Validation of Musculoskeletal Tissue Capture from a Living Donor: Experience from a Multi-tissue Bank
Keywords:
Tissue donation, Tissue transplantation, Biological Quality Control, Harmless Products, Human Tissue BankAbstract
Introduction: The harvesting of musculoskeletal tissues is essential to ensure the supply of biological products of human origin with safety and clinical efficacy. The harvesting stage must undergo a validation process to guarantee the quality of the tissues. Objectives: This article describes the experience of a public human multi-tissue bank (HMTB) in validating the harvesting of musculoskeletal tissue (femoral head) from a living donor. Methods: This involves evaluating and adapting a harvesting protocol to promote excellence in the quality of tissues distributed for therapeutic and research purposes. To this end, a technical visit was carried out at another tissue bank, and meetings were held with the orthopedic service team to present and discuss the process flow. Donor screening was done by applying forms evaluating the selection and exclusion criteria. After acceptance, through the consent form, the donor’s serological tests were requested and collected. The harvesting kit, control of the temperature thermal transport box, and collecting microbiological material from the piece at the time of removal were validated. The validated harvested tissue underwent macroscopic, radiological, and microbiological evaluations to consider the process valid. The forms and other documents in the medical record were audited by the institution’s health quality and safety center. Process mapping was also carried out, targeting risks and opportunities for improvement. Results: The harvesting protocol was validated as foreseen in the action plan. The harvesting technique was performed sterilely in the operating room. Microbiological and serological analyses showed negative results, and the tissue was considered macroscopically viable. After the audit, the documentation was deemed adequate to comply with current legislation (Resolução da Diretoria Colegiada – RDC Nº 707, of July 1, 2022), and the mapping of processes guaranteed the security of harvesting and provided opportunities for improvement. Conclusion: A protocol for capturing musculoskeletal tissues in the reference service is presented, with the validation process being replicable through a fundamental tool to ensure harmlessness and safety in tissue harvesting.
Downloads
References
Corsi CAC, Shoji M, Scarpelini KCG, Bento RL, Becari C, Assunção-Luiz AV, et al. Implementation and certification of ISO 9001:2015 seal in human tissue bank HCFMRP-USP. Cell Tissue Bank 2020;21(4):56371. https://doi.org/10.1007/s10561-020-09852-1
Johnston C, Callum J, Mohr J, Duong A, Garibaldi A, Simunovic N, et al. Disinfection of human skin allografts in tissue banking: a systematic review report. Cell Tissue Bank 2016;17(4):585-92. https://doi.org/10.1007/s10561-016-9569-2
Germain M, Strong DM, Dowling G, Mohr J, Duong A, Garibaldi A, et al. Disinfection of human cardiac valve allografts in tissue banking: systematic review report. Cell Tissue Bank 2016;17(4):593-601. https://doi.org/10.1007/s10561-016-9570-9
Bagaria V, Tiwari A, Kini A, Gajiwala AL, Bhagunde P, Dave A. It’s the biology orthopods! Heralding a reconstructive revolution through musculoskeletal tissue banks (MSTB) in India. India Journal of Orthopaedics 2022;56(9):1533-46. https://doi.org/10.1007/s43465-022-00661-0
BRASIL. Poder Executivo. Decreto Nº 9.175, de 18 de outubro de 2017. Regulamenta a Lei nº 9.434, de 4 de fevereiro de 1997, para tratar da disposição de órgãos, tecidos, células e partes do corpo humano para fins de transplante e tratamento. Brasília (DF): Poder Executivo; 1997.
BRASIL. Ministério da Saúde. Portaria de Consolidação Nº 4, de 28 de setembro de 2017. Consolidação das normas sobre os sistemas e os subsistemas do Sistema Único de Saúde. Brasília (DF): Ministério da Saúde; 2017.
BRASIL. Ministério da Saúde. Resolução da Diretoria Colegiada – RDC Nº 707, de 1 de julho de 2022. Dispõe sobre as boas práticas em tecidos humanos para uso terapêutico. Brasília (DF): Ministério da Saúde; 2022.
