The successful procurement of deceased donor kidney is a prerequisite for a smooth kidney transplantation process. The procurement surgery must be carried out according to standardized procedures. To ensure the smooth progress of the donor kidney procurement surgery， the surgeon must possess：a clear understanding of anatomy， good spatial cognition， exquisite surgical skills， and close teamwork. To further standardize the technical operation of donor kidney procurement surgery， minimize unnecessary damage， ensure the quality of the donor kidneys， and maximize the utilization rate of donor kidneys， the Branch of Organ Transplant of Chinese Medical Association has organized organ donation and transplantation experts to pool collective insights on clinical issues. Drawing upon existing operational standards， expert consensus， and clinical practice experience， along with a thorough scientific literature search， we have synthesized， analyzed， and iteratively discussed the evidence and recommendations for the technique of deceased donor kidney procurement and have formulated this operational guideline to assist organ donation and kidney transplantation professionals in standardizing and optimizing the management and procedures involved in donor kidney procurement surgery.
Airway complications represent a significant challenge for recipients post-lung transplantation， with the potential to significantly impact quality of life and transplant outcomes. In consideration of the exponential growth in the number of domestic lung transplants， Branch of Organ Transplantation of Chinese Medical Association， in an effort to further enhance the prognosis of lung transplant recipients， convened a panel of experts in the field of lung transplantation to draft the Chinese guideline for clinical diagnosis and treatment of airway complications in lung transplant recipients （2024 edition）. The guideline address the risk factors associated with airway complications following lung transplantation， as well as the diagnosis， prevention， and treatment of 10 clinical issues. They present 21 evidence-based recommendations.
Quality Control Center for Donated Organ Procurement National, of Organ Transplantation of Chinese Medical Association Branch, of Organ Transplant Physicians of Chinese Medical Doctor Association Branch, Hospital Association Organ Procurement and Allocation Work Committee Chinese, Organ Transplantation Development Foundation China
To investigate the protective effect of resveratrol on the liver in mice subjected to hepatic ischemia-reperfusion injury （HIRI） and elucidate its mechanism.
Methods
Forty male C57BL/6 mice were randomly divided into four groups （10 mice per group） by random number table method：Sham group， HIRI group， HIRI+bilobalide group （HIRI+BB group）， and HIRI+N-acetylcysteine group （HIRI+NAC group）. The HIRI mice model was established by clamping the portal vein to block hepatic blood flow for 90 min and then reperfusing the liver for 6 h after releasing the clamp. Serum ALT and AST levels were measured， liver pathology was observed using HE staining，liver cell apoptosis was assessed by TUNEL assay， neutrophil and macrophage infiltration as well as cleaved caspase-3 expression in liver tissue were detected by immunofluorescence， and TNF-α and IL-1β levels in liver tissue were measured using ELISA kits. One-way ANOVA was used for comparison among groups， and Duncan's test was applied for pairwise comparisons. P＜0.05 was considered statistically significant.
Results
The serum ALT and AST levels in the HIRI+BB group were （455.0±64.1） and （508.3±72.7） U/L， respectively， both of which were significantly lower than those in the HIRI group ［（8 658.5±334.6） and （5 708.1±357.7）U/L， respectively）］， with statistically significant differences （all P＜0.05）. HE staining showed that the Suzuki score of liver tissue in the HIRI+BB group was lower than that in the HIRI group ［（3.7±0.3） and （7.5±0.7） points， P＜0.05］， and it was also lower than that in the HIRI+NAC group ［（3.7±0.3） and （5.9±0.4） points， P＜0.05］. Additionally， compared with the HIRI group， the infiltration of neutrophils and macrophages in the liver tissue of the HIRI+BB group was significantly reduced under a 400×microscope field ［（61.4±5.3） and （166.0±32.2）， （198.0±10.7） and （305.4±20.3） respectively， all P＜0.05］. Moreover， the expression of inflammatory factors TNF-α and IL-1β in the HIRI+BB group were significantly lower than in the HIRI group ［（12 190.4±1 424.2） and （25 283.1±2 596.6） pg/mL， （13 275.8±1 764.1） and （32 526.3±4 777.8） pg/mL， all P＜0.05］.TUNEL assay revealed that the number of apoptotic liver cells in the HIRI+BB group was significantly lower than in the HIRI group under a 200× microscope field ［（2.5±0.4） and （259.7±9.2）， P＜0.05］.
Conclusion
Bilobalide mitigates HIRI by reducing cell apoptosis and inhibiting the inflammatory response.
To investigate the expression level of FMNL3 in hepatocellular carcinoma （HCC） and its relationship with clinicopathological features and prognosis of liver transplant recipients with HCC.
Methods
The clinical data of recipients who underwent liver transplantation for liver cancer and were diagnosed as HCC by histopathology from January 2014 to December 2020 in the Organ Transplantation Center of the Affiliated Hospital of Qingdao University were retrospectively analyzed. Double Immunohistochemical staining was used to detect the expression of FMNL3 in 93 recipients and 56 cases of paracancerous tissues. The clinicopathological characteristics of recipients were collected. Survival curves were plotted by Kaplan-Meier method， and log-rank test was used to compare survival between groups. Cox regression models were used to analyze the risk factors of the prognosis of HCC liver transplant recipients. P＜0.05 was considered statistically significant.
