器官移植

2020 Vol. 11, No. 2

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Special Column of COVID-19 Pneumonia
Editorial
Diagnosis and Treatment Specification
Academic Summary
Original Article
Guideline Interpretation
Donation Window
Review Article
Transplantation Cloud College

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Special Column of COVID-19 Pneumonia

Guidelines for organ donation and transplantation in China during novel coronavirus pneumonia epidemic

Branch of Organ Transplantation of Chinese Medical Association

2020, 11(2): 179-184. doi: 10.3969/j.issn.1674-7445.2020.02.001

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Abstract:
In December 2019, a novel coronavirus pneumonia outbreak in Hubei Province spread rapidly to many provinces and cities. As organ transplantation is in the stage of high-quality development in China, how to carry out organ donation and transplantation in a scientific and orderly manner during the severe epidemic, summarize and analyze the clinical characteristics of COVID-19 on organ transplant recipients, and optimize the prevention, early diagnosis and treatment strategies of COVID-19 to ensure medical safety is essential to the development of organ transplantation and the treatment of the patients with end-stage organ failure as well as the overall situation of the prevention and control of COVID-19 epidemic. Thus, based on the instructions of the National Health Committee, the guidelines are issued by several experts organized by Branch of Organ Transplantation of Chinese Medical Association, providing help to the workers and managers of organ donation and transplantation in China. Approved by the Standing Committee of Branch of Organ Transplantation of Chinese Medical Association, the guidelines adopt the 'expert advice', 'prevention and control strategies' and 'guidance' published in China for reference, and will be revised upon changes of the further understanding of COVID-19 and epidemic control situation.

Clinical characteristics of novel coronavirus pneumonia in organ transplant recipients and management strategy during the epidemic (1st edition)

Ju Chunrong, Li Ning, Qiu Tao, Xue Wujun, Shi Bingyi

2020, 11(2): 185-193. doi: 10.3969/j.issn.1674-7445.2020.02.002

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Abstract:
In December 2019, a number of cases of pneumonia with unknown causes were successively reported in multiple hospitals in Wuhan City, Hubei Province, China. The pathogen is a novel coronavirus, which can lead to novel coronavirus pneumonia (COVID-19) and even threaten the patients' lives. In the following, the COVID-19 epidemic is spreading rapidly in many provinces and cities. It is particularly important to summarize and analyze the clinical characteristics of COVID-19 in solid organ transplantation (SOT) recipients and to optimize the prevention, early diagnosis and treatment strategies. Therefore, we organized Chinese experts in the field of organ transplantation to draft this article according to the characteristics of lung infection of SOT recipients and the characteristics of current COVID-19 by referring to relevant guidelines and specifications at home and abroad, aiming to provide reference for transplant physicians in China. This management strategy will be revised at any time with the deepening understanding of the COVID-19 infection.

Editorial

Research progress on biomarkers of rejection risk in organ transplantation

Shi Bingyi, Chen Wen, Liu Zhijia

2020, 11(2): 194-198. doi: 10.3969/j.issn.1674-7445.2020.02.003

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Rejection is the main cause of transplantation failure. Currently, the specificity and sensitivity of clinical parameters are relatively poor, which cannot accurately prompt the exact cause of rejection. It is of great clinical significance to explore novel biomarkers for monitoring the rejection. In this article, the latest research progress on the biomarkers of rejection risk in organ transplantation were summarized from the perspectives of transplantation pathology, immune cells and regulatory immune cells, non-human leukocyte antigen antibodies, exosomes, cell-free DNA and combination gene prediction, aiming to provide reference for early warning and treatment of rejection in organ transplantation.

