Definition & Overview
Biologic implants can refer to a bone, soft tissue, or skin that is harvested from a donor site and transplanted into the recipient site. Also called biological tissue, such implants can be categorised as autograft, allograft, or xenograft.
Autograft implants are tissue harvested from another location of the recipient’s body. Some good examples are myocutaneous flaps and skin grafts. Allografts, on the other hand, are harvested from a donor of the same species. For instance, heart and kidney transplants are considered allografts. The majority of human transplant procedures fall under this category.
Meanwhile, xenografts are harvested from a different species. Some well-known xenografts are heart valves harvested from the heart of a pig and transplanted into a human heart to repair a faulty valve. Blood vessels from cows are also commonly transplanted into humans to repair broken blood vessels.
Biologic implants are used in many fields of medicine, including cardiovascular, dental, and orthopaedic. They are also used in ophthalmology and urology as well as plastic and reconstructive surgery.
In the past, the safety of transplanting biological tissue from a living or deceased donor was a major concern. This has led to the establishment of several organisations that ensure transplant practices adhere to the highest standards of safety. These organisations include the American Association of Tissue Banks, the American Food and Drugs Administration, the Society of Quality Assurance, and Centres for Disease Control and Prevention, among others.
Who Should Undergo and Expected Results
In most cases, the implantation of biologic implants is not an elective or optional procedure. The procedure is usually performed if it is absolutely necessary. For example, a heart transplant is not performed simply because a person wants a new heart. It is only performed if the heart is doomed to failure and needs to be replaced as soon as possible.
Therefore, it is safe to say that when a doctor recommends a biologic implant, it would not only be the best decision, but most likely the only option available.
Just like with any type of medical procedure, patient education is crucial in the implantation of biologic implants. Patients should be fully aware of their situation. They should know why they need the implant, where the implant will be harvested from, and the details of the implant procedure.
They should be aware of the associated risks and the chances of the procedure being successful. Fortunately, even though the implantation of biologic implants is far from perfection, many of the concerns have already been addressed. Technological advancements have also increased the safety of the procedure and the chances of success.
How Does the Procedure Work?
Prior to recommending such a procedure, the doctor will first assess the patient’s condition carefully. Doctors need to be sure that a biologic implant is the best solution to the patient’s condition, and that there is no other better alternative.
The doctor will then decide whether to perform an autograft, allograft, or xenograft procedure. For autograft procedures, doctors will test the viability of the donor site. For example, if the patient is due for a flap surgery, blood flow in the donor site will be tested to ensure that the flap will survive after transplantation.
If an allograft procedure is to be performed, doctors will have to ensure the safety of the donor tissue, in a sense that it is free from any disease or conditions that may affect the survivability of the tissue once transplanted into the recipient site.
Xenograft procedures require the same degree of preparation, perhaps even a bit more stringent since the donor will typically be of a different species.
Once all the necessary preparations have been successfully completed, the surgeon will proceed with the implantation procedure. The exact procedure will depend on the type of tissue being implanted. However, the majority of such procedures are performed under anaesthetics in a hospital setting.
After the implant procedure, the condition of the patient will be closely monitored. Patients need to understand that even with all the necessary precautions, there is still a possibility that the body will reject the implant. If this happens, the implant procedure will need to be repeated as soon as possible.
Possible Risks and Complications
Every surgical procedure has associated risks and possibilities of complications. However, if the procedure involves the implantation of a biologic implant, the risks increase. Such risks include:
- Risk of the body rejecting the implant
- Risk of contamination
- Risk of infections
Patients must also understand there is a risk of death should the procedure not go as planned. A good example is the development of bacterial infection. If this happens, it is possible for the patient to go into shock that could lead to death.
Lastly, there is also a risk of the implant not surviving as long as expected. As such, patients will need to undergo regular examinations during and after the recovery period to evaluate the condition of the implant.
- Allograft Info.com; “What you need to know about allograft implants”; http://www.allograftinfo.com/index.php
- American Association of Tissue Banks; “Safety of Tissue Transplants”; http://www.aatb.org/files/safetyoftissuetransplants.pdf
- Centers for Disease Control; “Update: Allograft-Associated Bacterial Infections”; http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5110a2.htm