OBJECTIVE: Cranioplasty using a cryopreserved skull flap is a wide spread practice. The most well-known complications of cranioplasty are postoperative surgical infections and bone flap resorption. In order to find biological evidence of cryopreserved cranioplasty, we investigated microorganism contamination of cryopreserved skulls and cultured osteoblasts from cryopreserved skulls. METHODS: Cryopreserved skull flaps of expired patients stored in a bone bank were used. Cryopreserved skulls were packaged in a plastic bag and wrapped with cotton cloth twice. After being crushed by a hammer, cancellous bone between the inner and outer table was obtained. The cancellous bone chips were thawed in a water bath of 30°C rapidly. After this, osteoblast culture and general microorganism culture were executed. Osteoblast cultures were done for 3 weeks. Microorganism cultures were done for 72 hours. RESULTS: A total of 47 cryopreserved skull flaps obtained from craniectomy was enrolled. Of the sample, 11 people were women, and the average age of patients was 55.8 years. Twenty four people had traumatic brain injuries, and 23 people had vascular diseases. Among the patients with traumatic brain injuries, two had fracture compound comminuted depressed. The duration of cryopreservation was, on average, 83.2 months (9 to 161 months). No cultured osteoblast was observed. No microorganisms were cultured. CONCLUSION: In this study, neither microorganisms nor osteoblasts were cultured. The biological validity of cryopreserved skulls cranioplasty was considered low. However, the usage of cryopreserved skulls for cranioplasty is worthy of further investigation in the aspect of cost-effectiveness and risk-benefit of post-cranioplasty infection.
Bacterial Infections ; Baths ; Bone Banks ; Brain Injuries ; Cell Culture Techniques ; Cryopreservation ; Decompressive Craniectomy ; Female ; Humans ; Osteoblasts* ; Plastics ; Skull* ; Vascular Diseases ; Water

BACKGROUND: Tissues for transplantation can save lives or restore essential functions. According to national policies and regulations, access to suitable transplantation, as well as the level of safety, quality, efficacy of donation, and transplantation of tissues, differ significantly between countries. We reviewed a few guidelines on tissue banking from the aspect of screening tests. In addition, four-year experience with screening panels for donated bones and donors at a tertiary hospital is introduced. METHODS: Seven national and international guidelines for screening tests for donors and donated tissues were reviewed. At our institution, screening tests for donation involve two steps. At retrieval, the first screening panel, including ABO/Rh typing, unexpected antibody screening, VDRL, HBsAg, anti-HBs, anti-HBc IgM, anti-HCV, anti-HIV, and microbiological cultures was performed. The second screening panel, including the same tests, except culture studies, was performed after 90 days. From 2008 to 2011, a total of 245 retrievals of bone tissue were performed and the screening panel results were analyzed. RESULTS: Mandatory screening serologic tests for living donors can differ according to local law or regulation and/or screening for endemic diseases. At our institution, among 245 donated bones for a period of four years, 61 bone tissues were discarded due to noncompliance for the second screening (n=32), contamination or no culture study results (n=9), abnormal serologic test results (n=8), and so on. CONCLUSION: Donor screening policies for tissue banking are various according to national laws or endemic disease status. Second screening tests with consideration of the window period should be adopted.
Adoption ; Bone and Bones ; Donor Selection ; Endemic Diseases ; Hepatitis B Surface Antigens ; Humans ; Immunoglobulin M ; Jurisprudence ; Living Donors ; Mandatory Testing ; Mass Screening ; Serologic Tests ; Social Control, Formal ; Tertiary Care Centers ; Tissue Banks ; Tissue Donors ; Transplants

bone loss was found. Therefore, surgical treatment was performed. After surgical exposure of the defect, granulation tissue was removed and implant surface was treated using tetracycline and chlorhexidine. Then, the flaps were sutured. The wound healing was performed in a non-submerged mode. The present finding demonstrates stable results without progression of bone loss. In one subject, deep V shaped bone defect was filled with bone substitute (ICB, CanCellous Bone, Rockey Mountain Tissue Bank, USA), and resorbable membrane (Lyoplant(R), B.Braun Aesculap AG, Germany) was placed over the grafted defect and healing abutment was connected. However, the inflammation was not resolved and more bone loss was found. At one month after regenerative surgery, the implant was removed.]]>
Bone Substitutes ; Chlorhexidine ; Granulation Tissue ; Hygiene ; Inflammation ; Membranes ; Peri-Implantitis ; Tetracycline ; Tissue Banks ; Transplants ; Wound Healing

