[Bone bank management using a thermal disinfection system (Lobator SD-1). A critical analysis].
In the study presented on 380 allogenic bone donations from living and organ donors, we analyzed the safety of allograft handling bone-band documentation, logistics and costs. For transplant treatment we routinely used a thermal disinfection system (Lobator SD-1). From 380 allograft donors, 400 bone transplants were gained. The rejection rate was 12.2%. After thermal disinfection for 1 h at 80 degrees C, the grafts were cryopreserved at -80 degrees C and released from the bone bank for potential transplantation after 14-16 days. Five of 730 microbiological specimens showed bacterial contamination after thermal graft decontamination. The bacterial species found on the allografts normally have an inactivation temperature under 80 degrees C. Therefore, only secondary contamination can explain the positive bacteriological test results. With reform of the health care system the economical aspects of bone banking have triggered more interest. The cost for one bone transplant released from the bone bank was 424.75 DM: the overall cost for the bone bank in one year was 75,076 DM. Laboratory (58.2%) and material costs (22.5%) were the major factors. Personnel costs and apparatus costs were relatively low (< 20%). With introduction of the thermal disinfection system (Lobator SD-1) into the bone bank, the safety of allogenic bone transplants was greatly improved. Clinical and serological donor screening must be performed according to international bone bank directives. Considering the low rejection rate and the short turnover rate, the economical costs could be reduced. Using an appropriate disinfection system (thermal disinfection at 80 degrees C), laboratory tests covering venereal diseases, malaria and cytomegalia are no longer required. Also, secondary HIV testing of living donors can be omitted without reducing the safety of the transplant.
Hofmann
C
C
Klinik für Unfallchirurgie, Philipps-Universität-Marburg.
von Garrel
T
T
Gotzen
L
L
D018586:Bone Banks / Q000191:economics*; D016025:Bone Transplantation / Q000191:economics / Q000295:instrumentation* / Q000706:statistics & numerical data; D003362:Cost-Benefit Analysis; D015925:Cryopreservation / Q000191:economics / Q000295:instrumentation; D004203:Disinfection / Q000191:economics / Q000295:instrumentation*; D005858:Germany; D006084:Graft Rejection / Q000453:epidemiology; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission; D006361:Heating / Q000191:economics / Q000295:instrumentation*; D006509:Hepatitis B / Q000517:prevention & control / Q000635:transmission; D006526:Hepatitis C / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D012307:Risk Factors; D014021:Tissue Preservation / Q000191:economics / Q000295:instrumentation