title: Disinfection of human cardiac valve allografts in tissue banking: systematic review report.
abstract: Cardiovascular allografts are usually disinfected using antibiotics, but protocols vary significantly between tissue banks. It is likely that different disinfection protocols will not have the same level of efficacy; they may also have varying effects on the structural integrity of the tissue, which could lead to significant differences in terms of clinical outcome in recipients. Ideally, a disinfection protocol should achieve the greatest bioburden reduction with the lowest possible impact on tissue integrity. We conducted a systematic review of methods applied to disinfect cardiovascular tissues. The use of multiple broad spectrum antibiotics in conjunction with an antifungal agent resulted in the greatest reduction in bioburden. Antibiotic incubation periods were limited to less than 24 h, and most protocols incubated tissues at 4 °C, however one study demonstrated a greater reduction of microbial load at 37 °C. None of the reviewed studies looked at the impact of these disinfection protocols on the risk of infection or any other clinical outcome in recipients.
authors: Héma-Québec, 1070 Sciences-de-la-Vie Avenue, Quebec, QC, G1V 5C3, Canada.
authors: M
authors: M
authors: Germain
authors: Department of Orthopaedics and Sports Medicine, University of Washington School of Medicine, 98104, Seattle, WA, USA.
authors: D M
authors: DM
authors: Strong
authors: Comprehensive Tissue Centre, 8230 Aberhart Centre, 11402 University Avenue NW, Edmonton, AB, T6G 2J3, Canada.
authors: G
authors: G
authors: Dowling
authors: Canadian Blood Services, 270 John Savage Ave., Dartmouth, NS, B3B 0H7, Canada.
authors: J
authors: J
authors: Mohr
authors: Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada.
authors: A
authors: A
authors: Duong
authors: Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada.
authors: A
authors: A
authors: Garibaldi
authors: Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada.
authors: N
authors: N
authors: Simunovic
authors: Department of Surgery, McMaster University, 293 Wellington St. N, Suite 110, Hamilton, ON, L8L 8E7, Canada. Ayenif@mcmaster.ca.|McMaster University Medical Centre, 1200 Main St W, Room 4E15, Hamilton, ON, L8N 3Z5, Canada. Ayenif@mcmaster.ca.
authors: O R
authors: OR
authors: Ayeni
mesh_terms: D064591:Allografts / Q000382:microbiology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001419:Bacteria / Q000302:isolation & purification; D001424:Bacterial Infections / Q000517:prevention & control; D018929:Cell Culture Techniques / Q000379:methods; D004203:Disinfection / Q000379:methods*; D005658:Fungi / Q000302:isolation & purification; D006351:Heart Valves / Q000382:microbiology* / Q000637:transplantation*; D006801:Humans; D009181:Mycoses / Q000517:prevention & control; D013242:Sterilization / Q000379:methods*; D014015:Tissue Banks; D014184:Transplantation, Homologous
chemical_list: D000900:Anti-Bacterial Agents
keywords: Bioburden; Cardiovascular allografts; Tissue banking; Tissue decontamination; Tissue donation