Adenomyomatous hyperplasia (AMH) of the gallbladder commonly accompanies chronic cholecystitis and may be classified into three types according to the gross features: segmental, localized (fundal), and diffuse types. In situ or invasive carcinomas arising from and confined to AMH are rarely observed, especially of the segmental type. Intracystic papillary neoplasm (IPN) is one of the precancerous lesions of the gallbladder. IPN usually grows into the lumen and produces a polypoid or papillary mass. Here, we report an extremely rare case of IPN arising from and limited to a localized AMH incidentally detected in a brain-dead 68-year-old female patient during organ harvesting.
Aged ; Cholecystitis ; Female ; Gallbladder* ; Humans ; Hyperplasia* ; Tissue and Organ Harvesting

The donor organ harvesting technique is an essential component of a successful recipient outcome in organ transplantation. The careful assessment and rapid recovery of deceased donor organs without medical and surgical impairment is the cornerstone for transplant physicians. To expand the donor pool, transplant physicians are continually modifying criteria to accept organs, so-called expanded or marginal donor criteria included: age >65 years, non-heart beating donor, positive viral serology, split-liver, hypernatremia, prior carcinoma, and fatty liver. The technique of organ harvest has been obvious that a uniform procedure should be developed which is flexible enough to allow the excision of various organ combinations without jeopardy to any of the individual grafts in deceased donor. The rapid infusion method entails no preliminary dissection of the intra-abdominal organs since those organs are cooled by in situ infusion of cold preservation solution and rapid remove in a bloodless field. Avoiding perigraft dissection before cross clamp (warm dissection) contributes to better early graft function than with the warm dissection. The supreme goal of organ harvesting is to ensure that none of the organs are damaged during preparation, perfusion and removal of the organs.
Fatty Liver ; Humans ; Hypernatremia ; Organ Transplantation ; Perfusion ; Tissue and Organ Harvesting ; Tissue and Organ Procurement* ; Tissue Donors* ; Transplantation ; Transplants

In spite of efforts to promote organ donation through media campaigns, educating the public and improved organization for organ retrieval, the number of donors has remained relatively stable over the past few years. On the contrary, adverse scandals such as "buying & selling organs" or "The Exodus to China" for renal transplantation are recent issues in the field of organ transplantation". It has been suggested that non-heart beating donors (NHBD) could bridge the gap between supply and demand for renal transplantation; however, NHB donation is being used to a limited degree. This article reviews the selection criteria, technical approaches and logistical organization, the graft function and survival in NHBD. Actually, the primary non-function of grafts is significantly worse for NHBD kidneys, but the result could be improved by utilizing better patient selection and retrieval team organization. Delayed graft function is also more frequent in NHBD kidneys. This poses problems in the short term, but in the long term it does not seem to influence the outcome. Indeed, NHBD has consistently increased the number of available kidneys and it has no effect on heart beating (HB) donations.
Delayed Graft Function ; Heart ; Humans ; Kidney ; Kidney Transplantation* ; Patient Selection ; Tissue and Organ Harvesting ; Tissue and Organ Procurement ; Tissue Donors* ; Transplants

Humans ; Liver ; blood supply ; Liver Transplantation ; methods ; Living Donors ; Survival Analysis ; Tissue and Organ Harvesting ; methods

The goal of auricular cartilage harvest is to obtain a sufficient amount for reconstruction and to minimize the change in ear shape. The cartilage can be harvested by a posterior or anterior approach, and each method has advantages and disadvantages. The posterior approach presents the advantage of scar concealment, but there are limits to the amount of cymba cartilage that may be harvested. In contrast, the anterior approach may cause a noticeable scar. However, as cartilage is collected, the anterior approach provides a view that facilitates the preservation ear structure. In addition, it is possible to obtain a greater amount of cartilage. From January 2014 to December 2015, we harvested auricular cartilage graft material in 17 patients. To prevent the development of trapdoor scars or linear scar contracture, short incisions were made on the superior border of the cymba and cavum. Two small and narrow incisions were made, resulting in suboptimal exposure of the surgical site, which heightens the potential for damaging the cartilage when using existing tools. To minimize this, the authors used a newly invented ball-type elevator. All patients recovered without complications after surgery and reported satisfaction with the shape of the ear.
Autografts ; Cartilage* ; Cicatrix ; Contracture ; Ear ; Ear Cartilage ; Elevators and Escalators ; Humans ; Methods ; Tissue and Organ Harvesting ; Transplants

Humans ; Liver Transplantation ; methods ; trends ; Living Donors ; Postoperative Complications ; Tissue and Organ Harvesting ; methods ; trends

Humans ; Living Donors ; Tissue and Organ Harvesting ; Nephrectomy ; Printing, Three-Dimensional ; Technology ; Laparoscopy