Review and prospect of clinical application of umbilical cord blood transplantation for 30 years

Sun Zimin

2020, 11(2): 199-203. doi: 10.3969/j.issn.1674-7445.2020.02.004

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Hematopoietic stem cell transplantation is a pivotal method to treat hematological malignancies, hematopoietic failure diseases and inherited metabolic diseases. Umbilical cord blood is one of the main sources of hematopoietic stem cells and the most ideal cell source for stem cell research and application. In this article, the clinical application of umbilical cord blood transplantation for more than 30 years was reviewed from the aspects of the history, current situation, advantages, improvement, application prospect and expectation of umbilical cord blood transplantation.

The development of lung transplantation: current situation and future of lung transplantation in China

Hu Chunxiao, Li Xiaoshan, Wei Dong, Chen Jingyu

2020, 11(2): 204-207. doi: 10.3969/j.issn.1674-7445.2020.02.005

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As one of the four major types of organ transplantation, lung transplantation has been developed rapidly in recent years. With the establishment of Quality Management and Control Center for Lung Transplantation of National Health Commission, the formulation of Technical Management Specifications for Lung Transplantation and Standard Procedures and Technical Specifications for Lung Transplantation and the implementation of a series of measures, the quality and quantity of lung transplantation have been steadily increased in China. It will provide a guarantee for further promoting the development of lung transplantation in China by the establishment and improvement of scientific quality control parameters for clinical application of lung transplantation technology, the formulation of standard procedures and technical specifications for lung transplantation, strengthening the management of standardized training bases for lung transplantation, building up a multidisciplinary lung transplantation team and constructing a complete lung transplantation database.

Diagnosis and Treatment Specification

Technical specification of blood purification in organ transplantation (2019 edition)

Branch of Organ Transplantation of Chinese Medical Association

2020, 11(2): 208-221. doi: 10.3969/j.issn.1674-7445.2020.02.006

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In order to further standardize the clinical technical operation of blood purification related to organ transplantation, experts in the fields of organ transplantation and nephrology organized by Branch of Organ Transplantation of Chinese Medical Association have formulated this specification from the perspectives of technical operation specifications of vascular access, hemodialysis, peritoneal dialysis, hemofiltration, plasma exchange and immunoadsorption.

Academic Summary

Overview of international forefront hotspots and new progress on organ transplantation in 2019 ATC

Wang Xianghui

2020, 11(2): 222-233. doi: 10.3969/j.issn.1674-7445.2020.02.007

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In this paper, forefront hotspots in clinical and applied basis of organ transplantation as well as translational medicine during 2019 American Transplant Congress (ATC) were summarized. It involved transplantation clinical priorities and difficulties which were concerned by transplant surgeons. These hot topics included the immunological mechanisms, risk factors, prognosis evaluation and important biological markers of donor specific antibody (DSA) and antibody-mediated rejection (AMR), desensitization strategy in highly sensitized patients and progress of AMR prevention and treatment, current status and development direction of clinical immune tolerance, hotspots and prevention progress on transplantation-related infection, and brief evaluation of various donor organ mechanical perfusion methods, etc.

Original Article

Effect of pretransplant iron overload on clinical efficacy of allogeneic hematopoietic stem cell transplantation on severe aplastic anemia

Pan Tianzhong, Tang Baolin, Zhu Xiaoyu, Liu Huilan, Song Kaidi, Wan Xiang, Yao Wen, Sun Guangyu, Wang Jian, Sun Zimin

