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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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Um I, Choi S, Kim Y, Pang K, Lee J, Lee M, Kim B. Measurement of hepatitis B virus DNA in fresh versus processed dentin from chronically infected patients. J Transl Med 2018; 16:351. [PMID: 30541555 PMCID: PMC6292124 DOI: 10.1186/s12967-018-1719-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 12/02/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Demineralized dentin matrix (DDM) is commonly used as a bone-graft substitute. This study measured and compared human hepatitis B viruses (HBV) DNA in fresh dentin to that of dentin processed into DDM extracted during dental treatment from HBV-infected patients. The hypothesis was that the processing procedure for DDM would inactivate or eliminate HBV in the dentin matrix obtained from infected patients. METHODS Dentin from eighteen HBV-infected patients was collected and each dentin specimen was divided into two fragments. One fragment was used before processing as fresh dentin (control group) and the other was processed into DDM (experimental group). DNA was extracted and purified from each fresh and processed dentin specimen and the HBV DNA copy number quantitated by real time polymerase chain reaction. The HBV DNA copy number in the fresh dentin specimens were compared relative to serologic test results. The second parameter was to evaluate the effectiveness of the processing procedure (defatting, demineralization, freeze-drying, and sterilization) to inactivate or eliminate HBV by comparing the DNA copy number in the processed DDM with that in the matched fresh dentin specimens. All results were analyzed using Mann-Whitney U test to compare numerical measurements between groups and differences were considered statistically significant at P-values less than 0.05. RESULTS The presence of HBV DNA was detected in 55.56% (10/18) of the fresh dentin specimens. For the ten HBV DNA-positive fresh dentin specimens, HBV DNA was detected in two (20%) of the matched processed dentin specimens. The copy number of HBV DNA in the two positive processed dentin specimens was 1.79 and 4.03, which were statistically lower than that of the fresh dentin specimens (P = 0.0167). CONCLUSIONS The results from this study suggested that fresh dentin may be a carrier of HBV and that the procedure used to generate DDM extensively reduced the levels of HBV DNA. Further studies are needed to evaluate the infectivity of HBV in processed dentin.
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Affiliation(s)
- Inwoong Um
- R&D Institute, Korea Tooth Bank, 622 Eonju-ro, Gangnam-gu, Seoul, 06101 South Korea
| | - Sungweon Choi
- Oral Oncology Clinic Research Institute and Hospital National Cancer Center, 323 Ilsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do 10408 South Korea
| | - Youngkyun Kim
- Department of Oral and Maxillofacial Surgery, Seoul National University Bundang Hospital, 82 Gumi-ro 173beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620 South Korea
| | - Kangmi Pang
- Department of Oral and Maxillofacial Surgery, Seoul National University Gwanak Dental Hospital, 1 Gwanak-ro, Gwanak-gu, Seoul, 08826 South Korea
| | - Jongho Lee
- Clinical Trial Center, Seoul National University Dental Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080 South Korea
| | - Minsun Lee
- Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, 101 Daehark-ro, Jongno-gu, Seoul, 03080 South Korea
| | - Bongju Kim
- Dental Life Science Research Institute/Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, 101 Daehark-ro, Jongno-gu, Seoul, 03080 South Korea
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4
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Paolin A, Montagner G, Petit P, Trojan D. Contamination profile in allografts retrieved from multitissue donors: longitudinal analysis. Cell Tissue Bank 2018; 19:809-817. [PMID: 30460478 DOI: 10.1007/s10561-018-9739-5] [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: 08/24/2018] [Accepted: 11/17/2018] [Indexed: 11/27/2022]
Abstract
Microbiological contamination of retrieved tissues has become an issue of key importance and is a critical aspect of allograft safety, especially in the case of multi-tissue donations, which frequently become contaminated during retrieval and handling. We analysed contamination in 11,129 tissues with a longitudinal contamination profile for each individual tissue. Specifically, 10,035 musculoskeletal tissues and 1094 cardiovascular tissues were retrieved from a total of 763 multi-tissue donors, of whom 105 heart-beating organ donors and 658 deceased tissue donors. Of the 1955 tissues found to be contaminated after the first decontamination step, 1401 tissues (72%) were contaminated by the same species as the one(s) isolated at retrieval (Time1) and 554 (28%) by different species. Among the 113 tissues testing positive after the 2nd decontamination (Time3), 36 tissues (32%) were contaminated by the same species detected at Timel while the contaminating species differed from Time1 in 77 tissues (68%). The higher the number of contaminating species per tissue the higher the percentage of tissues in which contamination changed over time compared to Time1. The analysis revealed a 28% incidence of new species in tissues already testing positive after retrieval and of 3.5% of tissues becoming positive after admission to the tissue bank. Of these, coagulase-negative Staphylococcus accounted for over 70% of new contaminations.
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Affiliation(s)
| | | | - Pieter Petit
- Foundation European Tissue Banks, Berlin, Germany
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5
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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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6
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Schmidt S, Schulte A, Schwarz S, Hofmann N, Tietz S, Boergel M, Sixt SU. Fresh osteochondral allografts-procurement and tissue donation in Europe. Injury 2017; 48:1296-1301. [PMID: 28551055 DOI: 10.1016/j.injury.2017.05.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Fresh osteochondral allografts are a well-established treatment for large, full-thickness cartilage defects. The clinical outcome for carefully selected patients is very favorable, especially for the young and active and graft survival up to 25 years has been described in the literature. Furthermore, a high patient satisfaction rate has been reported, but the biggest obstacle to overcome is the availability of tissue for transplantation. Large fresh bone allografts for cartilage damage repair only can be harvested from organ donors following organ removal or cadaveric donors, preferably in the setting of an operation room to minimize possible contamination of the tissue. Apart from the logistic challenges this entails, an experienced recovery team is needed. Furthermore, the public as well as medical staff is much less aware of the possibility and requirements of tissue donation than organ donation and families of deceased are rarely approached for bone and cartilage donation. This review aims to highlight the current situation of organ and tissue donation in Europe with special focus on the processing of bones and possible safety and quality concerns. We analyze what may prevent consent and what might be done to improve the situation of tissue donation.
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Affiliation(s)
- S Schmidt
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany.
| | - A Schulte
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - S Schwarz
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - N Hofmann
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - S Tietz
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - M Boergel
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany
| | - S U Sixt
- Deutsche Gesellschaft für Gewebetransplantation, Hannover, Germany; Clinic for Anesthesiology, University Hospital of Düsseldorf, Heinrich-Heine University, Düsseldorf, Germany
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7
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Paolin A, Trojan D, Petit P, Coato P, Rigoli R. Evaluation of allograft contamination and decontamination at the Treviso Tissue Bank Foundation: A retrospective study of 11,129 tissues. PLoS One 2017; 12:e0173154. [PMID: 28267776 PMCID: PMC5340366 DOI: 10.1371/journal.pone.0173154] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 02/15/2017] [Indexed: 11/24/2022] Open
Abstract
Microbiological contamination of retrieved tissues has become a very important topic and a critical aspect in the safety of allografts. We have analysed contamination in 11,129 tissues with a longitudinal contamination profile for each individual tissue. More specifically, 10,035 musculoskeletal tissues and 1,094 cardiovascular tissues were retrieved from a total of 763 multi-tissue donors, of whom 105 were heart-beating donors as well as organ donors, while the remaining 658 were non-heart beating donors and tissue donors only. All tissues were decontaminated twice, the first time immediately after retrieval and the second time after processing. Each tissue was submitted to microbiological culture three times, i.e., upon retrieval (Time 1), after the first decontamination (Time 2) and after the second decontamination (Time 3). The contamination rate for musculoskeletal tissues was 52%, 16.2% and 0.5% at Time 1, 2 and 3, respectively. The contamination rate for cardiovascular tissues was 84%, 42% and 6%. More than one strain was simultaneously present in 10.8% of musculoskeletal tissues and 44.6% of cardiovascular tissues. Out of 8,560 non-heart-beating donor musculoskeletal tissues, 4,689 (54.8%), 1,383 (16.2%) and 42 (0.5%) were contaminated at Time 1, Time 2 and Time 3, respectively. Out of 1,475 heart-beating donor musculoskeletal tissues, 522 (35.4%) 113 (7.7%) and 2 (0.1%) tissues were found to be contaminated at Time 1, 2 and 3, respectively. Out of 984 non-heart beating donor cardiovascular tissues, 869 (88.3%), 449 (45.6%) and 69 (7%) proved positive at Time 1, 2 and 3 respectively, while 50 (45.5%) and 10 (9.1%) heart-beating donor cardiovascular tissues were contaminated at Time 1 and 2. No tissue was contaminated at Time 3. Based on our methods, the two-step decontamination approach is mandatory in order to drastically reduce the number of tissues found to be positive at the end of the process.
