Infection in massive bone allografts
Infection in massive bone allografts
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DOI：
10.1097/01.blo.0000150371.77314.52
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发表时间：
2005-03-01
影响因子：
4.2
通讯作者：
Raskin, KA
中科院分区：
文献类型：
--
作者：
Mankin, HJ;Hornicek, FJ;Raskin, KA
我们研究了自1971年以来945例因非骨盆骨或软组织肿瘤病变而接受尸体同种异体移植的患者。我们特别感兴趣的是感染在移植过程中的作用，更具体地说，它的历史、频率和对结果的影响。75例患者发生原发性感染（与移植物不连或骨折的再手术无关）（7.9%），另外46例患者发生与再手术相关的感染，使感染患者总数增加到121例（12.8%）。感染的最高频率发生在软组织肿瘤、放射部位、肌肉骨骼肿瘤学会分期IIB肿瘤或由同种异体关节融合术组成的手术患者。大多数感染的移植物失败；然而，没有患者死亡。一名患者患上了丙型肝炎，一名患者在输血后感染了艾滋病毒。与其他系列手术治疗的患者（包括那些接受金属装置的患者）的比较表明，感染率可能与手术或移植物的免疫抵抗力有关，而不是移植物本身。感染问题是肿瘤外科医生的一个主要问题。并就如何减少这种并发症的发生提出了建议。
We studied a series of 945 patients who received cadaveric allografts implanted for nonpelvic bone or soft tissue tumor lesions since 1971. We specifically were interested in the role of infection in the graft process, and, more specifically its history, frequency, and affect on outcome. Primary infections (not related to reoperations for nonunions or fractures of the graft) occurred in 75 patients (7.9%), and an additional 46 patients had infections related to reoperations, increasing the total number of patients with infections to 121 (12.8%). The highest frequency of infection occurred in patients with soft tissue tumors, radiated sites, Musculoskeletal Tumor Society Stage IIB tumors, or surgeries consisting of an allograft arthrodesis. Most of the infected grafts failed; however, none of the patients died. One patient had hepatitis C develop, and one patient became HIV positive after receiving the virus from a blood transfusion. A comparison with other series of surgically treated patients, including those receiving metallic devices, suggests that the infection rate may be related to the surgery or the graft's immunologic resistance, rather than the graft. The problem of infection is a major issue for tumor surgeons. Suggestions regarding how to decrease the frequency of this complication are presented.