Abstract
We analyzed the prevalence and predisposing factors for the overall rejection rate after retrieval of 267 fresh femoral head allografts over the past 7 years. The present study aimed to assess the quality system of institutional bone banking that can provide high-standard allografts with a low infection rate. Retrospective analysis of bone banking from June 2013 to December 2019 was conducted on 267 donors and 153 recipients. Of the 267 donated femoral heads, 74 were rejected, giving an overall rejection rate of 27.71%. The leading cause of allograft rejection was the inability to perform serology tests due to donor death; the absence of serological tests itself, and the donor refusal to perform the serology 6-month retest in 42 donors (15.72%). At retrieval, 12 allografts were positive, giving an overall contamination rate of 4.49%. Seven (2.62%) of the 267 allografts failed the blood screening tests. Thirteen allografts (4.86%) were discarded because of suspected damage to the packaging or disuse during surgery. An infection rate of 1.30% was found following transplantation. Over the past 7 years of bone banking, our results show that the overall rejection rate and the allograft-related infection rate correlate with international standards. The leading cause of allograft rejection was the inability to perform serology tests due to donor death and their refusal to perform the serology retests. Besides stringent aseptic allograft handling, donor motivation to participate in bone banking is extremely important for its efficient functioning.
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References
American Association of Tissue Banks (1992) Technical manual for tissue banking. AATB
Barnhart B, Allan DG, Milbrandt JC, Khardori N, Hall A, Barenfanger J (2009) Intra-operative culturing of donor allograft bone: a lack of clinical utility. U Pa Orthop J. Available from http://upoj.org/site/files/v19/v19_10.pdf
Chiu CK, Lau PY et al (2004) Microbial contamination of femoral head allografts. Hong Kong Med J 10(6):401–405
Deakin DE, Bannister GC (2007) Graft incorporation after acetabular and femoral impaction grafting with washed irradiated allograft and autologous marrow. J Arthroplasty 22(1):89–94
Deijkers RLM, Bloem RM, Petit PLC, Brand R, Veh Meyer SBW, Veen MR (1997) Contamination of bone allografts: analysis of incidence and predisposing factors. J Bone Joint Surg (Br) 79(1):161–166
EAMST, EATB, (1997) Common standards for musculoskeletal tissue banking. European Association for Musculoskeletal Transplantation and European Association of Tissue Banks, Vienna
Hou CH, Yang RS (2005) Hospital-based allogenic bone bank—10-year experience. J Hosp Infect 59:41–45
Hovanyecz P, Lorenti A, Lucero JM, Gorla A, Castiglioni AE (2015) Living donor bone banking: processing and discarding—from procurement to therapeutic use. Cell Tissue Bank 16(4):593–603. https://doi.org/10.1007/s10561-015-9507-8
Ibrahim T, Aswad MG, Dias JJ, Brown AR, Esler CN (2011) Long-term outcome of total hip replacement in patients with or without femoral head contamination. J Orthop Surg (Hong Kong) 19(2):174–6
Ivory JP, Thomas IH (1993) Audit of a bone bank. J Bone Joint Surg Br 75:355–357
James LA, Ibrahim T, Esler CN (2004) Microbiological culture results for the femoral head. Are they important to the donor? J Bone Joint Surg Br 86(6):797–800
Journeaux SF, Johnson N, Bryce SL, Friedman SJ, Sommerville SM, Morgan DA (1999) Bacterial contamination rates during bone allograft retrieval. J Arthroplasty 14(6):677–681
Kappe T, Cakir B, Mattes T, Reichel H, Flören M (2010) Infections after bone allograft surgery: a prospective study by a hospital bone bank using frozen femoral heads from living donors. Cell Tissue Bank 11:253–259
Kowalczewski JB, Rutkowska-Sak L, Marczak D et al (2013) Bone graft incorporation after revision hip arthroplasty in patients with rheumatoid arthritis, seventy-eight revisions using bone allografts with or without metal reinforcements. Int Orthop (SICOT) 37:595–598
Meermans G, Roos J, Hofkens L, Cheyns P (2007) Bone banking in a community hospital Acta Orthop. Belg 73:754–759
Nielsen HT, Larsen S, Andersen M, Ovesen O (2001) Bone bank service in Odense, Denmark. Audit of the first ten years with bone banking at the Department of Orthopaedics, Odense University Hospital. Cell Tissue Bank 2:179–183
Pruss A, Seibold M, Benedix F et al (2003) Validation of the Marburg bone bank system for thermodisinfection of allogenic femoral head transplants using selected bacteria, fungi, and spores. Biologicals 31(4):287–294
Saies AD, Davidson DC (1990) Femoral head allograft bone banking. Aust N Z J Surg 60:267–270
Sakellariou VI, Babis GC (2014) Management bone loss of the proximal femur in revision hip arthroplasty: update on reconstructive options. World J Orthop 5(5):614–622
Sims L, Kulyk P, Woo A (2017) Intraoperative culture positive allograft bone and subsequent postoperative infections: a retrospective review. Can J Surg 60(2):94–100
Sommerville SM, Johnson N, Bryce SL et al (2000) Contamination of banked femoral head allograft: incidence, bacteriology, and donor follow up. Aust N Z J Surg 70(7):480–484
Stepanovic ZL, Ristic BM (2014) The effectiveness of bone banking in Central Serbia: audit of the first seven years. Cell Tissue Bank 15:567–572
Sutherland AG, Raafat A, Yates P et al (1997) Infection associated with the use of allograft bone from the North East Scotland Bone Bank. J Hosp Infect 35:215–222
The Canadian Council for Donation and Transplantation (CCDT) (2006) Evaluation of Surgical Bone Banking and Utilization in Canada page 19. Available from www.organsandtissues.ca/s/.../Surgical-Bone.pdf
Tomford WW, Thongphuasuk J, Mankin HJ, Ferraro MJ (1990) Frozen musculoskeletal allografts: a study of the clinical incidence and causes of infection associated with their use. J Bone Joint Surg (am) 72(8):1137–1143
Urrutia J, Molina M (2013) Fresh-frozen femoral head allograft as lumbar interbody graft material allows high fusion rate without subsidence. Orthop Traumatol Surg Res 99(4):413–418
van de Pol GJ, Sturm PD, van Loon CJ, Verhagen C, Schreurs BW (2007) Microbiological cultures of allografts of the femoral head just before transplantation. J Bone Joint Surg Br 89(9):1225–1228
Vehmeyer SBW, Slooff RMA, Bloem RM, Petit PLC (2002) Bacterial contamination of femoral head allografts from living donors. Acta Orthop Scand 73(2):165–170
Winter JM, Cowie AI, Wood DJ, Zheng MH (2005) Musculoskeletal tissue banking in Western Australia: review of the first ten years. ANZ J Surg 75(8):665–671
Zwitser E, van Royen B (2011) Quality control in hospital bone banking. In: Wide spectra of quality control, (Ed Akyar I), vol 14. In Tech, pp 259–260. Available from http://www.intechopen.com/books/wide-spectra-of-quality-control/quality-control-in-hospital-bone-banking
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Zeljko, S.L., Branko, R.M. The quality assessment of the University hospital bone bank in Central Serbia: the second audit after fourteen years. Cell Tissue Bank 23, 285–291 (2022). https://doi.org/10.1007/s10561-021-09942-8
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DOI: https://doi.org/10.1007/s10561-021-09942-8