2020, 11(2): 234-239. doi: 10.3969/j.issn.1674-7445.2020.02.008

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Objective To evaluate the effect of pretransplant iron overload on the clinical efficacy of allogeneic hematopoietic stem cell transplantation (allo-HSCT) in patients with severe aplastic anemia (SAA). Methods Clinical data of 80 SAA recipients who underwent allo-HSCT for the first time were retrospectively analyzed. According to the incidence of iron overload, all recipients were divided into the iron overload group (n=20) and non-iron overload group (n=60). The engraftment rate, incidence of postoperative complications and clinical prognosis of the recipients afterallo-HSCT were statistically compared between two groups. The influencing factors of 2-year overall survival (OS) and 180 d transplantation related mortality (TRM) were analyzed by Cox proportional hazards regression model. Results The engraftment rate of neutrophils in the non-iron overload group was 98% (59/60), significantly higher than 75% (15/20) in the iron overload group (P < 0.05). The engraftment rate of platelet in the non-iron overload group was 90% (54/60), significantly higher than 65% (13/20) in the iron overload group (P < 0.05). The incidence rate of bloodstream infection in the non-iron overload group was 23% (14/60), remarkably lower than 40% (8/20) in the iron overload group (P < 0.05). The 180 d TRM of the recipients in the non-iron overload group was 17%, significantly lower than 45% in the iron overload group (P < 0.05). The 1- and 2-year OS of the recipients in the non-iron overload group were 82% and 80%, significantly higher than 50% and 44% in the iron overload group (both P < 0.05). Iron overload or not was an independent risk factor of the OS and TRM of the recipients (both P < 0.05). Conclusions Iron overload can affect the OS and TRM of SAA patients after allo-HSCT.

Analysis of the efficacy of pretreatment regimen containing idarubicin in allogeneic hematopoietic stem cell transplantation for high-risk refractory leukemia

Cheng Haoyu, Yang Yixin, Yang Fan, Zhang Weijie, Fei Xinhong, Yin Yuming, Gu Jiangying, Man Qihang, Zhao Jie, Wang Jingbo

2020, 11(2): 240-246. doi: 10.3969/j.issn.1674-7445.2020.02.009

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Objective To investigate the clinical efficacy of pretreatment regimen containing idarubicin (IDA) in allogeneic hematopoietic stem cell transplantation (allo-HSCT) for high-risk refractory leukemia. Methods A total of 116 patients with high-risk refractory leukemia who received allo-HSCT treated with 7 types of IDA-containing pretreatment regimes were enrolled in this study. The implantation rate of 116 recipients was summed up. The 2-year overall survival (OS), 2-year disease free survival (DFS), cumulative recurrence rate, recurrent mortality, transplantation related mortality (TRM), cumulative incidence of acute graft-versus-host disease (aGVHD) and chronic graft-versus-host disease (cGVHD) were statistically analyzed by Kaplan-Meier survival curve. Results All 116 recipients successfully implanted. The median follow-up time was 28 (7-70) months. Among them, 64 recipients survived, the 2-year OS was 55.2%, 2-year DFS was 51.7%, 2-year recurrent mortality was 23.3% and 2-year TRM was 18.1%. Among 116 recipients, 72 cases suffered from aGVHD. The 2-year cumulative incidence rate of aGVHD was 62.1% including 20 cases of grade Ⅲ-Ⅳ aGVHD, the 2-year cumulative incidence rate was 17.2%. Among 116 recipients, 59 cases presented with cGVHD. The 2-year cumulative incidence rate was 55.4%, of which the 2-year cumulative incidence rate of extensive cGVHD was 14.7%. Among 116 recipients, 30 cases recurred with a 2-year cumulative recurrence rate of 25.9%. Conclusions IDA-containingpretreatment regime has high safety and effectiveness, and can be used as an effective pretreatment regime for transplantation preprocessing in patients with high-risk refractory leukemia.

Relationship between expression level of 15-PGDH and clinical prognosis of liver transplantation for hepatocellular carcinoma

Li Haibo, Wang Guoying, Zeng Kaining, Zhang Jianwen, Tang Hui, Liu Wei, Yang Yang

