Cardiovascular tissue banking in the non-cadaveric setting: Ten-year experience of a university hospital-based bank with active organ donation program

Background and aim of the study: Today, transplantation of cardiovascular t issues is common practice, and tissue banking has become routine. Consequen tly, many institutions exist which carry out high-quality tissue banking. Methods: The Hospital Clinico of the University of Barcelona established it s cardiovascular tissue bank in 1989. The bank follows international and na tional regulations, and functions as a non-profit-making organization. Orga n and tissue donors are recruited by the Transplant Coordination unit, whic h works closely with the Catalonian Organ Transplant Network (OCAT) and the Spanish National Organ Transplantation Network (ONT). The hearts are remov ed during multi-organ donation and processed using aseptic techniques in a laminar flow hood. Hearts are only accepted from brain-dead multi-organ and non-beating-heart donors. The heart valves are dissected, decontaminated, cryopreserved in specific media and stored in liquid nitrogen at 196 degree s C under strict bacteriological and serological control. Results: Between 1989 and 1999, a series of 1,005 cardiovascular donors fro m within Spain was identified, from which 840 hearts were processed. After evaluation, 1,099 (65.4%) valves were cryopreserved, and 1,023 (61.5%) give n clearance for implantation. In total, 534 aortic, 530 pulmonary, 33 mitra l and two tricuspid valves were processed; ultimately 92.8% of aortic and 9 3.9% of pulmonary valves were accepted for clinical implantation. The rejec tion rate was 39.1%. Homografts were transported to their destination in dr y ice in a cryogenic container. Overall, 608 valves were implanted at our o wn institution and at hospitals in Barcelona and Europe. Only two cases of complaint were received from implanting surgeons. Conclusion: After ten years' experience, the degree of satisfaction of impl anting surgeons appears to be adequate. Strict control of the entire tissue banking process has permitted the availability of high-quality homografts for clinical implantation.