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U.N. Agency Aiding Knee Tissue Transplants

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U.N. Agency Aiding Knee Tissue Transplants

U.N. Agency Aiding Knee Tissue Transplants

December 12, 2002

VIENNA, Austria (AP) - It's the softer side of the U.N. agency better known for sending weapons inspectors to Iraq: a program that uses nuclear technology to sterilize tissue grafts that help burn victims and others heal.

The Vienna-based International Atomic Energy Agency has 66 tissue banks around the world that use radiation to sterilize tissues such as skin, tendons, cartilage, corneas and heart valves.

The United States is considering introducing the technique to avoid transmission of disease in tissue transplants.

Global experts who met here Wednesday discussed ways to expand the program, which has helped thousands worldwide. Beneficiaries include victims of the nightclub bomb attack in Bali last month and people injured by a fireworks explosion last January at a market in Lima, Peru.

The U.N. program has produced more than 200,000 grafts over three decades, saving developing countries millions of dollars in tissue import costs.

The IAEA is working to develop a worldwide sterilization standard that would enable countries to import grafts from anywhere in the world without concern that the tissue might be contaminated.

Such a move would go a long way toward easing a global shortage of skin and other tissues for grafts, said Jan Koller, the secretary of the European Tissue Banking Association.

"For example, had the (World Trade Center) buildings in the United States not collapsed, most victims" would have suffered burn injuries in need of skin grafts, he said, referring to the Sept. 11, 2001 terror attacks. "For 3,000 burns you need a large amount of skin, and you can't have all that in one country."

The United States may switch to radiation sterilization of tissue grafts because of concerns that its current method has failed to prevent at least 57 cases of disease transmission in the past 18 months, said Dr. Sam Doppelt, president of the American Association of Tissue Banking.

In the worst case, a 23-year-old Minnesota man died in November 2001, four days after receiving a cartilage transplant in a knee. Investigators found the bacterium clostridium in both his body and the cadaver from which the tissue was taken.

Tissue banks in the United States rely on screening, blood tests and processing of the tissue to ensure safety.

"Those tests are very good, but they don't give 100 percent assurance that there is no infection. It's good, but it's not ideal," Doppelt said. "We need to do something different and better. We are very interested in adding radiation sterilization as another method of safety."

Radiation isn't 100 percent effective; though it zaps bacteria, higher doses are needed to kill viruses, such as HIV, which causes AIDS. So far, scientists have been unable to increase the dosage enough to kill viruses without damaging the tissue.

But the method is "very safe indeed," said Dr. Glyn Phillips, a consultant to the IAEA project. "There has not been a single case of disease transmission in the whole program."

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