The tissue donor selection process aims to avoid the transmission of diseases and to ensure an optimal quality standard of bone tissue. Each patient who is suffering from coxarthrosis is a potential donor. A specialist orthopaedic diagnosis is necessary to assess the donor's suitability. Pathologies of the bone such as idiopathic and secondary osteonecrosis, severe osteoporosis and dysplasias are important factors of exclusion.

The potential donor needs to be thoroughly informed before deciding to donate, that is why we provide an informative brochure that you can find in the Attachments section below. The donor selection is carried out by a doctor who is trained in the procedure and can evaluate the potential donor through detailed screening. 

Other than transmittable diseases that could compromise donation, a careful evaluation is carried out over radiological exams, and other medical tests available in addition to pre-surgical serologic and blood screening. 

• A leukocytosis needs further screening to exclude acute infections, myeloproliferative disorders, solid tumours, collagen diseases, parasitosis and lymphomas
• If leucopenia is present, it must not be correlated to viral or bacterial infections or SLE (Lupus Erythematosus)
• Elevated transaminase levels must be thoroughly investigated
• The electrophoretic analysis must not include monoclonal fractions
• Azotemia and creatinin: patients under chronic dialysis treatment are to be excluded
• Low levels of serum iron and transferrin with high levels of ferritin are typical symptoms of chronic inflammatory diseases, collagenopathies and neoplastic processes. Patients with these symptomatologies are not suitable for donation

In the case of a positive test result for any of the following, the subject will not be suitable for donation, and the tissue will not be utilised for transplantation purposes:

• Anti-Hepatitis B Surface Antigen (HBsAg)
• Anti-Hepatitis C Virus antibodies (anti-HCV)
• Anti-HIV 1 & 2 antibodies (anti-HIV 1 and 2)
• TPHA or other tests resulting positive for anti-treponema antibodies

The rapidity of transmission of certain viruses such as the West Nile Virus, Zika Virus, Chikungunya Virus etc. makes it mandatory to ask potential donors about any travels in areas of the world where these viruses are endemic. For this reason, potential donors of femoral heads are asked to fill in and sign a specific questionnaire about viral diseases (Mod 3 SL) at the moment of donation. In the case of a specific travel destination at high risk for the abovementioned diseases, we will carry out the appropriate checks. 

In the case of a health crisis requiring additional tests, it will be our duty to follow promptly all the guidelines issued by the National Transplant Centre CNT. Following all the measurements for the prevention of infection from SARS-CoV-2 via organ donation, it is necessary to evaluate the risk of potential donors. We have therefore provided a questionnaire about Covid 19  (Mod 3 SL) to fill in and sign, which is going to be periodically updated according to the National Transplant Centre CNT guidelines.