This study was aimed to develop and establish an efficient method for high through-put automatically extracting genomic DNA from EDTA-anticoagulated whole blood samples, and to utilize this method in routine rSSO HLA genotyping by luminex flow array assay, the genomic DNA was extracted automatically from 400 microl blood samples by using TECAN DNA workstation and 96-well plate with 2 ml volume per well. The yield and purity of each DNA sample was tested by UV-spectrophotometer, the integrity of these DNA samples were run electrophoresis on the agarose gel. Each DNA sample was subjected to PCR amplification and hybridization using One lambda rSSO HLA-A, -B and -DRB1 commercial kit, the fluorescent intensity for positive bead and negative bead hybridized with HLA-A, -B and -DRB1 PCR products were calculated and analyzed. The results showed that the mean yield and purity (A260/A280) of genomic DNA extracted from 400 microl whole blood samples were 3.217+/-0.715 microg and 1.710+/-0.103 respectively. The molecular weight was more than 15 kb in size and the fluorescent intensity for positive bead hybridized with HLA-A, -B and -DRB1 PCR products of each sample was >600 RFU, however, the fluorescent intensity for negative bead for each sample was <50 RFU. It is concluded that the highly qualified genomic DNA can be extracted automatically from blood samples of marrow-donors by using TECAN DNA workstation, and the extracted DNA samples are suitable for high through-put HLA genotyping by luminex flow array assay and other downstream transplant immunological and molecular biological experiments.
Biological Specimen Banks ; Bone Marrow ; DNA ; isolation & purification ; DNA Primers ; Genotype ; HLA Antigens ; genetics ; High-Throughput Screening Assays ; methods ; Humans ; Living Donors ; Nucleic Acid Hybridization ; methods ; Oligonucleotide Array Sequence Analysis ; methods

Limb salvage surgery for treatment of malignant bone tumors is an acceptable alternative to amputation in most patients as marked improvement has been achieved in diagnostic imaging, neoadjuvant chemotherapy, and operative techniques. There are several options for limb salvage: endoprosthesis, allograft, treated autobone, etc and each has its own advantages and disadvantages. Prosthetic replacement is an option for limb salvage surgery, but loosening, breakage, and wear are encountered during long-term follow up. Allografts require a large scale bone bank system, and there are concerns of immunologic responses, transmission of disease, religious and social circumstance, and high complication rate. Low heat treated autobone graft are reasonable option of treated autobone. Multiple studies and clinical application of heat treated bone proved the superiority of low heat treated bone(pasteurization, heating at 60 degrees ... to 65 degrees ... for 30 minutes) over other methods of heat treatment such as autoclaving or boiling. Low heat treatment has a lethal effect on malignant cells while preserving sufficient biomechanical strength and bone inducing property. Low heat treatment showed satisfactory results of bone remodeling and union, function, complication (fracture, infection and bone resorption). Several studies suggest that low heat treatment(pasteurization) may be superior to other cell-lethal treatment for autologous bone graft used for limb salvage surgery.
Allografts ; Amputation ; Bone Banks ; Bone Remodeling ; Diagnostic Imaging ; Drug Therapy ; Extremities* ; Heating ; Hot Temperature* ; Humans ; Limb Salvage* ; Transplants

