Disinfection of human musculoskeletal allografts in tissue banking: a systematic review
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Disinfection of human musculoskeletal allografts in tissue banking: a systematic review J. Mohr . M. Germain . M. Winters . S. Fraser . A. Duong . A. Garibaldi . N. Simunovic . D. Alsop . D. Dao . R. Bessemer . O. R. Ayeni . on behalf of the Bioburden Steering Committee and Musculoskeletal Tissue Working group
Received: 15 July 2016 / Accepted: 9 September 2016 Ó The Author(s) 2016. This article is published with open access at Springerlink.com
Abstract Musculoskeletal allografts are typically disinfected using antibiotics, irradiation or chemical methods but protocols vary significantly between tissue banks. It is likely that different disinfection protocols will not have the same level of microorganism kill; they may also have varying effects on the structural integrity of the tissue, which could lead to significant differences in terms of clinical outcome in recipients. Ideally, a disinfection protocol should achieve the greatest bioburden reduction with the lowest possible impact on tissue integrity. A systematic review of three databases found 68 laboratory and clinical studies that analyzed the microbial bioburden or contamination rates of musculoskeletal allografts. The use of peracetic acid–ethanol or ionizing radiation was found to be most effective for disinfection of tissues. The use of irradiation is the most frequently
Electronic supplementary material The online version of this article (doi:10.1007/s10561-016-9584-3) contains supplementary material, which is available to authorized users. J. Mohr S. Fraser Canadian Blood Services, 270 John Savage Ave., Dartmouth, NS B3B 0H7, Canada M. Germain He´ma-Que´bec, 1070 Sciences-de-la-Vie Avenue, Quebec, QC G1V 5C3, Canada M. Winters Nelson Laboratories, 6280 South Redwood Road, Salt Lake City, UT 84123-6600, USA
published method for the terminal sterilization of musculoskeletal allografts; it is widely used and its efficacy is well documented in the literature. However, effective disinfection results were still observed using the BioCleanseTM Tissue Sterilization process, pulsatile lavage with antibiotics, ethylene oxide, and chlorhexidine. The variety of effective methods to reduce contamination rate or bioburden, in conjunction with limited high quality evidence provides little support for the recommendation of a single bioburden reduction method. Keywords Musculoskeletal allograft Tissue donation Tissue banking Bioburden Introduction Tissue banking is a process in which allografts are recovered from a donor and stored (banked) for future use. Prior to storage, the tissue banks process the tissues to remove microbial contaminants and ensure A. Duong A. Garibaldi N. Simunovic D. Alsop D. Dao R. Bessemer O. R. Ayeni Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON L8L 8E7, Canada O. R. Ayeni (&) McMaster University Medical Centre, 1200 Main St W, Room 4E15, Hamilton, ON L8N 3Z5, Canada e-mail: [email protected]
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Cell Tissue Bank
safety of the allografts for transplan
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