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Affiliation(s)
- Adolfo Paolin
- Treviso Tissue Bank Foundation, Treviso, Italy
- * E-mail:
| | | | - Pieter Petit
- Foundation European Tissue Banks, Berlin, Germany
| | - Paola Coato
- Department of Clinical Pathology, Regional Hospital, Treviso, Italy
| | - Roberto Rigoli
- Department of Clinical Pathology, Regional Hospital, Treviso, Italy
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8
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Kitala D, Klama-Baryła A, Kawecki M, Kraut M, Łabuś W, Glik J, Ples M, Tomanek E, Nowak M. Infections in the tissue material and their impact on the loss of transplants in the Laboratory of in vitro Cell and Tissue Culture with Tissue Bank in the years 2011-2015. Cell Tissue Bank 2016; 18:61-68. [PMID: 27796524 DOI: 10.1007/s10561-016-9597-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 10/24/2016] [Indexed: 12/20/2022]
Abstract
Radiation sterilization eliminates microbiological infections but causes the degradation of the cell factor. The negative result of microbiological examination for tissue transplants is one of the conditions for approval for distribution in patients. The study attempts to verify impact of the presence of microbes onto material for transplant loss. In the 2011-2015 period, we analyzed 293 donors of skin and amnion. Microbiological sampling was performed. The total of 21 strains of bacteria, molds and fungi was identified in collected tissue. The widest spectrum of strains was found in skin (17), followed by amnia (8). The total number of positive findings was 147 and was again highest in skin (129), while the number of positive findings in amnia was 18 only. The general percentage of fungal infections was very low. The presence of fungal strains was only observed in allogeneic skin (2%). Large number of microorganisms isolated from the skin before sterilization was observed, so it seems impossible to use allogeneic intravital skin. However, the intravital application of allogeneic amnion obtained from cesarean section remains to be considered.
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Affiliation(s)
- D Kitala
- Dr Stanisław Sakiel Center for Burns Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland.
| | - A Klama-Baryła
- Dr Stanisław Sakiel Center for Burns Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland
| | - M Kawecki
- Dr Stanisław Sakiel Center for Burns Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland.,Department of Health Sciences, Technical-Humanistic Academy, Willowa 2, 43-309, Bielsko-Biała, Poland
| | - M Kraut
- Dr Stanisław Sakiel Center for Burns Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland
| | - W Łabuś
- Dr Stanisław Sakiel Center for Burns Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland
| | - J Glik
- Dr Stanisław Sakiel Center for Burns Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland.,Department of Chronic Wounds Management Organization, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - M Ples
- Dr Stanisław Sakiel Center for Burns Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland
| | - E Tomanek
- Non-Public Laboratory of Microbiology, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland
| | - M Nowak
- Dr Stanisław Sakiel Center for Burns Treatment, Jana Pawła II 2, 41-100, Siemianowice Śląskie, Poland
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9
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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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10
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Skin donors and human skin allografts: evaluation of an 11-year practice and discard in a referral tissue bank. Cell Tissue Bank 2015; 17:11-9. [DOI: 10.1007/s10561-015-9528-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Accepted: 07/31/2015] [Indexed: 01/03/2023]
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11
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Lee JE, Hong EJ, Shim SM, Kim JW, Bae GR, Cho YS, Jeon JP, Han BG. Bacterial Contamination of Blood DNA Samples is Associated with Donor's Health Condition. Biopreserv Biobank 2014; 8:127-31. [PMID: 24836480 DOI: 10.1089/bio.2010.0012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Bacterial contamination often occurs in human blood DNA samples, possibly due to bacteremia or an inappropriate procedure during sample preparation. This study aimed at analyzing the clinical significance of bacterial DNA contamination in human blood DNA samples and to assess its influence on experimental data. DNA samples (N = 1359) were randomly selected from population-based cohort samples to determine bacterial DNA contamination by polymerase chain reaction and direct DNA sequencing. Bacterial DNA contaminated samples (N = 150) were then assessed for experimental quality of single nucleotide polymorphism (SNP) chip data, compared with uncontaminated DNA samples (N = 1209). DNA sequencing data showed that a major source of bacterial contaminants was derived from Alcaligenes species. The occurrence of bacterial DNA contaminations was significantly associated with some clinical variables including a postprandial glucose level at 60 min, % body fat, and waist-to-hip ratio. It was also found that there was no difference of SNP call rates between bacterial DNA contaminated samples and uncontaminated DNA samples. This study showed that bacterial DNA contamination in human blood samples was related to donor's health condition, suggesting that the occurrence of bacterial DNA contamination may provide useful health information of blood donors and a potential tool for human disease genomics.
