Overview of safety issues concerning the preparation and processing of soft-tissue allografts.

With the increasing use of allograft tissue and the recent infections found in patients undergoing surgical procedures, the current practices that prepare grafts for implantation must be examined. Initially, most tissue banks harvest allografts aseptically. There are many steps in the different techniques of preparation and processing of allograft tissue.

Viruses adsorbed on musculoskeletal allografts are inactivated by terminal ethylene oxide disinfection.

In 1987 it was anticipated that unsterilized tissues would transmit virus diseases such as hepatitis and HIV-1 from infected donors so a freeze-drying process for musculoskeletal tissue was developed to include terminal ethylene oxide (EO) exposure for 14 h. We found no studies of EO efficacy when viruses were associated with human allografts so we studied the antiviral effect of terminal EO disinfection using all but the final freeze-drying phase of this clinical processing protocol (CPP). Specifically we looked at EO inactivation of HIV-1, a human hepatitis B surrogate and test viruses known to be highly resistant to disinfecting agents, including irradiation.

Allograft transplantation in the knee: tissue regulation, procurement, processing, and sterilization.

Use of musculoskeletal allografts has become increasingly popular, with widespread use among knee surgeons. The advantages and disadvantages of their use have been documented. In the knee, allografts are used for ligament reconstruction, meniscal transplantation, and articular surface reconstruction.