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Microbial contamination and tissue procurement location: A conventional operating room is not mandatory. An observational study.
Louart, Benjamin; Charles, Claire; Nguyen, Tri-Long; Builles, Nicolas; Roger, Claire; Lefrant, Jean-Yves; Vachiery-Lahaye, Florence; De Vos, John; Couderc, Guilhem; Muller, Laurent.
Afiliación
  • Louart B; Department of Anesthesiology Intensive Care, Pain and Emergency medicine, Nîmes University Hospital, Montpellier University, Nîmes, France.
  • Charles C; Department of Anesthesiology Intensive Care, Pain and Emergency medicine, Nîmes University Hospital, Montpellier University, Nîmes, France.
  • Nguyen TL; Department of Clinical Pharmacy, Niîmes University Hospital, Niîmes, France.
  • Builles N; Banque de Tissue, Centre des Collections Biologiques Hospitalières de Montpellier, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
  • Roger C; Department of Anesthesiology Intensive Care, Pain and Emergency medicine, Nîmes University Hospital, Montpellier University, Nîmes, France.
  • Lefrant JY; Department of Anesthesiology Intensive Care, Pain and Emergency medicine, Nîmes University Hospital, Montpellier University, Nîmes, France.
  • Vachiery-Lahaye F; Coordination Hospitalière des Prélèvements d'Organes et de Tissus, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
  • De Vos J; Banque de Tissue, Centre des Collections Biologiques Hospitalières de Montpellier, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
  • Couderc G; Banque de Tissue, Centre des Collections Biologiques Hospitalières de Montpellier, Centre Hospitalier Universitaire de Montpellier, Montpellier, France.
  • Muller L; Department of Anesthesiology Intensive Care, Pain and Emergency medicine, Nîmes University Hospital, Montpellier University, Nîmes, France.
PLoS One ; 14(1): e0210140, 2019.
Article en En | MEDLINE | ID: mdl-30620747
BACKGROUND: Standard operating rooms (SOR) are assumed to be the best place to prevent microbial contamination when performing tissue procurement. However, mobilizing an operating room is time and cost consuming if no organ retrieval is performed. In such case, non-operating dedicated rooms (NODR) are usually recommended by European guidelines for tissue harvesting. Performing the tissue retrieval in the Intensive care unit (ICU) when possible might be considered as it allows a faster and simpler procedure. OBJECTIVE: Our primary objective was to study the relationship between the risk of microbial contamination and the location (ICU, SOR or NODR) of the tissue retrieval in heart-beating and non-heart-beating deceased donors. MATERIALS AND METHOD: We retrospectively reviewed all deceased donors' files of the local tissue banks of Montpellier and Marseille from January 2007 to December 2014. The primary endpoint was the microbial contamination of the grafts. We built a multivariate regression model and used a GEE (generalized estimating equations) allowing us to take into account the clustered structure of our data. RESULTS: 2535 cases were analyzed involving 1027 donors. The retrieval took place for 1189 in a SOR, for 996 in a hospital mortuary (NODR) and for 350 in an ICU. 285 (11%) microbial contaminations were revealed. The multivariate analysis found that the location in a hospital mortuary was associated with a lower risk of contamination (OR 0.43, 95% CI [0.2-0.91], p = 0.03). A procurement performed in the ICU was not associated with a significant increased risk (OR 0.62, 95% CI [0.26-1.48], p = 0.4). CONCLUSION: According to our results, performing tissue procurement in dedicated non-sterile rooms could decrease the rate of allograft tissue contamination. This study also suggests that in daily clinical practice, transferring patients from ICU to SOR for tissue procurement could be avoided as it does not lead to less microbial contamination.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obtención de Tejidos y Órganos / Recolección de Tejidos y Órganos / Microbiología del Aire / Aloinjertos Tipo de estudio: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Obtención de Tejidos y Órganos / Recolección de Tejidos y Órganos / Microbiología del Aire / Aloinjertos Tipo de estudio: Guideline / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: Europa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: Francia Pais de publicación: Estados Unidos