Disinfection of human heart valve allografts with antibiotics in low concentration

Strickett, Marianne G.; Barratt‐Boyes, B. G.; MacCulloch, D

doi:10.3109/00313028309085175

Cited by 61 publications

(18 citation statements)

References 23 publications

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“…The duration of the incubation is 20-48 h at the low temperature conditions (+48C). The low concentrations of different antibiotics are supposed to sterilize the allografts, without having any harmful effect on the allograft structure (Strickett et al 1983). …”

Section: Methodsmentioning

confidence: 99%

Decontamination of heart valve and arterial allografts in the European Homograft Bank (EHB): comparison of two different antibiotic cocktails in low temperature conditions

Jashari

Tabaku

Hoeck

et al. 2007

Cell Tissue Banking

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The aim of the study was to compare the efficiency of two different antibiotic cocktails in the cardiovascular allograft decontamination. Low temperature, low-concentration antibiotic cocktail with Cefoxitin, Lincomycin, Polymixin B and Vancomycin was decontamination protocol in EHB for many years. The modified cocktail doesn't contain Cefoxitin. The study had two steps. First step: cardiovascular allografts from 80 donors are incubated in classical (group 1) or modified cocktail (group 2). Second step: 184 and 182 allografts of group 1 and group 2 are incubated in the modified and classical antibiotic cocktail, respectively. The bacteriological examination is performed in three steps: A-transport solution, B-decontamination solution and C-cryopreservation solution. During the first step 23.75% of the tissues were initially contaminated mainly with Staphylococcus (78.95%). 93.75% of the allografts of group 1 and 100% of group 2 were sterile after incubation (p = 0.058). 25.54% and 30.77% of group 1 and 2, respectively were contaminated in A-examination during the second step. Staphylococci were isolated in 82.98% and 69.64% in group 1 and 2, respectively. About 4.35% of group 1 and 5.5% of group 2 were contaminated in A, B, and C whereas 5.4% of group 1 and 4.4% of group 2 were contaminated in B or C after being sterile in A. Finally 9.78% of the tissues were rejected and 90.22% cryopreserved in the modified, whereas 9.89% rejected and 90.11% accepted in the classical group (p = 0.1). The difference was non-significant in the level of decontamination between the two cocktails. Contamination of some tissues with low growing, low-pathogen germs that appeared in B or C examination, couldn't be explained. This issue needs complementary investigation.

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Section: Methodsmentioning

confidence: 99%

Decontamination of heart valve and arterial allografts in the European Homograft Bank (EHB): comparison of two different antibiotic cocktails in low temperature conditions

Jashari

Tabaku

Hoeck

et al. 2007

Cell Tissue Banking

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“…Although the setting of antibiotic treatment does have a significant impact on decontamination success, to date, no consensus exists on an optimal formula. Several different decontamination protocols are applied in the different tissue banks (Angell et al 1976;Strickett et al 1983;Kirklin et al 1987; BarrattBoyes et al 1987;Gall et al 1995;Stolinski et al 2006;Jashari et al 2007). The differences between these protocols are mainly in the composition and concentration of antibiotic cocktail, the temperature and the duration of antibiotic incubation.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of decontamination process of heart valve and artery tissues in European Homograft Bank (EHB): a retrospective study of 1,055 cases

Fan¹,

Hoeck²,

Holovska³

et al. 2011

Cell Tissue Bank

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To evaluate the efficiency of decontamination practice in European Homograft Bank (EHB), the data of the cardiovascular tissues received during recent 2 years were retrospectively analysed in this study. After initial assessment, the tissues were incubated in a 3-antibiotics' cocktail at 4°C for 20-48 h. The states of contamination were evaluated before and after incubation with the focus on the differences in donor type, tissue type, germ type and incubation time. Amongst 1,055 eligible tissues, 77.2% were hearts and 22.8% were arteries. 82.2% of the tissues were retrieved from the multi-organ donors (MOD), 15.4% from the recipients of heart transplantation (RHT) and 2.4% from the non-heart beating donors (NHBD). The initial contamination rate was 27.4% with a significantly higher incidence in arteries. The RHT tissues had the lowest contamination rate comparing to that of MOD and NHBD. Staphylococcus species was the major source of contamination. After antibiotic incubation, 76.8% of the contaminated tissues were disinfected, which was significantly higher for the hearts than the arteries. The RHT tissues had the highest decontamination rate than that of MOD and NHBD tissues. Propionibacterium acnes was detected in 48.1% of the remaining contaminated cases. The average incubation time of the Propionibacterium-positive tissues was significantly shorter than that of decontaminated tissues. In conclusion, the current decontamination protocol of EHB is sufficient for most of the initially contaminated bacteria, whereas it is inadequate for Propionibacterium acnes. This may be related to the slow-growing nature of this bacterium and thereby the relative shorter antibiotic incubation time.