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Affiliation(s)
- Jae-Eun Lee
- Center for Genome Science, Korea National Institute of Health , Korea Centers for Disease Control and Prevention, Seoul, Korea
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12
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Terzaghi C, Longo A, Legnani C, Bernasconi DP, Faré M. Incidence of bacterial contamination and predisposing factors during bone and tendon allograft procurement. Cell Tissue Bank 2014; 16:151-7. [DOI: 10.1007/s10561-014-9456-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Accepted: 05/05/2014] [Indexed: 11/29/2022]
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13
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Lannau B, Van Geyt C, Van Maele G, Beele H. Analysis of potential factors affecting microbiological cultures in tissue donors during procurement. Cell Tissue Bank 2014; 16:65-71. [DOI: 10.1007/s10561-014-9439-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2013] [Accepted: 03/14/2014] [Indexed: 11/29/2022]
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14
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Nguyen H, Cassady AI, Bennett MB, Gineyts E, Wu A, Morgan DAF, Forwood MR. Reducing the radiation sterilization dose improves mechanical and biological quality while retaining sterility assurance levels of bone allografts. Bone 2013; 57:194-200. [PMID: 23912050 DOI: 10.1016/j.bone.2013.07.036] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2013] [Revised: 07/22/2013] [Accepted: 07/25/2013] [Indexed: 01/10/2023]
Abstract
BACKGROUND Bone allografts carry a risk of infection, so terminal sterilization by gamma irradiation at 25kGy is recommended; but is deleterious to bone quality. Contemporary bone banking significantly reduces initial allograft bioburden, questioning the need to sterilize at 25kGy. METHODS We inoculated allograft bone with Staphylococcus epidermidis and Bacillus pumilus, then exposed them to gamma irradiation at 0, 5, 10, 15, 20 and 25kGy. Mechanical and biological properties of allografts were also assessed. Our aim was to determine an optimal dose that achieves sterility assurance while minimizing deleterious effects on allograft tissue. RESULTS 20-25kGy eliminated both organisms at concentrations from 10(1) to 10(3)CFU, while 10-15kGy sterilized bone samples to a bioburden concentration of 10(2)CFU. Irradiation did not generate pro-inflammatory bone surfaces, as evidenced by macrophage activation, nor did it affect attachment or proliferation of osteoblasts. At doses ≥10kGy, the toughness of cortical bone was reduced (P<0.05), and attachment and fusion of osteoclasts onto irradiated bone declined at 20 and 25kGy (P<0.05). There was no change in collagen cross-links, but a significant dose-response increase in denatured collagen (P<0.05). CONCLUSIONS Our mechanical and cell biological data converge on 15kGy as a threshold for radiation sterilization of bone allografts. Between 5 and 15kGy, bone banks can undertake validation that provides allografts with an acceptable sterility assurance level, improving their strength and biocompatibility significantly. CLINICAL RELEVANCE The application of radiation sterilization doses between 5 and 15kGy will improve bone allograft mechanical performance and promote integration, while retaining sterility assurance levels. Improved quality of allograft bone will promote superior clinical outcomes.
