The promotion of deceased organ donation has effectively alleviated the shortage of kidney supply, yet the imbalance between supply and demand remains significant. In the context of organ scarcity, challenges persist in the field of kidney transplantation regarding how to rationally utilize donated kidneys, ensure their optimal allocation, and guarantee both short-term and long-term survival of kidney allografts and recipients. The evaluation and selection strategy of donated kidneys tests the expertise of transplant specialists. Donated kidney assessment involves multiple dimensions, including donor age, body mass index, history of hypertension/diabetes, tumors, infections, infectious diseases, imaging studies, renal function, pathological examinations, warm/cold ischemia times, and mechanical perfusion parameters. This consensus document aims to assist clinicians in conducting pre-transplant evaluations of deceased donor kidneys, optimizing donor-recipient matching, maximizing kidney utilization rates, increasing transplantation success rates, and improving long-term outcomes for kidneys and recipients.

With the progress of abdominal surgery technology and the development of comprehensive tumor treatment, abdominal surgery combined with vascular resection became more and more popular. As one of the alternative materials for vascular resection and reconstruction, allogeneic blood vessels had their unique advantages in morphology and histocompatibility. However, there was still a lack of unified application standards for the source, preservation, reconstruction methods and techniques of allogeneic blood vessels and the management after reconstruction. To this end, academic chapters such as the Society of Liver Transplantation, China International Exchange and Promotive Association for Medical and Health Care organized relevant domestic experts to participate in the discussion and formulation of this guidelines. The guideline mainly aimed at the source, preservation, clinical application and postoperative management of allogeneic vascular, and gave 10 recommendations based on existing evidence, aiming to guide clinical practice through evidence-based, and provide guiding suggestions for the application of allogeneic vascular transplantation in abdominal surgery.

To investigate the value of ultrasound in dynamic monitoring of bridging vessels in adult right half liver transplantation.

The data of adult right half liver transplantation recipients in the Organ Transplantation Center of the Affiliated Hospital of Qingdao University from January 1, 2015 to June 30, 2024 were retrospectively analyzed. A total of 27 recipients were included and divided into bridging group (n=19) and non- bridging group (n=8) according to the mode of liver resection and middle hepatic vein (MHV) branch reconstruction. Perioperative data and liver function parameter 1 week after operation were collected. Ultrasound was used to dynamically monitor the blood flow of portal vein, bridging vessels, Ⅴ and Ⅷ segment veins during and after operation, and spectral shape was observed and blood flow parameters were measured. Measurement data were compared using independent sample t test or Mann-Whitney U test, and enumeration data were compared using chi-square test or Fisher′s exact probability test. P value <0.05 was considered statistically significant.

There was no significant difference in sex, body mass index, model for end-stage liver disease score and albumin level, operation time, blood loss, anhepatic phase time and red blood cell transfusion, total postoperative hospital stay, portal vein flow on the 1st and 30th day after operation between the bridging group and the non-bridging group (P>0.05). The median postoperative ICU length of stay was 4.0 (3.0, 4.5) and 6.0 (5.5, 7.5) days in the bridging and non-bridging groups, respectively, and the difference was statistically significant (Z=-2.042, P<0.05). Within 1 week after operation, the liver function indicators of recipients in both groups steadily decreased, and the differences were not statistically significant (P>0.05). The flow velocities of the bridging vessels were (38.3±14.4), (30.7±13.4), (42.2±14.7), (38.7±14.4) and (36.0±21.4) cm/s during the operation and at 1, 7, 14, 30 days after transplantation, respectively, and the blood flow and spectrum showed well. Hepatic venous return was good in segments Ⅴ and Ⅷ of the transplanted liver, with venous flow velocities of (25.0±11.5) and (15.6±9.0) cm/s in segments Ⅴ on postoperative days 1 and 30, respectively; and (22.9±8.2) and (23.0±9.1) cm/s in segments Ⅷ on postoperative days 1 and 30, respectively.

