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Golemovic M, Skific M, Haluzan D, Pavic P, Golubic Cepulic B. Ten-year experience with cryopreserved vascular allografts in the Croatian Cardiovascular Tissue Bank. Cell Tissue Bank 2022; 23:807-824. [PMID: 35129755 PMCID: PMC8818844 DOI: 10.1007/s10561-022-09992-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 01/10/2022] [Indexed: 11/28/2022]
Abstract
The Croatian Cardiovascular Tissue Bank (CTB) was established in June 2011. Activities managed by CTB are processing of heart valves and blood vessels, as well as quality control, storage, medical release and distribution of allografts. The aim of this report is to present CTB's vascular tissue activities and retrospectively evaluate the outcomes of their use in the University Hospital Centre Zagreb. Between June 2011 and July 2021, 90 vascular allografts (VAs) from 55 donors after brain death were referred to CTB. Only 54% of VAs met the tissue quality requirements while 46% of tissues were discarded. The most frequent reasons for discard were unacceptable morphology and initial microbiological contamination. Altogether 42 VAs were released for transplantation and 37 of them were used in 27 surgical procedures. The most common indication for surgery was prosthetic graft or stent infection. According to the anatomic position of vascular reconstruction, patients were divided in the aortic and peripheral reconstruction group. A total of 23 patients were treated. In the aortic reconstruction group 58% of patients did not experience any graft-related complications. In the group of patients who underwent peripheral reconstruction significant incidence of reinfection was observed highlighting it as a major graft-related complication. Despite the small patient groups and limited duration of follow-up, presented clinical outcomes provide valuable information on the efficacy of vascular allografts. Additional clinical results collected on a larger patient groups and comparison to other reconstructive treatment options are necessary.
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Affiliation(s)
- M Golemovic
- Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - M Skific
- Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
| | - D Haluzan
- Department of Surgery, Division for Vascular Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - P Pavic
- Department of Surgery, Division for Vascular Surgery, University Hospital Centre Zagreb, Zagreb, Croatia
| | - B Golubic Cepulic
- Department of Transfusion Medicine and Transplantation Biology, University Hospital Centre Zagreb, Zagreb, Croatia
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2
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Heng WL, Wang QW, Sornarajah R, Tremblay J, Putri NM, Hamid SSA, Pungrasmi P, Wang HJ, Kim DC, Saito D, Nguyen NL, Sulaiman WAW, Wardhana A, Puri V, Matsumura H, Dai NT, Ahuja RB, Luo G, He W, Chong SJ, Chua AWC. A Review of Skin Banking Guidelines and Standards Worldwide: Towards the Harmonization of Guidelines for Skin Banking in Therapeutic Applications for the Regions under the Asia Pacific Burn Association (APBA). BURNS & TRAUMA 2020; 8:tkaa019. [PMID: 33123605 PMCID: PMC7573737 DOI: 10.1093/burnst/tkaa019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/16/2020] [Indexed: 11/14/2022]
Abstract
Currently, there are no harmonized guidelines which govern skin banking in the Asia Pacific region. Therefore, skin banks are either unregulated or rely on their nation's legislation or international accreditation to uphold their quality standards. A new set of skin banking guidelines was developed through a comprehensive review and collation of best international practices for the Asia Pacific Burn Association (APBA) members, from donor screening and testing, to skin recovery, processing, storage and distribution, and quality assurance. National regulatory requirements reviewed include the European directives, Australia's Therapeutic Goods Administration and Singapore's tissue banking standards. Further technical and quality management recommendations are referenced from the American Association of Tissue Banks (AATB), the United States Food and Drug Administration standards and guidance documents, various relevant European guides, Japanese Society of Tissue Transplantation guidelines and the Asia Pacific Association of Surgical Tissue Banking. Adapted mainly from the AATB standards, the new Asia Pacific Burn Association Guidelines for Skin Banking in Therapeutic Applications offer a comprehensive manual, addressing: governance and contracts; staff responsibilities; quality management; facilities, equipment and supplies management; donor consent and testing; and recommendations of good practices pertaining to skin recovery, processing, storage and distribution. Besides complementing current generic regulations, they provide technical specifications of major aspects unaddressed in most legislations. This inaugural set of new regional skin banking guidelines would be a start for regional members of the APBA to adopt, and will hopefully culminate in a set of standards so that, in the long run, skin allografts from this region can be of similar quality, which can simplify import process and facilitate the exchange of allografts between members.
