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Tikkala S, Tirkkonen K, Ekman E, Lehtimäki K. Experience with Tissue Bank Services in 2014 and 2020 in Turku, Finland. Transplant Proc 2023; 55:2345-2353. [PMID: 37891018 DOI: 10.1016/j.transproceed.2023.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND The objective of a musculoskeletal tissue bank is to collect, test, store, and provide musculoskeletal tissue allografts required in orthopedic procedures. Strict exclusion criteria are followed when selecting suitable cadaver musculoskeletal tissue donors, and the allografts are procured under sterile conditions to avoid bacterial contamination. Tissue banking in Turku, Finland, began in 1972, and tissue bank services were last reviewed in 2003. This study aimed to review the operation of the musculoskeletal tissue bank in Turku, Finland, between 2014 and 2020 and to analyze the number, types, and contamination rate of the allografts procured from the cadaver donors. Potential donor-related factors causing bacterial contamination of the allografts and whether potential musculoskeletal tissue donors were overlooked among multiorgan donors were also studied. METHODS A retrospective review of all cadaver musculoskeletal tissue donors used in the Hospital District of Southwest Finland Tyks Orto Musculoskeletal Tissue Bank during the study period was conducted, and data on the procured allograft was collected and presented. The donors were selected among patients treated in the intensive care unit (ICU) of Turku University Hospital (TYKS). RESULTS A total of 28 cadaver donors were used, and 636 allografts were procured between 2014 and 2020. The bacterial contamination rate was 2.5%, which was lower than that in the previous international literature. The median treatment time in the ICU was significantly longer, and the median value of the highest C-reactive protein level was significantly higher in the group of donors with positive allograft bacterial cultures. CONCLUSIONS The bacterial contamination rate in the tissue bank was low on an international scale. Some suitable musculoskeletal tissue donors were overlooked among multiorgan donors.
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Affiliation(s)
| | - Kari Tirkkonen
- Department of Orthopaedic Surgery, Turku University Hospital, Turku, Finland
| | - Elina Ekman
- Department of Orthopaedic Surgery, Turku University Hospital, Turku, Finland
| | - Kaisa Lehtimäki
- Department of Orthopaedic Surgery, Turku University Hospital, Turku, Finland
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2
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Baseri N, Meysamie A, Campanile F, Hamidieh AA, Jafarian A. Bacterial contamination of bone allografts in the tissue banks: a systematic review and meta-analysis. J Hosp Infect 2021; 123:156-173. [PMID: 34752801 DOI: 10.1016/j.jhin.2021.10.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 10/02/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bone allografts are harvested and transplanted under sterile conditions. However, the risk of bacterial contamination of grafts during these processes is a health concern. Bioburden testing and bacterial contamination detection are conducted to ensure allograft sterility. AIM The present study aimed to determine the incidence of bacterial contamination in bone allografts based on different classifications. METHODS PROSPERO registration number was received for the study. Systematic searches were conducted in PubMed and EMBASE databases with relevant keywords from January 2000 to March 2021. After choosing related studies according to the PRISMA flow diagram, Stata software was used for data analysis. We considered I2 ˃ 50% as heterogeneity between studies. FINDINGS The overall incidence of bacterial contamination was 12.6% (95% CI 0.100, 0.152) among 19,805 bone allografts of 17 studies. The bacterial contamination rate among bone allografts was 10.8% before 2010 and 14.7% in 2010-March 2021. The contamination frequency in Asia, Europe, and Australia was 11.5%, 14.3%, and 5.2%, respectively. Bone contamination rates were higher in cadaver donors (19.9%), retrieval time sampling (13.5%), and swab samples (13.2%) compared to those in living donors (7.5%), implantation time sampling (6.9%), and bone fragments cultures (6.3%). Bacterial contamination was recovered 24.4%, 19.7%, 13.2%, and 21% from tibia, fibula, femoral, and other bones, respectively. Staphylococcus spp. was the predominant isolated bacteria from bones (63.2% of all isolated genera), followed by Propionibacterium spp. (10.6%). CONCLUSION The high contamination of bone allografts is a health concern, indicating the need for more health monitoring and improvement of standards.