2020, 11(2): 247-252, 281. doi: 10.3969/j.issn.1674-7445.2020.02.010

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Objective To investigate the relationship between the expression level of 15-hydroxyprostaglandin dehydrogenase (15-PGDH) and clinical prognosis of liver transplantation for hepatocellular carcinoma. Methods The clinical data of 94 recipients undergoing liver transplantation for hepatocellular carcinoma were retrospectively analyzed. The expression of 15-PGDH in the pathological tissues of all recipients was detected by immunohistochemical staining. The relationship between the expression level of 15-PGDH protein and clinical parameters of hepatocellular carcinoma patients was analyzed. The 5-year tumor-free survival and overall survival rates of liver transplant recipients were calculated. The possible independent risk factors of the clinical prognosis of liver transplant recipients were analyzed. Results The expression level of 15-PGDH was significantly correlated with age, Child-Pugh grade and preoperative level of alpha-fetoprotein (AFP) of the recipients (all P < 0.05). The tumor-free survival and overall survival rates of the recipients with low expression of 15-PGDH were significantly lower than those in their counterparts with high expression of 15-PGDH (both P < 0.05). The expression level of 15-PGDH, degree of tumor differentiation and American Joint Committee on Cancer (AJCC) staging were the independent risk factors of clinical prognosis of liver transplantation for hepatocellular carcinoma (all P < 0.05). Conclusions The expression level of 15-PGDH is an independent risk factor of clinical prognosis of liver transplantation for hepatocellular carcinoma.

Effect and mechanism of human gingival mesenchymal stem cell on B cells

Zhang Kai, Chen Keyan, Li Kai, Ma Tieliang, Gu Jian

2020, 11(2): 253-258. doi: 10.3969/j.issn.1674-7445.2020.02.011

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Objective To investigate the regulating function of human gingival mesenchymal stem cell (GMSC) on the proliferation and differentiation of B cells and its underlying molecular mechanism. Methods GMSC were isolated and B cells were isolated from peripheral blood. GMSC or fibroblasts were co-cultured with B cells in vitro and assigned into the GMSC group and fibroblast group. The proliferation of B cells was detected in two groups. The expression of IgG1 and IgM in the cell supernatants was measured between two groups. The secretion of interleukin (IL)-6, Perforin, interferon (IFN)-γ and tumor necrosis factor (TNF)-α was compared between two groups. The expression levels ofIL-10 and transforming growth factor (TGF)-β in B cells were detected between two groups. The expression of PC-1 in B cells was measured in two groups. The signaling pathway involved with the regulating effect of GMSC on B cell function was investigated. The regulating effect of GMSC on the role of B cells in activating T cell function was assessed. Results Compared with the fibroblast group, the proliferation of B cells was significantly weakened in the GMSC group (P < 0.05). Co-culture of GMSC and B cells significantly inhibited the secretion of IgG1 and IgM from B cells and the secretion ofIL-6, Perforin, IFN-γ and TNF-α (all P < 0.05). Compared with the fibroblast group, the secretion of IL-10 and TGF-βwas significantly higher in the GMSC group (both P < 0.05). The expression level of PC-1 in the GMSC group was significantly down-regulated (P < 0.05). After adding ALK5, an inhibitor of TGF-β receptor, the inhibitory effect of GMSC upon B cells was significantly weakened (P < 0.05). Compared with the fibroblast group, the ability of B cells to activate and proliferate T cells was significantly attenuated in the GMSC group (P < 0.05). Conclusions GMSC can inhibit B cells and their mediated immune responses. The activation of B cells and other related functions can be suppressed through the TGF-β signaling pathway.

Application of hypothermic machine perfusion in the renal transplantation from deceased donor with high-risk delayed graft function

Li Yang, Tian Xiaohui, Ding Chenguang, Chen Guozhen, Ding Xiaoming, Xiang Heli, Tian Puxun, Zheng Jin, Hu Xiaoyun, Xue Wujun

