Contamination of tissue allografts from a deceased donor through haematic dissemination: a case study
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Contamination of tissue allografts from a deceased donor through haematic dissemination: a case study R. J. Escribano Rey Æ B. L. Va´zquez Garcı´a Æ M. Alfonso Olmos-Garcı´a Æ M. San Julia´n Aranguren
Received: 24 April 2009 / Accepted: 20 August 2009 / Published online: 18 September 2009 Ó Springer Science+Business Media B.V. 2009
Abstract Infection is one of the most dangerous complications that can be seen when implanting bone or tendon allografts from a deceased donor. The most common germs isolated are found among the cutaneous florae, but sometimes they may be present in the bloodstream as a result of severe injuries suffered before the time of the decease. We present a case of contamination of allografts in a musculoskeletal tissue donor deceased after an accident, whose allografts were contaminated by gastrointestinal microorganisms, probably disseminated through the donor’s blood. Keywords Allograft Contamination Deceased donor Dissemination Hemoculture
Introduction Tissue grafts have become of great importance in the Orthopaedic surgical field when dealing with cases in which there is a lack of bone or tendon matter in multiple pathologies (tumours, fractures or traumatisms with serious bone loss, osteoarticular infections, R. J. Escribano Rey (&) B. L. Va´zquez Garcı´a M. Alfonso Olmos-Garcı´a M. San Julia´n Aranguren Department of Orthopaedic Surgery and Traumatology, University Clinic of Navarra, Av. Pı´o XII, 36, 31008 Pamplona, Spain e-mail: [email protected]
repairing ligaments and knee or ankle tendons, etc. (San Julian and Valentı´ 2006). Since the early stages of obtaining bone implants from donors, it became clear that the donor must not only be healthy but also not pose any risk of transmitting infections to the recipient (San Julian and Valentı´ 2006). Therefore, the processes to recover tissue, specifically osteotendinous tissue, are subject to an established protocol and they are usually carried out in conditions which guarantee a risk-free extracted tissue for the recipient. One of the major risks, specially in cases of bone graft, is the transmission of germs which may cause bone infections. Even though most of the microorganisms cultivated in donor bone samples are not highly pathogenic there are times in which bacteria may be isolated that could pose a serious threat, as in the case of Gram negatives or Staphylococci. The majority of these microorganisms may be transmitted directly while manipulating grafts in the recovery stage. At times this type of microorganism can be found in the donor’s bloodstream although the grafts’ test cultures turn out negative. Now we are going to examine the case of a bone donor who was probably infected with haematic contamination and whose bones were retrieved in our Center.
Case history Male donor, 49 years of age, construction worker whose clinical record showed solely a slight
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respiratory infection—already dealt with—and gastroesophageal reflux. He died when a truck backed into him, crushing both h
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