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Affiliation(s)
- Neda Baseri
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging infectious diseases, Pasteur Institute of Iran, Tehran, Iran; National Reference laboratory for Plague, Tularemia and Q fever, Research Centre for Emerging and Reemerging infectious diseases, Pasteur Institute of Iran, Akanlu, Kabudar Ahang, Hamadan, Iran
| | - Alipasha Meysamie
- Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Floriana Campanile
- Department of Biomedical and Biotechnological Sciences (BIOMETEC), Medical Molecular Microbiology and Antibiotic Resistance laboratory (MMARLab), University of Catania, Catania, Italy
| | - Amir Ali Hamidieh
- Pediatric Cell and Gene Therapy Research Center, Tehran University of Medical Sciences, Tehran, Iran; Iranian Tissue Bank & Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Arefeh Jafarian
- Iranian Tissue Bank & Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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3
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Legnani C, Borgo E, Macchi V, Ventura A. Autograft versus allograft tenodesis for chronic ankle instability: a single-center retrospective comparative study. J Comp Eff Res 2020; 10:5-11. [PMID: 33355492 DOI: 10.2217/cer-2020-0070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To compare the outcomes of patients who underwent autograft tenodesis with those who underwent allograft tenodesis for the treatment of chronic mechanical ankle instability. Patients & methods: Ten patients who underwent allograft lateral tenodesis were compared with 15 patients who underwent lateral tenodesis using a split peroneus brevis tendon. Patients were followed up after an average time of 10.5 years. Results: No statistically significant differences concerning American Orthopaedic Foot and Ankle Society and Karlsson-Peterson scores were reported (p = n.s.). A reduced average radiographic anterior talar translation was observed in the autograft group compared with the allograft group (1.4 and 4.0 mm respectively, p < 0.001). Conclusion: Both surgical techniques significantly improved subjective and objective outcomes in patients suffering from chronic ankle instability compared with pre-operatory status. Autograft stabilization provided reduced post-operative anterior talar translation compared with allograft tenodesis.
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Affiliation(s)
- Claudio Legnani
- IRCCS Istituto Ortopedico Galeazzi, Sport Traumatology and Minimally Invasive Surgery Center, Milan, Italy
| | - Enrico Borgo
- IRCCS Istituto Ortopedico Galeazzi, Sport Traumatology and Minimally Invasive Surgery Center, Milan, Italy
| | - Vittorio Macchi
- IRCCS Istituto Ortopedico Galeazzi, Sport Traumatology and Minimally Invasive Surgery Center, Milan, Italy
| | - Alberto Ventura
- IRCCS Istituto Ortopedico Galeazzi, Sport Traumatology and Minimally Invasive Surgery Center, Milan, Italy
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Viñuela-Prieto JM, Soria-García AM, González-Romero M, Candel FJ. Bacterial contamination rate and associated factors during bone and tendon allograft procurement from Spanish donors: exploring the contamination patterns. J Hosp Infect 2019; 102:287-294. [PMID: 30772451 DOI: 10.1016/j.jhin.2019.02.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 02/08/2019] [Indexed: 01/05/2023]
Abstract
BACKGROUND Allograft contamination during extraction represents a major limiting factor for tissue bank availability. Contamination rates remain persistently high independent of the hospital, country or year considered. AIM To analyse the factors associated with contamination of bone and tendon samples extracted from Spanish donors. METHODS Data for 1162 bone and tendon samples extracted from 102 donors between 2014 and 2017 were collected retrospectively from the hospital database. Descriptive statistics, potentially associated factors and correlation of contamination between samples extracted from different anatomical locations of the same donor were analysed. FINDINGS In total, 227 (19.54%) of the extracted samples [131 (18.49%) bone samples and 96 (20.92%) tendon samples] rendered positive cultures and were discarded. Male sex [odds ratio (OR) 2.023; P=0.019], extraction of >10 samples per donor (OR 1.997; P<0.001) and extraction time >240 min (OR 1.755; P=0.001) were factors independently associated with a higher contamination rate. Meanwhile, the tissue sample type 'bone-patellar tendon-bone' was associated with a significantly lower contamination rate (OR 0.446; P=0.001). Significant correlation between certain localization of contaminated samples and the concordance of bacterial species was also observed. CONCLUSION Factors related to the extraction procedure, such as total extraction time, extraction sequence, number of samples extracted and anatomical location of extracted samples, play a major role in allograft contamination. Further optimization of procedures, guided by the contamination patterns analysed in this study, should help to increase tissue bank availability.
