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Changing Lives through Tissue Donation

Changing Lives through Tissue Donation. Bruce W. Stroever, President & CEO Musculoskeletal Transplant Foundation. MTF is an AATB accredited, non-profit tissue bank located in NJ MTF provides over 400,000 grafts per year throughout the US

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Changing Lives through Tissue Donation

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  1. Changing Lives through Tissue Donation Bruce W. Stroever, President & CEO Musculoskeletal Transplant Foundation

  2. MTF is an AATB accredited, non-profit tissue bank located in NJ • MTF provides over 400,000 grafts per year throughout the US • Partnered with Gift of Life Michigan for over 20 years in the recovery, processing and distribution of tissues to hospitals in Michigan

  3. MTF is a non-profit serviceorganization dedicated to providing quality tissue through a commitment to excellence in education, research, recovery and care for recipients, donors and their families. MTF Mission Statement

  4. Two Novel Tissue Forms • Flex HD – Acellular dermis • Trinity Evolution – Viable cryopreserved cellular bone matrix

  5. Acellular Dermis Used primarily for: • Abdominal wall repair • Reconstruction following mastectomy Essentially a sheet of human collagen processed from human skin

  6. What Makes a Good Hernia Repair Material? • Strong enough to withstand physiological stress over a period of time • Conforms to the abdominal wall • Promotes strong host ingrowth, which mimics normal healing • Resists formation of bowel adhesions and erosion into visceral structures • Doesn’t induce allergic or foreign body reaction • Resists infection

  7. What Makes a Good Hernia Repair Material? • Strong enough to withstand physiological stress over a period of time • Conforms to the abdominal wall • Promotes strong host ingrowth, which mimics normal healing • Resists formation of bowel adhesions and erosion into visceral structures • Doesn’t induce allergic or foreign body reaction • Resists infection

  8. Revascularization Gross examination of acellular dermal matrix after 8 weeks in rabbit study revealed neovascularization around graft perimeter Source: FlexHD Acellular Dermal Matrix. Histology: In Vitro and In Vivo Studies

  9. Acellularity • Processing removes cells and maintains matrix integrity • Intact matrix structure allows for cell infiltration and revascularization Before Processing After Processing Source: FlexHD Acellular Dermal Matrix. Histology: In Vitro and In Vivo Studies

  10. Preserved Collagen Elastin, in conjunction with collagen, contributes to the strength and structure of the dermal matrix scaffold Magnification shows collagen fibrils in normal skin (left) and acellular dermis (right). Source: FlexHD Acellular Dermal Matrix. Histology: In Vitro and In Vivo Studies

  11. Abdominal Wall Repair Wound dehiscence Trauma Infected sites General - Applications • Abdominal Wall Repair Source: T.N. Robinson et al, Major mesh-related complications following hernia repair: events reported to the Food and Drug Administration. Surgical Endoscopy 2005; 19:1556-1560. Source: DermaMatrix Acellular Dermis brochure

  12. Plastic - Applications Breast Reconstruction – Post Mastectomy Source: DermaMatrix Acellular Dermis brochure

  13. Post-Op 10 months Pre-op Case Studies: Repair and Reconstruction *All images and patient data owned by E. Parra-Davila, MD, permitted use by MTF only. Do not redistribute

  14. A Major Concern of the Surgeon is the Size of the Graft • Use of dermatomes – 8cm maximum width • Shift to free hand dissection – 20 x 24cm • Skill of the recovery team is key to producing large grafts

  15. Viable Cryopreserved Cellular Bone Matrix • Trinity Evolution

  16. Trinity Evolution: Inception • Background: • Stem cells are critical in facilitating bone repair • Bone marrow aspirates containing live stem cells often taken from the patient during surgery and combined with bone graft for fusion/bone healing applications • Limitations include limited volume and second surgery site • Trinity Evolution concept: • Novel tissue form containing viable stem cells inside an allograft bone matrix

  17. Bone Formation

  18. Structure & Function What are the key characteristics of Trinity Evolution? Osteoconductive Matrix Osteoinductive Factors Osteogenic Cells

  19. Stem Cell Characterization Trinity Evolution contains stem cells that are capable of forming bone CD166 positive Osteocalcin positive

  20. Production in the Core • 3 teams work around-the-clock • Processing completed within 96 hours post mortem • Processing technology maintains: • Cell viability • Cell location within the matrix

  21. Cryopreservation at MTF

  22. Clinical Applications To expedite the bone healing process for spinal and orthopaedic needs

  23. Spinal Fusion

  24. Critical Issues for Fresh/Viable Allografts • Time Time Time – the current shelf life of Trinity Evolution is about 6 months • All paperwork and testing must be expedited for tissue to be usable • Sterile Technique • These tissues are processed at risk • More than 15% of all donors are rejected following recovery • No graft sterilization is possible

  25. Thank You

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