Winter Joyleen M, Cowie Anne I, Wood David J, Zheng Ming H
Perth Bone and Tissue Bank, Hollywood Private Hospital, Nedlands, WA, Australia.
ANZ J Surg. 2005 Aug;75(8):665-71. doi: 10.1111/j.1445-2197.2005.03492.x.
Musculoskeletal tissue allotransplantation has been used as a standard approach for reconstructive surgery. The present study has reviewed the banking of musculoskeletal tissue at the Perth Bone and Tissue Bank (PBTB) and provided evidence of quality assurance on musculoskeletal tissue allotransplantation.
All donor tissues were processed in accordance with the Therapeutic Goods Administration's relevant codes of good manufacturing practices. Microbiological monitoring at each step of manufacture and postoperative surveying of the musculoskeletal allotransplantations were both conducted. The possible contribution of contaminants in allografts to postoperative infections was also assessed.
Of the 5276 donors obtained over the last 10 years, 1672 were rejected, giving an overall donor rejection rate of 32%. Milled femoral heads were the most frequently implanted allografts, followed by whole femoral heads. In the postoperative survey an infection rate of 4.9% was found (113/2321 recipients). The infectious agents were identified in 65 cases but for 60 of these there were no correlations with the positive culture test results for the allografts. The organism most commonly identified in postoperative infections was Staphylococcus species.
The present study shows evidence that musculoskeletal tissue allotransplantation is a safe procedure when accompanied by high standards of quality assurance.
肌肉骨骼组织同种异体移植已被用作重建手术的标准方法。本研究回顾了珀斯骨与组织库(PBTB)的肌肉骨骼组织储存情况,并提供了肌肉骨骼组织同种异体移植质量保证的证据。
所有供体组织均按照治疗用品管理局的相关良好生产规范进行处理。在制造的每个步骤进行微生物监测,并对肌肉骨骼同种异体移植进行术后调查。还评估了同种异体移植物中污染物对术后感染的可能影响。
在过去10年获得的5276名供体中,1672名被拒绝,总体供体拒绝率为32%。磨碎的股骨头是最常植入的同种异体移植物,其次是整个股骨头。在术后调查中,发现感染率为4.9%(2321名受者中的113名)。在65例中鉴定出了感染病原体,但其中60例与同种异体移植物的阳性培养测试结果无关。术后感染中最常鉴定出的病原体是葡萄球菌属。
本研究表明,在有高标准质量保证的情况下,肌肉骨骼组织同种异体移植是一种安全的手术。