Eagle MJ, Man J, Rooney P, McQuillan TA, Galea G, Kearney JN. Assessment of a closed wash system developed for processing living donor femoral heads. Cell Tissue Bank 2017;18(4):547-54. https://doi.org/10.1007/s10561-017-9664-z
Corsi CAC, Scarpelini KCG, Bento RL, Assunção-Luiz AV, Garcia FL, Martins LGG. O uso de técnicas para controle de qualidade microbiológico adotadas em um banco de tecidos humanos. Braz J Transplant 2024;27(1):e0924. https://doi.org/10.53855/bjt.v27i1.565_PORT
Corsi CAC, Assunção-Luiz AV, Cintra AS, Almeida EC. Models of quality management systems applied in specialized services for the donation and transplantation of human organs and tissues. Transplant Proc 2023;55(6):1337-45. https://doi.org/10.1016/j.transproceed.2023.01.026
Huang J, You JX, Liu HC, Song MS. Failure mode and effect analysis improvement: a systematic literature review and future research agenda. Reliab Eng Syst Saf 2020;199:106885. https://doi.org/10.1016/j.ress.2020.106885
Amatuzzi MM, Croci AT, Giovani AM, Santos LAU. Banco de tecidos: estruturação e normatização. Rev bras ortop [periódicos na Internet] 2000;35(5):165-72. [acesso em 01 Abr 2024]. Disponível em: https://www.rbo.org.br/detalhes/328/pt-BR/banco-de-tecidos--estruturacao-e-normatizacao
Granjeiro RC, Souza BGSE, Antebi U, Honda EK, Guimarães RP, Ono NK, et al. Aspectos da distribuição de tecidos músculoesqueléticos de um banco de tecidos. Acta ortop bras 2009;17(6):336-9. https://doi.org/10.1590/S1413-78522009000600004
De Freitas Filho LH, Silva NP, Neves CCS, Campos GC. O impacto da gestão por processos e pessoas na obtenção da licença sanitária de funcionamento [resumo]. Sínteses: Revista Eletrônica do SimTec [periódicos na Internet] 2023 [access on 09 Maio 2024];8:e02201008. Available at: https://econtents.bc.unicamp.br/inpec/index.php/simtec/article/view/18217
Teofili L, Bianchi M, Valentini CG, Bartolo M, Orlando N, Sica S. Validation plan of bone marrow collection, processing and distribution using the failure mode and effect analysis methodology: a technical report. Cytotherapy 2022;24(3):356-64. https://doi.org/10.1016/j.jcyt.2021.10.005
Hovanyecz P, Lorenti A, Lucero JMJ, Gorla A, Castiglioni AE. Living donor bone banking: processing and discarding – From procurement to therapeutic use. Cell Tissue Bank 2015;16(4):593-603. https://doi.org/10.1007/s10561-015-9507-8
Baseri N, Meysamie A, Campanile F, Hamidieh AA, Jafarian A. Bacterial contamination of bone allografts in the tissue banks: a systematic review and meta-analysis. J Hosp Infect 2022;123:156-73. https://doi.org/10.1016/j.jhin.2021.10.020
Jain D, Sharma R, Reddy S. WHO safe surgery checklist: barriers to universal acceptance. J Anaesthesiol Clin Pharmacol 2018;34(1):7. https://doi.org/10.4103/joacp.JOACP_307_16
Diego LADS, Salman FC, Silva JH, Brandão JC, Filho GDO, Carneiro AF, et al. Construção de uma ferramenta para medida de percepções sobre o uso do checklist do Programa de Cirurgia Segura da Organização Mundial da Saúde. Braz J Anesthesiol 2016;66(4):351-5. https://doi.org/10.1016/j.bjan.2015.09.011
Pinheiro MB, Campos RKGG, Maniva SJCF, Rolim KMC, Bonfim IM. Tecnologias disponíveis para o processo de auditoria interna em classificação de risco: revisão integrativa. Revista Brasileira De Pesquisa Em Saúde 2024;25(4):81-8. https://doi.org/10.47456/rbps.v25i4.41760
De Freitas Filho LH, Neves CDCS, Silva NP, Corsi CAC, Cardoso EM, De Miranda JB, et al. Challenges of implementing a human multi-tissue bank in a public hospital in the interior of São Paulo: under the light of the quality management system. Transplant Proc 2024;S0041134524000113. https://doi.org/10.1016/j.transproceed.2024.01.007
Dos Santos RHA, De Oliveira EPDS, Dinelly KMDO, Cunha ICDO, Dinelly JADS, Oliveira DMDM, et al. Gerenciamento de ferramentas utilizadas em auditorias internas e o aperfeiçoamento dos processos de saúde. Braz J Hea Rev 2023;6(6):30721-32. https://doi.org/10.34119/bjhrv6n6-315
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Luiz Henrique de Freitas Filho, Cristina de Carvalho Silva Neves, Carlos Alexandre Curylofo Corsi, Evelyn Machado Cardoso, Nilcilene Pinheiro Silva, Gustavo Constantino de Campos
This work is licensed under a Creative Commons Attribution 4.0 International License.