Nerves

The nerve distributed by FBTV is a peroneal, tibial, femoral or sural nerve fragment.

Measures
Length: > 5 cm L
width: > = 1 mm A
FEATURES
They are cleared of soft tissue No fibre lesions are present Sizes are variable
Area of ApPlication

Major Clinical Applications

Used in neurosurgery for:

  • Brachial or lumbosacral plexus nerve reconstruction
DESCRIPTION
Nerves
TISSUE CODE
FMS277
STORAGE
Cryo-preserved -160°C

Donor Selection

Homologous tissue comes from carefully selected donors, with careful evaluation of their medical history and thorough physical examination. Standard screening includes: anti-HIV 1/HIV 2, anti-HCV, HBsAg, anti-HBc, anti-HBsAg, anti-Treponema pallidum, anti-HTLVI/ HTLVII, HBV-DNA, HCV-RNA, HIV-1 RNA. On each donor and tissue are also subjected to microbiological screening and, if deemed necessary, additional tests. Tissues are harvested exclusively in the operating room to ensure sterility. The harvested tissue is kept at +2oC /+8oC until processing begins in FBTV’s classified laboratories.

Conservation

The nerves are cryopreserved at -160°C, after immersion in a solution containing a cryoprotectant (DMSO), in order to minimise tissue damage due to water crystallisation during freezing, a process that is carried out by means of a computer-controlled temperature descent. They are then stored in liquid nitrogen vapour with continuous temperature monitoring.

Distribution

The fabric is sent frozen in a container with dry ice, athermic, certified to ensure temperature maintenance during transport. The expiry date for tissues distributed and kept at a temperature of -70°C/-80°C is 90 days from the date of shipment, once thawed they must be used within 7 days. The Bank guarantees proper storage until receipt of the tissue; in the event of any problems occurring during transport, the user must immediately report it to FBTV.

All tissues distributed to implantation centres are accompanied by documentation describing: suitability of the donor, origin and characteristics of the tissue, expiry date, serological and microbiological tests performed, method of preservation, specific instructions for preservation and implantation, documentation for follow-up of the implanted tissue.

Each tissue must be used for a single patient.

Processing

All preparation, handling and storage operations are carried out in an environment with facilities in compliance with national regulations. Laboratory activities are carried out in environments classified as Grade A according to the European Guide to Good Manufacturing Practices (GMP), the classification of the environments is verified with continuous checks in order to minimise contamination risks.

Access to classified environments requires specific clothing to minimise possible contamination from outside and safeguard the safety of personnel.

Entry to the processing premises is strictly limited to persons involved in the process or visitors accompanied by in-house personnel. Nerve processing includes:

  1. antibiotic decontamination with Gentamicin, Vancomycin, Meropenem
  2. packing the tissue in a double bag with cryoprotective solution containing 10% DMSO
  3. scheduled freezing and storage in quarantine until all quality controls performed are reviewed and

approved.

Quality and safety are guaranteed:

  1. a morphological assessment of the tissue on arrival and during

the processing with grading, according to a defined scale;

B.tissue decontamination by

immersion in antibiotic solutions for 24 – 48h at +4°C; C. culture tests for aerobic bacteria and

anaerobes, mycetes, during all phases of activity.

Other Informations

The clinical use of human tissue offers important benefits for recipients. Like any product of human origin, their use is not without risks, although these are rare. A control system is needed to ensure traceability and identification of the tissue at any stage of the process, from donation to recipient. Each tissue is identified with a unique code to allow traceability from origin to destination. Once the tissue is transplanted the code must be attached to the recipient’s medical history. FBTV must be informed when the tissue has been transplanted, through the completion of the “Traceability Card” attached to the tissue. The bank must be informed if the tissue has not been implanted.

If there is suspicion or evidence of a serious adverse reaction or an effect in the recipient possibly related to the safety and quality of the transplanted tissue, the physician should contact immediately and complete the ‘Rapid Notification of Suspected Serious Adverse Events of Suspected Serious Adverse Events” or “Rapid Notification of Suspected Serious Adverse Reactions”.

FBTV is registered on the list of Tissue Banks accredited by the National Transplant Centre; regulated activities include donation, collection, evaluation, preparation, preservation and distribution of homologous tissues. It operates in compliance with international standard ISO 9001:2015 and has a certification process in place to certify that tissues meet predefined safety, traceability and morphological requirements. Homologous tissues procured, processed, stored and distributed meet the requirements of Italian legislation (Law 91/99, Legislative Decree 191/97, Legislative Decree 15/11/2016, Legislative Decree 256 16/12/2016, State/Regions Agreement 66/CSR 8/3/2018) and European Directive 2004/23 and Directives 2006/17/EC, 2006/86/EC, 2012/39/EU, 2015/565/EU, 2015/566/EU. FBTV follows the standards of the main scientific associations: European Association of Tissue Banks (EATB), American Association of Tissue Banks (AATB), and the recommendations of: Good Tissue Practices (Euro-GTP) and the Council of Europe EDQM Guide to the quality and safety of tissues and cells for human application.

    Bibliography

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