Contamination profile in allografts retrieved from multitissue donors: longitudinal analysis
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Contamination profile in allografts retrieved from multitissue donors: longitudinal analysis Adolfo Paolin . Giulia Montagner . Pieter Petit . Diletta Trojan
Received: 24 August 2018 / Accepted: 17 November 2018 Ó Springer Nature B.V. 2018
Abstract Microbiological contamination of retrieved tissues has become an issue of key importance and is a critical aspect of allograft safety, especially in the case of multi-tissue donations, which frequently become contaminated during retrieval and handling. We analysed contamination in 11,129 tissues with a longitudinal contamination profile for each individual tissue. Specifically, 10,035 musculoskeletal tissues and 1094 cardiovascular tissues were retrieved from a total of 763 multi-tissue donors, of whom 105 heart-beating organ donors and 658 deceased tissue donors. Of the 1955 tissues found to be contaminated after the first decontamination step, 1401 tissues (72%) were contaminated by the same species as the one(s) isolated at retrieval (Time1) and 554 (28%) by different species. Among the 113 tissues testing positive after the 2nd decontamination (Time3), 36 tissues (32%) were contaminated by the same species detected at Timel while the contaminating species differed from Time1 in 77 tissues (68%). The higher the number of contaminating species per tissue the higher the percentage of tissues in which contamination changed over time compared to Time1. The analysis revealed a 28% incidence of new species
A. Paolin G. Montagner D. Trojan (&) Treviso Tissue Bank Foundation, Treviso, Italy e-mail: [email protected] P. Petit Foundation European Tissue Banks, Berlin, Germany
in tissues already testing positive after retrieval and of 3.5% of tissues becoming positive after admission to the tissue bank. Of these, coagulase-negative Staphylococcus accounted for over 70% of new contaminations. Keywords Tissues Homograft Contamination Cardiovascular tissues Musculoskeletal tissues
Introduction Bacterial contamination is one of the primary problems to be addressed at Tissue Banks (TB) to ensure allograft safety. After retrieval, the contamination rate can be as high as 80% for cardiovascular (CVT) and up to 50% for musculoskeletal tissues (MST) (Paolin et al. 2017a), thus prompting the adoption of stringent decontamination protocols. Decontamination of allografts with antibiotics was first described in 1969 (Barratt-Boyes and Roche 1969), but to date the regimens used by banks differ in terms of antimicrobials used, temperature and duration of treatment. Some protocols have as a result, proven to be less satisfactory than others, despite being validated (Heng et al. 2013). Sterilization is performed using gamma irradiation or ethylene oxide, but high doses of gamma irradiation can alter the biomechanical properties of allografts (Gibbon et al. 1991) and ethylene oxide can cause immune response (Jackson et al. 1990). One
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