The impact of the International Atomic Energy Agency (IAEA) program on radiation and tissue banking in Brazil
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The impact of the International Atomic Energy Agency (IAEA) program on radiation and tissue banking in Brazil Marisa Roma Herson Æ Monica Beatriz Mathor Æ Jorge Morales Pedraza
Received: 2 June 2008 / Accepted: 2 June 2008 / Published online: 10 July 2008 Ó Springer Science+Business Media B.V. 2008
Abstract Until 2000, efforts into organising tissue banks in Brazil had not progressed far beyond small ‘‘in house’’ tissue storage repositories, usually annexed to Orthopaedic Surgery Services. Despite the professional entrepreneurship of those working as part time tissue bankers in such operations, best practices in tissue banking were not always followed due to the lack of regulatory standards, specialised training, adequate facilities and dedicated personnel. The Skin Bank of the Plastic Surgery Department of the Hospital das Clinicas of Sao Paulo, the single skin bank in Brazil, was not an exception. Since 1956, restricted and unpredictable amounts of skin allografts were stored under refrigeration for short periods under very limited quality controls. As in most ‘‘tissue banks’’ at that time in Brazil, medical and nursing staff worked on a
M. R. Herson (&) Donor Tissue Bank of Victoria, 57083 Kavanagh St, Southbank, Melbourne, Australia e-mail: [email protected] M. B. Mathor Instituto de Pesquisas Energe´ticas e Nucleares, IPEN – CNEN/SP, Av. Prof. Lineu Prestes, 2242 Cidade Universita´ria, CEP 05508-000 Sao Paulo, SP, Brasil e-mail: [email protected] J. Morales Pedraza Charasgasse 3, apart. 13, 1030 Vienna, Austria e-mail: [email protected]; [email protected]
volunteer and informal basis undergoing no specific training. IAEA supported the implementation of the tissue banking program in Brazil through the regional project RLA/7/009 ‘‘Quality system for the production of irradiated sterilised grafts’’ (1998–2000) and through two interregional projects INT/6/049 ‘‘Interregional Centre of Excellence in Tissue Banking’’, during the period 2002–2004 and INT/6/ 052 ‘‘Improving the Quality of Production and Uses of Radiation Sterilised Tissue Grafts’’, during the period 2002–2004. In 2001–2002, the first two years of operation of the HC-Tissue Bank, 53 skin transplants were carried out instead of the previous 4–5 a year. During this period, 75 individuals donated skin tissue, generating approximately 90,000 cm2 of skin graft. The IAEA program were of great benefit to Brazilian tissue banking which has evolved from scattered make shift small operations to a well-established, high quality tissue banking scenario. Keywords Brazil Tissue banking Radiation processing Sterilisation Allografts
The early period Since 1997, Federal Law No. 9.434 regulates organ donation. It basically states that every individual is a potential multi-organ donor, unless stated against in the identity card and/or in the driver’s license. In
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1998, an addendum to the law was adopted, suggesting family consent before organ procurement. The Federal Decree 2.268 from 1997 established the National Transplant System, by which th
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