Abstract
Allograft bone is a widely used as a convenient tool for reconstructing massive bone defects in orthopedic surgery. However, allografts are associated with the risk of viral disease transmission. One of the viruses transmitted in this manner is human T-lymphotropic virus type 1 (HTLV-1), which is found worldwide but is unevenly distributed. The southwestern parts of Japan are a highly endemic for HTLV-1. We investigated the HTLV-1 seroprevalence in candidate allograft donors at the regional bone bank in Kagoshima, Japan during its first 5 years of service. Between 2008 and 2012, we collected 282 femoral heads at the Kagoshima regional bone bank from living donors with osteoarthritis of the hip joint. Among the 282 candidate donors, 32 donors (11.3 %) were seropositive for anti-HTLV-1 antibody; notably, this prevalence is higher than that reported for blood donors in this area. Additionally, to determine if HTLV-1 genes are detectable after processing, we examined the bone marrow of the femoral heads from seropositive donors by conducting PCR assays. Our results confirm the existence of viral genes following the heat treatment processing of the femoral heads. Therefore, it is important to inactivate a virus completely by heat-treatment. Together, our findings highlight the importance of HTLV-1 screening at bone banks, particularly in HTLV-1-endemic areas such as southwest Japan.
Highlights
Allograft bone is a widely used as a convenient tool for reconstructing massive bone defects in orthopedic surgery (Engh and Ammeen 2007; Komiya et al 2003; Rogers et al 2012; Urabe et al 2007)
Allografts are associated with the risk of viral disease transmission, including the transmission of human immunodeficiency virus type 1 (Li et al 2001; Simonds et al 1992), hepatitis C virus (HCV) (Conrad et al 1995), and human T-lymphotropic virus type 1 (HTLV-1) (Sanzen and Carlsson 1997)
Japan is an endemic area for HTLV-1
Summary
Allograft bone is a widely used as a convenient tool for reconstructing massive bone defects in orthopedic surgery (Engh and Ammeen 2007; Komiya et al 2003; Rogers et al 2012; Urabe et al 2007). Allografts are associated with the risk of viral disease transmission, including the transmission of human immunodeficiency virus type 1 (Li et al 2001; Simonds et al 1992), hepatitis C virus (HCV) (Conrad et al 1995), and human T-lymphotropic virus type 1 (HTLV-1) (Sanzen and Carlsson 1997). HTLV-1 is a retrovirus associated with adult T-cell leukemia/lymphoma (ATL) and HTLV-1-associated myelopathy/tropical spastic paraparesis (Edlich et al 2003; Izumo et al 2000). This virus is distributed globally, its distribution is uneven. The main causes of HTLV-1 transmission include blood transfusion, breastfeeding, and sexual contact (Gessain and Cassar 2012; Manns et al 1999)
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