title: Feasibility of liver graft procurement with donor gallbladder preservation in living donor liver transplantation.
abstract: OBJECTIVE
  Cholecystectomy is routinely performed at most transplant centers during living donor liver transplantation (LDLT). This study was performed to evaluate the feasibility of liver graft procurement with donor gallbladder preservation in LDLT.
  
  
  METHODS
  Eighty-nine LDLTs (from June 2006 to Dec 2012) were retrospectively analyzed at our hospital. The surgical approach for liver graft procurement with donor gallbladder preservation was assessed, and the anatomy of the cystic artery, the morphology and contractibility of the preserved gallbladder, postoperative symptoms, and vascular and biliary complications were compared among donors with or without gallbladder preservation.
  
  
  RESULTS
  Twenty-eight donors (15 right and 13 left-liver grafts) successfully underwent liver graft procurement with gallbladder preservation. Among the 15 right lobectomy donors, for 12 cases (80.0 %) the cystic artery originated from right hepatic artery. From the left hepatic artery and proper hepatic artery accounted for 6.7 % (1/15), respectively. Postoperative symptoms among these 28 donors were slight, although donors with cholecystectomy often complained of fatty food aversion, dyspepsia, and diarrhea during an average follow-up of 58.6 (44-78) months. The morphology and contractibility of the preserved gallbladders were comparable with normal status; the rate of contraction was 53.8 and 76.7 %, respectively, 30 and 60 min after ingestion of a fatty meal. Biliary and vascular complications among donors and recipients, irrespective of gallbladder preservation, were not significantly different.
  
  
  CONCLUSIONS
  These data suggest that for donors compliant with anatomical requirements, liver graft procurement with gallbladder preservation for the donor is feasible and safe. The preserved gallbladder was assessed as functioning well and postoperative symptoms as a result of cholecystectomy were significantly reduced during long-term follow-up.
authors.affiliation: Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxin Road, Beijing, 100853, China.
authors.forename: Jia-Hong
authors.initials: JH
authors.lastname: Dong
authors.affiliation: Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxin Road, Beijing, 100853, China. yesheng301@163.com.
authors.forename: Sheng
authors.initials: S
authors.lastname: Ye
authors.affiliation: Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxin Road, Beijing, 100853, China.
authors.forename: Wei-Dong
authors.initials: WD
authors.lastname: Duan
authors.affiliation: Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxin Road, Beijing, 100853, China.
authors.forename: Wen-Bing
authors.initials: WB
authors.lastname: Ji
authors.affiliation: Hospital and Institute of Hepatobiliary Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, 28 Fuxin Road, Beijing, 100853, China.
authors.forename: Yu-Rong
authors.initials: YR
authors.lastname: Liang
mesh_terms: D000328:Adult; D049448:Cholangiopancreatography, Magnetic Resonance; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D005704:Gallbladder / Q000033:anatomy & histology / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000098:blood supply*; D016031:Liver Transplantation / Q000379:methods*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D018579:Patient Selection; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors; D009927:Tissue and Organ Procurement / Q000379:methods*; D018608:Ultrasonography, Doppler; D055815:Young Adult
keywords: Gallbladder preservation; Liver transplantation; Living donor