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Microbial Contamination in Deceased Musculoskeletal Tissue Donors: A Large-Scale US Analysis of Infection Risk
Anthony Montedonico1, Kimberly Elliott1, Lee Brandenburg1
1Eurofins Donor and Product Testing, LLC, Centennial, Colorado, USA.
Background:
Microbial contamination of musculoskeletal tissues recovered from deceased donors poses a risk for donor-derived infections and may lead to tissue exclusion under regulatory standards. Despite stringent aseptic protocols, recovery and processing contamination remains a critical challenge. This study presents a large-scale analysis of microbial prevalence and distribution in deceased tissue donors in the United States.
Methods:
We conducted a retrospective analysis of 1 186 392 musculoskeletal tissue recovery swabs collected from 69 920 deceased donors between 2019 and 2024. Growth-positive cultures underwent organism identification using MALDI-TOF mass spectrometry and biochemical methods. Microbial findings were stratified by anatomical recovery zone, and organisms considered potentially disqualifying for transplantation were assessed according to American Association of Tissue Banks (AATB) standards.
Results:
Microbial growth was observed in 12.4% of swabs, with 64.8% of donors having at least one growth-positive sample. Among positive swabs, 92.4% yielded bacteria, 5.0% fungi, and 2.6% yielded both. Organisms considered potentially disqualifying were identified in 5.0% of donors, most commonly Clostridium species and Streptococcus pyogenes. The prevalence of virulent organisms varied by anatomical recovery zone, with the highest rates observed in lower extremity and pelvic sites and the lowest in thoracic and vertebral tissues.
Conclusion:
In this large national cohort, potentially virulent microorganisms were identified in a clinically meaningful proportion of deceased tissue donors, with substantial anatomical variability in contamination risk. These findings reinforce the importance of stringent microbiological screening to reduce the risk of recipient infection while supporting safe and effective tissue transplantation.
Insights
Microbial contamination is common in deceased tissue donors, with over 12% of swabs showing growth. Potentially virulent organisms were found in 5% of donors, varying by anatomical site, highlighting the need for rigorous screening in tissue transplantation.
Area of Science:
- Microbiology
- Transplantation Science
- Public Health
Background:
- Microbial contamination of musculoskeletal tissues from deceased donors presents a significant risk for donor-derived infections and potential tissue exclusion.
- Despite strict aseptic techniques, contamination during recovery and processing remains a persistent challenge in tissue banking.
- This study addresses the critical need for understanding microbial prevalence in deceased tissue donors.
Purpose of the Study:
- To conduct a large-scale analysis of microbial prevalence and distribution in deceased tissue donors across the United States.
- To identify specific microorganisms and assess their potential disqualification for transplantation based on established standards.
- To investigate the anatomical variability of microbial contamination in tissue recovery sites.
Main Methods:
- A retrospective analysis of 1,186,392 musculoskeletal tissue recovery swabs from 69,920 deceased donors (2019-2024) was performed.
- Growth-positive cultures were identified using MALDI-TOF mass spectrometry and biochemical assays.
- Microbial findings were stratified by anatomical recovery zone and assessed against American Association of Tissue Banks (AATB) standards for disqualifying organisms.
Main Results:
- Microbial growth was detected in 12.4% of swabs, with 64.8% of donors exhibiting at least one positive sample.
- Bacteria were the predominant organisms (92.4%), followed by fungi (5.0%) and mixed growth (2.6%).
- Potentially disqualifying organisms, notably Clostridium species and Streptococcus pyogenes, were found in 5.0% of donors, with higher prevalence in lower extremity and pelvic sites.
Conclusions:
- A significant proportion of deceased tissue donors harbor potentially virulent microorganisms, underscoring infection risks in transplantation.
- Substantial anatomical variation in contamination risk necessitates targeted microbiological surveillance strategies.
- Reinforces the critical importance of stringent microbiological screening protocols to ensure the safety of tissue transplantation and minimize recipient infections.