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Affiliation(s)
- Wee Ling Heng
- Transplant Tissue Centre, Singhealth Duke-NUS Transplant Centre, Singapore
| | - Qi Wei Wang
- Transplant Tissue Centre, Singhealth Duke-NUS Transplant Centre, Singapore
| | - Renuka Sornarajah
- Heart Valve and Tissue Bank, Lady Ridgeway Hospital for Children, Dr Danister De Silva Mawatha, Colombo, Sri Lanka
| | | | - Nandita Melati Putri
- Burn Unit, Faculty of Medicine, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Suzina Sheikh Ab Hamid
- Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Pornthep Pungrasmi
- Plastic and Reconstructive Surgery Division, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Hsian-Jenn Wang
- Plastic and Reconstructive Surgery, Taipei Medical University, Taipei, Chinese Taipei
| | - Dong Chul Kim
- Plastic and Reconstructive Surgery, Bundang Jesaeng Hospital, Seongnam, South Korea
| | - Daizo Saito
- Division of Traumatology, Research Institute, National Defence Medical College, Saitama, Japan
| | | | - Wan Azman Wan Sulaiman
- Reconstructive Sciences Programme, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Aditya Wardhana
- Burn Unit, Faculty of Medicine, Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
| | - Vinita Puri
- Department of Plastic Surgery, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, India
| | - Hajime Matsumura
- Department of Plastic and Reconstructive Surgery, Tokyo Medical University, Tokyo, Japan
| | - Niann-Tzyy Dai
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei
| | - Rajeev B Ahuja
- Plastic and Aesthetic Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Gaoxing Luo
- Institute of Burn Research, Southwest Hospital, Army Medical University, Chongqing, China
| | - Weifeng He
- Institute of Burn Research, Southwest Hospital, Army Medical University, Chongqing, China
| | - Si Jack Chong
- Transplant Tissue Centre, Singhealth Duke-NUS Transplant Centre, Singapore
- Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore
| | - Alvin Wen Choong Chua
- Transplant Tissue Centre, Singhealth Duke-NUS Transplant Centre, Singapore
- Department of Plastic, Reconstructive and Aesthetic Surgery, Singapore General Hospital, Singapore
- Musculoskeletal Sciences Academic Clinical Programme, Duke-NUS Medical School, Singapore
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3
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Situación actual de los bancos de tejidos en Colombia: tejido cardiovascular. REVISTA COLOMBIANA DE CARDIOLOGÍA 2020. [DOI: 10.1016/j.rccar.2018.12.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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4
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Ribeiro VST, Kraft L, Suss PH, Cieslinski J, Wollmann LC, Tuon FF. Anaerobic bioburden in transport solution of human cardiovascular tissues. J Microbiol Methods 2019; 166:105723. [PMID: 31526821 DOI: 10.1016/j.mimet.2019.105723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 09/10/2019] [Accepted: 09/11/2019] [Indexed: 11/26/2022]
Abstract
Although reports of infections caused by anaerobes after tissue transplantation are uncommon, contamination of allografts may result in substantial complications. Anaerobic incubation and testing of organ transport solution (TS) are not routine. The aim of this study was to determine the bioburden of strict anaerobic bacteria and oxygen tension of heart-TS. Forty TS from different donors were evaluated cultured using membrane filtration (MF), direct inoculation on broth and automated blood culture bottle (ABCB). Bacterial identification was performed by MALDI-TOF. The transport conditions were simulated to verify the bacterial recovery. A sterile bag fulfilled with 250 ml-1 of sterile saline was spiked with 100 CFU ml-1 of Clostridium perfringens and the fluid recovered 0 h, 1 h, 2 h, 6 h, 12 h, 24 h and 48 h for culture and oxygen measurement. Strict anaerobic bacteria were not isolated in heart-TS. The recovery of C.perfringens spiked in heart-TS was 100% using automated blood culture bottles. MF method detected >100 CFU only after 6 h of spiking. The manual culture was not able to recover C.perfringens after the process. The percentage of O2 measures varied from 77.6 to 87.9%. MF or ABCB are better than direct inoculation for recovery of anaerobes from heart-TS. Although all samples from heart donors were negative for anaerobes (probably due to low incidence of contamination), C.perfringens were all recovered in the simulated transport condition.
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Affiliation(s)
- Victoria Stadler Tasca Ribeiro
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná 80215-901, Brazil
| | - Letícia Kraft
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná 80215-901, Brazil
| | - Paula Hansen Suss
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná 80215-901, Brazil
| | - Juliette Cieslinski
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná 80215-901, Brazil
| | | | - Felipe Francisco Tuon
- Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná 80215-901, Brazil; Human Tissue Bank, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná 80215-901, Brazil.
