title: Impact of manufacturing, irradiation and filtration steps to bacterial contamination of autologous fibrin sealant.
abstract: BACKGROUND
  Preoperative production of autologous fibrin sealant has become a routine procedure during the last years. As a certain percentage of blood products is contaminated with bacteria, contamination of plasma used for the production of fibrin sealant cannot be excluded. Especially in the orthopaedic setting, application of contaminated fibrin sealant can cause severe infections.
  
  
  METHODS
  We contaminated plasma with Staphylococcus epidermidis, Corynebacterium striatum, Bacillus subtilis or Escherichia coli and produced fibrin sealant by cryoprecipitation and alcohol precipitation. Additionally, the products were gamma-irradiated at a dose of 30 Gy, frozen at -55 degrees C and filtered through a 0.2 microm filter after thawing. After each preparation step, samples were drawn and numbers of colony forming units were counted after incubation on agar plates.
  
  
  RESULTS
  Cryoprecipitation, irradiation, freezing at -55 degrees C, and alcohol precipitation have only little impact on numbers of colony forming units. Filtration through a bacterial filter results in a sterile product.
  
  
  CONCLUSIONS
  Bacteria in plasma as a starting material for production of fibrin sealant survive all routine steps of production, including gamma irradiation and freezing. Filtration of the product through a qualified bacterial filter is the only safe means to provide a sterile product.
authors.affiliation: Department for Blood Group Serology and Transfusion Medicine, Vienna Medical University, Vienna, Austria. christoph.buchta@meduniwien.ac.at
authors.forename: Christoph
authors.initials: C
authors.lastname: Buchta
authors.forename: Markus
authors.initials: M
authors.lastname: Dettke
authors.forename: Philipp T
authors.initials: PT
authors.lastname: Funovics
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Hirschl
authors.forename: Maria
authors.initials: M
authors.lastname: Macher
authors.forename: Nina
authors.initials: N
authors.lastname: Worel
authors.forename: Paul
authors.initials: P
authors.lastname: Höcker
mesh_terms: D001419:Bacteria; D003257:Consumer Product Safety; D004340:Drug Contamination; D015718:Fibrin Tissue Adhesive; D005374:Filtration; D005720:Gamma Rays; D006801:Humans; D014182:Transplantation, Autologous; D014462:Ultrafiltration
chemical_list: D015718:Fibrin Tissue Adhesive