2020, 11(2): 259-264. doi: 10.3969/j.issn.1674-7445.2020.02.012

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Objective To evaluate the clinical effect of hypothermic machine perfusion (HMP) in the storage of renal grafts from deceased donor (DD) with high-risk delayed graft function (DGF). Methods Clinical data of 52 donors with high-risk DGF were collected in this prospective randomized controlled study. Two renal grafts from each donor were randomly divided into the HMP group (n=52) and static cold storage (SCS) group (n=52). In the HMP group, the renal grafts were stored by LifePort under HMP, whereas the renal grafts in the SCS group were preserved in University of Wisconsin solution (UW solution). The incidence of DGF and primary nonfunction (PNF) after renal transplantation was statistically compared between two groups. The recovery of renal graft function, the survival rates of the recipients and renal grafts within postoperative 1 year were observed in two groups. Results The incidence of DGF in the HMP group was 4%(2/52), significantly lower than 17% (9/52) in the SCS group (P < 0.05). No PNF was reported in the HMP group and 1 case of PND was noted in the SCS group, the difference was not statistically significant (P > 0.05). The recovery time of graft function of the recipients in the HMP and SCS groups were (7.2±0.6) d and (7.7±1.0) d with no statistical significance (P > 0.05). In the HMP group, the urine volume of the recipients on the day of operation, postoperative 1 and2 d was significantly larger than that in the SCS group (all P < 0.05). In the HMP group, the levels of serum creatinine at each time point after operation were significantly lower than those in the SCS group (all P < 0.05). The 1-year survival rates of the recipient and kidney were 98.1%, 92.3% and 100%, 96.2% in the HMP and SCS groups with no statistical significance (all P > 0.05). Conclusions HMP can significantly reduce the incidence of DGF after renal transplantation from DD with high-risk DGF and promote the early recovery of graft function.

Literature analysis report of de novo malignant tumors of digestive system after liver transplantation in China

Jiang Xiaoqing, Zhang Qun, Xie Man, Kong Xinjuan, Zang Yunjin, Rao Wei

2020, 11(2): 265-270. doi: 10.3969/j.issn.1674-7445.2020.02.013

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Objective To investigate the incidence of de novo malignant tumors of the digestive system after liver transplantation (LT) in China. Methods Relevant literature review was performed from Wanfang data, China National Knowledge Infrastructure (CNKI) and Chongqing VIP. The retrieval time started from the establishment of each database to May 9, 2019. The Chinese search terms were liver transplantation+ postoperative/de novo+ malignant tumor/cancer. The age distribution, sex composition, time of diagnosis, involved organs, treatment and clinical prognosis of recipients with de novo malignant tumors of the digestive system after LT in China were retrospectively analyzed. Results After literature screening, 16 articles were eventually selected including 47 cases of de novo malignant tumors of the digestive system after LT. A majority of them were male recipients. The age of the recipients was 51 (23-65) years old, most of them were middle age (45-59 years old). The average time of diagnosis of de novo malignant tumors of the digestive system after operation was 43 (2-156) months, with the highest number of cases within postoperative 1-3 years. Colon and stomach were the most common tumor sites. Surgery combined with radiotherapy and chemotherapy remained the main treatment option. However, the overall clinical prognosis of patients with de novo malignant tumors of the digestive system after LT was poor with a mortality rate of 51%. Conclusions In China, colon cancer and gastric cancer are the main de novo malignant tumors of the digestive system after LT. The overall clinical prognosis of patients with de novo malignant tumors of the digestive system is poor. Sufficient attention should be paid to postoperative monitoring and prevention.

Analysis of clinical effects of elderly donor liver from organ donation after citizen's death in liver transplantation: a single-center experience

Xie Yunliang, Yang Zhou, Yang Qing, Feng Xiao, Tang Hui, Liu Wei, Fu Binsheng, Yi Shuhong, Yang Yang, Chen Guihua

