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

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

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

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

OBJECTIVE: To investigate the feasibility and advantage of hand-assisted laparoscopic live donor nephrectomy in renal transplantation. METHODS: Six living relative donors received retroperitoneal left-side laparoscopic nephrectomy. The operating time of nephrectomy, the warm ischemic time, the recovery time of allograft and donors were recorded and analyzed. RESULTS: The mean operating time of nephrectomy was 150 minutes, the mean warm ischemic time was 3.5 minutes, and the mean time of micturition after graft reperfusion was 82 seconds. The donors recovered rapidly and returned to normal within 30 days . The urine volume and renal function of the 6 recipients were normal without complications in the following 3 months. CONCLUSION Hand-assisted laparoscopic live donor nephrectomy is feasible with short operating time and warm ischemic time; the donors experience less pain, and recover rapidly. This technique may be widely used in living donor nephrectomy.
Adolescent ; Adult ; Female ; Humans ; Laparoscopy ; methods ; Living Donors ; Male ; Middle Aged ; Nephrectomy ; methods ; Tissue and Organ Harvesting ; Young Adult

Following a post-traumatic incident, orthopaedic surgeons often struggle to look for an abundant source of alternative bone graft because the bone defect is too big or when nonunion is refractory to treatment. We present two cases where the patients' bone grafts were harvested from the healthy femur. This process involved the use of a new intramedullary reamer, which allowed the bone graft to be harvested simultaneously during the reaming process.
Adult ; Bone Transplantation ; instrumentation ; methods ; Equipment Design ; Femur ; pathology ; Humans ; Male ; Middle Aged ; Therapeutic Irrigation ; Tissue and Organ Harvesting ; instrumentation ; methods

Kidney transplantation is the preferred treatment for eligible end-stage renal disease patients. However, the supply of donated kidneys has been consistently insufficient to meet the transplantation requirements of the population. In this paper, I discuss the feasibility of several policy options that engage potential donors or key individuals in a Singapore context, including financial and non-financial incentives for deceased/living organ donors and their families, improving actualisation rates of both donation after brain death, donation after cardiac death through quality improvement programmes and remuneration schemes, and a media platform for directed organ donation. I conclude by highlighting the most feasible policies to be considered.
Altruism ; Health Policy ; Humans ; Kidney ; surgery ; Kidney Failure, Chronic ; surgery ; Kidney Transplantation ; methods ; Living Donors ; Nephrectomy ; Quality Improvement ; Singapore ; Tissue Donors ; Tissue and Organ Harvesting ; Tissue and Organ Procurement

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 evaluate the feasibility and safety of transperitoneal laparoscopic nephrectomy in live-donors.

METHODSTwo cases of live-donor underwent laparoscopic nephrectomy in May and August 2008 respectively and both were followed up.

RESULTIn two cases the operation time was 130, 10 min; blood loss was 50 ml; warm ischemic time was 30 s and 2 min; the length of artery was 4.0 cm and 3.5 cm; the length of vein was 3.0 cm. The grafted kidneys started to produce urine at 30 s and 10 s after blood supply. Renal function of donor returned to normal after two days. The donors were discharged at 7th day after the operation. Renal function of recipient was normal after 3 days.

CONCLUSIONTransperitoneal laparoscopic nephrectomy in live-donor is a safe and effective procedure, which provides kidney with satisfactory blood vessels and ureter for graft.

Female ; Humans ; Kidney Transplantation ; Laparoscopy ; Living Donors ; Male ; Middle Aged ; Nephrectomy ; methods ; Peritoneum ; surgery ; Tissue and Organ Harvesting

OBJECTIVETo explore the operational strategy of harvesting total facial allograft by autopsy.

METHODSTwelve fresh human cadavers were dissected. They were divided into two groups randomly. The total facial-scalp flap of the group I was elevated by the bi-pedicle method, the group II was operated with single-pedicle method. Both were dissected at the deep plane of the SMAS. : the time of facial flap harvesting, length of the artery vein and nerve pedicles of the donor were measured and marked, after operation, in each group we transferred one facial allograft to another. Then the free graft of group I was poured through artery by methylthioninium chloride to study vascular territories.

RESULTSMean harvesting time of the group I (46 +/- 11) minutes, group II (111 +/- 7) minutes, P < 0.01. Perfusion result shows that unilateral superficial temporal artery and the opposite side of the facial artery can supply blood for whole face. The pedicle was long enough for anastomosis. Post-operation appearance: the face looks like neither the donor nor the recipient primarily, It's mainly due to the characteristics of the skeleton and the soft tissues.

CONCLUSIONSThe bi-pedicle method of the harvesting total facial allograft is concise, fast, safe can be widely applied in clinical.

Aged ; Face ; surgery ; Facial Transplantation ; methods ; Female ; Humans ; Male ; Skin Transplantation ; Surgical Flaps ; Tissue Donors ; Tissue and Organ Harvesting ; methods ; Transplantation, Homologous ; methods ; Transplants