ABSTRACT
A prospective trial was carried out in 156 unselected patients (41 men, mean age 67.5 years, 115 women, mean age 71.4 years) who had undergone total hip joint replacement because of degenerative or inflammatory arthritis or fracture of the neck of the femur. The excised femoral heads were subjected to three-stage bone bank screening so as to ascertain how many of them would pass the clinical, biochemical and microbiological exclusion criteria. Only 26 out of 156 femoral heads (17%) proved to be acceptable for the bone bank. Ninety patients (58%) were excluded on clinical grounds such as old age (over 80 years), malignant neoplasms, rheumatoid arthritis, previous intraarticular injections or long-term steroid medication. Positive hepatitis serology excluded 19%, and raised preoperative neopterin concentration excluded 25%, though three months postoperatively this was confirmed in only 2%. Routine neopterin assay seems to be a useful step towards improved bone bank screening, since neopterin concentration is clearly increased in recent virus infections such as HIV. Bacterial contamination was of no practical importance. Because of the low proportion of femoral heads passed as suitable for the bone bank, the existing exclusion criteria will have to be critically scrutinized, and alternative procedures for harvesting bone safe for transplantation (freeze drying, autoclaving, irradiation) will have to be employed.
Subject(s)
Bone Transplantation , Tissue Banks , Tissue Donors , Tissue and Organ Procurement/methods , Aged , Bone Transplantation/standards , Bone Transplantation/statistics & numerical data , Female , Femur Head/transplantation , Germany , Hip Prosthesis , Humans , Male , Prospective Studies , Tissue Donors/statistics & numerical data , Tissue and Organ Procurement/statistics & numerical dataABSTRACT
HIV-1 and HIV-2 antibodies, erythrocyte sedimentation rate, leucocytes and additionally serum neopterin levels were measured in 100 potential spongiosa donors. HIV antibodies were negative in all patients, whereas in 24% neopterin levels were elevated (greater than 10 nmol/l). Enhanced neopterin production is related to activity in cell-mediated immune response. In further investigations of these patients we found in 29% infections, 38% tumor diseases and 13% autoimmune diseases, all being exclusion criteria for spongiosa transplantation. In 3 patients increased neopterin values were the only pathological screening parameters. The measurement of serum neopterin levels showed to be a helpful parameter for the selection of spongiosa donors.
