, have developed this expert consensus by integrating the experience of major domestic auto-HSCT centers and the latest international research advances. This consensus covers multiple aspects, including pre-transplant evaluation and preparation (indications for auto-HSCT and patient assessment), implementation of auto-HSCT (timing of hematopoietic stem cell mobilization and collection, transplant procedure, management principles for related complications, and peri-transplant care), and post-transplant follow-up management (post-transplant maintenance therapy, hematopoietic reconstitution, immune reconstitution, and follow-up). It aims to provide scientific and standardized guidance for domestic clinicians, optimize the therapeutic outcomes of auto-HSCT in patients with HIV-associated lymphoma, and improve their long-term survival benefits.

To analyze the application effect of multimodal warming in the perioperative period of liver transplantation and its impact on early postoperative complications.

Patients who underwent liver transplantation at Affiliated Jinling Hospital, Medical School of Nanjing University from September 1, 2019 to January 31, 2025 were selected as observation subjects. They were divided into the conventional warming group and the multimodal warming group, using the implementation time of multimodal insulation regulations as the demarcation point. A total of 150 pairs of recipients were matched using a 1 ∶1 propensity score matching method. Perioperative temperature data and prognosis-related data of liver transplant recipients were collected, and the duration of intraoperative hypothermia, severity of hypothermia, and postoperative complications between the two groups were compared. Normally distributed measurement data were expressed as mean±standard deviation (±s), and comparisons between groups were performed using independent-samples t-test. Non-normally distributed measurement data were presented as median (interquartile range) [M(P₂₅, P₇₅)], and Mann-Whitney U test was used for inter-group comparison. Count data were expressed as number (percentage), and comparisons between groups were conducted using the χ² test or Fisher′s exact probability test. A P value <0.05 was considered statistically significant.

The incidence of hypothermia in the multimodal warming group was 42.7% (64/150), with a cumulative time of (22.3±8.4) min and a cumulative area of (4.5±2.3) ℃·min, all of which were lower than those in the conventional warming group [65.3% (98/150), (29.6±10.0) min, (5.8 ± 2.7) ℃·min] (χ²=15.152, t=6.844 and 4.771, all P<0.05). The body temperature of the multimodal warming group during hepatic portal occlusion was (36.2±0.3) ℃, and (35.6±0.6) ℃ at 5 min after inferior vena cava recanalization, both higher than those in the conventional warming group [(36.1±0.3) ℃ and (35.2±0.6) ℃, t=-2.459 and -4.955, all P<0.05]. The multimodal warming group also showed significantly lower intraoperative bleeding [1 600 (1 250, 2 190) vs 1 870 (1 300, 2 600) mL, Z=-2.508, P< 0.05], plasma transfusion [900 (700, 1 300) vs 1 000 (800, 1 600) mL, Z=-2.303, P<0.05], incidence of reperfusion syndrome [22.7% vs 35.3%, χ²=5.844, P<0.05], and a shorter postoperative time to extubation of tracheal tube [3(2, 9) vs 7(3, 13) h, Z=-4.110, P<0.05].

Multimodal warming technology can reduce the incidence and duration of intraoperative hypothermia in liver transplantation, decrease intraoperative bleeding and blood product requirements, lower the incidence of postoperative complications, and shorten the time of postoperative extubation, which promotes the rapid recovery of liver transplant recipients.

To investigate the psychological states, including depression, anxiety, loneliness, and post-traumatic stress symptoms, and the current situation of social support among parents who have lost their only child after organ donation in Zhejiang Province, and to analyze the influencing factors.

The questionnaire consisted of a general information questionnaire, the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder-7(GAD-7), the 6-items University of California Los Angeles loneliness scale (ULS-6), the Impact of Event Scale-Revised (IES-R), and the Social Support Rating Scale (SSRS). The t-test and Fisher′s exact test were applied to analyze the effects of various factors on mental status for normally distributed measurement data and count data, respectively. A value of P<0.05 was considered statistically significant.

A total of 90 questionnaires were distributed, and 36 valid questionnaires were retrieved, with an effective recovery rate of 40%. Among the 36 respondents, 21 individuals (58.3%) exhibited varying degrees of depressive symptoms, with a mean PHQ-9 score of 13.6±7.3. In terms of anxiety, 11 participants (30.6%) showed moderate to severe symptoms, with a mean GAD-7 score of 15.3±4.0. 21 respondents(58.3%) reported moderate to severe loneliness, with a mean ULS-6 score of 17.5±3.8. 27 individuals (75.0%) exhibited symptoms of post-traumatic stress, with a mean IES-R score of 47.9±27.5. Only 11.1% of the respondents received a high level of social support.

Parents who have lost their only child after organ donation in Zhejiang Province have high levels of depression, anxiety, loneliness, and post-traumatic stress. The occurrence of these mental issues is associated with economic burden, life difficulties, age, and the presence of chronic diseases.

Organ donation and transplantation serve as critical medical interventions for saving the lives of end-stage patients, and their sustainable development relies heavily on robust support from the social security system. Based on a review of literature and practical experience, this study systematically explores the mechanisms through which the social security system functions in the field of organ donation and transplantation. These mechanisms primarily include: alleviating the pressures on donors and their families through charitable assistance, humanitarian care, educational support, and transplant priority policies; enhancing the stability and capability of professional donation teams via human resource guarantees, team development, and training systems; improving registration, allocation, and sharing policies as well as medical security systems to reduce the economic and psychological burdens on transplant candidates; and standardizing medical practices while improving the quality of healthcare through stringent professional admission procedures, physician training, and certification systems. The multi-dimensional support provided by the social security system not only safeguards the rights and interests of key stakeholders but also enhances the overall efficiency of the system, playing a central role in promoting high-quality, standardized, and sustainable development in organ donation and transplantation.