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5
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Suss PH, Ribeiro VST, Cieslinski J, Kraft L, Tuon FF. Experimental procedures for decontamination and microbiological testing in cardiovascular tissue banks. Exp Biol Med (Maywood) 2019; 243:1286-1301. [PMID: 30614255 DOI: 10.1177/1535370218820515] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
IMPACT STATEMENT Sterility testing is a critical issue in the recovery, processing, and release of tissue allografts. Contaminated allografts are often discarded, increasing costs, and reducing tissue stocks. Given these concerns, it is important to determine the most effective methodology for sterility testing. This work provides an overview of microbiological methods for sampling and culturing donor grafts for cardiovascular tissue banking.
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Affiliation(s)
- Paula Hansen Suss
- 1 Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil
| | - Victoria Stadler Tasca Ribeiro
- 1 Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil
| | - Juliette Cieslinski
- 1 Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil
| | - Letícia Kraft
- 1 Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil
| | - Felipe Francisco Tuon
- 1 Laboratory of Emerging Infectious Diseases, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil.,2 Human Tissue Bank, Pontifícia Universidade Católica do Paraná, Curitiba, PR 80215-901, Brazil
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6
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Tasca Ribeiro VS, Tuon FF, Kraft L, Suss PH, Wollmann LC, Roderjan JG, Brito DA, Alexandrino F, Malgarin JS, Morello LG, da Costa FDA, Pillonetto M. Conventional culture method and qPCR using 16S rDNA for tissue bank: a comparison using a model of cardiac tissue contamination. J Med Microbiol 2018; 67:1571-1575. [PMID: 30207519 DOI: 10.1099/jmm.0.000837] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Real-time polymerase chain reaction (qPCR) using 16S rDNA is an alternative to conventional culture-based tests. The aim of this study was to compare the conventional culture method with qPCR using 16S rDNA in a model of cardiac tissue contamination. Samples of cardiac tissue for artificial contamination with Escherichia coli and control samples were submitted for DNA extraction, which was conducted by selective and alkaline lysis and purification steps. A standard curve for 16S rDNA was constructed to determine the efficiency and analytical sensitivity of the assay in concentrations from 106 to 102 c.f.u. ml-1 using TaqMan Master Mix. 16S rDNA was detected in all contaminated samples; however, it was not detected in the the final washing step solution of the sample with a bioburden of 102 c.f.u. ml-1. Using qPCR is a potential alternative to conventional culture for microbiological safety testing of allograft tissues for biobanking, reducing the time and labour input required.
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Affiliation(s)
- Victoria Stadler Tasca Ribeiro
- 1Human Tissue Bank, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Paraná, Brazil
| | - Felipe Francisco Tuon
- 2Department of Medicine, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.,1Human Tissue Bank, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Paraná, Brazil
| | - Letícia Kraft
- 1Human Tissue Bank, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Paraná, Brazil
| | - Paula Hansen Suss
- 1Human Tissue Bank, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Paraná, Brazil
| | - Luciana Cristina Wollmann
- 1Human Tissue Bank, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Paraná, Brazil
| | - João Gabriel Roderjan
- 1Human Tissue Bank, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Paraná, Brazil
| | - Diego Armando Brito
- 3Central Laboratory of Paraná State, Rua Sebastiana Santana Fraga, 1001, Curitiba, Paraná, Brazil
| | - Fabiana Alexandrino
- 4Molecular Biology Institute of Paraná, Rua Prof. Algacyr Munhoz Mader, 3775, Curitiba, Paraná, Brazil
| | - Juliane Soldi Malgarin
- 4Molecular Biology Institute of Paraná, Rua Prof. Algacyr Munhoz Mader, 3775, Curitiba, Paraná, Brazil
| | - Luis Gustavo Morello
- 4Molecular Biology Institute of Paraná, Rua Prof. Algacyr Munhoz Mader, 3775, Curitiba, Paraná, Brazil.,5Carlos Chagas Institute, Rua Prof. Algacyr Munhoz Mader, 3775, Curitiba, Paraná, Brazil
| | - Francisco Diniz Affonso da Costa
- 1Human Tissue Bank, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Paraná, Brazil.,2Department of Medicine, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil
| | - Marcelo Pillonetto
- 2Department of Medicine, School of Medicine, Pontifícia Universidade Católica do Paraná, Curitiba, Paraná, Brazil.,3Central Laboratory of Paraná State, Rua Sebastiana Santana Fraga, 1001, Curitiba, Paraná, Brazil
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7
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Comparison of automated and conventional microbiological examination of donated human cardiac tissue in heart valve banking. Cell Tissue Bank 2018; 19:499-505. [DOI: 10.1007/s10561-018-9695-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 04/17/2018] [Indexed: 10/17/2022]
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8
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Bioburden in transport solutions of human cardiovascular tissues: a comparative evaluation of direct inoculation and membrane filter technique. Cell Tissue Bank 2018; 19:447-454. [PMID: 29556882 DOI: 10.1007/s10561-018-9692-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 03/01/2018] [Indexed: 10/17/2022]