Along with the development of innovative stent designs, preclinical trials in animal models are essential. Many animal models have been used and appear to yield comparable results to clinical trials despite substantial criticisms about their validity. Among the animal models, porcine coronary artery models have been the standard models for the preclinical evaluation of endovascular devices. However, rapid growth rate, high body weight potential, and the propensity to develop granulomatous inflammatory reactions are major limitations of the porcine coronary artery model. Compared with porcine coronary artery models, the comparative rabbit iliac artery model has the advantages of being small and easy to handle and relatively inexpensive. Furthermore, the rabbit model has been known to reliably reflect human restenosis histopathologically and have major advantages such as pairwise comparison, which makes each animal serve as its own control subject, therefore, maximizing its statistical power for comparative testing. However, despite the widespread use of this model, a systematic description of the procedure and harvest protocols has never been published. This article describes the surgical procedure, stent implantation procedure, method for tissue harvesting, and how measurements are performed. Although the results of animal models may not perfectly extrapolate to humans, the comparative rabbit iliac artery model may be a useful tool for assessing and comparing the efficacy of new coronary stents with conventional stent systems. This thorough description of the techniques required for vascular access, stent implantation, tissue preparation, and measurement, should aid investigators wishing to begin using the comparative rabbit iliac artery model.
Animals ; Body Weight ; Coronary Vessels ; Humans ; Iliac Artery ; Models, Animal ; Rabbits ; Research Personnel ; Stents* ; Tissue and Organ Harvesting

OBJECTIVETo observe the influence of endoscopic radial artery harvesting techniques on the prevalence of complications after coronary artery bypass grafting, and to assess the potential trauma to the radial artery through the histological changes.

METHODSFrom August 2003 to June 2008, 87 patients undergoing CABG had radial artery harvested by endoscopic harvesting system. About 4 mm proximal and distal radial artery end segment of 10 patients undergoing endoscopic and conventional harvesting were examined with light and electro-microscope.

RESULTSThe endoscopic harvest time was 42 to 98 min, with a mean of (57.6 +/- 17.3) min. The harvested conduit length was 15 to 20 cm, with a mean of (17.5 +/- 1.6) cm. Objective dorsal thenar numbness remained in 7 patients, none complained of forearm numbness at 3-month follow-up. The result of light and electro-microscope had no differences in the intima, media, or adventitia between endoscopically and conventionally obtained radial artery segments.

CONCLUSIONThe use of endoscopic radial artery harvesting in coronary artery bypass grafting can be performed safely with infrequent complications. This method results in excellent patient satisfaction, particularly regarding the cosmetic outcome.

Adult ; Aged ; Coronary Artery Bypass ; Endoscopy ; Female ; Humans ; Male ; Middle Aged ; Radial Artery ; transplantation ; Tissue and Organ Harvesting ; methods ; Treatment Outcome

OBJECTIVETo compare the clinical effects and graft outcomes of 4 surgical approaches for nephrectomy in living related kidney donors.

METHODSBetween June, 2004 and June, 2007, 119 living related kidney donors underwent nephrectomy via different surgical approaches, and their clinical data were retrospectively analyzed. Of these donors, 22 received retroperitoneal open nephrectomy, 21 had retroperitoneoscopic nephrectomy, 13 had hand-assisted laparoscopic nephrectomy, and 63 underwent transperitoneal open nephrectomy. The operating time, warm ischemia time of the graft, renal graft artery and vein lengths, reduction rate of recipient serum creatinine in the first 3 days after renal transplantation, mean hospital stay and complications of the donors were compared between the 4 surgical approaches.

RESULTSOpen surgeries were associated with significantly shorter operating time (P=0.0033) and warm ischemia time of the graft (P=0.0001), longer hospital stay (P=0.0000), higher hospital expenses (P=0.0000), faster postoperative reduction of recipient serum creatinine (P=0.0001), and longer renal artery and vein lengths (P=0.0000 on the left and P=0.0001 on the right) than laparoscopic surgeries. In the laparoscopic surgery group, subcutaneous emphysema occurred in 1 case, DGF in 2 cases, and lumbar vein hemorrhage in 2 cases for which open surgery was performed. In the open surgery group, only one case required reoperation due to adrenal gland hemorrhage. All the kidney grafts were successfully harvested without other complications observed in the donors.

CONCLUSIONSBoth open and laparoscopic surgeries are safe for nephrectomy in living related kidney donors, and the selection of the surgical approaches depends on the kidney and donor conditions and the surgical proficiency of the surgeons.

Adult ; Female ; Humans ; Kidney Transplantation ; Laparoscopy ; methods ; Living Donors ; Male ; Middle Aged ; Nephrectomy ; methods ; Retrospective Studies ; Tissue and Organ Harvesting