bone New Zealand’s bone banks
No bones about it, making donations to the New Zealand Blood Service could change someone’s life, writes Nicole Lawton.
Condensation billows to the floor as a frozen knob of bone, covered in blood vessels and cartilage, is brought from a deep freeze.
It was once part of a living, breathing human, but now spends its days chilling at minus 80 degrees Celsius in one of New Zealand’s many bone banks.
Eventually, it will be transplanted into another body to ease chronic bone pain, provide structural support and ‘‘change someone’s life’’.
Now, those in charge of the bone banks are calling for more donations, to explore greater potential uses for the organic material, to help more people.
‘‘Currently, if surgeons need sophisticated modifications of donor-bone, they have to import it,’’ said Dr Richard Charlewood, the national tissue bank’s medical director. ‘‘The flux of supply and demand is about even at the moment, but if we had greater stocks we could look into more and different uses for donated bone in the future.’’
BONE DONATION
No bigger than a egg, the femoral head bone – the ‘‘ball’’ of the hip’s ‘‘ball and socket’’ joint – was donated by someone undergoing a hip replacement.
But instead of the surgeon discarding the sawed-off bone like normal, it is sealed in a jar and couriered to the nearest bone bank, run by the New Zealand Blood Service (NZBS).
From there, the appropriate checks and tests are completed before it goes into hibernation in one of the bank’s many state-of-theart freezers, which range in temperature from a standard -35C to a liquid nitrogen-induced -180C. Once in the freezer, any living cells die, but the bone itself remains intact.
‘‘They’re not very pretty,’’ said Charlewood, ‘‘they’re a bit bloody and have bits of tissue and cartilage hanging off them.’’ But they have a special purpose: ‘‘As anyone who’s experienced chronic bone pain can appreciate, it’s a lifetransforming event having that pain removed, and this is part of that life-changing process.’’ The donor bone acts as ‘‘organic scaffolding’’ and is used in spinal operations, padding out loose hip replacements, mending bad fractures or filling the holes created by bone tumour removal.
‘‘The donated bone is a framework for the recipient’s own bone to grow into, remodel and make it’s own,’’ he said.
Charlewood, a doctor of 29 years, specialised in haematology and transfusion medicine before joining the NZBS and becoming the national tissue bank’s medical director.
He said the bones have a shelf life of up to five years, but often don’t make it past a year because of the growing demand for the organic tissue.
‘‘Demand is slightly more than supply at the moment, but that’s why we have a reserve.’’
More than 700 donated femoral head bones are currently shared across the six NZBS bone bank centres around New Zealand; in Auckland, Hamilton, Palmerston North, Wellington, Christchurch and Dunedin.
And as with other organ transplant systems, many conditions must be satisfied before donation can take place.
When matching donors to recipients, conditions are the same as blood donations – the blood groups must match before the transfer can take place.
‘‘We provide careful screening of the donor through a questionnaire and blood tests, then collate the microbiology testing that’s done on the bone and make sure it is safe and suitable for use.’’
Only the femoral head bones are taken, as most other bone donations require the patient to be deceased – something the NZBS doesn’t deal in.
Inter-species bone donation is also a no-no for the service, because it can lead the way for diseases to be passed from animals to humans, explains Charlewood.
Despite bone banks having been around for a long time – more than 20 years in New Zealand – only about 1000 of the 15,000 people who had hip replacements done in the last year donated the left over bone.
‘‘It doesn’t cost the patient anything, they just have to fill out a questionnaire and the surgeon will save the bone from going in the bin.
‘‘We’ve got a process that New Zealand can be very proud of, and more people should know about it,’’ Charlewood said.
And it doesn’t stop with bones; aside from banking blood, the NZBS also banks stem cells, bits of skull, and live skin flaps for burn victims, among various other tissues.
DONOR – JOHN CHRISTIANSEN, 52
John Christiansen donated bone during his hip replacement when he was 47.
‘‘I found out about bone donation working at the blood service, and as soon as I knew there was an opportunity for me to do it I really wanted to do it.
‘‘I was really pleased to be able to help someone else in such a major way, and it didn’t cost me anything really. ‘‘The bone is being removed anyway, if you don’t save it, it’s just going in the bin. ‘‘Knowing that a little piece of my bone is being used to help somebody else makes me feel really good, because I know it’s only needed for really extreme things like bone cancers and problems people have with their bone.’’
RECIPIENT – MEGHNA NARAYAN, 17
Meghna Narayan, a sporty teen from Papatoetoe, in Auckland, found out she had a cyst in her hip bone about a year ago.
The cyst, a small, fluid-filled hole, was compromising the structural integrity of the bone.
‘‘If I did not get a bone replacement, I’d probably end up fracturing my leg, and the cyst would have caused me to be in a lot of pain and I probably would not have been able to walk again.’’
So surgeons replaced a section of her bone with donated bone, which provided structural support and the ‘‘scaffolding’’ for her own bone and cells to grow into.
‘‘I have no idea who the donor is but I’m pretty lucky to have that person as my donor,’’ Narayan said. ‘‘The New Zealand bone bank has been really great to me on my journey so far, it’s been amazing.’’
‘‘The flux of supply and demand is about even at the moment, but if we had greater stocks we could look into more and different uses for donated bone in the future.’’ Dr Richard Charlewood National tissue bank medical director