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“…These variables significantly influence not only the rate of contamination but also the types of germs involved [17]. The success of decontamination, that uses a culture medium with low concentrations of antibiotic, is related to a low level of contamination and sterilized harvesting techniques [18]. In our series, 76.8% of the grafts were not contaminated in any of the processing phases.…”

Section: Commentsmentioning

confidence: 71%

Análise das atividades dos oito anos iniciais do Banco de Valvas Cardíacas Humanas do Hospital de Caridade da Irmandade da Santa Casa de Misericórdia de Curitiba

Costa¹,

Costa²,

Nazareno³

et al. 2005

Rev Bras Cir Cardiovasc

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Objective: The aim of this study was to retrospectively evaluate the first eight years of activities of the Human Heart Valve Bank of Hospital de Caridade da Irmandade da Santa Casa de Curitiba (BVCHSC), analyzing aspects related to procurement, processing, storage and distribution of homologous cardiovascular grafts.Method: Initial donor screening was achieved according the national guidelines for human organ procurement, besides specific BVCHSC criteria. Hearts were obtained from multiple organ donors, non-beating heart donors and heart transplant recipients, with total ischemic times under 48 hours. Donor ages varied from neonates up to 60 years for aortic valves and 65 years for pulmonary valves. The dissected grafts had their dimensions measured and their morphology evaluated, using a classification system with category 0 (discarded), 1 (minimal morphological alterations) and 2 (perfect). The incidence and microorganisms responsible for organ contamination were determined, as was the efficiency of the decontamination solution. Aspects related to graft distribution were also analysed. Results: From September 1996 to February 2005, 1059hearts from 19 Brazilian states were received at BVCHSC. From these, 977 (92.3%) were from brain-death donors. A total of 2105 grafts were processed and of the aortic and pulmonary grafts that were analysed, 783 were in category 2, 697 in category 1 and 186 were discarded due to morphological abnormalities. In total, 433 received grafts were contaminated and the sterilization solution was efficient in 330 cases. 571 (27.1%) grafts were rejected during some phase of the processing, mainly due to contamination and morphological abnormalities. A total of 1338 grafts were distributed to 74 health institutions and were more commonly used for aortic valve replacement (529), correction of congenital heart diseases (478) and during the Ross procedure (272).Conclusions: The activities of the BVCHSC during the initial eight years were satisfactory, fulfilling the proposed goals.Descriptors: Tissue banks. Transplantation, homologous. Cryopreservation. Tissue preservation. 399COSTA Cardiovasc Surg 2005; 20(4) , MTBA ET AL -Analysis of the inicial eight years of activities of the Human Heart Valve Bank of the Hospital de Caridade da Irmandade da Santa Casa de Misericórdia de Curitiba Braz J

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Disinfection of human heart valve allografts with antibiotics in low concentration

Cited by 61 publications

References 23 publications

Decontamination of heart valve and arterial allografts in the European Homograft Bank (EHB): comparison of two different antibiotic cocktails in low temperature conditions

Decontamination of heart valve and arterial allografts in the European Homograft Bank (EHB): comparison of two different antibiotic cocktails in low temperature conditions

Evaluation of decontamination process of heart valve and artery tissues in European Homograft Bank (EHB): a retrospective study of 1,055 cases

Análise das atividades dos oito anos iniciais do Banco de Valvas Cardíacas Humanas do Hospital de Caridade da Irmandade da Santa Casa de Misericórdia de Curitiba

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