The contamination of allografts in multi-organ donors: a bone bank experience.

As a consequence of the preference for homologous tissues, bone banks are the primary source of bone and tendon grafts. However, the bacterial, viral, and fungal contamination of these grafts remains a considerable challenge in bone banks and often results in high rates of graft discarding and infections in patients. This study intended to investigate bacterial contamination in 509 bone grafts harvested from 110 multiorgan donors. Specimen collection included bone and soft tissue retrieved from culture-swabbing as well as bone and capsule for histopathology. Microbiological, histopathological, and radiographic analyses were carried out. Secondary sterilization was also conducted using cobalt 60 at the dose of 2.5 × 104 Gy. There were 106 multi-organ donors. Of the 506 grafts, there were 54 Hemi pelvis, 191 femur, 142 tibia, and 119 fibulae. The surface swab contamination rate for all the grafts retrieved was 16.6%, and bone culture from all the grafts was 6.1%. When we looked at the incidence of contamination according to the location than the surface swab contamination rate for hemipelvis was 18 (33.3%), femur 30 (15.7%), tibia 21(14.7%) and fibula 15 (12.6%). The bone cultures were hemipelvis 12 (22.2%) femur 8 (4.1%), tibia 5 (3.5%) and fibula 6 (5.04%). These findings suggest that separate harvesting of the grafts in reverse order may help prevent contamination. The study also recommends discarding all grafts contaminated even with low pathogenicity organisms. However, bioburden needs to be further investigated to be detected and reduced.

Principles of bone and tissue banking in Saudi Arabia: 10-year experience report.

BACKGROUND: The role of bone and tissue banking is well known to meet the ever-growing need of bone and soft tissue allografts. Strict guidelines have been established to ensure high standard and minimize complications related to bone transplantation. METHODS: The Bone Bank in King Faisal Specialist Hospital and Research Centre (KFSH&RC), affiliated with the Saudi Council of Organ Transplantation, was inaugurated in 2010, and it has since been an integral part of the KFSH&RC organ retrieval team. The bank has a very strict regulations which were described. RESULTS: Between January 2010 and January 2020, there were 143 multi-organ donors (mean age: 36 years, range: 24-55 years). The total number of allografts used was 2191 which were utilized in 1047 patients. CONCLUSIONS: In this paper, we present our 10-year experience of administrative structure, donor and recipient testing protocols, allograft retrieval, processing procedures, and the internal audit safety arrangements. The utilization of allografts in various pathologies such as revision joint replacement, spine surgery, and tumor surgery is discussed with our results over a 10-year period.