Tissue Bank

There is an increase in demand for bone grafts at our hospital due to the enormous number of polytrauma, revision joint replacement surgeries and benign tumor patients who need complex reconstructive procedures. Tissue Bank is located inside the Ganga Hospital premises (Department of Orthopedics) and was launched in 2008 with the technical assistance from Tissue Bank at the Tata Memorial Hospital Mumbai. It is a self-funded, non-profit Tissue bank aimed at providing class leading service. The bank follows International Atomic Energy Agency (IAEA) standards followed by most of the Tissue banks in the world. We use Gamma irradiation as a method of sterilization.

Tissue bank is currently using well processed and gamma irradiated cortico cancellous bone allografts from tibial slices and femoral heads, long bones from amputated stumps in various clinical conditions like comminuted fractures and Non-unions with bone loss of both upper & lower limbs, revision joint replacement surgeries, tumour and spinal fusion surgeries. We also use tendon allografts for multi ligamentous conditions around the knee. All the grafts are screened routinely for HIV, HCV, HBV and syphilis to eliminate the risk of disease transmission. It is very safe to use the processed and gamma irradiated allografts from Tissue bank as risk of disease transmission is almost negligible. In our institution, we have utilized over 4000 bone allografts so far for various orthopedic procedures.

Dr S Rajasekaran heads the department of Tissue bank. Dr. P. Dhanasekara Raja has received the Degree of Diploma in Tissue banking from National University of Singapore. Dr. A Devendra is the Scientific Officer in charge of preparation, processing, storage and transportation of the allografts. He has received training in Tata Memorial Hospital Bone Bank in Mumbai and National University, Singapore. Also, visited the Tissue bank at Rizzoli institute, Bologna as an observer. Three technical assistants are involved in routine processing procedures and gamma irradiation of bone.

Design of Tissue bank

1. Building Design

2. Tissue bank Committee

• Director
• Processing Manager
• Quality control Manager
• Technical assistant

3. Equipment

Wet processing Laboratory

• Deep Freezer (-80degrees)
• Band Saw
• Water Shaker bath
• Ultrasonic cleanser

Dry Processing laboratory

• Lyophiliser
• Laminar airflow cabinet
• Vacuum sealer

Tissue preservation

Freeze- Drying / Deep Freezing:

The preservation of tissue is done by either Freeze Drying or Deep Freezing. Freeze drying removes at least 95% of the total water. This enables the biological material to be stored for long periods of time at room temperature, without any fear of detrimental enzymatic activity. Biologically useful properties of the graft are also preserved.

Procurement and processing of bone:

All grafts are harvested from either live donors or cadavers. The femoral head and tibial slices are retrieved from joint replacement surgeries intra operatively under sterile conditions and long bones are harvested from amputated limbs and cadavers after fulfilling donor selection criteria and obtaining informed consent. In view of the spread of transmissible diseases , particularly with reference to the serodiagnostic window for HIV, all donated bones are processed. The bones are pasteurized at 600 C for 3 hours, vigorously washed, cleaned of all soft tissue and cut into the required shapes and sizes. They are subsequently washed free of blood and bone marrow using jet lavage and placed in 70% ethanol for 1 hour. The cleaned bones are stored at - 800C and finally freeze-dried to remove 95% of the moisture.

Steps of bone processing

Allografts Storage

Frozen Allografts are stored in Deep Freezing at - 80 degrees temperature.

No special requirements like refrigeration, humidity control, sterile environment, etc. are necessary for storage of packaged , Freeze dried, irradiated Allografts. Such grafts may be kept indefinitely provided the integrity of the packaging is maintained.

TOTAL NUMBER OF ALLOGRAFTS UTILISED IN THE LAST FOUR YEARS