FAQ Bone & Tissue Donation

What is bone donation?
There are two types of bone donation:

• Patients undergoing hip replacement surgery may donate the ball part of the joint (femoral head) to the Bone Bank.  There is no age limit for this type of donation. Click here for information about femoral head donation.
• Persons who have indicated a wish to donate organs and/or tissue after their death may donate musculoskeletal bone and tissue (long bone and associated tissue such as tendons and ligaments), with the consent of the next of kin. Persons aged between 15 and generally 65 years at the time of death may donate musculoskeletal bone and tissue.

What is the Bone & Tissue Bank?
The Perth Bone & Tissue Bank is a not-for-profit institution which co-ordinates the collection, screening, storage and distribution of donated human bone and tissue for surgical procedures.

Bone graft procedures are very common, second only in number to blood transfusions.  The demand for human bone graft materials is growing rapidly, and bone & tissue donations assist many patients in need.

All Australian Tissue Banks are regulated and licensed by the Therapeutic Goods Administration (TGA), which is the regulatory body of the Commonwealth Dept of Health & Ageing.

How can my bone / tissue be used?
Donated bone is very valuable for use for patients who may require a bone graft e.g. for bone tumours, spinal surgery, hip revisions and a variety of general orthopaedic procedures.  Bone graft can be used in many ways to aid patients who have bone defects.  Use of tissue grafts such as tendons and ligaments are also common.

It is not necessary for the donor and recipient to be tissue matched as for the transplant of organs.  However, it is helpful if we know the Rhesus factor of the donor.

Bone grafts are often used in conjunction with prosthetic implants such as hip prostheses, plates & screws.  Once implanted into the recipient, the bone graft does not grow, but can encourage the recipient’s own bone to grow into the graft to repair areas of lost bone.

How can I become a bone & tissue donor after death?
In the event of your death, an authorised person will confirm your registration status on the Australian Organ Donor Registry (AODR). After discussion with the Tissue Bank,  a Donor coordinator will approach your senior next of kin to discuss musculoskeletal bone and tissue donation, and seek consent to donate from your family.  The Donor Coordinator will specify which tissues will be retrieved.

A number of questions will be asked regarding the medical and social history of the deceased.

In most cases, it is not possible to donate bone and tissue unless the deceased is to undergo routine post mortem examination. This is necessary to provide information regarding the cause of death, and any abnormal pathology findings.

What sort of questions will be asked about the donor’s medical history?

In order to eliminate the likelihood of transmission of infectious diseases, a thorough examination of the medical history is conducted.  In some instances, the GP may be contacted to clarify some medical history details.

There are certain people who may not donate bone & tissue, and this group includes people who have any history of the following:

• Organ or cornea transplant
• HIV (AIDS) risk
• Hepatitis B or C
• Intravenous (IV) non-prescribed (illicit) drug use within the last 5 years.
• Current active infection / unexplained fever
• Human derived growth hormone therapy
• Rheumatoid Arthritis
• Tattoos / body piercing within last 4 months (deceased donors only)
• Malignant cancers including skin cancers such as Melanoma and Squamous Cell Carcinoma (Basal Cell Carcinoma and some Cervical cancers are accepted).
• Dementia including Alzheimer’s disease
• Paget’s disease
• Type 1 diabetes
• Confinement in a prison or detention centre, for more than 72 hours within the last 12 months.
• Having lived in the United Kingdom (UK) for 6 months or more between 1980 and 1996, including having made frequent visits during this time which add up to 6 months or more; or having had a blood transfusion in the UK since 1980 (Creutzfeldt-Jakob disease, commonly known as Mad Cow’s Disease).

How is the bone & tissue retrieved after death?
At all times, the body of the deceased is handled with care and respect.  Each bone is carefully removed and packaged by trained surgical staff.  Using prosthetic implants, the limbs are reconstructed to restore alignment, and all wounds are sutured as for any surgical procedure.  It is possible for the family to view the body following the retrieval should they wish.

What happens after the bone & tissue has been retrieved?
A variety of laboratory specimens are collected for routine testing, including blood, swabs and bone chips.   These specimens are sent to a licensed laboratory for examination.

Tests are undertaken for a wide range of viral diseases, including:

• Syphilis
• Hepatitis B & C
• HIV (AIDS)

The swabs and chips are cultured to ensure that there has been no contamination of the donated bone & tissue during the collection process.  A bone chip is also sent for examination by a Pathologist.

The retrieved bone and tissue is placed in a -70°C freezer whilst awaiting clearance.  Upon clearance, the bone & tissue may then be used for transplantation, or further processed to produce special types of grafts.  Processing involves removing soft tissue from the bone, then segmenting and packaging into individual graft items to optimise the donation, and to reduce wastage of this precious tissue..

Graft material may be stored for up to 5 years awaiting transplant.

Will bone & tissue donation cost the family anything?
Bone & tissue donation is a voluntary act.  The family will not be charged for the tests performed as part of the donation process, nor will any payment be made for the donation.

What if the donated bone / tissue is not suitable for transplantation?
The focus of donor programs is to provide much needed tissue for transplantation. Research is a very important aspect of the work of the Bone Bank, to assist in the development of new processing techniques and graft material.

In some instances donated tissue is not suitable for transplantation. The Donor Coordinator will discuss this eventuality with the next of kin at the time of approaching them for donation consent. With the consent of the next of kin, this tissue may be used for ethically approved research purposes.

Should you or your family not agree to research, any tissue not suitable for transplantation will be destroyed.

How can I register as a donor?
If you wish to be included on the Australian Organ Donor Registry you must complete a donor registration form. Forms are in any Medicare Office and under ‘Popular Forms’ at www.medicare.gov.au/public/services/aodr