• 대한관절경학회지
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• 제2권1호
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• pp.40-44
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• 1998

The use of autogenous tissues is preferred for knee ligament reconstruction. However allografts play a role in major ligament reconstructive procedures in which multiple substitutions or revisions are required. In the dislocated knee, allografts may offer an advantage in reconstructing the PCL. But allografts in knee ligament surgery must be considered in terms of biomechanical and regenerative properties, disease transmission and immunogenecity, and methods of preservation and sterilization. Also only a few authors have described the use of allograft for reconstruction of a ruptured PCL, either a single procedure, or in combination with ACL repair following knee dislocation. Furthermore, the problems that the clinician faces with use of allografts is the necessity for supervision to ensure that the grafts are correctly processed, secondarily sterilized, and free of transmissible diseases. For these reasons, the routine use of allograft materials in the treatment of ligament deficiencies should be avoid and provide with meaningful outcome studies, including longterm follow-up.

• Journal of Chest Surgery
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• 제28권8호
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• pp.731-741
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• 1995

Cardiac valve allografts have been used as replacements for diseased valves and right ventricular outflow tract reconstruction, the long term follow-up of which has been reported satisfactory. For a good long-term result, it is essential that the allograft be viable at implantation. In this study, we aimed at preparing the cardiac valve allografts aseptically, preserving them at cold- and cryo-conditions, and testing the viability of the allografts after preservation by four methods. We tested the viability of the cardiac valve allografts preserved in cold refrigerated state[4$^{\circ}$C in nutrient media & in liquid nitrogen tank[cryopreservation under -149$^{\circ}$C for pre-planned time periods. The testing methods were 1 glucose utility test 2 tissue culture 3 thymidine uptake test and 4 histologic evidence by light microscopy. We observed no differences in the viability between cold- & cryo-groups and similar results among the methods for testing the viability. In conclusion, there was no difference in the viability between cold- and cryopreserved-allografts at least for 14 days of preservation. And glucose utility test and thymidine uptake test were satisfactory in the evaluation of the allograft viability, since they were easy and rapid with relatively quantitative results.

• Journal of Chest Surgery
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• 제37권8호
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• pp.623-631
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• 2004

배경: 대망의 가장 중요한 성질 중 하나인 혈관 형성 촉진 기능을 이용하여 초냉동 보관된 기관 이식편의 대망 내 이식이 기관 이식편의 생육성이나 혈관 형성에 미치는 영향을 연구하고자 한다. 대상 및 방법: 8주령의 Sprague Dawley rat 수컷의 초냉동 보관된 기관 이식편을 백서의 복강 내 대망에 이식하였다. 연구군은 냉동 보관기간과 대망 내 이식기간에 따라 4개의 군으로 분류하였다(n=52). 이식된 기관 이식편을 획득하여 기관 평활근 및 주변 결합 조직의 섬유화 및 염증 정도, 기관 연골의 석회화 정도, 기관 내 상피세포의 변화 및 연골간 간격에서의 혈관 형성 정도 등을 검사하였다. 결과: 기관 평활근의 염증 정도는 냉동 보관기간이나 대망 내 이식기간에 따라 유의한 차이를 보이지 않았고, 기관 연골의 석회화 정도는 냉동 보관기간과 상관없이 대부분 심하게 진행되어 있었다. 혈관 형성은 기관 이식편의 양끝뿐만 아니라 중간 부위에서도 충분히 이루어져 있었다. 결론: 초냉동 보관된 백서의 장분절 기관 이식편을 2주간 대망 내 이식을 시행한 결과 기관 이식편의 조직 생육성이 적절히 유지되면서 새로운 혈관이 형성되었다. 향후 동종 기관 이식 시 초냉동 보관된 기관 이식편을 대망 내 이식하여 새로운 혈관이 형성된 후 단계적으로 기관 이식을 시행하는 데 도움이 될 수 있다고 생각한다.

• Journal of Korean Neurosurgical Society
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• 제50권6호
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• pp.503-506
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• 2011

Objective : The aim of this study was to assess the safety and efficacy of radiation-sterilized allografts of iliac bone and fascia lata from cadaver specimens to repair skull base defects after transsphenoidal surgery. Methods : Between May 2009 and January 2010, 31 consecutive patients underwent endonasal transsphenoidal surgery and all patients received sellar reconstruction using allografts following tumor removal. The allografts were obtained from the local tissue bank and harvested from cadaver donors. The specimens used in our approach were tensor fascia lata and the flat area of iliac bone. For preparation, allografts were treated with gamma irradiation after routine screening by culture, and then stored at $-70^{\circ}C$. Results : The mean follow-up period after surgery was 12.6 months (range, 7.4-16 months). Overall, postoperative cerebrospinal fluid (CSF) leaks occurred in three patients (9.7%) and postoperative meningitis in one patient (3.2%). There was no definitive evidence of wound infection at the routine postoperative follow-up examination or during re-do surgery in three patients. Postoperative meningitis in one patient was improved with the use of antibiotics and prolonged CSF diversion. Conclusion : We suggest that allograft materials can be a feasible alternative to autologous tissue grafts for sellar reconstruction following transsphenoidal surgery under selected circumstances such as no or little intraoperative CSF leaks.

