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[骨库股骨头捐献者中丙型肝炎感染的发生率]

[Incidence of hepatitis C infection among donors of femur heads to the tissue bank].

作者信息

Bonanad Boix S, Mirabet Lis V, Martí Martínez V, Planelles Silvestre D, Soler García A, Miguel García A

出版信息

Rev Esp Salud Publica. 1998 May-Jun;72(3):267-71.

PMID:9810833
Abstract

Living donors of femoral heads belong to a highly specific group in terms of age and pathological characteristic, forming the core of the group who supply many tissue banks with spongy bone, to cover the needs of several specialties in the field of repair and corrective surgery. Analysis for the presence of the hepatitis C virus in this population was conducted as a part of quality control programs, while habitual blood donors from the same geographical location were used as the control group. Although the comparison of results could give rise to erroneous interpretations, due to the lack of qualitative fit between the groups, a much higher incidence of infection by VHC was found in the donors of spongy bone than was the case for blood donors (3.816% vs. 0.569%), although a smaller proportion of donors had hepatic alterations (measured by transaminases). In spite of the fact that the prevalence of VHC is almost 6 times that corresponding to the control group, the elimination of live donors of spongy bone would create serious problems with supply to tissue banks. We therefore propose that more severe exclusion criteria be applied to the selection of bone donors, and also that sterilisation techniques be employed, using physical-chemical procedures (liophilisation, dehydration, chemical treatment, irradiation) to process these tissues. We also recommend that younger multiple organ tissue donors be used as sources of spongy bone for cold storage that is not to be subjected to any additional sterilisation treatment.

摘要

从年龄和病理特征来看,股骨头活体供者属于一个高度特殊的群体,他们构成了为许多组织库提供松质骨的群体核心,以满足修复和矫正手术领域多个专业的需求。作为质量控制项目的一部分,对该人群进行了丙型肝炎病毒检测,同时将来自同一地理位置的常规献血者作为对照组。尽管由于两组之间缺乏质量匹配,结果比较可能会产生错误解读,但松质骨供者中丙型肝炎病毒感染的发生率远高于献血者(3.816%对0.569%),尽管肝改变(通过转氨酶测量)的供者比例较小。尽管丙型肝炎病毒的流行率几乎是对照组的6倍,但取消松质骨活体供者会给组织库的供应带来严重问题。因此,我们建议在选择骨供者时采用更严格的排除标准,并且采用物理化学程序(冻干、脱水、化学处理、辐照)等灭菌技术来处理这些组织。我们还建议使用较年轻的多器官组织供者作为松质骨的来源进行冷藏,且不进行任何额外的灭菌处理。

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