Since the end of 2019, the novel coronavirus infection pandemic has swept the world. Although the current novel coronavirus mutants have decreased in pathogenicity and virulence compared with the original strains, and most patients have a good prognosis, the solid organ transplant (SOT) recipients are vulnerable to novel coronavirus. And even with vaccination, the risk of hospitalization or death is still high in SOT recipients infected with novel coronavirus. What′s more, the clinical manifestations, diagnosis and treatment strategy of SOT recipients infected with novel coronavirus has its unique features, which need high attention. At present, there is a lack of guidelines or consensus in the diagnosis and treatment field of novel coronavirus for such a large number of SOT recipients. Therefore, referring to the "Diagnosis and treatment plan of coronavirus (Trial Version 10)" and global published literature, the writing team wrote the "Expert consensus on diagnosis and treatment of novel coronavirus infection in solid organ transplant recipients (2023 edition)" . This consensus was evidence-based written and reached by experts after multiple rounds of discussions, forming 21 recommendations, providing reference for the diagnosis and treatment of SOT recipients infected with novel coronavirus.

自2019年新型冠状病毒感染(COVID-19)首次发现以来，截至2022年12月21日，全球确诊病例已超过6.49亿例，且死亡病例达660多万例^[1]。目前我国境外输入和本土疫情的新型冠状病毒(以下简称"新冠病毒")主要流行株是奥密克戎变异株^[2]。该病毒变异株传染性更强、传播速度更快、再感染率更高，在已接种新型冠状病毒疫苗(以下简称"新冠疫苗")的人群中易发生免疫逃避及突破感染^[3]。实体器官移植受者(solid organ transplant recipient，SOTR)因长期使用免疫抑制剂，且可能伴有高血压、糖尿病等慢性基础性疾病，感染新冠病毒后重症率和病死率均高于普通人群^[4]。按照中华人民共和国国家卫生健康委员会印发的《新型冠状病毒感染诊疗方案(试行第十版)》^[5]中将"免疫功能缺陷(如长期使用皮质类固醇或其他免疫抑制药物导致免疫功能减退状态)"人群列为重型/危重型高危人群之一。因此，应高度重视SOTR感染新冠病毒的健康管理，优化其预防、早期诊断和治疗策略。

Antibody-mediated rejection (AMR) is proved to be a crucial complication in heart transplantation, which has not been well evaluated and studied in China. Nowadays, it is considered that AMR contains a series of evolution process from pathological changes to clinic manifestation, which starts with the accumulation of immune factors (such as antibody, complement), the activation of complement and ends with graft tissues injury. Clinically, AMR was classified as circulating antibody silent stage, sub-clinical stage and symptomatic AMR stage. The mechanism of AMR involved in an inflammatory reaction induced by deposition of immunoglobulins and complements within the microvessels of the grafts, in which the activation of complements played a core role. Therefore, immunological assay of C4d and C3d in endomyocardial biopsy specimens combined with evidence of histopathology capillaries injury were necessary for the diagnosis of AMR. While noninvasive gene detection with Allomap and donor-derived cell-free DNA were effective method serving as screening and monitoring AMR. Recommendations on management of AMR consisted a combination of corticosteroid, intravenous immune globulin, plasmapheresis or rituximab by scale of AMR, which were proven to be effective against immune injury. However, the efficacy of anti-CD52 monoclonal antibody, eculizumab and photochemotherapy remains to be further evaluated.

Liver transplantation is recognized as the most effective treatment for end-stage liver diseases. In addition to excellent surgical skills, postoperative ischemia reperfusion injury (IRI) and rejection are important factors affecting the prognosis, long-term survival and life quality of patients. Kupfer cell (KC) is resident macrophages in the liver, which plays a crucial role in the process of IRI, rejection and immune tolerance after liver transplantation. This review summarizes the current status and progress of the research on the effects of KC on IRI, rejection and induction of immune tolerance after liver transplantation.

Nanotechnology is a new research direction in tissue engineering of tracheal grafts. Nanotechnology involves not only the nano biomaterials, but also the generation technology of nanofiber structure. Nano biomaterials are mainly divided into inorganic and organic, but in the specific operation, organic nano biomaterials have a broader prospect. There are three main types of nanofiber structure generation technologies: electrospinning, self-assembly and phase separation. Compared with the latter two technologies, electrospinning technology is more convenient and cost-effective. The purpose of this article is to review some important nano biomaterials, the application of nanofiber structure generation technology in tracheal grafts and the prospect of nanotechnology in tracheal grafts.

