**8. Musculoskeletal tissue banks**

Like in the USA, where the American Association of Tissue Banks (AATB) regulates and supervises the functioning of all in-country tissue banks since 1976, in Brazil the Ministry of Health, with the Norm No. 220 of December 27th, 2006, provides the technical regulations for the functioning of Musculoskeletal and Skin Tissue Banks of human origin. This regulation relates to the facility characteristics, screening of living donors or cadavers, equipment and human resources. These rules, although quite rigid, greatly increased the quality of processed tissues and the safety on its use.

In relation to screening, the decision to accept or reject a donor is carried out by the Medical Director of the Bank of Musculoskeletal Tissues (BMST) after rigorous tests and following a established protocol. As the protocols used by the Tissue Banks, one must consider the history, physical examination and laboratory tests of the donor.


Like in the USA, where the American Association of Tissue Banks (AATB) regulates and supervises the functioning of all in-country tissue banks since 1976, in Brazil the Ministry of Health, with the Norm No. 220 of December 27th, 2006, provides the technical regulations for the functioning of Musculoskeletal and Skin Tissue Banks of human origin. This regulation relates to the facility characteristics, screening of living donors or cadavers, equipment and human resources. These rules, although quite rigid, greatly increased the

In relation to screening, the decision to accept or reject a donor is carried out by the Medical Director of the Bank of Musculoskeletal Tissues (BMST) after rigorous tests and following a established protocol. As the protocols used by the Tissue Banks, one must consider the

**8. Musculoskeletal tissue banks** 

quality of processed tissues and the safety on its use.

history, physical examination and laboratory tests of the donor.

**Date of Birth: Age (y): Sex: Race:** 







**CONDITIONS YES NO** 

**Name: Medical record No.:** 

**Checking date: Collecting date:** 

 **HAS THE DONOR HAD ANY BEHAVIOUR OR OTHER CONDITION BELOW IN THE PAST** 

Toxic substances or illegal drug abuses

**DONOR PAST HISTORY** 

**12 MONTHS?** 



done so?

persons?

person?

piercing?





The Biology of Bone Grafts 251

There are many differences when comparing the types of graft, with variations as for the source, production methods, processing, uses (block or shredded) sterilisation, storage and cost of the process. Thus, it is essential the implementation of protocols for processing and quality control of all types of bone grafts. This measure will facilitate the monitoring and analysis of the results obtained in distinct surgical procedures, and shall provide grafting

Although there are reports of the use of bone grafts and transplants for many years, many mechanical and biological issues such as physical and chemical composition, incorporation, bone remodelling and immune responses are still incompletely assessed. These issues are still requiring more knowledge and further clinical and laboratory investigations to allow a more scientifically based choice of the graft and appropriate indication to surgical use on

There is no doubt on the importance of bone transplants in orthopaedic surgery, especially in hip procedures. Their results are well-known and, to some extent predictable when its use is carried out by experienced surgeons. It is also indubitable that bone tissue is a biologically privileged material, since several alternative bone grafts can be used quite well. It is undeniable, however, that we still knowing little about many aspects of the host-graft interaction and sometimes seems we are resigned with this situation, when in fact, many studies have yet to be carried out in several ways to attempt to answer questions that sometimes are underestimated, since "most of the time the graft works". For instance, why do 85% of the grafts theoretically integrate? Though it seems a good percentage, how about the other "not so lucky" 15% of the cases? Is it a matter of technique, immune response, mechanical effect or biological feature? Which is the best substitute for autologous grafts? The frozen allogeneic sterile or non-sterile or the freeze-dried irradiated or autoclaved graft?

These are just some of important yet unanswered issues that should be carefully investigated and analysed if best clinical responses, increased biosafety and lower complication rates as well as higher scientific basis to precisely and reliably analyse the

American Association of Tissue Banks - AATB's. http://www.aatb.org [accessed Mar 29th,

Barth H. Histologische untersuchungen uber knochen-transplantation. Beitr. Path. Anat.

Buck BE, Malinin TI. Human bone and tissue allografts. Preparation and safety. Clin

Buma P, Lamerigts N, Schreurs BW, Gardeniers J, Versleyen D, Slooff TJ. Impacted graft

incorporation after cemented acetabular revision. Histological evaluation in 8

http://www.pharmacy.wisc.edu/courses/718-430/handouts/ tisgraft.pdf

Should a method of definitive sterilisation be employed by the Tissue Banks?

grafts and surgical outcomes are to be sought.

Autograft, allograft, and xenograft [Lecture 17].

Orthop. Jun; (303):8-17; 1994.

Allg. Path.;17: 65-142; 1895 (in German).

patients. Acta Orthop Scand. Dec;67(6):536-40; 1996.

material of better quality, thoroughly tested and ready available.

**9. Conclusion** 

any particular situation.

**10. References** 

2011]

[accessed Feb 27th, 2011]


Source: Bank of musculoskeletal tissues (BMST), Hospital São Vicente de Paulo - Passo Fundo BMST of the Hospital de Clinicas de Porto Alegre University Hospital (licensed, but awaiting accreditation by Ministry of Healthy Quality Control Committee - ANVISA)

Table 2. Screening protocol for muscoskeletal tissue donors.
