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Headline: Letters of gratitudeFeature
Letters of
gratitude

Tissue Bank Manitoba works under the
radar to help recipients live a better life
Kimberly Dodds and Christopher Snow hold packages of bone allografts at Tissue Bank Manitoba.
By Susie Strachan Photography by Marianne Helm Sept/Oct 2017
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The letter says it all.

"A simple thank-you falls pitifully short for expressing my gratitude to you," it reads in part. "I am enjoying life without pain and fear of the possible loss of function in my arms and legs."

The letter was written by a car accident survivor to the family of a Manitoban who had made a donation of bone tissue. The donation was used to replace damaged discs in the letter-writer's neck.

This letter is just one among many contained in a blue folder that holds pride of place on the desk of Christopher Snow, Director of Tissue Bank Manitoba.

The tissue bank - one of three agencies, along with the Misericordia Eye Bank and Transplant Manitoba, that recover human tissue or organs for transplantation - tends to fly a bit under the radar, says Snow. Indeed, many Manitobans may not have even heard of the agency.

"But those letters we do receive, they mean so much to us, and to the donor's family and to the recipient," he says.

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The sentiment in the letters is very much the same: grateful recipients writing to donor families, thanking them for making such a wonderful gift that allows them to live a healthy life. Some survived car accidents, burns, tears to ligaments or needed surgery on discs in their neck or spine. Some sent poems; others included little drawings of flowers and birds with their letters.

Letters from donors' families to recipients also touch the heart.

"I am very much a supporter of donor tissue, even though in a time of crisis, it is an emotional and stressful decision to make. I am so glad that our decision has made a positive difference in your life," reads an excerpt from one of the letters.

Another expresses thanks for the kindness of the tissue bank staff when they conducted their interview on the fateful night when a family lost their loved one.

"For most, it helps to know that their loved one is living on in a new person," says Snow.

Tissue Bank Manitoba team members
Tissue Bank Manitoba team members, from left:
Christopher Snow, Hubert Clouatre, Maureen Hizon,
Debbie Beniac, Kimberly Dodds, and Shifa Hassaun.

The tissue bank focuses on procuring allografts - bones, ligaments, cartilage, tendons or sections of skin that are processed before being transplanted from one person to another.

Since the bank opened in 2003, it has seen a steady increase in the number of allografts distributed in Manitoba, from a few hundred back then to 1,500 in 2016.

Last year, 43 people donated tissue. Their donations have helped thousands of people, given that one person's donation can help at least 100 people.

Each donor is carefully screened and respectfully handled, says Kimberly Dodds, Quality Assurance and Regulatory Affairs Officer with Tissue Bank Manitoba.

Unlike organs that must be transplanted into another person with minimal if any processing as soon as possible, tissue must be cleaned, shaped, cut, or otherwise prepared for transplant under strict federal regulatory requirements and tissue banking standards.

"Once a donor has been cleared medically, we procure the donations and send it for processing at a primary processor in the United States," she says. "In our case, we use the Musculoskeletal Transplant Foundation (MTF) and Lattice Biologics. Each donor is carefully documented and tracked, so a surgeon using that donation is able to trace where it came from."

A package of bone allografts ready for transplantation
A package of bone allografts ready for
transplantation.

These companies will process the tissue and send back the allografts that are needed here. Depending on the type of processing, the allografts can be frozen or freeze-dried prior to shipment, and, once here, can be stored under temperature controlled conditions for up to five years. Allografts provided to surgeons by the tissue bank include bone for spinal and orthopedic surgery, tendons for reconstructive surgery, skin for burns and breast reconstruction, nerves for plastic surgery, and heart valves for cardiac surgery.

Surgeons at the Pan Am Clinic are major users of tendon allografts, especially for people suffering from a sports injury. "For example, they use them to repair tears to the anterior cruciate ligament in the knee," says Snow. "The surgeons could choose to take a tendon from somewhere else on the patient's body, but it's easier to use an allograft. That way, the patient only has one surgical site to heal, rather than two."

In the case of burn patients, the allograft is made up of a dermal layer of skin that has been deconstructed to the point where it resembles a scaffold. This scaffold is called an acellular dermal matrix (ADM), and is made of tissue that the recipient's body is unlikely to reject.

"ADM is used for healing wounds, repairing hernias. or for other places on the body," says Snow. "The patient's body can grow blood vessels through this sterile scaffolding, and deposit their own cells into it, allowing their own issue to replace the allograft. This helps prevent fluid loss, which is a vital component during early days after a burn."

Tissue Bank Manitoba is the only bank in Canada that procures donations that are turned into ADM, according to Snow. The most commonly used allograft is crushed bone, which can be shaped and used as filler. For example, a surgeon might use it to replace a disc in a patient's spine, or a neurosurgeon might use it to fill in areas after surgery on a patient's skull. Donations from Manitobans have been used in 28 countries around the world, says Snow.

Susie Strachan is a communications specialist with the Winnipeg Regional Health Authority.

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