Tissue Banks

Tissue Banks

A similar procedure begins for tissue donation. Consider how the process works at John Muir Medical Center in Walnut Creek, CA. The California Transplant Donor Network will call the tissue bank that John Muir contracts with. The tissue bank then contacts the hospital and nurses go over the patient's chart again and discuss the patient's medical history, which could include age and cause of death.

"When a patient is an organ donor, they are often tissue donors as well," Brailoff says. "So, the tissue people will come at the same time as the organ people."

If the tissue bank determines the deceased patient is medically suitable to be a donor, a representative contacts the next of kin. Then, teams from the procurement organization come to the hospital to perform their work, which includes removing the tissues, Brailoff says.

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At the Northern California Transplant Bank, which is one of the tissue banks in the area, teams that visit the hospital are trained technicians who recover and culture the tissue before taking it back to the San Rafael processing center, says Mary Freeman, a donor development coordinator with NCTB. The tissue is quarantined for 30 days while serology (blood) and other tests are run. If one culture or test comes back positive, all the tissues recovered from the donor are discarded, Freeman says. Medically suitable tissues are then cleaned and processed. For example, an Achilles tendon recovered from a deceased donor will be shaped so an orthopedic surgeon can use it for whatever procedure he or she needs to do, Freeman says.

Tissue donations also have a different and more restrictive set of standards than organ transplants.

For example, if you knew you would die without a heart transplant, would you be concerned that the donor heart had a treatable disease? Maybe. But would you decline the heart? Probably not.

This rationale does not apply to tissue, however.

"Organs have the potential to save someone's life and do so immediately," says a spokesperson for NCTB. "Tissue may help save a life, but they are primarily life "enhancing" rather than life "saving." For that reason, regulations applied to tissue are more stringent than those applied to organs.

Thus tissue banks cannot recover tissue from someone who has tested positive or was at high risk for blood transmissible diseases, such as hepatitis B or C or HIV, the NCTB spokesperson says. But a deceased donor with hepatitis could possibly donate an organ like their liver to a patient who also has hepatitis. After all, that liver may still function better than the recipient's failing liver.

Mary Freeman remembers a tissue donation case where staff spent hours digging into the donor's medical history. When the deceased patient was a child he had hepatitis, but people close to him couldn't remember what kind, she says. Staff finally found the doctor who treated him as a child, only to discover the doctor had died.

"We couldn't get the records, so we had to rule him out," as a tissue donor, Freeman says.

Another difference between tissue and organ donations concerns treatment of brain-dead donors with drugs. If during the organ recovery process, an infection occurs in the donor's body, organ procurement organizations can administer drugs and antibiotics. The recipient receiving the organs may also be treated. Tissue banks, on the other hand, do not have the option to treat people, mostly because there is no blood flow to send antibiotics through tissue, says Freeman.

Plus, tissue must be immaculate for it to be useful, Freeman says.

And tissue must be recovered no more than 24 hours after death to reduce microbial contamination, according to a NCTB spokesperson.