title: Microbiological examination of donated human cardiac tissue in heart valve banking.
abstract: OBJECTIVE
  Microbiological examination of donated human cardiac tissue is a necessary procedure for Heart Valve Banks to determine the biological safety of preserved allografts. Test protocols must be validated to prevent false-negative outcomes that pose a risk of infection to recipients of the tissue. The Heart Valve Bank in Rotterdam evaluated a validated, alternative entry test for donated tissues to compare the performance of its standard microbiological examinations.
  
  
  METHODS
  Samples of explanted heart transport medium from 275 donors were examined for the presence of microorganisms using blood culture flasks (standard test) and fluid thioglycolate medium (alternative test). Results were compared with the outcome of microbiological assessment of subvalvular myocardial fragments and the cryoprotective medium that were collected before and after treatment of the grafts with antibiotics, respectively.
  
  
  RESULTS
  Microorganisms, mainly skin flora, were detected in transport medium of 177 hearts (64%). The alternative validated culture method detected a growth in 80 transport medium samples that was not identified by the standard method. Microorganisms were only identified in the cultivated cardiac tissue fragments from 56 donors (20%). After antibiotic treatment of the tissue, microorganisms could still be encountered in cryoprotective medium samples from 55 donors (20%). Most of the contaminants in these final samples were identified as Propionibacterium species and Corynebacterium species and had already been detected in the transport medium by the alternative validated culture method.
  
  
  CONCLUSIONS
  The use of blood culture flasks for microbiological assessment of non-blood liquid media and the cultivation of myocardial tissue fragments may hamper detection of certain microorganisms and therefore provide less complete information about microbiological safety. Heart Valve Banks may want to review their microbiological examination and decontamination procedures regarding the ability to detect and eliminate anaerobic skin flora, respectively.
authors.affiliation: Heart Valve Bank, Department of Cardio-Thoracic Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands. svankats@hotmail.com
authors.forename: Jorge P
authors.initials: JP
authors.lastname: van Kats
authors.forename: Corina
authors.initials: C
authors.lastname: van Tricht
authors.forename: Alice
authors.initials: A
authors.lastname: van Dijk
authors.forename: Michel
authors.initials: M
authors.lastname: van der Schans
authors.forename: Antoon
authors.initials: A
authors.lastname: van den Bogaerdt
authors.forename: Pieter L C
authors.initials: PL
authors.lastname: Petit
authors.forename: Ad J J C
authors.initials: AJ
authors.lastname: Bogers
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001021:Aortic Valve / Q000382:microbiology / Q000637:transplantation; D001419:Bacteria / Q000302:isolation & purification; D015925:Cryopreservation; D003470:Culture Media; D006321:Heart / Q000382:microbiology; D006351:Heart Valves / Q000382:microbiology* / Q000637:transplantation; D006801:Humans; D011664:Pulmonary Valve / Q000382:microbiology / Q000637:transplantation; D012867:Skin / Q000382:microbiology; D014015:Tissue Banks; D014019:Tissue Donors; D014021:Tissue Preservation / Q000379:methods
chemical_list: D000900:Anti-Bacterial Agents; D003470:Culture Media