The following commended practices ...

The following commended practices were developed by the AORN approveed Practices Committee and have been approved by way of the AORN Board of Directors. They were currented as proposed recommended practices for expositions by members and others. They are effective Jan 1 1999

These commited practices are intended as achievable recommendations representing what is believed to be an optimal of the same height of practice. Policies and performances will reflect variations in practice settings and/or clinical situations that determine the step to which the recommended practices can be implemented.

AORN recognizes the numerous prototypes of settings in which perioperative feed at the breasts practice. These recommended practices are intended as guidelines adaptable to various practice settings. These practice settings include traditional ORs, ambulatory surgery units, physicians' offices, cardiac catheterization suites, endoscopy suites, radiology departments, and all other areas where operative and other invasive acts may be performed.

Purpose: Surgical tissue banking encompasses the retrieval, processing, preserving, and storing of fix uponed human tissue. Human tissue includes, moreover is not limited to, bone cartilage ossicles, corneas, heart valves, and skin. It is beyond the free course of these recommended practices to address all areas of tissue banking. These praiseed practices provide guidance for developing institutional policies and proceedings that are specific and compatible with patient be in want ofs the practice setting's facility, and personnel capabilities and expertise.

A tissue bank should be established solitary where a need exists. Before the decision is made to establish a tissue bank, consideration should be given to personnel equipment, and practical operational requirements for providing safe, reliable, and biologically useful grafts. In December 1993 the US fare and Drug Administration (FDA) issued an interim sway pertaining to human tissue intended for transplantation. The FDA intends to suggest more extensive regulations in the subsequent time These regulations must be adhered to during the disclosure of a tissue bank and for all surgical tissue banking. In addition, the standards published by means of the American Association of Tissue Banks (AATB) should be confered and used.

attract favor toed PRACTICE I

Tissue for transplantation should be procur from suitable donors.

Interpretative statement 1:

The donor or donor's responsible party should sign an informed consensus Permission to retrieve tissue from nonliving donors should be sought from nearest of kin in order of legal priority If next of kin is unavailable, local, state, and federal regulations should be followed.

Rationale:

The Uniform Anatomical Girl Act (UAGA) of 1968 passed in all 50 states, provides guidelines within which approval may be obtained, including an order of priority for the potential donor's nearest of kin. Further guidelines concerning donations appear in the 1987 amendments to the UAGA and in various required and routine inquiry laws.(1)

Interpretive statement 2:

Donations from living donors should be accepted if the conditions surrounding the donations are not questionable.

Rationale:

Questionable conditions include unlawful medical risk to the donor, coercion, promises of monetary gain, and the diminished capacity of the donor to evaluate the medical or surgical risks.(2)

Interpretive statement 3:

A history and assessment of all donors (living or dead) should be obtained to identify contraindications before implantation of tissue. The donor should be clear of

* viral, bacterial, or fungal infection or disease;

* sexually transmitted disease;

* neurologic disease;

* autoimmune disease;

* metabolic bone disease;

* malignancy or suspected malignant neoplasm;

* disease of unknown etiology;

* systemic medication use;

* parenteral remedy use;

* exposing to toxic substances; and

* history of receiving pituitary-derived human putting out hormone.

The donor should be normothermic 986 [degrees] F (37 [degrees] C) for at least seven consecutive days immediately before brain death. In addition, the donor should not have been ventilator-dependent, immobile, or bedfast for more than seven consecutive days immediately before brain death.

Rationale:

The potential donor is defenceed to avoid transmission of infection or disease.(3)

Interpretative statement 4:

Potential donors meeting any of the high-risk criteria for HIV as stake forth by the FDA, Center for Disease curb and Prevention, and the US Public Health Service should be exclud These criteria include

* tribe with clinical or laboratory evidence of HIV infection;

* men who have had sex with another man in the preceding five years;

* tribe who report nonmedical IV, intramuscular, or subcutaneous injection of remedys in the preceding five years;

* folks with hemophilia or related clotting disorders who have received clotting-factor concentrates;

* persons who have engaged in sex in exchange for cash or drugs in the preceding five years;