title: Decontamination of heart valve and arterial allografts in the European Homograft Bank (EHB): comparison of two different antibiotic cocktails in low temperature conditions.
abstract: The aim of the study was to compare the efficiency of two different antibiotic cocktails in the cardiovascular allograft decontamination. Low temperature, low-concentration antibiotic cocktail with Cefoxitin, Lincomycin, Polymixin B and Vancomycin was decontamination protocol in EHB for many years. The modified cocktail doesn't contain Cefoxitin. The study had two steps. First step: cardiovascular allografts from 80 donors are incubated in classical (group 1) or modified cocktail (group 2). Second step: 184 and 182 allografts of group 1 and group 2 are incubated in the modified and classical antibiotic cocktail, respectively. The bacteriological examination is performed in three steps: A-transport solution, B-decontamination solution and C-cryopreservation solution. During the first step 23.75% of the tissues were initially contaminated mainly with Staphylococcus (78.95%). 93.75% of the allografts of group 1 and 100% of group 2 were sterile after incubation (p = 0.058). 25.54% and 30.77% of group 1 and 2, respectively were contaminated in A-examination during the second step. Staphylococci were isolated in 82.98% and 69.64% in group 1 and 2, respectively. About 4.35% of group 1 and 5.5% of group 2 were contaminated in A, B, and C whereas 5.4% of group 1 and 4.4% of group 2 were contaminated in B or C after being sterile in A. Finally 9.78% of the tissues were rejected and 90.22% cryopreserved in the modified, whereas 9.89% rejected and 90.11% accepted in the classical group (p = 0.1). The difference was non-significant in the level of decontamination between the two cocktails. Contamination of some tissues with low growing, low-pathogen germs that appeared in B or C examination, couldn't be explained. This issue needs complementary investigation.
authors: European Homograft Bank, International Association, c/o Military Hospital, Rue Bruynstaat, Brussels, 1120, Belgium. jasharir@yahoo.com
authors: R
authors: R
authors: Jashari
authors: M
authors: M
authors: Tabaku
authors: B
authors: B
authors: Van Hoeck
authors: C
authors: C
authors: Cochéz
authors: M
authors: M
authors: Callant
authors: A
authors: A
authors: Vanderkelen
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001158:Arteries / Q000382:microbiology / Q000637:transplantation*; D015925:Cryopreservation; D003666:Decontamination; D005060:Europe; D006351:Heart Valves / Q000382:microbiology / Q000637:transplantation*; D006801:Humans; D011446:Prospective Studies; D014015:Tissue Banks; D014184:Transplantation, Homologous
chemical_list: D000900:Anti-Bacterial Agents