Abstract
National Blood Service (NBS) Tissue Services (TS) operates living donor and deceased donor tissue banking programmes. The living bone donor programme operates in collaboration with 91 orthopaedic departments across the country and collects bone donations, in the form of surgically removed femoral heads (FHs), from over 5000 patients per annum undergoing total hip replacement. Bone donated via the living programme constitutes approximately 55% of the total bone donated to NBS. Non-NBS tissue banks, primarily in hospital orthopaedic departments, also bank donated bone for the UK. A survey of information received from 16 collaborating orthopaedic centres, between April 2003 and August 2004, identified 709 excluded donors. The total number of donations banked from these sites was 1538. Donations can be excluded before collection if there are contraindications noted in a potential donor’s medical history before their operation. Donors may also be excluded after collection of the FH, for instance because of reactive microbiology tests for blood borne viruses, or if the donation storage conditions or related documentation have not met stringent quality requirements. In this survey, bone or joint conditions were the major reasons for excluding potential donors before donation (154 of 709 exclusions, 22%), followed by a current or a past history of malignancy (139 of 709 exclusions, 20%). Local staffing and operational difficulties sometimes resulted in potential donors being missed, or specific reasons for exclusion not being reported (117 exclusions). These out numbered exclusions due to patient refusal (80 exclusions). A small number (< 5) appear to have been excluded erroneously. There was considerable local variation in the reasons given for exclusion and certainly under-reporting. A survey of donations discarded after collection in the same period highlighted that 43% were donor related; 110 of 370 did not provide a follow-up blood sample. More than 30% were due to delays in forwarding blood samples to the microbiological laboratory for testing, resulting in deterioration of the sample quality. Training to ensure that standards are complied with and a firm evidence base for exclusion criteria, applied uniformly, will help focus donor identification efforts on individuals meeting rational criteria so that fewer potential donations are lost.
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References
Committee on Microbiological Safety of Blood and Tissues for Transplantation, Department of Health: guidance on the microbiological safety of human tissues and organs used in transplantation (NHS ExecutiveAugust 2000).
Eye Banks Association for America Medical Standards, Eye Bank Association of America, www.restoresight.org.
European Eye Bank Association Standards, www.europeaneyebanks.org.
G.A. Gie L. Linder R.S.M. Ling J.P. Simon T.J.J.H. Slooff A.J. TImperley (1993) ArticleTitleImpacted cancellous allografts and cement for revision total hip arthroplasty J. Bone Joint Surg. 75 IssueIDB 14–21 Occurrence Handle1:STN:280:ByyC3s3gt1A%3D
H.V. Gartner C. Seidl C. Luckenbach G. Schumm E. Seifried H. Ritter B. Bültmann (1996) ArticleTitleBrief report: genetic analysis of a sarcoma accidentally transplanted from a patient to a surgeon NE J. Med. 335 1494–1497 Occurrence Handle1:STN:280:ByiD3s3mslA%3D
E.A. Gugel M.E. Sanders (1986) ArticleTitleNeedle-stick transmission of human colonic adenocarcinoma NE J. Med. 315 1487 Occurrence Handle1:STN:280:BiiD28vovF0%3D
Guidelines for the UK Blood Transfusion Services, The Stationery Office, London(www.transfusionguidelines.org.uk).
Hip replacements – an Update. National Audit OfficeThe Stationery Office, 2003, Available at www.nao.org.uk/publications/nao_reports/02-03/0203956.pdf.
R. Lomas O. Drummond J.N. Kearney (2000) ArticleTitleProcessing of whole femoral head allografts: a method for improving clinical efficacy and safety Cell Tissue Bank. 1 193–200 Occurrence Handle1:STN:280:DC%2BD2czltlSmsQ%3D%3D Occurrence Handle15256945
A.J. McGeorge B.J. Vote D.A. Elliot P.J. Polkinghorne (2002) ArticleTitlePapillary adenocarcinoma of the iris transmitted by corneal transplantation Archives of Ophthalmology 120 1379–1383 Occurrence Handle12365921
S.H. Palmer C.L.M.H. Gibbons N.A. Athansou (1999) ArticleTitleThe pathology of bone allograft J. Bone Joint Surg. 81 IssueIDB 333–335 Occurrence Handle1:STN:280:DyaK1M3hvFKrsw%3D%3D
A. Pruss B. Baumann M. Seibold M. Kao K. Tinteinot R. Verson Particlevon H. Radtke T. Dorner G. Pauli U.B. Gobel (2001) ArticleTitleValidation of the sterilization procedure of allogeneic avital bone transplants using peracetic ethanol Biologicals 29 59–66 Occurrence Handle10.1006/biol.2001.0286 Occurrence Handle1:CAS:528:DC%2BD3MXntFKqs70%3D Occurrence Handle11580210
L. Sanzen A. Carlsson (1997) ArticleTitleTransmission of human T-cell lymphotrophic virus type 1 by a deep-frozen bone allograft ACTA Ortho. Scand. 68 IssueID1 72–74 Occurrence Handle1:STN:280:ByiB3M%2FltVU%3D
S. Sugihara A.D. Ginkel ParticleVan T.U. Jiya B.J. Royen ParticleVan P.J. Diest ParticleVan P.I.J.M. Wuisman (1999) ArticleTitleHistopathology of retrieved allografts of the femoral head J. Bone Joint Surg. 81-B 336–341
Wilson C.J. and Galea G. 2002. Current trends in the use of bone allograft in orthopaedic surgery: Is demand still exceeding supply? Abstract, American Association of Tissue Banks Annual Meeting.
C.J. Wilson G.R. Tait G. Galea (2002) ArticleTitleUtilisation of bone allograft by orthopaedic surgeons in Scotland Cell Tissue Bank 3 49–53 Occurrence Handle1:STN:280:DC%2BD2czltlSqtA%3D%3D Occurrence Handle15256901
A. Pruss M. Kao R. Verson Particlevon G. Pauli (1999) ArticleTitleVirus safety of avital bone tissue transplants: evaluation of sterilization steps of spongiosa cuboids using a peracetic acid methanol mixture Biologicals 27 95–201 Occurrence Handle10.1006/biol.1999.0177
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Pink, F., Warwick, R.M., Purkis, J. et al. Donor Exclusion in the National Blood Service Tissue Services Living Bone Donor Programme. Cell Tissue Banking 7, 11–21 (2006). https://doi.org/10.1007/s10561-005-2362-2
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DOI: https://doi.org/10.1007/s10561-005-2362-2