Recommended practices for surgical tissue banking - Recommended Practices

AORN Journal,  Feb, 2004  

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(3.) The expiration time of tissue should not exceed the recommendations of the AATB. (2) Tissue should be stocked and rotated to ensure use in a timely manner. Recommended expiration times are as follows:

* refrigerated musculoskeletal tissue--five days,

* refrigerated skin--14 days,

* frozen and cryopreserved cells and tissue five--years, and

* lyophilized or dehydrated tissue--five years.

(4.) Refrigerator and freezer units used for storing tissue should

* be limited to access by authorized personnel,

* be monitored and have daily temperature checks recorded,

* have annual calibration checks,

* have an alarm system that is continuously monitored and sounds when the temperature is not within the acceptable range.

Restricted access is required to verify the safety and security of the tissues. Maintenance of temperatures within the refrigerator or freezer unit ensures tissue integrity. Acceptable temperature range limits for the storage of tissue at each phase of the operation should be set in accordance with standard federal and state regulations. Temperature fluctuations outside the recommended temperature range may render tissue unusable. The alarm should sound in an area where an individual who can initiate corrective action is present at all times.

5. Personnel should have a specific contingency plan for freezer malfunction. Storage freezers and refrigerators should be attached to an emergency power system. In the event of a refrigerator or freezer failure, the temperature of tissue should be maintained to prevent tissue compromise.

RECOMMENDED PRACTICE X

Tissue should be quarantined until all steps of the tissue banking process have been reviewed and found acceptable.

1. Allografts should be segregated and considered unavailable until all screening, testing, processing, labeling, and storage criteria have been reviewed and determined to be satisfactory for release. The tissue should remain in an area segregated from available tissue until this review has been completed and the tissue is available for implantation. Segregation minimizes the risk of implanting unsuitable tissue. A checklist of criteria for release provides a standardized method of verifying release criteria and minimizes the potential for errors.

2. Autografts should be segregated and considered unavailable until all processing, labeling, and storage criteria have been reviewed and determined to be satisfactory for release. Segregation minimizes the risk of implanting unsuitable tissue. A checklist of criteria for release provides a standardized method of verifying release criteria and minimizes the potential for errors.

3. Autografts meeting all criteria for release should be released only for use on the donor. Two unique identifiers (eg, donor name, medical record number) should be used for releasing autografts. Autografts have not undergone testing for infectious agents and diseases and must only be released to the donor. Release to another recipient may cause serious injury. Using two unique donor identifiers is in accordance with JCAHO's patient identification safety goal. (26) This strategy minimizes the potential for errors.