Pruss A, von Versen R
Institute of Transfusion Medicine, Tissue Bank, Charité-Universitätsmedizin Berlin, Chariteplatz 1, 10117 Berlin.
Handchir Mikrochir Plast Chir. 2007 Apr;39(2):81-7. doi: 10.1055/s-2007-965134.
The transplantation of allogenic tissue (bone, cartilage, tendon, skin, amnion and special preparations such as demineralised bone matrix and acellular dermis) is an important component of the treatment of bone and soft tissue defects, particularly in traumatology and orthopaedic, reconstructive and plastic surgery. In Germany, the requirement for such tissue transplants is met by supply from local tissue banks (in particular bone banks) and a small number of regional and national tissue banks. These banks operate on the basis of the "Guidelines for Bone Banks" laid down by the German Chamber of Physicians, and of the German Drug Law (AMG). The 2004/23/EG guidelines issued by the European Parliament and ratified on 31/3/2004 define the quality and safety standards for the donation, procurement, testing, processing, preservation, storage and distribution of human tissues and cells. These guidelines will have a major impact on all aspects of tissue banking and transplantation. In particular, the new guidelines will remove the possibility for local tissue banks to operate outside of national drug laws ( section sign 4 a [4]). The currently in draft law on "Quality and Safety of Human Tissues and Cells" ("Tissue Law") of the Federal Health Ministry seems to be heading in this direction, but it also includes possibilities for the continuation of local banks. An additional European guideline draft "Proposal for the regulation of advanced therapeutic medical products" is currently under discussion. This paper assesses the impact of these new pieces of legislation on the quality, safety and availability of human cell and tissue transplants in terms of the current situation and future prospects in Germany.
同种异体组织(骨、软骨、肌腱、皮肤、羊膜以及特殊制剂,如脱矿骨基质和无细胞真皮)的移植是骨与软组织缺损治疗的重要组成部分,尤其在创伤学、骨科、重建外科和整形手术中。在德国,此类组织移植的需求通过当地组织库(特别是骨库)以及少数地区和国家组织库的供应来满足。这些组织库依据德国医师协会制定的《骨库指南》以及德国药品法(AMG)开展运作。欧洲议会于2004年3月23日发布并于2004年3月31日批准的2004/23/EG指南,界定了人体组织和细胞捐赠、采集、检测、处理、保存、存储及分发的质量和安全标准。这些指南将对组织库和移植的各个方面产生重大影响。特别是,新指南将消除当地组织库在国家药品法(第4a[4]条)之外运作的可能性。联邦卫生部目前正在起草的关于“人体组织和细胞的质量与安全”的法律(“组织法”)似乎正朝着这个方向发展,但其中也包含了当地组织库继续存在的可能性。另外,一份欧洲指南草案“关于高级治疗性医疗产品监管的提案”目前正在讨论中。本文根据德国的现状和未来前景,评估了这些新立法对人体细胞和组织移植的质量、安全性及可及性的影响。