bone, skin, cornea and cardiovascular tissues. Allogenic bone grafts have possibility of transmission of hepatitis C, human immunodeficiency virus (HIV-1), human T-Cell leukaemia virus (HTLV), tuberculosis and other bacterias. The tissue bank should have a policy for obtaining information from the patient's medical report as to whether the donor had risk factors for infectious diseases. Over the past several years, improvements in donor screening criteria, such as excluding potential donor with "high risk" for HIV-1 and hepatitis infection, and donor blood testing result in the reduction of transmission of these diseases. During tissue processing, many allografts are exposed to antibiotics, disinfectants and terminal sterilization such as irradiation, which further reduce or remove the risk of transmitting diseases. Because the effectiveness of some tissue grafts such as, fresh frozen osteochondral grafts, depends on cellular viability, not all can be subjected to sterilization and processing steps and, therefore, the risk of transmission of infectious disease remains. This article is review of the transmission of considering infectious disease in allogenic bone transplantation and the processing steps of reducing the risk. The risk of viral transmission in allografts can be reduced in several standards. The most important are donor-screening tests and the removal of blood and soft tissues by processing steps under the aseptic environment. In conclusion, final sterilizations including the irradiation, can be establish the safety of allografts.]]>
Allografts ; Anti-Bacterial Agents ; Bacteria ; Bone Transplantation ; Communicable Diseases ; Cornea ; Disease Transmission, Infectious ; Disinfectants ; Donor Selection ; Hematologic Tests ; Hepatitis ; Hepatitis C ; HIV ; HIV-1 ; Humans ; Risk Factors ; Skin ; Sterilization ; T-Lymphocytes ; Tissue Banks ; Tissue Donors ; Tissue Transplantation ; Transplants ; Tuberculosis

This study was performed to evaluate the effect of freeze-dried bone graft on space-making capacity and bone formation in the procedure of guided bone regeneration with titanium reinforced ePTFE membrane. After decortication in the calvaria, GBR procedure was performed on 8 rabbits with titanium reinforced ePTFE membrane filled with human FDBA(Rocky Mountain Tissue Bank, Aurora Co., USA). Decortication was performed to induce the effect of bone forming factor from bone marrow. The animals were sacrificed at 2 weeks, 4 weeks, 8 weeks and 12 weeks after the surgery. Non-decalcified specimens were processed for histologic analysis. The results of this study were as follows: 1. Titanium reinforced-ePTFE membrane was biocompatable and capable of maintaining the space-making. 2. FDBA particle was surrounded with connective tissues but there was no evidence on new bone formation. 3. FDBA particle resorbed continuously but it remained until 12weeks after the surgery. Within the above results, TR-ePTFE membrane could be used effectively for Guided bone regeneration but It was assumed that FDBA does not appear to contribute to bone formation.
Animals ; Bone Marrow ; Bone Regeneration ; Connective Tissue ; Humans ; Membranes ; Osteogenesis ; Rabbits ; Skull ; Tissue Banks ; Titanium ; Transplants*

Progress in medical science and cell biology has resulted in the transplantation of human cells and tissues from on human into another, facilitating reproduction and the restoration of form and function, as well as enhancing the quality of life. For more than 40 years, society has recognized the medical and humanitarian value of donation and transplanting organs and tissues. The standard operating procedures of hard tissues reflect the collective expertise and conscientious efforts of tissue bank professionals to provide a foundation for the guidance of tissue banking activities. Procurement of allograft tissues from surgical bone donors is a part of tissue banking. During the past decades the use of bone allografts has become widely accepted for the filling of skelectal defects in a variety of surgical procedures. In particular in the field of orthopaedic and oral and maxillofacial surgery the demand for allografts obtained from either living or post-mortem donors has increased. Hospital-based tissue banks mainly retrieve allografts from living donors undergoing primary total hip replacement for osteoarthritis or hemi arthroplasty for hip fractures and orthgnatic surgery such as angle reduction. Although bone banks have existed for many years, the elements of organized and maintaining a hospital bone bank have not been well documented. The experience with a tissue bank at Korea Tissue Bank(KTB) between 2001 and 2004 provides a model of procurement, storage, processing, sterilization and documentation associated with such a facility. The following report describes the standard operating procedures of hard tissues such as femoral head obtained from living donors.
Allografts* ; Arthroplasty, Replacement, Hip ; Bone Banks ; Head* ; Hemiarthroplasty ; Hip Fractures ; Humans ; Korea ; Living Donors* ; Osteoarthritis ; Quality of Life ; Reproduction ; Sterilization ; Surgery, Oral ; Tissue Banks ; Tissue Donors