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Affiliation(s)
- J M Viñuela-Prieto
- Transplant Coordination Department, Hospital Clínico San Carlos, Madrid, Spain; School of Medicine, Complutense University, Madrid, Spain.
| | - A M Soria-García
- Transplant Coordination Department, Hospital Clínico San Carlos, Madrid, Spain
| | - M González-Romero
- Transplant Coordination Department, Hospital Clínico San Carlos, Madrid, Spain
| | - F J Candel
- Transplant Coordination Department, Hospital Clínico San Carlos, Madrid, Spain; Health Research Institute, Hospital Clínico San Carlos, Madrid, Spain
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Evaluation of allograft decontamination with two different antibiotic cocktails at the Treviso Tissue Bank Foundation. PLoS One 2018; 13:e0201792. [PMID: 30071084 PMCID: PMC6072104 DOI: 10.1371/journal.pone.0201792] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 07/23/2018] [Indexed: 01/15/2023] Open
Abstract
Microbiological contamination of retrieved tissues is a critical aspect of allograft safety and tissue banks must continuously implement decontamination procedures to minimize tissue contamination. In this study we compared the decontamination efficacy of a new antibiotic cocktail (cocktail B: BASE medium with Gentamicin, Meropenem and Vancomycin) with the cocktail previously adopted at Treviso Tissue Bank Foundation (FBTV) (cocktail A: RPMI medium with Ceftazidime, Lincomycin, Polymyxin B and Vancomycin). Two decontamination steps were carried out, the first immediately after retrieval, the second after processing. The contamination rate was calculated before processing (Time 1) and cryopreservation (Time 2) for total tissues, musculoskeletal tissues and cardiovascular tissues, and the bacterial species involved were analyzed. Cocktail A was used to decontaminate 3548 tissues, of which 266 were cardiovascular and 3282 musculoskeletal tissues. For cocktail A, total tissue contamination was 18.6% at Time 1 and 0.9% at Time 2, with 15.7% contaminated musculoskeletal tissues at Time 1 and 0.4% at Time 2, respectively, while cardiovascular tissues were 50% contaminated at Time 1 and 6.4% at Time 2. Cocktail B was used to decontaminate 3634 tissues of which 318 were cardiovascular and 3316 musculoskeletal tissues. For cocktail B, total tissue contamination was 8.6% at Time 1 and 0.2% at Time 2, with 7.6% contaminated musculoskeletal tissues at Time 1 and 0.03% at Time 2, respectively. Contamination of cardiovascular tissues was 20.4% at Time 1 and 1.9% at Time 2. Intergroup and intragroup contamination rates decreased statistically significantly (p<0.05). Our results have shown that cocktail B was more effective than cocktail A in killing bacteria in both cardiovascular and musculoskeletal tissues during the two decontamination cycles.