Ultrasonography plays an important role in monitoring bridging vessels after MHV branch reconstruction in adult right half liver transplantation, and provides a sensitive and effective evaluation method for the detection of early postoperative vascular complications and liver allograft regeneration.

To explore the application value of rapid fluorescence staining in patients with infection after lung transplantation.

A retrospective analysis was conducted on the results of rapid fluorescence staining (including tissue cell fluorescence staining and fungal fluorescence staining) and microbiological culture of 69 respiratory samples from 19 patients who underwent lung transplantation surgery at the 8th Medical Center of PLA General Hospital from September 2021 to July 2024. The microbiological culture results were analyzed for pathogen detection and distribution. Performing morphological observation and analysis on rapid fluorescence staining. And using microbial culture results as the gold standard, evaluate rapid fluorescence staining, including detection rate, conformity rate, sensitivity and specificity. Count data were compared using chi-square test. Using ROC curve to evaluate the diagnostic value of rapid fluorescence staining for infection in patients after lung transplantation.

In 69 respiratory tract sample microbiological cultures, 80 pathogenic bacteria were detected, with 44 strains (55.0%) of bacilli, 11 strains (13.8%) of cocci, and 25 strains (31.2%) of fungi. The positive rate of histocyte fluorescence staining was 82.6% (57/69), which showed no significant difference compared to the positive rate of microbiological culture (85.5%) (χ²=0.460, P>0.05). Using bacterial culture results as the gold standard, the consistency, sensitivity, and specificity of histocyte fluorescence staining for detecting bacteria were 85.5%, 89.8%, and 60.0%, respectively. The positive rate of fungal fluorescence staining was 39.1% (27/69), which showed no significant difference compared to the positive rate of fungal culture (43.5%) (χ²=0.612, P>0.05). Using fungal culture results as the gold standard, the consistency, sensitivity, and specificity of fungal fluorescence staining for detecting fungi were 81.2%, 73.3%, and 87.2%, respectively. The areas under the ROC curves for histocyte fluorescence staining in diagnosing bacterial infections and fungal fluorescence staining in diagnosing fungal infections were 0.749 (P<0.05, 95% CI: 0.558-0.940) and 0.812 (P<0.05, 95% CI: 0.702-0.922), respectively.

Rapid fluorescent staining can preliminarily identify the types of bacterial and fungal infections within a short period of time, and visually assess the degree of inflammatory response in infections, thus possessing high diagnostic and clinical application value.

To explore the correlation of IL-6, IL-8, soluble tumor necrosis factor receptor 1 (sTNFR1), regenerating islet-derived protein 3-alpha (Reg3α), soluble suppression of tumorigenesis 2 (sST2) and elafin with acute graft versus host disease (aGVHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT).

A retrospective analysis was conducted on the clinical data of 106 patients who underwent allo-HSCT in the Department of Hematology at the 940th Hospital of the Joint Logistics Support Force of PLA between January 2019 and January 2023. Forty-nine patients who developed aGVHD were assigned to the aGVHD group, while 57 patients without aGVHD were included in the non-aGVHD group. Peripheral blood samples were collected from all patients at post-transplantation days + 28, + 56, and + 90 for cytokine quantification. Intergroup comparisons of normally distributed continuous variables were performed using the independent samples t-test. The Mann-Whitney U test was employed for non-normally distributed continuous variables. Categorical variables were compared using the chi-square test. A P-value < 0.05 was considered statistically significant.