Abstract
All cardiac allograft tissues are under potential contamination, requiring a validated terminal sterilization process or a minimal bioburden. The bioburden calculation is important to determine the bacterial burden and further decontamination and disinfection strategies for the valve processing. The aim of this study was to determine the bioburden from transport solution (TS) of heart valves obtained from non-heart-beating and heart-beating donors in different culture methods. The bioburden from TS was determined in 20 hearts donated for valve allograft tissue using membrane filter (MF) and direct inoculation. Tryptic soy agar and Sabouraud plates were incubated and colonies were counted. Ninety-five percent of samples from this study were obtained from heart-beating donors. The warm ischemic time period for heart was 1.06 ± 0.74 h and the cold ischemic time period was 25.66 ± 11.16 h. The mean TS volume was 232.68 ± 96.67 mL (48.5-550 mL). From 20 samples directly inoculated on TSA agar plates, 2 (10%) were positive. However, when MF was used, from 20 samples in TSA, 13 (65%) were positive with a mean count of 1.36 ± 4.04 CFU/mL. In Sabouraud plates, the direct inoculation was positive in 5 samples (25%) with a mean count of 0.24 ± 0.56 CFU/mL. The use of MF increased the positivity to 50% (10 samples from a total of 20) with a mean of 0.28 ± 0.68 CFU/mL. The positivity was superior using MF in comparison with direct inoculation (p < 0.05). The bioburden of TS is low and MF is the technique of choice due to higher positivity.
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9
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Mehrotra P, Quinonez LG, Surana NK, Pollock N, Sandora TJ. Clinical Utility of Preimplantation Homograft Cultures in Patients Undergoing Congenital Cardiac Surgery. J Pediatric Infect Dis Soc 2017; 6:202-204. [PMID: 27242191 PMCID: PMC6075073 DOI: 10.1093/jpids/piw030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 04/19/2016] [Indexed: 11/13/2022]
Abstract
Institutional practice at our hospital (Boston Children's Hospital) is to culture homografts before implantation during congenital cardiac surgery. Over a 4-year period, 5% (73 of 1376) of these cultures were positive, but the results had minimal clinical impact. Our experience demonstrates that there is limited utility in preimplantation cultures of cardiac homografts.
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10
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Tissue recovery practices and bioburden: a systematic review. Cell Tissue Bank 2016; 17:561-571. [PMID: 27761677 PMCID: PMC5116036 DOI: 10.1007/s10561-016-9590-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 10/07/2016] [Indexed: 11/23/2022]
Abstract
For successful transplantation, allografts should be free of microorganisms that may cause harm to the allograft recipient. Before or during recovery and subsequent processing, tissues can become contaminated. Effective tissue recovery methods, such as minimizing recovery times (<24 h after death) and the number of experienced personnel performing recovery, are examples of factors that can affect the rate of tissue contamination at recovery. Additional factors, such as minimizing the time after asystole to recovery and the total time it takes to perform recovery, the type of recovery site, the efficacy of the skin prep performed immediately prior to recovery of tissue, and certain technical recovery procedures may also result in control of the rate of contamination. Due to the heterogeneity of reported recovery practices and experiences, it cannot be concluded if the use of other barriers and/or hygienic precautions to avoid contamination have had an effect on bioburden detected after tissue recovery. Qualified studies are lacking which indicates a need exists for evidence-based data to support methods that reduce or control bioburden.
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11
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Ferreira RM, da Costa MTBA, Canciglieri Junior O, Sant'Anna ÂMO. Profile of Heart Donors from the Human Valve Bank of the Santa Casa de Misericórdia de Curitiba. Braz J Cardiovasc Surg 2016; 31:191-7. [PMID: 27556322 PMCID: PMC5062726 DOI: 10.5935/1678-9741.20160033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 04/25/2016] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Human heart valves are used as replacement valves and have satisfactory functional results compared with conventional prostheses. OBJECTIVE Characterize the profile of effective heart donors from the human valve bank of the santa casa de misericórdia de curitiba and analyze the association between the profile variables. METHODS It consists of a retrospective and quantitative study of electronic medical records from heart donors for heart valves. every heart donation made to the bank between january 2004 and december 2014 was studied. RESULTS 2,149 donations were analyzed, from donors aged 0 to 71 years old, with an average of 34.9 ± 15.03 years old. most donors were male 65.7% (n=1,411) and 34.3% (n=738) were female. among the most frequent causes of the donors' death are trauma at 53% (n=1,139) and cerebral vascular accident at 34.2% (n=735). there was significant statistical association between the analyzed variables. CONCLUSION There has been an improvement in brazil's donation rate, being essential that the tissue banks work together with the state and federal district centers for notification, procurement and distribution of organs in order to increase the number of donors.