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Mirabet V, Melero A, Ocete MD, Bompou D, Torrecillas M, Carreras JJ, Valero I, Marqués AI, Medina R, Larrea LR, Arbona C, Garrigues TM, Gimeno C. Effect of freezing and storage temperature on stability and antimicrobial activity of an antibiotic mixture used for decontamination of tissue allografts. Cell Tissue Bank 2018; 19:489-497. [DOI: 10.1007/s10561-018-9693-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 04/17/2018] [Indexed: 01/05/2023]
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Paolin A, Romualdi C, Romagnoli L, Trojan D. Analysis of potential factors affecting allografts contamination at retrieval. Cell Tissue Bank 2017; 18:539-545. [PMID: 29043523 PMCID: PMC5682874 DOI: 10.1007/s10561-017-9667-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 10/10/2017] [Indexed: 12/03/2022]
Abstract
The microbiological contamination of retrieved tissues has become a very important topic and it is a critical aspect in the safety of allografts, especially from multi-tissue donors whose tissues are frequently contaminated as a consequence of retrieval. We analysed a total of 10,107 tissues, 8178 musculoskeletal and 1929 cardiovascular tissues, retrieved from 978 multi-tissue donors. Of these, 159 heart-beating donors (HBD) were also organ donors, while the remaining 819 non-heart-beating donors (NHBD) were tissue donors only. A multivariate logistic model was used to determine the factors affecting contamination risk during retrieval. In the model, the dependent variable was the presence/absence of contamination while the covariates included were: gender, type of donor, age of donor, cause of death, previous skin donation, cadaver time, number of people attending the retrieval, number of tissues retrieved. Moreover, a second log-linear model was used to determine the number of strains isolated per tissue. Tissue contamination was statistically correlated with gender, type of donor, cadaver time, number of people attending the retrieval and season. In conclusion, to minimize the risk of bacterial contamination, aseptic techniques should be used at retrieval, with the number of retrieval team members kept to a minimum. In addition, cadaver time should be as short as possible and the donor should be refrigerated within a few hours after death.
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Affiliation(s)
- A Paolin
- Fondazione Banca dei Tessuti di Treviso onlus, Treviso, Italy.
| | - C Romualdi
- Department of Biology, University of Padova, Padova, Italy
| | | | - D Trojan
- Fondazione Banca dei Tessuti di Treviso onlus, Treviso, Italy
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9
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Ravichandran A, Lim J, Chong MSK, Wen F, Liu Y, Pillay YT, Chan JKY, Teoh SH. In vitro cyclic compressive loads potentiate early osteogenic events in engineered bone tissue. J Biomed Mater Res B Appl Biomater 2016; 105:2366-2375. [PMID: 27527120 DOI: 10.1002/jbm.b.33772] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 07/14/2016] [Accepted: 08/01/2016] [Indexed: 12/17/2022]
Abstract
Application of dynamic mechanical loads on bone and bone explants has been reported to enhance osteogenesis and mineralization. To date, published studies have incorporated a range of cyclic strains on 3D scaffolds and platforms to demonstrate the effect of mechanical loading on osteogenesis. However, most of the loading parameters used in these studies do not emulate the in vivo loading conditions. In addition, the scaffolds/platforms are not representative of the native osteoinductive environment of bone tissue and hence may not be entirely accurate to study the in vivo mechanical loading. We hypothesized that biomimicry of physiological loading will potentiate accelerated osteogenesis in bone grafts. In this study, we present a compression bioreactor system that applies cyclic compression to cellular grafts in a controlled manner. Polycaprolactone-β Tricalcium Phosphate (PCL-TCP) scaffolds seeded with Mesenchymal Stem Cells (MSC) were cyclically compressed in bioreactor for a period of 4 weeks at 1 Hz and physiological strain value of 0.22% for 4 h per day. Gene expression studies revealed increased expressions of osteogenesis-related genes (Osteonectin and COL1A1) on day 7 of cyclic loading group relative to its static controls. Cyclic compression resulted in a 3.76-fold increase in the activity of Alkaline Phosphatase (ALP) on day 14 when compared to its static group (p < 0.001). In addition, calcium deposition of cyclic loading group was found to attain saturation on day 14 (1.96 fold higher than its static scaffolds). The results suggested that cyclic, physiological compression of stem cell-seeded scaffolds generated highly mineralized bone grafts. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2366-2375, 2017.
