Nather Aziz, David Vikram
National University Hospital Tissue Bank and Department of Orthopedic Surgery, National University of Singapore, Republic of Singapore.
Orthopedics. 2007 Apr;30(4):308-12. doi: 10.3928/01477447-20070401-07.
National University Hospital Tissue Bank protocol follows guidelines recommended by the American Association of Tissue Banks and the European Association of Tissue Banks using donor selection criteria: medical history, clinical examination, chart review and laboratory tests for acquired immunodeficiency syndrome (AIDS), hepatitis B, hepatitis C, syphilis, and specimen for culture/sensitivity tests. For living donors, repeat testing is performed for AIDS and hepatitis C approximately 180 days after procurement. Femoral heads are procured using the "sterile double jar technique" and stored at -80 degrees C. Our first study of 273 consecutive potential donors undergoing hemiarthroplasty from 1989 to 1994 showed that a high percentage (42.5%) was unsuitable for use. A second study involving 175 potential donors was conducted from 1995 to 2003 after hepatitis C screening was introduced. The bacterial contamination rates in both studies (3.5% and 5.7%) are low. The incidence of other diseases also are low: hepatitis B, 2.3% and syphilis, 1.8% in the first study and hepatitis B, 5.7%; hepatitis C, 0.6%; and syphilis, 5.1% in the second cohort. No cases of AIDS were reported in either study. By 2003, femoral heads were transplanted in 205 patients with a low complication rate of 2.9%.
国立大学医院组织库的方案遵循美国组织库协会和欧洲组织库协会推荐的指南,采用供体选择标准:病史、临床检查、病历审查以及针对获得性免疫缺陷综合征(艾滋病)、乙型肝炎、丙型肝炎、梅毒的实验室检测,还有用于培养/药敏试验的标本。对于活体供体,在获取组织后约180天对艾滋病和丙型肝炎进行重复检测。股骨头采用“无菌双罐技术”获取,并储存在-80摄氏度。我们对1989年至1994年连续273例接受半关节置换术的潜在供体进行的首次研究表明,很大比例(42.5%)不适合使用。在引入丙型肝炎筛查后,于1995年至2003年对175例潜在供体进行了第二项研究。两项研究中的细菌污染率都很低(分别为3.5%和5.7%)。其他疾病的发生率也很低:第一项研究中乙型肝炎为2.3%,梅毒为1.8%;第二项队列中乙型肝炎为5.7%,丙型肝炎为0.6%,梅毒为5.1%。两项研究均未报告艾滋病病例。到2003年,205例患者接受了股骨头移植,并发症发生率低至2.9%。