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12
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Germain M, Strong DM, Dowling G, Mohr J, Duong A, Garibaldi A, Simunovic N, Ayeni OR. Disinfection of human cardiac valve allografts in tissue banking: systematic review report. Cell Tissue Bank 2016; 17:593-601. [PMID: 27522194 PMCID: PMC5116039 DOI: 10.1007/s10561-016-9570-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 07/14/2016] [Indexed: 11/25/2022]
Abstract
Cardiovascular allografts are usually disinfected using antibiotics, but protocols vary significantly between tissue banks. It is likely that different disinfection protocols will not have the same level of efficacy; they may also have varying effects on the structural integrity of the tissue, which could lead to significant differences in terms of clinical outcome in recipients. Ideally, a disinfection protocol should achieve the greatest bioburden reduction with the lowest possible impact on tissue integrity. We conducted a systematic review of methods applied to disinfect cardiovascular tissues. The use of multiple broad spectrum antibiotics in conjunction with an antifungal agent resulted in the greatest reduction in bioburden. Antibiotic incubation periods were limited to less than 24 h, and most protocols incubated tissues at 4 °C, however one study demonstrated a greater reduction of microbial load at 37 °C. None of the reviewed studies looked at the impact of these disinfection protocols on the risk of infection or any other clinical outcome in recipients.
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Affiliation(s)
- M Germain
- Héma-Québec, 1070 Sciences-de-la-Vie Avenue, Quebec, QC, G1V 5C3, Canada
| | - D M Strong
- Department of Orthopaedics and Sports Medicine, University of Washington School of Medicine, 98104, Seattle, WA, USA
| | - G Dowling
- Comprehensive Tissue Centre, 8230 Aberhart Centre, 11402 University Avenue NW, Edmonton, AB, T6G 2J3, Canada
| | - J Mohr
- Canadian Blood Services, 270 John Savage Ave., Dartmouth, NS, B3B 0H7, Canada
| | - A Duong
- Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - A Garibaldi
- Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - N Simunovic
- Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada
| | - O R Ayeni
- Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada. .,McMaster University Medical Centre, 1200 Main St W, Room 4E15, Hamilton, ON, L8N 3Z5, Canada.
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Abstract
Tissue transplantation is a life-enhancing therapeutic modality for damaged or non-functioning tissues. In most cases, there is no alternative other than human tissue as replacement, and taking into account the ever-increasing demand for tissue grafts, it makes sense to set up an establishment in charge of human tissue procurement to meet local needs. A quality assurance system, clearly defined standards, and regular audits complement the infrastructure which make this activity feasible. The process of tissue procurement consists of donor identification, consent, tissue recovery, donor screening and testing, tissue processing, preservation, packaging, labeling, terminal sterilization, storage and distribution. The transplantation of homograft heart valves remains controversial, due to the availability of prosthetic and bioprosthetic alternatives. The limited durability of homografts has not yet outweighed the advantages which this graft offers. Adherence to regulations and regularly revised guidelines improve long-term efficacy and minimizes complications or malfunction. Furthermore, the lower price of homograft heart valves and the removal of the need for a lifetime of anticoagulation therapy are noteworthy advantages of this replacement. In our practice, the proportion of homograft heart valves meeting release criteria and successfully implanted grafts were 83% and 95%, respectively.
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Affiliation(s)
- Alireza Heidary Rouchi
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mitra Mahdavi-Mazdeh
- Iranian Tissue Bank and Research Center, Tehran University of Medical Sciences, Tehran, Iran
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14
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Akhtar N, Rahman MS, Jamil HM, Arifuzzaman M, Miah MM, Asaduzzaman SM. Tissue banking in Bangladesh: 12 years of experience (2003–2014). Cell Tissue Bank 2016; 17:189-97. [DOI: 10.1007/s10561-016-9549-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 02/22/2016] [Indexed: 01/28/2023]
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15
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Efficacy of decontamination protocol by antimicrobial treatment in Iranian Tissue Bank (ITB). Cell Tissue Bank 2014; 16:381-8. [DOI: 10.1007/s10561-014-9482-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 11/06/2014] [Indexed: 11/25/2022]
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