Cook S D, Salkeld S L, Prewett A B
Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, Louisiana, USA.
Spine (Phila Pa 1976). 1995 Jun 15;20(12):1338-42.
Infection of rhesus monkeys (Macaca mulatta) with simian immunodeficiency virus (SIV, HIV-II) was used to study disease transmission in allograft bone. Four allograft bone processing techniques--fresh, fresh frozen, double freeze-thaw, and double freeze-thaw with chemical decontamination--were evaluated.
To determine if SIV could be transmitted in allograft bone and if processing techniques could be used to eliminate the potential for disease transmission.
Although the risk of HIV transmission in bone allograft was reported to be low, HIV transmission had occurred. In all cases, frozen allograft was used. Donor screening and serologic testing significantly reduced the risk of transmission, although a window of time existed in which an individual was infected but had not seroconverted. Experimental infection of rhesus monkeys with SIV induced a disease syndrome similar to AIDS and provided an ideal model to study disease transmission.
Corticocancellous cylinders were obtained aseptically from SIV-infected rhesus monkeys. The grafts were randomly placed into one of four processing groups and implanted into noninfected animals. The presence of SIV antibody was monitored by serologic testing. After the monkeys were killed, the graft sites were studied by histology.
All animals receiving fresh allograft or allograft bone that had been subjected to either single or double -70 C freeze-thaw cycles became infected with SIV. Animals receiving allograft that had been subjected to a double freeze-thaw cycle and chemical decontamination were disease-free after 26 weeks when the animals were killed.
The results show that SIV (HIV-II) can be transmitted in bone allograft procedures. Although freeze-thaw cycles and lavaging to remove blood elements can reduce the infectivity of a graft, it appears chemical decontamination is necessary to provide a high level of confidence in its safety.
采用恒河猴感染猿猴免疫缺陷病毒（SIV，即HIV-II）来研究同种异体移植骨中的疾病传播情况。评估了四种同种异体移植骨处理技术——新鲜的、新鲜冷冻的、双重冻融的以及双重冻融并进行化学去污处理的。
确定SIV是否能在同种异体移植骨中传播，以及处理技术是否可用于消除疾病传播的可能性。
尽管据报道同种异体骨移植中HIV传播的风险较低，但仍有HIV传播的情况发生。所有这些病例均使用了冷冻同种异体骨。供体筛查和血清学检测显著降低了传播风险，不过在个体已被感染但尚未发生血清转化的这段时间内仍存在窗口期。恒河猴感染SIV可诱发类似于艾滋病的疾病综合征，为研究疾病传播提供了理想模型。
从感染SIV的恒河猴身上无菌获取皮质骨松质圆柱体。将移植物随机置于四个处理组之一，然后植入未感染的动物体内。通过血清学检测监测SIV抗体的存在情况。在处死猴子后，通过组织学研究移植物部位。
所有接受新鲜同种异体移植骨或经历过一次或两次-70℃冻融循环的同种异体移植骨的动物均感染了SIV。接受经历双重冻融循环并进行化学去污处理的同种异体移植骨的动物在处死时26周后未患病。
结果表明SIV（HIV-II）可在同种异体骨移植过程中传播。尽管冻融循环和冲洗以去除血液成分可降低移植物的感染性，但似乎化学去污对于确保其安全性具有高度信心是必要的。