2020, 11(2): 271-275. doi: 10.3969/j.issn.1674-7445.2020.02.014

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Objective To explore the clinical efficacy of marginal liver from elderly donors in liver transplantation. Methods According to the inclusion and exclusion criteria, the clinical data of 127 donors and recipients were retrospectively analyzed. According to the age of donors, 127 donors were divided into the elderly group (n=27) and control group (n=100). The recovery of liver function, the occurrence of postoperative complications and survival rate of the recipients after transplantation were statistically analyzed between two groups. Results The incidence of primary nonfunction (PNF) and initial poor graft function (IPGF) did not significantly differ between the elderly and control groups (both P > 0.05). Within postoperative 2 weeks, the average levels of alanine aminotransferase (ALT) and serum total bilirubin (TB) of liver transplant recipients in the elderly group was not significantly different from those in the control group (both P > 0.05). There was no significant difference in the incidence of postoperative complications in the postoperative elderly group compared with the control group (all P > 0.05). The 1-and 3-year survival rates of the recipients in the elderly group were 84% and 78% respectively, which did not significantly differ from 89% and 79% in the control group (both P > 0.05). Conclusions Strict and sufficient quality evaluation and functional maintenance should be done for elderly donor livers. It can achieve good transplantation results by intraoperative fine operation, reducing bleeding and trauma, shortening the time of cold ischemia and operation, strengthening postoperative monitoring and implementing enhanced recovery after surgery.

Guideline Interpretation

Interpretation of Guide to the Quality and Safety of Organs for Transplantation (6th edition): organ procurement, preservation and transportation

Shi Huibo, Wang Xinqiang, Xu Jing, Zeng Mengjun, Li Xiaoqin, Zhang Limin, Jiang Jipin

2020, 11(2): 276-281. doi: 10.3969/j.issn.1674-7445.2020.02.015

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The procurement, preservation and transportation of the donor organs directly affect the clinical prognosis of the recipients. The establishment of process optimization and quality control standards of organ procurement, preservation and transportation contributes to improving the quality and utilization rate of donor organs and reducing the medical risk. According to Guide to the Quality and Safety of Organs for Transplantation (6th edition) proposed by European Union, the 11th chapter of organ procurement, preservation and transportation was interpreted and summarized in this article.

Interpretation of Guild to the Quality and Safety of Organs for Transplantation (6th edition): risk of infectious disease transmission

Ye Bogen, Zhang Lei

2020, 11(2): 282-287. doi: 10.3969/j.issn.1674-7445.2020.02.016

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Donor infection can be transmitted to the recipients through the grafts, leading to complications and even death. Donor-derived infection is an important cause of early infection after solid organ transplantation. The Chinese version of Guide to the Quality and Safety on Organs for Transplantation (6th edition) drafted by European Union in 2016 has been officially published. The Chapter 8 entitled 'Risk of infectious disease transmission' elaborates the medical history and behavioral history of infection risk of asymptomatic donors, basic screening highlights of various types of infections, transmission risk, prevention and control strategies of various pathogens. This chapter was mainly interpreted in this article.

Donation Window

Key strategies of ICU in promoting organ donation: a relay for life

Pan Aijun, Wang Pang, Xie Chaoyang, Fang Yang, Fan Xiaoqin, Chen Sheng, Wu Weiwen, Zhao Xingwang, Liang Wu, Jiang Wenshi, Ou Yalin

2020, 11(2): 288-292. doi: 10.3969/j.issn.1674-7445.2020.02.017

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Organ transplantation is an effective treatment for end-stage organ failure. However, organ shortage has always been a common problem faced by countries around the world. The recognition and active participation of intensive care unit (ICU) medical staff in organ donation contributes to promoting the development of organ donation, thereby alleviating the shortage of donor organ. In this article, the key strategies of ICU donor management to promote organ donation and the key strategies of ICU medical staff management to promote organ donation were summarized, aiming to provide reference for organ donation practitioners (especially ICU medical staff) and jointly facilitate the professional development of organ donation.

