Decontamination of heart valve and arterial allografts in the European Homograft Bank (EHB): comparison of two different
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Decontamination of heart valve and arterial allografts in the European Homograft Bank (EHB): comparison of two different antibiotic cocktails in low temperature conditions R. Jashari Æ M. Tabaku Æ B. Van Hoeck Æ C. Coche´z Æ M. Callant Æ A. Vanderkelen
Received: 17 January 2007 / Accepted: 15 March 2007 / Published online: 13 April 2007 Ó Springer Science+Business Media B.V. 2007
Abstract The aim of the study was to compare the efficiency of two different antibiotic cocktails in the cardiovascular allograft decontamination. Low temperature, low-concentration antibiotic cocktail with Cefoxitin, Lincomycin, Polymixin B and Vancomycin was decontamination protocol in EHB for many years. The modified cocktail doesn’t contain Cefoxitin. The study had two steps. First step: cardiovascular allografts from 80 donors are incubated in classical (group 1) or modified cocktail (group 2). Second step: 184 and 182 allografts of group 1 and group 2 are incubated in the modified and classical antibiotic cocktail, respectively. The bacteriological examination is performed in three steps: A–transport solution, B–decontamination solution and C–cryopreservation solution. During the first step 23.75% of the tissues were initially contaminated mainly with Staphylococcus (78.95%). 93.75% of the allografts of group 1 and 100% of group 2 were sterile after incubation (p = 0.058). 25.54% and 30.77% of group 1 and 2, respectively were contaminated in A-examination during the second R. Jashari (&) M. Tabaku B. Van Hoeck C. Coche´z A. Vanderkelen European Homograft Bank, International Association, c/o Military Hospital, Rue Bruynstaat, Brussels 1120, Belgium e-mail: [email protected] M. Callant LCA (Laboratory for Control and Analysis), Brussels, Belgium
step. Staphylococci were isolated in 82.98% and 69.64% in group 1 and 2, respectively. About 4.35% of group 1 and 5.5% of group 2 were contaminated in A, B, and C whereas 5.4% of group 1 and 4.4% of group 2 were contaminated in B or C after being sterile in A. Finally 9.78% of the tissues were rejected and 90.22% cryopreserved in the modified, whereas 9.89% rejected and 90.11% accepted in the classical group (p = 0.1). The difference was nonsignificant in the level of decontamination between the two cocktails. Contamination of some tissues with low growing, low-pathogen germs that appeared in B or C examination, couldn’t be explained. This issue needs complementary investigation. Keywords Allograft Antibiotic cocktail Arterial allograft Bacterial contamination Cryopreservation Donor tissue Heart valve allograft
Introduction The first aortic valve allografts were implanted in the orthotopic position in 1962 separately by Donald Ross in London (Ross 1962) and Bryan Barrat-Boyes in Auckland (Barrat-Boyes 1964). Since then the valve and vascular allografts have been successfully used as the acceptable solution for different complicated congenital and acquired cardiac and/or vascular diseases.
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The European Homograft Bank (EHB) in Brussels has been banking the human
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