At days + 28, sST2 level was significantly lower in the non-aGVHD group [52.2 (34.9-93.0) pg/mL] compared to the aGVHD group [98.2 (58.3-186.7) pg/mL], Z=-3.268, P < 0.05. At days + 56, the non-aGVHD group exhibited significantly reduced level of sTNFR1 [1 971.2 (1 656.8-2 537.0) pg/mL], sST2 [76.4 (40.0-134.4) pg/mL], and Reg3α [38.8 (23.8-92.6) pg/mL] relative to the aGVHD group [sTNFR1 2 791.2 (1 698.4-3 468.2) pg/mL, sST2 191.0 (113.5-620.2) pg/mL, Reg3α 77.0 (41.5-162.0) pg/mL], Z=-2.926, -4.420 and -3.393, all P < 0.05. At days + 90, the sST2 level was lower in the non-aGVHD group [78.6 (51.0-107.1) pg/mL] than the aGVHD group [146.9 (81.0-327.8) pg/mL], Z=-3.578, P<0.05. Patients with grade Ⅱ-Ⅳ aGVHD demonstrated significantly elevated sTNFR1 level at days + 56 [3 245.4 (2 804.6-3 557.6) pg/mL] and days + 90 [2 891.2 (2 024.6-4 534.0) pg/mL], as well as higher Reg3α level at days + 56 [162.0 (65.4-310.3) pg/mL] and days + 90 [92.5 (58.1-157.7) pg/mL] compared to those with grade Ⅰ aGVHD [sTNFR1 2 009.7 (1 599.5-3 259.1) pg/mL at days + 56, 1 870.9 (1 620.2-2 334.4) pg/mL at days + 90, Reg3α 53.7 (33.2-79.7) pg/mL at days + 56, 43.9 (39.2-64.7) pg/mL at days + 90], Z=-2.639, -2.242, -3.026 and -2.743, all P<0.05. Additionally, elafin level was significantly higher in the grade Ⅱ-Ⅳ aGVHD group [14.0 (10.3-24.7) pg/mL] versus the grade Ⅰ group [8.4 (7.5-14.3) pg/mL] at days + 90 (Z=-2.162, P<0.05). Patients in the gastrointestinal aGVHD group exhibited significantly increased Reg3α level at days + 28 [94.7 (27.9-307.8) pg/mL], days + 56 [306.4 (162.1-524.4) pg/mL], and days + 90 [124.5 (70.1-312.8) pg/mL] compared to those in the non-gastrointestinal aGVHD group [33.5 (19.6-57.3), 53.8 (33.8-81.7) and 43.9 (37.6-66.7) pg/mL, respectively], Z= -2.352, -3.857 and -2.800, all P<0.05. Similarly, sTNFR1 level significantly elevated in the gastrointestinal aGVHD group at days + 56 [3 250.5 (2 980.8-4 413.2) pg/mL] and days + 90 [4 534.0 (2 419.4-6 171.2) pg/mL] relative to the non-gastrointestinal aGVHD group [2 189.4 (1 609.7-3 297.1) pg/mL and 1 885.2 (1 715.0-2 530.0) pg/mL, respectively], Z=-2.842 and -2.100, all P<0.05.

The serum biomarkers (sST2, sTNFR1, Reg3α and elafin) are associated with the occurrence and severity of aGVHD in patients treated with allo-HSCT, which may be valuable for clinical diagnosis and intervention.

To systematically analyze the related literature of xenogeneic liver transplantation (XLT) at home and abroad, and to explore the hot issues in this field.

CiteSpace software was used to conduct a detailed visual analysis of XLT related literature included in the Web of Science core database, China National Knowledge Infrastructure (CNKI) and Wanfang database from January 1, 2012 to December 31, 2023. The analysis dimensions included annual publication volume, author, country/region, institution and key words.

