The aim of this study was to analyze factors contributing to bacteriological contamination of bone and tendon allograft. Between 2008 and 2011, 2,778 bone and tendon allografts obtained from 196 organ and tissue donors or tissue donors only were retrospectively analysed. Several variables were taken into account: donor type (organ and tissue donors vs. tissue donor), cause of death, time interval between death and tissue procurement, duration of the procurement procedure, type of allografts, number of team members, number of trainees members, associated surgical procedures, positivity to haemoculture, type of procurement. The overall incidence of graft contamination was 23 %. The cause of death, the procurement time, the duration of procurement, the associated surgical procedures were not associated with increased risk of contamination. Significant effect on contamination incidence was observed for the number of staff members performing the procurement. In addition, our study substantiated significantly higher contamination rate among bone allografts than from tendon grafts. According to these observations, in order to minimize the contamination rate of procured musculoskeletal allografts, we recommend appropriate donor selection, use of standard sterile techniques, immediate packaging of each allograft to reduce graft exposure. Allograft procurement should be performed by a small surgical team.
This is a preview of subscription content, log in to check access.
We would like to thank Dr. Vittorio Macchi for his effort in collecting data.
Bettin D, Harms C, Polster J, Niemeyer T (1998) High incidence of pathogenic microorganisms in bone allografts explanted in the morgue. Acta Orthop Scand 69:311–314CrossRefPubMedGoogle Scholar
Bisharat N, Gorlachev T, Kenness Y (2012) 10 years hospital experience in Pseudomonas stutzeri and literature review. Open Infect Dis J 6:21–24CrossRefGoogle Scholar
Bohatyrewicz A, Mazur R, Bohatyrewicz R, Bialecki P, Ratajski R, Kedzierski M, Zukowski M, Ostrowski M (2002) Bone allograft harvesting following multiorgan procurement. Transpl Proc 34:707–708CrossRefGoogle Scholar
Bohatyrewicz A, Bohatyrewicz R, Klek R, Kaminski A, Dobiecki K, Bialecki P, Kedzierski M, Zienkiewicz M, Dziedzic-Goclawska A (2006) Factors determining the contamination of bone tissue procured from cadaveric and multiorgan donors. Transpl Proc 38:301–304CrossRefGoogle Scholar
Commission directive 2006/17/EC of 24 October 2006. Official Journal of the European UnionGoogle Scholar
Deijkers RL, Bloem R, Petit P, Brand R, Veen MR (1997) Contamination of bone allografts: analysis of incidence and predisposing factors. J Bone Joint Surg 79:161–166CrossRefGoogle Scholar
Directive 2004/23/EC of the European Parliament and the Council. Official Journal of the European UnionGoogle Scholar
Dziedzic-Goclawska A (2000) The application of ionizing radiation to sterilize connective tissue allografts. In: Phillips GO (ed) Radiation and tissue banking. World Scientific Publishing Co. Pte. Ltd., Singapore, pp 57–99Google Scholar
Eastlund T (2006) Bacterial infection transmitted by human tissue allograft transplantation. Cell Tissue Bank 7:147–166CrossRefPubMedGoogle Scholar
Hamer AJ, Strachan JR, Black MM, Ibbotson CJ, Stockley I, Elson RA (1996) Biomechanical properties of cortical allograft bone using a new method of bone strength measurement. A comparison of fresh, fresh-frozen and irradiated bone. J Bone Joint Surg 78:363–368Google Scholar
Ireland L, Spelman D (2005) Bacterial contamination of tissue allografts—experiences of the donor tissue bank of Victoria. Cell Tissue Bank 6:181–189CrossRefPubMedGoogle Scholar
Ivory JP, Thomas IH (1993) Audit of a bone bank. J Bone Joint Surg 75:355–357Google Scholar
Journeaux SF, Johnson N, Bryce SL, Friedman SJ, Sommerville SM, Morgan DA (1999) Bacterial contamination rates during bone allograft retrieval. J Arthroplast 14:677–681CrossRefGoogle Scholar
Könönen E, Bryk A, Niemi P, Kanervo-Nordström A (2007) Antimicrobial susceptibilities of Peptostreptococcus anaerobius and the newly described Peptostreptococcus stomatis isolated from various human sources. Antimicrob Agents Chemother 51:2205–2207CrossRefPubMedCentralPubMedGoogle Scholar
Mroz TE, Joyce MJ, Steinmetz MP, Lieberman IH, Wang JC (2008) Musculoskeletal allografts: risks and recalls in the United States. J Am Acad Orthop Surg 16:559–565PubMedGoogle Scholar
Schubert T, Bigaré E, Van Isacker T, Gigi J, Delloye C, Cornu O (2012) Analysis of predisposing factors for contamination of bone and tendon allografts. Cell Tissue Bank 13:421–429CrossRefPubMedGoogle Scholar
Segur JM, Suso S, Garcia S, Combalia A, Ramon R (1998) Bone allograft contamination in multiorgan and tissue donors. Arch Orthop Trauma Surg 118:156–158CrossRefPubMedGoogle Scholar
Segur JM, Suso S, Garcia S, Combalia A, Farinas O (2000) The procurement team as a factor of bone allograft contamination. Cell Tissue Bank 1:117–119CrossRefPubMedGoogle Scholar
Temesgen Z, Toal DR, Cockerill FR III (1997) Leclercia adecarboxylata infections: case report and review. Clin Infect Dis 25:79–81CrossRefPubMedGoogle Scholar
Vehmeyer S, Wolkenfelt J, Deijkers RL, Petit P, Brand R, Bloem R (2002) Bacterial contamination in postmortem bone donors. Acta Orthop Scand 73:678–683PubMedGoogle Scholar