Comparison of bone marrow component removal from processed femoral head bone from living and deceased donors: presence of geodes in living donor bone can prevent maximum removal of marrow components.

Abstract

NHS Blood and Transplant Tissue and Eye Services banks and issues, cut, shaped and washed bone from deceased donors. The bone is cut/shaped prior to washing and then processed to remove up to 99.9% of blood, bone marrow and associated cells. The processed bone is then sterilised by gamma irradiation with or without a freeze-drying step. Removal of donor blood and bone marrow has been reported to aid incorporation of allograft bone without affecting the biomechanical properties of the bone. However, cut and shaped bone is not suitable for some orthopaedic procedures and some orthopaedic surgeons do not wish to use irradiated bone. Therefore, Tissue and Eye Services have also developed a method for washing intact femoral head bone, from living and deceased donors. We have observed that processing of intact femoral head bone does not always result in removal of 99% (or above) of marrow components and can be as low as 93% removal. We have examined washed femoral head bone and found the presence of internal fluid-filled cysts within subchondral cancellous bone in bone from living donors. The cysts have been identified as geodes and we suggest that these geodes may be responsible for the reduction in bone marrow component removal in living donor bone during processing.