Results
FMNL3 was highly expressed in 57 of 93 HCC tissues （61.3%） and 7 of 56 paracancerous tissues （12.5%）. The expression rate of FMNL3 in HCC tissues was higher than that in paracancerous tissues， and the difference was statistically significant （χ2=33.957， P＜0.05）. Recipients with hepatic capsular invasion， microvascular invasion （MVI）， and vascular tumor thrombus had higher proportions of high FMNL3 expression in HCC tissues than recipients without the above pathological features （χ2=4.890， 4.115， and 8.114， P＜0.05 for all）. As of December 31， 2022， 93 recipients were followed up for a median of 44.9 months （2.7-104.7 months）， with 37 cases of postoperative recurrence and 30 cases of death. Kaplan-Meier survival analysis showed that the 1 -， 3-and 5-year disease-free survival rates （PFS） were 66.7%， 56.1%， 42.8% and 88.9%， 83.3%， 80.2%， and the 1 -， 3-and 5-year overall survival were 80.6%， 68.1%， 53.0%， and 94.4%， 86.1%， 81.6% in the high and low FMNL3 expression groups， respectively， and the differences were statistically significant （χ2=10.494 and 6.994， P＜0.05）. Cox regression analysis showed that FMNL3 expression （HR=2.567， 95%CI：1.070-6.157）， maximum tumor diameter （HR=2.342， 95%CI：1.043-5.260）， preoperative alpha fetoprotein level （HR=0.325， 95%CI：0.127-0.832）， hepatic capsule invasion （HR=3.660， 95%CI：1.496-8.957）， MVI （HR=8.190， 95%CI：2.639-25.422） and vascular tumor thrombus （HR=2.566， 95%CI：1.130-5.829） were independent risk factors affecting postoperative PFS in HCC liver transplant recipients （P＜0.05 for all）.
Conclusions
The expression of FMNL3 in HCC is higher than that in paracancerous tissues， and the expression of FMNL3 in HCC is closely related to hepatic capsular invasion， MVI and vascular tumor thrombus. HCC liver transplant recipients with high FMNL3 expression in HCC tissues had lower PFS and overall survival after transplantation， and FMNL3 expression was an independent risk factor affecting the PFS of HCC liver transplant recipients after transplantation.
To systematically review and meta-analyze the evaluation reports of health-related quality of life （HR-QOL） in pediatric liver transplant recipients at home and abroad，and to explore the influencing factors of HR-QOL in pediatric liver transplant recipients.
Methods
A systematic search of domestic and foreign medical professional databases from January 2016 to February 2023 was performed to include studies related to HR-QOL assessment in pediatric liver transplant recipients. To summarize the scores of the pediatric quality of life inventory 4.0 generic core scales（PedsQL4.0） and the pediatric quality of life inventory 3.0 transplant module （PedsQL3.0TM），summarize the influencing factors of HR-QOL， and perform a meta-analysis to compare the differences in scores between different respondents and different scales. Continuous variables were introduced and standardized mean difference （SMD） were used as effect statistics， and point estimates and 95%confidence intervals （CI） were given.
Results
A total of 19 studies were included. Fifteen studies used PedsQL4.0 with a total score of 55 to 88.1 points. Nine studies used PedsQL3.0TM with a total score of 64.9 to 91 points. Disease factors， fatigue， and sleep are identified as predictors for HR-QOL in pediatric liver transplant recipients. Meta-analysis results indicated that parent-reported scores using the PedsQL4.0 were significantly lower than child self-reports （SMD=-0.18， 95%CI：-0.31 to -0.04， P＜0.05）， there was no significant difference in scores between child self-reports and parent reports using the PedsQL3.0TM （SMD=0.03， 95%CI：-0.15 to 0.20， P＞0.05）， and the PedsQL 3.0TM scores were significantly higher than those obtained with the PedsQL 4.0 scale （SMD=0.35， 95%CI：0.18 to 0.53， P＜0.05）.
Conclusions
There are some problems in the quality of life evaluation of pediatric liver transplantation， such as small quantity， poor quality and heterogeneity. The HR-QOL of pediatric liver transplantation recipients is affected by many factors. here are differences between parent and child reports of PedsQL4.0. Better consistency can be obtained by using PedsQL3.0TM.
Hypersplenism is a common complication in cirrhotic patients with portal hypertension. The main manifestations are splenomegaly and hemocytopenia. The outcome of patients with hypersplenism after liver transplantation is different due to the severity of the disease. At the same time， the treatment methods and principles of hypersplenism are different in different stages during liver transplantation. This article reviews the status quo of hypersplenism in liver cirrhosis， the changes of hypersplenism after liver transplantation， its potential mechanism and treatment， in order to provide reference for the diagnosis and treatment of hypersplenism resulted from cirrhosis.
Organ transplantation is an effective treatment for end-stage organ failure， but the survival of transplanted organs is significantly limited by transplant rejection and the adverse effects of immunosuppressive therapies. T cells play a central role in transplant rejection， as they recognize foreign antigens， become activated， and initiate effector responses that lead to organ damage.Identifying immunosuppressive strategies that can effectively suppress rejection while preserving normal immune function remains a major challenge for researchers and clinicians. T cell function is heavily dependent on metabolic pathways， which not only provide the energy required for T cell growth and proliferation but also supply essential substrates for immune responses. Increasing evidence suggests that the metabolic characteristics of T cells are closely linked to the initiation and regulation of immune responses， and metabolic pathways and metabolites may serve as novel targets for modulating immune responses. Consequently， modulating T cell metabolism is being explored as a potential strategy to promote transplant tolerance. This review focuses on the metabolic characteristics of T cells and their role in transplant immunity. We summarize recent advances in the regulation of transplant tolerance through metabolic interventions and discuss the potential clinical applications of these strategies. We propose that future immunosuppressive protocols may incorporate metabolic modulation， offering a more precise approach to immune tolerance and improving both transplant success and long-term patient survival.
