Disinfection of human musculoskeletal allografts in tissue banking: a systematic review

Musculoskeletal allografts are typically disinfected using antibiotics, irradiation or chemical methods but protocols vary significantly between tissue banks. It is likely that different disinfection protocols will not have the same level of microorganism kill; they may also have varying effects on...

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Bibliographic Details
Published in:Cell and tissue banking 2016-12, Vol.17 (4), p.573-584
Main Authors: Mohr, J., Germain, M., Winters, M., Fraser, S., Duong, A., Garibaldi, A., Simunovic, N., Alsop, D., Dao, D., Bessemer, R., Ayeni, O. R.
Format: Article
Language:English
Subjects:
Allografts - microbiology
Allografts - virology
Biomedical and Life Sciences
Biomedicine
Bone and Bones - microbiology
Bone and Bones - virology
Bone Transplantation - adverse effects
Cell Biology
Cell Culture Techniques - methods
Disinfection - methods
Full Length Review
Humans
Life Sciences
Muscles - microbiology
Muscles - transplantation
Muscles - virology
Sterilization - methods
Tissue Banks
Transplant Surgery
Transplantation, Homologous
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Summary:Musculoskeletal allografts are typically disinfected using antibiotics, irradiation or chemical methods but protocols vary significantly between tissue banks. It is likely that different disinfection protocols will not have the same level of microorganism kill; 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. A systematic review of three databases found 68 laboratory and clinical studies that analyzed the microbial bioburden or contamination rates of musculoskeletal allografts. The use of peracetic acid–ethanol or ionizing radiation was found to be most effective for disinfection of tissues. The use of irradiation is the most frequently published method for the terminal sterilization of musculoskeletal allografts; it is widely used and its efficacy is well documented in the literature. However, effective disinfection results were still observed using the BioCleanse™ Tissue Sterilization process, pulsatile lavage with antibiotics, ethylene oxide, and chlorhexidine. The variety of effective methods to reduce contamination rate or bioburden, in conjunction with limited high quality evidence provides little support for the recommendation of a single bioburden reduction method.
ISSN:1389-9333
1573-6814
DOI:10.1007/s10561-016-9584-3