Disinfection of human cardiac valve allografts in tissue banking: systematic review report
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Disinfection of human cardiac valve allografts in tissue banking: systematic review report M. Germain . D. M. Strong . G. Dowling . J. Mohr . A. Duong . A. Garibaldi . N. Simunovic . O. R. Ayeni . on behalf of the Bioburden Steering Committee and Cardiac Tissue Working group
Received: 14 April 2016 / Accepted: 14 July 2016 Ó The Author(s) 2016. This article is published with open access at Springerlink.com
Abstract Cardiovascular allografts are usually disinfected using antibiotics, but protocols vary significantly between tissue banks. It is likely that different disinfection protocols will not have the same level of efficacy; 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. We conducted a systematic review of methods applied to disinfect cardiovascular tissues. The use of multiple broad spectrum antibiotics in conjunction with an antifungal agent resulted in the greatest reduction in bioburden. Antibiotic incubation periods were limited to less than 24 h, and most protocols incubated tissues Electronic supplementary material The online version of this article (doi:10.1007/s10561-016-9570-9) contains supplementary material, which is available to authorized users.
at 4 °C, however one study demonstrated a greater reduction of microbial load at 37 °C. None of the reviewed studies looked at the impact of these disinfection protocols on the risk of infection or any other clinical outcome in recipients. Keywords Cardiovascular allografts Tissue donation Tissue decontamination Bioburden Tissue banking
Introduction Prior to the advent of tissue preservation, transplantation of cardiac valves had to occur shortly after recovery to reduce the incidence of contamination and tissue damage. Advances in cardiovascular preservation have allowed for the creation of heart valve banks worldwide
M. Germain He´ma-Que´bec, 1070 Sciences-de-la-Vie Avenue, Quebec, QC G1V 5C3, Canada
J. Mohr Canadian Blood Services, 270 John Savage Ave., Dartmouth, NS B3B 0H7, Canada
D. M. Strong Department of Orthopaedics and Sports Medicine, University of Washington School of Medicine, 98104 Seattle, WA, USA
A. Duong A. Garibaldi N. Simunovic O. R. Ayeni Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON L8L 8E7, Canada
G. Dowling Comprehensive Tissue Centre, 8230 Aberhart Centre, 11402 University Avenue NW, Edmonton, AB T6G 2J3, 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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to increase the number and quality of heart valves available for transplantation (Chaukar et al. 1990; Gall et al. 1998; Germain et al. 2010; Goffin et al. 1996; Heng et al. 2013a, b; Jashari et al. 2007; Tabaku et al. 2004; Verghese
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