The South Australian Tissue Bank
27 February 2023
SA Pathology’s Tissue Bank has been supplying grafts and improving patient outcomes for South Australians since 1988.
Housed in the Royal Adelaide Hospital (RAH) the bank is home to a variety of tissue – mainly bones, which are donated, stored and provided to Orthopedic surgeons to be used in a variety of different operations.
The bones that make up the bulk of the Tissue Bank’s inventory are femoral heads (top of the thigh bone, or femur) and skull flaps.
Living Donor Program
The femoral heads are donated through the Living Donor Program, where consenting patients who are undergoing a primary hip replacement are given the option to donate part of the hip joint that is routinely removed during the operation.
Hip replacement surgery involves replacing part of the damaged hip joint with an implant or prosthetic device. Erfan Safaeian, supervising Medical Scientist says, “Over time the acetabulum or “socket” of the joint may become damaged, causing pain and increasing the risk of fractures. When the joint is opened for repair, grafts provided by our team are used to help reconstruct the damaged joint, especially in cases of a failed previous hip replacement, resulting in improved patient outcome.”
A femoral head, however, cannot just be taken from one patient and placed into another. All donors and their donated bone go through a stringent series of checks to determine whether the graft is safe for use. As with blood donors, tissue donation is completely voluntary, and donors may choose to opt out at any point if they do not wish to go ahead with the donation.
When someone consents to donate, a medical history questionnaire is completed with a Doctor, Nurse or Scientist and a blood sample is collected and tested for infectious diseases such as HIV, Syphilis, and Hepatitis. Donated bones are stored in the tissue bank facility within freezers at temperatures below minus 40 degrees.
Donated grafts are tested for microorganisms at pathology laboratories and checked microscopically for diseases to ensure no complications arise when they are implanted into patients.
Donated grafts remain in quarantine for a minimum of 6 months after which most grafts undergo sterilisation. Final checks are performed by a Medical Doctor and Scientists before the graft is cleared for use.
When Orthopedic surgeons send through requests, Tissue Bank staff allocate correctly sized grafts and ensure they are packed, labelled, dispatched and transported in accordance with strict requirements. There are certain cases where Tissue Bank staff must take the blood group of a patient into account when allocating a graft – such as for women of childbearing age, where a graft of matching blood group must be used to reduce the risk of complications with future pregnancies.
Another vital function of the Tissue Bank’s work is the storage of skull flaps received mostly from the RAH and the Women’s and Children’s Hospital. “If a patient has a lot of intracranial swelling from trauma to the brain, the surgeon will release the pressure by removing a portion of the skull which can then be reimplanted into the patient at a later date when swelling has subsided.”
The Tissue Bank stores the skull flap in a freezer until it is ready to be reimplanted into the same patient, referred to as an autograft. “We’re in constant communication with the Neurosurgical department at the RAH and at the Women’s and Children’s, providing them with reports on stored autografts.”
Other Tissue Grafts
So, what happens when a certain type of tissue isn’t available?
The team can assist surgeons in sourcing grafts from interstate Tissue Banks, which can be stored and dispatched from the Tissue Bank facility when required.
Not all bones that are sent for operation are used - these bones are returned to the bank, where a number of checks are performed to ensure the bone is still viable before being stored back into a freezer.
Bones can be kept for up to five years providing they are stored appropriately.
The SA Tissue Bank is a not-for-profit unit, the grafts managed and sent out by the staff deliver life changing outcomes for many South Australians.
Ask your surgeon about becoming part of the living donor program.
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