肝移植是治疗终末期肝病最有效的方法。随着外科技术和免疫抑制药物的发展，肝移植受者和移植物生存率已显著提高。根据中国肝移植注册中心(China Liver Transplant Registry，CLTR)数据，2015至2021年我国共实施肝移植35 566例，公民逝世后器官捐献肝移植和活体肝移植受者术后1、3、5年生存率分别为83.7%、74.5%、68.9%和92.4%、89.3%、88.2%^[1]。肝移植受者的长期存活和生存质量很大程度上取决于术后中长期健康管理和免疫抑制方案。长期服用免疫抑制剂可导致受者出现肾损伤、代谢性疾病和新发恶性肿瘤等严重并发症，甚至增加肝癌肝移植术后肿瘤复发风险^[2]。目前肝移植受者常用的免疫抑制方案以钙调磷酸酶抑制剂(calcineurin inhibition，CNI)为基础，其中以他克莫司+吗替麦考酚酯(mycophenolate mofetil，MMF)+泼尼松方案最为普遍。但是CNI引起的肾脏毒性、神经毒性和促进肿瘤复发等问题极大地影响了受者预后，近年来临床逐渐减少其用量并寻求替代药物。

Post-transplant diabetes mellitus (PTDM) is a common endocrine and metabolic disorder after adult solid organ transplant (SOT), affecting 10% to 40% of recipients. PTDM has been associated with increased mortality, heightened risk of infections, graft-related complications and cardiovascular diseases, all of which seriously threaten the quality of life and long-term survival of recipients. According to recent studies and the domestic healthcare system, this consensus provides a comprehensive overview of the epidemiology, risk factors, pathogenesis, screening and diagnosis, treatments, prevention strategies, cardiovascular risk factor management and microvascular complications associated with PTDM, in order to further standardize the diagnosis and treatment of PTDM. The objective is to standardize the comprehensive management of PTDM with the aim of enhancing the long-term quality of life and clinical outcomes for SOT recipients.

游离DNA(cfDNA)反映其来源细胞的病理生理状态，已经广泛应用于肿瘤和产前基因检测。在器官移植领域，供体来源游离DNA(ddcfDNA)作为一种无创"液体活检"标志物在肾移植中越来越被重视，其在各种疾病状态中的价值和意义逐渐被阐释。中国肾移植供体来源游离DNA应用与研究专家组和中国医药生物技术协会移植技术分会组织相关专家参考国内外最新进展，结合我国肾移植临床实际撰写了初稿，广泛征求国内本领域临床一线专家修改意见后统稿完成本共识。共识围绕cfDNA检测与ddcfDNA计算、标本留取规范、ddcfDNA绝对值和相对值的意义、ddcfDNA与移植肾排斥反应(包括与移植肾损伤/排斥反应、供体特异性抗体、亚临床排斥反应、移植肾活检病理的关系、在诊断小管间质性TCMR的作用)、动态ddcfDNA的监测意义、ddcfDNA与儿童肾移植、重复肾移植、肾小球滤过率、移植肾BK多瘤病毒感染及ddcfDNA检测的影响因素等十个方面进行了论述，并给出了相关专家推荐意见。

Kidney transplantation, the preferred treatment for patients with end-stage renal disease, has given millions of uremic patients a second chance in life. In the past year, as the world fought against the COVID-19, excellent outcomes had been achieved in the field of kidney transplantation in China and abroad. This article summarizes advances and achievements in the field focusing on donor sources, the influence and prevention of COVID-19 on kidney transplantation, graft rejection, immunologic tolerance, regenerative medicine in 2022.

The organ donation and transplantation in China has entered a new stage. The proportion of donation after cardiac death (DCD) in organ donation has decreased year by year. In order to guide the evaluation and application of DCD organs more scientifically and normatively, and ensure the transplantation effect, the Chinese College of Transplant Doctors, the Chinese Society of Organ Transplantation, the Section of Organ Transplantation, Chinese Society of Surgery, and the Chinese Hospital Association Organ Procurement and Dispensation Work Committee organize experts to update the latest progress on the basis of the Expert consensus on evaluation and application of organ donation after cardiac death in China (2014 edition), combing with evidence-based medical proof and clinical experience in recent years.

