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On-demand segments

FBTV is always available to evaluate individual requests in collaboration with the clinician.

On-demand segments, harvested upon specific request, are mostly large-sized bone tissues used in
massive grafts.

Examples:

  • Humerus
    Proximal third with rotator cuff or distal third
  • Radius
    Distal or proximal third
  • Ulna
    Distal or proximal third
  • Femur
    Distal or proximal third
  • Tibia
    Distal or proximal third
  • Clavicle
  • Inferior vena cava
  • Iliac vein
  • Brachiocephalic artery
  • Knee
  • Elbow
  • Tibia with complete extensor apparatus
  • Finger (hand/foot)

Measures
We match the measurements requested by the surgeon according to the recipient.
FEATURES
Depending on the tissue type.
Area of ApPlication

Major Clinical Applications

Depending on the surgeon’s requirements

DESCRIPTION
Cryopreserved segment specific request
Frozen segment harvested upon specific request
Whole joint
Other minor structures
TISSUE CODE
FMS282
FMS382
FMS262
FMS261
STORAGE
Storage at the End-user Site: Frozen segmenmt at below –80°C for 5 years from the date of retrieval
Frozen segment at –20/–30°C for 90 days
Cryo segments at below -80°C for 90 days
If storage is not possible, please contact the logistics office at logistica@fbtv.it

Donor Selection

Homologous tissue comes from carefully selected donors, with a thorough evaluation of their medical and social history and thorough physical examination. Standard screening includes: Ac anti-HIV 1/HIV 2, Ac anti-HCV, HBsAg, Ac anti-HBc, Ac anti-HBsAg, anti-Treponema pallidum, Ac 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

Tissues taken at the surgeon’s specific request can be stored:

if bone tissue, frozen at -80°C inside a double EVA bag, resistant to low temperatures;

  • if cardiovascular or tendon 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. All tissues are initially stored in a ‘quarantine’ freezer and then moved to the ‘suitable for distribution’ freezer, after careful evaluation of the donor and related tissues.

Distribution

The tissue is shipped frozen in a container with dry ice, athermic, certified to ensure temperature maintenance during transport. The expiry date for cryopreserved tissues maintained at a temperature of -70°C/- 80°C is 90 days from the date of shipment; for con- gelled tissues maintained at a temperature of -20°C/- 30°C is 90 days from the date of shipment, if maintained at -70°C/-80°C, 5 years from the date of procurement. Once thawed, they must be used within 7 days.

The Bank guarantees proper preservation until receipt of the tissue; in the event of any problems occurring during transport, the user must immediately notify 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 storage and implantation, documentation for follow-up of the implanted tissue.

Each tissue must be used for a single patient.

Processing

The results obtained to date show that homologous tissues, thanks to processing techniques, retain their original haemodynamic, inductive, conductive and elastic properties and can be considered first choice materials.

All preparation, handling and storage operations are carried out in an environment with facilities in accordance

to national regulations. The laboratory activity takes place in environments classified as Grade A according to the European Guide to Good Manufacturing Practice (GMP), the classification of the environments is verified with continuous checks in order to minimise the risk of contamination.

Access to classified rooms requires specific clothing to minimise possible contamination from outside and to safeguard the safety of personnel. Access to the processing rooms is strictly limited to persons involved in the process or visitors accompanied by internal staff. To guarantee quality and safety, these tests are carried out:

  1. a morphological evaluation of the fabric on arrival and during processing with grading according to a defined scale;
  2. decontamination of tissues by immersion in antibiotic solutions for 24 to 48 hours at

+2°C/+8°C;

  1. culture tests for aerobic and anaerobic bacteria, fungi, 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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