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Affiliation(s)
- Huynh Nguyen
- Griffith Health Institute and School of Medical Science, Griffith University, Gold Coast, QLD 4222, Australia; Queensland Bone Bank, Organ and Tissue Donation Service, Queensland Health, Brisbane, QLD, Australia
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15
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Varettas K. Bacteriology laboratories and musculoskeletal tissue banks in Australia. ANZ J Surg 2012; 82:775-9. [DOI: 10.1111/j.1445-2197.2012.06145.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2012] [Indexed: 11/29/2022]
Affiliation(s)
- Kerry Varettas
- Microbiology Department; South Eastern Area Laboratory Services; Kogarah; New South Wales; Australia
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Kowalski JB, Merritt K, Gocke D, Osborne J. Assessment of bioburden on human and animal tissues: part 2--results of testing of human tissue and qualification of a composite sample for routine bioburden determination. Cell Tissue Bank 2012; 13:431-9. [PMID: 22328024 DOI: 10.1007/s10561-012-9296-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 01/24/2012] [Indexed: 12/26/2022]
Abstract
A quantitative method was developed and validated to assess bioburden on tissue from human donors and to compare bioburden determination results to swab culture results from the same donor. An initial study with allograft tissue from 101 donors showed a wide range of bioburden levels; values from no colony-forming units (CFU) detected to >28,000 CFU were observed. Tissues from donors that had swab cultures negative for objectionable microorganisms generally had lower bioburden than tissues from donors where objectionable microorganisms were recovered by swab culturing. In a follow-up study with 1,445 donors, a wide range of bioburden levels was again observed on tissues from donors that were swab culture negative for objectionable microorganisms. Tissues from 885 (61%) of these donors had no recoverable bioburden (<2 CFU). Importantly, tissues from 560 (39%) of the donors had recoverable bioburden which ranged from 1 to >24,000 CFU. Identification of bioburden isolates showed a diversity of genera and species. In compliance with the recent revision of the American Association of Tissue Banks K2.210 Standard, the quantitative bioburden determination method was validated with a composite tissue sample that contains bone and soft tissue sections tested together in one extraction vessel. A recovery efficiency of 68% was validated and the composite sample was shown to be representative of all of the tissues recovered from a donor. The use of the composite sample in conjunction with the quantitative bioburden determination method will facilitate an accurate assessment of the numbers and types of contaminating microorganisms on allografts prior to disinfection/sterilization. This information will ensure that disinfection/sterilization processes are properly validated and the capability of the overall allograft process is understood on a donor by donor basis.
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Rey RJE, García BLV, Olmos-García MA, Aranguren MSJ. Contamination of tissue allografts from a deceased donor through haematic dissemination: a case study. Cell Tissue Bank 2009; 11:295-8. [PMID: 19763883 DOI: 10.1007/s10561-009-9153-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2009] [Accepted: 08/20/2009] [Indexed: 11/29/2022]
Abstract
Infection is one of the most dangerous complications that can be seen when implanting bone or tendon allografts from a deceased donor. The most common germs isolated are found among the cutaneous florae, but sometimes they may be present in the bloodstream as a result of severe injuries suffered before the time of the decease. We present a case of contamination of allografts in a musculoskeletal tissue donor deceased after an accident, whose allografts were contaminated by gastrointestinal microorganisms, probably disseminated through the donor's blood.
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Affiliation(s)
- R J Escribano Rey
- Department of Orthopaedic Surgery and Traumatology, University Clinic of Navarra, Av. Pío XII, 36, 31008, Pamplona, Spain.