PURPOSE: Current pediatric cancer research requires an organized pediatric tumor tissue bank with standardized guidelines for preparation and storage of human tumor tissue samples, white cells, serum, genomic DNA, RNA, cDNA and proteins.. Our institution established and managed pediatric tumor tissue bank for the last one year, and we want to present an overview of our experiences and guidelines. METHODS: From leukemia patients, peripheral blood and bone marrow aspirates were collected at initial diagnosis. Leukemic cells were prepared by Ficoll density-gradient centrifugation and stored at 196oC liquid nitrogen. For solid tumors, tissue cultures were performed as soon as possible after surgical excision or needle biopsy. Serum free media and primary cultured cells were collected and stored at 20degrees C and at 196degrees C, respectively. Genomic DNA, RNA and cDNA were isolated from leukemic cells and cultured solid tumor cells, and stored at 20degrees C. We also isolated genomic DNA from white blood cells of solid tumor patients and stored at 20degrees C. Finally we collected serum samples from all pediatric cancer patients at diagnosis and stored at 20degrees C. RESULTS: Among the 41 cases of leukemia and 100 cases of solid tumor patients who were diagnosed at department of pediatrics, Samsung Medical Center, from August 2000 to July 2001, 26 cases (63%) of leukemia and 59 cases (59%) of solid tumor patients were registered to Pediatric Tumor Tissue Bank. Primary cell cultures were performed in 21 cases of solid tumors and were successful in 19 cases (90%). The isolated genomic DNA, RNA and cDNA were all in high quality confirmed by electrophoresis in agarose gel. CONCLUSION: The problem of tissue sample size obtained by needle biopsy could be overcome by primary cell cultures. For the effective management of pediatric tumor tissue bank, fresh tissue collection with active cooperation of surgeons, organized personnel structure, and multidisciplinary standardized guidelines are necessary.
Biopsy, Needle ; Bone Marrow ; Cell Culture Techniques ; Cells, Cultured ; Centrifugation ; Culture Media, Serum-Free ; Diagnosis ; DNA ; DNA, Complementary ; Electrophoresis ; Ficoll ; Humans ; Leukemia ; Leukocytes ; Nitrogen ; Pediatrics ; Primary Cell Culture ; RNA ; Sample Size ; Sepharose ; Tissue Banks*

Since surgical bone banks were set up at several university hospitals in early 1970s, the number of allograft is getting increased in Korean society. Most orthopedic surgeons have used allografts supplied by their own surgical bone banks for tumor reconstruction, arthroplasty, and ligament reconstruction. In 2000, a nation-wide survey for surgical bone banks was performed by Korean orthopedic Association. The questionnaires were prepared by the Committee on Tissue Bank in the Association, and sent to 110 university and training hospitals. Fifty-six surgical bone banks were encountered. However, facilities of the banks were not updated. Most of them were using one or two deep freezers only. Most of them do not have a full-time technician. While most bone banks were using surgically excised femoral heads and amputated limbs, some banks retrieved the tissues from cadaver or organ donors. Since the law for organ transplantation from brain death was established in February 2000, the number of allograft transplantation is growing tremendously. In order to secure the safety of allograft transplantation, the enactment of "the Law for Tissue Transplantation" is mandatory. Unlike organs, the tissues can be procured and stored in advance and can be used whenever they are needed by establishing and operating a form of tissue bank. Therefore, since it is difficult to regulate or supervise tissue banking by "the Law on the Organs and Transplantation", the enactment of a separate law is highly recommended. The government should set the certification standards for the bone and tissue banks suitable for the domestic circumstances. The request of certification of bone and tissue banks should be obtained by the banks that are currently in operation. Also, actual inspection team should be organized involving the professionals and public officers. This team will be responsible for audit of the banks. The certified bone and tissue banks should renew by paper review or actual inspection every 2~3 years. For safe and smooth operation of the banks, the licence system for certified tissue bank specialist(CTBS) should be adopted. Requirements such as academic requirement or professional experience in bone and tissue banks for a certain period of time will be needed.
Allografts ; Arthroplasty ; Bone Banks* ; Brain Death ; Cadaver ; Certification ; Extremities ; Head ; Hospitals, University ; Humans ; Jurisprudence ; Korea* ; Ligaments ; Organ Transplantation ; Orthopedics ; Quality Improvement* ; Surgeons ; Tissue Banks ; Tissue Donors ; Transplants