Since the successful development of liver transplantation in the 1960s, after half a century of development and improvement, liver transplantation has given new life to hundreds of thousands of patients with end-stage liver disease. Currently, about 8,000 liver transplants are performed annually abroad, with a 1-year survival rate of over 90% and a 5-year survival rate of over 70%; domestic liver transplantation has also developed rapidly in recent years, with about 2,000-3,000 liver transplants performed annually, with a 1-year survival rate of over 85% and a 5-year survival rate of over 50%. It can be seen that although the development of liver transplantation in China is fast, there is still a big gap between the long-term survival rate of patients and foreign countries. As one of the first centers to carry out liver transplantation in China, the Department of Hepatobiliary Surgery at Peking University People’s Hospital has performed more than 600 liver transplantations in 8 years since the first liver transplantation was performed on May 18, 2000, until June 2008, including 20 living liver transplantations. Among the patients regularly followed up in People’s Hospital, the 1-year survival rate reached 90% and the 5-year survival rate reached over 65%, which is close to the international advanced level. In order to better ensure the long-term survival of liver transplant patients, we believe that the medium and long-term management of patients is a topic that must be studied, and the education of long-term survivors is also very important. on May 18, 2008, on the occasion of the 8th anniversary of liver transplantation at Peking University People’s Hospital, we held a lecture on medium and long-term management of liver transplant patients in cooperation with the Beijing Liver Transplant Patients Association. Next, we will discuss our views on the mid- and long-term management of liver transplant patients after surgery, taking into account the content of this lecture and our own experience in liver transplant clinical work for nearly 10 years. During many years of clinical work, it has been found that with the passage of time after surgery, the number of patients with hypertension, hyperglycemia, hyperlipidemia and decreased renal function in liver transplant patients gradually increases. Some patients have to bear many additional medical costs as a result, and the patients’ quality of life is greatly affected, and the patients’ long-term survival is not guaranteed. Why does this phenomenon occur? It can be analyzed mainly from two aspects. 1. Side effects of drugs. We know that liver transplant patients need to take immunosuppressive drugs for life after surgery. Currently, most of the immunosuppressive regimens for liver transplant patients are based on calcium phosphatase inhibitors (CNI for short, such as cyclosporine, FK506, etc.) CNI drugs play a huge role in ensuring long-term survival of liver transplant patients, with a large number of patients surviving for more than 10 years after liver transplantation. However, CNI drugs inevitably produce a series of side effects while reducing the occurrence of rejection. Among them, the nephrotoxicity of CNI drugs, as well as the side effects causing hypertension, hyperglycemia and hyperlipidemia have received extra attention and research in recent years. 2, unhealthy lifestyle. For example, smoking, alcoholism, staying up late, excessive weight gain, uncontrolled diet and excessive maintenance, etc. can induce the above diseases. So, what are our countermeasures for these two causes? For drug toxicity, because the toxicity of CNI drugs is dose-dependent, which means that the higher the dose, the greater the toxicity, it is necessary to appropriately reduce the dose of CNI drugs for side effects such as renal function impairment caused by CNI toxicity. Some patients may worry whether this will cause insufficient immunosuppression. It is believed that in cases where CNI dose reduction is necessary, immunosuppressive drugs without associated side effects, such as primaquine (chemical name: morte-macrolide), can be added to prevent the occurrence of acute draining. Snapdragon is an immunosuppressive agent with minimal nephrotoxicity. A common example is often given to patients: for example, if a person eats food, eating only one plate of food and eating two plates of food and eating a little bit of each plate, although both can be full, but obviously, eating two plates of food is more complete nutrition. Immunotherapy after liver transplantation is a complex process. In the past, many scholars advocated monotherapy, believing that monotherapy is convenient and has the same high survival rate after surgery. However, with the development of liver transplantation, the side effects caused by monotherapy have become more and more prominent as the cumulative number of liver transplant patients has increased. An attempt was made to adjust the dosing regimen for 12 patients diagnosed with CNI toxicity-induced renal impairment by reducing the dose of CNI to half of the original dose for 4 weeks while adding primaquine 1 g daily, and after 3 months, 11 patients were in remission and no acute exclusion occurred. It can be seen that “eating two plates of food” is better nutritionally as long as it is properly combined. For a healthy lifestyle, also combined with years of experience, to the majority of patients and friends some advice. 1, quit smoking, quit drinking. Some patients ask friends, a small drink a day can not? You can, but it is best to wine and other degrees of low, white wine or not, in addition, must control the amount! 2, the diet should be careful. Liver transplant patients, to high vitamin, low sugar, low fat, and moderate amount of high-quality protein. Eat less and more meals, with fine and easy to digest, less fiber, less stimulating soft food or semi-liquid diet. To strictly limit the intake of sugar: 150-300g/day of fruit, generally no more than 250 g/day. The diet should be light, do not consume fried or deep-fried foods. Limit the intake of foods containing high cholesterol, such as: animal offal, egg yolk, squid fish, etc. Proper calcium supplementation: Immunosuppressants can inhibit calcium absorption, and long-term application can lead to osteoporosis, joint pain, hand and foot twitching, etc. You can supplement milk, bone broth, etc. Don’t overeat and don’t consume too much of foods that can cause allergies, such as: shrimp, crab, shallow sea-farmed shellfish, etc. Patients with high uric acid should not consume too much meat soup. Eat less food with high salt content, such as salty cookies. 3.Rational allocation of work, rest and exercise time. Liver transplant patients can live and work exactly like normal people. Just be careful not to strain, rest on time, and at the same time exercise properly, which is good for improving their immunity. 4. The most important point is to review the patient on time. This is crucial for the long-term survival of patients! Some patients insist on review for a year and feel that everything is stable, so they slowly give up the review, or even change the medication or adjust the medication by themselves with “experience”. This is irresponsible behavior to themselves, their families, the donor and the doctors. The goal of liver transplantation is not only to make the surgery successful, but to provide a new life for the critically ill patient and to enable him to live a long and healthy life. Only with regular review can a patient’s poor condition be detected in time for treatment to be taken to ensure long-term survival. The real success of liver transplantation depends on the improvement of the long-term survival rate of patients, and this cannot be achieved without the active cooperation of doctors and patients. We hope that our patients, especially those with medium to long-term conditions, will follow the doctor’s instructions and have a longer and healthier life!