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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2006 June;57(3):125-40
Transmission of disease through musculosckeletal allografts: a critical analysis of the cases reported in literature through Italian Guidelines
Mosetto F. 1, Biondi A. M. 2, Sacco F. 1, Boffano M. 1, Pibiri L. 2, Albertini U. 1, Gino G. C. 1, Piana R. 1, Bistolfi A. 1, Brach del Prever E. M. 2
1 Dipartimento di Ortopedia e Traumatologia Unità Operativa Dipartimentale di Chirurgia Ortopedica Oncologica e Ricostruttiva ASO CTO, CRF, MA, Torino
2 Banca dei Tessuti Muscolo-Scheletrici della Regione Piemonte presso ASO CTO, CRF, MA, Torino
Aim. The diffusion of bank musculoskeletal tissues (MST) in orthopaedic surgery lightened the risk for patients of transmission of various diseases. The analysis of known cases reveals that they are mostly external contaminations. The National Guide Linees (GL) in Italy represent the protocol to reduce contaminations and transmission of diseases from donor to recipient. Aim of the study was to search in literature real cases of transmitted infections or other diseases by using MST and to analyse which ones could be avoided with the application of Italian GL.
Methods. Cases of transmitted diseases were searched in literature through the consultation of informatics data base and traditional library. The cases were critical analysed through Italian GL and up-to-date scientific knowledge.
Results. We found in literature 5 cases or series of cases about transmission of C hepatitis virus, 3 about Human Immunodeficiency virus, 1 about T-cell leukaemia virus, 1 about bacterium tuberculosis, 6 about other non-specific bacterial infections. With the application of Italian GL all viral infections should be avoided; about bacterial ones, bacteriostasis could be a problem for cultures at retrieval.
Conclusion. Italian GL offer a proper means whether for the prevention of transmitted infections from the donor through donor selection or to prevent from external contamination of the allograft through protocol starting from the retrieval to the implantation. Till now no cases of donor transmitted infection has been reported in Italy.