흉부외과 분야 조직은행의 실상과 바람직한 운영방안 제언

Abstract

Since Dr. Angell introduced cryopreservation method for tissue preservation in 1980s, it became a preferred method for cardiovascular tissues. Cryopreservation has been proven to provide better cell viavility and clinical result than any other preservation method. The quality of cryopreserved cardiovascular tissue is a very critical point of patients’ survival when transplanted. To obtain high quality cryopreserved tissue, each processing methods from harvesting to delivery should be standardized. Various factors, such as range of possible tissues, acceptable ischemic time, temperature during transportation, facility for processing, method of freezing, use of cryoprotectant, method of storage, condition of delivery, and method of thawing for cardiovascular tissues should be standardized. Different standards should be established and applied to different tissues. Various kinds of tissues can be harvested from each living or cadaveric donor. Therefore, it is reasonable to harvest and handle all tissues in one laboratory by one tissue bank. In U.S.A, tissue banks are operated under standardized condition. The American Association of Tissue Banks affords the certification of specialist and tissue banks on very strict conditions, and provides the Food and Drug Administration with consultation in making regulations regarding tissue transplantation. In Korea, tissues have been simply stored in refrigerator since mid 1990s, and cryopreservation method is getting popular. Tissue banking has been started recently and now six major hospitals treat the cardiovascular tissues and are equipped with good facilities. Korean Association of Tissue Banks was established last year and now setting up regulations and standards. In Conclusion, I suggest that the cardiovascular tissue bank should belong to a university hospital till regulations and standards are completed. And then commercial tissue bank will be able to take it over to manage more tissues. The financial state of tissue banking is also an important point to be considered to balance between quality control and easy access to the public. Also the cost of cryopreserved allograft should be covered by medical insurance.