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Impact of Bacterial and Fungal Donor Organ Contamination in Lung, Heart–Lung, Heart and Liver Transplantation. Infection 2008; 36:207-12. [DOI: 10.1007/s15010-007-7157-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2007] [Accepted: 10/24/2007] [Indexed: 10/22/2022]
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Eastlund T. Bacterial infection transmitted by human tissue allograft transplantation. Cell Tissue Bank 2006; 7:147-66. [PMID: 16933037 DOI: 10.1007/s10561-006-0003-z] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2005] [Accepted: 02/01/2006] [Indexed: 01/12/2023]
Abstract
Bacterial contamination of tissue allografts obtained from cadaveric donors has been a serious cause of morbidity and mortality in recipients. Recent cases of fatal and nonfatal bacterial infections in recipients of contaminated articular cartilage (distal femur) and tendon allografts have called attention to the importance of avoiding tissue donors suspected of carrying infectious disease, of not processing donated tissue carrying virulent bacteria, the occurrence of falsely negative final sterility tests, and the need to sterilize tissues. These cases demonstrated that contamination can arise from an infected donor, during tissue removal from cadaveric donors, from the processing environment, and from contaminated supplies and reagents used during processing. Final sterility testing can be unreliable, especially when antibiotics remain on tissues. There is an increasing need for control of microbial contamination in tissue banks, and sterilization of tissue allografts should be recommended whenever possible.
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Affiliation(s)
- Ted Eastlund
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN, USA.
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Nguyen H, Morgan DAF, Forwood MR. Sterilization of allograft bone: is 25 kGy the gold standard for gamma irradiation? Cell Tissue Bank 2006; 8:81-91. [PMID: 16821106 DOI: 10.1007/s10561-006-9019-7] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2005] [Accepted: 05/10/2006] [Indexed: 12/22/2022]
Abstract
For several decades, a dose of 25 kGy of gamma irradiation has been recommended for terminal sterilization of medical products, including bone allografts. Practically, the application of a given gamma dose varies from tissue bank to tissue bank. While many banks use 25 kGy, some have adopted a higher dose, while some choose lower doses, and others do not use irradiation for terminal sterilization. A revolution in quality control in the tissue banking industry has occurred in line with development of quality assurance standards. These have resulted in significant reductions in the risk of contamination by microorganisms of final graft products. In light of these developments, there is sufficient rationale to re-establish a new standard dose, sufficient enough to sterilize allograft bone, while minimizing the adverse effects of gamma radiation on tissue properties. Using valid modifications, several authors have applied ISO standards to establish a radiation dose for bone allografts that is specific to systems employed in bone banking. These standards, and their verification, suggest that the actual dose could be significantly reduced from 25 kGy, while maintaining a valid sterility assurance level (SAL) of 10(-6). The current paper reviews the methods that have been used to develop radiation doses for terminal sterilization of medical products, and the current trend for selection of a specific dose for tissue banks.
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Affiliation(s)
- Huynh Nguyen
- Department of Anatomy and Developmental Biology, School of Biomedical Sciences, The University of Queensland, QLD 4072 Brisbane, Australia
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Uchiyama K, Ujihira M, Mabuchi K, Takahira N, Komiya K, Itoman M. Development of heating method by microwave for sterilization of bone allografts. J Orthop Sci 2005; 10:77-83. [PMID: 15666127 DOI: 10.1007/s00776-004-0857-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2004] [Accepted: 10/05/2004] [Indexed: 12/29/2022]
Abstract
The purpose of this study was to develop a disinfection method using a microwave apparatus to treat large bone allografts. Heating of a bone allograft is an effective method for the disinfection of bacteria or inactivation of viruses. However, the size of the bone we can treat is limited, and following the popular method of using a bathtub is a lengthy process. The experimental system described here was designed using a microwave oven, an optical-fiber thermometer, and a power regulator. Large and small specimens, a femoral head, and a metatarsal were harvested from a bovine femur. The influence of size and the electrical or thermal characteristics of the specimens were assessed regarding temperature distribution after microwave irradiation. The effects of humidity or hot-air supply were also assessed. The average temperature of the bovine femoral head became 80 degrees C throughout the 15 min of microwave irradiation, although the temperature in the metatarsal did not attain uniformity. Microwave irradiation with a hot-air supply realized a uniform distribution of temperature at 83.0 degrees +/- 0.4 degrees C in the metatarsal within 15 min. Use of microwave irradiation enables quick heating for disinfection of large allograft bones when a hot-air supply was used as well.
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Affiliation(s)
- Katsufumi Uchiyama
- Department of Orthopaedic Surgery, Kitasato University, School of Medicine, 1-15-1 Kitasato, Sagamihara, 228-8555, Japan
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