On Thursday, August 4, The Lancet published Nationwide Tuberculosis Outbreak in the United States Linked to a Bone Graft Product: An Outbreak Report. In May 2021, a tuberculosis outbreak was linked to a contaminated bone graft product containing live cells used in spinal surgery. While the safety record for allograft tissue is exemplary, even one recipient's death is one too many.
Upon notification of this sentinel event, AATB immediately established a TB Transmission Workgroup to proactively monitor the situation, assess the risk of transmission of Mycobacterium tuberculosis (Mtb) through human tissue, and suggest possible recommendations or guidance to tissue bank medical directors. Subsequently, the AATB Physicians Council established a subgroup, the Panel on Mtb, that commissioned a formal literature review on Mtb to assist in evaluating current tissue screening and testing protocols. The result of the Panel on Mtb deliberations was the distribution of AATB Bulletin 22-2: Recommendation Issued to Tissue Banks Regarding the Risk of Mtb Transmission on March 22, 2022.
This Lancet article may raise questions in healthcare practitioners and others regarding the adequacy of screening and testing of allograft tissue and its inherent safety. Presently, there is no single accurate and reliable method to detect and prevent tuberculosis transmission. The consensus of AATB's Panel on Mtb is that consideration of all factors recommended in AATB Bulletin 22-2 combined should reduce the risk. Each tissue establishment needs to consider the best approach to minimizing the risk of transmission of Mtb via HCT/Ps.
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