Validation of musculoskeletal tissue banking in Australia

Katherine Elise Mackie

    Research output: ThesisDoctoral Thesis

    410 Downloads (Pure)

    Abstract

    [Truncated abstract] Musculoskeletal allografts are one of the most transplanted human tissues in Australia. The majority of musculoskeletal allografts are used for reconstructive surgery following trauma, limb salvage following tumour resection, prosthetic joint revision surgery, spinal surgery and non‐union fracture healing. Musculoskeletal tissues, including bone and tendons, are sourced from both living and deceased donors in Australia. As with the use of any human tissue there is a risk of disease transmission. Although vigilant screening of donors' serology and medical history, microbiological monitoring of grafts during processing and treatment with gamma irradiation now occurs, there is still a risk of viral and bacterial transmission from donated grafts. The aim of this thesis is to assess current screening protocols for musculoskeletal tissue allografts, determine the risks associated with tissue allograft, and propose strategies to increase safety associated with their use based on evidence‐based risk estimates. Areas with a current need for focus include hepatitis B virus screening protocols, histopathological examination of donated bone, and bone allograft recipient monitoring. In order to carry out these objectives, data was retrieved and analysed retrospectively from the Perth Bone and Tissue Bank (PBTB) in Western Australia. These databases are maintained as part of standard tissue bank practice and in accordance with the Therapeutic Goods Act. Additional supporting data was retrieved from the state-wide Western Australian Cancer Registry, Hospital Morbidity Data Collection, Emergency Department Data Collection and Death Registry. Histopathological examination and follow-up investigations of 6161 femoral heads donated for allografts between 1993 and 2006 revealed a total of 105 femoral heads demonstrating abnormal or reactive histopathological features, and thus these donations were rejected for use as allograft. Of these, two patients we
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2012

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