Review Article

Treatment progress of severe aplastic anemia

Ji Yanping, Sun Zimin

2020, 11(2): 293-297, 310. doi: 10.3969/j.issn.1674-7445.2020.02.018

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Severe aplastic anemia (SAA) is a rare type of bone marrow hematopoietic failure, which is associated with toxic T lymphocyte-based immune dysfunction, abnormal hematopoietic microenvironment and damage of hematopoietic stem cells in patients. SAA characterized by acute onset, rapid progression and high mortality rate, which requires rapid and stable recovery of the patients' hematopoietic function. In this article, the therapeutic progresses on immunosuppressive therapy (IST), sibling human leukocyte antigen (HLA)-matched allogenetic hematopoietic stem cell transplantation (allo-HSCT), replacement of donor hematopoietic stem cell transplantation and unrelated umbilical cord blood hematopoietic stem cell transplantation (UCBT) for SAA were reviewed.

Research progress on molecular mechanism of hepatitis B virus reactivation after liver transplantation

Yang Jian, Xie Yan, Tian Dazhi, Zhang Li, Zhang Yangming, Jiang Wentao

2020, 11(2): 298-303. doi: 10.3969/j.issn.1674-7445.2020.02.019

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Liver transplantation is the most effective method for hepatitis B-related liver failure, liver cirrhosis and hepatocellular carcinoma. However, the reactivation of hepatitis B virus (HBV) after liver transplantation is not conducive to the recovery of liver function and leads to poor clinical prognosis. The prevention and treatment of HBV reactivation is currently the focus of research by physicians and surgeons. The current viral suppression strategies can not completely eradicate HBV nor completely prevent the recurrence of HBV infection in the future. This article aims to explore the molecular mechanism of HBV reactivation after liver transplantation, in order to more effectively prevent the recurrence of hepatitis B after liver transplantation.

Progress on application of marginal donor liver and organ function maintenance in liver transplantation

Dai Qingqing, Zhao Hongchuan, Wang Guobin, Huang Fan

2020, 11(2): 304-310. doi: 10.3969/j.issn.1674-7445.2020.02.020

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Liver transplantation is the only effective method to treat various end-stage liver diseases. The shortage of standard donor liver is the main factor limiting the development of liver transplantation, whereas the application of marginal donor liver has significantly expanded the source of donor liver. New technologies, such as extracorporeal membrane oxygenation (ECMO), mechanical perfusion and hypothermia, can significantly improve the quality of marginal donor liver, which has good development prospects in organ function maintenance. This article reviews the common types of marginal donor liver and the application of related novel technologies in the maintenance of marginal donor liver function.

Research progress on fatigue in recipients of renal transplantation

Li Yue, Ming Yingzi, Zhuang Quan, Wu Xiaoxia, Yin Dongfang, Liu Lifang, Liu Jia

2020, 11(2): 311-315. doi: 10.3969/j.issn.1674-7445.2020.02.021

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Renal transplantation is one of the most effective treatment methods for end-stage renal diseases. However, some recipients present with fatigue symptoms after renal transplantation. Fatigue not only affects the quality of life, but also reduces the compliance of recipients with immunosuppressive agents. To strengthen the attention of medical staff to the fatigue, make early diagnosis and deliver effective interventions for renal transplant recipients, the current situation, risk factors and intervention methods of fatigue in renal transplant recipients were reviewed in this article.

Transplantation Cloud College

Transplant Cloud College academy inventory in the second half of 2019

Shi Bingyi, Wu Xiaotong, Li Ning, Chen Zhishui, Guo Hui, Chen Jianghua, Wang Rending, Zhu Zhijun, Liu Ying

2020, 11(2): 316-320. doi: 10.3969/j.issn.1674-7445.2020.02.022

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In the second half of 2019, the last four sessions of Transplant Cloud College jointly established by Chinese Research Hospital Association and Medical Neighbor Network were successfully held. During the courses in the second half of this year, the lecturers from each institution mainly focused upon four topics including management of hyperuricemia (HUA) after kidney transplantation, renal graft pathology, diagnosis and treatment of acute antibody-mediated rejection (AMR) after kidney transplantation and pulmonary infection after liver transplantation. All participants delivered discussions and exchanges in kidney and liver transplantation from multiple perspectives.