YILMAZ TOMAK, Nevzat DABAK, Cemal KÖKÇÜ, Birol GÜLMAN, T. Nedim KARAİSMAİLOĞLU, Alper ANDAÇ

Allogreft kullanımı ve kemik bankası üzerine deneyimlerimiz

Amaç: Ondokuz Mayıs Üniversitesi Tıp Fakültesi Ortopedi ve Travmatoloji Anabilim Dalı’nda kurulan kemik bankasından sağlanan allogreftlerin uygulandığı olgular değerlendirildi. Çalışma planı: Ağustos 1994 - Ocak 1998 tarihleri arasında 33 hastada allogreft kullanıldı. Yaş ortalaması 33.2 (dağılım 5 -70 yaş) idi. Alıcılar kaynama sağlanıncaya kadar aylık, daha sonra yıllık süreçler ile klinik ve radyolojik olarak değerlendirildi. Sonuçlar: Bir olgu dışında, tüm olgularda tam kaynama sağlandı (%97.1). Bu olgu, tekrarlanan allogreft uygulaması ile başarı ile tedavi edildi. Allogreftlerin ortalama bütünleşme süresi 8 hafta (4-22 hafta idi. Olguların izlemleri sırasında üç komplikasyonla karşılaşıldı: Bir olgu pulmoner emboli nedeni ile ameliyat sonrası ikinci günde kaybedildi. Bir olguda steril, bir olguda enfekte drenaj gelişti. Bunlar uygun yöntemlerle başarıyla tedavi edildi. Çıkarımlar: Donörün serolojik-mikrobiyolojik tetkiklerinin eksiksiz yapılması ve greftin usulüne uygun alınıp saklanması koşulu ile, banka allogrefti kullanımının donör saha morbiditesini ortadan kaldıran, cerrahi sırasında kan kaybını azaltan, cerrahi süresini kısaltan, yüksek kaynama potansiyeline sahip, ekonomik ve güvenli bir yöntem olduğu kanısına varıldı.

Anahtar Kelimeler:

Ameliyat sonrası komplikasyonlar, Kemik bankası, Nakil, homolog, Kemik nakli, Ortopedik işlemler

Our clinical experience with the use of allografts and bone banking

Objectives: We evaluated patients in whom allografts were used. The allografts were obtained from the bone bank in the Department of Orthopaedics and Traumatology, Medical Faculty of Ondokuz Mayis University. Methods: Allografts were used in 33 patients between August 1994 and January 1998. Mean age was 33.2 years (range 5-70 years). The patients were clinically and radiologically examined monthly and annually before and after complete union was obtained, respectively. Results: Complete union was achieved in all patients but one (97.1%), who was successfully treated with the reutilization of an allograft. The average consolidation time was 8 weeks (range 4-22 weeks). Only three adverse events were encountered. One patient died from pulmonary thromboembolism on the second postoperative day. Sterile and infected drainages occurred in two patients, respectively, both of which were successfully treated. Conclusion: Provided that thorough serologic and microbiologic examinations of donors are made and appropriate techniques are applied in the removal and storage of allografts, use of bone bank allografts is more reliable and economic and offers many advantages including decreased donor site morbidity, decreased blood loss and operation time during surgery, and high osteogenic potential.

Keywords:

Postoperative Complications, Bone Banks, Transplantation, Homologous, Bone Transplantation, Orthopedic Procedures,

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