title: The effectiveness of bone banking in Central Serbia: audit of the first seven years.
abstract: We analyzed the incidence and predisposing factors for overall discard rate after retrieval of 295 femoral head allografts. The aim of the present study was to evaluate the quality system of institutional bone banking and to ensure that we can provide high standard allografts with low infection rate. Audit of bone banking was conducted on 295 donors and 180 recipients. Of the 295 donated femoral heads 77 were discarded, giving an overall discard rate of 26.1 %. At retrieval, 37 allografts were positive, giving an overall contamination rate of 12.54 %. The organism most commonly identified was Staphylococcus species. Seven (2.37 %) of the 295 allografts failed the blood screening tests. Twelve allografts (4.06 %) were discarded because of suspected damage of the packaging or disuse during surgery. Due to donor death or inability to perform serology retests, 21 (7.11 %) allografts were discarded. In the postoperative survey an infection rate of 2.22 % was found. After 7 years of bone banking, our results show that overall discard rate and allograft related infection rate are in accordance with the international standards. The leading cause of allograft discarding was bacterial contamination influenced by the surgical team. We suggest stringent aseptic allograft handling during harvesting and thawing within highly concentrated antibiotic solution to reduce a possibility of its contamination.
authors.affiliation: Department of arthroplasty, Clinic for Orthopaedic and Trauma Surgery, Clinical Center Kragujevac, Zmaj Jovina 30, 34000, Kragujevac, Serbia, zeljko.stepanovic@medf.kg.ac.rs.
authors.forename: Zeljko Lj
authors.initials: ZLj
authors.lastname: Stepanovic
authors.forename: Branko M
authors.initials: BM
authors.lastname: Ristic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001424:Bacterial Infections / Q000453:epidemiology* / Q000517:prevention & control; D018586:Bone Banks / Q000592:standards*; D016025:Bone Transplantation / Q000592:standards*; D054869:Clinical Audit / Q000592:standards*; D015925:Cryopreservation / Q000592:standards; D005260:Female; D005270:Femur Head / Q000382:microbiology / Q000637:transplantation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D055771:Serbia / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents