Cell and Tissue Banking

, Volume 7, Issue 1, pp 11–21 | Cite as

Donor Exclusion in the National Blood Service Tissue Services Living Bone Donor Programme



National Blood Service (NBS) Tissue Services (TS) operates living donor and deceased donor tissue banking programmes. The living bone donor programme operates in collaboration with 91 orthopaedic departments across the country and collects bone donations, in the form of surgically removed femoral heads (FHs), from over 5000 patients per annum undergoing total hip replacement. Bone donated via the living programme constitutes approximately 55% of the total bone donated to NBS. Non-NBS tissue banks, primarily in hospital orthopaedic departments, also bank donated bone for the UK. A survey of information received from 16 collaborating orthopaedic centres, between April 2003 and August 2004, identified 709 excluded donors. The total number of donations banked from these sites was 1538. Donations can be excluded before collection if there are contraindications noted in a potential donor’s medical history before their operation. Donors may also be excluded after collection of the FH, for instance because of reactive microbiology tests for blood borne viruses, or if the donation storage conditions or related documentation have not met stringent quality requirements. In this survey, bone or joint conditions were the major reasons for excluding potential donors before donation (154 of 709 exclusions, 22%), followed by a current or a past history of malignancy (139 of 709 exclusions, 20%). Local staffing and operational difficulties sometimes resulted in potential donors being missed, or specific reasons for exclusion not being reported (117 exclusions). These out numbered exclusions due to patient refusal (80 exclusions). A small number (< 5) appear to have been excluded erroneously. There was considerable local variation in the reasons given for exclusion and certainly under-reporting. A survey of donations discarded after collection in the same period highlighted that 43% were donor related; 110 of 370 did not provide a follow-up blood sample. More than 30% were due to delays in forwarding blood samples to the microbiological laboratory for testing, resulting in deterioration of the sample quality. Training to ensure that standards are complied with and a firm evidence base for exclusion criteria, applied uniformly, will help focus donor identification efforts on individuals meeting rational criteria so that fewer potential donations are lost.


Donor deferral Donor selection Hip replacement Malignancy Tissue donation Tissue transplantation 


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  1. Committee on Microbiological Safety of Blood and Tissues for Transplantation, Department of Health: guidance on the microbiological safety of human tissues and organs used in transplantation (NHS ExecutiveAugust 2000).Google Scholar
  2. Eye Banks Association for America Medical Standards, Eye Bank Association of America, www.restoresight.org.Google Scholar
  3. European Eye Bank Association Standards, www.europeaneyebanks.org.Google Scholar
  4. Gie, G.A., Linder, L., Ling, R.S.M., Simon, J.P., Slooff, T.J.J.H., TImperley, A.J. 1993Impacted cancellous allografts and cement for revision total hip arthroplastyJ. Bone Joint Surg.751421Google Scholar
  5. Gartner, H.V., Seidl, C., Luckenbach, C., Schumm, G., Seifried, E., Ritter, H., Bültmann, B. 1996Brief report: genetic analysis of a sarcoma accidentally transplanted from a patient to a surgeonNE J. Med.33514941497Google Scholar
  6. Gugel, E.A., Sanders, M.E. 1986Needle-stick transmission of human colonic adenocarcinomaNE J. Med.3151487Google Scholar
  7. Guidelines for the UK Blood Transfusion Services, The Stationery Office, London(www.transfusionguidelines.org.uk).Google Scholar
  8. Hip replacements – an Update. National Audit OfficeThe Stationery Office, 2003, Available at www.nao.org.uk/publications/nao_reports/02-03/0203956.pdf.Google Scholar
  9. Lomas, R., Drummond, O., Kearney, J.N. 2000Processing of whole femoral head allografts: a method for improving clinical efficacy and safetyCell Tissue Bank.1193200PubMedGoogle Scholar
  10. McGeorge, A.J., Vote, B.J., Elliot, D.A., Polkinghorne, P.J. 2002Papillary adenocarcinoma of the iris transmitted by corneal transplantationArchives of Ophthalmology12013791383PubMedGoogle Scholar
  11. Palmer, S.H., Gibbons, C.L.M.H., Athansou, N.A. 1999The pathology of bone allograftJ. Bone Joint Surg.81333335Google Scholar
  12. Pruss, A., Baumann, B., Seibold, M., Kao, M., Tinteinot, K., Verson, R., Radtke, H., Dorner, T., Pauli, G., Gobel, U.B. 2001Validation of the sterilization procedure of allogeneic avital bone transplants using peracetic ethanolBiologicals295966CrossRefPubMedGoogle Scholar
  13. Sanzen, L., Carlsson, A. 1997Transmission of human T-cell lymphotrophic virus type 1 by a deep-frozen bone allograftACTA Ortho. Scand.687274FebGoogle Scholar
  14. Sugihara, S., Ginkel, A.D., Jiya, T.U., Royen, B.J., Diest, P.J., Wuisman, P.I.J.M. 1999Histopathology of retrieved allografts of the femoral headJ. Bone Joint Surg.81-B336341Google Scholar
  15. Wilson C.J. and Galea G. 2002. Current trends in the use of bone allograft in orthopaedic surgery: Is demand still exceeding supply? Abstract, American Association of Tissue Banks Annual Meeting.Google Scholar
  16. Wilson, C.J., Tait, G.R., Galea, G. 2002Utilisation of bone allograft by orthopaedic surgeons in ScotlandCell Tissue Bank34953PubMedGoogle Scholar
  17. Pruss, A., Kao, M., Verson, R., Pauli, G. 1999Virus safety of avital bone tissue transplants: evaluation of sterilization steps of spongiosa cuboids using a peracetic acid methanol mixtureBiologicals2795201CrossRefGoogle Scholar

Copyright information

© Springer 2006

Authors and Affiliations

  • F. Pink
    • 1
  • R. M. Warwick
    • 2
  • J. Purkis
    • 2
  • J. Pearson
    • 2
  1. 1.Guy’s, King’s and St Thomas’s School of MedicineLondonUK
  2. 2.Tissue Services, National Blood ServiceEdgwareUK

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