Femoral Head Banking: NUH Tissue Bank Experience

Abstract

National University Hospital Tissue Bank protocol follows guidelines recommended by the American Association of Tissue Banks and the European Association of Tissue Banks using donor selection criteria: medical history, clinical examination, chart review and laboratory tests for acquired immunodeficiency syndrome (AIDS), hepatitis B, hepatitis C, syphilis, and specimen for culture/sensitivity tests. For living donors, repeat testing is performed for AIDS and hepatitis C approximately 180 days after procurement. Femoral heads are procured using the "sterile double jar technique" and stored at -80 degrees C. Our first study of 273 consecutive potential donors undergoing hemiarthroplasty from 1989 to 1994 showed that a high percentage (42.5%) was unsuitable for use. A second study involving 175 potential donors was conducted from 1995 to 2003 after hepatitis C screening was introduced. The bacterial contamination rates in both studies (3.5% and 5.7%) are low. The incidence of other diseases also are low: hepatitis B, 2.3% and syphilis, 1.8% in the first study and hepatitis B, 5.7%; hepatitis C, 0.6%; and syphilis, 5.1% in the second cohort. No cases of AIDS were reported in either study. By 2003, femoral heads were transplanted in 205 patients with a low complication rate of 2.9%.