Current scenario and challenges for bone retrieval for allograft use in North India


  • Mohit K. Tejwani Department of Orthopaedics, Government Medical College, Kota, Rajasthan, India
  • Ram K. Meena Department of Orthopaedics, Government Medical College, Kota, Rajasthan, India
  • Kartik Arya Department of Orthopaedics, Government Medical College, Kota, Rajasthan, India
  • Rohith G. Bhat Department of Orthopaedics, Government Medical College, Kota, Rajasthan, India
  • Lokendra S. Chauhan Department of Orthopaedics, Government Medical College, Kota, Rajasthan, India
  • Ramandeep Singh Department of Orthopaedics, Government Medical College, Kota, Rajasthan, India



Bone bank, Allograft, Organ and tissue transplant


Bone grafts are the second most common tissue transplanted. With advances in the treatment of musculoskeletal tumors, limb salvage surgery, with its concomitant demand for bone graft, has increased significantly. This study aims to evaluate current scenario for bone donation in north India. This study was done in bone bank, Government Medical College, Kota, Rajasthan. Inclusion and exclusion criteria of bone donors were followed as per the APASTB standards of tissue banking. Bone was retrieved from deceased donor and live donors after proper consent and counselling in this institute during period 01 January 2021 to 31 January 2022. During the period of study bones were retrieved from 26 donors – 24 live donors and 2 cadavers. Out of 24 live donors 20 were femoral head, 2 tibia and fibula and 2 hemi-radius and hemi-ulna. All donors were between 28-71-year age group and mean age was 56 years. 18 males and 8 females participated in study. There is huge difference between demand and supply of bone allograft in this region of country. There is lack of initiative from government for encouraging people to donate bone along with other organ and tissue donations. Lack of infrastructure for to and fro transport of bone retrieval from deceased and live donors to storage unit results in loss of bone samples. Less trained personnel and sufficiently low coordination between various institutes. Concerns of family members and misconceptions to be addressed properly to reduce morbidity burden in society.


Tomford WW. Bone allografts: Past, Present and Future. Cell Tissue Bank. 2000;1:105-9.

Lobo Gajiwala A, Agarwal M, Puri A, D’Lima C, Duggal A. Reconstructing tumour defects: Lypholised, irradiated bone allografts. Cell and Tissue Banking. 2003;4:109-18.

Lobo Gajiwala A, Trivedi V, Deshpande S. The use of irradiated allografts in posterior spinal fusion for healed tubercular kyphosis in children. Cell and Tissue Banking. 2003;4:119-23.

Salai M, Dudkiewitz I, Amit Y, Chechick A, Ganel A. Versatile utilization of massive bone grafts in orthopedic surgery. Cell Tissue Bank. 2000;1:223-7.

Gajiwala K, Lobo Gajiwala A. Use of banked tissue in plastic surgery. Cell and Tissue Banking. 2003;4:141-6.

Johari A, Shingade A, Lobo Gajiwala, Shah V, D’Lima C. The use of irradiated allografts in paediatric population: an Indian experience. Cell and Tissue Banking. 2007;8:13-22.

Paul Baldwin, Deborah J Hi, Danyl A Auslan, Hassan S Mir, Richard S, et al. Autograft, Allograft and Bone Graft Substitute: Clinical evidence and Indication for use in the setting of Orthopedic Trauma Surgery. J Orthop Trauma. 2019;33:203-13.

Lobo Gajiwala A, Dilip Kumar B, Chokhani P. Evaluation of demineralised, freeze- dried, irradiated bone allografts in the treatment of osseous defects in the oral cavity. Cell and Tissue Banking. 2007;8:23-30.

Miranda B, Vilardell J, Gringo JM. Optimizing cadaveric organ procurement: The Catalan and Spanish experience. Am J Transplant. 2003;3:1185-7.

Campana V, Milano G, Pagano E. Bone substitutes in orthopaedic surgery: from basic science to clinical practice. J Mater Sci Mater Med. 2014;25(10):2445-61.

Chiarello E, Cadossi M, Tedesco G. Autograft, allograft and bone substitutes in reconstructive orthopedic surgery. Aging Clin Exp Res. 2013;25(Suppl 1):S101-3.

Kurien T, Pearson RG, BE S. Bone graft substitutes currently available in orthopaedic practice. Bone Joint J. 2013;95-B:583-97.

Bohatyrewicz A. Factors determining the contamination of bone tissue proceeding from cadaveric and multiorgan donors. Transplant Proceedings. 2006;38:301-4.

Bettin D, Harms C, Polster J, Neimeyer T. High incidence of pathogenic Micro-organism in bone allografts explanted in the morgue. Acta Orthop Scand. 1998;69:311-4.

APASTB Standards of Tissue Banking. 1st Edition, in Radiation inTissue Banking, Basic Sciences and Clinical Applications of Irradiated Tissue Allografts, World Scientific, Singapore. 2007;383-442.

Tomford WW, Ploetz JE, Mankin HJ. Bone allograft of femoral head: Procurement and Storage. J Bone Joint Surg (Am). 1986;68:534-7.

Yazdi M, Bernick S, Paule WJ, Nimni ME. Postmortem degradation of demineralized bone matrix osteoinductive potential: Effect of tissue and storage potential 1991. Clin Orthop Res. 1991;262:281-5.

Carlo R, Figueroa D, Ledezme CD, Vaismon A, Figueroa F. Bone allografts and bone bank function. Rev Med Chile. 2011;139:660-6.

Pakhare AP, Bali S, Pawar RB, Lokhande GS. Assessment of cold chain maintenance in vaccine carrier during Pulse polio immunization day in a rural block in India. WHO South East Asia J Public Health. 2014;39:190-3.

Dzeidzic-Goclawska A, Kaminski A, Uhrynowska-Tyszkiewicz I, Stachowicz W. Irradiation Safety procedure in tissue banking. Cell Tissue Bank. 2005;6:201-9.

Regional Cum State Organ and Tissue Transplant Organization, Ministry of Health and Family Welfare, Government of India. 2021.

Segur JM, Suso S, García S, Combalía A, Fariñas O, et al. The procurement team as a factor of bone allograft contamination. Cell Tissue Bank. 2000;1:117-9.

Brubaker S, Lotherington K, Zhao J, Hamilton B, Rockl G. Tissue Recovery Working Group. Tissue recovery practices and bioburden: a systematic review. Cell Tissue Bank. 2016;17:561-71.






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