Tissue donor selection and safety.

Authors of recent reports in the medical literature indicate that allograft-associated infection primarily is attributable to violations of proper tissue processing procedures, and illustrate the need for effective quality assurance systems to avoid transplantation of potentially infectious tissue. I describe the experience of the members of the Musculoskeletal Transplant Foundation with the selection, the processing, and the safety of bone and tissue donors for allograft implantation. In 2002, the Musculoskeletal Transplant Foundation screened 10,497 potential donors, but only 4431 (42%) met stringent criteria for recovery. After recovery, another 10% of the donors were rejected, usually because of positive infectious disease tests (45%) or an autopsy finding (31%) that rendered the tissues unsuitable for transplantation. Procedures used by the Musculoskeletal Transplant Foundation for ensuring safety of the tissue and for investigating reports of putative infection are described. The Musculoskeletal Transplant Foundation has had no confirmed cases of allograft-associated infection in over 2 million units transplanted during the past 15 years.