2023-04-21 09:39:13
We collect donated femoral heads from thirty hospitals and treatment centers, says Marja. ‘In addition to the fact that hospitals can supply us with femoral heads, they can also order donated bone tissue from us, i.e. femoral heads or bone chips. Those are little freeze-dried pieces of bone. Orthopedic surgeons use the donor bone, for example, to build up bone in prostheses or to fill defects in the bone. We therefore have to be sure that the bone comes from healthy patients.’ To ensure safety, the patient must complete an extensive questionnaire before being allowed to donate. If the answer to one of the pre-selection questions is “yes”, for example have you had cancer or have you had a viral infection in the last two weeks, then someone cannot donate.
Ready-made kits
The orthopedic surgeon also completes a questionnaire, Marja continues. ‘He does this just before the operation and on the form he puts the time and date of the operation, among other things.’ Ready-made kits are available in the OR ETB-BISLIFE ready for bone donation. Marja: ‘This contains the forms, stickers with the identification number, a jar for the femoral head, tubes to take blood and finally a rod with which the operating assistant can take a culture of the bone.’
A donated femoral head is packaged in a sealed jar after being removed from the OR and is only removed from the packaging when another doctor wants to use the bone tissue on another patient. This guarantees the safety of the donor bone tissue. ‘Usually on the same day of the operation, a courier collects the removed femoral heads from the hospital and puts them in the refrigerator here’, Marja explains. ‘The next morning we do the first checks. Today, a Tuesday, we received 18 femoral heads. We rarely get anything in on Friday because almost no planned hip operations are done on that day.’
Safety first
Marja: ‘We first check whether there have been any procedural errors. If we have additional questions, we may still call the patient. We then have the blood and the culture analyzed in the laboratory. So that we can be sure that no infection with a virus, bacteria or fungus can be transmitted with the donor bone. Safety is absolutely paramount.’
Non-profit foundation
The femoral heads are frozen after the first checks. In a separate room there are four rows of freezers that can go down to minus 80° Celsius. These freezers contain femoral heads that have not yet been released, but also donated femoral heads that have already been approved for use.
In addition to donated femoral heads, the Bone Department also stores other types of donor bone. ‘These are bones of people who have agreed to donate organs and/or tissues after their death’, director Frank Beneker explains. ‘ETB-BISLIFE is much more than a “bone bank” for femoral heads. Hospitals can also contact us for, among other things, donated heart valve tissue, corneal tissue and skin tissue. We are a foundation, so we do not make a profit and strive to keep the costs of processing donated fabrics as low as possible. You can compare us with Sanquin (the blood bank), but then for donated tissues. I would like us to receive donor femoral heads from more hospitals. I think that orthopedic surgeons perform between 30,000 and 35,000 hip arthroplasties in the Netherlands every year. We receive the removed femoral head in at most 10% of those operations. We can process more donor bone here and donor bone can be put to good use in hospitals. Now artificial bone is sometimes used, while donor bone from a human is much better for the patient.’
Many hospitals used to have their own internal bone bank. But due to strict laws and regulations, this is no longer feasible for most hospitals. Frank: ‘Quality and safety are our number one priority. This way we can always find out who the donor bone came from that was used on someone else in the unlikely event that there is something wrong with it. The IGJ (the Inspectorate) checks whether we are doing our job properly.’
Four weeks
Isala supplies a relatively large number of femoral heads to ETB-BISLIFE, and also purchases many. The courier collects most femoral heads from the Hip Center in Meppel. Hospitals receive compensation for the donated femoral heads they provide. Hospitals that need bone tissue from, pay for it again. Theoretically, a femoral head that has been removed can be returned to Isala within four weeks for “re-use” in another patient. But because the oldest femoral heads are released first, most jars are in the freezer a little longer.
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