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Affiliation(s)
- Akhilandeshwari Ravichandran
- Centre for Bone Tissue Engineering, School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore
| | - Jing Lim
- Centre for Bone Tissue Engineering, School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore
| | - Mark Seow Khoon Chong
- Centre for Bone Tissue Engineering, School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore
| | - Feng Wen
- Centre for Bone Tissue Engineering, School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore
| | - Yuchun Liu
- Centre for Bone Tissue Engineering, School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore.,Academic Clinical Program (Research), National Dental Centre of Singapore, Singapore 168938, Singapore
| | - Yaesshna T Pillay
- Department of Medicine and Medical Science, School of Medicine, University College Dublin, Dublin, Ireland
| | - Jerry K Y Chan
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119077, Singapore.,Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore 229899, Singapore.,Cancer and Stem Cell Biology Program, Duke-NUS Graduate Medical School, Singapore 169857, Singapore
| | - Swee-Hin Teoh
- Centre for Bone Tissue Engineering, School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore 637459, Singapore
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Gut G, Marowska J, Jastrzebska A, Olender E, Kamiński A. Structural mechanical properties of radiation-sterilized human Bone-Tendon-Bone grafts preserved by different methods. Cell Tissue Bank 2015; 17:277-87. [PMID: 26679928 PMCID: PMC4882344 DOI: 10.1007/s10561-015-9538-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 12/08/2015] [Indexed: 01/28/2023]
Abstract
To avoid the risk of infectious disease transmission from donor to recipient, allografts should be terminally sterilized. In the previous paper (Kaminski et al. in Cell Tissue Bank 10:215–219, 2009) we presented the effect of various methods of preservation (deep fresh freezing, glycerolization, lyophilization), followed by irradiation with different doses of electron beam (EB), on material (intrinsic) mechanical properties of human patellar tendons cut out as for anterior cruciate ligament reconstruction, obtained in failure tensile test. As structural mechanical properties are equally important to predict the behaviour of the graft as a whole functional unit, the purpose of the present paper was to show the results for failure load and elongation, obtained in the same experiment. Paired Bone-Tendon-Bone grafts (BTB) were prepared from cadaveric human patella tendons with both patellar and tibial attachments. They were preserved by deep freezing, glycerolization or lyophilization and subsequently EB-irradiated with the doses of 25, 35, 50 or 100 kGy (fresh-frozen grafts) or a single dose of 35 kGy (glycerolized and lyophilized grafts). Each experimental (irradiated) group was provided with control (non-irradiated), donor-matched group. The specimens from all groups were subjected to mechanical failure tensile test with the use of Instron system in order to measure their structural properties (failure load and elongation). All lyophilized grafts were rehydrated before mechanical testing. In our study we did not observe significant deterioration of structural mechanical properties of BTB grafts processed by fresh-freezing and then terminal sterilized with growing doses of EB up to 100 kGy. In contrast, BTB grafts processed by glycerolization or lyophilization and irradiated with 35 kGy showed significant decrease of failure load. Obtained results suggest that deep-frozen irradiated grafts retain their initial mechanical properties to an extent which does not exclude their clinical application. However, biomechanical investigations constitute only the first step to evaluate the potential clinical usefulness of such allografts and further extensive in vivo studies are needed.
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Affiliation(s)
- Grzegorz Gut
- Department of Transplantology and Central Tissue Bank, Medical University of Warsaw, Ul. Chalubinskiego 5, 02-004, Warsaw, Poland. .,National Centre for Tissue and Cell Banking, Chalubinskiego 5, 02-004, Warsaw, Poland.
| | - Joanna Marowska
- National Centre for Tissue and Cell Banking, Chalubinskiego 5, 02-004, Warsaw, Poland
| | - Anna Jastrzebska
- National Centre for Tissue and Cell Banking, Chalubinskiego 5, 02-004, Warsaw, Poland
| | - Ewa Olender
- Department of Transplantology and Central Tissue Bank, Medical University of Warsaw, Ul. Chalubinskiego 5, 02-004, Warsaw, Poland.,National Centre for Tissue and Cell Banking, Chalubinskiego 5, 02-004, Warsaw, Poland
| | - Artur Kamiński
- Department of Transplantology and Central Tissue Bank, Medical University of Warsaw, Ul. Chalubinskiego 5, 02-004, Warsaw, Poland.,National Centre for Tissue and Cell Banking, Chalubinskiego 5, 02-004, Warsaw, Poland
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