A total of 283 English articles and 38 Chinese articles on XLT were included in this analysis. The analysis showed that during this period, the number of Chinese literature published was generally stable, while the number of English literature published showed an overall decline. The top three authors of Chinese literature were Tao Kaishan (11 articles), Dou Kefeng (10 articles) and Li Xiao (10 articles). The top three authors of English articles were Ayares David (13 articles), Burlak Christopher (11 articles), and A Joseph Tector (9 articles). The top three institutions in terms of the number of Chinese articles were Xijing Hospital of Air Force Medical University (9 articles), the First Affiliated Hospital of Xi 'an Jiaotong University (8 articles) and Chinese Academy of Agricultural Sciences (4 articles). The top three institutions in terms of the number of English articles were Harvard University (24 articles), Massachusetts General Hospital (17 articles) and Hospital Clinico Universitario Virgen de la Arrixaca (17 articles) in Spain. The research cooperation between relevant core authors and core institutions at home and abroad had the potential to be further explored. A total of 37 countries and regions participated in XLT research, and the top three countries in terms of the number of articles were the United States (77 articles), China (70 articles), and South Korea (32 articles). Keyword topic cluster analysis revealed that the research focus in the field of XLT at home and abroad mainly focused on seven theme groups: inflammation, cell therapy, experimental model, public attitude, immune microenvironment regulation, biomedical engineering and clinical application. Keyword cluster timeline analysis showed that the research related to immune rejection, inflammation, animal models, cell therapy and attitude had become hot topics in domestic and foreign research, and the research hotspots were closely related.

XLT research is of great significance, and it is expected to further promote the development of this field by strengthening the cooperation between domestic and foreign authors, policy encouragement and preferential funding allocation in the future.

Despite numerous clinical studies finding associations between non-HLA antibodies and graft tissue damage or dysfunction, only a limited number of studies have provided evidence that non-HLA antibodies can cause graft injury. This article categorizes non-HLA antibodies based on whether their target antigens are polymorphic and the primary expression sites of these antigens in tissues and cells. It also proposes clinical measures based on the likelihood of these antibodies causing or participating in antibody mediated rejection.

The liver has a strong regenerative capacity, but in some cases, such as liver fibrosis, cirrhosis, or acute liver injury, the liver′s ability to repair itself is inhibited, leading to disease progression. Mesenchymal stem cells (MSCs), with their unique biological properties, show important potential in disease treatment and regenerative medicine, but they carry risks such as tumorigenesis and transplant rejection. MSC-derived exosomes (MSC-Exos) have comparable functions to them and are safer, providing a new direction for disease diagnosis and treatment as a new cell-free therapy. MSC-Exos can effectively promote liver regeneration by regulating autophagy and inflammatory responses, exerting antioxidant effects, inhibiting hepatocyte apoptosis, and promoting angiogenesis. This article primarily reviews the characteristics of MSC-Exos and their potential mechanisms in liver regeneration, aiming to facilitate the application of MSC-Exos in the field of liver regeneration.

Castleman′s disease (CD) is a rare reactive lymphoproliferative disorder characterized by lymphoid tissue hyperplasia. Multicentric Castleman′s disease (MCD), involving multiple lymph nodes or regions, can lead to conditions such as glomerulonephritis, amyloid nephropathy, and interstitial nephritis, resulting in impaired renal function. Therefore, close monitoring of renal function in patients with MCD is necessary during clinical practice. Although renal transplantation following renal failure caused by MCD is relatively rare, the complexity of treatment and prognosis warrants increased attention. This article reviews currently reported cases related to CD and kidney transplantation, aiming to explore the challenges and benefits of kidney transplantation in MCD patients with renal failure and to provide feasible recommendations for clinical practice.

Liver transplantation is an important treatment method for the end-stage liver diseases. The thyroid hormone system plays a key role in the perioperative period of liver transplantation. Its dynamic changes are closely associated with the preoperative status of patients and the occurrence of perioperative complications. Thyroid hormone can regulate liver metabolic homeostasis and regenerative capacity through nuclear receptor-mediated signaling networks, while the liver affects thyroid functional status by regulating thyroid hormone metabolism, binding protein synthesis and bile excretion. Clarifying the role and mechanism of thyroid hormone in the perioperative period of liver transplantation can provide a theoretical basis for its optimal management during the perioperative period.