Savelev V.I., Bort G.S., Ivanov I.N., Lekishvili M.V., Rykov U.A., Reznik A.G.

Inspection of the donor on dangerous infections is one of the major questions of a tissue donor service. The basic environment of research is blood. Experience shows, that blood not always provides reliable results because of probably bad quality. Principal causes of failures can become small quantity of blood, its frequent enough haemolysis or autolysis. In such cases blood and donor tissues are utilized, that leads to significant amount loss implants and money. Thereupon our researches have shown that to the optimal for preservation of donor tissues, increases of reliability and productivity of tests is the fence and serological researches of dangerous infections in pericardial liquids. Work is executed on a material taken from 149 corpses at the age from 22 till 71 years, died from the different reasons. Blood from the right half of heart (149 tests) and pericardial liquid (46 tests) centrifugated during 20 min. at 2000 rpm, and then the received whey was investigated on hepatitis markers B and C, HIV and syphilis. Presence of markers defined, using commercial sets for the express analysis: the Hepatitis B-Hexagon, HUMAN, Syphilis RPR the test, HUMAN, ImmunoComb II HCV, Determin HIV 1/2, Dinabot Co Ltd., Japan and immunoenzyme method: Vektogep B a HBs-antigen, Rekombi-Best anti-VgS, Rekombi-Best antipallidum-total antibodies Vector Best, DZHENSK-RIN PLUS of HIV AG-AT, Biorad. In pericardial liquid and blood whey established concentration of free haemoglobin by haemoglobincyanide method. For each analyzed sample selected an optimum parity between volume of investigated hemolysate and a transforming reactant. Statistical processing of results spent with the help: dispersive analysis Anova and t-criterion of Student. For an objective estimation of suitability of the donor and its tissues it has been decided to use the sum of products of temperature and time from the moment of death to a fence of tissues as thermal hour. Use of thermal hour and level of free haemoglobin has revealed accurate sequence of doubtful reactions occurrence. Their occurrence in blood and pericardial liquids at hepatitis B diagnostics was marked after death approach accordingly through 6,4 and 15,3 h; a syphilis through 14,7 and 18,4 h; a HIV 12,2 and 24,3 h. Accordingly at definition of a hepatitis C doubtful reactions in blood and pericardial liquids were absent. Comparative serological research of pericardial liquid and blood from the right half of heart on markers of hepatitises B, C, HIV and syphilis by means of the express test and immune-enzyme analysis has revealed the least quantity of doubtful reactions in pericardial liquids. Results of the carried out research have allowed to make some conclusions: - visual blood haemolysis is not an absolute indicator of donor tissues unfitness for transplantation if the researches of blood and pericardial liquids carried out at them have not revealed markers of infectious diseases of hepatitises B and C, and also HIV and syphilis; - offered in work techniques of blood and pericardial liquids research at haemolysis can be used for hepatitis B, C, HIV and syphilis diagnostics in a donor material only taking standpoint thermal hour and concentration of free haemoglobin; - in comparison with blood level of free pericardial liquid haemoglobin more low and it accrues more slowly, that at serological researches is shown by smaller quantity of doubtful reactions which appear later; - the developed way of doubtful bottom border definition results has appeared effective in all cases when results of researches of blood at donors were in the traditional way doubtful because of haemolysis; - the algorithm of infectious diseases markers definition in blood and pericardial liquids, considering established in work time of their occurrence, should be the following: hepatitis B, syphilis, HIV, hepatitis C

1. Вялков А.И. Инструкция по медицинскому освидетельствованию доноров крови, плазмы, клеток крови. - М., 1998.
2. Генкин А.А. Новая информационная технология анализа медицинских данных (програм­мный комплекс ОМИС). - СПб.: Политехника, 1999.
3. Гублер Е.В. Информатика в патологии, клинической медицине и педиатрии. - Л.: Медицина, 1990.
4. Лушников Е.Ф., Шапиро Н.А. Аутолиз (Морфология и механизмы развития). - М., 1974.
5. Масяго А.В. Некоторые ошибки при постановке ИФА Информационно-методическое пособие. - Кольцово: ЗАО «Вектор-Бест», 2004.
6. Покровский В.В., Ермак Т.Н., Беляева В.В., Юрин О.Г. ВИЧ-инфекция: клиника, диагностика и лечение / Под общ. ред. В.В. Покровского. - 2-е изд., испр. и доп. - М.: ГЭОТАР-МЕД, 2003.
7. Савельев В.И., Корнилов Н.В., Калинин А.В. Актуальные проблемы трансплантации тканей. - СПб.: «МорсарАВ», 2001.
8. David J. Gocke. Tissue Donor Selection and Safety. - Clinical orthopaedics and related research, 2005, no. 435, pp. 17 - 21.
9. Ireland L., McKelvie. Tissue banking in Australia. - Cell and Tissue Banking, 2003, no. 4,
   pp. 151 - 156.
10. Kennedy A.P., West J.C., Kelley S.E., Brotman S. Utilization of trauma related deaths for organ and tissue harvesting. - J. Trauma., 1992, vol. 33, no. 4, pp. 516 - 519.
11. Conrad E.,Gretch D., Obermeyer K. et al. The transmission of hepatitis С virus by tissue transplantation. - J. Bone Joint Surg., 1995, vol. 77, pp. 214 - 224.
12. Eastlund D.T. Infectious disease transmission through cell, tissue and organ transplantation: reducing the risk through donor selection. Ell. - Transplant., 1995, vol. 4, pp. 455 - 477.
13. Padley D.,Ferguson M., Warwick R. et al. Challenges in the testing of non-heart-beating cadavers for viral markers: implications for the safety of tissue donors. - Cell. Tissue Bank, 2005, vol. 6, pp. 171 - 179.
14. Vangness C.Th., Triffon M.J., Joyce M.J., Moore T.M. Soft tissue for allograft reconstruction of the human knee: A survey of the American Associattion of Tissue Banks. - Amer. J. Sports Med., 1996, vol. 24, no. 2, pp. 230 - 234.
15. Rosocha J., Hrbkova H., Harvanova D. Slovakia: Five years experience of multitissue bank with the production of allografts and cultured living cells. - Cell and Tissue Banking, 2003, vol. 4, pp. 179 - 183.
16. Strong M. The US Navy Tissue Bank: 50 years on the cutting edge. - Cell and Tissue Banking, 2000, vol. 1, pp. 9 - 16.
17. Suzutani T., Ishibashi H., Takatori T. Studies on the estimation of the postmortem interval. - Hokkaido Igaku Zasshi, 1978, vol. 53, pp. 345-356.
18. Stanworth S.J., Warwick R.M., Ferguson M., Barbara J.A. A UK Survey of virological testing of cadaver tissue donors. - Vox Sanguinis, 2000, vol. 79, pp. 227 - 230.