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Bone & Soft Tissue Transplant Program

Patient Story

Peter Williams: Back On His Feet After Bone Transplant For Limb Salvage Following Osteosarcoma

“I wasn’t that scared because the doctors put together a plan really fast.” So says 13-year-old Peter Williams of Cleveland Heights, Ohio, about the limb salvage surgery he recently underwent at Cleveland Clinic.

After an afternoon spent playing touch football with friends in 2012, Peter began experiencing pain in his leg and started limping. Diagnosed with osteosarcoma in his proximal tibia, Peter soon underwent surgery to remove the tumor and place a tibial allograft/allograft-prosthetic composite to salvage his leg.

The procedure involved two free flaps and close collaboration between Cleveland Clinic orthopaedic and plastic surgeons as well as pediatric oncologists. Peter is now disease-free and resumed walking four months after his surgery.

Program Highlights

Cleveland Clinic's Department of Orthopaedics is ranked 3rd in the nation in the U.S. News & World Report “America’s Best Hospitals” 2014-15 rankings. This distinction follows years of continued excellence in a variety of musculoskeletal surgeries and transplantations. The Department of Urology is ranked 2nd in the nation, and cardiology and cardiac surgery are ranked 1st in the country for the 19th straight year.

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.

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.

Cleveland Clinic's Musculoskeletal Tissue Storage Facility

The facility is a model tissue management program that monitors the safety, effectiveness and availability of musculoskeletal tissue grafts. The program ensures that Joint Commissions standards are met by qualifying all vendors; tracing tissues from receipt through storage, preparation and use; identifying and reporting recipient adverse events; and handling tissue recalls successfully. At Cleveland Clinic, the storage facility requires a swipe badge for entry and has a carbon dioxide tank backup system in case of electrical failure.

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
Phone: 216.444.3927
Toll-free: 800.223.2273 ext. 43927

The musculoskeletal system is made up of muscles, tendons, ligaments, bones, joints and associated tissues that help the body move and maintain its form. Musculoskeletal disorders and diseases significantly impact the quality of life. Your care team may recommend for you to have a surgical procedure in which a bone or other musculoskeletal tissue will be replaced. This type of transplant has the potential to greatly impact your quality of life.

According to the American Association of Tissue Banks, bone and soft tissue is the most common type of transplant available.

Cleveland Clinic is here to help you every step of the way in your Bone or Soft Tissue Transplant. Reasons and conditions may range for each individual transplantation, but the level of excellence and care do not.

Once a Bone and Soft Tissue Transplant is considered an option, you will need to go through a series of tests and evaluations to make sure you meet all criteria to receive the transplant. Your physician and care team will give you all the information needed on what types of testing you will need to have done before your specific transplant.

You Play the Largest Role in Your Transplant Success

We understand that you are both excited and nervous about your transplant; these are normal reactions. Being prepared in advance by learning and understanding what to expect will help ease your fear of the unknown.

It is important that you ask any questions you may have or ask your care team to clarify something that is confusing to you.

The benefits of Bone and Soft Tissue Transplantation cannot come from surgery alone; it also depends on you. You have to follow the demanding treatment plan that the doctors and multidisciplinary team prescribe. However, even then, there are risks and complications to having any type of transplant. You must be aware of potential risks and complications that can result in serious injury, and even death. Your doctors cannot predict exactly how your body will respond to a transplant. The operation itself is complex and the risks remain high for many patients.

Cardiology/Cardiothoracic Surgery

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.

Learn more about our services:

Bone Transplant

The bone and musculoskeletal transplant program includes adult and pediatric orthopaedics, sports medicine, spine/neurology, limb salvage and bone and soft tissue tumors.

Adult and Pediatric Orthopaedics:

Adult and pediatric procedures are performed to address trauma, bone healing problems and congenital deformities. Cleveland Clinic performs large bone replacements for reconstruction after cancer resection to create a structural support, as well as performs procedures for large segment allografts for extremity limb salvage for tumors and trauma. 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.

Sports Medicine:

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 can also be used in partial or total joint replacement. Tissue is also 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 and bone-tendon-bone allografts for anterior cruciate ligament (ACL) knee repairs. About 30,000 of these surgeries are done every year with allograft tissue.

Learn more about our services:


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.

Colorectal Surgery

Digestive Disease and Surgery Institute was ranked 2nd in the nation in 2013-14 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.

Vascular Surgery

The Department of Vascular Surgery performs 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.

Plastic Surgery

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.

    Because the Bone and Soft Tissue Transplant Program encompasses several clinical areas, the list below represents only those team members who are responsible for the program as a whole.


    Cleveland Clinic’s pediatric transplant program began in 1963 with the goal of providing the most normal life possible for young patients. Pediatric and adolescent patients are admitted to Cleveland Clinic Children’s. Cleveland Clinic Children’s provides state-of-the-art care in a homelike setting. In addition, because the family is recognized as an important part of a hospitalized child’s recovery, our hospital rooms are designed to enable a parent to spend the night in the room with his or her child.

    For more information on Cleveland Clinic’s pediatric transplant program, please call 216.444.6123.

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    To find a transplant specialist for your needs, contact the Transplant Center at 216.444.2394 (or toll-free 800.223.2273, ext. 42394)