Bone Transplant

Bone Transport

Bone grafting is a surgical procedure that replaces missing bone in order to repair bone fractures that are extremely complex, pose a significant health risk to the patient, or fail to heal properly. Some kind of small or acute fractures can be cured but risky for large fractures like compound fractures.

Bone generally has the ability to regenerate completely but requires a very small fracture space or some sort of scaffold to do so.

Autologous (bone harvested from the patient’s own body, often from the iliac crest),

Allograft (cadaveric bone usually obtained from a bone bank)

Synthetic (often made of hydroxyapatite or other naturally occurring and biocompatible substances) with similar mechanical properties to bone.

Most bone grafts are expected to be reabsorbed and replaced as the natural bone heals over a few months’ time.

Osteoconduction

(guiding the reparative growth of the natural bone),

Osteoinduction

(encouraging undifferentiated cells to become active osteoblasts)

Osteogenesis (living bone cells in the graft material contribute to bone remodeling).

Osteogenesis only occurs with autograft tissue and allograft cellular bone matrices.

Orthopaedics is a medical specialty that deals with the musculoskeletal system and uses medical, physical, and surgical methods to restore function lost as a result of injury or disease.

An orthopaedist, also called an orthopaedic surgeon, is a highly skilled physician trained in a variety of medical and surgical techniques that will be used during your surgery.

The lengthy educational process that is required to become an orthopaedic surgeon helps assure a high level of skill and competence

Bone or tissue transplanted from one part of a person’s body to another part is called an autograft.

Bone or tissue transplanted from the body of one person to another person is called an allograft.

The term graft is commonly used to refer to either an allograft or an autograft.

As you may be aware, many people choose to donate their organs and tissues. These otherwise healthy people often become donors as the result of an unexpected death. Most allograft musculoskeletal tissue used comes from such donors. Occasionally though, allograft bone may come from a living patient.

A tissue bank is an organization that provides donor screening, recovery, processing, storage, and/or distribution of allograft tissue. Specialists trained in transplantation recover and process donated musculoskeletal tissues. These professionals are well trained and most have passed a rigorous examination that certifies them on the basis of their knowledge in all areas of tissue banking including decontamination techniques, quality assurance, quality control, product testing, labeling, and record keeping.

The Tissue Banks is the national standard-setting organization that provides this certification. Presently, not all tissue banks are accredited. However, tissue banks may choose to undergo this voluntary accreditation.

Before donation, all potential donors must undergo strict screening scrutiny that includes physical examination, comprehensive medical history, and social risk review. A detailed medical history that includes social risk background and medical issues is obtained. The information collected on potential donors is compared against criteria established by the transplant unit to identify and exclude individuals with high-risk behaviors. Furthermore, all tissue is held in quarantine until microbiological and blood tests are completed. These tests are required, and include analysis of infectious diseases including HIV, hepatitis B and C, and syphilis.

All of the information is evaluated by a team of medical specialists in the fields of infectious disease and tissue banking. No allograft can be released until the tissue bank’s medical team determines the tissue to be safe after review of the screening and testing information.

Preparing the tissue for transplant begins with the removal of debris and organic matter. The allograft is then soaked in various solutions to prevent the transmission of bacteria and viruses. Processing and packaging are performed using sterile techniques in clean room conditions to maintain biological integrity. On occasion, low dose radiation is used to aid in sterilization. Final processed tissues are tested for microbiological contamination in accordance with guidelines to ensure compliance with regulatory requirements. Although there is some theoretical risk for disease transmission, the use of allografts that have undergone rigorous donor screening, serological testing, and formal processing has significantly reduced this risk.

Over the past years, more than five million musculoskeletal allografts have been distributed to surgeons for transplant into patients with a remarkable record of safety.

Once the transplanted bone or soft tissue graft is accepted by the body, it is slowly converted into new living bone or soft tissue and incorporated into the body as a functional unit.

It is illegal to buy or sell human organs or tissues. Costs for recovering organs and tissues for donation are never passed on to the donor or the donor family.

Many protocols are followed in tissue banks to ensure safety. Tissue banks insist on professional expertise in maintaining uniform and standardized donor screening, testing, quality control, and state-of-the-art applications of processing procedures. They also explore advancements in the areas of tissue sterilization and incorporation of bone grafts into the body. Tissue banks must also keep abreast of the development of new products, processing procedures, and regulations regarding good manufacturing processes. All these efforts represent the costs of providing the utmost safety in allograft tissue. These expenses are then passed on to the hospital, surgeon, or recipient. Costs are kept at a minimum, but must cover personnel and services in the areas of acquiring, processing, and storage of the allograft.

Some tissue that does not meet the criteria for transplantation for human use is directed to research projects in order to advance the science in musculoskeletal transplantation. Other selected tissue may go into programs of tissue engineering.

With regard to tissue banks when it began formal regulation of tissue banking. The purpose being to standardize the operations of participating tissue banks throughout the country and to achieve nationally recognized uniform levels of safety and quality in allograft transplants. Accreditation status  ensures that a bank has met national standards for donor screening, procurement, processing, and storage of human tissue. Each bank voluntarily agrees to be inspected on a regular basis to insure compliance in providing the safest tissues possible for transplantation. to ensure an exemplary record of safety to the public.

Before donation, all potential donors must undergo strict screening scrutiny that includes physical examination, comprehensive medical history, and social risk review. A detailed medical history that includes social risk background and medical issues is obtained. The information collected on potential donors is compared against criteria established by the Health Service to identify and exclude individuals with high-risk behaviors. Furthermore, all tissue is held in quarantine until microbiological and blood tests are completed. These tests are required  and include analysis of infectious diseases including HIV, hepatitis B and C, and syphilis.

All of the information is evaluated by a team of medical specialists in the fields of infectious disease and tissue banking. No allograft can be released until the tissue bank’s medical team determines the tissue to be safe after review of the screening and testing information.

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