• Journal of Chest Surgery
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• 제29권7호
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• pp.713-722
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• 1996

폐이식후의 수용자들의 낮은 생존율은 주로 거부반응 또는 면역억제제 사용에 따른 합병증과 관련이 있다. 따라서 이식편에대한 수용자의 관용을 유도해낼 수 있는 더욱 좋은 방법이 절실히 요구된다. 저자 는 동종의 골수간세포가 주입되어진 혼합동종이 인자형 키메라 쥐에서 특정 동종 공여군의 공여 폐이식 편에대한 관용의 초래여부를 연구하였다. Fisher(F344)와 Wistar Forth(WF)종주의 쥐에서 치사량의 (1100c0y) 방사선조사후 T-임파구를 제거한 동일종주와 동종이인자형 골수의 혼합물로 재구성하였다 (F)44+WFIWF, AC1+F3441F3f4).28일후 말초혈액에서 임파구형의 검사로 혼합형 키메리즘이 확 인된 쥐에서 특정 공여군 또는 제3군의 동종 공여폐로 좌측의 동소 폐이식을시행하였다. 이식후 어떠 한 면역억제제도 투여하지 않았다. 이식편의 거부는 흉부 X선검사로 관찰하였고 조직학적으로 확인하 였다. 혼합형 키메라쥐들은 특정 공여군의 폐들을 받아들였으나 종주들 끼리의 특정효과에의한 것은 아 니었고, 이들에서 150일이상 거부반응을 관찰할 수 없었다. 이식편에대한 관용은 키메리즘의 백분율과 는 관계없이 일어났으며 제3군의 공여폐에대해서 \ulcorner정상대조군에서와 마찬가지로 10일내에 이식편에 대한거부반응이 완료되었다. 이 결과들은흔합형 키메라에서 정상적인 면역기전을 유지하면서도,특정 공여군의 폐이식후 안정적이고_1. 지속적 인, 이식 편에대한 관용이 일어난다는 것을 보여준다.

• Journal of Chest Surgery
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• 제30권6호
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• pp.553-558
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• 1997

동종동맥판은 심장판막질환, 선천성 심기형 및 대동맥 질환의 치료에 있어서 우수한 판막도관으로 사용 되고 있다. 이 때 동종동맥 판의 장기성적을 좌우하는데 있어서 혈관내피세포의 생육성이 중요한 역활을 할 것이다. 혈관내피세포의 생육성을 평가하기 위하여 현재 임상에서 사용되는 보존방법으로 보존처리된 성돈의 대동맥판 및 대동맥 벽을 collagenase로 분해시켜서 순수한 내퍼세포군을 획득한 뒤, 혈관내피세포에 특이한 친화성을 갖는 GSA-FTTC(Criffonia simplicifolia agglutininfluorescein isothiocyanate)와 반응시켰다. 이 내피세포군을 세척한 다음, 살아있는 세포에는 침착되지 않는 Pl(Ropidium iodide)와 반응시켰다. 이렇게 처리된 내피세포군을 Row Cytometry 로 분석하여 GSA-FTIC(+), Pl(-) 인 세포를 생육성을 유지한 것으로 평가하였다. 동종동맥판은 $4^{\circ}C의$ 멸균용액에 24시간 담궈 멸균처리를 한 후, 2개군으로 나누어 (1군)은 $4^{\circ}C$ RPM 1640 with HEPES buffer cultlue medium with 10% fetal bovine uTm 용액에 1~14일간 보존하였고 (2군)은 냉동보존을 하였다. 조직의 획득과정과 멸균과정에서 각각 22.8%와 24.4%의 생육성이 소\ulcorner되었다. (1군) 에서는 14일의 보존기간 동안 11.9%의 생육성감소가 일어났고 (2군) 에서는 13.7%의 생육성감소가 일어났다. 이 실험의 결과로 동종동맥 판의 보존처리과정 초기에 대부분의 생육성소실이 일어나며, 14일간의 냉장보존이나 냉동보존 후에도 약 40%의 생육성이 보존됨을 알 수 있었다. 또한 혈관내피세포가 판막에서 얻어진 경우나 동맥벽에서 얻어진 경우에서 생육성의 차이는 없었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권4호
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• pp.365-370
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• 2006

