2011 Cleveland Clinic bone and soft tissue transplantation facts and figures
Cleveland Clinic's Department of Orthopaedics is ranked 3rd in the nation in the U.S. News & World Report “America’s Best Hospitals” 2012-13 rankings. This distinction follows years of continued excellence in a variety of musculoskeletal surgeries and transplantations. The Department of Urology is ranked 1st in the nation, and cardiology and cardiac surgery are ranked 1st in the country for the 18th straight year.
In 2011, Cleveland Clinic staff used approximately 6,500 tissue segments and obtained hundreds of oocytes and sperm donations for in vitro fertilization.
According to the American Association of Tissue Banks, more than 900,000 bone and soft tissue allografts are used every year for a variety of procedures nationally, making bone and soft tissue the most common type of transplant. Some 20 disciplines across 11 of Cleveland Clinic’s institutes and Ambulatory Surgery Centers (ASC) utilize bone and soft tissue during surgical reconstruction.
The Tissue Transplant Program includes Cardiology/Cardiothoracic Surgery, Bone Transplant (which includes Orthopaedics, Pediatric Orthopaedics, Spine and Neurology), Urology, Colorectal Surgery, Vascular Surgery, Dentistry, Plastic Surgery, Obstetrics and Gynecology, Andrology and In Vitro Fertilization, General Surgery and Dermatology.
In 2007, the Transplant Center and the Quality and Patient Safety Institute implemented tissue tracking compliance software designed to ensure adherence to Joint Commission standards for tissue transplantation and improve patient safety. This web-based program allows for bi-directional tracking of tissue from the donor or source facility to the recipient or other final disposition, including inventory monitoring, the ability to track the movement of tissue throughout the organization, storage of validation and patient implant records and the ability to monitor and log adverse events or donor infections so they can be properly reported. By the end of 2007, the tissue tracking system was in use at Main Campus and the three Ambulatory Surgery Centers for all areas using tissue.
Cleveland Clinic has the largest heart valve surgery practice in the United States, performing 2,816 procedures in 2011. This type of surgery is performed on patients who suffer from valvular stenosis or valvular insufficiency, congenital defects, infection, cardiomyopathy, hypertension, and heart attacks. Three types of tissue valves are used in valve surgery, including pig tissue (porcine), cow tissue (bovine), and human (allografts or homografts). Some valves combine mechanical parts with the tissue, and some are totally mechanical.
The bone/musculoskeletal transplant program includes adult and pediatric orthopaedics, sports medicine and spine/neurology.
Adult and Pediatric Orthopaedics:
Adult and pediatric procedures are performed to address trauma, bone healing problems and congenital deformities. Large bone replacement for reconstruction after cancer resection to create structural support also is performed. The adult and pediatric services use donor bone to fill in defects and loose bone from fractures and joint replacement for support. The pediatric service uses allograft tissue that is size-matched with the recipient with the intent that the allograft eventually will be replaced by normal living host tissue.
Many sports injuries occur to the soft tissue of the knee and ankle. These injuries can be surgically repaired using tendons and ligaments from a tissue donor. These soft tissues also can be used in partial or total joint replacement. Tissue also is used in repairing rotator cuff injuries.
Cleveland Clinic offers a fresh-tissue osteochondral-allograft program for cartilage defects in the knee, which is dependent on the availability of osteochondral grafts supplied by LifeBanc. This area also performs autologous cell-cultured chondrocyte transplantation for cartilage surface defects of the knee, as well as allograft meniscal transplants.
Cleveland Clinic spine surgeons are experienced in the surgical management of spinal disorders, including spinal stenosis, disc herniation, spinal tumors, spinal trauma, scoliosis and other complex deformities and disorders of the cervical, thoracic and lumbar spine. These disorders may require bone transplants to help alleviate pain and enhance the patient’s quality of life.
U.S. News & World Report has ranked Glickman Urological and Kidney Institute the best in the nation and the best in Ohio. Glickman Urological and Kidney Institute utilizes tissue as a treatment option for incontinence and for the reinforcement of soft tissue after surgery. Tissue allografts also are used in urethroplasties and pubovaginal sling procedures.
Digestive Disease Institute was ranked 2nd in the nation in 2012-13 by U.S. News & World Report. The Institute’s Department of Colorectal Surgery utilizes tissue in some specialized procedures, including anal fistulas repair using a tissue plug and ventral hernia repair.
The Department of Vascular Surgery more than 2,000 procedures each year and frequently uses tissue allografts for repair and reconstruction of weak or severely diseased blood vessels. One-third of all the procedures performed by Vascular Surgery are for atherosclerosis, peripheral arterial disease and peripheral vascular disease. Other conditions treated surgically include aneurysms, carotid artery disease and venous disease.
The Department of Dentistry utilizes tissue in the surgical repair of extraction sockets and periodontal defects and in the setting of dental implants. Bone allografts in these procedures promote additional bone growth to strengthen the various implants used.
The Department of Plastic Surgery uses tissue, primarily skin grafts, for a variety of procedures and surgeries. Some include facial cosmetic surgery, reconstruction of pediatric craniofacial defects, wound coverage and cosmetic and reconstructive breast surgery. Skin grafts are widely used in surgery for wound closure in mastectomies, repair of cleft palate and other facial defects, rhinoplasty and general surgery applications. In 2008, Cleveland Clinic surgeons performed the world's first near-total face transplant in U.S. history.
Andrology and In Vitro Fertilization
The Cleveland Clinic Andrology Laboratory and Reproductive Tissue Bank, which has provided therapeutic sperm banking services since 1980, conducts sperm counts and a variety of tests on semen. The Cleveland Clinic Fertility Center, in the Department of Obstetrics and Gynecology, offers a wide range of procedures, such as in vitro fertilization (IVF), intracytoplasmic sperm injection, sperm aspiration, assisted hatching, blastocyte transfer and embryo cryopreservation, as well as egg and sperm donation and an IVF surrogate program.
Focus on Quality
To ensure safety and the best possible results, the allograft donor is extensively screened with an in-depth medical history and also is tested for viruses and bacteria. Safety procedures follow published rules, standards and guidelines of the U.S. Food and Drug Administration (FDA) and the American Association of Tissue Banks. Our Tissue Transplantation program also adheres to the new Joint Commission Standards that were established in 2007. These standards are meant to provide higher quality assurance and patient safety through the ability to trace all tissues from the donor or source facility to all recipients or other final disposition.
Research and Innovations
Cleveland Clinic has established activities in musculoskeletal stem cell research, tissue engineering and musculoskeletal tissue healing at the Orthopaedic Research Center. Cleveland Clinic physicians also have been active in the American Association of Tissue Banks, American Academy of Orthopaedic Surgeons Committee on Biological Implants, American Society of Testing and Materials and with the FDA and Centers for Disease Control in promoting safety of tissues.
For More Information
Tissue Recovery Coordinator
Ph: 216.444.3927 or 800.223.2273 x43927