心脏移植是目前治疗终末期心脏病的主要手段^[1,2]。肺动脉高压(pulmonary hypertension，PH)作为终末期心力衰竭常见的并发症，是心脏移植的高危因素，可能会增加心脏移植术后右心衰竭发生风险和受者术后早期病死率^[3,4]。PH是指静息状态下，经右心导管检查(right heart catheterization，RHC)测定的肺动脉平均压(mean pulmonary artery pressure，mPAP)≥25 mmHg(1 mmHg＝0.133 kPa，下同)^[5]；2022年欧洲心脏病学会与呼吸学会更新了PH的诊断标准，为mPAP≥20 mmHg^[6]。RHC是将导管经外周静脉送入右心及肺动脉，并行血流动力学及氧动力学检测的技术，其中使用Swan-Ganz导管进行检查的技术称为右心漂浮导管检查^[7]。右心漂浮导管检查不仅是诊断PH的金标准，也是评估心脏移植不良事件或死亡风险的重要手段^[8,9]。2016年，国际心肺移植学会指南提出应对所有心脏移植成人候选者进行右心漂浮导管检查，据此来评估和确定心脏移植等待者名单；若等待时间超过半年以上，移植前复查右心漂浮导管检查并根据其状态动态调整检查间隔时间直到移植结束^[10]。据中国心脏移植注册系统数据，我国心脏移植数量已从2015年的279例增至2021年的738例，但仍无法满足大量终末期心力衰竭患者的救治需求^[11]。因此，对心脏移植患者术前肺动脉压进行可逆性评估至关重要，以优化围手术期的管理，提高心脏移植成功率及受者生存率^[12]。本文通过回顾性分析心脏移植术前行右心漂浮导管检查的35例受者临床资料，评估和总结右心漂浮导管检查临床应用效果及护理经验，现报道如下。

Kidney injury is a common complication after liver transplantation, including acute kidney injury and chronic kidney disease. Kidney injury in liver transplant recipients seriously affects their long-term survival and life quality, and is one of the main causes of death after liver transplantation. In order to standardize and optimize the diagnosis and treatment of kidney injury in liver transplant recipients, Branch of Organ Transplant of Chinese Medical Association and Branch of Organ Transplant Physicians of Chinese Medical Doctor Association organize experts to develop the "Clinical Practice Guidelines for Kidney Injury Management of Liver Transplant Recipients in China (2023 Edition)" to adapt to the rapid development of diagnosis and treatment. The guideline is based on "Chinese expert consensus on management of kidney injury in liver transplant recipients (2017 edition)" and in conjunction with recent evidence-based medicine and clinical practice experience in China. This guideline focuses on the definition, classification, assessment and preoperative, intraoperative and postoperative prevention and treatment of kidney injury in liver transplant recipients. By presenting a series of scientifically standardized recommendations, the guideline is aimed to optimize the management of kidney injury in liver transplant recipients in China.

Liver transplantation is one of the most important tools for the radical treatment of hepatocellular carcinoma (HCC). As the incidence of HCC continues to rise worldwide, the number of patients awaiting transplantation with HCC as a primary indication is increasing. However, the recurrence after transplantation remains inevitable and is one of the leading causes of death after liver transplantation. Therefore, the key to improving the long-term outcome of liver transplantation for HCC is to prevent tumor recurrence after transplantation. This article reviews recent advances in HCC liver transplant recipient and donor selection, preoperative bridging and downstaging therapy, intraoperative tumor-free techniques and ischemia-reperfusion injury in transplantation, personalized immunosuppressive regimens, and postoperative adjuvant and antiviral therapy to provide a reference for research and clinical practice in the prevention of tumor recurrence after liver transplantation for HCC.

In January 2015, organ donation after citizens′ death has become the only legal source of organs in China. After 8 years of reform practice and 2 years of special rectification, organ donation and transplantation in our country show fast, leap-forward development on a legal, ethical, scientific and standardized road, and has shown a good trend of high-quality, healthy and sustainable development along the same track as the international community. At present, China′s organ donation and transplantation ranks first in Asia and second in the world, which has been highly praised and supported by the international transplant community. However, the huge quantitative difference between donors and recipients is still a realistic problem that organ transplant doctors have to face. The development of xenotransplantation may be an effective means to alleviate the current situation of organ shortage, and its clinical promotion needs to overcome the serious complications caused by cross-species genetic differences. This paper summarizes the current development status of organ donation and transplantation in China and the progress of clinical research on xenotransplantation.