Viral, bacterial and fungal infections can be transmitted via allografts such as bone, skin, cornea and cardiovascular tissues. Allogenic bone grafts have possibility of transmission of hepatitis C, human immunodeficiency virus (HIV-1), human T-Cell leukaemia virus (HTLV), tuberculosis and other bacterias. The tissue bank should have a policy for obtaining information from the patient's medical report as to whether the donor had risk factors for infectious diseases. Over the past several years, improvements in donor screening criteria, such as excluding potential donor with "high risk" for HIV-1 and hepatitis infection, and donor blood testing result in the reduction of transmission of these diseases. During tissue processing, many allografts are exposed to antibiotics, disinfectants and terminal sterilization such as irradiation, which further reduce or remove the risk of transmitting diseases. Because the effectiveness of some tissue grafts such as, fresh frozen osteochondral grafts, depends on cellular viability, not all can be subjected to sterilization and processing steps and, therefore, the risk of transmission of infectious disease remains. This article is review of the transmission of considering infectious disease in allogenic bone transplantation and the processing steps of reducing the risk. The risk of viral transmission in allografts can be reduced in several standards. The most important are donor-screening tests and the removal of blood and soft tissues by processing steps under the aseptic environment. In conclusion, final sterilizations including the irradiation, can be establish the safety of allografts.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제30권5호
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• pp.406-413
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• 2004

Progress in medical science and cell biology has resulted in the transplantation of human cells and tissues from on human into another, facilitating reproduction and the restoration of form and function, as well as enhancing the quality of life. For more than 40 years, society has recognized the medical and humanitarian value of donation and transplanting organs and tissues. The standard operating procedures of hard tissues reflect the collective expertise and conscientious efforts of tissue bank professionals to provide a foundation for the guidance of tissue banking activities. Procurement of allograft tissues from surgical bone donors is a part of tissue banking. During the past decades the use of bone allografts has become widely accepted for the filling of skelectal defects in a variety of surgical procedures. In particular in the field of orthopaedic and oral and maxillofacial surgery the demand for allografts obtained from either living or post-mortem donors has increased. Hospital-based tissue banks mainly retrieve allografts from living donors undergoing primary total hip replacement for osteoarthritis or hemi arthroplasty for hip fractures and orthgnatic surgery such as angle reduction. Although bone banks have existed for many years, the elements of organized and maintaining a hospital bone bank have not been well documented. The experience with a tissue bank at Korea Tissue Bank(KTB) between 2001 and 2004 provides a model of procurement, storage, processing, sterilization and documentation associated with such a facility. The following report describes the standard operating procedures of hard tissues such as femoral head obtained from living donors.

• 대한관절경학회지
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• 제1권1호
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• pp.116-122
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• 1997

We have studied the results of reconstruction by freeze-dried patellar allografts or patellar autografts in ACL-deficient patients prospectively. From January 1995 to December 1995, we performed ACL reconstruction using an arthroscopic-assisted technique with patellar autografts in 21 patients and patellar allografts in 13 patients. Minimum followup time was 1 year(average 26 months). All patients were evaluated by using KT-2000 arthrometer and MRI as well as by physical examination. Final results were rated as satisfactory or unsatisfactory by using a modified Feagin knee scoring scale. Good or excellent were considered to have satisfactory results and fair or poor were considered to have unsatisfactory results. As measured by the KT-2000, 19 cases$(90.5\%)$ had a 5-mm or Jess side-to-side differential, a satisfactory results in autograft group, 2 cases of unsatisfactory results had joint instability. In allograft group, 10 cases$(76.9\%)$ had a 5-mm or less side-to-side differential, a satisfactory results, 3 cases of unsatisfactory results had joint instability including postoperative infection(1 case). In conclusion, the results of ACL reconstruction with autografts were better than those with allografts. The problem of allograft reconstruction were rehydration, aseptic control and improper mechanical tensioning. So, we thought that success of allograft reconstruction was depended on careful implant preparation including pretensioning technique.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제27권6호
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• pp.523-527
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• 2005

Allograft donations are commonly found to be contaminated. The most of tissue banks has promoted the use of ionizing radiation for the sterilization of biological tissues. The potential for transmission of human infectious diseases and contamination of microorganism has created serious concern for the continued clinical use of hard and soft-tissue allografts. Tissue banks have employed 15-25kGy for sterilization of hard and tendon allografts, which, according to the national standards, approaches the level at which the tissue quality is adversely affected for transplantation. The donations of allogeneic tissues to the Korea Tissue Bank over a 2-year period were reviewed, and the incidence and bacteriology of contamination were detailed. Clinical outcomes were determined for donors who had positive cultures at the time of retrieval and during the processing and they were compared with those of post sterilization. After exposure of the frozen block bone to 25kGy and the processed tissues to 15kGy of gamma irradiation, the authors were able to demonstrate complete inactivation of the bacteria. The aim of this study was to obtain the effects of gamma irradiation and the irradiation dose according to the type of tissue, through conventional microbiologic test without on influence of biocompatibility in allografts. The contamination rate after the final irradiation sterilization is 0% in the processed allografts. This may be due to the fact that the gamma radiation and processing steps are effective to control contamination.